目的探讨干预性护理措施对预防和减少脊髓损伤(SCI)患者脊髓功能的进一步损害、防止并发症发生的作用。方法对65例SCI患者在入院后进行康复护理评定,并随机分为观察组 (29例)和对照组(36例)。对照组患者实行常规护理,观察组患者在常规护理的基础上针对康复期存在的或潜在的功能障碍和并发症,采取干预性护理措施,12周后评定两组的护理效果并进行统计学分析。结果观察组和对照组患者的常见功能障碍和并发症是相同的,但观察组患者的肺部感染和尿路感染率低于对照组患者(P<0.05),深静脉血栓、皮肤压疮和烫伤的发生率明显低于对照组(P<0.01)。结论干预性护理措施可降低康复期SCI患者的肺部感染和尿路感染率,并使深静脉血栓、皮肤损伤等并发症明显减少。

Objective To explore quality of life (QOL) of spouses of spinal cord injury patients,as well as its influencing factors.Methods Sixty-eight spouses of spinal cord injury patients were recruited as an observation group.At the same time,another 70 healthy married people who had no serious chronic diseases in the family but were matched in gender,age,occupation and education were chosen as a control group.The QOL of all the subjects in both groups was investigated by way of a questionnaire survey.The results of both groups were compared and factors that influenced their QOL were explored.Results The QOL of spouses of spinal cord injury patients,including total QOL ( 3.22 ± 0.37 ),physiological function ( 60.57 ± 14.22 ),psychological state ( 60.09 ± 8.06 ),social relations (63.37 ± 8.10 ) and the living environment (66.86 ± 11.26 ) were significantly lower than in the control group (4.62 ± 0.75 ; 82.48 ± 10.92 ; 86.02 ± 8.75 ; 85.94 ± 10.13 and 83.23 ± 9.54,respectively).The QOL of spouses of spinal cord injury patients was closely related to the patient's injury type,injury position,the treatment protocol,as well as their own gender,vocation and education.Conclusion The QOL of spouses of spinal cord injury patients is significantly lower than that of normal people,and closely related with the patients' injury type,injury position and treatment,as well as their own gender,vocation and education.

Objective To explore the effects of comprehensive rehabilitation on nutriture and medical costs in the treatment of patients with dysphagia following stroke. Methods Eighty-seven patients with dysphagia were divided into an intervention group (IG) and a control group (CG). Comprehensive rehabilitation therapy including deglutition training, electric neuromuscular stimulation and acupuncture were used with the IG patients, but not with those in the CG. Nutriture parameters included a biochemistry index and a body measurement index. Medical costs were observed before and after one month of treatment for both groups. Results After one month of treatment, average deglutition scores and nutriture indices were significantly higher in the IG than in the CG. Medical costs for the IG had decreased significantly compared with the CG. Conclusions Comprehensive rehabilitation therapy improved deglutition function and slowed nutriture deterioration, while decreasing medical costs in the treatment of patients with dysphagia following stroke.

Objective To evaluate the effect of three different choices of indwelling urethral catheter clamping. Indwelling urethral catheter clamping choices included according to patients′complaints to clamp the catheter (Group A), released as schedule (Group B),and smooth passway of indwelling urinary catheter all the way (Group C). Methods We searched RCT about the effect of different choices of indwelling urethral catheter clamping from CNKI, VIP database,Wanfang database, PubMed on line. Literatures were searched from the database had been established till now. Two reviewers evaluate the literatures independently according to the RCT authentic assessment manual of Cochrane Collaboration. Other than different results, negotiation took as the measure to attach an agreement. No agreement reached, consult the opinion of the third person. RevMan5.2 was used to analyses the result of the study. Results Statistical difference between three clamping choice on the rate of successful in autonomous urination after catheter removed: both group A and group B preceded group C (Z=2.97, Z=4.34, P < 0.05), mean well group A preceded group B (Z=5.30, P < 0.05). Statistical difference did not found on the rate of urinary tract irritation after catheter removed between three choices. Conclusion Clamping indwelling urethral catheter according to patients′ complaints seems useful in bladder reconditioning before indwelling urethral catheter removal.

Objective To explore the clinical efficacy of motor imagery therapy in treating neurogenic bladder dysfunction after traumatic spinal cord injury (SCI).Methods Seventy patients with neurogenic bladder control problems after SCI were randomly divided into an experimental group and a control group using a random number table.All patients of the two groups were given general bladder function intervention,including intermittent catheterization,inducing voiding by reflex detrusor contraction,Credé's maneuver urination,etc.Additionally,the patients in the experimental group were given supplemental motor imagery therapy.The times of urinary incontinence,average bladder capacity,maximum voided volume and residual urine volume of the two groups were measured before treatment and at 2 months after treatment.The two groups' outcomes were quantified using a quality of life (QOL) score.Results Incidents of urinary incontinence,average bladder capacity,residual urine volume,voided volume and the QOL score showed significant improvements in both groups,but the experimental group showed better improvements than the control group.The differences were statistically significant.Conclusion The combination of general bladder function intervention with motor imagery therapy can improve the voiding function of patients with neurogenic bladder disorders after SCI more significantly and enhance their QOL.

Objective:To investigate the imaging manifestations and diagnostic significance of multislice spiral CT angiography for aortic intramural hematoma.Methods:Forty-three patients with aortic intramural hematoma who received digital subtraction angiography or multislice spiral CT angiography in Yiwu Central Hospital from November 2017 to September 2018 were included in this study. The misdiagnosis rate and image quality were compared between the two imaging examination methods.Results:The misdiagnosis rate of digital subtraction angiography was 6.98% (3/43) and that of multislice spiral CT angiography was 4.65% (2/43). There was no significant difference in the misdiagnosis rate between the two methods ( P > 0.05). The numbers of patients receiving multislice spiral CT angiography with grade III image quality ( n = 4) and grade IV image quality ( n = 2) were lower than those of patients receiving digital subtraction angiography ( χ2 = 3.957 and 4.074, both P < 0.05). There were no significant difference in the numbers of patients with grade I and II image quality between the two methods (both P > 0.05). Multislice spiral CT angiography showed that among 43 patients, 18 patients had non-ulcerative aortic wall hematoma, 25 patients had ulcerative aortic wall hematoma. Among patients with aortic wall hematoma, 14 patients had moderate or more amount of pleural effusion, with the average thickness of hematoma tissue of 11.42 mm, the maximum diameter of the involved ascending aorta of 56 mm, and the maximum diameter of the involved descending aorta of 44 mm. Conclusion:Multislice spiral CT angiography is superior to digital subtraction angiography in the diagnosis of aortic wall hematoma because it provides clearer images, which can help better present lesion changes.

Objective To investigate the effect of vertical bed training on the extubation time and pulmonary infection of patients with tracheotomy in rehabilitation department .Methods Sixty-five new patients with tracheotomy and pulmonary infection more than a month were randomly divided into the control group (33 cases) and the observation group (32 cases) by stratified block randomization .All the patients received routine nursing and rehabilitation therapy , in addition, the patients in the observation group received electrodynamic vertical bed training .The decannulation rate , cure rate of pulmonary infection , sputum culture negative rate and the clinical pulmonary infection scale ( CPIS) were compared.Results One patient was lost in each of the groups during follow up .After the nursing intervention , the CPIS of the observation group was significantly lower than that in the control group (t=9.276,6.609, respectively;P<0.01).22 patients (71.0%) in the control group removed the tracheal tube;20 patients (64.5%) cured of pulmonary infection;15 patients (48.4%) had negative sputum culture;the sare of CPIS was (2.8 ±1.1), those values of the control group were 43.8%, 37.5%, 25.0%and (3.9 ±1.5).There were significant differences between groups ( t/χ2 =4.76,4.60, 6.22,3.36, respectively;P<0.05).Conclusions Vertical bed training can reduce the time of tracheostomy , and help in control the pulmonary infection of patients with tracheotomy in rehabilitation department .

Objective To observe the effect of pulmonary function training instrument combined with resistance abdominal breathing training on respiratory function recovery of patients with cervical spinal cord injury.Methods Sixty cases of patients with cervical spinal cord injury were randomly divided into the research group(n=30)and the control group(n=30).The control group adopted sputum drainage nursing , abdominal breathing training and the comprehensive rehabilitation treatment such as limbs functional rehabilitation training , while the research group used pulmonary function training instrument combined with resistance abdominal breathing training in addition for eight weeks .Forced vital capacity ( FVC), forced expiratory volume in one second(FEV1.0), maximal voluntary ventilation ( MVV) and the detected rate of pulmonary pathogens were observed and compared.Results The FVC, FEV1.0, MVV was respectively (68.6 ±11.3)%, (75.8 ± 9.3)%and ( 67.4 ±11.6 )% in the research group after eight weeks , and ( 60.1 ±14.9 )%, ( 64.3 ± 13.2)%and (57.8 ±13.5)%in the control group, with statistically significant differences (t=2.78,2.52, 2.61, respectively;P<0.05).The rate of pulmonary pathogens was 6.67%(2/30) in the research group and 30.00%(9/30) in the control group, and the difference was statistically significant (χ2 =21.23,P<0.05). Conclusions Pulmonary function training instrument combined with resistance abdominal breathing training can improve respiratory function recovery and reduce infection rate in patients with cervical spinal cord injury .

This article reviews the social support service for family main caregivers of stroke patients at home and abroad from four aspects including the instrumental support, information support, self-esteem support and social companion support. This article aims at providing a reference for formulating scientific and standardized social support services for family main caregivers of stroke patients, promoting the development of social support services, thereby improving the quality of care and life of caregivers, and improving patient outcomes.

The protein production system using a baculovirus Antheraea pernyi nucleopolyhedrovirus (AnpeNPV) as a gene expression vector and its host insect as a natural bioreactor was successful established and its excellent performance in the protein production has been demonstrated. In this paper, the system is used to produce recombinant human epidermal growth factor (rhEGF), which have been widely used in medical and cosmetic treatment. A recombinant AnpehEGF virus has been constructed by replacing the viral polyhedrin gene with the rhEGF gene, and then injected it to Samia cynthia ricini pupae. Amplification and expression of rhEGF gene in the pupae was clearly detected by PCR, Western blot and ELISA analyses. These analyses have also revealed that rhEGF in the pupae was significantly increased at 6 days post-infection, and reached maximum level at the 12th day. The concentrations of rhEGF were 19.77, 24.90, 618.59 and 1 952.46 ng/g pupae at 3, 6, 9 and 12 days post-infection, respectively. However, the rhEGF concentration reduced at later stage (days 15). The rhEGF in the pupae could be purified using ammonium sulfate precipitation and Ni-NTA agrose affinity chromatography. Results demonstrate that Samia cynthia ricini pupae can be used as a bioreactor to produce rhEGF and, if successfully improved, will be a novel method of rhEGF production with lower cost and more efficient.
Amino Acid Sequence ; Animals ; Bombyx ; genetics ; metabolism ; Epidermal Growth Factor ; biosynthesis ; genetics ; Genetic Vectors ; genetics ; Humans ; Molecular Sequence Data ; Nucleopolyhedrovirus ; genetics ; Recombinant Proteins ; biosynthesis ; genetics