Objective In this paper,we aimed at discussing the impacts of follow-up nursing on treatment compliance and lung function of patients with chronic obstructive pulmonary disease(COPD)during the rehabilitation period after discharge.Methods COPD patients(68 cases)were divided randomly into the intervention group and the control group with 34 cases in each group.We gave the intervention group follow-up nursins during the ensuing 6 months after discharge to give them guidance on health problems in order to promote the treatment compliance of patients.On the contrary,the control group did not take any follow-up nursing.Six months later,we conducted an evaluation of the tmalment compliance and amelioration of lung function in the t wo groups.Results As a result,six months after discharge,the patients'treatment compliance status and lung-function indicators in the intervention group were significantly better than those of the control group(P＜0.01).Conclusions The follow-up nursingcan promote the COPD patients'treatment compliance status and amelioration of lung function during the rehabilitation period.

Objective To investigate the effects of minocycline,a selective microglia inhibitor on dorsal GABAB receptor expression in the spinal cord in a rat model of neuropathic pain and the possible mechanism.Methods Forty-eight male SD rats weighing 220-260 g were used in this study.Neuropathic pain was induced by ligation of L5 spinal nerve(SNL).The animals were randomly divided into 4 groups(n=12 each):Ⅰ sham operation;Ⅱ SNL;Ⅲ sham operation+intrathecal(IT)minocycline 50 μg;IV SNL+IT minecycline 50 μg.Paw withdrawal threshold to von Frey hair stimulation was measured before operation(baseline)and at post-surgery days 1,2,4,6,8,10,12,14,16,18 in 6 animals in each group.The GABABR2 expression in dorsal horn of spinal cord was detected by Western blot at the time point when paw withdrawal threshold to mechanical stimulation was the lowest in another six animals which did not undergo yon Frey hair stimulation test.Results The paw withdrawal threshold to mechanical stimuli and the GABABR2 expression in the dorsal horn of spinal cord were significantly lower in SNL group than in sham operation group.The decreased paw withdrawal threshold to von Frey hair stimulation and the down-regulated GABABR2 expression in the spinal cord induced by SNL were ameliorated by intrathecal administration of micmglia inhibitor- minocycline in group Ⅳ.Conclusion The mechanism of neuropathic pain mediated by microglia activation may be related to the inhibition of GABAB receptor activation.

OBJECTIVE:To establish a HPLC method for the determination of levofloxacin hydrochloride in the levoflo_ xacin hydrochloride ointment.METHODS:The chromatographic column was C 18 ,the mobile phase was consisted of0.05mol/L citric acid-acetonitrile(85∶15)with detection wavelength at293nm and flow speed at1.0ml/min,the column temperature was40℃and the sample size was10?l.RESULTS:Good linear relation was achieved when the levofloxacin hydrochloride concen-tration was at the range of3.88～37.88ug/ml(r=0.9998);The average recovery was99.4%(n=9).CONCLUSION:This determination method is accurate,reliable and it can act as an effective quality control for levofloxacin hydrochloride ointment.

Objective To observe the effect of moxibustion on the blood lipid and hemorheology in senile patients with coronary heart disease (CHD) due to heart blood stagnation who underwent interventional treatment.Method A hundred senile CHD patients were randomized into a treatment group and a control group, 50 cases in each group. The control group was intervened by conventional medications, while the treatment group was additionally by thunder-fire moxibustion. The blood lipid and hemorheology were observed before the treatment and after 3 treatment courses.Result The blood lipid parameters (including CHO, TG, HDL-C and LDL-C) were changed significantly in the treatment group after the intervention (P<0.05). The CHO, TG, and LDL-C levels of the treatment group were significantly different from that of the control group (P<0.05). The hemorheology parameters (whole blood viscosities at a high-, middle-, and low-shear rate, and fibrinogen) were significantly changed in the treatment group after the intervention (P<0.05). The whole blood viscosities at a high-, middle-, and low-shear of the treatment group were markedly different from that of the control group (P<0.05).Conclusion Thunder-fire moxibustion can down-regulate the blood lipid and blood viscosity of CHD patients undergone interventional treatment, and thus improve myocardial ischemia.

In order to set up a base for stem cells to be widely used in clinical medicine, we tried to optimize, in this study, the technique that induces human mesenchymal stem cells (hMSCs) to differentiate into neural stem cells by using cerebrospinal fluid (CSF) from the different groups. After the induction, presence of neural stem cells was confirmed with microscope observation, flow cytometry analysis, immunohistochemistry and fluorescent immunohistochemistry. At the same time, we also compared and analysed the data of the number of stem cells when it totally met the requirements for clinical treatment and the days required. At last, we confirmed that hMSCs could be induced to differentiate into neural stem cells, and that the number of cells totally met the requirements for clinical treatment. But there were some differences both in the number of cells and the days required. Among the groups, the group that marrow mesenchymal stem cells from patients own induced by CSF from healthy volunteers used the shortest time and the quantity of the cells was significantly higher than those of the others.
Cell Differentiation ; Cerebrospinal Fluid ; chemistry ; Culture Media ; chemistry ; Flow Cytometry ; Humans ; Immunohistochemistry ; Mesenchymal Stromal Cells ; cytology ; Neural Stem Cells ; cytology

Objective To evaluate effectiveness of peripheral Mohs micrographic surgery for the treatment of extramammary Paget′s disease (EMPD). Methods A total of 28 patients with EMPD were treated with peripheral Mohs micrographic surgery. The depth and extent of tumor infiltration were evaluated before the surgery. One day before the surgery, 20% aminolevulinic acid hydrochloride was topically applied to determine and label surgical margins under a Wood′s lamp. After fluorescence-based localization, peritumoral skin tissues were resected and underwent frozen-section examination according to the protocol for Mohs micrographic surgery. Meanwhile, the tumor was resected. After surgery, patients were followed up every 3 - 6 months to detect local recurrence and metastasis. Results Of the 28 patients, 25 were male and 3 were female. Six patients each underwent 3 sessions of frozen-section examination, and 12 patients each received 2 sessions, with an average of 1.86 sessions for each patient. During the follow-up for 5 - 72 months, local recurrence occurred in 3 cases, and 1 patient died of tumor metastasis and uremia after 2 years of follow-up. Conclusion Peripheral Mohs micrographic surgery is a time-saving and effective treatment for EMPD.

Objective To evaluate the diagnostic value of invasive cardiac catheterization for restrictive cardiomyopathy (RCM) and constrictive pericarditis (CP).Methods Twenty-seven children with CP or RCM hospitalized in Department of Cardiology,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiaotong University from February 2002 to December 2015,were selected,including 10 patients who had been surgically documented CP and 17 patients with RCM who underwent cardiac catheterization.Intracardiac pressure waveforms were recorded and all the measurement indexes of pressure of all the patients were analyzed.The changes of cardiac pressure under deep breathing in 9 patients with local anesthesia was recorded.Results There were significant differences in pulmonary artery pressure,difference between left ventricular end-diastolic pressure (LVEDP) and right ventricular end-diastolic pressure (RVEDP),and the ratio of RVEDP/right ventricular systolic pressure between group RCM and group CP [(50.2 ± 12.0) mmHg(1 mmHg =0.133 kPa) vs.(38.1 ±6.8) mmHg,(7.8±5.5) mmHgvs.(1.8 ±4.7) mmHg,0.27 ±0.10vs.0.45 ± 0.20,respectively;t =2.912,2.787,2.418,all P ＜ 0.05].However,there was overlapping for these criteria,and the predictive sensitivity of any of the criteria was less than 66.7％.In patients with CP,reciprocal changes in the filling between right ventricle and left ventricle occurred during respiration.In patients with RCM,the right ventricle and left ventricle pressures moved concordantly with respiration.The systolic area index was greater in group CP than that in group RCM (1.20 ± 0.03 vs.0.70 ± 0.14),and the difference was significant (t =6.152,P ＜ 0.01).The systolic area index had a sensitivity of 100.0％ and a predictive accuracy of 100.0％ for the identification of patients with surgically proven CP.Conclusions Measurements in catheterization,especially the ratio of right ventricular to left ventricular systolic area during inspiration and expiration is a reliable catheterization criterion for differentiating CP from RCM.

Objective Patients with single-ventricle physiology pose a wide variety of therapeutic challenges.Pulmonary artery or anastomosis stenosis in single-ventricle physiology will have only subtle hemodynamic derangements due to the lack of the pumping chamber to force blood across the stenosis.This study aimed to evaluate the feasibility and usefulness of the stent implantation for treatment of branch pulmonary artery and anastomosis stenosis in children with univentricular hearts.Methods Retrospective analysis of 8 implanted stents between March 2014 and January 2015 in Shanghai Children's Medical Center.Transthoracic echocardiography,chest roentgenography and electrocardiography were carried out as follow-up studies at the second day after operation and 1,3,6,12 months after the procedure.Results In all of eight patients (6 males and 2 females),5 cases were post-Glenn operation and 3 cases were post-Fontan operation.The median age was 6.6 years (range 4.0-8.5 years).The median weight was 19.5 kg(range 13.8-25.6 kg).9 stents were implanted successfully in all patient,6 in left pulmonary arteries,2 in right pulmonary arteries and 1 in anastomosis.All stents were placed in the target lesion without any complication.The diameter of the narrowed segment improved from (3.63 ± 2.06) mm to (7.89 ± 1.62) mm (P ＜ 0.01).During follow-up no other complication occurred except thrombus in one patient because of discontinuation anticoagulation.Conclusion Branch pulmonary arterial stenosis in single-ventricle patients may often be underestimated due to the low pressure venous system and/or the development of venovenous collaterals bypassing and decompressing the pulmonary circuit.In these patients,even mild stenosis should be treated aggressively,especially in the presence of pleural effusions,pericardial effusions,protein-losing enteropathy and low-output states.Stent implantation is an effective method of treating branch pulmonary artery stenosis.

Objective To explore the effects of application of the new model of evidence-based land humanized nursing in patients with universal pustular psoriasis.Methods Divided 84 patients with universal pustular psoriasis into the experimental group (42 cases) and the control group (42 cases) randomly.Evidence-based questions were raised according to the requests about humanized nursing of patients in the experimental group,and then retrieved and screened literature,sought high-level evidence,combined with previous nursing experience,developed new evidence-based and humanized nursing programs and implemented in the experimental group.The control group used conventional care program.Two weeks after admission,pain,anxiety,depression degree and the complications of two groups were compared.Results Two weeks after admission,the patients with 0 to 5 levels of pain in the experimental group was 0,5,26,7,4 and 0 cases respectively,which in the control group was0,0,0,12,20 and 10 cases respectively,the difference was significant between the two groups (U=6.957,P＜0.01).Anxiety and depression scores in the experimental group was (41.35±4.30) and (42.55±7.71) respectively,which in the control group was (51.31±4.56) and(50.36±6.89) respectively,the difference were significant between the two groups (t=10.540 and 4.893,P＜0.01).Conclusions The new model of evidence-based and humanized nursing can effectively improve the effects of humanized nursing in patients with universal pustular psoriasis.

OBJECTIVEThe Pul-stent is a new cobalt alloys stent, specially licensed for pulmonary artery stenosis. The aim of this study was to investigate the value of the stent implantation as the treatment of postoperative pulmonary artery stenosis.

METHODClinical practice was carried out to evaluate effectiveness, safety and maneuverability of Pul-stent in the defined clinical setting. Transthoracic echocardiography, chest roentgenography and electrocardiography were carried out as follow-up studies at 1 and 3 months after procedures.

RESULTTen patients (7 males and 3 females) received Pul-stent implantation in left or right pulmonary arteries (9 stents in left and 1 stent in right). For 9 cases transcatheter stent implantation was performed and in I case hybrid procedure. The median age was 7. 9 years (range 3. 4 - 13. 7 years). The median weight was 22. 3 kg (range 13 - 32 kg). Among them 6 cases were post surgical repair of tetralogy of Fallot, 2 cases were after Fontan procedures, 1 patient was post surgical repair of pulmonary atresia with ventricular septal defect, and 1 patient had stenosis at Glenn pathway. The pressure gradient at the stenosis decreased from (31. 6 ± 10. 2) mmHg(1 mmHg =0. 133 kPa) to (7. 3 ± 10. 3) mmHg, and the diameter of the narrowest segment increased from (4. 0 ± 2. 3) mm to (9. 6 ± 2. 7) mm, the right ventricle to aortic pressure ratio decreased from 0. 54 to 0. 36, all of these improvements were statistically significant (t = 3. 9, -9. 7, 4. 5; P =0. 008, 0. 000, 0. 004). The total procedure time ranged from 55 to 220 min (median 117 min) , and the fluoroscopy time ranged from 9 to 67 min (median 26 min). There were 2 cases of post-stenting pneumorrhagia. No stent fracture, stent malposition and other severe complications were observed. Initial follow-up of 1 and 3-months showed good results with maintenance of improved caliber of the stented vessel, and the gradient across the stenosis area measured by echocardiography was (32. 0 ± 14. 6) mmHg after 3 months. Compared with before stentifng ((40.6 ± 15. 2) mmHg) and 1 month later ((30. 6 ± 13. 6) mmHg), the difference was not statistically significant (t =2. 2,1. 76; P =0. 07, 0. 10).

CONCLUSIONPul-Stent tracking and delivery was excellent, the initial experience has shown that Pul-stent implantation was effective and safe in treating post-operative branch pulmonary artery stenosis. Further follow-up study should be conducted to make sure whether those good results would be kept constant.

Constriction, Pathologic ; Female ; Follow-Up Studies ; Fontan Procedure ; Humans ; Male ; Postoperative Complications ; Pulmonary Artery ; pathology ; Pulmonary Atresia ; Stents