Objective To investigate the effects of penehyclidine hydrochloride (PHCD) on acute lung injury (ALI) induced by blunt chest trauma and Toll-like receptor 4 (TLR4) expression in the lung tissues in rats.Methods Ninety-six male SD rats weighing 250-300 g were randomly divided into 3 groups ( n = 32 each):control group (group C), ALI group and PHCD group. ALI was induced by dropping a 300 g weight onto a precordial protective shield to direct the impact force away from the heart and toward the lungs in anesthetized rats according to the method described by Raghavendran et al. PHCD 2 mg/kg was injected intraperitoneally immediately after ALI was induced in group PHCD. Eight rats were selected at 2, 8, 12 and 24 h after ALI was induced, and arterial blood samples were collected for determination of the serum TNF-α concentration. Eight rats were selected at 8 h after ALI was induced, arterial blood samples collected for blood gas analysis and then the rats sacrificed. The lungs were immediately removed for determination of W/D lung weight ratio, myeloperoxidase (MPO) activity and TLR4 expression, and microscopic examination. Results The pH value and PaO2 were significantly lower, and the PaCO2, lactic acid level, MPO activity, W/D ratio, TLR4 expression and serum TNF-α concentration higher in groups ALI and PHCD than in group C (P ＜ 0.01 ). The pH value and PaO2 were significantly higher, and the PaCO2, lactic acid level, MPO activity, W/D ratio, TLR4 expression and serum TNF-α concentration lower in group PHCD than in group ALI ( P ＜ 0.05). The lung histopathologic damage was significantly ameliorated in PHCD group as compared with ALI group. Conclusion PHCD can protect the lungs against blunt chest trauma-induced ALI, and the down-regulation of TLR4 expression in lung tissues and reduction of inflammatory response are involved in the mechanism.

Objective To investigate the effect of penehyclidine hydrochloride on the cell apoptosis in lung tissues in a rat model of traumatic acute lung injury (ALI) .Methods Fifty-four SD rats weighing 225-275 kg were randomly divided into 3 groups ( n = 18 each) : control group (group C) , ALI group, penehyclidine hydrochloride group ( group P) . Traumatic ALI was induced by dropping a self-made impact device on the chest of anesthetized rats according to the technique described by Raghavendran et al. Intraperitoneal penehyclidine hydrochloride 2 mg/kg was injected immediately after blunt chest trauma and at 12 h after blunt chest trauma in group P. Six rats in each group were sacrificed at 3, 12 and 24 h after blunt chest trauma and the lung tissues collected for microscopic examination and determination of cell apoptosis (by TUNEL) and expression of Bax and Bcl-2 (by immuno-histochemical staining) . The apoptosis index was calculated. Results The apoptosis index and expression of Bax and Bcl-2 were significantly higher, while the ratio of Bcl-2/Bax was significantly lower at each time point in groups ALI and P than in group C ( P ＜ 0.05) . The apoptosis index and Bax expression were significantly lower,while the Bcl-2 expression and ratio of Bcl-2/ Bax higher at each time point in group P than in group ALI.The microscopic examination showed that penehyclidine hydrochloride injection significantly attenuated the pathologic changes. Conclusion Penehyclidine hydrochloride can reduce the traumatic ALI through inhibiting the cell apoptosis in rat lung tissues.

Objective To explore a novel strategy to repair traumatic soft tissue defects in the head and face by tissue expansion in the early stage.Methods Eighteen patients with traumatic soft tissue defects were treated with thorough debridement leaving the wound unclosed or simply closed with thin split-thickness scalp skin grafting,and adjacent expander implantation in the early stage and expanded flap transposition in the second stage.Results There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years [mean,(19.4±12.2) years],with average 15 months follow-up (range,3-67 months).The average expansion time was 74.3 days (range,53-96 days).The total of 18 patients with 22 expanders were treated with satisfactory results.All the flaps survived and the skin color,texture and contour well matched to those of the peripheral tissue.Only one complication of infection happened in the 18 cases (5.56％) and total 22 expanders (4.55％),which was similar to the rate reported in the literature.There were no any other complications related to the expander.Conclusions Debridement and tissue expansion in the early stage have been proved a more effective strategy to repair traumatic soft tissue defects in the head and face,which can not only achieve satisfactory color,unbulky and well matched texture similar to normal,but also can avoid unnecessary donor site injuries and does not increase the infection rate of tissue expansion.

Patients undergoing elective coronary artery bypass grafting may experience the further decline in physical function while they wait for surgery, affecting the prognosis of the disease. Pre-rehabilitation refers to surgical nursing that is performed before a patient has undergone surgery, even before admission to the hospital, including exercise, nutrition, and psychology. It has been carried out in some areas abroad and in China. This article reviews the implementation methods, effects and applications of strength training-based pre-rehabilitation in patients with coronary artery bypass grafting, so as to provide a theoretical basis for Chinese medical and nursing staff to carry out pre-rehabilitation.

Cytokinesis ; Humans ; Lymphocytes ; pathology ; Micronucleus Tests ; Neoplasms ; genetics ; Risk Factors

OBJECTIVE: To investigate the effect Pinggan Qianyang recipe on expression of Tpx, HSP27 and ANXA1 in the hypothalamus of spontaneously hypertensive rats (SHRs) with the hyperactivity of liver-YANG syndrome. METHODS: A total of 30 SHRs were subjected to administration of Aconiti Praeparatae Decoction to establish the model of SHR with liver-YANG hyperactivity first, then they were randomly divided into three groups: the control group, the model group and the treatment group (n=10 per group). A total of 10 SD rats were served as the normal group. The rats in control group and treatment group were given Enalapril plus Pinggan Qianyang recipe for four weeks. The change of behavior and blood pressure of rats were monitored. RT-PCR and Western-blot were performed to detect the expression of Tpx II, HSP27 and ANXA1 mRNA and protein in the hypothalamus, respectively. RESULTS: Compared with the normal SD rats, the heart rate, blood pressure and grade of irritability were significantly increased while rotation endurance time was dramatically reduced in the SHR model with liver-YANG hyperactivity (P<0.01), these changes were reversed by the application of Enalapril plus Pinggan Qianyang recipe. Compared with the normal SD rats, the protein and mRNA expression of Tpx II and ANXA1 in the model group were significantly upregulated (P<0.01) while the HSP27 was significantly downregulated (P<0.01). Compared with the model group, the protein and mRNA expression of Tpx II and ANXA1 in the control group or treatment group were significantly decreased (P<0.05 or P<0.01) while HSP27 was significantly increased (P<0.05 or P<0.01). Compared with the control group, the expression of Tpx II and ANXA1 protein in treatment group were significantly reduced (P<0.05 or P<0.01). CONCLUSION Pinggan Qianyang recipe can improve the blood pressure and behavior in SHRs with hyperactivity of Liver-YANG syndrome, which might be related to the regulation of Tpx, HSP27 and ANXA1 expression in hypothalamuses.
Animals ; Annexin A1 ; metabolism ; Blood Pressure ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Enalapril ; pharmacology ; HSP27 Heat-Shock Proteins ; metabolism ; Hypothalamus ; drug effects ; metabolism ; Liver ; physiopathology ; Rats ; Rats, Inbred SHR

Objective To explore the effects of the three-step sputum elimination on preventing pulmonary complications in patients with burns complicated with severe inhalation injury. Methods Totally 81 patients with burns complicated with severe inhalation injury who received artificial airway between April 2015 and April 2016 were selected as a control group who received conventional nursing, while another 72 patients with burns complicated with severe inhalation injury who received artificial airway from May 2016 to April 2017 were selected as an observation group who received pulmonary nursing with the three-step sputum elimination, namely, 1) sufficient and effective airway humidification, 2) standardized beating procedure, and 3) effective catherization. The number of days with indwelling cannula and the incidence of pulmonary infection between the patients in the two groups were then observed. Results Totally 13 patients in the observation group (18.06%) and 49 patients in the control group (60.49%) showed pulmonary infection (χ2=7.826, P<0.01). The number of days with indwelling cannula of the patients in the observation group, (14.02±1.21) d, was shorter than that of the patients in the control group, [(19.04±1.63) d, (t=3.563, P<0.05)]. Conclusions The key to treatment of patients with burns complicated with severe inhalation injury lies in effective measures taken to eliminate airway obstruction and ensure airway patency in patients. Enhanced management of artificial airway, correct and effective sputum elimination and early wound treatment can improve clinical efficacy and reduce the incidence of pulmonary infection.

Objective? To explore the effects of mindfulness-based stress reduction on post-traumatic growth and quality of life among postoperative breast cancer patients. Methods? From June 2017 to December 2017, we selected 112 postoperative breast cancer patients of breast department at a classⅢ grade A cancer hospital in He'nan Province as subjects by convenience sampling. All of the patients were divided into control group and observation group with the method of random number table, 56 cases in each group. Control group adopted routine nursing intervention. On the basis of routine nursing, observation group carried out mindfulness-based stress reduction for 8 weeks. The intervention effects were evaluated with the Posttraumatic Growth Inventory (PTGI) and the Functional Assessment of Cancer Therapy-Breast (FACT-B). Results? Before intervention, there were no statistical differences in the total score and dimension scores of PTGI of patients between two groups (P＞ 0.05). After intervention, the total score and dimension scores of PTGI of patients in observation group were higher than those in control group with statistical differences (P＜0.01). Before intervention, there were also no statistical differences in the total score and dimension scores of life quality of patients between two groups (P＞0.05). After intervention, the total score and dimension scores of life quality of patients in observation group were higher than those in control group with statistical differences (P＜0.01). Conclusions? Mindfulness-based stress reduction can improve post-traumatic growth and quality of life among postoperative breast cancer patients.

Objective We aimed to explore the clinical efficacy of precise electro-acupuncture stimulation in the pterygopalatine fossa for the treatment of chronic sinusitis.Methods In total,40 patients with chronic sinusitis who visited the Xiyuan Hospital,China Academy of Chinese Medical Sciences between January 2022 and January 2023 were selected.The subjects were randomly divided into two groups:the treatment group(receiving precise electro-acupuncture in the pterygopalatine fossa)and the control group(receiving standard western medical treatment),with 20 cases in each groups.The treatments were administered twice a week for a period of 12 weeks.The effectiveness of the treatments was evaluated through computed tomography(CT)of the sinus changes and the Lund-Mackay scoring system.Results In cases of total opacity and partial opacity,there were significant differences between the two patient groups before and after treatment(P<0.05).Intra-group comparison revealed statistically significant improvements in both groups before and after treatment(P<0.05).The treatment group exhibited significant improvement in various sinus conditions(P<0.05),while in the control group,a significant improvement was only observed in the left maxillary sinus(P<0.05).Inter-group comparison also demonstrated that the treatment group's improvements were superior to those of the control group across multiple indicators(P<0.05).Conclusion The precise electro-acupuncture stimulation technique in the pterygopalatine fossa demonstrated significant therapeutic effects in the treatment of chronic sinusitis,with superior outcomes with respect to radiological changes compared to standard western medicine treatment.

Objective: A graded response system based on pediatric early warning score (PEWS) was constructed to provide a scientific basis for clinical intervention and management by clinical nurses. Methods: Domestic and foreign literature and the results of previous research were reviewed to build a preliminary framework of graded response strategies. Two rounds of expert consultation were conducted by Delphi method and the results were statistically analyzed. Meanwhile, the results were integrated into the electronic medical record system to form the PEWS grading response system. Results: The positive coefficient of experts in the first and second rounds of consultation both were 15/15, and the average of the expert authority coefficient was 0.87 and 0.89 respectively. The expert coordination degree Kendall′s W value was 0.292 and 0.301 respectively (P<0.05), indicating that the experts′ opinions tended to be consistent. Finally, four segmented response systems were formed, with PEWS scored on the scale of 0-1, 2, 3 and 4 or single 3 points. Conclusions The graded response system based on pediatric early warning score constructed by using Delphi expert consultation method can be used in clinic, which can promote the nurses′ participation in clinical intervention decision-making and improve the quality of nursing.