ObjectiveTo probe into the clinical application effect of continuity care model in stroke patients. Methods58 patients with stroke in our hospital during June 2008 to June 2011 were selected.According to block randomization method,the selected patients were divided into the study group and the control group with 29 patients in each group.The control group received routine care interventions,while patients in the study group was given routine care interventions plus continuity care model.Activities of daily living,compliance behavior,quality of life,nursing satisfaction degree and other related indicators of patients in two groups were comparatively analyzed. ResultsCompared with the control group,the activities of daily living of the study group at discharge did not show significant differences,while 1 month,3 months,6 months after discharge,the activities of daily living was significantly increased.Regular medication,exercise time,timely return visit,proper diet and other indicators of compliance behaviors were significantly improved.The quality of life score did not show significant differences at discharge,while 3 months after discharge,the quality of life score were significantly higher in the study group than that of the control group.The satisfaction degree of patients was significantly higher in the study group than that of the control group. ConclusionsApplication of continuity care model in stroke patients can improve activities of daily living,compliance behavior,quality of life,satisfaction degree with nurses.It's worthy of further clinical application and promotion.

BACKGROUND: A latest research indicates that γ~δ T cells following touching with microbe products show characteristics as dendritic cells and antigen-presenting cells (APC) and induce intensive immune response of CD4~+ CD8~+ γ~δ T cells.OBJECTIVE: To verify APC-like functions of γ~δ T cells during transplantation rejection, investigate a simple and effective method to amplify γ~δ T cells in vitro, and to infect γ~δ T cells with FasL retrovirus system.DESIGN, TIME AND SETTING: An animal experiment was performed at Central Laboratory of the First Affiliated Hospital of the Fourth Military Medical University of Chinese PLA from August 2007 to August 2008. MATERIALS: A total of 60 healthy adult Wistar rats of clean grade and weighing 200-320 g were used to establish donor and receptor models with segmental heterotopic small intestine transplantation.METHODS: Models of segmental heterotopic small intestine transplantation were established using three sleevelet vascular anastomosis. γ~δ T cells were obtained using flow cytometry and its function was demonstrated. Mononuclear cells were routinely separated and amplified with Mtb-Ag. MAIN OUTCOME MEASURES: Cell proliferation was observed; percentage of γ~δ T cells for lymphocytes was detected using TCRγ~δ magnetic beads kit; γ~δ T cells following transfection were detected using pLXSN FasL retrovirus system. RESULTS: Activated γ~δ T cells showed dendritic cell-like adhesion function and APC-like functions during transplantation rejection. γ~δ T cells accounted 4.5% for mononuclear cells, the purification of γ~δ T cells was up to 72.2% on the 10~(th) day after activated by Mtb-Ag, and the purification of γ~δ T cells was up to 99.1% through positive magnetic sorting. 285 bp FasL fragment demonstrated that the gene integration was observed in PA317 cells. The ration of FasL+ cells was 97.3% after infected by pLXSN FasL retrovirus system.CONCLUSION: This study demonstrated APC-like functions of γ~δ T cells during transplantation rejection. γ~δ T cells were successfully amplified in vitro. PA317/ pLXSN2FasL+ retrovirus system was successfully constructed and γ~δ T cells were modified by FasL retrovirus system.

Objective To understand the status of soil-transmitted nematode infections,as well as the awareness and healthy behavior on soil-transmitted nematodiasis in rural residents of Dezhou City. Methods Six villages were selected according to the stratified sampling method;the permanent resident population aged 3 years or above was determined as the investigation objects. The modified Kato-Katz technique was adopted to detect the eggs of Ascaris lumbricoides,hookworm and Trichuris trichiura in the feces of the residents,and the method of cellophane anal swab was used to detect the Enterobius vermicularis infection in children under 12 years old. More than 50 households in each investigated site were randomly selected to investigate the awareness status on nematodiasis prevention and treatment and the condition of healthy behavior formation. Results A total of 2 294 residents were detected by Kato-Katz methods,11 of them were positive,and the total infection rate of soil-transmitted nematodes was 0.48%. To-tally 260 children were detected and 40 were infected with E. vermicularis,and the infection rate was 15.38%. A total of 898 resi-dents were investigated in the household survey and the awareness rate of nematodiasis prevention and treatment was 44.99%,the proportion of residents with healthy behavior was above 70%. Conclusions The infection rate of soil-transmitted nematode is low in rural areas of Dezhou City,but the infection rate of E. vermicularis in children is higher. The condition of healthy behavior forma-tion is satisfying,but the awareness rate of nematodiasis prevention and treatment of the residents is low. Therefore,the control measures as well as healthy education still should be strengthened.

Objective To identity the risk factors for supine hypotension syndrome (SHS) after spinal anesthesia in parturients.Methods A total of 204 parturients,scheduled for elective cesarean section,were divided into either control group or SHS group depending on whether or not SHS (systolic blood pressure [SBP] in the upper extremity decreased by ＞ 30 mmHg or decreased to ＜ 80 mmHg) developed after spinal anesthesia.The baseline patient characteristics such as age,body height and weight,gestational weeks and biparietal diameter were recorded.Supine stress test (SST) was performed.Heart rate,blood pressure in upper and lower extremities,perfusion index,pleth variability index and intravesical pressure were recorded when patients were in supine position and in left lateral position before spinal anesthesia.The risk factors of which P values were less than 0.05 would enter the multi-factor logistic regression analysis to stratify the risk factors for SHS.Results Among the 204 patients,99 cases developed SHS after spinal anesthesia,and the incidence was 48.5％.Logistic regression analysis showed that maternal body weight,biparietal diameter,the difference in SBP between upper and lower extremities in supine position,the difference in SBP in upper extremities caused by changing position and positive SST were risk factors for SHS after spinal anesthesia (P＜0.05 or 0.01).Conclusion Maternal body weight,biparietal diameter,the difference in SBP between the upper and lower extremities in supine position,the difference in SBP in upper extremities caused by changing position and positive SST are risk factors for SHS after spinal anesthesia in parturients.

Objective To evaluate the effect of anterior minimally invasive plate osteosynthesis (MIPO) for treatment of middle humeral shaft fracture.Methods From November 2011 to March 2014,10 cases of middle humeral shaft fracture were treated using MIPO via the anterior approach (MIPO group).Another 26 cases treated by open reduction and internal fixation (ORIF) of the middle humeral shaft fracture between October 2010 and March 2014 were included as controls (ORIF group).Fracture fixation using the 4.5 mm locking compression plate (LCP) was performed in both groups.Parameter measurements included operative time,intraoperative fluoroscopy times,grafting rate,intraoperative blood loss,postoperative drainage,hospital stay,bone healing time and complications.Results MIPO and ORIF groups differed significantly with respect to intraoperative blood loss [(93.5 ± 25.6) ml vs (325.3 ± 158.3) ml],intraoperative fluoroscopy times [(13.2 ± 6.1) vs 4.0 (0-6.0)] and hospitalization [(11.9 ± 1.7)days vs (18.0 ±4.7)days] (P ＜0.05).Bone grafting and drainage were not performed in MIPO group,while bone grafting rate was 54％ and postoperative drainage volume was (120.4 ± 69.6) ml in ORIF group (P ＜0.05).MIPO and ORIF groups were comparable with respect to operative time [(79.0 ± 22.0) min vs (97.5 ± 30.8) min],bone healing time [(15.2 ± 2.5) weeks vs (18.2 ± 4.8)weeks] and postoperative complications (10％ vs23％) (P＞0.05).Conclusion Anterior MIPO is an effective procedure for treatment of middle humeral shaft fracture,with advantages of small trauma,less bleeding,low risk of nerve injury and high rate of fracture healing.

Objective To evaluate the outcome of dorsal double locking compression plate (LCP) in treatment of stretched unstable distal radial fractures.Methods Fourteen cases of stretched unstable distal radial fractures were treated by reduction and internal fixation using straight or L-shaped anatomic LCP via dorsal approach.Wrist functional exercise was conducted immediately after operation.Follow up was made after operation to assess motion pain,functional score of wrist,and complication incidence at postoperative 12 weeks,24 weeks,and 1 year.Results Follow-up was lasted for 5-24 months.At postoperative 12 weeks,24 weeks and 1 year,mean visual analogue scale (VAS) was (1.88 ±0.26) points,(0.87 ± 0.14) points and (0.37 ± 0.06) points respectively and wrist functional score (Gartland-Werley score) was (6.45 ± 1.72) points,(2.73 ± 0.52) points and (2.10 ± 0.31) points respectively.According to Garfland-Werley score in the latest follow-up,the results were excellent in 10 cases,good in two,and fair in two.Besides,one case was combined with myotenositis of extensor pollicis longus muscle tendon and another case with myotenositis of extensor tendon.Conclusion Dorsal double LCP is one of the effective methods for stretched unstable distal radial fractures that can reconstruct anatomical structure of the wrist efficiently and attain satisfactory functional recovery,with no obvious pain.

Teaching and research section of orthodontics of the Affiliated Hospital of Stomatology of Chongqing Medical University took the lead in carrying out ‘ three early education' Students of stomatology in Chongqing Medical University established ‘ social practice volunteer team' and conducted ‘ three early education' in orthodontic clinic during winter,summer holiday and weekend.This let students of low grades contact with society,clinical practice and scientific research at early stage thus to comprehensively improve their overall quality.Questionnaire for student volunteers of the Affiliated Hospital of Stomatology of Chongqing Medical University showed that ‘ three early education' can effectively improve medical students' comprehensive quality.In the early stages of learning for students of stomatology,we cultivated students' occupation spirit,innovation consciousness,scientific literacy,clinical thinking and teamwork ability by strengthening training of students' social practice ability,communication ability,organization and coordination ability,professional interests,professional senses of belonging,team spirit and moral emotion.We achieved certain results and our experiences are worth extending.

Objective To find the rule of the distribution of H antigens on AB subgrouperythrocytes.Methods ABO subgroups were confirmed by using serological and molecular biology (PCR-RFLP) methods. AB subgroup with strong H was defined as red cell agglutination by anti-H of 2 scores or more higher than that of B cells.Results Strong H was only found in certain AB subgroups ,CisAB(100%),B(A)(100%), AxB(46.2%) and A2B(43.6%), but seldom in others among Chinese population.Conclusion The fact that H type-3, which comes from A type-2, can hardly be transferred by B and weak A glycosyltransferase can help to explain why some ‘strong’ H combines with ‘weak’ A in AB erythrocytes. Why only little H can be found in 53.8% AxB, 56.4% A2B and all A3B, AmB subgroup samples still cannot been explained.

Objective To gain the virus like particles (VLPs) based on Trop2 targets ,which provided the basis for further in vi‐vo induced experiments and anti‐tumor vaccine studies .Methods Using molecular cloning method to constract eukaryotic expres‐sion vector of pCAGGs/Trop2 and baculovirus expression vector of pFastbac1/Trop2 ,expression product of pCAGGs/Trop2 in HeLa cells were intended to be to be anchored to the cell membrane by the methods of Immunohistochemistry ;pFastbac1/Trop2 were transformed into E .coliDH10bac isolates to gain recombinant bacmids ,which were transfected into insect cells to express re‐combinant baculovirus with Gag rBV ,then sucrose density gradient centrifugation ,Western Blot and electron microscope were per‐formed to purify and identify the Trop2 VLPs .Results Building recombinant bacmids which were transfected into insect cells to express recombinant baculovirus with Gag rBV ,gained the recombinant Virus like Particles .Conclusion Trop2 VLPs was success‐fully prepared ,which laid the foundation for the subsequent induction of humoral and cellular immune response .

Objective To investigate the effect of dexmedetomidine combined anesthesia on postoperative delirium in the elderly patients undergoing hip joint replacement.Methods One hundred and sixty ASA Ⅱ or Ⅲ patients,aged 75-85 yr,with a body mass index of 20-25 kg/m2,scheduled for elective total hip joint replacement under general anesthesia,were randomly divided into 2 groups (n =80 each):sevoflurane-fentanyl control group (group C) and dexmedetomidine-sevoflurane-fentanyl group (group D).Dexmedetomidine was intravenously infused at 0.2 μg· kg-1 · h-1 until the end of operation after a loading dose of 0.6μg/kg over 15 min before induction of anesthesia in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with iv injection of fentanyl 2-4 μg/kg and etomidate 0.1-0.3 mg/kg at 5 min after the end of administration of the loading dose.Tracheal intubation was facilitated with cisatracurium 0.15 mg/kg and the patients were mechanically ventilated.Anesthesia was maintained with target-controlled inhalation of sevoflurane (the end-tidal concentration 1％-3％) and intermittent iv boluses of fentanyl 0.05 mg.BIS was maintained at 40-60 during operation.The consumption of etomidate,fentanyl,and sevoflurane,agitation during emergence from anesthesia,and postoperative delirium within 24 h after operation were recorded.Results Compared with group C,the consumption of etomidate,fentanly,and sevoflurane was significantly reduced and the incidences of agitation during emergence from anesthesia and postoperative delirium within 24 h after operation were significantly decreased in group D (P ＜0.05).Conclusion Dexmedetomidine combined anesthesia can reduce the occurrence of postoperative delirium in the elderly patients undergoing hip joint replacement.