Objective The study aimed to explore the reliability and validity of the Chinese version of the Nottingham Assessment of Functional Footcare (NAFF) in investigating the footcare behavior's level in patients with high risk of diabetic foot.Methods According to Bradley's principle,NAFF was converted into the Chinese version scale,then it was applied to 211 cases of patients with high risk of type 2 diabetic foot,and the reliability and validity of foot care be-havior scores were analyzed.Results In the Chinese version scale,the Cronbach's alpha coefficient was 0.77,test-retest reliability was 0.74.Content validity,ICVI was 0.80 to 1.00,S-CVI/Ave was 0.96,and the adjusted value of kappa was 0.75 to 1.00.Conclusions The questionnaire has been tested to have good reliability and validity.The NAFF possesses certain value in the clinical application and could be suitable for Chinese patients with high risk of type 2 diabetic foot.

Objective T_O analyze the electrophysiological features of shoulder-hand syndrome(SHS)fol- lowing stroke and investigate the relationships between peripheral nerve damage and the factors causing SHS.Meth- ods Fifty-eight stroke patients were divided into an SHS group(39 patients with shoulder-hand syndrome)and a model group(19 patients without shoulder-hand syndrome).Standard sensory and motor nerve conduction studies were performed with 58 of the patients,including sensory nerve conduction velocity(SCV),amplitude of the sensory nerve action potential(SNAP),distal motor latency(DMI)and the amplitude of the compound muscle action poten- tial(CMAP)of the median nerve.A needle electromyogram(EMG)test was performed on the abductor pollicis of the affected side with both groups.Results The needle EMG showed abnormal insertion potential,fibrillation po- tential and positive sharp waves in all 39 cases of the SHS group,which was significantly higher than in the model group.The amplitude of the sensory nerve action potential(7.77?4.34 mV)and the amplitude of the compound muscle action potential(10.13?3.15 mV)were significantly lower than those of the model group.Abnormal ampli- tude was more severe in sensory nerves than in motor nerves.Conclusion Peripheral nerve damage was found in the shoulder-hand syndrome patients,and this damage was mainly the dystrophy of axonal neuropathy.The damage severity was more in sensory nerves than in motor nerves.The study could offer an useful clue of prevention and treat- ment of shoulder-hand syndrome.

ObjectiveTo observe the effect of nursing interventions on improvement of psychological actions and quality of life of patients with Alzheimer disease. Methods50 patients with senile dementia diagnosed in our hospital were chosen.They were divided into the observation group and the control group with 25 patients in each group.All patients were taken with AD routine nursing care after admission.The observation group was taken with rehabilitation nursing interventions based on AD routine nursing care.The mini-mental state examination (MMSE)and the daily life ability scale (ADL)were used to evaluate the quality of life after nursing intervention. ResultsThe patients' MMSE score in the observation group was significantly higher than the control group,the difference was statistically significant.The ADL score of the observation group was significantly lower than the control group,the difference was statistically significant. ConclusionsThe use of integrated care intervention can significantly improve the cognitive function in AD patients,and improve daily living ability and quality of life significantly.

Objective In order to reveal the effect of extracorporeal shock wave therapy (ESWT) with ultrasonic orientation for soft tissue disorders of the shoulder. Methods 151 cases of severe disorders of the shoulder were treated with ESWT. The course of disorders was longer than 3 months. Among them, 65 cases were of subacromial bursitis (SB) and 86 of tenosynovitis of long-tendon of biceps muscle (ILBM). The treatment point of ESWT was oriented with color Doppler ultrasonography, while the pain-point was determined with tenderness combining with local anatomic markers. The energy density of ESWT was 0.12-0.16 mJ/mm2, and 1-2 shock-points were selected for each treatment, the number of shock waves were 800-1000 times, each course consisted of 2-5 times, with an interval of 5 days. 25 of 65 cases of SB were refered for ESWT by ultrasonic orientation, other 40 by pain-point orientation; 31 of 86 cases of ILBM were refered for ESWT of ultrasonic orientation, other 55 by pain-point orientation. The satisfactory rate of SB and ILBM with ESWT were compared between 2 different orientation cases. Results Through 6 months follow up, the satisfactory rates of SB and ILBM with ESWT were 89.6% and 92.3% respectively in cases of ultrasonic orientation, while in cases of pain-point orientation, the satisfactory rates of SB and ILBM with ESWT were 67.6% and 73.6% respectively, the difference of satisfactory rates was significant between 2 groups. Conclusion The effect of the ESWT with ultrasonic orientation is better than the ESWT with pain-point orientation both for SB and ILBM. The ultrasonic orientation plays an important role in promoting the satisfactory rates of ESWT.

To investigate the effect of prostaglandin E_1 (PGE_1) on the liver function following laparotomy, 55 adult patients with normal liver function, undergoing elective laparotomy for gastric cancer under total intravenous anesthesia ,were randomly allocated to receiving intravenous infusion of PGE_1 at rate of 20 to 60ng?kg~(-1). min~(-1)(group PGE_(1,n)=27), or normal saline (group control, n=28 )from the opening of abdomen to the end of operation,respectively. The serum concentrations of glutamin-pyruvic transaminase (GPT)and glutamic-oxaloacetic transaminase (GOT)were measured postoperatively. The results showed that as compared with the values before the operation,the levels of GPT and GOT increased significantly in both groups on the first postoperative day (P

Objective:To observe the effect of PGE1 in treatment of heart failure caused by cor pulmonale.Method:100-200 μg of PGE1 was added to 250 mL of 10% glucose and administered by intravenous drip to patients once per day for 7-10 days.Results:Of the 34 cases,21 cases were significantly improved,10 cases improved while only 3 cases remained the same as before. The total effective rate was 91%. The mean time of improvement was 7 days.Conclusion:PGE1 is effective in treating cor pulmonale heart failure,it can help decrease the danger of digitalis toxication.

Objective To investigate the clinical characteristics of septicemia in type 2 diabetes mellitus,to enhance prevention level and decrease death rate.Methods A retrospective study was carried out,the data were collected from 58 cases of type 2 diabetes mellitus complicated by septicemia in our hospital in the past 13 years.Results The pathogenic invasive pathways included:19 cases of urinary tract,17 cases of respiratory tract,7 cases of intravenous catheter detain,7 cases of biliary tract,1 case of skin breakage,and 7 cases of unclear origin.Twenty-three of 58 cases were from nosoeomial infection (39.7%),among which 10 cases of urethral detain,7 cases of intravenous catheter detain,and 6 cases of respiratory tract infection.Pathogenic distribution was as following:24 cases of klehsiella pneumoniae,16 cases of escherichia coli,10 cases of staph aureus,2 cases of staphylococcus cohnii cohnii,2 cases of staphylococcus epidermidis,2 cases of pseudomonas putida,2 cases of candida glabrata.Among the 24 cases of llehsiella pneumoniae,12 cases showed migrating hepatapostema (50.0%),and 15 showed pneumatosis phenomenon in the intrahepatie bile (62.5%).Two cases originated from fungal septicemia.Among 56 cases under antibacterial therapy 15 cases developed fungal septicemia (26.8%).Fifty-eight cases were treated with insulin for forcing down serum glucose,56 cases of bacterial septicemia were treated with the third generation cephalosporins and fluoroquinolones.Two cases of pseudomonas putida septicemia were treated with intravenous injection of fluconazole.Seven cases died (12.1%).Conclusions Gram-negative bacilli were the major pathogens of septicemia in type 2 diabetes mellitus.Migrating hepatapostema and pneumatosis phenomenon in the intrahepatic bile often showed klebsiella pneumoniae septicemia.The important risk factors for septicemia were intravenous catheter detain and urethral detain.Therefore,strictly aseptic operation and removing vessel detain in time is very important.It is key points to make an early diagnosis,have a strong antibiosis therapy and treat the migrating pathogenic focus.And it is important to intensify serum glucose monitoring and strengthen supportive treatment.

Objectives To understand current status of the admission and treatment for the patients with community-acquired pneumonia (CAP) in central hospitals of Shanghai area,and to evaluate the severity of patients admitted to the hospital with CAP by the criteria set in the Guidelines for Diagnosis and Treatment for CAP developed by the Chinese Medical Association in 2006 and provide evidence for its popularization and application throughout the country.Methods Medical records of 137 patients with CAP admitted to the hospital from January 1,2005 to September 30,2006 were retrospectively studied and analyzed with SPSS 10.0 software.Chi-square test and ANOVA were used to evaluate the severity of the patients with CAP by the criteria set in the Guidelines and to correlate it with pneumonia severity index (PSI).Statistical analysis was performed for the difference between length of hospitalization,cost,length of intravenous use of antibiotics,the number of risk factors,and fatality during hospitalization between three groups of patients categorized based on the severity criteria in the Guidelines.Results There existed a good relationship between the criteria for severity of CAP by the Guidelines and PSI,with a Pearson's coefficient of correlation of 0.577,P

Objective To study the influence of hydrogen sulfide (H2 S)on the mitochondrial function of pulmonary artery smooth muscle cells of the rats with high pulmonary blood flow pulmonary hypertension, and to clarify the function and its mechanism in the occurrence of high pulmonary blood flow pulmonary hypertension.Methods A total of 27 rats were randomly divided sham operation group,operation group,and operation+sodium hydrosulfide (NaHS)group (n=9).The pulmonary hypertension rat model was built by left lung resection.After fed for 35 d, the mean pulmonary artery pressure (mPAP),ratio of right ventricle/body weight (RV/BW),and ratio of right ventricle/(left ventricle+septum)[RV/(LV + S)]of the rats in three groups were measured.The plasma H2 S levels and the CSE activities in pulmonary artery tissue of the rats were detected;the activities of total mitochondrial ATP enzyme,superoxide dismutase (SOD),glutathione peroxidase (GSH-Px)and malondialdehyde (MDA)levels were determined;the ultrastructure of pulmonary artery smooth muscle mitochondria was observed through transmission electron microscope.Results Compared with sham operation group,the plasma H2 S level and the CSE activity in pulmonary artery tissue of the rats in operation group were decreased(P<0.01);the mitochondrial membrane of pulmonary tissue was swelling, and the mitochondrial activity was decreased (P<0.01);the mitochondrial ATP enzyme,SOD and GSH-Px activities were significantly decreased,and the MDA level was significantly increased (P<0.01).Compared with operation group,the H2S level in plasma and the activity of CSE in pulmonary tissue of the rats in operation + NaHS group were increased (P<0.01 );the mitochondrial membrane swelling was reduced, and the vitality was restored;the ATP enzyme, GSH-Px, and SOD level in pulmonary tissue were significantly increased (P<0.01),and the MDA level was significantly reduced (P<0.01).Conclusion H2 S can enhance the activities of mitochondrial ATP enzyme,GSH-Px,and SOD,and decrease the mitochondrial lipid peroxidation level,thus it plays a protective effect on rat pulmonary artery smooth muscle.

Objective Mining and exploring the positive experience of family caregivers of diabetic foot,aims to deepen the conceptual framework of positive aspects of caregiving and to provide a basis for interventions. Methods A qualitative study design was used guided by the conceptual framework of positive aspects of caregiving.Ten family caregivers of patients with diabetic foot were surveyed. The Colaizzi qualitative analysis method and the framework method were used to analysis the qualitative data. Results The caregivers′positive experience was described from 4 aspects:quality of caregiver/care receiver daily relationship, caregiver′s feeling of accomplishment, meaning of the caregiver′s role in daily life and the caregivers′gain. The caregivers′positive experience was influenced by the caregiver′s sense of self-efficacy and the enrichment events in daily life. Conclusions Family caregivers of diabetic foot get positive experiences in caregiving. The conceptual framework of positive aspects of caregiving explains the relationship between caregivers′positive experience and the determine factors, and it will be helpful to the designing and implementing of interventions. The positive experience should be considered when an intervention program will be conducted for supporting family caregivers.