Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; adverse effects ; Female ; Heart Injuries ; etiology ; Humans ; Iatrogenic Disease ; Syndrome

ObjectiveTo investigate the influence of gender and psychosocial parameters on the quality of life in patients with irritable bowel syndrome(IBS). MethodsOut-patients from Jan to Oct 2008 in the Department of Gastroenterology at the First Affiliated Hospital of Nanjing Medical University were enrolled. Based on Rome teria IBS was diagnosed. Interviewed by a GI physician with questionnaire of demographic data,Zung self-rating anxiety and depression scale(SAS/SDS) and IBS-specific quality of life(IBS-QOL) questionnaire. Results452 patients were diagnosed as IBS according to Rome Ⅲ criteria. IBS was more common in female. In male, anxiety and depression scales were significantly increased( t =7. 191、6. 459 ,P ＜ 0. 01 ) and the scale of IBS-QOL was significantly decreased ( t =9.119, P ＜ 0.01 ) in female IBS patients. In IBS patients, IBS-QOL scales were negatively associated with the anxiety and depression scales(P ＜0. 01 ). ConclusionThese results suggest that there were gender differences in psychological status and quality of life in IBS patients,and difference psychological status based on gender should influence the quality of life of patients with IBS.

OBJECTIVE: To explore the clinical application of gastric pharyngeal anastomosis assisted by laparoscope. METHOD: Apply laparoscope in the gastric pharyngeal anastomosis for 4 cases of advanced hypopharyngeal carcinoma and cervical esophageal carcinoma patients. RESULT: Gastric pharyngeal anastomosis assisted by laparoscope were successfully completed in all 4 patients, all patients avoided thoracotomy or laparotomy, one patient occurred pharyngeal fistula, and died six months later. One patient had cervical lymph node metastasis a year and a half later, without treatment again because of economicissue. The remaining two patients were still alive, one patient had survived 3 years and a half after operation, the other had survived 2 years and a half after operation. CONCLUSION Gastric pharyngeal anastomosis assisted by laparoscope is feasible. It can reduce the operation wound, improve the safety of operation and patients' life quality.
Anastomosis, Surgical ; Esophageal Neoplasms ; surgery ; Fistula ; pathology ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laparoscopy ; Lymphatic Metastasis ; Neck ; Pharynx ; pathology ; surgery ; Survival Rate

The culture conditions of Saccharomyces cerevisiae sp.strain by 1.1 b were optimized for the production of D-(-)-mandelate dehydrogenase which is useful for the asymmetric bioreduction of benzoylformate to form D-(-)-mandelate.The optimum medium(per liter)consistes of 60 g peptone,30 g maltose, 0.5 g MgSO_4,0.01 g ZnSO_4,1.0 g KCl.After optimization of the culture medium,the enzyme production in shake flasks is enhanced from 2.56 to 20.21 U/L.The optimum fermentation conditions were determined as follows:medium volume 100 mL(i.e.,40%for a 250-mL shake flask),pH 6.5,inoculum size 10%,temperature 30℃,and cultivation time 25 h.

The present paper consults the concept of clinical competence, cultivation actuality, examination and assessment system of master of nursing specialist (MNS) at home and aboard based on literature analysis.Currently there is neither unified concept of master nursing specialist clinical competence, nor a unique clinical ability training mode of MNS.This paper mainly expounds the differences of the nursing professional master degree graduate students clinical ability evaluation system at home and abroad in the assessment methods, assessment tools, assessment agencies and assessment index, pointing out that our country should make a unified concept of the clinical competence.We should develop a flexible, diverse clinical competency assessment method, establish specialized evaluation agencies which are independent of the government, and implement 3 level quality monitoring system-graduate school of the university, clinical college graduate school and nursing department of, to ensure the training quality.

Objective To explore the expression of BID protein and the relation ship of cell proliferation with apoptosis at different stages of IgAN.Methods The expression of BID protein、PCNA and FN in renal tissue was detected by immunohistochemistry,TUNEL and light microscopy were used to detect apoptotic cells.Results With the progress of IgAN,the expression of BID protein、PCNA、the number of apoptotic cells and FN increased gradually(P

Atherosclerosis ; diagnosis ; Humans ; Tomography, Optical Coherence ; methods

OBJECTIVEThis study aims to evaluate the reliability and validity of the Chinese version of the chronic oral mucosal disease questionnaire (COMDQ).

METHODSUsing translation, back-translation, quality evaluation, cross-cultural adaptation, and pre-assessment, a Chinese version of the COMDQ was drafted. A 26-item instrument which comprised of four domains: pain and functional limitation, medications and side effects, social and emotional aspects, and patient support was designed and tested. This questionnaire was given to patients who visited our clinic. After the patients accomplished the questionnaires, we analyzed the collected data to evaluate the reliability and validity of the scale.

RESULTSA total of 130 patients were enrolled in our study. All the COMDQ questionnaires were completely filled out. The Chinese version of the COMDQ showed the following psychometric properties: Cronbach's alpha of 0.914, split-half reliability of 0.809, and correlation of 0.697. Factor analysis of construct validity demonstrated that the 26 items were classified into four domains, and the cumulative proportion was 67.62%. Thus, the scale had certain logical relation between the items in the same domains.

CONCLUSIONThe Chinese version of the COMDQ demonstrate good reliability and validity by rigorous psychometric properties. It can be widely used to test the oral health-related quality of life of patients with oral mucosal diseases.

Objective To investigate the effects of propofol combined with remifentanil on he-patic ischemia-reperfusion injury in cirrhotic rats.Methods Sixty male SD rats of 260 to 300 grams were randomly divided into five groups(n=12):the sham-operated group(group S);the model con-trol group (group M);propofol group (group P);remifentanil group (group R);propofol combined with remifentanil group (group PR).In group M,P,R,PR,the hepatic arteries and veins of middle and left lobes were occluded for 20 min after 1 w hepatocirrhosis by using four principal factors,and group S went through an open surgery only.In groups P,R,and PR,porpofol (at a rate 20 mg·kg-1 ·h-1 for 1 h)、remifentanil (at a rate 1 μg·kg-1·min-1 for 1 h)and porpofol (at a rate 20 mg·kg-1· h-1 )combined with remifentanil(at a rate 1 μg·kg-1·min-1 for 1 h)was infused iv at 10 min before is-chemia,respectively.In group M,normal saline was infused iv at the same rate.Blood samples were taken at the end of 4 h reperfusion to determine serum AST,ALT activity.Meanwhile liver specimens were collected to assess Bcl-2 and Bax protein expression in liver cell and measuring the apoptosis in-dex(AI)of hepatic cell.The pathological change of liver was also examined.Results Compared with group S,the activity of AST,ALT,the expression of Bcl-2 and Bax and the apoptosis index(AI)of hepatic cell of the other groups all increased significantly(P <0.05);Compared with group M,the expression of Bcl-2 of groups P,R,PR significantly increased,and the activity of AST,ALT,the ex-pression of Bax and the apoptosis index(AI)of hepatic cell significantly decreased(P <0.05 );Com-pared with groups P and R,the expression of Bcl-2 of group PR significantly increased,and the activ-ity of AST,ALT,the expression of Bax and the apoptosis index(AI)of hepatic cell significantly de-creased(P <0.05);Microscopy and scanning electron microscopy showed that,for groups P,R,PR, pathological injury of liver tissue significantly reduced compared with group M.Conclusion Propofol combined with remifentanil can reduce the hepatic ischemia-reperfusion injury in cirrhotic rat by regu-lating Bcl-2 and Bax protein expression and inhibiting apoptosis.The effect is much more enhanced when they are used in combination than individuals.

Objective To study the etiology of severe acute pancreatitis (SAP) in Tibetan population at high altitude area.Methods Data of patients with acute pancreatitis (AP) from January 2013 to January 2016 were retrospectively collected.Tibetan and Han patients were selected.According to AP diagnosis criteria, the patients were divided into SAP and non-severe acute pancreatitis (NSAP).Chi square test and multiple Logistic regression analysis were used for data analysis.Results There were 53 Tibetan SAP patients, 98 Tibetan NSAP patients, and 47 Han SAP patients.The results of etiology analysis indicated that the ratios of biliary diseases caused pancreatitis in Tibetan SAP patients, Tibetan NSAP patients and Han SAP patients were 5.7% (3/53), 51.0% (50/98) and 6.4% (3/47), respectively;those alcohol caused pancreatitis were 39.6% (21/53), 10.2% (10/98) and 34.0% (16/47), respectively;those hyperlipidemia caused pancreatitis were 39.6% (21/53), 9.2% (9/98) and 40.4% (19/47), respectively;those drug caused pancreatitis were 1.9% (1/53), 2.0% (2/98) and 2.1% (1/47), respectively;those infection caused pancreatitis were 1.9%(1/53), 6.1%(6/98) and 2.1%(1/47), respectively;those trauma caused pancreatitis were 1.9%(1/53), 5.1%(5/98) and 2.1%(1/47), respectively;those other reasons were 3.8% (2/53), 13.3% (13/98) and 4.3% (2/47), respectively;and those unexplained pancreatitis were 5.7% (3/53), 3.1% (3/98) and 8.5% (4/47), respectively.The ratio of biliary diseases caused pancreatitis in Tibetan SAP patients was lower than that of Tibetan NSAP patients (5.7%, 3/53 vs 51.0%, 50/98), however the ratios of alcohol and hyperlipidemia higher than those of Tibetan NSAP patients (39.6%, 21/53 vs 10.2%, 10/98;39.6%,21/53 vs 9.2%, 9/98), and the differences were statistically significant (x2=31.069, 18.246 and 20.019, all P<0.01).Biliary disease was the independent etiology of NSAP in Tibetan (odd ratios (OR)=20.668, 95% confidence interval (CI) 5.072 to 59.427, P<0.01), but alcohol (OR=16.007, 95%CI 3.700 to 45.654) and hyperlipidemia disease (OR=11.590, 95%CI 2.581 to 33.859) were the independent etiologies of SAP (both P<0.01).There was no statistically significant difference in etiology of SAP between Tibetan and Han (P>0.05).Conclusion The etiology of SAP in high altitude Tibetan people is different from that of NSAP, however there is no difference in etiology of SAP between Tibetan and Han in the same area.