Objective To explore the damage of intestinal mucosal barrier caused by vinegar retention enema, and compare the degree of injury in intestinal mucosal barrier between isotonic vinegar and traditional hypertonic vinegar treat-ment. Methods Sixteen adult rabbits were randomly divided into two groups. The solution of vinegar mixed with normal so-dium was given to hypertonic group. Isotonic group was administered with isosmotic solution made of vinegar and double dis-tilled water, with the same volume fraction and pH as hypertonic group. Then two different osmosis solutions were given as enema solution to rabbits under the same condition. Finally, damages of intestinal mucosa were observed by light microscope and transmission electron microscope (TEM) in two groups. Results It was observed that injuries of rectum and distal part of colon were more severe in hypertonic group than those of isotonic group through light microscope. Besides, cell structures were morphologically normal, with in-line microvilli and intact tight junction in isotonic group. In hypertonic group, microvil-li of intestinal cells decreased or disappeared, the cell junction is widened, and cell apoptosis and necrosis were found through TEM. Conclusion Results showed that isotonic vinegar had less damage to mucosa. Consequently, isotonic vinegar can be considered as enema solution for hepatic encephalopathy to avoid damage by osmosis in clinic.

Objective Using the evidence-based medicine to investigate the effect of cognitive behavior intervention on physical and mental health in patients with type 2 diabetes mellitus.Methods Controlled studies related to psychological intervention on depression and glyeosylated hemoglobin in patients with type 2 diabetes were retrieved from electronic databases such as CNKI,VIP,Wanfang database and Pubmed,etc.The quality of included studies was evaluated and then data were analyzed by using RevMan5 software.Results A total of 273 articles were retrieved and finally 6 were enrolled.Results of Meta analysis were listed as follows:Cognitive behavior intervention could reduce score of Self-rated Depression Scale (SDS) in patients with diabetes mellitus.Cognitive behavior intervention could effectively reduce glycosylated hemoglobin values in patients with diabetes mellitus.Conclusions Cognitive behavior intervention can improve physical and mental health,decrease glycosylated hemoglobin and improve depression status in patients with type 2 diabetes mellitus.However,all the trials included in this review are of low quality; larger scale RCTs of higher quality are needed to confirm this conclusion.

Objective To test the reliability and validity of the Chinese version of Profile of Fatigue Scale (PROF)among the patients with Sjogren′s syndrome. Methods The English version of PROF was translated into Chinese according to Brislin Translation Model. 107 patients with Sjogren′s syndrome were investigated to test its reliability and validity. Results The Cronbachαcoefficient , Guttman split-half coefficient, test-retest reliability and content validity of Chinese version of PROF were 0.976, 0.953, 0.872 and 0.875. Two factors were extracted by factor analysis and the cumulated variance was 80.75%. The structure of PROF was in line with the original scale. The criterion-related validity was 0.621 measured by comparing with visual analog scale of fatigue, and was -0.707 measured by comparing with vitality domain in the MOS item Short From Health Survey (SF-36). Conclusions The Chinese version of PROF has been proved to be reliable and valid. It can be used to measure the fatigue in Chinese patients with Sjogren′s syndrome.

Objective To investigate the status quo of new allocated nurses to master relevant knowledge of blood specimen collection.Methods 197 new allocated nurses and young nurses within 5 working-years were included and the new allocated nurses accepted knowledge training of blood specimen collection.Differences in training effect between nurses with different work experience and education background were analyzed.Results Average score of new allocated nurses before training was lower than young nurses,while after training,there was no difference between them.The training score of new allocated nurses did not correlate with their background before and after training.Conclusions In order to improve the quality of testing and prompt development of new nurses,the department of clinical nursing should strengthen the relevant training about knowledge of blood specimen collection in new allocated nurses.

No abstract available.
Arthritis, Rheumatoid* ; Humans

ObjectiveTo investigate the clinical features and treatment of severe acute pancreatitis (SAP) complicated by pancreatic abscess (PA). MethodsThe clinical data of 17 SAP patients with PA who were admitted to Affiliated Hospital of Luzhou Medical College from January 1, 2005 to August 25, 2015 were analyzed retrospectively. The clinical manifestations, therapeutic methods, and outcome were summarized. ResultsOf all the 17 patients, 12 patients underwent surgical operation, among whom 9 were cured, 1 experienced postoperative intestinal fistula, and 2 experienced recurrence of abscess and underwent the surgery again (1 died of multiple organ failure), and the mean hospital stay was (108.29±52.37) d; 5 patients underwent percutaneous catheter drainage, among whom 4 were cured, and 1 underwent surgical treatment due to inadequate drainage, and the mean hospital stay was (53.03±6.71) d. ConclusionAdequate drainage should be performed once a confirmed diagnosis of PA is made, and appropriate drainage methods should be selected based on the patient′s actual condition. Minimally invasive treatment has a good effect, a short length of hospital stay, and few complications, and holds promise for clinical application.

Objective To explore the effects of different sleep quality, morbid state and psychological status on the fatigue of patients with sjogren syndrome based on the comprehensively investigation of fatigue status in patiens with sjogren syndrome. Methods We adopted descriptive study of the non-experimental study, and selected 135 patients who were dignosed with sjogren syndrome, received treatment in two tertiary hospitals and met the inclusion criteria by convenience sampling method. Patients were surveyed by questionnaire package about the fatigue status. The questionnaire package included the general information questionnaire, Piper profile of fatigue (PROF), Pittsburgh sleep quality index (PSQI), hospital anxiety and depression scale (HADS), and EULAR sjogren syndrome disease activity index (ESSDAI). Statistical analyses including t-test, Pearson correlation analysis and multivariate linear regression were performed to explore the influencing factors of fatigue. Results 56.1% of the patients with sjogren syndrome had fatigue symptom, and the score of PROF was (3.25± 1.95);while the score of PROF-somatic was (3.45±2.07) and the score of PROF-mental was (2.67±2.09). Multivariate regression analysis showed that: sleep status, anxiety, pain, ESSDAI were influencing factors of fatigue. Conclusions Rheumatology medical personnel should pay attention to the sleep quality of patients with sjogren syndrome, and give corresponding sleep guidance and nursing measures. In the clinical work, we should not only control the progress of disease, relievie pain, but also attach great importance to the patient′s mental health and early psychological intervention.

Peroral endoscopic myotomy (POEM) has emerged as a rescue treatment for recurrent or persistent achalasia after failed initial management. Therefore, we aimed to investigate the efficacy and safety of POEM in achalasia patients with failed previous intervention. We searched the MEDLINE, Embase, Cochrane, and PubMed databases using the queries “achalasia,” “peroral endoscopic myotomy,” and related terms in March 2019. Data on technical and clinical success, adverse events, Eckardt score and lower esophageal sphincter (LES) pressure were collected.The pooled event rates, mean differences (MDs) and risk ratios (RR) were calculated. A total of 15 studies with 2,276 achalasia patients were included. Overall, the pooled technical success, clinical success and adverse events rate of rescue POEM were 98.0% (95% confidence interval [CI], 96.6% to 98.8%), 90.8% (95% CI, 88.8% to 92.4%) and 10.3% (95% CI, 6.6% to 15.8%), respectively. Seven studies compared the clinical outcomes of POEM between previous failed treatment and the treatment naïve patients. The RR for technical success, clinical success, and adverse events were 1.00 (95% CI, 0.98 to 1.01), 0.98 (95% CI, 0.92 to 1.04), and 1.17 (95% CI, 0.78 to 1.76), respectively. Overall, there was significant reduction in the pre- and post-Eckardt score (MD, 5.77; p<0.001) and LES pressure (MD, 18.3 mm Hg; p<0.001) for achalasia patients with failed previous intervention after POEM. POEM appears to be a safe, effective and feasible treatment for individuals who have undergone previous failed intervention. It has similar outcomes in previously treated and treatment-naïve achalasia patients.

Objective:To explore the effect of postpartum fatigue(PPF) on maternal behavior in rats and its mechanisms.Methods:Sprague-Dawley (SD) rats on the first day after delivery were randomized into the control group and the PPF group using the random number table method, with eight rats in each group.The rat model of PPF was established by forcing rats to stand in a cage with water and last for seven days.To maintain galactosis and lactation, rats and pups were caged for 90 min after every 3 h of separation.The control group was separated routinely without any stimulus.The length and body mass of the pups were recorded at birth and postnatal day 7.On the seven days after modeling, the following maternal behaviors were observed via video recordings: suckling, nesting, clicking and retrieval.The morphology of neurons in the paraventricular nucleus of hypothalamus (PVH) was observed by HE staining.The expression of oxytocin in the paraventricular hypothalamus (OxtPVH) was determined by immunofluorescence and immunohistochemistry.Western blot and qRT-PCR were performed to detect mRNA and protein expression of prolactin (PRL) in pituitary gland, respectively.Statistical analysis was performed by SPSS version 22.0, normally distributed continuous variables were compared between the two groups using an independent-sample t test, and nonnormally distributed continuous variables were compared between the two groups by Mann-Whitney U test. Results:On the seventh day after modeling, the length and weight gain of pups in the PPF group ((5.82±0.17) cm, (5.33±2.54) g)were significantly lower than those of the control group ((6.24±0.36) cm, (7.92±2.54) g, t=3.199, 2.227, both P<0.05). Compared with the control group, the rats in PPF group exhibited abnormal maternal behaviors, such as gnawing cage, biting tails, turning circles, repeatedly nesting and refusal to suckling.The results from the maternal behavioral test revealed that the latency of first pup retrieval and last pup retrieval ((39.25±3.50) s, (280.75±59.16) s) in the PPF group were significantly prolonged compared with those in the control group((19.25±7.68) s, (146.00±49.62) s, t=-4.742, -3.490, both P<0.05), the duration of nesting building ((19.50±12.69) s)and clicking ((95.50±70.55)s) in the PPF group were significantly shorter than those in the control group((68.00±37.59) s, (243.00±62.07) s; t=2.445, 3.139, both P<0.05). Compared with control group, the neurons cells of PVH in the PPF group were in disordered manner and the OxtPVH content in the PPF group decreased significantly.The mRNA (0.33(0.29, 0.38) vs 0.85(0.76, 1.76), Z=-3.576, P<0.05) and protein ((1.00±0.65) vs (4.17±0.49), t=-7.726, P<0.05) levels of PRL in PPF group were significantly decreased compared with those in the control group. Conclusion:The behaviors of holding back, nesting and licking offspring are decreased in postnatal fatigued rats.This may be related to the decreased expression of OxtPVH and PRL in hypothalamus of female rats.

Objective To establish a high-quality and evidence-based interventions for management of oral mucositis on cancer patients who received chemo-radio therapy in Chinese clinical status .Methods Under the guidance of knowledge-to-action ( KTA ) process framework , we retrieved all evidence in evidence-based health care databases by the method of a structured search of the literature .Through reviewed and analysed the quality of literature and analysed national health environment , we synthesized , distilled and refined the evidence into best practice interventions according to JBI Best Practice Information Sheet author guideline and JBI -developed 2010 Grades of Effectiveness and levels of evidence .All interventions evaluated by relative experts and focus-group-discussion .Results After assessed the quality of literature , there were three articles that had been collected by the guideline of evidence based clinical practice , fourteen by systematically assessment , one by investigation report of current multicentric status , added three expert ’ s literature review or opinion , one evidence literature review .That all collected information had been formed four best information practice manual and one evidence-based summary.To establish the evidence-based nursing interventions for oral mucositis should include oral assessment process , oral care process , the pamphlet of patient education , basic oral care technique and quality audit standards .Conclusions Through the process of interventions ’ establishment , scientific credible and rigorous attitudes guided .Interventions supported by abundant evidence to ensure that they were practical , economical and suitable to manage and guide oral mucositis among cancer patients in Chinese clinical .