Objective To explore an effective perioperative nursing management mode for elderly patients without caregivers. Methods The perioperative nursing management mode was implemented for 151 elderly patients without caregivers from 9 surgery departments. The work mode included admission safety assessment,nursing care classification,design of clinical nursing pathway,establishment of nursing group and quality control. Results The new work mode provided elderly patients with high-quality nursing care,ensured patient safety,increased patient and relatives satisfaction. Conclusion The perioperative nursing management mode is an effective way to ensure patient safety and promote patient comfort during perioperative period for elderly patients without caregivers.

Objective To investigate the effect of exercise on calcium modulin in myocardial sarcoplasmic re-ticulum of animal type 1 diabetes model in rat. Methods A total of 40 Spragne-Dawley rats were randomly dividedinto 4 groups : a normal control group, an exercise training group, a diabetes group and a diabetes plus exercise-traininggroup. At the end of 4- week-exercise training after the establishment of the diabetes model by intraperitoncal injectionof sterptozotocin, the animals were sacrificed and the level of blood glucose, insulin, blood fat and glycosylated serumprotein were tested. The gene expression of calcium modulin proteins was measured by reverse transcription-polymerasechain reaction, and the Western blotting technique was used to measure the protein of sarcoplasmic endoplasmic reticu-lure Ca<'2+> -ATPase (SERCA2) and phaspholamban (PLB). Results The level of biochemical indicator of exercisegroup is not affected when comparing with that of the control group, but significantly changed in diabetic group ( P <0. 01 ) ; The level of blood glucose, insulin, blood fat and glycosylated serum protein were ameliorated in diabetic rats inthe exercise training group. No significant changes in mRNA level of SERCA2, PLB and ryanodine receptor type 2(RYR2) were observed between control and diabetic group, the same to protein expression of SERCA2 and PLB. Butexpression of calcium modulin mRNA was significantly increased in exercise group and diabetic rats in the exercisetraining group comparing with that of the control and diabetic groups ( P < 0.01 ), the same to protein expression ofSERCA2 and PLB. Conclusion Exercise exerted good protective effects on the myocardial injury with 1 type diabetesrat, which might attribute to the upregnlated expression of SERCA2, PLB and RYR2 in diabetic rat heart.

Objective To evaluate the efficacy of neuronavigation-guided selective percutaneous radiofrequency aiming at the target point semilunar ganglion in the treatment of trigeminal neuralgia.Methods One hundred and forty-seven patients with primary trigeminal neuralgia of both sexes,aged 32-99 yr,with VAS score ≥ 8,were randomly divided into 2 groups:C-arm group (group C,n =72) and neuronavigation group (group N,n =72).Hartel anterior puncture was used and the C-arm guided puncture was performed at the target point foramen ovale in group C.In group N,three-dimensional reconstruction was made after the skull MRI images were transmired to the navigational system of StealthStation,and then the puncture path and point were designed after the target in the trigeminal ganglion was determined.The successful puncture and puncture-and radiofrequency-related complications were also recorded.The VAS scores were recorded at 1 and 7 days and 1,6,12 and 24 months after operation and the analgesic efficacy was evaluated.The therapeutic effect was evaluated by using Barrow Neurological Institute scoring system at 1 and 24 months after operation.Results No puncture-related side effects,damage to the oculomotor nerve or tinnitus developed in group N.The success rate of puncture at first attempt and the effective analgesia rate at different time points after operation were significantly higher,and the treatment effect was better in group N than in group C (P ＜ 0.05).There was no significant difference in the time for location of the nerve and incidence of facial numbness between the two groups (P ＞ 0.05).Conclusion Neuronavigation-guided selective percutaneous radiofrequency aiming at the target point semilunar ganglion in the treatment of trigeminal neuralgia provides a better efficacy,and a lower recurrence rate and a higher probability of successful puncture,with fewer complications.

Background lnterleuldn-18(IL- 18) plays a key role in the development,progression and outcome of coronary artery disease and its complications.However,its variability relation to the characterization of atherosclerotic plaque and percutaneous coronary intervention are still unknown.Methods Fifty four patients with coronary artery disease [22 patients with stable angina (SA) and 32 patients with acute coronary syndrome (ACS)] were enrolled in this study.All patients underwent percutaneous coronary intervention (PCI).The stability of the plaques at the criminal vessels was assessed with analogical IVUS.Serum IL-18 levels were measured at the time points of 5 rain before PCI,and Oh,6h,24h and lmonth after PCI in all patients.Results ACS group consisted mainly of lipidic unstable plaques while SA group of fibrous stable plaques.Moreover,compared with those in SA group,eccentricity index (EI) and remodeling index (RI) were significantly higher in ACS group.Positive remodeling was seen in ACS group while negative or no remodeling in SA group.Further,serum IL-18 levels were significantly elevated in patients with ACS than those in SA group before PCI,increased at Oh,6h,24h after PCI (P＜0.05)and were not significant different at 1 month after PCI from those before PCI.Conclusions There is significant difference in the composition and structural characteristics of atherosclerotic plaques between ACS and UA groups.PCI triggersd and enhances the inflammatory response in a short time.Serum levels of IL- 18 are the predictors of progression of unstable plaque in atherosclerosis.Post-operative complications of PCI might be reduced by inhibiting IL- 18.(J Geriatr Cardiol 2008;5:21-24)

Objective To observe the efficacy of Mimics finite element analysis software in the gasserian ganglion radiofrequency treatment of trigeminal neuralgia. Methods 180 cases with primary trigeminal neuralgia and VAS score ≥8 were randomly divided into 2 groups (n = 90 each): CT group (group C) and Mimics group (group M). The preoperative skull CT image of the foramen of cranial base could be analyzed in group C. The preoperative cranial CT image could be reconstructed and analyzed by Mimics finite element analysis software in group M. The puncturing success rate, complications rate and the outcomes between two groups were recorded. Results The puncturing success rates were 100% in group M and 92% in group C (P < 0.05). 6 cases with hematoma and 1 case, which were stabbed into the oral cavity were found in group C. No puncture complication was found in group G. There was no statistically significant between the two groups (P < 0.05). The VAS score was 1.6 ± 0.3 in group C and 1.3 ± 0.4 in group G, there was no statistical significance (P > 0.05) between them. Conclusions The Mimics finite element analysis software could improve the success rate of basicranial foramen ovale puncture and reduce the occurrence rate of puncture complications. Therefore , it could be safely applied to the treatment of primary trigeminal neuralgia by gasserian ganglion radio frequency.

Objective To evaluate the effects of sevoflurane-remifentanil anesthesia on the balance between cerebral oxygen supply and demand during cerebral revascularization for ischemic moyamoya disease by monitoring regional cerebral O2 saturation (rSO2) with near infrared spectroscopy.Methods Forty patients of both sexes aged 19-59 yr with a body mass index of 19-25 kg/m2 undergoing superficial temporal artery-middle cerebral artery anastomosis were randomly allocated into 2 groups (n =20 each):propofol-remifentanil group (group PR) and sevoflurane-remifentanil group (group SR).Radial artery was cannulated for direct BP monitoring and blood sampling.Near infrared spectroscopy probe was placed on the forehead.Anesthesia was induced with propofol TCI (Cp =5 μg/ml),fentanyl 3 μg/kg and rocuronium 0.6 mg/kg.The patients were mechanically ventilated after tracheal intubation (VT 8-10 ml/kg,RR 10-12 bpm,I∶ E 1∶2,FiO2 =1.0).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with sevoflurane (end-tidal concentration 1.0％-1.7 ％) or propofol TCI (Cp =3-4 μg/ml) in combination with remifentanil TCI (Cp =3.5 ng/ml) and intermittent iv boluses of rocuronium 0.3 mg/kg.BIS was maintained at 40-60 during operation.rSO2 was recorded before induction of anesthesia (T0),10 min before and 10 min after blood vessel was clamped (T1,T2) and 10 min after anastomosis was completed (T3).Results rSO2 was significantly increased on the operated side at T3 in PR group while in SR group bilateral rSO2 was significantly increased at T1-3 as compared with the baseline values at T0 (P ＜ 0.05 or 0.01).rSO2 on the operated side was significantly higher at T1 in group SR than in PR group (P ＜ 0.05).Conclusion The efficacy of sevoflurane-remifentanil anesthesia is similar to that of propofol-remifentanil anesthesia for revascularization for moyamoya disease in terms of maintence of the balance between cerebral oxygen supply and demand.

Objective To explore the predictive value of ventricle late potential (LP) for arrhythmic events in the patients with Brugada syndrome. Methods Totally 43 patients with Brugada syndrome were divided into symptom group (n=24) and asymptom group (n=19).Signalaveraged electrocardiography(SAECG) was performed to analyze characteristics of LP in all subjects.The occurrence of arrhythmic events was observed in all patients during the dynamic follow-up for (33.8±9.0) months.Results There were 22 cases (91.7％) and 7 cases (36.8％) with LP positive in patients with symptom and asymptom,respectively.The incidences of arrhythmic events were 72.4％ in Brugada syndrome patients with positive LP and 14.3％ in patients with negative LP,respectively.The relative risk (RR,95％ CI) for LP prediction of the arrhythmic events was [5.1,(1.4～ 18.6)] (P =0.002). ConclusionsLP may be one of effective factors predicting arrhythmic events in the patients with Brugada syndrome.

To investigate the phenotypic characteristics of the strain of the rabies virus CTNCEC25, the strain of the China rabies virus CTN-1 adapted to primary chicken embryo cells (CECs), Vero cells, and mouse neuroblastoma N2a cells was inoculated with CTNCEC25 and parental CTN-1 strains to explore the cytopathic effect (CPE) and growth kinetics of CTNCEC25 on cultured cells. To determine the pathogenicity of CTNCEC25, suckling mice, adult mice, guinea pigs and rabbits were inoculated with CTNCEC25 via the intracerebral route and their survival monitored every day. Furthermore, the CTNCEC25 strain was passed serially in CECs for 20 passages and then 3 passages in the brains of suckling mice to determine phenotypic stability. CTNCEC25 achieved similar growth kinetics in Vero cells and N2a cells compared with parental CTN-1, but CTNCEC25 replicated more efficiently in CECs than the CTN-1 strain with a titer 72 h after infection reaching 10(7.5-7.6) FFU/mL, which was significantly higher than the 10(5.8) FFU/mL achieved by its parental strain, CTN-1. Moreover, CTNCEC25 induced apparent CPE in Vero cells, CECs and N2a cells. Analyses of intracerebral inoculation demonstrated that CTNCEC25 was attenuated profoundly in adult mice and was completely apathogenic to guinea pigs and rabbits, though it caused death in suckling mice. The CTNCEC25 strain proliferated steadily after serial passage in CECs and the brains of suckling mice, and remained avirulent in adult mice. These results suggest that CTNCEC25 is a highly attenuated and genetically stable strain of the rabies virus. CTNCEC25 replicated stably and efficiently in cultured cells and achieved high titers, so it could be a promising and safe vaccine strain for rabies prevention in China.
Animals ; Cell Line ; Cercopithecus aethiops ; China ; Guinea Pigs ; Humans ; Mice ; Rabbits ; Rabies ; virology ; Rabies virus ; genetics ; growth & development ; pathogenicity ; Serial Passage ; Viral Vaccines ; adverse effects ; genetics ; Virulence

Objective:To analyze the features and clinical significance of damages to non pulmonary organs like the heart,kidney and peripheral blood in SARS patients.Methods:SPSS 11.0 and SDAS software packages were used to retrospectively analyze the damages to the heart,kidney and peripheral blood in 330 clinically confirmed SARS cases.Results:(1)The heart damage occurred within 1 week after SARS onset in mild cases; the rates of LDH,HBDH,CK and CK MB returning to normal were 74.2%,80.6%,100% and 100%,respectively.In severe cases,the heart damage usually occurred 1 week after SARS onset; the rates of LDH,HBDH,CK and CK MB returning to normal were 32.2%,29.5%,55.2% and 44.4%,respectively.Ten patients whose CK MB didnot return to normal died.(2) The changes of RBC count appeared after an average of 1 week (1 10 d) in 54.2% of the patients.It returned to normal in all the mild SARS cases after an average of 12.5(4 21) d but didnot in 18.4% of the severe cases ( P

OBJECTIVE:To adopt SIMPLE pharmaceutical care mode in chronic disease management of bronchial asthma and COPD patients,and to evaluateits the effect. METHODS:By random sampling,a total of 200 bronchial asthma and COPD patientsselected from respiration department in the First Affiliated Hospital of Soochow University during Sept. 2016-Jun. 2017 were divided into control group(100 cases)and intervention group(100 cases)by simple randomization. Control group received routine treatment. Intervention group additionally received education on quitting smoking,effective use of the inhaler,monitoring detection indexes, selecting drugs correctly,scientific life style. Inhaled device scores,lung function indexes (FEV1％,FEV1/FVC),the number of patients with acute attack/exacerbation,clinical effective control rates,ADR occurrence rates,compliance of using apparatus(MMAS-8 score)were compared between 2 groups before enrollment,3 and 6 months after enrollment. RESULTS:Commpared with during enrollment,inhaled device score,clinical effective control rate and MMAS-8 score of intervention group incereased significantly 3,6 months after enrollment,while patients with acute attack/exacerbation ≥2 times decreased significantly,with statistical significance (P<0.05). Compared with control group,inhaled device score,clinical effective control rate,MMAS-8 score and FEV1％ of intervention group increased significantly,patients with acute attack/exacerbation ≥2 times decreased significantly 3 and 6 months after enrollment with statistical significance (P<0.05);the ADR occurrence rate was lower than control group,with statistical significance (P<0.05). CONCLUSIONS:Chronic disease management of bronchial asthma and COPD patients with SIMPLE pharmaceutical care mode can improve medication compliance and clinical efficacy,and reduce ADR.