Objective To analyze satisfaction of the clinical practice content of nursing postgraduates with different characteristic, and to provide transformative suggestions for the construction of clinical practice scheme of nursing postgraduates. Methods Using judgment sampling and snowball sampling, the questionnaire survey was conducted among 101 nursing postgraduates, and comparing satisfaction of clinical practice content of postgraduates with different age, work experience and teaching mode. SPSS 17.0 software package was used for data description and t test. Results The total satisfaction of clinical practice content of nursing postgraduates was low, and different postgraduates′satisfaction was different. On practical operation opportunity,> 30 years old of postgraduates′satisfaction was (3.95±0.87), which was higher than those 20~30 years old, (3.35±0.90), and the difference was statistically significant, t=2.748, P<0.01. On clinical practice assessment methods and frequency, the satisfaction of postgraduates with a fixed teacher was higher than those without a fixed teacher (3.40±0.74) vs. (2.83±0.87), and the difference was statistically significant, t=3.310, P<0.01. Conclusions At present, the clinical practice content of nursing postgraduates is in shortage, and need to be further improved.

OBJECTIVE: To analyze the features of orbital fracture and to discuss its forensic expertise points. METHODS: One hundred and thirty cases of simple orbital fracture from 2010 to 2012 collected from one public security bureau were retrospectively analyzed such as age, gender, tools, position and morphology of the fracture, periorbital and orbital compound injury and the follow-up results after 6 months. RESULTS: In the 130 cases, the wounded were mainly young men and hit by fist. The fracture of simple medial orbital wall accounted for up to 81.5% in all cases. In the periorbital and orbital compound injury, laceration and contusion of eyelid and ethmoidal cellules and maxillary sinus always occurred. After 6 months follow-up, there were 30 cases of comminuted fracture remained enophthalmos compared with the uninjured side. CONCLUSION It is inappropriate to judge the fracture of simple medial orbital wall as minor injury. We should judge the degree of simple orbital fracture after the injury is stable. Detailed ophthalmology inspection is necessary for forensic expertise of simple orbital fracture.
Craniocerebral Trauma ; Enophthalmos ; Female ; Fractures, Comminuted/pathology* ; Humans ; Male ; Ophthalmologic Surgical Procedures ; Orbit ; Orbital Fractures/surgery* ; Retrospective Studies ; Severity of Illness Index ; Trauma Severity Indices

Objectives To compare the effect of one-stage revision and two-stage revision for the treatment of culture-negative peripros-thetic joint infection after total hip arthroplasty.Methods A retrospective study was conducted with the clinical data of 41 patients who had chronic periprosthetic joint infection after total hip arthroplasty and then underwent one or two-stage revision surgery from February 2006 to February 2014.The patients were divided into two groups according to different surgical way,namely the 16 patients who received the one-stage revision surgery were regarded as the OSR group,and the other 25 cases who underwent the two-stage revision surgery were regarded as the TSR group.The clinical efficacy of the two surgical way were assessed with Harris Hip score,visual analogue scale (VAS),and rate of infection clearance.Results The average duration of follow up was 29.7 months (9 to 48 months).At the last follow-up,Harris Hip score of TSR group was higher than that of the OSR group,and the difference was statistically significant (P =0.04),and the VAS score of TSR group was lower than that of the OSR group with statistical differences (P =0.02).Additionally,the rate of infection clearance in TSR group was significantly higher than OSR group (P =0.04).Conclusion Culture-negative periprosthetic joint infection can be effectively controled by one or two-stage revision surgery.However,patients got a better prognosis after two-stage revision surgery.

BACKGROUND:Retinoid X receptor (RXR) plays a central role in the regulation of intracellular receptor signaling pathways. The activation of RXR has protective effect on H2O2-induced apoptosis of H9c2 ventricular cells in rats. But the protective effect and mechanism of activating RXR in cardiomyocytes against hypoxia/reoxygenation (H/R)-induced oxidative iniury are stillunclear. METHODS:The model of H/R injury was established through hypoxia for 2 hours and reoxygenation for 4 hours in H9c2 cardiomyocytes of rats. 9-cis-retinoic acid (9-cis RA) was obtained as an RXR agonist, and HX531 as an RXR antagonist. Cultured cardiomyocytes were randomly divided into four groups:sham group, H/R group, H/R+9-cis RA -pretreated group (100 nmol/L 9-cis RA), and H/R+9-cis RA+HX531-pretreated group (2.5 μmol/L HX531). The cellviability was measured by MTT, apoptosis rate of cardiomyocytes by flow cytometry analysis, and mitochondrial membrane potential (ΔΨm) by JC-1 fluorescent probe, and protein expressions of Bcl-2, Bax and cleaved caspase-9 with Western blotting. Allmeasurement data were expressed as mean±standard deviation, and analyzed using one-way ANOVA and the Dunnett test. Differences were considered significant whenP was <0.05. RESULTS:Pretreatment with RXR agonist enhanced cellviability, reduced apoptosis ratio, and stabled ΔΨm. Dot blotting experiments showed that under H/R stress conditions, Bcl-2 protein level decreased, while Bax and cleaved caspase-9 were increased. 9-cis RA administration before H/R stress prevented these effects, but the protective effects of activating RXR on cardiomyocytes against H/R induced oxidative injury were abolished when pretreated with RXR pan-antagonist HX531. CONCLUSION:The activation of RXR has protective effects against H/R injury in H9c2 cardiomyocytes of rats through attenuating signaling pathway of mitochondria apoptosis.

Adult ; Cardiac Catheterization ; instrumentation ; Device Removal ; Heart Septal Defects, Atrial ; therapy ; Humans ; Male ; Retreatment

Objective To investigate the effects of selenium-and zinc-enriched probiotics on the content of selenium and zinc in blood,antioxidation function and intestinal microflora in canine.Method Eight 18-month native canines,female and male in half,were randomly divided into the control and treatment groups on average.The control group received basal diet,the treatment group received basal diet supplemented with 2.0g selenium-and zinc-enriched probiotics everyday.To determine the experimental indices,the samples were collected on D0,D15 and D30,respectively.Results Compared with the control group,on D15,the content of selenium and zinc in blood,blood GPX,serum SOD,T-AOC and the amount of Lactobacillus in the experimental group were significantly increased,while the amount of Escherichia coli significantly decreased,but the serum MDA and the amount of Bifidobacterium,Staphylococcus and Enterococcus had no significant change.On D30,the content of selenium in blood,serum SOD,T-AOC and the amount of Lactobacillus were very significantly increased,while the content of zinc in blood,blood GPX and the amount of Bifidobacterium significantly increased;but serum MDA and the amount of Escherichia coli,Staphylococcus and Enterococcus very significantly decreased.Conclusion Selenium-and zinc-enriched probiotics could increase content of selenium and zinc in blood,enhance antioxidation function,improve and regulate the intestinal microflora.

Objective To evaluate clinical application of the gastrocnemius blood vessles as recevier ones to anastomose with free flaps. Methods From June 2005 to July 2011,twenty adult lower limbs were infused with red glue to observe the origin,streching,branches and communication with other blood vessles of the gastrocnemius blood vessles and to measure their outer diameters and pedicle length. Operations were also simulated on these specimens to make the above chacracters of the vessles clear further.CT images of 16 fresh adult lower limbs were got to observe the effects of obstruction of one side of the gastrocnemius blood vessels to the blood supply of the gastrocnemius muscles. Fifty-two free flaps were transplanted to legs with large defects of skin and soft tissues where the gastrocnemius blood vessles were anastomosed with the flaps to supply artery blood and receive vein blood. Results The main blood vessles of the gastrocnemius muscles were medial and lateral gastrocnemius blood vessles. They both origined from the popliteal arteries and communicated with other blood vessles. The pedicles of the medial gastrocnemius blood vessles were 8.0 -13.8 cm in length which averaged 11.1 cm and their outer diameters were (1.8 ± 0.3) mm when they entered the muscles. The pedicles of the medial gastrocnemius blood vessles were 5.4 - 12.3 cm in length which averaged 8.8 cm.The outer diameters of the two accompanying veins were (1.8 ± 0.3)mm when they entered the muscles.When one gastrocnemius blood vessle were obstructed,the gastrocnemius muscles could got enough blood supply by co mmunicating branches between the obstructed vessle and other blood vessles.All the 52 free flaps survived. Through one to two-years follow-up, the defects cured with no infection and the knees' motions were normal. Conclusions With a long pedicle and wide diameter,the medial or lateral gastrocnemius blood vessle can be a reliable alternative used in free flap transplautation for repairing large defects of skin and soft tissues of seriously injured legs with no other choice of blood vessles, which causes unobvious effects to the blood supply of the legs and can simplify the free flap transplantation.

Objective To evaluate the clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) and pcrcutaneous transhcpatic insertion of biliary stent (PTIBS) for malignant biliary obstruction.Methods PTBD or PTIBS were performed in 56 patients with malignant biliary obstruction, which were aused by hepatic carcinoma (n = 14), biliary duct carcinoma (n = 11), gallbladder carcinoma (n = 5),stomach carcinoma accompanied with metastasis of lymph node (n = 14), carcinoma of ampulla (n = 1 ) or carcinoma of pancreatic head (n = 11 ). The diagnosis was confirmed by ultrasonography, CT or MRI in all patients. The obstructed site was well identified, including high obstruction in 19 patients and lower obstruction in 37 patients. Based on the imaging findings, suitable interventional procedure was employed.Results PTBD or PTIBS were performed successfully in all 56 patients, of them PTBD was adopted in 11,PTIBS in 40 and both PTBD and PTIBS in 5. The serum total bilirubin decreased from (295.65±152.86)μmol/L before the procedure to (151.05 ± 107.36) μmol/L after the procedure, (P < 0.01 ). Postoperative infection could affect the fading of jaundice (P < 0.01 ), but the location of the obstruction carried no relationship with the fading of jaundice (P = 0.063). Conclusion Both PTBD and PTIBS are safe and effective palliative therapies for malignant biliary obstruction, which can markedly relieve patient of jaundice,improve the quality of life and elongate the survival period.

Objective Through clinical observation and research with persistent atrial fibrillation in patients with blood-brain natriuretic peptide ( BNP) level change detection renin, angiotensin Ⅱ, aldosterone, analyze their data, investigate persistent atrial fibrillation ( PAF ) serum brain natriuretic hormone levels change and the relationship between the renin-angiotensin-aldosterone system (RAAS).Methods 80 patients with coronary artery disease in our hospital from December 2013 to October 2015 were selected, randomly divided into experimental principle PAF group (40 cases) and control group ( patients in sinus rhythm,with 40 cases) , BNP, renin, angiotensinⅡ, aldosterone levels were measured in two groups, and left atrial diameter (LAD) measurements.Results Under the same condition of cardiac function, the blood BNP concentration in PAF group was higher than that in control group (P <0.05).The results of the linear regression analysis showed that the correlation coefficient of blood BNP level and AngII concentration in PAF group was 0.301, the correlation coefficient of blood BNP level and LAD indicators in PAF group was 0.373, the concentrations of BNP and RAAS were positively correlated with LVMI, the differences were statistically significant (P<0.05), the blood BNP level was closely related to the level of RAAS in the PAF group (P<0.05).Conclusion Blood BNP concentration was significantly higher in patients with PAF and blood BNP concentration is closely related with the RAAS, LAD indicators, and a positive correlation.

Objective To study the state of doctors' psychological capital in public hospitals,and to analyze the characteristics of such capital,so as to better leverage the capital as a hospital management tool.Methods A quantitative and qualitative research was made on the state of doctors＇ psychological capital.Results The doctors' task-oriented psychological capital scored 4.25,and guanxi-oriented psychological capital 4.41; “modesty and prudence”scored the highest in all dimensions of the doctors' psychological capital,“optimism and hope”lowest; the doctors with different genders,ages,seniority,and monthly average income have a difference in psychological capital.However,no significant difference was found with varying titles,hospital levels,and employment models.Conclusion The doctors were found with a strong psychological capital to cope with stress.Better psychological capital will raise quality of care in practice.