Objective To evaluate the clinical application of high quality for super-selective renal artery embolization (SRAE) in treating bleeding after percutaneous nephrolithotomy (PCNL).Methods 134 patients received percutaneous nephrolithotomy were divided into control group (67 patients) and observation group (67 patients).All of patients with serious bleeding after PCNL were given SRAE in the Second Affiliated Hospital of Kunming Medical College from June 2010 to June 2015.At the same time,we gave high quality nursing to observation group.The patients in control group received routine nursing.The effect of nursing was observed.Results The degree of hematuria disappear of the patients in observation group was higher than that in control group (P＜ 0.05).There were fewer complications in observation group.In the sixth month after discharge,none of them had obvious renal impairment.No recurrence of hematuria,pus kidney and urinary cyst was tested.All cases were satisfied with the treatment.Conclusion It's the key to prevent serious complications and cure successfully with effective and timely supervision and high quality nursing care during the perioperation of SRAE in treating bleeding after PCNL.

Objective To investigate the relationship between CRP, plasminogen activator inhibitor type 1 (PAI-1) levels, PAI-1 gene promoter 4G/5G polymorphism and the type of acute myocardial infarction (ST elevation myocardial infarction, STEMI vs the non-ST elevation Myocardial infarction, NSTEMI). Methods One hundred seventy-six consecutive patients with AMI were included for the study, of whom 60 had STEMI and 56 had NSTEMI, and 60 adults without cardiovascular and cerebrovascular disease were selected as controls. Blood samples were obtained from patients within 6 h of AMI and the plasma PAI-1, CRP, and the gene polymorphism were measured. Results Plasma levels of PAI-1 and CRP were higher in AMI groups, compared those in the control group, and plasma levels of PAI-1 were significantly higher in patients with STEMI compared to those with NSTEMI (80.12ng/ml VS.73.01ng/ml, P <0.01), while CRP levels were not significantly different between patient with STEMI and NSTEMI (3.87±0.79 mg/ml VS.4.01±0.69mg/ml, P>0.05). PAI-1 levels presented a significant correlation with CRP levels in the NSTEMI subjects. However, PAI-1 and CRP levels could explain the lack of a significant relationship between them in control and STEMI subjects.The frequencies of 4G/4G genotype in the AMI group were higher than those in the control group and higher in patient with STEMI than in patient with NSTEMI. Plasma levels of PAI-1 in subjects with 4G/4G genotype were significantly increased as compared to those in subjects with 4G/5G and 5G/5G genotype. Conclusions Plasma PAI-1 levels were associated with different myocardial infarction type, and PAI-1 promoter 4G/5G polymorphisms and CRP may be related to plasma PAI-1 levels.

Professor LI Zhi-dao's acupuncture technique at muscle belly and its clinical experiences for the treatment of arthralgia are introduced. From aspects of TCM, anatomical physiology and sports biomechanics, the theory basis of this technique is explained, while its method is elaborated in details from acupoint selection and manipulation combined with classic medical cases. The acupuncture technique at muscle belly is applied at the muscles which already have pathological changes, avoiding re-stimulation on the pain area. It provides new thinking methods and references for acupuncture to treat arthralgia.
Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Arthralgia ; therapy ; Female ; Humans ; Male ; Middle Aged

Objective To investigate the current status of unintentional injuries among rural children aged 0-12 years in Shaanxi.Methods Using a three-stage stratified random sampling method to study the status of unintentional injuries among 4668 children aged 0-12 years old during the period of 2010 in rural areas of Shaanxi province.Results The overall incidence of injure was 27.3％,with boys as 28.7％ and girls as 25.6％ respectively(x2=5.91,P=0.015).Age differences in unintentional injuries rate were also significant(x2=9.91,P=0.007),with children under 0-3 years old having the highest rate of injuries,followed by 7-12 and 4-6 year-olds.Falls took the leading type of accidence among both sexes and all age groups.Poorer the family economic situation was,higher the incidence of unintentional injuries appeared.Conclusion Falls was the leading cause of unintentional injuries among rural children in Shaanxi province,with age 0-3 year group appeared the highest to suffer unintentional injuries.Unintentional injuries were associated with the economic status of the families.

OBJECTIVETo identify the predictors of prolonged intensive care unit (ICU) stay in patients undergoing aortic arch replacement.

METHODSThe clinical data of 173 consecutive patients undergoing aortic arch replacement requiring deep hypothermic circulatory arrest plus antegrade selective cerebral perfusion were reviewed retrospectively. Patients who had undergone one-stage total or subtotal aortic replacement were excluded. Data collected from records were used to identify univariate and multivariate predictors for prolonged ICU stay, which was defined as longer than 5 days in ICU postoperatively.

RESULTSPatients aged (45.4 +/- 10. 6) years and male accounted for 76.3%. The incidence of prolonged ICU stay was 22.0%. The incidences of postoperative stroke and acute renal failure were 6.4% and 4.6%, respectively. The in-hospital mortality rate was 2.9%. Univariate predictors for prolonged ICU stay included body mass index, preoperative serum creatinine level, emergent surgery, coronary artery bypass grafting at the same time, cardiopulmonary bypass time, myocardial ischemic time, and occurrence of postoperative stroke and/or acute renal failure. Multivariable modeling identified that emergent surgery (odds ratio [95% confidence interval] -3.1 [1.3, 7.6]), cardiopulmonary bypass time longer than 180 min (3.3 [1.4, 8.1]), postoperative stroke (6.9 [1.1, 43.1]) and acute renal failure (14.5 [1.3, 161.6]) were the independent predictors for prolonged ICU stay.

CONCLUSIONSThe incidence of prolonged ICU stay is high after aortic arch replacement. Patients with identified multivariate predictors carry a higher risk of prolonged ICU stay and may benefit from enhanced perioperative protection of brain and kidney.

Aged ; Aorta, Thoracic ; surgery ; Circulatory Arrest, Deep Hypothermia Induced ; Female ; Humans ; Intensive Care Units ; Length of Stay ; statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Risk Factors

Objective To understand the perceived stigma and discrimination and received stigma and discrimination as well as the differences and reasons of them among people living with HIV/AIDS and their family members. Methods 307 people were investigated and 117 of which were HIV/AIDS and the others were their family members. Face to face interview was carried out. Results HIV/AIDS and their family were living in the social environment rounded by stigma and discrimination. Stigma and discrimination could be divided into perceived stigma and discrimination and received stigma and discrimination, and these two kinds of stigma and discrimination were statistically significant different between HIV/AIDS and their family members (t=-12.540, P=0.000) , and the perceived stigma and discrimination was more serious than received stigma and discrimination. The perceived stigma and discrimination were related to their self-efficacy (OR=0.558, P=0.041 ), family APGAR (OR= 0.650, P=0.027), infected with HIV or not (OR= 2.116,P=0.004). The received stigma and discrimination were related to their self-efficacy (OR=0.468,P=0.028), family APGAR (OR=0.427, P=0.000) whether infected by HIV (OR=3.412, P=0.001 ). Conclusion Stigma and discrimination did exist in the environment where HIV/AIDS and their family lived, suggesting that it was necessary to develop a series of policies and measures to fight against stigma and discrimination.

Adolescent ; Adult ; Anxiety ; epidemiology ; Family Relations ; Female ; Humans ; Male ; Students, Medical ; psychology ; Young Adult

OBJECTIVETo observe the efficacy of retention enema with Huchang Jiedu Decoction (, HJD) in treating chronic severe hepatitis B (CSHB).

METHODSSixty patients of CSHB were equally randomized into the treated group and the control group. Both groups were treated with conventional integrative medicine, but to patients in the treated group, retention enema with HJD was given in addition, once every day for 3 weeks. The dominant symptoms, physical signs, and related biochemical indices, as well as the incidence of complications in patients before and after treatment, were observed.

RESULTSGood therapeutic effects were shown in the treated group, with a total effective rate better than that in the control group (83.3% versus 60.0%, P<0.05), superior in terms of lowering alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), globulin (Glb), and endotoxin (ET) levels and increasing prothrombin activity (PTA), total cholesterol (TC), and calcium (Ca) levels, as well as eliminating ascites and preventing hepatic encephalopathy (P<0.05); especially in treating middle/early stage patients with Chinese medicine syndrome differentiated as water-toxin accumulation pattern.

CONCLUSIONRetention enema with HJD is surely effective in treating CSHB, and its primary mechanism may be related to the mitigation of enterogenous endotoxemia.

Adult ; Aged ; Ascites ; metabolism ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Endotoxins ; blood ; Enema ; Female ; Hepatitis B, Chronic ; blood ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome

BACKGROUNDDespite psycho-oncological concerns and studies having thrived these past decades, sparse reports illustrate to what extent Chinese cancer patients are involved and influenced by comorbid mental health problems. To investigate the mental health condition of cancer patient, as well as its possible impacts on prognosis, the first large-scale survey was performed in the west of China.

METHODSFor standardizing and facilitating the assessment of mental illness in inpatients with cancer, a multidisciplinary rating flow was designed and established. On the basis of this system, between May 1st and 31st 2009, 2279 cancer inpatients from nine medical centers received preliminarily screening executed by oncologists using screening scales Mental Health Screening Questionnaire (MHSQ), Zung self-rating depression scales (SDS), Zung self-rating anxiety scale (SAS), and posttraumatic stress disorder checklist-civilian version (PCL-C). Further analyses of the ones screened positively were conducted by psychiatrists applying corresponding symptom-rating scales (HAMA/HAMD/BPRS). We summarized the overall proportion of patients with impaired mental health based on the data acquired from preliminary screening, and then calculated occurrence rates of each clinical syndrome of mental disorder according to symptom conclusions. The impact of comorbid mental illness was evaluated through the follow-up scheduled 1 year later, by comparing the survival rate, progression of disease, and quality of life (QoL) between subgroup patients with or without clinical syndrome of mental disorder.

RESULTSIn preliminary screenings, 26.1% (595/2279) yielded positive results. Further symptom conclusions confirmed 15.8% (359/2279) with clinical syndrome of mental disorder. Regarding specific type of syndrome, the occurrence rates of depression, anxiety, psychotic symptoms, and stress-related disorders were 13.3%, 10.2%, 2.8%, and 1.4%, respectively. Follow-up assessments were successfully performed in 1918 subjects (84.2%). Further analyses indicated that although insignificant influence was observed in terms of 1-year survival rate and disease progression, cancer patients with a clinical syndrome of mental disorder obtained significantly lower levels (P < 0.05) in five domains of QoL (scored by QLQ-C30).

CONCLUSIONIn China, at least 26% of cancer patients experienced impaired mental health, of which 60% already had a detectable clinical syndrome of mental disorder, which could significantly undermine their QoL.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Male ; Mental Disorders ; epidemiology ; Mental Health ; Middle Aged ; Neoplasms ; psychology

Accidents ; statistics & numerical data ; Causality ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Risk Factors ; Rural Population ; Wounds and Injuries ; epidemiology