Objective To evaluate clinical results of endoscopic vein harvesting(EVH) in patients who underwent coronary artery bypass grafting(CABG).Methods From July 2013 to October 2014,500 patients who underwent isolate CABG in our institution were divided into two groups:EVH group (n =250) and open vein harvesting(OVH) group(n =250).The surgical result and perioperative complications were compared between the two groups.Results The procedures were completed successfully in all the patients in both groups.There was no significant difference existed in the length of the harvested vein and vein injury between the two groups(P ＞ 0.05).Similar results were obtained in the in-hospital mortality.Compared to group OVH,group EVH showed significantly shorter harvesting time,smaller incision,and lower rates of perioperative leg complications (P ＜ 0.01).Group EVH had a less bed staying time after operation and a shorter post-operation hospital stay (P ＜ 0.05).EVH group achieved an improved patient satisfaction and postoperative pain when compared with OVH in CABG(P ＜0.05).Conclusion EVH can provide adequate vein graft for CABG,and also significantly reduce wound related complications when compared with OVH.EVH is recommended for vein harvesting to improve patient satisfaction.

Objective To construct interpretation theory which is suitable to explain the connotation of interpersonal relationship among associate degree nursing students.Methods The data were collected through deep interviews.The content of interpersonal relationship was affirmed by three-level coding and comparing repeatedly.Results The core concept was gaining a feeling of belonging and it could be affected by 5 generic concepts including clinical teachers,head nurses,baccalaureate degree nursing students,patients and doctors.Conclusions Harmonious interpersonal relationship can be built according to the theory of interpretation and practice outcomes can be improved.

Objective To compare the effects of dexmedetomidine (DEX) and remifentainil (REM) combined with sevoflurane (SEV) for general anesthesia on recovery quality in patients undergoing laparoscopic cholecystectomy (LC).Methods Sixty patients (ASA grade Ⅰ-Ⅱ) who underwent LC were divided into DEX combined with SEV for general anesthesia group (DEX group) and REM combined with SEV for general anesthesia group (REM group) by table of random digit,with 30 cases each.Time of first inspiration,eye opening,extubation,orientation recovery and passage of gas by anus were recorded.Vital sign,numeric rating score (NRS),Ramsay score and untoward reaction were recorded.Degree of satisfaction of patients,post-anesthesia care unit (PACU) nurse and surgeon were evaluated.Results The time of extubation and passage of gas by anus in DEX group were significantly shorter than those in REM group [(12.0 ±3.9) min vs.(15.9 ±5.6) min,t =-3.130,P =0.003; (18.5 ±3.4) h vs.(23.6 ±5.8) h,t =-5.455,P =0.000].However,the time of eye opening and orientation recovery in DEX group were significantly longer than those in REM group [(15.5 ± 4.2) min vs.(11.7 ± 2.9) min,t =4.078,P =0.000;(19.5 ± 4.5) min vs.(14.8 ± 3.6) min,t =4.315,P =0.000].During the first 2 h after operation,Ramsay score in DEX group was significantly higher than that in REM group (P ＜ 0.05),but NRS in DEX group was significanty lower than that in REM group (P ＜ 0.05),the patients with additional analgesics was minor than REM group (2 cases vs.9 cases,P ＜ 0.05).The percentages of patients suffering shivering and postoperative nausea and vomiting in DEX group were significantly lower than those in REM group [3.3％(1/30) vs.33.3％(10/30),6.7％(2/30) vs.30.0％ (9/30),P ＜0.05].Degree of satisfaction of patients and PACU nurse in DEX group were higher than those in REM group [89.0(72.0-100.0) scores vs.80.0(70.0-95.0) scores,Z =-4.066,P =0.000; 92.0 (80.0-99.0) scores vs.90.0 (80.0-95.0) scores,Z =-2.906,P =0.004],but degree of satisfaction of surgeon in REM group was higher than that in DEX group [(91.8 ± 5.8) scores vs.(81.7 ±6.1) scores,t =-6.568,P =0.004].Conclusion Compared with REM combined with SEV for general anesthesia,DEX combined with SEV for general anesthesia has a faster recovery for respiration and passing of gas by anus,lower NRS and incidence rates of shivering,nausea and vomiting,improves the quality of recovery for patients undergoing LC.

OBJECTIVETo understand the comorbid characteristics and distribution of combined treatment of Chinese and Western medicine in depressive patients.

METHODThe descriptive statistic method and association rule were used to analyze the data from 19 general hospitals with 3-A level in China.

RESULTAmong the depressive disorder, the most frequent co-morbid physical diseases included hypertension (24.67%), coronary heart disease (16.10%) and cerebral infarction (12.89%), and the proportion of comorbid changes with the increasing age, from 6.51% to 12.55%, 16.33% and 12.47% for hypertension; from 2.79% to 5.69%, 10.17% and 14.22% for coronary heart disease; from 3.72%, 6.27%, 7.70% and 12.25% for cerebral infarction. The use frequency of the antidepressants is 77.18%, and the use frequency of flupentixol & melitracen is 20.95%. The use frequency of Huoxue Huayu Tongluo of traditional Chinese medicine is 59.97%, with that of 27.91% for Ginkgo biloba extract The combined use frequency of Huoxue Huayu Tongluo of TCM and the antidepressants is the highest, especially for the combined use of Shuxuening injection and fluoxetine.

CONCLUSIONThe most frequent comorbid diseases of depression include three kinds of diseases, such as hypertension, coronary heart disease and cerebral infarction, and its proportion gradually increased with the growth of age. The single use frequency of flupentixol & melitracen and G. biloba extract is the highest, while the combined use of Shuxuening injection and fluoxetine is the highest.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anthracenes ; therapeutic use ; Antidepressive Agents ; therapeutic use ; Child ; Child, Preschool ; China ; Combined Modality Therapy ; methods ; Depressive Disorder ; drug therapy ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fluoxetine ; therapeutic use ; Flupenthixol ; therapeutic use ; Ginkgo biloba ; chemistry ; Humans ; Infant ; Infant, Newborn ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Plant Extracts ; therapeutic use ; Young Adult

As a new therapy in past twenty years,biological agents have been approved for the treatment of inflammatory bowel disease (IBD). However,biological agents currently used for IBD treatment require intravenous or subcutaneous injections,and some require infusion under close observation. Therefore,it is of positive clinical significance to find a safe and effective oral biological agent. This article reviewed recent advances in study on novel oral biological agents in the treatment of IBD.

Objective To explore the value of transvaginal color doppler ultrasound(TVS) in the differential diagnosis of endom-etrial hyperplasia(EH) and endometrial cancer(EC) .Methods The clinical data concerning TVS in 48 patients with EH and 37 pa-tients with EC were reviewed retrospectively ,then we compared the ultrasonic diagnosis with the pathological diagnosis to observe the preoperative diagnostic accuracy of ultrasonic diagnosis .Results In 48 patients with EH ,the inspection results of 44 cases were accordant with the pathological diagnosis .The rest of 4 cases were misdiagnosed by TVS as EC before operation ,and the accurate rate is 91 .67% (44/48);In 37 patients with EC ,the checking results of 34 cases were consistent with the pathological diagnosis . The rest of 3 cases were misdiagnosed by TVS as endometrial atypical hyperplasia ,and the accurate rate is 91 .89% (34/37) .Con-clusion TVS has diagnostic significance in the differential diagnosis of EH and EC .

Objective To investigate the changes and its significance of serum content of soluble CD40L(sCD40L) and C-reactive protein(CRP) in patients with acute cerebral infarction(ACI).Methods The content of serum sCD40L and CRP in 40 patients with ACI and 30 normal controls were measured by enzyme-linked immuno-sorbent assay and immunonphelometry.The content of serum sCD40L and CRP were compared in the patients of different pathogenetic condition and infarction size.The correlation between sCD40L and CRP and pathogenetic condition and infarction size were analysised.Results The contents of serum sCD40L and CRP in ACI group were significantly higher than normal control group(all P

Objective To explore the protective effect of atorvastatin on irradiated endothelium and the thrombomodulin(TM)expression.Methods Cultured human coronary artery endothelial cells(HCAEC)and human umbilical vein endothelial cells(HUVEC)were treated by atorvastatin at the final concentration of 10 μmol/ml for 10 min,and then irradiated with 2 and 25 Gy.Cell cycles status and TM expression were quantitatively measured by flow cytometry 24 hours after irradiation.Protein C activation in endothelial cells was also assessod.Results After administration with atorvastatin for 24 h,the TM expression increased by 77%,59% and 61% in normal control group,2 Gy group and 25 Gy group,respectively(t=27.395,26.420,58.065;P=0.000).The protein C levels decreased by 23% and 34% compared with the normal group post-irradiation to 2 and 25 Gy,but increased by 79% and 76% compared with the irradiated control group after administration with atorvastatin.The rates of cell apoptosis decreased by 6% and 16% in 2 Gy and 25 Gy groups,respectively after administration with atorvastatin for 24 h(t=4.178,17.863;P=0.000).Conclusions Atorva statin can protect endothelia cell from irradiation-induced apeptosis by increasing TM expression and protein C activation.

Objective To investigate the effect of edaravone pretreatment on myocardial injury induced by carbon dioxide pneumoperitoneum in patients undergoing laparoscopic gynecologic surgery.Methods Thirty patients undergoing laparoscopic gynecologic surgery,ASA Ⅰ or Ⅱ grade,were divided into two groups by random digits table with 15 cases each:control group and edaravone group.Edaravone group following tracheal intubation received vein infusion of edaravone 0.5 mg/kg,control group received equal volume of 0.9％ sodium chloride.The carbon dioxide pneumoperitoneum pressure was maintained at 10-15 mm Hg (1 mm Hg =0.133 kPa).Venous blood samples were collected before anesthesia induction and after operation 8 h for the measurement of the serum creatine kinase (CK),creatine kinase-MB (CK-MB),aspartate aminotransferase (AST) and lactate dehydrogenase (LDH).Results The serum levels of CK and AST were significantly higher after operation 8 h in control group than those of before anesthesia induction in control group and after operation 8 h in edaravone group [(205 ± 27) U/L vs.(123 ± 25) and (123 ± 29)U/L,(48±5) U/L vs.(34 ±3) and (36 ±5) U/L,P＜0.05].There was no significant difference in the serum levels of CK-MB and LDH between two groups and the group (P ＞ 0.05).Conclusion Pretreatment with edaravone 0.5 mg/kg can protect myocardium in patients undergoing laparoscopic gynecologic surgery.

No abstract available.
Child* ; Humans