Objective The aim of the study is to explore the efficacy of Carbamazepine with manual massage on grand mal epilepsy.Methods Using a prospective research method,the grand mal epilepsy patients were randomly divided into the experimental group(40 cases)and the control group(40 cases).The experimental group was given manual massage based on oral Carbamazepine treatment.The control group was given oral Carbamazepine treatment.The treatment effect was compared between two groups.Results The curative efficacy of the experimental group was 92.5％,higher than 80.0％ of the control group.Conclusions Carbamazepine with manual massage for treatment of grand mal epilepsy can obviously improve curative efficacy,which is worthy of popularization and application.

Objective To study the diagnosis and treatment of bochdalek′s hernia in children, especially to introduce the methods of repairing the defect of diaphragm using rib-flap and terylene fabric.Methods The diagnosis, misdiagnosis and methods of repairing of diaphragm in 10 cases of bochdalek′s hernia were retrospectively reviewed, and the findings of reconstruction of diaphragm in 2 cases of defect of diaphragm were analyzed.Results All of the 12 cases were misdiagnosed for the first time. Ten cases were cured through abdominal surgery and 2 cases were cured through reconstruction of diaphragm.Conclusions Bochdalek′s hernias in children are lack of specific clinical manifestation and often misdiagnosed before operation. Early surgical treatment is necessary once the diagnosis is established, and the defect of diaphragm should be reconstructed. The repairment of diaphragm using rib-flap and terylene fabric is a practical methods.

Objective To investigate the expression of B-cell activating factor ( BAFF ) and its specific receptor BAFF-R in patients with B-cell non-Hodgkin′s lymphoma ( B-NHL) and to analyze the cor-relations between BAFF and the development of B-NHL.Methods RTQ-PCR and Western blot assay were used to measure the expression of BAFF and its specific receptor BAFF-R in patients with B-NHL.Fluores-cence immunocytochemical staining was used to determine the localization of BAFF and BAFF-R in Raji cells, a B-NHL cell line.The expression of BAFF in tumor tissues from patients with B-NHL of different his-tologic subtypes was measured by immunohistochemistry.WST proliferation and TUNEL assays were used to evaluate the effects of BAFF and BAFF-R on the proliferation, survival rate and apoptosis of Raji cells.Lin-ear correlations between the concentrations of lactate dehydrogenase ( LDH) and the expression of BAFF and BAFF at mRNA and protein levels in patients with B-NHL were analyzed.Results BAFF and its specific receptor BAFF-R were expressed in Raji cells and played an important role in the survival and proliferation of B-NHL cell line.The expression of BAFF in tumor cells from patients with B-NHL varied with the different histologic subtypes of B-NHL.Patients with small B-cell malignant lymphoma, large B-cell lymphoma ( LBCL) , mucosa-associated lymphoid tissue lymphoma ( MALT lymphoma) and follicular lymphoma showed higher levels of BAFF, while those with mantle cell lymphoma showed lower levels of BAFF.Compared with the healthy subjects, patients with B-NHL showed significantly increased expression of BAFF at mRNA and protein levels.The levels of LDH were closely related to the expression of BAFF at mRNA and protein lev-els.Conclusion BAFF and its specific receptor BAFF-R might play an important role in the growth and survival of malignant B cells.

Objective To explore the relations among blood lipid,blood rheology and microcirculation of bulbar conjunctiva of model rats of diabetesⅡwith heart blood stasis syndrome.Methods The rats were fed with high fat and caloric feed.Intraperitoneal injection of streptozotocin(STZ)in small dosage was applied to make the model of diabetesⅡ.Then the model of heart blood stasis syndrome was made through introperitoneal injecting dexamethasone and adrenalin.Eight hours after empty stomach,the rats were anaesthetized to measure the microcireulation of bulbar conjunctiva and test the blood lipid and carotid blood rheology.Results The indices of blood lipid,blood rheology and bulbar eonjunetiva microcirculation of model rats were all changed to abnormal,tallying with the changes of cardiovascular complications of diabetes.

Objective To explore the way of continuing education training of standardized management of community nurses in Tianjin.Methods A survey was conducted with self-designed questionnaires for 462 community nurses who attended the continuing education training,and behavioral event interview was carried out for 6 directors of district health bureau who participated in the continuing education.Results The acquirements and problems of continuing education training of standardized management in Tianjin community nurses were concluded from the data analysis.Conclusions It is necessary to give continuing education training of standardized management for Tianjin community nurses.We should improve the evaluation and feedback system,attach importance to management of teaching time and teaching manner.

Objective:To observe the clinical efficacy of Gao's nape acupuncture plus swallowing training in treating pharyngeal deglutition disorder after stroke.Methods:One hundred patients with post-stroke pharyngeal deglutition disorder were randomized into a treatment group and a control group,with 50 cases in each group.The two groups both received routine neurological intervention.In addition,the treatment group was given Gao's nape acupuncture plus swallowing training,while the control group was intervened by swallowing training alone.After eight-week treatment,the two groups were observed in terms of the changes in repetitive saliva swallowing test (RSST),modified water swallowing test (MWST),standardized swallowing assessment (SSA) and swallowing-related quality of life (SWAL-QOL).The clinical efficacies of the two groups were also compared.Results:After treatment,the RSST grading,and scores of MWST,SSA and SWAL-QOL changed significantly in both groups (P＜0.05 or P＜0.01).The RSST grading,and scores of MWST,SSA and SWAL-QOL in the treatment group were significantly different from those in the control group after treatment (P＜0.05 or P＜0.01).The total effective rate and markedly effective rate were respectively 100.0％ and 72.3％ in the treatment group,versus 97.9％ and 34.0％ in the control group.There was a significant difference in the markedly effective rate between the two groups (P＜0.01).The difference in the clinical efficacy between the two groups was statistically significant (P＜0.01).Conclusion:Gao's nape acupuncture plus swallowing training is an effective approach for post-stroke pharyngeal deglutition disorder.Its therapeutic efficacy is more significant than that of swallowing training alone.

OBJECTIVETo evaluate the clinical characteristics and short-term outcomes of neonatal asymmetric crying facies (ACF), in order to improve recognition of the disease.

METHODSThe clinical data of 11 infants with ACF between January 2010 and February 2012 were retrospectively studied. Physical and neurological development were followed up at correct gestational age 44 weeks and 3 months.

RESULTSOf the 11 infants with ACF, 4 had ipsilateral ear malformation, 2 had congenital heart disease and 1 had syndactyly and polydactyly. Of the 11 infants, 8 were male and 3 were female. Eight infants presented with lesions on the left side and 3 presented with lesions on the right. The fathers were aged over 35 in 8 cases and the mothers were over 30 in 7 cases. Eight mothers had a history of at least 3 pregnancies and 2 infants were born to mothers with diabetes mellitus. Physical index was below P10 in 1 case and 2 cases showed a low NBNA score and mild abnormal GMs (poor repertoire PR) during the writhing period at correct gestational age 44 weeks. Physical index was between P10-P90 and GM assessment during the fidgety period showed normal movements in all infants at correct gestational age 3 months, but they still had ACF.

CONCLUSIONSACF is associated with a high rate of other congenital malformations. The short-term outcomes of ACF infants are satisfactory, but long-term follow-up and interdisciplinary cooperation are necessary to improve prognosis.

Crying ; Facial Paralysis ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Male ; Retrospective Studies

Objective To observe the clinical efficacy of nape acupuncture plus basic treatment and rehabilitation in treating pseudobulbar palsy after cerebral stroke and the relation between the efficacy and age of onset. Method A hundred patients were randomized into an observation group and a control group, 50 cases each. The control group was intervened by basic treatment and swallowing rehabilitation training, and the observation group was intervened by nape acupuncture in addition to the treatment given to the control group, once a day, five sessions a week, for 8 weeks in total. The Repetitive Saliva Swallowing Test (RSST), Water Swallowing Test (WST) and Standardized Swallowing Assessment (SSA) were observed in the two groups before and after the treatment; the relation between the age of onset and the efficacy of the integrated treatment method was also observed. Result The scores of RSST, SSA and WST were significantly improved after the treatment in both groups (P<0.01), and the improvements in the observation group were more significant than those in the control group (P<0.01). The therapeutic efficacy of nape acupuncture plus basic treatment and swallowing rehabilitation training was associated with the age of onset (P<0.05). Conclusion Nape acupuncture plus basic treatment and swallowing training can effectively improve dysphagia in pseudobulbar palsy after cerebral stroke. This method produces the most significant efficacy for patients aged 51-60, better than that for those aged over 60 and equivalent to the efficacy for patients aged 41-50.

OBJECTIVETo compare the effects of different contrast media on the renal function in children, and to investigate the prophylactic efficacy of hydration.

METHODSSixty patients on whom either intravenous pyelography (IVP) or enhanced CT scan was required were divided into high osmolality contrast media (HOCM) group (n = 27) and low osmolality contrast media (LOCM) group (n = 33), and each group was randomly subdivided into hydration group (HG) and non-hydration group (NHG). In HOCM group, HG had 14 cases and NHG had 13 cases; while in LOCM group, HG had 18 cases and NHG had 15 cases. A 1/5-tonic solution at a dose of 20 ml/kg was intravenously given immediately after the exposure to a contrast medium within 3 hours in the HG, while the NHG cases were not given any infusion.

RESULTSThere were no significant difference between HG and NHG in baseline serum creatinin (SCr) and creatinin clearance (Ccr). After exposure, in HOCM group, SCr of NHG (59.71 +/- 12.49) micromol/L significantly increased as compared with baseline (49.91 +/- 6.09) micromol/L (P < 0.05), while Ccr (97.81 +/- 15.10)ml/(min x 1.73 m(2)) decreased compared with baseline (71.33 +/- 7.51) ml/(min x 1.73 m(2)) (P < 0.05). No significant changes of SCr and Ccr were observed in the HG before (48.37 +/- 7.11) micromol/L, (99.81 +/- 15.41) ml/(min x 1.73 m(2)) and after (49.63 +/- 6.84) micromol/L, (88.29 +/- 12.75) ml/(min x 1.73 m(2)) (P > 0.05) the exposure to contrast medium. Contrast medium-associated nephropathy (CAN) was found in 3 cases in NHG (23.1%, 3/13) but none in HG (P > 0.05). In the LOCM group, there was no significant difference in SCr and Ccr before and after the exposure to the contrast media. The incidence of CAN was 6.7% (1/15) in the NHG and 11.1% (2/18) in the HG (P > 0.05). The average increase of SCr in HOCM group was significantly higher than that in LOCM group (Z = -2.42, P < 0.05). The average decrease of Ccr in HOCM group was significantly higher than that in LOCM group (Z = -2.83, P < 0.05). The SCr and Ccr of the 6 CAN cases in both HOCM and LOCM groups returned to baseline level within 2 weeks.

CONCLUSIONS(1) Children can develop reversible CAN after the exposure to high or low osmolality contrast medium. (2) The high osmolality contrast medium seemed to have more serious toxicity in renal function than low osmolality contrast medium. (3) The prophylactic use of hydration can effectively prevent CAN in patients who will expose to high osmolality contrast medium. (4) Children can develop reversible CAN after the exposure to low osmolality contrast medium even after hydration.

Child ; Contrast Media ; adverse effects ; Creatinine ; blood ; Fluid Therapy ; Humans ; Infusions, Intravenous ; Kidney Diseases ; chemically induced ; prevention & control ; Kidney Function Tests ; Osmolar Concentration

Purpose: The purpose of this study was to (1) add relevant contemporary items to develop an assessment instrument for the self-efficacy of clinical nursing teachers, to verify and evaluate the validity and reliability of the instrument, and (2) investigate the self-efficacy of clinical nursing teachers.Method: A cross-sectional study was designed. A total of 205 clinical nursing teachers were recruited in Taiwan. Data were collected using the Clinical Nursing Teacher Self-efficacy Scale. An exploratory factor analysis was performed to examine the scale. Results: The degree of self-efficacy of clinical nursing teachers was moderate to high. The 35-item scale showed great psychometric qualities. The Cronbach coefficient of the overall scale was 0.92; and 0.83, 0.91, 0.93, and 0.87 on the four subscales were acceptable. Four factors were extracted by exploratory factor analysis and explained 68.53% of the total variance. Four factors were (i) teachers' professional growth ability, (ii) teaching ability, (iii) clinical nursing competencies, and (iv) personality traits. The highest self-efficacy category evaluated by teachers was personality traits; the second was clinical nursing competencies; after that, teaching ability and teachers’ professional growth ability. The item with the lowest self-efficacy was foreign language ability (English). Conclusion Clinical nursing teachers have a moderate to high degree of self-efficacy. This scale with good reliability and validity can be used for the training and evaluation of the self-efficacy of clinical nursing teachers.