ObjectiveTo investigate the status of benefit finding in diabetic patients,and mediating effect of resilience between family support and benefit finding in diabetic patients.MethodsFive hundred and thirteen diabetic patients from a hospital of Harbin were recruited as investigative subjects from September 2015 to June 2016.The resilience scale,family adaptability,cohesion scale and benefit finding scale were used in the study.ResultsThe scores of benefit finding,resilience and family adaptability and cohesion were 55.67±12.87,70.65±10.39 and 104.25±15.38,separately.The total score of family adaptability and cohesion was positively related to the total score of benefit finding(r=0.389,P<0.05).The total score of resilience was positively related to the total score of benefit finding(r=0.155,P<0.05).The total score of family adaptability and cohesion was positively related to the total score of resilience(r=0.112,P<0.05).Benefit finding as the dependent variable,the results of hierarchical regression analysis indicated that family adaptability and cohesion (β=0.382,P<0.01),resilience(β=0.098,P<0.01)entered the regression equation.There was a partial mediating effect of resilience between family support and benefit finding in diabetic patients.The mediating effect was 0.011,accounted for 2.8% of the total effect.The resilience was the important protective factor for benefit finding.ConclusionFamily support has a direct influence on benefit finding and an indirect effect mediated by resilience on benefit finding.

Objective To evaluate the efficacy of oxycodone in preventing catheter-related bladder discomfort (CRBD) during recovery from anesthesia in the patients undergoing general anesthesia.Methods A total of 155 male patients, aged 18-60 yr, weighing 46-75 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective spinal surgery performed under general anesthesia, were randomly divided into 3 groups: control group (group C, n =52), oxycodone group (group O, n=51), and sufentanil group (group S, n=52).After induction of anesthesia, the patients were tracheally intubated and mechanically ventilated.At 15 min before the end of surgery, oxycodone 0.07 mg/kg was injected intravenously in group O, sufentanil 0.10 μg/kg was injected intravenously in group S, and the equal volume of normal saline was given in group C.The emergence time and extubation time were recorded.Riker sedation-agitation scale (SAS) score was recorded at 5, 15 and 30 min, and 1, 2 and 4 h after extubation (T1-6).The occurrence and severity of CRBD within 4 h after surgery, and occurrence of nausea and vomiting and respiratory depression were observed and recorded.Results Compared with group C, the SAS score at T1-4 and incidence and severity of CRBD were significantly decreased, and the emergence time and extubation time were prolonged in group S, and the SAS score at T1-6 and incidence and severity of CRBD were significantly decreased (P＜0.05) , and no significant change was found in emergence time and extubation time in group O (P＞0.05).Compared with the group S, the SAS score at T1-4 was significantly increased, the SAS score at T5-6 and incidence and severity of CRBD were decreased, and the emergence time and extubation time were shortened in group O (P＜0.05).There was no significant difference in the incidence of nausea and vomiting and respiratory depression between the three groups (P＞0.05).Conclusion Oxycodone 0.07 mg/kg injected intravenously at 15 min before the end of surgery can prevent the occurrence of CRBD during recovery from anesthesia in the patients undergoing general anesthesia.

OBJECTIVETo investigate the surgical approaches for sinonasal tumors with intracranial extension.

METHODSSeventeen patients with intracranial invasion tumors were treated surgically by maxillectomy combined with frontal or infratemporal approaches in 11 cases, including squamous cell carcinoma 8 cases, papillocarcinoma 2 cases and meningioma 1 case. Nasofrontal bone translocation in 1 case which was a meningioma case, craniofacial approaches in 5 cases, including squamous cell carcinoma 4 cases and esthesioneuroblastoma 1 csae.

RESULTSOne of two meningioma cases with cavernous sinus invasion was incompletely resected, another case was resected en bloc. In malignant group, ten cases were treated by nasomaxillectomy combined with frontal or infratemporal approaches. One patient died 1 year after operation, 7 cases survived for over 3 years, and 5 for over 5 years. Five cases were treated by craniofacial approach, among them, one patient died 6 months after operation, 4 cases survived for over 3 years, and 2 for over 5 years. All patients healed smoothly.

CONCLUSIONSMaxillary nasopyramid translocation combined with frontocranial or infratemporal approach is available for en bloc removal of sinonasal tumors with intracranial extension. The nasofrontal bone translocation is available for removal of tumors with limited intracranial extension and well developed frontal sinus. Cranioanterolateral facial approach is suitable for nasocranial tumors with facial bone involvement.

Brain Neoplasms ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; pathology ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; pathology ; surgery

OBJECTIVETo explore the feasibility and the related surgical techniques of laryngeal function preservation in surgical treatment of pyriform sinus cancer.

METHODSTwo hundred and thirty cases (stage I, 6; stage II, 10; stage III, 91; stage IV, 123) with pyriform sinus cancer were treated surgically from 1978 to 1996 in the Department of Otorhinolaryngology of Qilu Hospital of Shandong University. The methods of removing tumor and repairing surgical defects were depended on the extension of lesions. The laryngeal and pharyngeal functions were rebuilt by normal tissue preserved with lesions entirely removed. One hundred and fifty-eight cases were surgically treated with laryngeal functions preserved and 72 cases total laryngectomy. The most of the cases received postoperative radiotherapy.

RESULTSThe overall 3 and 5 year survival rates were 67.4% (155/230) and 48.3% (111/230) respectively. For stage I, the survival rate was 5/6; stage 11, 70.0% (7/10); stage III, 57.1% (52/91) and stage IV, 38.2% (47/123); the 3 and 5 year survival rates in functionally preserved group were 67.7% (107/158) and 50.0% (79/158), while in none functional group were 66.7% (48/72) and 43.1% (31/72), respectively. 75.3% (119/158) patients have laryngeal functions (voice,respiration and deglutition) completely restored and 24.7% (39/ 158) partially restored(voice and deglutition).

CONCLUSIONSThe preservative surgery is feasible for the selected pyriform sinus cancer cases. Choosing and following optimum surgical methods is a prerequisite for improving the quality of life of the cases.

Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Female ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Larynx ; surgery ; Male ; Middle Aged ; Pharyngectomy ; methods ; Survival Rate ; Treatment Outcome

Objective To explore the effects of homogeneity management on the nursing quality in regional medical consortium. Methods A new nursing command system was established in the regional medical consortium. During October 2014 to October 2016, 45 union hospitals affiliated to Zhengzhou Central Hospital had carried out diversified training, unified culture construction and other measures to achieve homogeneity management, appling PDCA cycle management model all through. Ten nurses and ten patients were randomly selected from each department to conduct the regional medical consortium care status survey and patient satisfaction survey respectively. After two years intervention, the difference of nursing quality and patient satisfaction in the affiliated hospitals of the regional medical consortium were analyzed and compared. Results Compared with those who did not have homogeneity management, the qualified rate of first aid, the pass rate of ward management and patient satisfaction were significantly improved in the affiliated hospitals of the regional medical consortium, and the differences were statistically significant (P< 0.01). Conclusions Nursing homogeneity management can effectively improve the quality of nursing care in the affiliated hospitals of the regional medical consortium, ensure the safety of care and improve patient satisfaction.

Objective:To observe the influence of dabigatran etexilate combined with aspirin+clopidogrel on coagulation function and ankle-brachial index(ABI)in patients with non-valvular atrial fibrillation(NVAF).Methods:A total of 108 NVAF patients who underwent percutaneous coronary intervention(PCI)in Huangshi Fourth Hospital Co.,Ltd be-tween January 2018 and October 2020 were selected,and divided into combined treatment group(n=54,dabigatran etexi-late+aspirin+clopidogrel)and control group(n=54,aspirin+clopidogrel)according to random number table meth-od.After 6-month treatment,coagulation function,toe-brachial index(TBI),ABI,thromboelastography,serum level of matrix metalloproteinase-9(MMP-9),incidence of embolic events,bleeding events and adverse reactions were com-pared between two groups.Results:After treatment,compared with control group,patients in combined treatment group had significant higher activated partial thromboplastin time(APTT)[(45.46±4.27)s vs.(52.38±5.03)s],prothrom-bin time(PT)[(13.14±1.33)svs.(15.32±1.57)s],thrombin time(TT)[(22.67±2.21)s vs.(27.05±3.15)s],TBI[(0.78±0.13)vs.(0.84±0.15)],ABI[(1.11±0.14)vs.(1.18±0.13)],R value[(11.43±3.42)s vs.(14.48±4.51)s],K value[(8.54±2.18)s vs.(10.78±3.26)s]and MA value[(46.06±15.11)mm vs.(55.49±18.26)mm],and significant lower serum MMP-9 level[(182.47±18.84)μg/mlvs.(165.52±14.17)μg/ml](P＜0.05 or＜0.01).Total incidence rates of embolic events(5.56％)and bleeding events(1.85％)in combined treatment group were significantly lower than those of control group(18.52％,14.81％)(P＜0.05 both).There was no significant difference in incidence rate of adverse reactions between two groups(P=0.687).Conclusion:Dabigatran etexilate combined with aspi-rin+clopidogrel can significantly improve coagulation function,reduce embolic events and bleeding events,and reduce ser-um MMP-9 level in NVAF patients without increasing adverse reactions.

OBJECTIVETo explore the concentration-response relationship between ambient concentration of PM2.5 and daily total hospital emergency room visits in Beijing during 2012 and 2013. This study also examined the effects of ambient PM2.5 during heavy polluted days on emergency room visits compared with the light polluted days.

METHODSWe collected the daily meteorological factors monitoring data and concentrations of air pollutants in Beijing during October 1, 2012 to December 31, 2013. We also collected the daily emergency room visits from a tertiary hospital in Beijing in the same time period. Generalized additive model was fitted to estimate the association between the ambient PM2.5 and the hospital emergency room visits, by using the smooth function to adjust long term trend of time, public holidays and day of week. In addition, constrained piecewise linear function was then used to estimate the excess risk for different segment of concentration-response function.

RESULTSThe annual average concentration of PM2.5 was 90.9 µg/m(3) during October 1, 2012 and December 31, 2013. There were total 64 260 cases for total emergency room visits, of which respiratory disease had 9 849 cases and cardiovascular disease had 11 168 cases. PM2.5 was positive related with PM10, NO2 and SO2. The corresponding correlation coefficients were 0.87, 0.78 and 0.62, respectively (P<0.05). And PM2.5 was positively related with relative humidity, with correlation coefficient 0.45 (P<0.05). But PM2.5 was negatively related with mean temperature (r=-0.17, P< 0.05) and wind speed (- 0.32, P<0.05). In the single polluted model, after adjusting the effects of temperature, relative humidity and wind, every 10 µg/m(3) increase of concentration of ambient PM2.5, the corresponding excess risk of daily emergency room visits was 0.25% (95% CI: 0.07-0.43). In the two-pollutant model PM2.5+SO2 and PM2.5+NO2, every 10 µg/m(3) increase of concentration of ambient PM2.5, the corresponding excess risk of daily emergency room visits were 1.07% (95%CI:0.83-1.30) and 0.56% (95%CI: 0.32-0.80) respectively, which were higher than the effect in single pollutant model. Average concentration of ambient particulate matters (PM2.5) was 204.16 µg/m(3) during heavy pollution, higher than control period (85.24 µg/m(3)). When PM2.5 as the primary air pollutants during heavy polluted days, we observed a significant increase in emergency room visits, and the odd ratios was 1.16 (95% CI:1.09-1.22).

CONCLUSIONThere were positive correlation between high concentration of ambient particulate matters (PM2.5) and increasing daily emergency room visits. Especially during the heavy polluted days, the effects of elevated concentration of PM2.5 on hospital emergency room visits were much larger.

Air Pollutants ; analysis ; Beijing ; Cardiovascular Diseases ; diagnosis ; Emergency Service, Hospital ; statistics & numerical data ; Humans ; Meteorological Concepts ; Particulate Matter ; analysis ; Respiratory Tract Diseases ; diagnosis ; Temperature ; Tertiary Care Centers

OBJECTIVETo investigate the differences in semen quality at different times of reanalysis and the correlation of sperm DNA fragmentation index (DFI) with sperm motility alteration using semen samples completely liquefied and normal in initial examination.

METHODSWe analyzed 127 semen samples up to the inclusion criteria with the computer-assisted semen analysis (CASA) system at 15, 30 and 60 min after semen collection, and obtained sperm morphology parameters and DFI by Shorr staining and acridine orange test (AOT) , respectively.

RESULTSSperm concentration, and the percentages of grades a and b sperm showed no statistically significant differences at the three time points (P > 0.05). The percentages of grades a + b and a + b + c sperm were significantly higher at 15 min than at 30 and 60 min after semen collection (P < 0.05), but with no significant difference between the latter two time points (P > 0.05). The incidence of alternation from normal to abnormal in at least one index of sperm motility at different times was 25.2%, but there were no significant differences in sperm DFI and morphology between the normal and abnormal groups (P > 0.05). Among the altered parameters of sperm motility from 15 to 60 min, the percentages of grades a, a + b and a + b + c sperm were all positively correlated with sperm DFI (P < 0.05).

CONCLUSIONSemen samples completely liquefied within 15 min after collection and normal in initial examination, when reanalyzed at 30 and 60 min, showed significant decreases in the percentages of grades a + b and a + b + c sperm, but not in the percentages of grades a and b sperm, and the parameters of sperm motility might be abnormal. Thus, at least 2 sperm analyses are required for a comprehensive evaluation of fertility. Significant difference between the results of the two analyses, and particularly a markedly reduced percentage of rapidly progressive sperm, might indicate sperm DNA damage, and thus the necessity of sperm DNA damage detection.

Adult ; DNA Damage ; DNA Fragmentation ; Diagnosis, Computer-Assisted ; Fertility ; genetics ; Humans ; Male ; Middle Aged ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Young Adult

OBJECTIVETo investigate the indication and effect of the application of Ligasure vessel sealing instrument in laparoscopic hepatectomy for liver cancer.

METHODSEleven patients with liver cancer undergoing laparoscopic hepatectomy were analyzed for the tumor size and location, operation time, volume of intraoperative bleeding, postoperative hospital stay and short-term clinical outcomes.

RESULTSAll the operations were performed successfully in the 11 cases. All the tumors were less than 7 cm in diameter, locating at the segments II, III, V, VI and VII. The mean operation time was 91 min (80-126 min), and the intraoperative blood loss averaged 82 ml (20-200 ml). The average postoperative hospital stay of the patients was 8 days (7-9 days). No complications were observed in these cases.

CONCLUSIONLigasure vessel sealing instrument in laparoscopic hepatectomy is applicable in cases of perimeter liver cancer. This instrument can decrease the operation time, reduce the intraoperative blood loss and postoperative hospital stay with good safety and minimal invasiveness.

Adult ; Aged ; Female ; Hepatectomy ; instrumentation ; methods ; Humans ; Laparoscopy ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Treatment Outcome

This study was aimed to evaluate the efficacy and safety of dasatinib in BCR/ABL positive leukemia patients with primary or secondary resistance to imatinib. 27 patients with primary or secondary imatinib-resistant chronic myelogenous leukemia (CML) or Philadelphia chromosome positive acute lymphocytic leukemia (Ph(+) ALL) received 100 - 140 mg/d dasatinib orally. Their overall survival and tolerance were evaluated. The results showed that the median duration of dasatinib therapy was 8 (1-66) months in the 27 imatinib-resistant BCR/ABL positive leukemia cases, with a median follow-up of 54 (3-75) months. After the dasatinib treatment, 88.8% of all the 27 cases achieved complete hematologic response (CHR), 29.6% of them achieved major cytogenetic response (mCyR), 37% of all achieved complete cytogenetic response (CCyR) and 18.5% cases achieved major molecular response (MMR). Patients who received dasatinib in progress of disease (CML-AP, CML-BC and bone marrow relapse Ph(+) ALL) had a lower CCyR rate than those in stable disease (CML-CP and bone marrow remission Ph(+) ALL) (P = 0.0377), and 3 - 4 grade adverse events occurred more frequently in progress of disease than that in stable disease. Overall survival of the patients who achieved CCyR after dasatinib therapy was statistically longer than those who did not achieve CCyR (63 m vs 9 m, P = 0.0126). The most common grade 3 - 4 adverse events during dasatinib therapy including hematology events such as thrombocytopenia (51.8%), neutropenia (48.1%), anemia (33.3%), and non-hematologic events such as pleural effusion (18.5%), pulmonary infection (18.5%), pericardial effusion (11.1%). The 3-4 grade adverse events occurred within 12 months from dasatinib therapy, and were mainly observed in patients with progress of disease. It is concluded that dasatinib is an effective drug in imatinib-resistant BCR/ABL positive leukemia patients, the better curative effect and better tolerance has been observed in patients who received dasatinib in stable disease.
Adult ; Aged ; Benzamides ; therapeutic use ; Dasatinib ; Drug Resistance, Neoplasm ; Female ; Fusion Proteins, bcr-abl ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; blood ; drug therapy ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; drug therapy ; Protein Kinase Inhibitors ; therapeutic use ; Pyrimidines ; therapeutic use ; Thiazoles ; therapeutic use ; Treatment Outcome ; Young Adult