ObjectiveTo investigate the feasibility of apphcation of risk factors management in nursing of the fever outpatient.Methods145 patients from May to December 2009 admitted to fever clinic was defined as the control group, 157 patients from January to May 2010 admitted to fever clinic were set as the observation group. The control group was given routine nursing, while the observation group adopted risk factor management measures. The management indices of the two groups were compared.ResultsThe patients' recognition score of risk factors of fever clinic was (85.4 ± 2.7)in the observation group, higher than(73.2 ± 3.9)in the control group. Patients' satisfaction degree was 84.7％ in the observation group, higher than 67.6％ in the control group. Rate of risk event of the observation group was 1.3％, lower than 6.2％ in the control group, the incidence of nursing errors was 0.6％ in the observation group, lower than 4.1％ in the control group, rate of patients' complaints of nurses was 1.3％ in the observation group, lower than 5.5％ in the control group.ConclusionsThe implementation of risk factors management in fever clinics can reduce medical accidents, improve nursing quality, so this clinical management mode deserves promotion and application.

Objective To investigate the effect of nursing intervention on preventing leakage of urine in patients with indwelling catheter in neurology department.Methods A total of 76 patients with indwelling catheter in neurology department were randomly assigned into the observation group and the control group with 38 cases in each group.The control group received routine care,the observation group received systemic nursing intervention on the basis of routine care.The incidence of leakage of urine and patients satisfaction degree with nursing service was observed between two groups.Results The incidence of leakage of urine in the control group was 21.1％,higher than 2.6％ of the observation group.he score of satisfaction degree of the observation group was (4.66±0.62),higher than(3.26±0.42) of the control group.Conclusions Nursing intervention can effectively reduce the incidence of leakage of urine and improve the satisfaction degree of patients with indwelling catheter in neurology department,it is worthy of clinical application.

Objective To investigate the ureteral injury in gynecological laparoscopies and discuss its diagnosis,treatment and prevention.Methods Six cases of ureteral injury were reviewed.The clinical features including the type of diseases,uterine size,pelvic adhesion and the methods of diagnosis,treatment were studied.Results Ureteral injuries happened during laparoscopically assisted vaginal hysterectomy(LAVH). The gynecological disorders included pelvic adhesions,endometriosis and leiomyoma in cervical.Patients presented flank pain,fever,increased volumes discharge.Conclusion Ureteral injury is an uncommon and sever complication in gynecological laparoscopies.Fever,flank pain and abnormal vaginal discharge should be paid attention to be ureteral injury.

Objective To investigate the epidemiology and clinical features of epidemic cerebrospinal meningitis of children in Shanghai area in the last 2.5 years. Methods A retrospective study was conducted in 27 hospitalized patients with epidemic cerebrospinal meningitis by analyzing the clinical manifestation,epidemiology and laboratory test fingdings from Jan.2006 to Jun.2008.Statistical analysis of the clinical manifestations of cases in serogroup A,B and C was performed according to Neisseria meningitidis infection. Results There were sporadic cases of children with epidemic cerebrospinal meningitis in Shanghai area in the last 2.5 years.The seasonal distribution illustrated the peak occurrence from Feb.to Apr.Among all these cases,92.6% were floating children.Common types(74.1%) were the predominant clinical manifestations and the others were fulminate types(25.9%).Four cases in each of serogroup A and B,and 8 cases of serogroup C were identified by serotyping on 14 Neisseria meningitidis strains and genotyping on the other 2 cases′ cerebrospinal fluid specimens.All the patients in serogroup A with meningococcal diseases were not vaccinated before and 25.0% of them belonged to fulminate types.Half of the cases had petechia on the skin and the prevalence of skin necrosis was 25.0% and 50% had complications of nervous system.No fulminate type was present in cases of serogroup B meningococcal disease and only 1 case had slight petechia on the skin.However,intensive convulsions occurred in 75.0% of the patients,and all of them had complication of nervous system,with a few had sequela.Among the patients in serogroup C meningococcal disease,62.5% patients were vaccinated with serogroup A Neisseria meningitidis.In serogroup C,Neisseria meningitidis infection was found in each age group,with petechia on skin,skin necrosis,immunity correlation fever and complications of nervous system in 87.5%,50.0%,75.0% and 12.5% of the patients,respectively. Conclusions 1.Epidemic cerebrospinal meningitis occurred sporadically in children in Shanghai area,the majority of patients were floating populations.2.Clinical manifestation was typical in patients of serogroup A meningococcal disease.Subdural effusion or ventricalitis was more common in patients of serogroup B meningococcal disease.In serogroup C,Neisseria meningitidis was the most prevalent serotype leading to epidemic cerebrospinal meningitis.More cases were found in patients infected with serogroup C,Neisseria meningitidis with severe shock and immunity correlation fever compared with the other groups.Prophylactic vaccination of serogroup C polyvalent meningococcal organism should be recommended.

Objective To study the effect of H_2O_2 on the cultured melanocytes and the relationship between oxidative stress and vitiligo.Method Melanocytes were cultured with H_2O_2,the proliferation and melanogenesis of melanocyte were analysed by MTT and NaOH assay.Result H_2O_2 can inhibite the proliferation and melanogenesis of melanocytes,and the inhibition was concentration and-time-dependent.Conclusion Oxidative stress can inhibite the proliferation and melanogenesis of melanocytes,but oxidative damage can not induce vitiligo.

Dental Porcelain ; classification ; Humans

Objective To analyse the cause of misdiagnosis of tuberculosis peritonitis and discuss feasibility for diagnosis of tuberculosis peritonitis by laparoscopy. Methods 12 patients misdiagnosed as tuberculosis peritonitis were retrospectively analysed. Results Tuberculosis peritonitis wrongly diagnosed because of atypical clinical behaviors in spite of specific laboratory examination. However, laparoscopy could diagnose tuberculosis peritonitis exactly and quickly. Conclusion Laparoscopy is an effective method of diagnosis for tuberculosis peritonitis.

Objective To explore the functional expression and temporality of MDR1 gene in bone marrow of rabbits after autologous bone marrow transplantation with MDR1 transferred bone marrow mononuclear cells. Methods The supernatant of the amphotropic virus producer cell line PA317-HaMDR1/A was collected and concentrated to cocultivate with the bone marrow mononuclear cells of the rabbits. After large dose of chemotherapy with cyclophosphamide,the transferred cells were autotransplanted into the bone marrow. The integration,transfection rate and physiological function of MDR1 gene were tested by PCR,SP immunohistochemical method and daunorubicin (DNR) extrusion test respectively. Results After autologous bone marrow transplantation had been executed for 1-4 months,the integration of MDR1 gene in genome of bone marrow mononuclear cells was detected by PCR,and the expression rates of P-gp in cells tested by SP immunohistochemical method were 9.5%,8.5%,6.0% and 3.5% respectively. The physiological function of MDR1 gene in bone marrow cells was proved by DNR extrusion test. Conclusion After the autotransplantation with bone marrow mononuclear cells transferred by MDR1 gene,the MDR1 gene can implant into the bone marrow of rabbits and has expressed functionally for 4 months,which has provided a basis for further research on chemoprotection experiment of the MDR1 gene transferred into the bone marrow cells.

Objective To study the advantage of magnetic resonance imaging(MRI) in diagnosis of complications following liver transplantation.Methods The MRI appearances were analyzed retrospectively in seventy-eight patients with postoperative complications after liver transplantation which was confirmed by operation,hepatic biopsy,angiography and cholangiography.Results The symptoms of skin and sclera jaundice,fever and belly pain were found in sixty-four patients.Liver function was abnormal in laboratory tests.Fourteen were non-symptom with normal liver function.By analyzing the MRI images,the results were found including hepatic portal vein anastomosis stenosis(n=21),hepatic arterial anastomosis stenosis(n=10),inferior vena cava anastomosis stenosis(n=1),bile duct anastomosis stenosis(n=15),bile duct non-anastomosis stenosis(n=5),transplant rejection(n=17),hepatic carcinoma recurrence(n=9).Conclusion MRI can be revealed hepatic vessels and bile ducts stenosis and dilations;it's the best device in diagnosis of complications after liver transplantation.

Objective To investigated the efficacy of celecoxib for postoperative analgesia after endoscopic nasal surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes aged 18-64 yr were randomly assigned to one of three groups ( n = 40 each): control group ( group C); celecoxib 200 group ( group CEL1 ) and celecoxib 400 group ( group CEL2 ). The patients took celecoxib 200 and 400 mg by mouth at 1 h before induction of anesthesia in group CEL1 and CEL2 respectively. Anesthesia was induced with midazolam,propofol, remifentanil and rocuronium and maintained with iv propofol and remifentanil infusion. VAS was used to assess postoperative pain (0 = no pain, 10 = worst pain). In PACU when VAS score ≥3, the patients were given fentany125 μg iv every 5-10 min until the VAS score ＜ 3. After being discharged from PACU, the patients received celecoxib 200 mg every 12 h for 5 days in the 2 celecoxib groups. Oxycodone 5 mg was used as rescue analgesic when VAS score ≥ 4 until the VAS score ＜ 4. The number of patients who needed fentanyl for analgesia in PACU, the number of patients who needed oxycodone within 6 h, 6-24 h and day 2-5 after operation and side effects after operation were recorded. Analgesic efficacy was assessed at day 5 after operation and the satisfactory rate of patients calculated. Blood samples were obtained at 0, 6 and 48 h after operation for determination of PGE2,6-k-PGF1α and TXB2 concentrations. TXB2/6-k-PGF1α was calculated. Results The number of patients who needed fentanyl in PACU and the number of patients who needed oxycodone within 6 h and 6-24 h after operation were less, the satisfactory rate was significantly higher, and PGE2 concentrations in blood were significantly lower at 48 h after operation in the 2 celecoxib groups than in group C ( P ＜ 0.05 or 0.01 ). There was no significant difference in each index between the 2 celecoxib groups ( P ＞ 0.05 ). There was no significant difference in TXB2/6-k-PGF1α at each time point among the three groups. Nausea and vomiting occurred in one patient after operation in group C, but side effects were not observed in the 2 celecoxib groups. Conclusion Celecoxib given before and after operation can effectively relieve postoperative pain after endoscopic nasal operation by reducing PGE2 concentrations in blood.