Objective To analyze the falling events using root cause analysis (RCA) in hospitalized elderly patients in order to supply theoretic reference for precaution of falling events.Methods RCA method was used to analyze the root cause against 62 cases of nursing adverse events of hospitalized elderly patients' falling.Results Hospitalized elderly patients' falling is related to various factors such as body,disease,medicine,psychology,environment and so on.The root cause lied in the elderly' physical function decline,risk factors of external environment,unfulfilled health education,and lack of the care and support system for the elderly,among which cerebral infarction belonging to the disease factors accounted for 22.58％ (14/62),which was the highest;next was senile dementia [20.97％ (13/62)].The rates of agents against psychiatric disorders belonging to the medicine factors and no braking of bed pulley and no use of blister light belonging to environmental factors were the lowest,all were 3.23％ (2/62).Conclusions The falling reason of elderly inpatients can be found out by RCA in order to attain the purpose of improving procedure and prevention in advance.

Objective To observe the effect of transcutaneous electrical acupoint stimulation on stress reaction in elderly pa-tients with intravenous patient-controlled analgesia after total hip replacement operation.Methods A total of 60 cases of patients with patient-controlled intravenous analgesia spinal anesthesia after total hip replacement surgery were randomly divided into exper-imental group (n=30)and the control group (n=30).The experimental group respectively at the completion of surgery,postopera-tive 4,24,48 h was treated by transcutaneous electrical acupoint stimulation.The serum cortisol and blood glucose was detected in two groups at preoperative 30 min (T1 ),30 min after operation (T2 ),1 d after operation in the morning (T3 ),2 d after operation (T4 ).The pain scores,sedation scores,adverse reactions and analgesic dosage were investigated in two groups after operation.Re-sults In the experimental group,cortisol and blood glucose levels increased compared T2 and T1 (P <0.01 ).Compared with the control group,cortisol and blood glucose levels in the experimental group decreased at T3 and T4 (P <0.05 ).Compared with the control group,the VAS scores was significantly different in the experimental group(P < 0.01 ).The side effects in experimental group were significantly lower than those in the control group(P <0.05).After TEAS treatment,the physic liquor consumption and press the number decreased significantly (P < 0.05 ).Conclusion TEAS technology for elderly total hip replacement operation PCIA could effectively inhibit stress,enhance the analgesic effect,reduce or avoid the occurrence of adverse reactions.

Objective To investigate neural correlates of directed forgetting. Methods ERP was recorded from 12 healthy postgraduates while they performed a directed forgetting task based on the item-cueing method. During the study phase, each word was followed by a cue indicated that it need to be remembered, to be forgotten or just to be viewed. During the test phase, subjects were asked to make an old/new recognition response. One-way ANOVA of repeated-measurement and paired comparisons were carried out for the cue factor. Results Both of the accuracy and reaction time of the TBR group were significantly superior to those of the other two groups. No significant behavioral effect was found between the TBF group and the TBV group. In the study phase, statistical parametric mapping of ERP suggested the cue effects were presented in the frontal poles ( 200～300 ms ) and the parietal regions (300～400 ms) ,the left fronto-parietal and the right occipital region (450～700 ms). The difference between the TBF and the TBV was significant in the left parietal area (500～525 ms) and has the significant trend in the right frontal area ( 350～600 ms). In the retrieval phase, the old/new effects of ERP occurred in the left fro-nto-temporal (300～450 ms) for the TBF cue. Conclusions The TBF cue and the TBV cue have the equivalent behavioral performance. During the study period, the activation of the right frontal lobe and the left parietal suggests the active inhibition evoked by the TBF cue. And the TBR cue can enhance the rehearsal function of left hemisphere and improve the memory performance of words. The retrieval of the items of TBF is based on more familiarity and less recollection.

Objective To investigate the retrieval mechanism of prospective memory,spatiotemporal patterns of event-related potentials (ERP) were used to reveal neural correlates of the prospective interference effect. Methods A task of matching two sequential patterns was taken as the ongoing task and the detection of patterns with two salient levels as prospective memory tasks. Experiments were performed in blocks for single ongoing task block and two prospective memory blocks. Results No significant behavioral effect was found for prospective interference [reaction time(ms):control blocks 750.29±161.33,high salience blocks 770.94±174.89,low salience bocks 764.79±174.12,F(1.52,25.82)=0.48,P =0.57 and correction rate(%):control blocks 85.89±8.07,high salience blocks 88.26±7.00,low salience blocks 87.91±7.28,F(1.50,25.57)=2.46,P =0.12].But significant ERP effect was found at bilateral frontal regions from 160 ms to 240 ms for both two prospective memory blocks. Moreover,greater negativity at the right frontal polar region appeared significantly at 360'440 ms for higher salient patterns. Conclusion Prospective memory is retrieved based on strategic monitoring and high salient stimuli may enhance to keep the prospective goal and improve task switching.

ObjectiveTo investigate the point prevalence rate of nosocomial infection and discover the problems in the management of nosocomial infection.MethodsA team of surveyors were trained to collect necessary data of inpatients on a single day. Questionnaires about nosocomial infection cases were filled out and analysed.Results492 patients were investigated, 31 patients developed into nosocomial infection, the point prevalence rate was 6.30%. The point prevalence rate of nosocomial infection in ICU was 57%; The main infectious site was urinary tract. ConclusionThe survey on the point prevalence rate is beneficial to manage nosocomial infection.

With the development of the quality of life, the morbidity of hyperuricemia is increasing year by year. At the same time, it appears that this disease attacks the young people currently. As the study of pathogenesis of hyperuricemia advanced, a series of uric acid transporters were found during this process. Meanwhile, the definition of transporterome was proposed. They were divided into three groups according to the functions: reabsorption proteins, excretion proteins and skeleton proteins. At moment, the drugs for hyperuricmia mainly include uric acid composition inhibitors and uric acid excretion promoters. Since the excretion of uric acid plays a leading role during the process of attack of hyperurecimia, it makes sense to explore Chinese medicines with clear mechanism targeting the transporterome. Therefore, this paper would focus on transporterome and summarize the mechanisms of Chinese medicines in treating hyperuricemia.
Animals ; Biological Transport ; Carrier Proteins ; antagonists & inhibitors ; genetics ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hyperuricemia ; drug therapy ; metabolism ; Uric Acid ; metabolism

Asian Continental Ancestry Group ; Databases as Topic ; Humans ; Injury Severity Score ; Maxillofacial Injuries

Ethmoid Bone ; injuries ; Facial Bones ; injuries ; Humans ; Nasal Bone ; injuries ; Orbital Fractures ; surgery ; Osteogenesis, Distraction ; Skull Fractures ; surgery

Objective To explore the clinical significance of mycoplasma pneumoniae(MP) antibody IgM positive with high titers.Methods Two hundred and sixty-seven cases of respiratory tract infections of MP with MP-IgM positive were confirmed in our hospital during Jun.2005 to Aug.2008,of which 63 cases with significantly increased titers of MP-IgM antibodies(MP-IgM≥1:1 280).A prospective observation and later analysis of the clinical manifestations of the 63 cases were carried out.Results 1.Among 63 cases,6 cases were diagnosed as upper respiratory tract infection,12 cases as acute bronchitis and 45 cases as pneumonia,respectively.2.The 63 cases pre-sented mainly with fever and cough,of them 59 cases had fever and 45 cases with paroxysmal cough,39 cases could be found crackles on physical examination.3.Extrapulmonary manifestations could be found in many cases,including heart complications in 21 cases,abnormal liver functions in 35 cases,gastrointestinal manifestations in 22 cases,neurological manifestations in 1 case,dermatological disorders in 7 cases and renal manifestations in 3 cases.4.Patterns of chest X-ray findings of the 63 cases with MP infections were varied,of which 45 cases showed pulmonary abnormality.Chest X-ray findings of the 45 children included 12 cases with interstitial infiltration,6 cases with lobar condensation,15 cases with patch shadows,4 cases with enlarged porta pulmonis and 8 cases with reticulonodular infiltrates.Three cases were complicated with pleural effusion and 2 children with segmental atelectasis.5.The cases were given azithromycin,10 mg/(kg?d),a daily dose for 5 days and intermitted for 4 days.All cases repeated the treatment courses for 1 to 4 times.The mean duration of fever was 6.6 days,cough could last 11.7 days and the crackles on physical examination could not be found 7.5 days later after treatment.The abnormality of chest X-ray findings dissolved in 38 cases 2-3 weeks later after treatment.Conclusions Cases of MP infections with high titers of MP-IgM positive had severe symptoms,of which more than 90% patients presenting with lower respiratory tract infections,mainly with pneumonia.Recovery of chest radiological finding was posterior to clinical improvement,so timely and regular chest X-ray examinations were essential after treatment and could avoid the false ceasing of treatment of the cases.Patients of MP infections with high titers of IgM antibodies positive have good prognosis.

Objective To explore influential factors and features of relapse of presenting with an initial episode of acute central nervous system inflammatory demyelinating disease(IDDCNS) in children.Methods By group-control study,20 relapsing patients with IDDCNS compared with 50 single episoding patients with IDDCNS whose case history longer than 0.5 year,whose age at onset,gender,preceding infection or immunization,neurologic syndromes at presentation,therapeutic response,and final neurologic outcome after initial episode were analyzed by mono-factor analysis and multi-factor nonconditional Logistic regression model.Results 1.The risk of relapse increased in the near future,75.0% relapsed before 6 months.There were 18 cases diagnosed multiple sclerosis(MS),1 case neurooptic myelitis and 1 case immaturity myelitis in relapsing patients.There were 39 cases diagnosed acute disseminated encephalomyelitis in single episoding patients.2.Mono-factor analysis:8 factors were not statistically significant,including age at onset,gender,seizure,palsy,conscious disturbance,ataxia,natural relief,sequelae after the first attack;6 factors were statistically significant,including infectious or vaccination agents before episode,fever,visual disorder,multiple neurological signs,positive pathologic reflex,with marked improvement to cortical hormone.3.In the multi-factor stepwise regression analysis,visual disorder(OR=42.50)and positive pathologic reflex(OR=8.666)were the independent influencing factors,multiple neurological signs(OR=0.068)was independent protecting factor.Conclusions The rate of relapse in IDDCNS is lower than abroad and most relapse before 0.5 year,the main diagnosis of relapsing case is MS.When visual disorder and positive pathologic reflex presenting in the fist episode of IDDCNS,the opportunity of relapse will increase,and will decrease when multiple neurological signs presenting.