Objective To compare diversity and diagnostic concordance of Subjective Global Assessment (SGA) with Nutritional Risk Screening 2002 (NRS2002) in evaluating nutritional status among gastrointestinal cancer patients. Methods Two hundred and twenty-three patients with gastrointestinal cancer were conveniently selected and evaluated by SGA and NRS within 48h of admission from April to October 2009 using cross-sectional study. Diversity and diagnostic concordance between SGA and NRS2002 were analyzed by McNemar paired chi- square test and Kappa test. Results All patients completed both NRS2002 and SGA. The prevalence of nutritional risk or undernutrition evaluated by NRS2002 or SGA was 61% versus 32. 3%. There was a significant difference between NRS2002 and SGA after conducting McNemar paired chi-square test (P <0. 01) but diagnostic concordance of SGA and NRS2002 was poor (Kappa = 0.368, P < 0. 01). Conclusions Both NRS2002 and SGA were feasible in evaluating nutritional status in gastrointestinal cancer patients, but there was deference between NRS2002 and SGA. NRS2002 had higher sensitivity to detect early under nutrition and was more suitable in prevention under nutrition than SGA in gastrointestinal cancer patients.

Objective To explore the risk factors of systemic inflammatory response syndrome crisis (SIRS) after percutaneous nephrolithotomy (PCNL) in China. Methods Databases of CNKI, CBM, WanFan and VIP were searched to retrieve studies about systemic inflammatory response syndrome after percutaneous nephrolithotomy to October, 2016. Results 18 studies involving 5,323 patients were included. The results of meta-analysis showed that:a) univariate analysis indicated that renal insufficiency [O(R) =2.78, 95%CI (1.96 to 3.95), P = 0.000], preoperative positive urine culture [O(R) = 3.41, 95%CI (1.89 to 6.15), P = 0.000], preoperative routine urine leucocyte positive [O(R) = 3.78, 95%CI (3.02 to 4.72), P = 0.000], diabetes mellitus [O(R) = 2.14, 95%CI (1.33 to 3.45), P = 0.002], pelvic positive urine culture [O(R)= 5.14, 95%CI (2.46 to 10.73), P = 0.000] and operation time ≥120 min [O(R) = 2.31, 95%CI (1.40 to 3.82), P = 0.001] were the risk factors of SIRS; b) multivariate analysis showed that, preoperative positive urine culture [O(R) = 6.83, 95%CI (2.82 to 16.57), P = 0.000], preoperative routine urine leucocyte positive [O(R) = 5.43, 95%CI (3.51 to 8.41), P = 0.000], diabetes mellitus [O(R) = 2.85, 95%CI (1.45 to 5.58), P = 0.002], pelvic positive urine culture [O(R) = 4.30, 95%CI (1.30 to 14.21), P = 0.020] and operation time ≥120 min [O(R) = 2.72, 95%CI (1.62 to 4.59), P = 0.000] were the independent risk factors of MCAT. Conclusion The independent risk factors of SIRS for patients after PCNL are diabetes mellitus, preoperative positive urine culture, preoperative routine urine leucocyte positive, pelvic positive urine culture and operation time. However, due to the quantity and low quality of the included literature, the conclusion needs the support from high quality studies.

OBJECTIVE: To investigate the meaning of the mutation screening, prevalence, inheritance and the intervention or the prevention for the specific drugs in 10 families with non-syndrome hearing loss in Yunnan Province, China. METHOD: To do a questionnaire about the cases of ten families with non-syndrome hearing loss and to draw a detailed matriarchal family tree detailed. Following that, the A1555G mutation-positive individuals were detected and confirmed using DNA extracting, PCR amplification and sequencing for family volunteer. RESULT: There are 96 members have attended the blood collection in these ten families. Thirty-six of them had the normal hearing and 60 of them had the sensory neural hearing loss. However, 4 out of those had no A1555G point mutation, and 92 had A1555G point mutation (95.8%). While 7 of those were Heterogeneity, the rest were all homogeneous mutation. There were also 73 patients who had amino glycoside antibiotic medication history. However all the rest cases had a history of amino glycoside antibiotic medication were not clear yet. CONCLUSION The proportion of patients with drug-induced deafness is high in Yunnan province and the mutation rate of mitochondrial DNA A1555G is also high. It is worthy to do DNA 12SrRNA A1555G mutation screening for drug intervention and prevention.
Adolescent ; Adult ; Aged ; Child ; China ; epidemiology ; DNA Mutational Analysis ; DNA, Mitochondrial ; genetics ; Deafness ; epidemiology ; genetics ; Female ; Humans ; Male ; Middle Aged ; Pedigree ; Point Mutation ; RNA, Ribosomal ; genetics ; Young Adult

Objective To investigate the professional identity and career planning of new nurses and explore their correlation.Methods Totals of 76 new nurses were investigated by professional identity scale and career planning scale.Results Both the score of professional identity (3.61 ± 0.50)and career planning (3.92 ± 0.51) in new nurses were above the average level with the higher score of social persuasion (4.22 ±0.74),social comparison and self reflection (3.77 ± 0.67),Leave benefit and turnover risk (3.58 ± 0.76).The score of career planning of new nurses respectively were self-evaluation (4.04 ± 0.56),career awareness (3.92 ± 0.52),career development(3.81 ± 0.67).And professional identity degree was positively correlated with career planning level (P ＜ 0.01).Conclusions Professional identity and career planning of new nurses have their own characteristics,and nurse managers can provide targeted education for them.It can complement to each other by combining career planning education with professional identity education.

OBJECTIVETo explore an ideal skin substitute with its appearance and texture similar to normal skin, to repair wounds with full-thickness skin defect.

METHODSComposite skin (CS) in question was composed of allo/xenogeneic acellular dermal matrix (ADM) and razor thin autoskin. One step skin grafting was employed in the experimental study and clinical trial. Razor thin autoskin alone was used as the control in the study. Changes in the antigenicity of ADM and the reformation of basement membrane (BM) structure at epidermis-dermis junction (EDJ) of ADMs were studied at designated time points after the grafting with biochemical and immunohistochemical methods. Fifty-three patients with full thickness skin defects due to various causes, including scar excision were grafted with CS, and survival rate and long-term result were observed.

RESULTSThe grafted CS survived satisfactory. The reformation of the basement membrane structure was clearly observed at the 28th post-graft week. The basement membrane cells grew with polarization in an undulating arrangement. There was reformation of dermal papillae and ridges. The antigenicity of allo-ADM was obviously lower than that of xeno-ADM. Sixty-five out of 70 pieces of CS grafting (92.9%) survived totally, two of them survived partially, and three failed due to infection. The longest follow-up period was 8 and a half years. The grafted CS appeared similar to the normal skin in regard to the texture and color, especially allo-ADM, and no evident rejection reaction was seen.

CONCLUSIONADM possessed very low antigenicity, thus serving a lasting framework after grafting. In addition, it could serve as a "dermal template" for the induction of tissue regeneration.

Animals ; Burns ; surgery ; Dermis ; transplantation ; Follow-Up Studies ; Graft Survival ; Humans ; Male ; Rabbits ; Skin Transplantation ; methods ; Swine ; Transplantation, Autologous ; Transplantation, Heterologous ; Transplantation, Homologous ; Treatment Outcome ; Wound Healing

OBJECTIVETo explore the better clinical methods for the management of deep facial burn with optimal quality. Methods Fifty-four patients with deep facial burns were enrolled in the study and were divided into delayed skin grafting group (n=48) and early escharectomy group (n=6). In delayed grafting group, after the erosion of new born granulation tissue to the basal layer with blade holder or with peel or eschar shaving method at 3 postburn weeks (PBW) according to the eschar separation and granulation growth status, the whole face of the patients were divided into 10 regions and were then covered by split thickness auto skin. The same treatment was performed on the patients in early escharectomy group at 1 PBW. Physical therapy and plastic surgery were applied after skin grafting, and the patients were followed up from 3 month to 11 years. The first operation time, postburn facial operation time, operation times to repair the whole face, blood content of Hb, the amount of blood transfusion and hemorrhage and the prognosis were compared between the two groups.

RESULTSThere was no difference between the two groups in regards to the first operation time, the total operation times,blood concentration of Hb before and after operation,and the amount of blood transfusion during the operation (P > 0.05). The operation time in delayed grafting group (21.9 +/- 3.2) d was obviously later than that in early escharectomy group (12.6 +/- 1.3) d, (P < 0.05). And there was evidently less amount of hemorrhage during operation(98 +/- 52) ml/100 cm2 than that in early escharectomy group (331 +/- 121) ml/100 cm2 (P < 0.01). The facial appearance of the patients in delayed grafting group was plump with more elasticity and richer expression compared with those in early grafting group. There exhibited different degrees of microstomia and both eyebrow defect in both groups during and after 1 postoperative year. In addition, mild to moderate ectropion and hypertrophic scar on the conjunction of grafted skin could appear in 80% of these patients. These deformities might be corrected by several times of plastic surgery.

CONCLUSIONBased on the principle of arranging skin grafts according to the cosmetic and functional area units, split thickness skin grafting can provide satisfactory results for the repair of deep burn injury involving whole face when the wounds were treated with eschar peeling, tangential excision, escharectomy, granulation tissue scaling, or early escharectomy. In comparison with early escharectomy, eschar peeling, tangential excision, escharectomy, or granulation tissue scaling can get better results with less bleeding, full and round facial appearance, more elasticity of grafted skin and richer facial expression appearance after the operation. Meanwhile, effective physical therapy and scheduled plastic surgery after skin grafting can also be very important in achieving cosmetic results in the repair and reconstruction of whole facial deep burn.

Adolescent ; Adult ; Burns ; surgery ; Child ; Child, Preschool ; Facial Injuries ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Skin Transplantation ; Transplantation, Autologous ; Wound Healing

To explore new measures for functional reconstruction of multiple severe deformities as a result of extensive deep burn (total burn surface area > or = 90% TBSA, including deep burn > or = 70%TBSA) in late stage. Twelve severe burn patients with above-mentioned deformities were hospitalized in our ward during 1960--2005, the scars resulted from burns were distributed from head to foot with 173 deformities, including 27 scar ulcers. All patients lacked of self-care ability, among them some could not stand. Due to inadequate skin source, deformities were corrected by skin from matured scars expanded with subcutaneous balloon at late postburn stage. Following our former clinical experience, anatomic investigation and experimental research, we chose the following methods to correct deformities and restore functions: application of split-thickness scar skin after expansion (88 wounds); use of scar skin flap/scar-Achilles tendon flaps (59 wounds); combination of thin split-thickness skin grafts from scar and allogeneic acellular dermal matrix (composite skin, 40 wounds). All grafts survived, the appearance and function were improved obviously without complications. Follow-up 1-40 years, all patients could take care themselves with satisfactory function and appearance, and among them 8 patients returned to work (one had worked for 40 years), 2 patients married and had children. The above-mentioned measures are safe, reliable and effective for functional reconstruction of deformities.
Adult ; Burns ; complications ; surgery ; Cicatrix ; etiology ; surgery ; Contracture ; etiology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Recovery of Function ; Skin Transplantation ; Skin, Artificial ; Surgical Flaps ; Wound Healing

OBJECTIVETo establish a rat model of scalding with controllable depth and area by high pressure steam.

METHODSHigh pressure steam apparatus consisting of an autoclave and a self-made scalding frame was employed in the study. The rats were inflicted with scalding with 0.12 Mpa (1 Mpa = 7500 mmHg) high pressure steam on the back through a hole of 2.6 cm in diameter for 3, 4, 5, 6, 7, 8, 9 and 10 seconds, with five wounds at each time point. The tissue samples were harvested at 24 post injury hour (PIH) for pathomorphological examination. The depth of scald was measured, and injury to the sweat gland and hair follicles injury, the hair growth in scalded area, and the wound healing condition were observed with Photoshop software.

RESULTSThere was positive correlation between the scalding depth and scalding time. The injury time for superficial and deep partial thickness burn and full thickness burn were 3, 5 and 7 seconds respectively. The wound healing time was similar even the scalding became more and more serious when injury time increased from 7 to 10 seconds.

CONCLUSIONThe scalding depth and area in this model could be controlled, and the degree of scald injury could be graded accurately with easy manipulation. The result showed that it was an ideal model of skin burn wound.

Animals ; Burns ; pathology ; Disease Models, Animal ; Male ; Pressure ; Rats ; Rats, Sprague-Dawley ; Steam

OBJECTIVETo explore new methods to repair postburn contracture deformities in patients with extremely limited donor skin.

METHODSFive severely burned patients with extremely limited donor skin but severe deformities were enrolled in the study. The mature and the pliable scarred skin was utilized as the donor site for reconstruction of the postburn deformities. Split-thickness scarred skin was harvested for repair of postburn deformities after the scarred skin was expanded by expander, while thin razor-thin scarred skin with allo-acellular dermal matrix (ADM) was employed for the repair of postburn deformities when skin expansion was not feasible.

RESULTSAll the expanded scarred skin and composite skin grafts survived completely with good function and configuration. The long-term follow-up result was satisfactory, and the grafted skin was similar to that with split-thickness skin grafting.

CONCLUSIONIt is feasible to employ various split-thickness scarred skin for the reconstruction of postburn deformities. This technique is a new effective procedure for the reconstruction of postburn deformities, especially for those with extreme scarcity of donor site.

Adult ; Burns ; pathology ; surgery ; Cicatrix ; pathology ; Contracture ; surgery ; Female ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods

A survey on clinical skill application and training needs of general practitioners (GPs) was conducted in the community health service centers of Shanghai Changning District from March to May 2019. The heads of the medical/prevention departments of 10 community health service centers (CHS) in Changning District were invited to evaluate the application frequency of clinical skills and training needs of GPs. According to Residency Training Standards for General Practitioners (trial), Training Standards for Assistant General Practitioners (trial), Training Program for General Practitioners in Primary Medical and Health Institutions (trial), 369 clinical skills for general practitioners were included for evaluation. The application frequency of above 369 clinical skills among 198 general practitioners were evaluated and training needs were also assessed. The overall application frequency score of GPs for 369 clinical skills was 1.00 (0.30, 1.70) points, and the training needs score was 1.40 (1.10, 1.70) points. The application frequency of different clinical skills was positively correlated with training needs ( r=0.462, P<0.01). And the four-quadrant analysis results show that among the 369 clinical practice skills, 116 (31.4%) items were used by GPs with high frequency and high training needs, and 80 (21.7%) items were used with low frequency but high training needs. There were 45 (12.2%) items with high application frequency but low training needs, and 128 (34.7%) items with low application frequency and low training needs. The survey indicates that the training of clinical skills listed in the three major training standards or outlines should be strengthened in continuing education for general practitioners, and the practice skills with high application frequency and high training needs should be focused in training program to improve the quality, effectiveness and efficiency of training.