ObjectiveTo summarize the effect of staged operations strategy for delayed spontaneous rupture of esophagus with empyema.MethodsThree patients in the department of thoracic surgery of the second affiliated hospital of Guangzhou medical university underwent staged operative treatment for delayed spontaneous rupture of esophagus with empyema.The primary operative procedure consisted of removal of empyema sac,T-tube drainage and jejunostomies.The second operative procedure included alimentary reconstruction with thoracic esophageal resection and exclusion,or with esophageal resection and exclusion later.ResultsAll cases were cured with mean hospitalization of 78.7 days.None of them had any dysphagia at followup of 5-14 months.ConclusionDelayed spontaneous rupture of esophagus with empyema can be managed safely and effectively through staged operations strategy.

Objective To explore the purifying effects of clean bottling workshop in jugged or bottled drinking water manufacturing enterprise in Wuhan. Methods 32 manufacturing enterprises were sampled to test the purifying levels of bottling workshops according to GB50073-2001 The Criterion for Purifying Workshop Design, GB/T16294-1996 Detecting Method for Suspended Particle in Clean Shop or Area of Medical Industry and GB/T16249-1996 Testing Method for Sedimentation Bacteria in Clean Room or Area of Medical Industry. The microorganism determination was based on GB17324-1998 The Hygiene Standard for Bottled Drinking Pure water and GB8537-1995 The Hygiene Standard for Drinking Natural Mineral water and CJ94-1999 The Hygiene Standard for Bottled Drinking Water. Results The qualified rate was 78.1% for the count of dust in air and 81.3% for the count of bacteria in air of bottling workshops of 32 manufacturing enterprises.Among 32 manufacturing enterprises, 25(78.2%) and 8(25%) enterprises accorded with the requirement of 10 000 and 1 000 purifying level of air in whole bottling workshop respectively,only 2 accorded with the requirement of 100 purifying level of air at product line in bottling workshop. The qualified rate was 84.4% for temperature,light,noise,87.5% for flow rate, 46.9% for relative humidity, 34.4% for air pressure difference between indoor and outdoor.After the performance of sanitary management, the qualified rate of microorganism in barrelled water increased from 61.1% in 2001 to 84.1% in 2002. Conclusion The application air cleaning facility in bottling workshop of jugged or bottled drinking water manufacturing enterprise can improve the sanitary quality of microorganism in barrelled water.

Female ; Humans ; Hypophosphatemia ; etiology ; Middle Aged ; Osteomalacia ; etiology ; Paranasal Sinus Neoplasms ; complications

Objective In this study,we investigate the influence on nurses professional ability by the hierarchical level training under the advanced mode.Methods By referring to advanced mode of clinical expertise,combined with impacts including the ability of nurses,seniority factors,professional titles and educational background,1 527 nurses of our hospital were divided into five ranks (including nine grades).We developed training plan,training forms and training purposes aiming at all level of training objectives.In addition,we developed a training effect questionnaire and promotion criteria.All the nurses must be evaluated and compared with the traditional nursing mode,which contained 1 486 nurses as the control.Results Within two years after the start of the experiment in the observation group,1 106 nurses had been promoted.Compared with the traditional platform-based training model,nursing assessment indicators were significantly improved by the hierarchical level of training.Quality control of care services was significantly improved and the score of patient satisfaction was significantly increased.Nurses acceptance of tiered training was improved compared to the control group,published research papers were significantly increased.Conclusions Detailed training on the layer classification of the nurses can improve the ability of nurses including specialist knowledge,interpersonal communication and humanistic care,teaching,scientific research,management and other professional skills,so as to improve nursing quality and work efficiency.

Objective To investigate the immunity effects of quorum sensing in the pulmonary infection in rats due to Pseudomonas aeruginosa.Method(1)300 healthy,clean Sprague-Dawley rats were divided into 3 groups randomly:two different Pseudomonas aeruginosa(the wide-type Pseudomonas aeruginosa PAO1 and its double mutant PAO-JP2,in which the quorum sensing systems were defective,embedded in minute seaweed algiante beads which was made by an ejection set with an acuminate hole were inoculated to Sprague-Dawley rats to establish animal model of chronic pulmonary infection.The control group were dealed with the same methods using the sterile brine instead.(2)The levels of antibody IgG,IgM,IgG1,IgG2a to Pseudomonas aeruginosa in sera and cytokines including interferon-?(IFN-?),Interleukin-4(IL-4)in lung homogenate was measured at 3,7,14,28 days after infection.Results(1)The mortality in the PAO1-JP2-infected group(11.0%)was significantly lower than that of the PAO1-infected group(29.7%)and the control group(4.21%).(2) Compared with the PAO-JP2 group,during the early stages of infection(3 days after infection),the IFN-?level in lung homogenates was significantly higher;during the middle stages of infection(7 days after infection),the levels of IFN-?and IL-4 of PAO1-infected rats were significantly higher;In the later stages of infection(14 to 28 days after infection),levles of IFN-?,IgG2a were lower,while levels of IL-4,IgG,IgG1 were higher persistantly in PAO1-infected rats.Conclusions Quorum sensing system play an important role in pathogenesis and immunity effects of pseudomonas aeruginosa infection via modulating the expression of virulence factors and interfering with the immune system of hosts.

The study aimed to establish a population pharmacokinetic/pharmacodynamic (PPK/PD) model of warfarin. PCR-RFLP technique was used to genotype the CYP2C9 and VKORC1 polymorphisms of 73 patients. RP-HPLC-UV method was used to determine the 190 plasma concentrations of warfarin. Application of NONMEM, the clinical information and 263 international normalized ratio (INR) monitoring data were used to investigate the effect of genetic, physiological, pathological factors, other medication on clearance and anticoagulant response. The final model of warfarin PPK/PD was described as follows: CL = θCL · (WT/60)θWT · θCYP · eηCL (if CYP2C9*1/*1, θCYP = 1; if *1/*3, θCYP = 0.708); EC50 = θEC50 · θVKOR · eηEC50 (if VKORC1- 1639AA, θVKOR = 1; if GA, θVKOR = 2.01; V = θV; K(E0) = θK(E0); Emax = θEmax; E0 = θE0 · eηE0. Among them, the body weight (WT), CYP2C9 and VKORC1 genotype had conspicuous effect on warfarin PK/PD parameters. The goodness diagnosis, Bootstrap, NPDE verification showed that the final model was stable, effective and predictable. It may provide a reference for opitimizing the dose regimen of warfarin.
Anticoagulants ; pharmacology ; Body Weight ; Cytochrome P-450 CYP2C9 ; genetics ; Genotype ; Humans ; International Normalized Ratio ; Nonlinear Dynamics ; Polymorphism, Genetic ; Vitamin K Epoxide Reductases ; genetics ; Warfarin ; pharmacokinetics

Objective To investigate the infection situation of group A human rotavirus(HRV)among the infants and young children with diarrhea in Lanzhou city,and to observe the relation between genders and age with the viral positive rate.Methods 2 378 samples of feces in the infants and young children with diarrhea were collected in this hospital from January to December 2013.The group A HRV antigen in samples was detected by using the immunochromatographic sandwich method.The positive rates of group A HRV infection in different months were analyzed and compared with the bacterial diarrhea;the viral positive rates in different genders and ages were analyzed.Results Among 2 378 detected feces samples,the average positive rate of group A HRV was 24.1% and the highest was 39.8% during the months from October to December;the average positive rate of bacterial diarrhea was 28.2% and the highest was 38.2% during the months from July to September.The positive rate of group A HRV was 25.5% in male children patients and 22.6% in female children patients,but the difference was not statistically significant (P >0. 05).The differences in the positive rates of group A HRV among different ages had statistical significance (P <0.05).The average positive rate was highest(29.0%)in children patients aged less than 2 years old,followed by the children patients aged 2 - <4 years old,which was 21.6%.Conclusion The group A HRV has the higher infection positive rate in winter and early spring,which mainly focuses on the children patients aged less than 2 years old.

Objective To investigate the distribution characteristics of motor endplates in musculuslevatorani of dif-ferent gestational ages. Methods 20~24 weeks female fetuses were categorized as Group A, and 24~28 weeks female fetuses as group B. Karnovsky-Roots iron cyanide copper staining ( hematoxylin) was used to study the aver-age weight, the morphology, distribution and changes in number of motor end plate. Results The motor endplates morphology and distribution of consistent oval of 20 ~28 weeks female fetuses showed a curve distribution in the musculuslevatorani fibers foreign 1/3 . The weight and numbers of motor endplates in Group A were less than those of group B. Conclusion 20 ~28 weeks female fetuses' musculuslevatorani are visible on the motor end plates, and no significant difference is found in morphology and distribution of the curve along the muscle fibers. The num-ber of motor endplates increases with the increase of anal muscle weight mentioned.

Objective To explore the mediating effect and moderating effect of professional psycho?logical help?seeking intention and self?efficacy between mental symptoms and professional psychological help?seeking behavior in Chinese adults. Methods Totally 618 adult samples were selected on the internet and completed measures of help?seeking questionnaire,ISCI,SCL?90 and GSES. Results Females and middle a?dulthood subjects got higher ISCI and GSES scores than males and early adulthood subjects ((82.7±6.7) vs (77.8±7.8),(83.9±6.2) vs (76.8±7.3);all P<0.01). SCL?90 was significantly and positively correlated with psychological help?seeking behavior( r=0.162, P<0.01).ISCI was found to mediate the association be?tween SCL?90 and psychological help?seeking behavior(effect value=-0.004,95%CI=-0.008?-0.002). GSES significantly moderated the mediating effect of ISCI( B=0.006, P<0.05). Conclusion ISCI plays a mediating role between mental symptoms and professional psychological help?seeking behavior, which was moderated by GSES in Chinese adults.

Objective To study the influencing factors on the time of acute cerebral apoplexy patients visiting the hospital.Methods 64 patients with acute ischemic stroke were researched.The clinical data of all patients were collected.The influencing factors on treatment time were analyzed by univariate and multivariate Logistic regression analysis.Results In the 64 patients, 26 cases of the visiting time≤6 h(40.63%), 38 cases of visiting time>6 h(59.37%).The results of single factor analysis showed that the relationship between the time of treatment,pre-hospital transfer mode (x2=6.650,5.081,all P<0.05),educational level,living location,MRS score,whether or not know the stroke(x2=4.561,6.557,8.788,4.146,all P<0.05);the disturbance of consciousness and symptoms ≥3 symptoms compared with the visiting time had significant difference(x2=5.133,5.926,all P<0.05);in the multiple factors Logitic regression analysis,the degree of education(OR=2.332,95%CI:1.402~3.904),severity of illness(OR=3.956,95%CI:1.934~7.446),understanding of stroke(OR=3.621,95%CI:1.563~8.125),disturbance of consciousness(OR=4.336,95%CI:2.394~11.374),pre-hospital transport mode(OR=5.658,95%CI:2.546~12.554) were the risk factors of treatment time.Conclusion There is a close relationship with extension and various factors of acute ischemic stroke patients,in the future,not only need to improve the pre-hospital emergency care system,but also need to strengthen the public understanding of the disease.