ObjectiveTo explore the effects of extended nursing intervention (ENI) in nursing ability of discharged patients with intubation of T-tubes.Methods Eighty-two patients with biliary diseases discharged with intubation of T-tubes were equally divided into two groups.The patients in the experiment group were treated with ENI and those in the control group were treated with conventional nursing.Each group received routine nursing and health education before discharge.All patients were followed up by a self-designed written questionnaire.Data regarding patients’ compliance behavior,knowledge of the diseases and satisfaction were collected and analyzed.Result Significant differences were observed between the two groups,the patients in the experiment group exhibiting better compliance behavior,their knowledge of their diseases improved and the rate of satisfaction higher (P<0.05). Conclusion ENI may be effective for the discharged patients with intubation of T-tubes to improve their compliance behavior, enhance their knowledge of their diseases and raise the rate of satisfaction.

Cardiovascular Diseases ; drug therapy ; prevention & control ; Humans ; Hypolipidemic Agents ; administration & dosage ; therapeutic use ; Risk Reduction Behavior

Coronary Disease ; drug therapy ; Humans ; Hypolipidemic Agents ; administration & dosage ; therapeutic use

Cell Line, Tumor ; Enzyme Inhibitors ; pharmacology ; Heterocyclic Compounds, 1-Ring ; pharmacology ; Humans ; Proteasome Endopeptidase Complex ; drug effects

AIM: To investigate the effects of propofol on the expression of tissue-type plasminogen activator (tPA) and matrix metalloproteinase 9 (MMP9) in the hippocampus and the cognitive function in neonatal rats.METHODS: The 7-day-old rats were randomly divided into 3 groups: the rats in control (CON) group were intraperitoneally injected with normal saline for 7 d;the rats in single dose of propofol anesthesia (SP) group were intraperitoneally injected with normal saline for 6 d and with propofol on the 7th day;the rats in repeated dose of propofol anesthesia (RP) group were intraperitoneally injected with propofol for 7 d.Blood glucose and blood gas analysis were tested in 6 rats of each group.The rats were randomly selected from each group to isolate the hippocampal tissues at 2 h, 24 h, 48 h, 72 h and 30 d after the last injection.The spatial learning and memory functions of the other rats aged 25 d were determined by Morris water maze.The morphological changes of the hippocampus were observed by HE staining and Nissl's staining.The expression of tPA and MMP9 at mRNA and protein levels was determined by RT-PCR and Western blot.RESULTS: Compared with group CON, the protein expression of tPA and MMP9 in RP group was significantly decreased at each time point, while no significant decrease was observed in SP group except at the time point of 24 h.Compared with CON group, the mRNA expression of tPA and MMP9 was down-regulated obviously in RP group, which was not significantly down-regulated in SP group.From the 3rd training day of Morris water maze beginning, the escape latency was prolonged, and the space exploration time and the number of crossing the original platform location were reduced in RP group compared with CON group and SP group, while no significant difference was observed between CON group and SP group.Compared with CON group, the number of nerve cells reduced and nerve cells arranged in disorder in the hippocampus in RP group.Moreover, the number of Nissl body decreased significantly and finally developed into neuronal degeneration and necrosis in RP group, and no significant difference between SP group and CON group was observed.CONCLUSION: Repeated dose of propofol anesthesia leads to long-term cognitive dysfunction in neonatal rats, which may be related to the down-regulation of tPA and MMP9 expression and destruction of normal morphology and function of neurons in hippocampus, whereas single dose of propofol anesthesia has no such effects.

Objective To investigate the critical thinking ability of medical students and its related factors in order to provide evidence for higher medical education reform. Methods A total of 325 medical students were selected by cluster sampling method, and Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) was adopted for survery. Results The average total score of critical thinking ability of medical students was above 280, and 51.08% of students showed positive critical thinking ability. Among all the seven critical thinking dispositions, average scores of each item were all positive (>40) except that the significance of truth seeking (37.23) and systematicity (39.05) were indefinite. There were significant differences in critical thinking ability between medical students with different gender and academic years (P<0.05). Conclusion The critical thinking ability of medical students is positive, however, there still exist some shortages. An equal relationship between teachers and students should be established, the traditional course system be continuously reformed, a good environment for clinical training be created, and a variety of teaching methods be implemented to further strengthen the critical thinking ability of medical students.

Aim To observe the improvement effects of parecoxib on ventricular remodeling after acute myocardial infarction in rats and its influence on PI3K/Akt signaling pathway.Methods Forty male Sprague-Dawley rats were randomly divided into five groups(n=8):sham operation group (group S), ventricular remodeling model group(group R), low dose of parecoxib group(group P1), middle dose of parecoxib group(group P2), and high dose of parecoxib group(group P3).A myocardial infarction model was established by ligating the left anterior descending branch(LAD) of coronary artery in group R, group P1, group P2 and group P3.One day after the operation,the rats were given intraperitoneal injection of 4,8,12 mg·kg-1 parecoxibin Group P1, group P2 and group P3,respectively, for two weeks.The same volume saline was given in group S and group R.Four weeks later, LVSP, LVEDP,+dp/dtmax,-dp/dtmax were monitored.The hearts were harvested to calculate left ventricular hypertrophy index.The pathological change of heart was examined with an optical microscope.The expressions of atrial natriuretic peptide(ANP) mRNA and brain natriuretic peptide(BNP) mRNA were detected by RT-PCR.The expression of PI3K,Akt,P-Akt and caspase-3 was detected by Western blot.Results Compared with group S, the cardiac function was decreased, the left ventricular hypertrophy index, the expression levels of ANP,BNP mRNA, caspase-3 were increased, and the expression levels of PI3K, P-Akt were reduced in group R(all P<0.05).Compared with group R, the cardiac function was ameliorated, the left ventricular hypertrophy index were reduced in group P2 and group P3(all P<0.05).The expression levels of ANP,BNP mRNA, Caspase-3 were decreased, and the expression levels of PI3K and P-Akt were increased in group P1,group P2 and group P3(all P<0.05).Conclusions Middle and high doses of parecoxib can mitigate the process of ventricular remodeling after myocardial infarctionand improve the myocardial function, and its underlying mechanism may be related to activating PI3K/Akt signaling pathway.

Aim To investigate the role of matrix metalloproteinase-9 down-regulation in the learning and memory dysfunction induced by propofol treatment in rats.Methods 7-day-old SD rats were randomly divided into three groups(n=18):control group(NS group) and repeated doses of propofol group(RP group) was intraperitoneally injected with normal saline and propofol respectively for consecutive seven days, single dose of propofol group(SP group) were intraperitoneally injected with normal saline first for consecutive six days, and then injected with propofol on 7th day.The blood gas and glucose levels were monitored of six rats randomly selected from each group.Morris water maze was conducted to test the learning and memory functions of the remaining rats.The expression of MMP-9, BDNF and caspase-3 was detected by Western blot, and the hippocampal neuron apoptosis was determinated by TUNEL staining.Results Compared with NS group and SP group, the escape latency in RP group was prolonged significantly, exploration time and the number of crossing the platform in RP group were markedly decreased(P<0.05).The expressions of MMP-9 and mBDNF in RP group declined, but the expression of proBDNF and the ratio of proBDNF/mBDNF in RP group were higher than those in NS group and SP group(P<0.05).Compared with NS group and SP group, the number of apoptotic neurons and the expression of cleaved-caspase-3 in RP group were increased significantly, but the expression of pro-Caspase3 in RP group was reduced(P<0.05).There was no difference between SP group and NS group regarding all the results(P>0.05).Conclusions Repeated exposure to propofol can lead to a decline in long-term learning and memory functions in neonatal rats, which may be related to the down-regulation of MMP-9 expression, proBDNF and mBDNF conversion disorder in hippocampus and the apoptosis of hippocampal neurons.However, single exposure to propofol has no significant effect.

Objective: To observe the clinical efficacy of acupuncture plus subtle adjustment manipulation of the cervical spine for peripheral facial paralysis.Methods: A total of 60 patients with peripheral facial paralysis who met the screening criteria were selected and divided into two groups according to the method of random number table, with 30 cases in each group. The patients in the acupuncture plus tuina group received routine treatment of acupuncture and subtle adjustment manipulation of the cervical spine, while the patients in the acupuncture group only received the same acupuncture treatment. Assessment of peripheral facial paralysis with integrated traditional Chinese and Western medicine was adopted for rehabilitation assessment. Results: The total effective rate of the acupuncture plus tuina group was 93.3％, while that of the acupuncture group was 70.0％, and there was a significant between-group difference (P<0.05). After treatment, the total scores of rehabilitation assessment in both groups were significantly higher than those before treatment (both P<0.05), and the score of the acupuncture plus tuina group was significantly higher than that of the acupuncture group (P<0.05). Conclusion: The treatment of acupuncture plus subtle adjustment manipulation of the cervical spine can improve the function of facial muscles in patients with peripheral facial paralysis, and its clinical efficacy is better than that of the acupuncture treatment alone.

Objective To explore clinical value of serum total bile acid(TBA) and cholinesterase(CHE) in infantile hepatopathy.Methods Sixty infants diagnosed respectively with breast milk jaundice,cytomegalovirus hepatitis and congenital bile duct teratism were included.Twenty healthy infants were as control.The infants of cytomegalovirus hepatitis were self-compared in acute stage and convalescence stage.Serum TBA and CHE in every group were measured and compared.Results Serum TBA in control group,breast milk jaundice group,cytomegalovirus hepatitis group and congenital bile duct teratism group were(6.47?3.25),(8.71?1.79),(45.86?40.85),(119.50?31.73) ?mol/L,respectively;and CHE were(11295.50?1731.91),(10762.89?1237.30),(9771.32?860.27),(7967.304?31.58) U/L,respectively.Compared with other groups,the level of serum TBA and CHE in cytomegalovirus hepatitis group and the congenital bile duct teratism group were significantly different(all P