Objective To introduce the method and experience of the setting of psychological care nurses,to discuss its effect on high-quality nursing and on amelioration of the patients' negative moods.Methods Psychological care nurses were set up in all the clinical departments,after systemic training of psychological knowledge and became qualified psychological consultant via national certification examination.We took psychological care nurses as the leading role,assisted with other nursing modes.By the means of mental status scale in non-psychiatric settings (MSSNS) and the satisfaction questionnaire of psychological care to evaluate the patients' mental status and satisfaction degrees before and after the intervention in 297 cases.Results Patients'scores of anxiety scale,depression,anger,loneliness factor and the total score of the MSSNS after the psychological nursing intervention were significant differences than those before the psychological nursing intervention,[(39.66±4.70)vs (45.59±6.45),(23.31±2.28)vs (26.59±3.35),(13.91 ±3.01) vs (15.12±2.58),(17.58±3.74)vs (20.29 ±4.67),(92.09±6.85)vs (106.66±8.58),t values was 14.376,15.213,23.992,13.974,13.641 respectively,P＜0.05].The satisfaction rate of patients for psychological nursing intervention after the intervention was 96.97％(288/297),which was significant higher than that before the intervention,69.70％(207/297),x2=79.53,P＜0.05.Conclusions Psychological care demands professional qualities.Only through systemic training,can grasp the nurses master professional psychological knowledge and skill,so as to apply scientific psychological care to the patients and help them to solve their psychological perplexities and maintain physical and psychological well-beings.

Mean hemoglobin (Hb) concentration of about 3 500 subjects derived from 17 studies of Himalayan highlanders (Tibetans, Sherpas, and Ladakhis) was compared with lowlanders (Chinese Han, Indian Tamils) lived in the Himalayas, and European climbers during Everest expeditions as well as Andean natives. The results found that Hb concentration in Himalayan highlanders was systemically lower than those reported for Andean natives and lowland immigrants. These comparative data demonstrated that a healthy native population may successfully reside at high altitude without a significant elevation in Hb, and the lower Hb levels of Himalayan highlanders than those of migrated lowlanders and Andean natives are an example of favourable adaptation over the generations. In addition, excessive polycythemia has frequently been used as a marker of chronic mountain sickness (CMS). Altitude populations who have a higher Hb concentration also have a higher incidence of CMS. The low Hb in Himalayans suggested as showing adaptation over many generations in Tibetan stock. Recent work in Tibet, suggested that Tibetans there may have adapted to high altitude as a result of evolutionary pressure selecting for genes which give an advantage at altitude. All of the population genomic and statistical analysis indicated that EPAS1 and EGLN1 are mostly likely responsible for high altitude adaptation and closely related to low Hb concentration in Tibetans. These data supported the hypothesis that Himalayan highlanders have evolved a genetically different erythropoietic response to chronic hypoxia by virtue of their much longer exposure to high altitude.
Adaptation, Physiological ; Altitude ; Asian Continental Ancestry Group ; genetics ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; Evolution, Molecular ; Hemoglobins ; genetics ; Humans ; Hypoxia-Inducible Factor-Proline Dioxygenases ; genetics ; Tibet

Objective To investigate the clinical efficacy of Dahuang Xiaozhi Suppository in treating chronic abacterial prostatitis/chronic pelvic pain syndrome (CABP/CPPS) of moist heat and blood stasis syndrome. Methods Two hundred patients of CABP/CPPS were randomly divided into control group and observation group, 100 cases in each group. 2 groups were disabled anti-infective meidicne and other preparations, and received diet and life intervention. The control group received the treatment of Qianliean Suppository, and the observation group received the treatment of Dahuang Xiaozhi Suppository, one capsule each time, once a day, into the anus depth of about 3–4 cm. Ten days were a treatment course with two day interval between each course of treatment. The treatment lasted for three courses. The clinical efficacy of the two groups was observed and compared. The indexes including the scores of NIH-CPSI, leukocyte count and lecithin corpuscles in prostatic fluid, and urinary flow rate were evaluated. Results The total effective rate was 100% (100/100) in the observation group and 78% (78/100) in the control group, and the observation group was much higher than control group (P<0.05). The scores of NIH-CPSI and leukocyte count in both groups were significantly lower after treatment (P<0.01), and those in observation group weresignificantly lower than those in control group (P<0.01). The cases with lecithin corpuscles++++in both groups were significantly more after treatment (P<0.01), and those in observation group were significantly more than those in control group (P<0.01). The peak flow rate and mean flow rate in both groups were higher after treatment (P<0.01), and it was higher in observation group (P<0.01). Conclusion The efficacy of Dahuang Xiaozhi Suppository in treating CABP/CPPS of moist heat and blood stasis syndrome is remarkable, and it is better than Qianliean Suppository.

Objective To conduct an in vitro study of the growth of Pseudomonas aeruginosa,Staphylococcus aureus and Acin- etobacter spp.,and evaluate their response to various concentrations of tumor necrosis factor(TNF)-?,interleukin (IL)-1?, and IL-6.Methods To monitor the growth of bacteria incubated with the cytokines TNF?,IL-1?and IL-6 that were added to RPMI 1640 medium in various concentrations (10,50.100,500 pg,1 and 10 ng) at 2,4 to 6,8 and 16-18 h.The bacterial concentration was estimated when the mixtures of cytokines and specific neutralizing monoclonal antibodies (MoAbs) were in- cubated.Results We found that all three bacterial species showed concentration-dependent growth enhancement when incubated with one or more tested cytokines.Blockade by specific neutralizing cytokine significantly inhibited cytokine-induced growth. When compared with control,the 6 h growth response was maximal with IL-1?for Staphylococcus aureus and Acinetobacter spp.,and with IL-6 for Pseudomonas aeruginosa.Conclusions In this study we provide additional evidence for a newly de- scribed mechanism for bacterial proliferation in the presence of exaggerated and protracted inflammation.The effect that cyto kine-induced growth enhancement inhibited by specific neutralizing cytokine MoAbs may be useful for antimicrobial therapy.

Objective: To explore the clinical features and pregnancy outcomes of intrauterine subchorionic hematoma and retroplacental hematoma. Methods: From May 2016 to May 2018, in the Fourth Hospital of Xi′an City, 110 cases of intrauterine hematoma were selected in the middle of pregnancy, including 52 cases of subchorionic hemaloma (group A) and 58 cases of retroplacental hematoma (group B). The clinical features and pregnancy outcomes of the two groups were compared. Results: The volume of hematoma in group B was significantly smaller than that in group A [(8.8 ± 1.7) cm³ vs. (18.3 ± 2.0) cm³], the gestational weeks of group B was also significantly lower than that of group A [(35.2 ± 2.1) weeks vs. (38.4 ± 1.8) weeks], the full-term pregnancy rate in group B was lower than that in group A[56.9%(33/58) vs. 84.6%(44/52)], miscarriage rate and premature birth rate were higher than those in group A [20.7%(12/58) vs. 5.8%(3/52), 22.4%(13/58) vs. 7.7%(4/52)], and the differences were statistically significant (P < 0.05).The incidence of fetal distress in group B was higher than that in group A [17.4%(8/46) vs. 2.0%(1/49)], the incidence of fetal membrane rupture, placental abnormality, and placental residue was all higher than that in group A[41.3%(19/46) vs.10.2%(5/49), 37.0%(17/46)vs.12.2%(6/49), 28.3%(13/46) vs. 6.1%(3/49)], and the differences were statistically significant (P < 0.05). The neonatal body mass in group B was lower than that in group A [(3 091.7 ± 887.6) g vs. (3 457.6 ± 560.2) g], and the incidence of neonatal diseases was higher than that of group A [15.2%(7/46) vs. 2.0%(1/49)], and the differences were statistically significant (P < 0.05). Conclusions The volume of hematoma and gestational weeks of intrauterine retroplacental hematoma are lower than those of subchorionic hematoma, and the retroplacental hematoma is more likely to have adverse pregnancy outcomes.

ObjectiveTo explore the characteristics and rehabilitation of dysarthria patients who speak mandarin. Methods18 patients were rehabilitated with physiologic approach for 40 d. Before and after rehabilitation, maximum phonation time (MPT), frequency, tone and expiratory rate were tested with phonolaryngeal graph, while forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum midexpiratory flow (MMF), peak expiratory flow rate (PEFR) were tested with Microspiro; Articulation and intelligibility were tested with mandarin words table and rate of sentence and paragraph. ResultsCompared with that before intervention, MPT of the patients were longer after intervention (P<0.05). The FVC was lower than normal rate before intervention and it was remarkable higher after intervention(P<0.01).Correct rate of sentence and paragraph was remarkable higher(P<0.01). ConclusionTests of Phono-laryngograph, Microspiro and correct rate of sentence are good comprehensive evaluation methods to speech and phonation of dysarthria. Physiologic approach to rehabilitation can remarkably improve patient's communication ability.

OBJECTIVETo investigate the development of lactose intolerance in neonates with non-infectious diarrhea and its association with diarrhea, and to evaluate the diagnostic values of fecal pH value and urine galactose determination for neonatal lactase deficiency.

METHODSSeventy hospitalized neonates who developed non-infectious diarrhea between October 2012 and June 2015 were enrolled as the diarrhea group, and 162 hospitalized neonates without non-infectious diarrhea were enrolled as the non-diarrhea group. Test paper was used to determine fecal pH value. The galactose oxidase method was used to detect urine galactose. The neonates with positive galactose oxidase were diagnosed with lactase deficiency, and those with lactase deficiency and diarrhea were diagnosed with lactose intolerance. According to the results of urine galactose detection, 69 neonates in the diarrhea group who underwent urine galactose detection were classified into lactose intolerance group (45 neonates) and lactose tolerance group (24 neonates), and their conditions after treatment were compared between the two groups. The follow-up visits were performed for neonates with diarrhea at 3 months after discharge.

RESULTSFecal pH value and positive rate of urine galactose (65% vs 54%) showed no significant differences between the diarrhea and non-diarrhea groups (P>0.05). Fecal pH value showed no significant difference between the lactose intolerance and lactose tolerance groups (P>0.05), while the neonates in the lactose intolerance group had a significantly longer time to recovery of defecation than those in the lactose tolerance group (P<0.05).

CONCLUSIONSThe incidence of lactase deficiency is high in neonates, and diarrhea due to lactose intolerance tends to occur. Determination of fecal pH value has no significance in the diagnosis of lactose intolerance in neonates with diarrhea.

Diarrhea, Infantile ; etiology ; Galactose ; urine ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Lactase ; deficiency ; Lactose Intolerance ; complications

OBJECTIVEAim of our study was to compare hematological parameters in Tibetan natives with those in Han migrants living on the Tibet plateau in order to determine the potential effects of age, gender, and ethnicity on hematological response to hypoxia.

METHODSBlood hemoglobin (Hb, g/dl), hematocrit (Hct, %), red blood cells (RBC,10(6)/mm3) were measured in 3 588 healthy Tibetan natives and 3 371 Han migrants ranging in age from 5 to 72 years, living at a mean altitudes of 2 664 m, 3 813 m, 4 525m and 5 226 m.

RESULTSHemoglobin (Hb) concentration analysis was made by multiple regression equations relating hemoglobin to altitude and age. For 2 093 Han males, Hb = 9.612+ 0.001440xaltitude+ 0.06148xage. For 1 948 Tibetan males, Hb =12.202+ 0.000462xaltitude+ 0.02893xage. For 1 278 Han females, Hb = 10.858+ 0.000939xaltitude+ 0.02632xage. For 1 640 Tibetan females, Hb = 11.402+ 0.000626xaltitude+ 0.00412xage. Each of the four equations was statistically significant (P < 0.001), and had variance (r2) of 0.86 or more, indicating that altitude and age accounted for at least 85% of the variation in hemoglobin levels. The coefficients for altitude and for age were higher (P < 0.05) in Han males than in Tibetan males and higher (P < 0.05) in Han females than in Tibetan females. The Tibetan postmenopausal females had higher Hb values than premenopausal females only presented at altitude above 4 000 m while this phenomenon was beginning at altitude of 2 664 m among Han females.

CONCLUSIONWe conclude that gender and increasing age in Tibetans are associated with lower hemoglobin values than those in Han at high altitude, and we speculate that genetic factors seems to be important.

Adolescent ; Adult ; Aged ; Altitude ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Ethnic Groups ; Female ; Hematocrit ; Hemoglobins ; analysis ; Humans ; Hypoxia ; ethnology ; Male ; Middle Aged ; Tibet ; Transients and Migrants ; Young Adult

Objective To study the significance of the related parameters of the abduction angle ,anteversion angle and summit arc angle in the intraoperative localization of anterior column and anterior wall acetabular fractures .Methods The safety angle of abduction angle ,an-teversion angle,summit arc angle and anterior wall acetabular of 318 adult pelvic specimen(109 males and 109 females) were measured.The data was statistical analyzed.Results For the male pelvic specimen,the measured values of abduction angle of acetabulum was (43.5 ± 2.9)°, anteversion angle was (13.7 ±5.2)°,summit arc angle inside was(25.5 ±7.3)°,summit arc angle front was(37.8 ±7.2)°,sum-mit arc angle back(49.9 ±12.7)°.For female pelvic specimen,the measured values of abduction angles of acetabulum was (44.1 ±3.2)° and anteversion angle was (14.3 ±4.9)°,summit arc angle inside was(27.1 ±6.5)°,summit arc angle front was(36.3 ±9.2)°,summit arc angle back was(52.3 ±13.6)°.According to '2-7' sector method, the thickness of different point of anterior wall was measured .There were statistically significant differences in abduction angles ,anteversion angle and summit arc angle (P<0.05).And there was no statistically sig-nificant difference in the thickness of anterior column and anterior wall between the above three one angles (P>0.05),there was no signifi-cant difference in the acetabular abduction angle ,anteversion angle and summit arc angle between males and females .Conclusion The intra-operative localization of acetabulum abducted angle ,anteversion angle and summit arc angle in the acetabulum anterior column and anterior wall fractures can achieve satisfactory therapeutic effect .

Objective To analyze the characteristics of preoperative CTO lesions by coronary CT angiography (CCTA) and to compare the lesion characteristics and clinical data of patients with subsequent vs failed PCI.Methods A total of 113 patients were randomly selected and 116 vessels were analyzed by CCTA before PCI.The patients were further investigated as PCI success group vs PCI failure group according to their PCI result.Multivariate logistic regression analysis was used to determine the factors that affected the success of CTO intervention.The ROC curve was used to determine and evaluate the CT-CTO score and J-CTO score for diagnostic efficacy.Results The success rate of PCI was 55.2％.64 lesions were successfully opened,with the success rate of 72.4％.The prevalence of smoking in patients in the PCI failure group was significantly higher than that in PCI success group (65.4％ vs.42.2％,P ＜ 0.05).There were no significant differences between the two groups in age,gender,history of hypertension,diabetes mellitus,and myocardial infarction(P ＞ 0.05).Statistical differences were observed between the PCI success group and the PCI failure group in the presence of occlusion segment head-end bifurcation,occlusion severe incision,severe calcification (calcification ≥ 180°),occlusion segment length ≥ 20 mm,occlusion of calcification lesions,occlusion segment distal shape of the unambiguous of fiber cap shape of the distal occlusion segment under CCTA(P ＜ 0.05).In the PCI failure group,approximately 17.3％ of the patients had previous attempt to open the CTO lesions,which were higher than the PCI success group (9.4％).However,The difference was not statistically significant (P ＞ 0.05).Multivariate logistic regression analysis showed that the unambiguous distal fibrous cap of the occlusion segment and the occlusion of the proximal branch and the occlusion length ≥20 mm were the main factors affecting the failure of CTO intervention.In terms of prediction,the predictive value 30 CT-CTO score yielded a higher area under the ROC curve than that of the J-CTO score (0.8776 vs 0.7387,P ≤ 0.05).Conclusion CT angiography can predict the success rate of intervention for CTO lesions.Compared with J-CTO score,CT-CTO score has a higher predictive value.Unambiguous fiber cap shape,occlusion segment head end bifurcation,occlusion segment length ≥20 mm were the independent risk factors that affecting the success of CTO operation.