Objective To improve the quality of health education to make burned patients receive timely and effective health education.Methods 100 inpatients were divided into study group and control group at random.the study group using clinical nursing pathway to give health education,the control group using traditional health education.Results The patient satisfaction was 96.0％ in the patients,satisfaction was 82.0％,the comparative differences between groups are statistically significant ( x2 =5.01,P ＜ 0.05 ).The health education with the mastery of the knowledge rate was 94.0％ and 70.0％ in control group,comparative differences between groups were statistically significant ( x2 =12.0,P ＜0.05).Conclusions Applying clinical nursing pathways carry out health education for burned diseases was an effective working methods.

OBJECTIVETo study the efficacy of hepatitis B immunoglobulin (HBIG) combining hepatitis B vaccine in high risk infants born to HBsAg positive mothers through a follow-up study program.

METHODS184 infants (4 twin pairs) born to HBsAg carrier mothers who were consecutively recruited from December 2002 to August 2004 were followed. Major HBV serologic markers in all infants were detected by enzyme-linked immunosorbent assay (ELISA) when they were at birth, at 7th, at 24th and at 36th months.

RESULTS7 of the 184 infants were HBsAg positive at birth, making the transplacental intrauterine infection rate of HBV as 3.80% (7/184). 125 infants were followed up at 7th months and 108 infants were followed up at 24th and 36th months. Only 2 of the 7 infants born to HBsAg-positive and HBeAg-positive mothers were persistently sera positive for HBsAg, making the chronic infection rate of HBV as 28.57%. The other 140 infants were HBsAg negative during t he follow-up period. The rate o f detectable anti-HBs i ninfants was 7.02% at birth. After infants were immunized by HBIG combining hepatitis B vaccine, the anti-HBs-positive rate reached 92% at 7th months, and gradually descended thereafter. 72.04% of the infants at 24th and 60% at 36th months showed detectable levels of anti-HBs. There was significant correlation between the produce of anti-HBs in infants and HBsAg-positive at birth while HBsAg-positive and HBeAg-positive in mothers did not relate to the produce of anti-HBs in their infants. Of 39 infants born to HBsAg-positive and HBeAg-positive mothers, 25 showed detectable levels of HBeAg. During the follow-up peirod, HBeAg was still detectable in 2 infants who were also HBsAg positive and the others all became HBeAg-negative but no infant became HBeAg-positive.

CONCLUSIONThe efficacy of HBIG combining hepatitis B vaccine in high risk infants was fine.

Adult ; Enzyme-Linked Immunosorbent Assay ; Female ; Follow-Up Studies ; Hepatitis B Antibodies ; immunology ; Hepatitis B Vaccines ; immunology ; therapeutic use ; Hepatitis B e Antigens ; immunology ; Humans ; Immunoglobulins ; immunology ; therapeutic use ; Infant, Newborn ; Pregnancy ; Young Adult

OBJECTIVEIn China, liver failure is also termed as severe hepatitis in whom chronic severe hepatitis B (CSHB) is most common. The aim of this study was to assess whether CSHB based on different liver injury extent can meet the international definition of acute-on-chronic liver failure(ACLF)criteria, according by their clinical and pathological feature.

METHODSA total of 91 patients with CSHB were involved in the study. The clinical findings, laboratory data and liver pathology features were retrospectively analyzed and grouped by hepatitis virus B carrier state (HBC), chronic hepatitis B (CHB) or liver cirrhosis (LC) before they started liver failure.

RESULTS74 out of the 91 patients were male and 17 were female, the mean age was 40.6+/-11.2 years. 9.9%, 7.7% and 82.4% of the patients were based on HBC, CHB and LC respectively. The ages of HBC group were youngest. The mean age of HBC group (years) (25.8+/-6.6) was significantly lower than that of CHB group (36.9+/-9.0) and LC group (42.0+/-10.5)with P values of 0.032 and 0.001 respectively. Most cases presented with sub-acute liver failure characterized by high icterus and ascites. Predisposing factors included exertion, superinfection, virus variation, drugs or alcoholic injury. No difference found between PTA (F = 0.906, P = 0.408) and TBil (F = 0.839, P = 0.436) among the above three groups. The Alb and CHE levels in LC group were (30.3+/-5.1) g/L and (2926.8+/-1471.1) U/L respectively, which were lower than both HBC group [Alb (35.6+/-5.1) g/L, CHE (4363.5+/-2063.2) U/L] and CHB group [Alb (37.4+/-5.0) g/L, CHE (5167.1+/-1522.1) U/L] (F = 9.450; F = 9.297; P value less than 0.01).The level of CHO (1.8+/-1.0) mmol/L in LC group was lower than that of HBC group (2.9+/-1.0mmol/L, P = 0.034), while serum HBV DNA level of HBC group [(6.8+/-1.7) log10copies/ml] was higher than that of LC group [(4.2+/-2.6) log10copies/ml]. The liver tissue in HBC and CHB group showed massive or submassive necrosis which distribute evenly in different parts of liver and similarly in slides, most like acute/subacute severe hepatitis. The chronic lesion was easily covered by extensive necrosis in CSHB based on CHB, with portal fibrosis can be seen by masson stain. Characteristic picture of LC group were massive or submassive necrosis with some nodules were intact or only patchy necrosis of the parenchyma, disparity of extent and stage of necrosis existed in slides, which were the major difference in histopathological change in HBC and CHB group.

CONCLUSIONMost of CSHB cases were based on liver cirrhosis, which match with the international definition of ACLF, while small part of CSHB cases based on HBC and CHB are identical to acute/subacute liver failure.

Adult ; Carrier State ; pathology ; virology ; Female ; Hepatitis B, Chronic ; pathology ; Humans ; Liver Cirrhosis ; pathology ; virology ; Liver Failure ; etiology ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo investigate the effects of the different treatments of deep venous thrombosis (DVT) of lower extremities on the incidence of the pulmonary embolism (PE).

METHODS201 patients (97 males and 104 females, mean age 60.4 years ranged from 24 to 83) from August 2002 to June 2008 with DVT were retrospectively reviewed and divided into 3 groups based on different treatment, including anticoagulants plus thrombolytics alone (group 1), thrombectomy plus anticoagulants plus thrombolytics (group 2) and anticoagulants plus thrombolytics after delivery of inferior vena cava (IVC) filter (group 3) respectively. One hundred and seventy-four cases had left lower limb DVT, 24 cases had right lower limb DVT and 3 cases had both sides of lower limb DVT. Different incidence of PE in different period (7-14 d in hospital and follow-up after discharge) were calculated. Effects of the three different treatment methods of DVT on the incidence of PE were studied.

RESULTSFor in-patients, the prevalence of symptomatic PE was 2.8% (3/107) in the group of receiving anticoagulants plus thrombolytics alone, but in the other two groups, no symptomatic PE happened. There was no significant difference in incidence of symptomatic PE among the 3 groups (P=0.425). For patients discharged, after 6 to 72-month follow-up (mean 24-month), we found that no PE happened in group 1 and group 2, while in group 3, the incidence of PE was 2.4% (1/42). There was also no significant difference (P=0.656) among 3 groups.

CONCLUSIONSThere is no significant difference in relation to the incidence of PE in these 3 groups. Therefore vena cava filter implantation should be restricted to optimal indication.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Pulmonary Embolism ; etiology ; prevention & control ; Retrospective Studies ; Venous Thrombosis ; complications ; therapy

OBJECTIVETo investigate the value of virtual imaging technique in diagnosis of intracranial aneurysms.

METHODSFifty-four cases of 54 intracranial aneurysm diagnosed by three-dimensional CT angiography (3D-CTA) examinations were enrolled in this study. Three-dimensional virtual images of the skull and cerebral vessels were acquired by three-dimensional reconstruction of the original CT images using the surgical planning system, and the location, size and shape of the aneurysms and their anatomical relationship with the adjacent tissues were observed and measured from several angles. All the patients underwent surgical planning and simulated surgical operations using the virtual surgical instruments available in the system.

RESULTSAll the 54 cases had successful three-dimensional virtual image reconstruction and the surgical planning operations. The virtual imaging system generated clear and vivid three-dimensional virtual images which clearly visualized the location and size of the aneurysms and their precise anatomical relations to the parent arteries and skull. This virtual reality imaging system also allowed simulation of simple surgical procedures.

CONCLUSIONThe surgical planning system based on the virtual reality imaging can serve as a useful means to assist the diagnosis and provide precise imaging details of intracranial aneurysms.

Cerebral Angiography ; methods ; Humans ; Imaging, Three-Dimensional ; methods ; Intracranial Aneurysm ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

OBJECTIVETo investigate the histopathological features in livers of chronic severe hepatitis B (CSHB) patients.

METHODSHistology of 42 livers was studied. HE, Masson, Sweet and D-PAS staining and cytokeratin 7, CD68 and proliferating cell nuclear antigen immuno-histochemical staining were used in the study.

RESULTSIn CSHB, the livers showed massive or submassive necrosis in a background of other histological changes of chronic hepatitis B. The characteristic pictures of these livers were necrosis of all the hepatocytes in some nodules, while in other nodules there were only patchy necroses of the parenchyma. In some other nodules the necrotic hepatocytes were all removed and only the scaffolding stroma remained. Meanwhile, regeneration of hepatocytes and bile ductules were also seen.

CONCLUSIONSThe liver histopathological changes in CSHB are identical, but not of the same degree as those of acute severe and subacute severe hepatitis B. In making differential diagnoses for liver aspiration biopsies of these patients, this fact should be kept in mind.

Adult ; Aged ; Female ; Hepatitis B, Chronic ; diagnosis ; pathology ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Staining and Labeling ; Young Adult

BACKGROUNDThe diagnostic value of virtual imaging combined with three-dimensional computed tomographic angiography (3D-CTA) for intracranial aneurysms has not been fully elucidated yet. This study aimed to evaluate the value of combined application of virtual imaging techniques and 3D-CTA in diagnosing patients with aneurismal subarachnoid hemorrhage (SAH) at the acute stage.

METHODSEighty patients with non-traumatic SAH received 3D-CTA examinations. The raw CT data of these patients were reconstructed and transferred into the 3D mode through the surgical plan system based on virtual reality (VR) image, and the 3D virtual images of skulls and brain blood vessels were acquired. The location, size and shape of aneurysms and their anatomic relationship with adjacent tissues were measured from many points of view.

RESULTSSeventy-three aneurysms were detected in 68 of the 80 patients, but 2 aneurysms were detected in 2 of the 5 patients who had been found free of aneurysms previously and had received 3D-CTA examinations for a second time one month later. The 3D virtual images produced by the virtual imaging system were clear and vivid, and they could reveal the location and size of the aneurysm and its relations to the parent artery and skull directly.

CONCLUSIONSThe imaging of 3D-CTA is convenient, reliable and fast in diagnosing intracranial aneurysms and can be regarded as the first choice for the diagnosis and treatment of ruptured intracranial aneurysms. Combined with the surgical plan system based on the VR image, 3D-CTA may obtain more imaging information about aneurysms.

Adolescent ; Adult ; Aged ; Angiography ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Intracranial Aneurysm ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed ; methods ; Young Adult

The working principle of TMC BC ROBO 6 intelligent blood collection system was described in brief.The causes of three faults during daily operation of the system were analyzed,and the countermeasures were put forward accordingly.References were provided for clinical engineers to treat similar faults.[Chinese Medical Equipment Journal,2024,45(6):113-116]

Objective To explore the clinical factors affecting the prognosis of craniocerebral traffic injuries to provide scientific evidence for ameliorating the prognosis. Methods We retrospectively analyzed the clinical data of 652 patients treated in our hospital for serious injuries in car accidents (Glascow Coma score [GCS] 3～8) between February, 1998 and February, 2008. According to the Glasgow Outcome Scale (GOS) three months after injury, patients were divided into good prognosis and poor prognosis groups. Their gender, age, type of brain injury, admission time, pupil status, blood oxygen saturation, systolic blood pressure, level of blood sugar, Injury Severity Score (ISS) and GCS were compared. Results As compared with the good prognosis group, the poor prognosis group showed a significant low level of blood oxygen saturation and systolic blood pressure, low GCS and pupils status score (P<0.05);it showed a long admission time, a significant high level of blood sugar and high ISS (P<0.05). Bad prognosis appeared in intracranial hematoma, contusion and laceration of the brain. And the level of blood sugar and oxygen, GCS and ISS were the independent factors affected the prognosis. Conclusion The level of oxygen saturation and blood sugar, ISS and GCS can help to evaluate the prognosis of patients with severe brain injury, effectively.

Objective:To investigate the protective effects and mechanisms of targeted inhibition of type 3 deiodinase (Dio3) on skeletal muscle mitochondria in sepsis.Methods:① In vivo experiments: adeno-associated virus (AAV) was employed to specifically target Dio3 expression in the anterior tibial muscle of rats, and a septic rat model was generated using cecal ligation and puncture (CLP). The male Sprague-Dawley (SD) rats were divided into shNC+Sham group, shD3+Sham group, shNC+CLP group, and shD3+CLP group by random number table method, with 8 rats in each group. After CLP modeling, tibial samples were collected and Western blotting analysis was conducted to assess the protein levels of Dio3, peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α), and silence-regulatory protein 1 (SIRT1). Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was utilized to examine mRNA expression of genes including thyroid hormone receptors (THRα, THRβ), monocarboxylate transporter 10 (MCT10), mitochondrial DNA (mtDNA), and PGC1α. Transmission electron microscopy was employed to investigate mitochondrial morphology. ② In vitro experiments: involved culturing C2C12 myoblasts, interfering with Dio3 expression using lentivirus, and constructing an endotoxin cell model by treating cells with lipopolysaccharide (LPS). C2C12 cells were divided into shNC group, shD3 group, shNC+LPS group, and shD3+LPS group. Immunofluorescence colocalization analysis was performed to determine the intracellular distribution of PGC1α. Co-immunoprecipitation assay coupled with Western blotting was carried out to evaluate the acetylation level of PGC1α. Results:① In vivo experiments: compared with the shNC+Sham group, the expression of Dio3 protein in skeletal muscle of the shNC+CLP group was significantly increased (Dio3/β-Tubulin: 3.32±0.70 vs. 1.00±0.49, P < 0.05), however, there was no significant difference in the shD3+Sham group. Dio3 expression in the shD3+CLP group was markedly reduced relative to the shNC+CLP group (Dio3/β-Tubulin: 1.42±0.54 vs. 3.32±0.70, P < 0.05). Compared with the shNC+CLP group, the expression of T3-regulated genes in the shD3+CLP group were restored [THRα mRNA (2 -ΔΔCt): 0.67±0.05 vs. 0.33±0.01, THRβ mRNA (2 -ΔΔCt): 0.94±0.05 vs. 0.67±0.02, MCT10 mRNA (2 -ΔΔCt): 0.65±0.03 vs. 0.57±0.02, all P < 0.05]. Morphology analysis by electron microscopy suggested prominent mitochondrial damage in the skeletal muscle of the shNC+CLP group, while the shD3+CLP group exhibited a marked improvement. Compared with the shNC+Sham group, the shNC+CLP group significantly reduced the number of mitochondria (cells/HP: 10.375±1.375 vs. 13.750±2.063, P < 0.05), while the shD3+CLP group significantly increased the number of mitochondria compared to the shNC+CLP group (cells/HP: 11.250±2.063 vs. 10.375±1.375, P < 0.05). The expression of mtDNA in shNC+CLP group was markedly reduced compared with shNC+Sham group (copies: 0.842±0.035 vs. 1.002±0.064, P < 0.05). Although no difference was detected in the mtDNA expression between shD3+CLP group and shNC+CLP group, but significant increase was found when compared with the shD3+Sham group (copies: 0.758±0.035 vs. 0.474±0.050, P < 0.05). In the shD3+CLP group, PGC1α expression was significantly improved at both transcriptional and protein levels relative to the shNC+CLP group [PGC1α mRNA (2 -ΔΔCt): 1.49±0.13 vs. 0.68±0.06, PGC1α/β-Tubulin: 0.76±0.02 vs. 0.62±0.04, both P < 0.05]. ② In vitro experiments: post-24-hour LPS treatment of C2C12 cells, the cellular localization of PGC1α became diffuse; interference with Dio3 expression promoted PGC1α translocation to the perinuclear region and nucleus. Moreover, the acetylated PGC1α level in the shD3+LPS group was significantly lower than that in the shNC+LPS group (acetylated PGC1α/β-Tubulin: 0.59±0.01 vs. 1.24±0.01, P < 0.05), while the expression of the deacetylating agent SIRT1 was substantially elevated following Dio3 inhibition (SIRT1/β-Tubulin: 1.04±0.04 vs. 0.58±0.03, P < 0.05). When SIRT1 activity was inhibited by using EX527, PGC1α protein expression was notably decreased compared to the shD3+LPS group (PGC1α/β-Tubulin: 0.92±0.03 vs. 1.58±0.03, P < 0.05). Conclusion:Inhibition of Dio3 in skeletal muscle reduced the acetylation of PGC1α through activating SIRT1, facilitating nuclear translocation of PGC1α, thereby offering protection against sepsis-induced skeletal muscle mitochondrial damage.