Objective:To investigate the effect of holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy. Methods: 80patients with cervical cancer were divided into observation group (40cases) and control group (40cases), and patients of control group received routine nursing modein perioperative period while patients of observation group received holistic nursing mode in the same stage. The complication of the two groups were compared and analyzed, and the satisfaction degree for nursing mode was investigated.Results: Under the intervention of holistic nursing, the number of complication of observation group was significantly lower than that of control group (x2=8.205,P<0.05). And the satisfaction degree for nursing of observation group was significantly higher than that control group(x2=5.000,P<0.05).Conclusion: The holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy can significantly improve the life quality of patients, and reduce the occurrence of complication, and enhance the satisfaction degree of patients for nursing.

Objective To investigate the features of the cerebrospinal fluid (CSF) in the modified ZeiM-Neelsen (MZN) positive tuberculous mengningitis (TBM).Methods We retrospectively reviewed the clinical data of 170 patients with tuberculous meningitis confirmed by MZN stain from December 2012 to July 2015.The purpose of the present study was to investigate the relationship of MZN staining and CSF cytology.Results Among 170 patients with TBM confirmed by MZN staining,128 cases had first detectable acid-fast bacillus (AFB) in earlier stage.The cytology included 15.5％ mixed cellular cytology,58.5％ lymphoid cytology,19.5％ neutrophilic cytology and 6.5％ normal cytology.Twenty-four cases had first detectable AFB within 1-2 months following disease onset.The cytology included 13.1％ mixed cellular cytology,56.6％ lymphoid cytology,21.7％ neutrophilic cytology and 8.7％ normal cytology.Eighteen cases had first detectable AFB 2 months after disease onset.The cytology included 26.7％ mixed cellular cytology,46.7％ lymphoid cytology,20.0％ neutrophilic cytology,6.6％ normal cytology.There was no significant difference in median time of first detectable AFB among those four types of cytology (P=0.812).There was significant difference in median time of first detectable AFB between patients with and without anti-TB therapy [21.5 (12.3,37.8) days vs.8.5 (6.0,16.3)days,P＜0.001].There was no significant difference in median time MZN stain turning negative between patients with and without anti-TB therapy [11 (5.75,19.25) days vs.6(4.25,10.75)days,P=0.230].Conclusions AFB can be detectable within a month after the onset of TBM in most of cases.(MZN) positive staining is not associated with the major type of cytology.Anti-TB therapy may delay the first detectable time of AFB.

Objective To investigate the influence of intravenous infusion by double-lumen peripherally inserted central catheter (PICC)on continuous dynamic central venous pressure(CVP)monitoring.Methods In the patient undergoing the double-lemon PICC,continuous dynamic CVP monitoring was performed by a lumen and the intravenous infusion was conducted by another lu-men.Whether the simultaneous venous infusion affecting the values of continuous dynamic CVP monitoring was observed.Results Intravenous infusion through double-lumen PICC had no influence on simultaneously continuous dynamic CVP monitoring (P>0.05),which could influence the values of CVP monitoring when simultaneously using the intravenous infusion pump(P<0.05). The speed of pumping fluid had no influence in a shout time(10 min),with significant difference(P>0.05).The CVP values could recovered to the status before infusion when continuously infusing after stopping using the infusion pump.Compared with before in-fusion,the CVP values after stopping intravenous infusion had no obvious change(P>0.05).Conclusion Intravenous infusion by double-lumen PICC has no influence on continuous dynamic CVP monitoring.But simultaneously adding infusion pump has certain influence on the CVP monitoring values.

Objective To investigate the effect of the balloon Bionic midwifery on the delivery outcomes and to analyze the clinical value.Methods 1 683 parturients from June 2014 to May 2015 were selected.They were randomly divided into observation group (832 cases,applied balloon Bionic Midwifery) and control group 851 cases.We compared the labor,the postpartum hemorrhage,the outcomes of pregnancy and the rate of survival of neonates of the two groups.Results The first and second stage as well as the total stage of labors of the observation group were lower than the control group (P＜0.01);Also,the rate of cesarean delivery and the hemorrhage together with the asphyxia of neonates were lower than the control group (P＜0.01).However,the rate of vaginal delivery was higher than the control group (P ＜0.05).The differences between them had a great statistical significance.Conclusions The balloon bionic midwifery technology has an advantage in reducing the rate of cesarean delivery and the maternal pain of pregnant women as well as the maternal complications.It is an effective and safe midwifery technology.So it has a great value of spreading in clinical trials.

Objective To explore the diagnostic significance of Xpert MTB/RIF in cerebrospinal fluid,and evaluate the application for early diagnosis of tuberculous meningitis(TBM).Methods Sixty cases of TBM and 30 cases of non-TBM patients were selected as our subjects.Xpert MTB/RIF and modified Ziehl-Neelsen stain were performed in cerebrospinal fluid.The detection rate of the system and the resistance of the patients were analyzed.Results Eleven cases were diagnosed as the positive cases in 60 cases with TBM,and 0 case was diagnosed as TBM in control group.Sensitivity and specificity of Xpert with TBM were 18.33％ and 100％,respectively.The difference of the two groups was statistically significant (P =0.014).The positive rate of definite group was 23.68％(9 cases),18.18％(2 cases) in probable group and 0％ in possible group,and the difference of the three groups was statistically significant(x2 =3.070,P＞0.05).The resistance rate was 36.36％ (4/11).Sensitivity of the modified Ziehl-Neelsen staín was 63.33％ (38/60).Eleven cases were detected positive by Xpert MTB/RIF,9 cases were positive with modified acid fast staining,and the positive rate was 18.33％,and the difference of the two methods was statistically significant (P =0.000).Conclusion Xpert MTB/RIF test is simple and rapid diagnostic method.The combination of Xpert MTB/RIF and modified ZiehlNeelsen stain will improve the efficiency of the early diagnosis of TBM.

ObjectiveTo analyze the clinical manifestation of hemolytic disease of the newborn (HDN) due to anti-M and Rhesus system.MethodsClinical information was collected and analyzed for three cases with HDN due to anti-M and 64 with Rhesus hemolytic disease, who were admitted to Department of Neonatology, Beijing Children's Hospital Affiliated to Capital Medical University from February 2011 to January 2015, as well as another 28 cases of HDN due to anti-M with complete information retrieved from literature in Wanfang and China National Knowledge lnfrastructure (CNKI) Database from 1992 to 2014.Chi-square test was performed for statistical analysis.ResultsTwo out of the 64 Rh hemolytic babies gave up therapy due to kernicterus and another two out of the 31 MN hemolytic babies, obtained from literature, died 24 h after birth because of anemia or edema, while the rest survived. Although more babies were the first child of the family in HDN due to anti-M than those of Rh hemolytic disease [26%(8/31) vs 9%(6/64),χ2=4.487, P=0.034], but lower incidence of jaundice [81%(25/31) vs 98%(63/64),χ2=9.686,P=0.002], less proportion of presentation of jaundice within 24 h after birth [29% (9/31) vs 64%(41/64),χ2=10.279,P=0.001] and lower positive rate of direct antiglobulin test [39%(12/31) vs 100%(64/64), Fisher exact test,P=0.000] were shown in HDN due to anti-M. No significant difference was found in the incidences of hyperbilirubinemia [58%(18/31) vs 66%(42/64),χ2=0.513], severe hyperbilirubinemia [23%(7/31) vs 36%(23/64),χ2=1.724], anemia [81%(25/31) vs 89%(57/64),χ2=1.253] and severe anemia [29%(9/31) vs 34%(22/64),χ2=0.271] between HDN due to anti-M and Rh hemolytic babies (allP>0.05).ConclusionsHDN due to anti-M and Rhesus hemolytic disease can cause severe pathological jaundice and/or anemia in newborns. Indirect antiglobulin test should be offered when direct antiglobulin test is negative which is helpful in the diagnosis of HDN due to anti-M.

Objective To assess the efficiency and safety of mycophenolate mofetil (MMF) in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO). Methods Twenty-seven patients with MS or NMO were selected, and the patients were divided into 2 groups:MMF group (MMF combined with glucocorticoid treatment group, 10 cases) and glucocorticoid group (only glucocorticoid treatment group, 17 cases). There were 5 cases with MS and 5 cases with NMO in MMF group. There were 13 cases with MS and 4 cases with NMO in glucocorticoid group. The therapeutic efficacy 6 months after treatment, expanded disability status scale (EDSS) before treatment and 6 months after treatment, and annualized relapse rate (ARR) were compared; and the safety was observed. Results There was no statistical difference in efficacy rate 6 months after treatment between MMF group and glucocorticoid group: 9/10 vs. 11/17, P>0.05. The EDSS scores 6 months after treatment in MMF group and glucocorticoid group were significantly lower than those before treatment: (2.41 ± 2.05) scores vs. (3.40 ± 2.05) scores and (1.17 ± 0.92) scores vs. (2.38 ± 1.28) scores, and there were statistical differences (P<0.05), particularly for the patients with MS. The ARR 6 months after treatment in MMF group was significantly lower than that before treatment: 0 time/year vs. 0.75 times/year, and there was statistical difference (P<0.05). The difference of ARR before and after treatment in MMF group was significantly higher than that in glucocorticoid group: 0.75 times/year vs.- 0.46 times/year, and there was statistical difference (P<0.01), particularly for the patients with MS. Only 1 female patient had myalgia when taking higher dosage of MMF, and the symptom tended to relieve after the dosage was reduced. Conclusions MMF is effective in the treatment of MS and NMO. MS can improve the neurological function and reduce the recurrence of the disease;and the safety is high.

Objective: To compare the efficacy and safety of Cardi-O-fix patent foramen ovale (PFO) occluder and Amplatzer PFO occluder for the treatment of patients with PFO. Methods: A total of 246 consecutive patients (105 males and 141 females) with PFO were prospectively enrolled from May 30, 2013 to March 30, 2015 in our hospital. PFO interventional closure was applied according to the anatomical structure of the disease and patients′ wishes.Cardi-O-fix PFO occluder was used in 180 cases (COF group), Amplatzer PFO occluder was used in the remaining 66 cases (Amp group). Post-procedure safety including recurrent stroke, transient ischemic attack, death, and complete closure rate, and efficacy including procedure related complications of different devices were compared during the 12 months follow-up. Results: (1) Rate of transient ischemic attack was similar between COF group and Amp group at 12 months after procedure(1.1%(2/180) vs. 1.5%(1/66), P=1.000). There was no recurrent stroke and death during the 12 months follow-up period.Complete closure rate was similar between COF group and Amp group at 12 months after the procedure(90.6%(163/180)vs. 86.4%(57/66), P=0.355). (2) Three cases(1.7%) of paroxysmal atrial fibrillation were observed in COF group during the 12 months follow-up period, 1 patient converted spontaneously to sinus rhythm and 2 patients received successful pharmacologic conversion and converted to sinus rhythm. One patient(1.5%)developed paroxysmal atrial fibrillation and was pharmacologically converted to sinus rhythm in the Amp group. There was no significant difference in rate of paroxysmal atrial fibrillation between the two groups(P=1.000). There was no complications such as occluder translocation, erosion, pericardial effusion and puncture site bleeding in the 2 groups during the 12 months follow-up. Conclusion Efficacy and safety are similar for PFO treatment with Cardi-O-fix PFO occluder or Amplatzer PFO occluder in this patient cohort.

OBJECTIVETo study the toxicological effects of benzo[a]pyrene(BaP) on mammalian animal's nerve tissue.

METHODS50 Kunming mice were divided into 5 groups at random, the exposed groups(3 dose level groups), the vehicle control group and standard control group. Every group got 10 mice. The exposed groups were treated by intraperitoneal injection with BaP dissolved in vegetable oil at 7.8, 3.2 and 1.3 mg/kg respectively, 4 times/week, for 10 weeks, the vehicle control group were given vegetable oil and the standard control group were not given any treatment. All the mice were anesthetized with 0.02 mol/L pentobarbital and infused with 1.33 mol/L paraformaldehyde dissolved in PBS through heart after 10 weeks. Then the brain, spinal cord and sciatic nerve were removed. Slices of these tissues were made and morphological changes were observed by optical microscope and electron-microscope. Cell appoptosis was examined by TUNEL(TdT-mediated x-dUTP nick end labeling) method.

RESULTSMorphological observations showed tissue injury in BaP exposed groups. There were focal necrosis areas found in the high-dose group. The cell apoptosis rates in 3.2 and 1.3 mg/kg groups were 90.02%-94.22% and 62.45%-77.54% respectively, significantly higher than those of vehicle control group and standard control group(4.60%-5.57%).

CONCLUSIONBaP is neurotoxic. It could damage the nerve tissue as well as induce DNA breaks and cell apoptosis.

Animals ; Apoptosis ; drug effects ; Benzo(a)pyrene ; toxicity ; Brain ; drug effects ; pathology ; Dose-Response Relationship, Drug ; In Situ Nick-End Labeling ; Mice ; Sciatic Nerve ; drug effects ; pathology ; Spinal Cord ; drug effects ; pathology

OBJECTIVETo observe the effect of oversized occluder on endothelialization post percutaneous closure of experimental atrial septal defect (ASD) in dogs.

METHODSASD was established with the help of transthoracic echocardiography in 18 dogs. ASD size was (6.0 ± 0.2) mm. Dogs were randomly divided into normal size group (implanted with 8 mm occlude, n = 9) and oversized group (implanted with 12 mm occluder, n = 9). Dogs were randomly killed at 3, 6 and 14 months after percutaneous closure. The endothelialization process on device surface was observed by scanning electron microscope.

RESULTSFour animals died around 1 month post procedure. Microscopic sections from normal group showed nearly complete endothelialization at 3 months after device implantation and complete endothelialization at 6 and 14 months after device implantation. While microscopic sections showed lack of endothelialization at 3 months post implantation, nearly endothelialization at 6 months, and complete endothelialization at 14 months after device implantation in oversized group.

CONCLUSIONIncomplete endothelialization of occluder surface is observed at 6 months after implantation of an oversized ASD occluder device in this model.

Animals ; Dogs ; Echocardiography ; Heart Septal Defects, Atrial ; diagnostic imaging ; therapy ; Percutaneous Coronary Intervention ; Septal Occluder Device