Objective:To establish nursing quality indicator system for freestanding hemodialysis facilities and identify the weight values of indicators.Methods:With the structure-process-outcome quality model as the framework, the literature analysis method, field survey and semi-structure interview were used to form the indicators item pool. Through Delphi method, experts were consulted for two rounds. The indicator weight was calculated by AHP.Results:The indicator system of this study included 3 primary indicators, 15 secondary indicators and 46 tertiary indicators. Among the primary indicators, the process quality indicator had the largest weight (0.493), followed by the outcome quality indicator (0.310), and the structure quality indicator had the smallest weight (0.196).The process quality were the main evaluation contents. According to the indicator weight, the main manpower allocation (0.131) in secondary indicators had the highest weight, and the proportion of nurses with different hemodialysis work experiences (0.108) in the tertiary indicators had the highest weight.Conclusion:The indicator system of this study is scientific and integrated, which can be used as a nursing quality evaluation tool to verify its practicability in clinical nursing practice.

Objective To investigate the diagnosis and treatment of pancreatic carcinoma with acute and chronic pancreatitis as the initial symptoms.Methods The clinical data of 13 patients with pancreatic carcinoma who were admitted to the First Affiliated Hospital of Dalian Medical University and the Affiliated Central Hospital of Dalian Medical University from January 2003 to June 2014 were retrospectively analyzed.The first symptoms were acute and chronic pancreatitis.Laboratory and imaging examinations were carried out on all the patients,and the treatment plan was designed according to the location and stage of the tumor as well as the patient's wishes.Surgery,radiotherapy,chemotherapy and other symptomatic treatment were selected.All the patients were followed up by telephone interview till July 2014.Results The major symptoms included abdominal pain and lumbodorsal pain (7 patients).Of the 13 patients,1 patient refused to received laboratory examination,and the levels of CA19-9 of the other 12 patients were elevated (the levels of CA19-9 of 11 patients were above 1 × 105 U/L).The levels of carcinoembryonic antigen (CEA) of 5 patients were elevated.Thirteen patients received plain or enhanced abdominal computed tomography (CT),3 received magnetic resonance imaging (MRI) and 3 received sonography.The tumors located at the head of the pancreas wcrc observed in 9 patients,tumors located at the neck of the pancreas was observed in 2 patients,and tumors located at the tail of the pancreas were observed in 2 patients.The sizes of the tumors ranged between 1.7 cm × 1.7 cm and 4.9 cm × 4.8 cm.The common bile duct,intrahepatic bile duct and pancreatic duct of 7 patients were dilated.The superior mesenteric vein of 3 patients were invaded by the tumor.The lymph nodes of 4 patients were swollen,and 3 patients had peritoneal effusion.The results of CT confirmed that 2 patients were with cholecystolithiasis,and the results of magnetic retrograde cholangiopancreatography (MRCP) confirmed that 1 patient had choledocholithiasis.The size of he pancreas of all the patients were increased using ultrasonography,and the main pancreatic ducts of 2 patients were dilated.Ten patients were diagnosed as with advanced pancreatic carcinoma.All the patients were staged by the imaging findings,5 patients belonged to stage Ⅱ and 8 belonged to stage Ⅳ.Two patients underwent pancreaticoduodenectomy,and 1 of them underwent postoperative radiotherapy and chemotherapy,and the other patient underwent palliative biliary enteric anastomosis and gastrojejunostomy.Two patients were treated by chemotherapy and 1 by radiotherapy in the 10 patients who did not received surgery.The rest 7 patients were treated with symptomatic therapy.The pathological results of the 2 patients who underwent pancreaticoduodenectomy were both moderately and poor-differentiated adenocarcinoma,and the size of the tumors were 4.0 cm × 3.0 cm × 2.5 cm and 2.5 cm × 2.0 cm × 1.0 cm.Three patients lost to follow-up among the 13 patients.The survival time of the patients with acute pancreatitis as the initial symptom ranged from 2.0 months to 6.0 months,and the median survival time was 4.5 months.The survival time of the patients with chronic pancreatitis as the initial symptom ranged from 0.5 months to 10.0 months,and the median survival time was 3.0 months.The median survival time of the 4 patients with elevated level of CEA was 3.5 months,and the median time of the 5 patients with normal level of CEA was 5.4 months.All the 10 patients who were followed up died of tumor recurrence and metastasis.Conclusion The clinical presentation of patients with acute and chronic pancreatitis as the initial symptoms is atypical,and it is difficult to achieve early diagnosis.Dynamic monitoring and combined diagnosis with laboratory and imaging examinations will improve the accuracy of diagnosis.Surgery based treatment is the preferred option.

Objective To explorer the effect of midnight-noon ebb-flow of five elements of music therapy on anxiety and depression in type 2 diabetic patients.Methods A total of 60 type 2 diabetic patients with anxiety and depression in our hospital were divided into the experiment group and the control group according to the order of admission,with 30 patients in each group.The control group received routine nursing care and general music therapy.The experiment group received routine nursing care and midnight-noon ebb-flow of five elements of music therapy.After four weeks,the results of the two groups were compared using HAMD and HAMA scales.Result Four weeks after intervention,there was improvements in the two groups ((P＜0.01) and the anxiety and depression levels in the experiment group were significantly improved than those in the control group (P＜0.01).Conclusion The midnight-noon ebb-flow of five elements of music therapy can alleviate the levels of anxiety and depression in patients with type 2 diabetes.

The suitable distribution regions of medicinal clematis armandii in Sichuan province were extracted based on the suitable requirements of clematis armandii,comprehensive analysis and quantification on environmental indicators suitable forclematis armandii,following remote sensing (RS) and GIS spatial analysis,spatial database building and other technologies,extracted land use information.The results showed that regions suitable forclematis armandii were Gulin county,Xuyong county,Baoxing county and Tianquan county and other areas in Sichuan province.Among them,Gulin county and Xuyong county were the main distributed regions,which accounted for 23.2% and 25.4% of the total area,respectively.Through the comparison with the Chinese Materia Medica (CMM) Resource Database,this research result was basically coincided with census data from the Third National CMM.It also showed that RS and GIS technology were suitable for the investigation of suitable area of clematis armandii scientifically and feasibly.It improved the rational use of clematis armandii.It provided supporting information for rational planting of clematis armandii.It also of fered references for monitoring other wild herbs.

P2X7 receptor is a member of ATP-gated non-selective cation channels. P2X7 receptor is widely distributed in vivo, and its expression is always observed to be up-regulated in the pathological inflammatory circumstances. P2X7 receptor has an unusual property of forming membrane pore during prolonged agonist exposure or high concentrations of agonist activation, different from other members of P2X receptors (P2X1-6). Because of this property, P2X7 receptor has been implicated in inflammatory cytokine release, and is closely related to inflammatory diseases. With the wide application of the P2X7-knockout animal model and specific P2X7 receptor antagonists in inflammatory disease research, P2X7 receptor is emerging as a new target for the treatment of inflammatory diseases. This article will review the recent progress regarding the effect of P2X7 receptor on inflammatory diseases and its mechanism.
Animals ; Cytokines ; metabolism ; Disease Models, Animal ; Inflammation ; metabolism ; Purinergic P2X Receptor Antagonists ; pharmacology ; Receptors, Purinergic P2X7 ; metabolism

Objective To explore hemodynamic parameter changes in pulmonary arterial hypertension(PAH)treated by transplantation of bone marrow mesenchymal stem cells(MMSCs)in the experimental rats.Methods MMSCs cells were collected from bone marrow of Sprague-Dawleye(SD)rat's femoral and tibial bones,cultured and passaged in vitro,then stained by Hoechst 33342 fluorescence dye stuff.Ninety healthy male SD rats were randomly divided into 3 groups(n=30):normal control group(group N),MMSCs transplanted group(group M),PAH model group(group H).The rats in the two latter groups were given a single subcutaneous crotaline(50 mg/kg)to establish the model of PAH.The rats of group N were injected respectively a single subcutaneous 9 g/L saline water(6 mL/kg).After 21 days,5?109 L-1 MMSCs cultured in 1 mL phosphate-buffered saline were infused into the rats respectively in group M by sublingual vein and 1 mL L-DMEM was given in group H.The indexalso of right ventricle systolic pressure(RVSP),right ventricle hypertrophy index,arterial blood gas analysis and the changes of small pulmonary blood vessel were observed after 28 days.Results The administration of MMSCs 28 days after PAH nearly completely prevented the increase in RVSP with PAH alone [(32.20?2.32)mmHg vs(48.30?1.56)mmHg P

Notopterygium incisum is the important medicinal materials of the Tibetan-Qiang medical system in China, also one of the rare and endangered medicinal materials in the Plateau areas in the meantime. Taking the planting of in Sichuan province as an example, research on the N. incisum in Sichuan utilize remote sensing and GIS techniques, bind growth environment factor, including height factor, average annual precipitation, average annual temperature, forest information, were chosen according to habitat conditions. And combine field measurement to verify. The results indicate that N. incisum resources in Sichuan province were mainly distributed in the alpine valley and the northwest of the plateau, which suitability distribution areas of 4145 km2 approximately and accounting for 2% of the total area. Suitability areas accounting for more than 2% of the respective total area in Heishui county, Lixian county, Xiaojin county, Kangding county, ect. According to the field investigation and the related document information record, drawn that the suitability distribution based on RS and GIS were corresponded with the actual distribution areas of N. incisum resources. It's feasible to divide the suitability distribution area of N. incisum using RS and GIS, which will provide a scientific basis for a comprehensive investigation of the distribution as well as its rational exploitation and protection.
Apiaceae ; China ; Conservation of Natural Resources ; Geographic Information Systems ; Telemetry

OBJECTIVETo identify the relative factors of recent discovered atrial fibrillation (AF) following isolated coronary artery bypass grafting (CABG).

METHODSClassified the 649 cases undergoing isolated CABG from January 2005 to December 2006 to two groups according to whether AF appeared after operation. Collected the peri-operative data and operative strategy, then analyzed with single-factor analysis and Logistic regression.

RESULTSThe incidence of AF was 8.0% (52 cases), and 84.6% (44 cases) recovered sinus-rhythm leaving hospital. Age, standard European system for cardiac operative risk evaluation (EuroSCORE), ratio of high-operative-risk, left atrium diameter and ratio of left coronary artery dominance were higher in AF group than in non-AF group. Age, eject fraction, left atrium diameter, operative risk evaluation, left coronary artery dominance and anastomosis on right coronary artery were the relative factors of recent discovered AF following isolated CABG. But off-pump operation, prescription of adrenergic beta-antagonists pre-operatively and degree of coronary artery stenosis had no influence to AF.

CONCLUSIONSAF following CABG is a result of common influence by many factors. EuroSCORE might forecast partially the incidence of AF following CABG. Improve the myocardial protection and reduce the surgical damage during operative progress maybe the mostly approach to decrease the incidence of AF following CABG.

Aged ; Atrial Fibrillation ; etiology ; Coronary Artery Bypass ; adverse effects ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications ; Risk Factors

OBJECTIVETo study the humoral immunity reconstitution and its relationship with infection in patients with multiple myeloma (MM) after undergoing autologous hematopoietic stem cell transplantation (auto-HSCT).

METHODSForty-two MM patients undergoing auto-HSCT were included in this study. Peripheral blood were obtained for immunoglobulin detection, including IgG, IgA and IgM before transplantation and 1, 3, 6, 12, 18 and 24 months after transplantation. The time, type, pathogen of infection between 1 and 24 month after transplantation were analyzed.

RESULTSThe level of IgA at 6 month [(0.75±0.59) g/L] after auto-HSCT was lower than that of pre-auto-HSCT [(1.04±0.70) g/L], and reached the level of pre-auto-HSCT at 9 months [(0.99±0.52) g/L] after auto-HSCT. The level of IgM reached the level of pre-auto-HSCT [(0.45±0.26) g/L] at 3 months after auto-ASCT [(0.50±0.26) g/L]. The level of IgG reached the level of pre-auto-HSCT [(9.80±2.98) g/L] at 1 month after auto-HSCT [(11.09±2.69) g/L], and higher than that of pre-auto-HSCT at 9 months after auto-HSCT [(12.07±3.57) g/L]. The level of IgG with IgG-type MM was higher than that of patients with light-chain type and IgD-type MM at 6, 9 and 12 months after auto-HSCT. The IgA level of patients who obtained complete remission (CR) is much higher than that of patients who obtained nCR in IgG-type patients. The incidence of infection in 6 month after auto-HSCT was higher than that of (6-12) month and >12 month after auto-HSCT. The incidence of infection was strongly negative correlated with IgA (r =-0.943, P=0.005) and IgG (r=-0.943, P=0.005) level. The frequency of viral infection was also negatively correlated with IgA and IgG.

CONCLUSIONThe reconstitution time of IgG, IgA and IgM was different in MM patients after auto-HSCT. IgG recovered first, then IgM, and IgM the last. The incidence of infection was negatively correlated with IgA and IgG. With the recovery of IgG and IgA, the incidence of infection was decreased accordingly.

Adult ; Aged ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunity, Humoral ; Male ; Middle Aged ; Multiple Myeloma ; immunology ; therapy ; Transplantation, Autologous ; Virus Diseases ; immunology

Aneurysm ; pathology ; Aneurysm, Dissecting ; diagnosis ; Cardiovascular Abnormalities ; pathology ; Deglutition Disorders ; pathology ; Humans ; Male ; Middle Aged ; Subclavian Artery ; abnormalities ; pathology