Objective To explore the advantages and disadvantages of high quality care in clinical care. Methods 2000 cases of hospitalized patients from August 2010 to August 2011 in department of neurology were selected as research subject.The 2000 hospitalized patients were divided into the control group and the research group with 1000 cases in each group.The control group was given routine care,the research group selected high quality care.General activity of daily living (ADL) assessment and satisfaction degree of patients was surveyed at discharge for two groups and the results were compared. Results When patients were discharged,ADL scores and satisfaction degree of patients in the research group were higher than those of the control group. Conclusions Application of high quality care for patients can promote the improvement of activity of daily living and satisfaction degree of patients.

Adrenergic beta-Agonists ; therapeutic use ; Aged ; Androstadienes ; therapeutic use ; Cholinergic Antagonists ; therapeutic use ; Fluticasone ; Humans ; Male ; Middle Aged ; Scopolamine Derivatives ; therapeutic use ; Silicosis ; drug therapy ; Tiotropium Bromide

Objective To investigate incidence,risk factors and the prevention strategy of local recurrence 6 months after surgery for metastatic bone tumors.Methods Data of 797 patients who had undergone operations for metastatic bone tumors from March 1997 to March 2012 were retrospectively analyzed.Sixty-three patients (7.9％) who had local recurrence 6 months after operation were enrolled in the recurrence group,including 40 males and 23 females,and the average age at the time of operation was 55.21 years.Seven hundred thirty-four patients were enrolled in the non-recurrence group,including 432 males and 302 females,with an average age of 56.49 years.The risk factors for local recurrence 6 months after operation for metastatic bone tumors were statistically analyzed.Results The statistical analysis showed the risk factors for local tumor recurrence 6 months after surgery for metastatic bone tumors included preoperative general condition (10.9％ vs 6.2％),the rate of progress of the primary tumor (10.1％ vs 6.1％),site of bone metastasis (9.1％ vs 3.9％),surgical method (11.4％ vs 6.4％),whether local radiotherapy was performed preoperatively (28.0％ vs 6.6％),whether local radiotherapy was performed postoperatively (8.7％ vs 2.8％),whether sensitive systemic therapy was performed preoperatively (12.2％ vs 6.1％),whether sensitive systemic therapy was performed postoperatively (10.3％ vs 5.6％) and whether local therapy was performed in primary tumor site (10.1％ vs 5.8％).Multivariate analysis showed the independent risk factors included preoperative general condition (OR=0.534),rate of progress of the primary tumor (OR=2.164),site of bone metastasis (OR=2.906),whether local radiotherapy was performed preoperatively (OR=3.184),whether sensitive systemic therapy was performed preoperatively (OR=2.344) and whether sensitive systemic therapy was performed postoperatively (OR =0.468).Conclusion When the patients has following conditions:poor preoperative general condition,fast progressive primary tumor,metastatic tumor in the axial skeleton,application of local radiotherapy preoperatively,and application of sensitive systemic therapy,the surgical treatment should be chosen cautiously.

Object To investigate clinical features,surgical strategy and prognostic factors of bone metastasis from thyroid cancer.Methods A total of 46 patients with bone metastasis from thyroid cancer,who had undergone surgical treatment from January 1999 to July 2011 and had complete follow-up data,were enrolled in this retrospective study.There were 20 males and 26 females,aged from 40 to 87 years (average,56.87 years).Forty two (91.3％) cases of metastatic lesion located in axial skeleton,while 4 (8.7％) in limbs.The tumor histology type was well-differentiated in 35 patients and poorly differentiated in 11 cases.Nineteen patients (41.3％) had an isolated metastatic bone lesion,while other 27 patients (58.7％) had multiple lesions.Kaplan-Meier survival curve and Cox regression model were performed to identify prognostic factors among 19 factors including gender,age,tumor subtype,number of bone metastasis,site of bone metastasis,visceral metastasis,skeletal-related events,timing of metastasis,whether metastatic lesion was detected when thyroid cancer was diagnosed,whether thyroid surgery was performed,whether 131Ⅰ therapy was performed,whether chemotherapy or radiotherapy were performed,preoperative general condition (good or poor),surgical type (excisional surgery or palliative surgery),characteristics of metastatic lesion (osteolytic or mixed),intraoperative blood loss,whether measures were applied to prevent intraoperative bleeding,perioperative complications and long-term complications.Results Excisional surgery was performed in 36 patients (78.3％),while palliative surgery in other 10 patients (21.7％).The average amount of blood loss was 2603.26ml.The postoperative 5-year survival rate and 10-year survival rate were 37.3％ and 12.4％,respectively.Univariate analysis showed the significant prognostic factors include tumor subtype,number of bone metastasis,whether 131Ⅰ therapy was performed,and preoperative general condition (good or poor).Multivariate analysis showed the independent prognostic factors were number of bone metastasis (solitary or multiple) and whether 131Ⅰ therapy was performed.Conclusion For patients with bone metastasis from thyroid cancer,the prognostic factors are useful for determining indications for operation and improving treatment outcome.

Humans ; Malocclusion ; therapy ; Orthodontics, Corrective ; Treatment Outcome

Objective To study the anemia status and genotype of thalassemia in preschool children in Shenzhen. Methods 658 preschool with anemia hospitalized in Shenzhen Longgang Maternal and Child Health Hospital from October 2012 to September 2015 were screened by complete blood analysis . The most common mutations of thalassemia genotype (17 β thalassemia genotype mutation,3 α thalassemia genotype mutation and 3α thalassemia genotype absence change) in Chinese population were detected. Results All cases have microcytic hypochromic anemia. 426 cases were identified to be thalassemia (64.7%). 23 genotypes and 13 gene mutation type were detected. The most common genotype type were SEA/αα(46%),β654/βN(15%),β41?42/βN(12.7%). And the most common allele gene mutation type were SEA (49.1%),IVS?Ⅱ?654( C→T)(14.4%),CD41?42(?TTCT)(12.4%) re?spectively. MCV and MCH of thalassemia children was significantly lower than that of children diagnosed as without thalassemia. The differences of RBC,Hb,MCV,MCH,MCHC,RBC?SD between the two groups were statistical?ly significant. Conclusion The proportion of thalassemia among preschool anemia children in Shenzhen area was high,and it is necessary to strengthen the local thalassemia prevention and decrease anemia effect on preschool children′s health.

Objective To isolate and observe Pityrosporum yeasts from a patient with onychomycosis. Methods The involved nail specimens were investigated by means of culture, pathological and scanning electron microscopic examination and 20% KOH preparation. Results Physical examination showed that each finger and toe nail appeared brownish black, rough and thick, some of the fore part of the nail plate detached from the nail bed. Fingernail specimen's culture results showed that Trichophyton rubrum grew on Sabouraud's dextrose agar and Pityrosporum ovale grew on the medium containing rapeseed oil. The pathological examination revealed P.ovale yeast involvement in the fissure of the nail plate. Under the scanning electron microscopy, a lot of P.ovale yeasts with characteristic collarette structure inserted in the nail tissue was noticed. In the 20% KOH preparations of nail incubated at 56℃for 1h and stained with Quink Parker ink, spores and hyphae were identified morphologically with P.ovale and T.rubrum respectively. The patient received intermittent pulse therapy with itraconazole, the color of the nails became much brighter 1 to 2 months after the fourth cycle of therapy, but no further improvement was observed afterwards. P.ovale and T.rubrum grew again 6 months after treatment when the clippings of the fingernail were cultured. Conclusion This is the first document of onychomycosis related with P.ovale in China.

Objective To study the morphological,biologic response of cultured human keratin ocytes to Candida albicans and the molecular mechanism.Methods ①A yeast form of C.albicans was added t o a monolayer of keratinocytes.The adherent organisms were observed by scanning and transmission electron mi-croscope at different incubation periods.Boiled C.albicans and latex beads of a similar size(3.2?m)were also inoculated for comparison.②The effect of supernatant from the co-culture of keratinocytes with inta ct C.albicans on keratinocyte growth was measured by the fluorescence intensity and cell count.③Keratinocytes were incubated with C.albicans or latex beads,and the level of cytok ine in the keratinocytes and supernatant were measured with enzyme -linked im munosorbent assay kits.Results①The number of adherent C.albicans increased with the lapse of time,whi le boiled C.albicans did not adhere at all.Many latex bead s adhered to the keratinocytes,and were then easily phagocytised.Fibril -like structu res stretched from the keratinocyte s adhered to the organisms or latex beads.②The conditioned medium of 50%concen tration significantly promote cell growth,while that with boiled C.albicans or latex beads moderately stimulate d keratinocyte growth.③Ker-atinocytes treated with intact C.albicans had significantly higher level of IL-1?in the supernatant but lower in the cell extract.Both TGF -?and bFGF increased either in the medi a or in the extract.Conclusion These results suggest that keratinocytes have non -specific phagocytic activ ity.C.albicans are able to adhere to ker-atinocytes and stimulate the release of various cytokines from keratinocytes,which may induce an inflammatory reaction and cell growth.

Adolescent ; Adult ; Aged ; Child ; Female ; Foreign Bodies ; diagnostic imaging ; Head ; Humans ; Male ; Middle Aged ; Neck ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Young Adult

Humans ; Mouth Diseases ; diagnosis ; therapy ; Orthodontics, Corrective