ObjectiveTostudythetumorpatientswithcentralvenouscatheterrelatedbloodstreaminfection ( CRBSI) risk factors related to monitoring the clinical guidance value and nursing intervention results.Methods Through to the cancer center venipuncture and maintain hand hygiene,aseptic technique and in the process of CRBSI infection monitoring,analysis of risk factors for infection rates change,effective nursing intervention measures for im-plementation.Results CRBSI infection rate was down from 9.31‰ in July 2013 to 0 in september and October 2013.Conclusion Process and results of monitoring is conducive to timely find CRBSI infection risk factors give cor-responding nursing intervention,control and reduce CRBSI rates.

BACKGROUND: Intravascular low-level laser irradiation (ILLLI) therapy with He-Ne laser can effectively inhibit the occurrence of heroin withdrawal syndrome, but the therapeutic effect should be evaluated by quantitative standards.OBJECTIVE: To evaluate the effect of intravascular low-level He-Ne laser irradiation against withdrawal syndrome with intravenous according to the criteria proposed by the authors.DESIGN: Randomized controlled trial in heroin-addicted patients.SETTING: Analysis and Testing Laboratory of Xinxiang Medical College and Center of Laser Medical Research of Zhenzhou University Medical CollegePARTICIPANTS: The study was completed in Center of Laser Medical Research in Zhengzhou University in January 2003. Thirty heroin addicts from the Detoxification Center of Zhengzhou including 25 male and 5 female patients aged 19- 45 years were divided randomly into experimental group and control group with 15 cases in each. The patients' history of drug abuse ranged from 0. 5 to 5 years and the daily doses they took was 1.0-4.0 g.INTERVENTIONS: Patients in the experimental group were treated by ILLLI therapy after hospitalization. The therapy was administered once daily for 60 minutes in each session, for a total of 10 days for a treatment course. The irradiating power of the laser was 2.0-3.0 mW with a power density of 7.07-10.6 mW/mm2. Patients in the control group were treated with conventional therapy with algidon combined with buprenorphine hydrochloride. The 12 main symptoms(vomiting, goose pimples, sweating, agitation, shaking, lacrimation, nasal congestion, insomnia, abdominal pain,body temperature changes, muscular pain, and heart rate changes) were scored for 0, 1, 2, and 3 corresponding to absent, mild, moderate, and severe symptoms, with the total score of 36.MAIN OUTCOME MEASURES: Comparison of the scores for the withdrawal symptoms between the two groups.RESULTS: The 30 cases were all available for result analysis. The scores of vomiting, insomnia, agitation, shaking, goose pimples and abdominal pain in the experimental group were 2.0±0.5, 2.5±0.4,4.6±0.3,3.6±0.7,3.1±0.3 and 5.7±0.6 respectively, which were obviously lower than those in control group(5.1±0.7,6.0±0.7,7.4±0.6, 7.1±0.6,5.7±0.6 and 6.4 ±0.7 respectively, t =9.90-16. 81, P＜0.01).CONCLUSION: Intravascular low-level He-Ne laser irradiation can effectively relieve heroin withdrawal syndrome.

Objective To examine the levels of serum adipaneetin in patients with incipient chronic kidney disease (CKD, GFR≥ 60ml/min, and identify the relationship between serum adiponectin and albumin (ALB), urinary protein excretion amount, blood lipid and renal function. Methods Forty-two CKD patients and twenty normal healthy persons were involved in this study. These patients were divid- ed into two groups: nephrotic syndrome and non-nephrotic syndrome. The level of serum adiponectin, serum ALB, urinary protein excretion amount, blood lipid, renal function were measured and compared. Results The level of serum adiponectin in nephritic syndrome patients [(21.9±11.3) mg/L] and non-nephrotic syndrome patients [ ( 11.0±7.0) mg/L] was significantly higher than that in normal healthy per- sons[ (5.6±3.3) mg/L] ( P<0.01 ), and the level of serum adiponectin in nephritic syndrome patients was higher than that in non-ne- phrotic syndrome patients( P <0.01 ). Correlative analyses revealed a negatively correlation between serum adiponectin and serum total pro- tein(TP, ALB, BMI( r=-0.5680, r = -0.6241, r = -0.4083,respectively), and a positive correlation between serum adiponectin and urinary protein excretion amount ( r =0.4083). Stepwise regression analyses showed that serum adiponoctin was highly influenced by BMI, ALB and urinary protein excretion amount. Conclusion Serum adipanectin was markedly increased in incipient CKD, especially in patients with macroalbuminura. The effect of high level adiponectin in CKD was still not clear.

OBJECTIVETo compare the clinical efficacy difference between encircling needling combined with physical factor therapy and simple physical factor therapy for severe pressure sore, and to explore the optimal method for severe pressure sores.

METHODSThirty-four patients with IV-grade pressure sore were randomly divided into an observation group and a control group, 17 cases in each one. Patients in the control group were treated with conventional nursing, ultrasonic wave and short-wave ultraviolet therapy; additionally, the encircling needling was applied in the observation group. All the treatment was given once a day, 5 times a week, and 4-week treatment constituted one session. Totally, two sessions of treatment were performed. Three indices, including the area of pressure sore, 24-h volume of exudates and wound-bed tissue type, were compared between the two groups before and after treatment; the clinical efficacy was evaluated in the two groups.

RESULTSAfter treatment of one session and two sessions, the area of pressure sore, 24-h volume of exudates and wound-bed tissue type were significantly reduced in the two groups (P < 0.01, P < 0.05), which was more obvious in the observation group (all P < 0.05). The total effective rate in the observation group was 76.5% (13/17) after 1 session and 94.1% (16/17) after 2 sessions, which were superior to 35.3% (6/17) after 1 session and 64.7% (11/17) after 2 sessions in the control group (both P < 0.05).

CONCLUSIONEncircling needling combined with physical factor therapy can obviously reduce the pressure sore area and 24-h volume of exudates and improve wound-bed tissue type, which is superior to simple physical factor therapy.

Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Pressure Ulcer ; therapy ; Short-Wave Therapy ; Ultrasonic Therapy ; Ultrasonic Waves

Objective To examine the levels of serum adipunectin (ADPN)in patients with end-stage renal disease (ESRD), and identify the relationship between serum ADPN and tumor necrosis factor (TNF)-α, high sensitivity C-reactive protein(hs-CRP) and renal function. Methods Sixty ESRD patients and twenty normal healthy persons were involved in this study. The patients were divided into three groups: patients with chronic renal failure (CRF, 18 cases), patients with hemodialysis (HD,22 cases) and patients with peritoneal dialysis (PD,20 cases). The levels of serum ADPN, TNF-α and hs-CRP were detected by means of ELISA. Differences in continuous variables be-tween the three groups were evaluated. Results The levels of serum ADPN, TNF-α and hs-CRP in CRF, HD and PD patients were signifi-cantly higher than those in control group ( P<0.01 ). Serum ADPN levels in ESRD patients were positive related to serum TNF-α( r≥0.478, P<0.01 ), and negative related to GFR ( r≥-0.582, P<0.01 ). Conclusion The level of serum ADPN was markedly in-creased in patients with ESRD, and correlated with serum TNF-α level and.renal function.

Objective To investigate the levels of serum interleukin(IL)-18 in patients with chronic renal failure (CRF)and its relationship with relevant indexes. Methods Sixty patients with CRF were divided into three groups: patients with CRF (CRF group, n = 18) ,patients with bemedialysis (HD group, n = 22) and patients with peritoneal dialysis (PD group,n = 20). 20 healthy subjects were taken as controls. The levels of serum IL-18, tumor necrosis factor (TNF)-α and high sensitivity C-reactive protein (hs-CRP) were detected by means of ELISA. Serum albumin (ALB) ,total cholesterol (TC) ,triglyceride (TG) and serum creatinine (SCr) levels were detected by con-ventional means. The GFR was measured by using the abbreviated Modification of Diet in Renal Disease study (MDRD) equation. Differences in continuous variables between the three groups were evaluated. Results The lev-els of serum IL-18 were significantly increased in CRF[(497.7 ± 120.7) ng/L], HD[(538.1 ± 113.2) ng/L] and PD[(565.7 ± 122.1) ng/L] patients than those in healthy subjects[(163.9±42.2) ng/L] (P <0.01). Further-more,serum IL-18 levels in HD patients were higher than these in CRF patients (P <0.05). Serum IL-18 levels in CRF were positively related to serum TNF-α,hs-CRP and SCr(r =0. 636,0.436,0.367,P <0.01) ,and negatively related to GFR(r = -0.515 ,P <0.05). Conclusion The levels of serum IL-18 are markedly increased in patients with CRF,HD and PD,and related to the levels of TNF-α,hs-CRP and GFR,so IL-18 might be an important marker of sub-clinical inflammation in patients with chronic renal failure.

Objective To investigate the role of GABAAα3and GABAB receptors in the ventrolateral periaqueductal gray in the development of paw acute pain in rats.Methods Twelve male SD rats, weighing 280~320 g, were randomly divided into two groups: normal saline group (group NS), formaldehyde-induced pain group (group F), 6 rats in each group.In group F, rats were subcutaneously injected with 2% formaldehyde 50 μl into the ventral surface of right hind paw to induce periphery inflammatory pain.In group NS, rats were subcutaneously injected with normal saline into the ventral surface of right hind paw.Mechanical threshold was assessed using von Frey hairs for every ten minutes.The rat pain behavior scores were recorded for every five minutes.The thickness of skin and skin temperature were recorded for every fifteen minutes.Results Mechanical hyperalgesia were induced in group F after formalin injection into right hind paw.Compared with group NS, rat pain behavior scores were increased significantly in group F at all time points after injection, mechanical threshold were decreased significantly in group F at 10-60 min after injection, the temperature of the skin and the skin thickness were increased significantly in group F at 15-60 min after injection (P<0.05), the levels of the expression of GABAAα3 and GABAB were significantly increased in group F (P<0.05).Conclusion GABAAα3and GABAB receptors mediates formalin-induced hyperalgesia at ventrolateral portion of the PAG (vlPAG) of rats.

Objective To evaluate the risk factors of massive blood loss in resection of giant liver hemangioma.Method The clinical data of 141 patients who underwent giant liver hemangioma resection were retrospectively studied.These data included general physical condition,laboratory tests,radiologic findings,and various surgical parameters.The patients were divided into the massive blood loss group (＞ 1 000 ml,n =27) and the minor blood loss group (≤1 000 ml,n =114).Logistic regression was performed to determine the risk factors of intraoperative massive blood loss.Results The average diameter of the liver hemangioma was significantly greater in the massive blood loss group than that in the minor blood loss group [(21.7 ± 8.5) cm vs.(14.1 ± 5.3) cm,P ＜ 0.05].The incidences of preoperative leukopenia,anemia,thrombocytopenia and prolonged prothrombin time were higher in the massive blood loss group than that in the minor blood loss group (48.1％ vs.16.7％,37.0％ vs.11.4％,25.9％ vs.3.5％,22.2％ vs.3.5％,respectively,all P ＜ 0.05).Hepatic hemangioma with compressed hepatic veins,inferior vena cava and porta hepatis were more frequently found in the massive blood loss group than in the minor blood group (55.6％ vs.14.9％,44.4％ vs.14.0％,55.6％ vs.12.3％,respectively,all P＜0.05).Logistic regression analysis demonstrated a diameter of hemangioma greater than 15 cm was a risk factor of intraoperative massive blood loss during surgical resection.Conclusions Giant hepatic hemangioma may cause disorders in the hematological and coagulation systems.Compression of major hepatic vessels raised technical difficulty and risks in surgery.Hemangioma with a diameter greater than 15 cm was recognized as a high-risk factor of intraoperative massive blood loss.

Objective To analyze the differences between benign and potential malignant small pancreatic cystic lesions.Methods We retrospectively analyzed the clinical and pathological data of asymptomatic patients with pancreatic small cystic lesions and divided them into benign group (including serous cystic neoplasms,lymphoepithelial cyst and pseudocyst) and potential malignant group (including mucinous cystic neoplasms,intraductal papillary mucinous neoplasms and solid pseudopapillary neoplasms).Comparison of clinical data was made between the two groups.Results 46 patients with pathological results were included (22 cases in benign group and 24 cases in potential malignant group).No difference was detected on demographic data and lab results between the two groups.Compared with benign patients,patients in the potential malignant group were more likely to show thicken wall (P =0.000),mural nodule (P =0.000),solid constituents inside the cyst (P =0.001),wall enhancement (P =0.003) and uneven wall on CT scan (P =0.024).The diagnostic sensitivity,specificity and accuracy of the combination of above mentioned CT features for potential malignant diseases were 91.7％,77.3％ and 84.8％,respectively.Conclusions Pancreatic cystic lesions with thicken wall,mural nodule,wall enhancement,solid parts inside the cyst and uneven wall on CT were more likely of potential malignant entities.

Objective To set up the reference value of serum glyeated albumin (CA) in Chinese for using in clinical practice through a multi-center clinical trial. Methods Three hundred and eighty individuals with normal weight and normal glucose regulation, including 183 males and 197 females ranging from 20 to 69 years, were recruited from 10 hospitals in China. Serum GA levels were measured with liquid enzymatic method. Results (1) The GA level of the 380 subjects was (14. 5±1.9)%. When dividing these subjects by age into 3 subgroups, there was no difference in the GA levels among the 3 subgroups (P>0.05). Compared with the women, the men had higher GA level in the first subgroup aging from 20 to 39 (P =0.028). However, no significant difference was detected after adjusting with BMI as confounder.(2) When dividing those subjects by BMI into 3 subgroups, with BMI ranging from 18. 5-20. 9 kg/m2,21.0-22. 9 kg/m<'2>and 23.0-24. 9 kg/m<'2>respectively, we came to the following results: for men, there was no difference in the GA levels among the 3 subgroups (P>0.05), but for women, the GA level of the first subgroup was higher than that of the second subgroup (P =0.024). (3) The level of GA in the 2. 5th to 97.5th percentile was 10. 8%-17. 1%. (4) Sixty normal subjects were chosen to repeat evaluation of GA levels after 2-3 weeks and the GA levels were of no difference (P>0.05).Conclusion The normal range of serum GA for the Chinese population could be suggested at 11%-17%.