valuating the unilateral renal function of hydronephresis.

Objective To evaluate the value of MSCT perfusion imaging in assessment of single renal function of hydronephrotic kidney.Methods 64-slice spiral CT perfusion was performed in 36 obstructive nephrohydrosis patients whose split renal glomerular filtration rate(GFR) was measured by SPECT renal dynamic imaging. ①The perfusion parameters of the renal cortex and renal medulla of the hydronephrotic kidney were compared with the normal kidney studied by contrast group. ②The 72 kidneys were divided into normal renal function, mild and severe renal impairment groups according to renal function. Differences between the groups respect to all the mean perfusion parameters of the renal cortex and renal medulla were assesses by ANOVA. ③Using Pearsons correlation test, the correlations between all the mean perfusion parameters of the renal cortex and renal medulla and renal GFR were examined.Results ① The time-density curves of bilateral normal renal cortex and medulla were not symmetric. The mean BF, BV, PS, PBV of renal cortex were (203. 2±44.9)ml·100 ml~(-1)·min~(-1), (27.6±3.9)ml/100 ml, (30.7±6.5)ml·100 ml~(-1)· min~(-1), (46.5±10. 9)ml/100 ml; and the mean BF, BV, PS, PBV of renal medulla were (99.9±24.1)ml·100 ml~(-1)·min~(-1) ,(18. 3±4.3)ml/100 ml, (51.8±12.1)ml · 100 ml~(-1)· min~(-1) , (21.3±3.0)ml/100 ml. The mean perfusion parameters of the cortex and medulla of obstructed kidney were lower compared to that of normal kidney. ②There were significant differences of all the perfusion parameters of the renal cortex and me-dulla between 3 groups (P<0. 05). ③The perfusion parameters of the renal cortex and medulla had positive linear correlation with GFR. The best correlation was the blood flow of the cortex of kidney. The correlation coefficient r=0.852.Conclusions64-slice spiral CT perfusion imaging can quantita-tively evaluate the haemodynamic condition and functional lesion of the kidney, classify the impaired kidney function. The perfusion parameters of the renal cortex and medulla had positive linear correlation with GFR.

Objective To find differential expression proteins in patients with T cell non-Hodgkin’ s lymphoma (T-NHL) by using surface-enhanced laser desorption and ionization time-of-flight mass spectrometry (SELDI-TOF-MS) technique and study their related clinical application value and prospect.Methods Serum protein of 36 T-NHL patients and 30 DLBCL patients were detected by the SELD1-TOF-MS technique and weak cation exchange (wcx-2) chip.Lactate dehydrogenase (LDH) was detected by biochemistry method.Beta2-microglobulin (β2-MG) was detected by enzyme-linked immunesorbent assay (ELISA).The significant different protein spectrometry were analyzed between DLBCL patients and T-NHL patients.The correlation analysis with protein spectrometry,disease staging,LDH and β2-MG were analyzed with Spearman.Results Nine potential candidate proteins,including the peak intensity of M/Z 1142.67,1451.43,1472.49,1512.03,3194.22,3267.41,3933.86,4593.12 and 9182.24,were identified in T-NHL patients.The 9 protein markers had no contact with disease staging of T-NHL (P ＞ 0.05).The protein markers of 4593.12 and 9182.24 were high level in T-NHL patients.LDH in these two protein markers’ positive group [(290.82±29.95) U/L,(283.94±100.94) U/L] was higher than that in negative group [(169.22±55.42) U/L,(169.50±59.25) U/L](t =-3.199,P =0.004; t =-2.378,P =0.026),and LDH was positive correlation with these two protein spectrometry (r =0.265,r =0.178,P ＜ 0.01).There was no statistically significant difference ofβ2-MG between these two protein markers’ positive group and negative group (P ＞ 0.05).The other 7 protein markers were low level in T-NHL patients,and there was no statistically significant difference of LDH and β2-MG in these 7 protein markers (P ＞ 0.05).Conclusion The protein marker of 4593.12 and 9182.24 may be the specific serological markers to identify T-NHL.The combination of these two protein markers and LDH may assess the tumor load,and provide guiding value for clinical treatment.

Objective:To explore the effect of nursing interventions based on individual and family self-management theory (IFSMT) on postoperative rehabilitation of patients undergoing percutaneous transforaminal endoscopic surgery.Methods:A total of 835 patients who underwent percutaneous transforaminal endoscopic surgery in Shanxi Provincial People's Hospital from January 2018 to January 2020 were selected as research objects by the convenient sampling method. According to the random envelope method, patients were divided into the control group ( n=417) and the observation group ( n=418) according to the approximate 1∶1 standard. The control group was given routine nursing intervention, while the observation group was given nursing intervention based on IFSMT on the basis of the control group. The differences in self-management ability, postoperative recovery time, lumbar functional recovery, pain score and postoperative complication rate before and after intervention were compared between the two groups. Results:After intervention, the scores of treatment management, psychological management, life management and knowledge and skill management in the observation group were higher than those before intervention and were higher than those in the control group, and the differences were statistically significant ( P<0.01). The hospitalization days, self-care time and work recovery time of observation group were shorter than those of control group, and the differences were statistically significant ( P<0.01). After intervention, the Oswestry dysfunction index and pain score in the observation group were lower than those before intervention and lower than those in the control group. The treatment score evaluated by the Japanese Orthopedic Association was higher than that before intervention and higher than that of the control group, and the differences were statistically significant ( P<0.01). The incidence of postoperative complications in observation group was lower than that in control group, and the difference was statistically significant ( P<0.05) . Conclusions:IFSMT based nursing intervention for patients undergoing percutaneous foraminal endoscopic surgery is beneficial to postoperative rehabilitation of patients, which is worthy of clinical promotion.

Objective:To explore the effect of pain nursing based on acknowledge, introduce, duration, explanation, thank you (AIDET) communication model on postoperative pain and psychological resilience of patients with tibial fractures.Methods:From January 2019 to April 2021, convenience sampling was used to select 98 patients with tibial fractures from Shanxi Provincial People's Hospital as the study subject. A total of 56 patients who received routine nursing before May 2020 were assigned to the control group, and 42 patients who received pain nursing based on AIDET communication model after May 2020 were assigned to the observation group. All patients received nursing intervention from 12 nurses in the department. The scores of the Self-Rating Anxiety Scale (SAS) , Pittsburgh Sleep Quality Index (PSQI) , Self-Rating Depression Scale (SDS) , and Connor-Davidson Resilience Scale (CD-RISC) , as well as the pain before and after 10 days of intervention between two groups of patients were compared. The ambulation time, hospital stay, and fracture healing time between the two groups of patients were compared.Results:After intervention, the SAS, SDS, and PSQI scores of the observation group were lower than those of the control group ( P<0.05) , while the scores of all dimensions of CD-RISC were higher than those of the control group ( P<0.05) , and the differences were statistically significant. The severity of pain in the observation group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . After follow-up, the ambulation time and fracture healing time in the observation group were shorter than those in the control group with statistical differences ( P<0.05) . Conclusions:AIDET communication model-based pain nursing in patients with tibial fractures can alleviate negative emotions and postoperative pain, and promote postoperative recovery.

Objective Endothelial microparticles (EMPs) are direct indicator of endothelial cell activation or apoptosis,and may also reflect endothelial inflammation,increased coagulation,and vascular tone.The aim of this study is to investigate whether EMPs would be able to evaluate systemic involvement and be a new indicator of disease activity in Beh(c)et's disease (BD).Methods Thirty-nine consecutive BD patients (who fulfilled the modified International Study Group on BD in 1990 or International Criteria for BD in 2006) and 67 age and sex-matched healthy controls were enrolled (Including 37 patients with hypertension and 30 healthy subjects).The plasma levels of EMPs were measured by flow cytometry utilizing specific labels for endothelial MPs (CD31+ and CD42b-).The measurement data of each group were expressed as-x±s,and the comparison data betwen groups were analyzed by independent sample t test and analysis of variance,Spearman/Pearson correlation analysis,P＜0.05 was statistically significant.Results The levels of circulating EMPs (CD31 + and CI42b-) were significantly elevated in the case group compared with the healthy control group and hypertension (F=6.845,P＜0.05).Moreover,BD patients plasma EMPs were positively correlated with active BD (r=0.802,P＜0.05).Vascular involvement in BD patients was higher than in patients without vascular EMPs,t=4.707,P＜0.05.Gastrointestinal involvement in BD patients was more frequent than that in patients without Gastrointestinal involvement,t=2.673,P＜0.05.Conclusion Levels of circulating EMPs are elevatedd in BD patients and correlated with disease activity in BD.Elevated EMPs may be a potential indicator to predict disease activity of BD.The plasma level of EMPs is increased,which indicats increased risk of vascular and digestive tract involvement in BD.

Objective To analyze the correlation of the left common iliac vein(LCIV)diameter and the lower extremity deep venous thrombosis(DVT)by direct multi spiral computed tomography venography(MSCTV).Methods The MSCTV images of 218 patients with lower extremity DVT(DVT group)and the enhanced CT images of 168 patients in the control group were analyzed retrospectively.The diameter of the LCIV was measured and the compression degree was evaluated.Results In the DVT group,the diameter of the LCIV significantly reduced,with an average value of(5.150±2.352)mm.In the control group,the average diameter of the LCIV was(6.401±2.550)mm.The difference between the two groups was statistically significant(Z=-5.453,P＜0.05).The degree of compression in the LCIV was 61％(50％-95％)in the DVT group and 39.6％(0％-73％)in the control group,showed a statistically significant difference(Z=-10.555,P＜0.05).There were statistically significant differences in LCIV diameter between males and females within both DVT and control groups(P＜0.05),and there were no statistically significant differences in LCIV compression degree between males and females within both DVT and control groups(P＞0.05).Regression analysis showed a positive correlation between LCIV diameter and lower extremity DVT.Conclusion The lower extremity MSCTV enables accurate diagnosis of DVT by visualizing compression of the LCIV and quantifying its degree of compression.A reduced diameter of the LCIV is an independent risk factor for lower extremity DVT.

Objective:To retrieve and obtain evidence related to postoperative rehabilitation training of patients with lumbar disc herniation and to summarize the best evidence.Methods:The computer was used to search domestic and foreign guideline networks, evidence-based databases, original research databases and orthopedic related websites for relevant evidence on rehabilitation training for patients with lumbar disc herniation after surgery, including evidence summary, guidelines, expert consensus, systematic review and Meta-analysis. The retrieval time limit was from the establishment of the database to April 30, 2021. The literature quality evaluation, evidence extraction, classification and integration were conducted independently by two researchers, and disagreements were discussed or adjudicated by a third party.Results:A total of 14 articles were included, including 3 evidence summaries, 1 guideline, 6 expert consensuses, and 4 systematic reviews. A total of 13 best evidences of rehabilitation training for patients with lumbar disc herniation after surgery were summarized in 8 categories, including rehabilitation assessment, rehabilitation principle, rehabilitation time, rehabilitation intensity, rehabilitation mode, patient education, rehabilitation psychotherapy and follow-up monitoring.Conclusions:This study can provide evidence-based basis for nursing staff to carry out postoperative rehabilitation guidance, but in clinical practice, physical, psychological and cultural background conditions of patients should be comprehensively assessed, and individualized rehabilitation programs should be formulated for patients based on local medical level and conditions.

Objectives:Analyze the clinical characteristics of patients with primary antiphospholipid syndrome (PAPS) progressing to systemic lupus erythematosus (SLE).Explore the risk factors for the progression from PAPS to SLE.Methods:The clinical data of 262 patients with PAPS enrolled in Peking Union Medical College Hospital from February 2005 to September 2021 were evaluated. Assessments included demographic data, clinical manifestations, laboratory tests (serum levels of complement, anti-nuclear antibodies, anti-double-stranded DNA antibodies), treatment, and outcomes. Kaplan-Meier analysis was used to calculate the prevalence of SLE in patients with PAPS. Univariate Cox regression analysis was employed to identify the risk factors for PAPS progressing to SLE.Results:Among 262 patients with PAPS, 249 had PAPS (PAPS group) and 13 progressed to SLE (5.0%) (PAPS-SLE group). Univariate Cox regression analysis indicated that cardiac valve disease ( HR=6.360), positive anti-double-stranded DNA antibodies ( HR=7.203), low level of complement C3 ( HR=25.715), and low level of complement C4 ( HR=10.466) were risk factors for the progression of PAPS to SLE, whereas arterial thrombotic events ( HR=0.109) were protective factors ( P<0.05 for all). Kaplan-Meier analysis showed that the prevalence of SLE in patients suffering from PAPS with a disease course>10 years was 9%-15%. Hydroxychloroquine treatment had no effect on the occurrence of SLE in patients with PAPS ( HR=0.753, 95% CI 0.231-2.450, P=0.638). Patients with≥2 risk factors had a significantly higher prevalence of SLE compared with those with no or one risk factor (13-year cumulative prevalence of SLE 48.7% vs. 0 vs. 6.2%, P<0.001 for both). Conclusions:PAPS may progress to SLE in some patients. Early onset, cardiac-valve disease, positive anti-dsDNA antibody, and low levels of complement are risk factors for the progression of PAPS to SLE (especially in patients with≥2 risk factors). Whether application of hydroxychloroquine can delay this transition has yet to be demonstrated.