Objective To evaluate the clinical efficacy of traditional Chinese mental intervention in treating post-apoplexy depressive disorder and its effects on recovery of activities of daily living(ADL).Methods 64 cases of post-apoplexy depressive disorder patients of light or moderate degree(evaluated by HAMD scale)were randomly separated into an experiment group and a control group.On the basis of identical basic clinical treatments,the experiment group was treated with traditional Chinese mental intervention,and the results were evaluated by HAMD scale and ADL scale at the 40th,the 70th and the 100th day.Results There were no differences in marks of the two scale between the experiment group and the control group at the beginning(P＞0.05).At the 40th day,the HAMD scale mark was 13.04±4.86 in the experiment group and 17.92±5.82 in the control group,showing significant differences(P＜0.05)between the two groups.At the same time,the ADL scale mark was 61.85±11.73 in the experiment group and 53.02±10.54 in the control group,showing significant differences between the two groups too(P＜0.05).At the 70th day and 100th day,the differences became much more notable(P＜0.01).Conclusion Traditional Chinese mental intervention was effective in promoting the motor function and activities of daily living and relieving the depress disorder for post-apoplexy depressive disorder.Post-apoplexy depress disorder patients should be treated with Chinese traditional mental intervention as soon as possible.

N-terminal pro-brain natriuretic peptide(NT-proBNP) with no biological activity is the best cardiac marker in the diagnosis,risk stratification,prognosis and therapeutic monitoring of the patients with cardiac dysfunction,and is one of the natriuretic peptides.In this review,we aim to the latest progress of NT-proBNP study on its change during peri-cardiopulmonary bypass,and its applications in the diagnosis of preoperative cardiac function and in the guidance of heart failure therapy.

ObjectiveTo evaluate th effect and safety of tolterodine on detrusor hyperreflexia of patients with spinal cord injury.Methods20 cases of spinal cord injury patients with detrusor hyperreflexia were treated with tolterodine (2mg, twice daily), and the data of urodynamics and voiding diary before and after treatment were evaluated.ResultsAfter 12 weeks of treatment, it showed a significant increase from baseline in mean voiding volume (P<0.01), functional bladder volume (P<0.05) and interval of voiding (P<0.01). The bladder volume at first contraction significantly increased from (62.62±36.37)ml to (126.75±34.64)ml (P<0.01), the maximal pressure of detrusor contraction significantly decreased from (74.81±28.60) cm H2O to (61.90±16.22) cm H2O (P<0.05), the maximal amplitude of wave significantly decreased from (47.24±30.42) cm H2O to (39.36±25.28) cm H2O.ConclusionTolterodine is effective and safety to detrusor hyperreflexia of patients with spinal cord injury, and has a better therapeutic compliance and less adverse reactions.

OBJECTIVETo investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty.

METHODSFrom October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula.

RESULTSThe mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups.

CONCLUSIONRivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

Arthroplasty, Replacement, Hip ; adverse effects ; Case-Control Studies ; Female ; Hemorrhage ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Morpholines ; pharmacology ; Postoperative Complications ; prevention & control ; Risk ; Rivaroxaban ; Thiophenes ; pharmacology ; Time Factors

AlM: To observe the therapeutic effects of improved external dacryocystorhinostomy.
METHODS:Retrospective analysis on 94 patients with monocular chronic dacryocystitis in our hospital from October 2010 to December 2013 were taken the improved external dacryocystorhinostomy. The improved surgery which was based on the traditional surgery including: 1. Nasal packing after anesthesia to relieve the pain and bleeding; 2. Not cut the medial palpebral ligament; 3. Suture the upper membrane of the nasal mucosa only;4. Pipe placement;5. Skin layered hairdressing suture. The patients were follow-up 3mo-2a after operation.
RESULTS: Ninety-three cases of patients cured with completely asymptomatic, no epiphora or mucopurulent secretion flow out from the lacrimal punctum, unobstructed lacrimal irrigation, the efficiency is 99%, 1 case of patient was epiphora, obstructed lacrimal irrigation, 1% was invalid.
CONCLUSlON:The improved external dacryocystorhinostomy is an effective surgical method which is easy to operate with high cure rate and its long term effect is precise.

Carcinoma, Renal Cell ; complications ; Humans ; Kidney Neoplasms ; complications ; Lymphoma, Non-Hodgkin ; complications ; Male ; Middle Aged

Objective To improve the awareness of the CT and/or MRI appearances and clinical presentations of Kasabach-Merritt syndrome(KMS),6 cases were reported.Methods The CT and/or MRI and clinical characters of 6 cases of KMS were reviewed and analyzed.Results Thrombocytopenia,and consumption coagulopathy were presented in all 6 cases.The paravertebral mass of posterior mediastinum, right pericardial lesion,skin and soft tissue of left arm were shown as iso-,hypointensity on T1-weighted image,iso-,hyper-intensity on T_2-weighted image,and with heterogeneous enhancement after contrast administration in three cases.Splenomegaly was presented in one case,it showed homogenous hypoattenuation on unenhanced CT,and diffused heterogeneous enhancement after contrast administration. On MRI,spleen was shown as hypointensity on T_1-weighted image,hyperintensity on T_2-weighted image, and with heterogeneous enhancement after contrast administration.There were lesions in both bones and spleen in one case.Osteopenia and thinned cortex were shown on the metaphyses of upper and lower extremities.Spleen enlarged and showed multifocal hypoattenuation lesions,the peripheral region enhanced on the early phase,and some of the lesions filled on the delayed phase after the contrast administration.One case showed huge hypoattenuation lesion in the left lobe of liver with gradually filling of the mass after peripheral enhancement.Conclusion Thrombocytopenia and consumption coagulopathy suggest the entity of extensive hemangioma.Splenomegaly with diffuse or focal hypoattenation or hypointensity in MRI infers the diagnosis of hemangioma.

Objective To observe the therapeutic effect of therapy of tonifying kidney,activating bone-marrow, and unblocking collaterals for patients with chronic aplastic anemia (CAA), and to investigate its effect on thromboelastogram platelet maximum amplitude (Ma) value for exlporing its therapeutic mechanism. Methods Sixty CAA patients were randomized into trial group and control group, 30 cases in each group. The control group was given oral use of Stanozolol and Cyclosporin A, and the trial group was orally given the recipe with the actions of tonifying kidney,activating bone-marrow,and unblocking collaterals,which is mainly composed of Radix Rehmanniae,Radix Rehmanniae Preparata,Caulis Spatholobi,Semen Cuscutae,Fructus Lycii,Radix Angelicae Sinensis, Fructus Ligustri Lucidi, Herba Ecliptae, Pheretima, and Semen Strychni Preparata. The clinical efficacy was evaluated after treatment,and peripheral hemogram and thromboelastogram Ma value of the two groups were compared before and after treatment. Results (1)The trial group had better western medicine therapeutic effect and traditional Chinese medicine (TCM)syndrome therapeutic effect than the control group, the difference being signficant (P < 0.01).(2) After treatment, TCM syndrome scores, parameters of blood routine test,thromboelastogram Ma value of the two groups were improved compared with those before treatment (P < 0.05 or P < 0.01),and the improvement in the trial group was superior to that in the control group (P <0.05). Conclusion Therapy of tonifying kidney, activating bone-marrow, and unblocking collaterals is effective on improving blood coagulation function by increasing the quality and amount of platelet.

Objective To investigate the status and needs of community nurses' education in Changzhou,and to provide evidence for improving quality of further training.Methods Totally 402 community nurses from 72 community hospitals in Changzhou were recruited in the survey and finished the questionnaires.Results 73.1％ of community nurses continue to degree education after work,79.3％ of them have attend the post training.98.7％ of them considered post training is necessary,and only 35.6％ were willing to participate in training.Age and whether received community nursing education are the most important influence factors (OR =0.541,P =0.001 ; OR =2.430,P =0.003).In the need of knowledge and skills,there were significant differences in the age groups ( F =3.074,P =0.028).Conclusions Teaching reform is necessary.Increasing the training of young community nurses backbone is imperative and giving full play to the advantages of high qualification community nurses.

Approximately 3 to 5％ of newly diagnosed metastatic cancers are of unknown primary tissue origin due to difficulties identifying a primary tumor using standard diagnostic approaches.MicroRNAs (miRNAs) have recently been demonstrated to be able to assist pathologist with improved accuracy in diagnosing cancers of unknown primary origin (CUP).In this short commentary,we will highlight some of the recent advancements in miRNA based cancer diagnosis as well as some future directions for the field.