Objective To investigate and analyze the nursing assistance requirements and the influencing factors of county hospital of Nanchang city.Methods A total of 327 nurses in 6 country-level hospital of Nanchang city were surveyed by the self-made questionnaire.Results The total demand score of county hospital was (4.29±0.47) scores,which was in a high level.The helping content demand was the highest,the form of assistance needs was the lowest.From the specific items of view,prevention of incision infection,nursing training,critically ill patients with bedsore nursing were higher in the content of assistance.Send a nurse to support education,nursing training,hospital experts on-site guidance were higher in the form of assistance.Long term assistance for 1 years,short-term assistance for 4-6 months were the highest in demand of helping times.The main factors of influencing county hospital nursing assistance were work area,department,degree,title etc.The work area was the important influencing factor of nursing assistance of county hospital.Conclusion The relevant departments are recommended to develop personalized assistance scheme according to the recipient hospital needs.

Objective To investigate the resistant patterns of Mycobacterium tuberculosis (MTB) strains against first- and second-line anti-tuberculosis drugs. Methods Drug susceptibility tests of 518 MTB strains collected from January 2008 to March 2009 were performed using BactecMGIT 960. The data were analyzed by chi square test. ResultsIn 518 strains, 168 (32.44％) were all sensitive to all seven drugs, 350 (67.56％) were resistant to at least one drug. Among all strains, 72 (13.90％) were resistant to one drug, 24 (4.63％) were resistant to two drugs, 254 (49.03％) were resistant to three or more drugs. A total of 217 strains (41.89 ％) were classified as multi-drug resistant tuberculosis (MDR-TB)strains and 65(12.55％)were extensively drug resistant tuberculosis (XDR-TB) strains which accounted for 29.95 ％ of MDR-TB strains. The drug resistant rate of isoniazid which belonged to first-line drugs was 53.67％ (278 strains) and that of ofloxacin which belonged to second-line drugs was 39.77 ％ (206 strains). In 433 retreated patients, the drug resistant rate against any drugs, MDR rate and XDR rate were 72.05％, 46.42％ and 13.86％,respectively, which were all higher than those in treatment naive patients (44.70％, 18. 82％ and 5.88％, respectively; x2 = 24. 253, x2 ＝ 22. 229 and x2 ＝ 4. 117, respectively; all P ＜ 0.01).ConclusionsThe resistant rate of MTB is high in a tuberculosis specialized hospital in Shanghai, and MDR-TB also shares a high resistant rate as well as XDR-TB. Furthermore, drug resistance is more common in retreated patients.

Objective To investigate the effects of high flow hemodialysis (HFHD) on cardiac function in uremia patients. Methods A prospective randomized controlled study was conducted. Sixty patients who were diagnosed with uremia, taken maintenance hemodialysis (MHD) and 30 healthy controls admitted to the Second People's Hospital of Guiyang from December 2014 to June 2015 were enrolled. They were randomly divided into two groups:HFHD group (HFHD three times a week) and the routine hemodialysis group (HD group, HD three times a week), with 30 in each group. Patients in each group were received hemoperfusion and hemofiltration once a month. Before the treatment and 6 months after the treatment, venous blood from all the patients were collected for testing the brain natriuretic peptide (BNP), cardiac troponin T (cTnT) and the ultrasound cardiograph were done at the same period by a special person, the left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular posterior wall thickness (LVPWT), interventricular septum thickness (IVST), early and late diastolic blood flow to the largest ratio (E/A), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI) were recorded. Results Compared with the health control group, BNP, cTnT, LVEDD, LVESD, LVESV, LVPWT, IVST were significantly increased, LVEDV were significantly lowered before treatment in the HD group and HFHD group. But no significant differences in the above indexes and E/A, LVEF, LVMI between two groups were found. Compared with the data before treatment, the BNP, LVPWT were significantly lowered after treatment in HD group [BNP (ng/L): 641.50±60.09 vs. 2676.20±454.30, LVPWT (mm): 10.57±1.16 vs. 12.57±1.41, both P < 0.05]. The BNP, LVPWT were significantly lowered in HFHD group as compared with HD group [BNP (ng/L): 253.10±48.77 vs. 641.50±60.09, LVPWT (mm): 9.29±1.08 vs. 10.57±1.16, both P < 0.05]; in addition, the cTnT, IVST, LVMI were significantly lowered after the treatment in HFHD group compared with those before treatment [cTnT (μg/L): 0.014±0.005 vs. 0.028±0.011, IVST (mm): 7.81±1.69 vs. 11.04±2.23, LVMI (g/m2): 149.10±15.77 vs. 158.70±17.25, all P < 0.05], and the LVEF were significantly increased in HFHD group as compared with those before treatment (0.574±0.068 vs. 0.528±0.082, P < 0.05). Conclusion HFHD has obvious advantages than the routine HD in improving cardiac function of uremia patients.

Objective To discuss the effects of multimodal combination dialysis on Klotho protein, fibroblast growth factor-23 (FGF-23) and brain natriuretic peptide (BNP) in patients with maintenance hemodialysis (MHD). Methods A randomized controlled trial (RCT) was conducted. 120 patients who was diagnosed with chronic renal failure (CRF) uremia receiving MHD over 3 months admitted to Blood Purification Centre of Department of Nephrology of the Second People's Hospital of Guiyang from December 2015 to December 2016 were enrolled, who were randomly divided into hemodialysis (HD) group (HD for 8 times a month), HD + hemofiltration (HF) group (HD for 8 times a month + HF once a month), and HD + HF + hemoperfusion (HP) group (HD for 8 times a month + HF for 4 times a month + HP once a month), with 40 patients in each group. Before and after treatment for 6 months and 12 months, blood was taken from venous circuit tube, the serum Klotho protein and FGF-23 levels were determined by enzyme linked immunosorbent assay (ELISA), and the serum BNP level was determined by electrochemiluminescence. Results 120 patients with MHD were enrolled in the final analysis without withdrawal. There were no significant differences in the levels of Klotho protein, FGF-23, or BNP before enrollment among the three groups (all P > 0.05). Compared with those before enrollment, the levels of serum Klotho protein after enrollment in three groups showed a sustained upward tendency, which were higher in HD + HF + HP group than in HD + HF group and HD group (μg/L: 2.59±0.61, 1.63±0.35, 1.13±0.26 at 6 months, F = 119.374, P = 0.000; 6.98±1.21, 3.57±1.03, 2.12±0.43 at 12 months, F = 275.675, P = 0.000); the levels of FGF-23 showed a sustained downward tendency, which were lower in HD + HF + HP group than in HD + HF group and HD group (ng/L: 69.22±38.26, 132.28±61.18, 178.50±74.64 at 6 months, F = 33.509, P = 0.000; 32.81±17.32, 87.93±43.27, 146.33±69.28 at 12 months, F = 55.466, P = 0.000);the BNP showed a similar tendency as FGF-23 (ng/L: 4083.39±2864.53, 7245.69±4643.81, 7969.12±5360.85 at 6 months, F = 8.758, P = 0.000; 1521.86±894.63, 4554.32±1969.84, 5013.89±2033.64 at 12 months, F = 49.003, P = 0.000). Conclusion Multimodal combination dialysis can increase the Klotho protein level, and decrease the levels of FGF-23 and BNP in MHD patients with CRF uremia.

Objective To provide reference for anti-infection drugs in Zunyi area by analyzing the etiological characteristics of children with severe pneumonia.Methods The sputum, throat swabs and serum of children with severe pneumonia in pediatric intensive care unit of our hospital from January 2014 to December 2015 were collected in this study.The pathogen species which caused severe pneumonia were detected and identified by the method of pathogen culture,and typical pathogens were detected by RT-PCR and indirect immunofluorescence.Results A total of 337 children with severe pneumonia were included,the pathogen positive rate was 86.65%(292/337).The rate of viral infection(37.32%)was the highest,followed by bacterial infection accounting for 28.42%,then the mixed infection accounting for 27.74%,and the mycoplasma pneumoniae infection accounting for 6.50%.The respiratory syncytial virus type B accounting for 28.44% was the most common in viral infection,and there were significant differences in age distribution(P<0.05),the children under 3-years-old,especially the infants under 1-year-old had the highest susceptibility.Viral infection had certain seasonality,compared with spring and winter,autumn and winter(November to April) had higher viral detection rate and the difference was statistically significant(x2=29.28,P=0.001).The escherichia coli was the most common in bacterial infection,accounting for 21.69%.Klebsiella pneumoniae,Escherichia coli were more common in neonates and infants under 1-year-old,Haemophilus influenzae occured in 1~3 years old children,Streptococcus pneumoniae infection could occur in any age.Conclusion Viral infection is the most common pathogen in children with severe pneumonia in Zunyi area followed by bacterial infection,which is more common in children under 1-year-old,and with the high incidence in autumn and winter.Bacterial infection is more common in children over 3 years of age.Bacterial and viral mixed infection is common in children under 3 years of age,especially in children under 1-year-old.

Objective To confirm the death of a child injured by a dog was due to rabies and to understand the molecular biologic features of rabies virus in Kaili,Guizhou province.Methods Brain tissue samples of patient and dog were collected to detect the rabies virus by direct immunofluorescence assay (DFA) and RT-nested PCR assay.Homology and phylogenetic tree were analyzed based on the whole nucleotide and deduced amino acid sequence of N gene of rabies virus followed by molecular epidemiological analysis.Results Both the human and dog brain tissue samples were confirmed positive by DFA and RT-nested PCR assay.The homology analysis of N gene sequences among GZH,GZD and other epidemic and vaccine rabies strains isolated from other provinces and other countries indicated that the detected samples shared the highest homology with the strain detected in Anlong prefecture in Guizhou in the year of 2006,and the homology between GZH and GZD was as high as 100％.Besides,among the vaccine strains,GZH and GZD showed the highest homology with strain CNT.Phylogenetic analysis indicated that the two samples were very close and belonged to genetype 1 lyssavirus,with the closest relationship between samples reported in Guizhou and Beijing.Conclusion It was confirmed on the viral molecular level that both the human and dog in Kaili were suffered from rabies,and the pathogens were genetype 1 lyssavirus.The prevalent strains in Kaili city was probably imported from other prefectures of Guizhou province,suggesting that prevention and control measures on rabies in Guizhou province should be strengthened.

To study the characteristic of glycoprotein gene sequence of rabies virus in Guizhou Province in recent years and provide scientific basis for effective control and prevention of rabies,RT-PCR assay were used to detect human and dog brain tissues derived from different prefectures of Guizhou.The amplification products were sequenced and analyzed with bioinformatics software.The results showed that the full-length G gene sequences of 8 positive samples were obtained by RT-PCR amplification,sequencing and splicing.The homology of eight G gene sequences from Guizhou Province were between 87.4％ -99.9％ and 83.3.％- 100％ on nucleotide and deduced amino acid level,respectively,and the highest homology were found with the genotype 1 strains ( 86.5 ％- 87.0％ for nucleotide and 83.3 ％- 100 ％ for amino acid) among genotype 1- 7 representative strains.Besides,phylogenetic analysis based on the G gene indicated that the relationship of 8 strains derived from Guizhou were closest to genotype 1 Lyssavirus,and the strains of Guizhou were very close to the strains come from Hubei,Hunan,Anhui,Guangxi,Jiangsu provinces and Shanghai,except for GZ01 and GZ09.Moreover,GZ09 were evolutionarily closed to the strains come from Malaysia and Thailand,while the remaining sequences were closed to the strain of Indonesia.This study confirmed on the G gene level that rabies virus epidemic strains circulated in Guizhou Province in recent years belonged to rabies virus genotype 1 and the evolutionary relationship with reported strains come from different provinces of China and different countries were revealed in this study.It will provide scientific basis for effective control and prevention of human and animal rabies in Guizhou Province.

Objective:To investigate any change in the effective connectivity between the bilateral anterior central gyruses after transcranial magnetic stimulation (TMS).Methods:Twenty-one healthy subjects were examined using resting state functional magnetic resonance imaging (rs-fMRI) before and after receiving continuous theta burst stimulation (cTBS). The brain atlas of the Institute of Automation of the Chinese Academy of Sciences was used for fine partitioning of the bilateral anterior central gyruses. Granger causality analysis was used to compare any changes in the effective connectivity between them.Results:After the cTBS inhibited the right M1 area, significant changes in effective connectivity among the sub-regions of the bilateral M1 area were observed. The effective connectivity of the right upper limb to the left upper limb and the left head to face were weakened, while that of the left upper limb to the right head, as well as of the face to the right upper limb was enhanced.Conclusion:For people whose right M1 area has been inhibited by cTBS, the effective connectivity changes in both upper limb functional areas of the M1 region reflect inter-hemispheric inhibition. Opposite changes were found in the trunk and upper limbs.

Objective To study the differences of glycoprotein gene (G gene) between rabies virus epidemic strains of Guizhou province in recent years and vaccine strains,and to provide scientific basis for the development of rabies vaccine and establishment of effective control and prevention measures.Methods RT-PCR assay was used to amplify the G gene of rabies positive brain tissues samples of human and dog derived from Guizhou province in recent years.The amplification products were sequenced and comparatively analyzed with that of vaccine strains by using bioinformatics software.Results Eight full-length G gene sequences were obtained by RT-PCR amplification,sequencing and splicing.The homogeny of G gene between 8 epidemic strains of Guizhou province and 9 vaccine strains were 82.0％-94.1％ and 87.6％-97.5％ on nucleotide and deduced amino acid level,respectively,and the highest homogeny were found with the human vaccine strain CTN (87.0％-94.1％ for nucleotide and 93.7.％-97.5％ for amino acid) among the 6 human rabies vaccine strains,while highest homogeny were found with strain Flury (83.9％-84.6％ for nucleotide and 91.1％-93.0％ for amino acid) among the three animal vaccine strains.Besides,among the 8 epidemic strains from Guizhou province,strain GZ09 collected in the year of 2005 was of the highest homogeny with human rabies vaccine strain CTN and animal rabies vaccine strain Flury,while strain GZ30 collected in the year of 2010 was of lowest homogeny with human rabies vaccine strain CTN and animal rabies vaccine strain Flury.Moreover,phylogenetic analysis based on the G gene indicated that the relationship of 8 epidemic strains derived from Guizhou,the 9 vaccine strains and genotype 1 Lyssavirus were clustered to a same branch.Vaccine strain CTN among the 9 vaccine strains was closest to the 8 epidemic strains,and the other 8 vaccine strains were relatively more distant from the epidemic strains of Guizhou province.In addition,phylogenetic analysis indicated that among the 8 epidemic strains from Guizhou province,strain GZ09 collectcd in the year of 2005 was of closest evolutionary relationship to CTN,while the other 7 epidemic strains were relatively more distant from CTN.Conclusion This study confirmed on the G gene level that rabies virus strains circulated in Guizhou province in recent years and the vaccine strains used in China belonged to rabies virus genotype 1,and the virus strains circulated in Guizhou province in recent years is of smallest difference with the human vaccine strain CTN and animal vaccine strain Flury.Besides,as time goes on,the difference between the epidemic strain and the vaccine strains becomes more and more obvious.The results of this study will provide scientific basis for the development of rabies vaccine and establishment of effective control and prevention measures.

OBJECTIVETo investigate the biomechanical effect of different volume, distribution and leakage to adjacent disc of bone cement on the adjacent vertebral body by three-dimensional osteoporosis finite element model of lumbar.

METHODSL(4)-L(5) motion segment data of the cadaver of an old man who had no abnormal findings on roentgenograms were obtained from computed tomography (CT) scans. Three-dimensional model of L(4)-L(5) was established with Mimics software, and finite element model of L(4)-L(5) functional spinal unit (FSU) was established by Ansys 7.0 software. The effect of different loading conditions and distribution of bone cement after vertebroplasty on the adjacent vertebral body was investigated.

RESULTSThis study presented a validated finite element model of L(4)-L(5) FSU with a simulated vertebroplasty augmentation to predict stresses and strains of adjacent untreated vertebral bodies. The findings from this FSU study suggested the endplate and disc stress of the adjacent vertebral body was not influenced by filling volume of bone cement but unipedicle injection and leakage to the disc of bone cement could concentrate the stress of adjacent endplate.

CONCLUSIONSAsymmetric distributions and leakage of cement into intervertebral disc can improve the stress of endplate in adjacent vertebral body. These results suggest that optimal biomechanical configuration should have symmetric placement and avoid leakage of cement in operation.

Bone Cements ; adverse effects ; pharmacology ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Lumbar Vertebrae ; surgery ; Male ; Polymethyl Methacrylate ; adverse effects ; pharmacology ; Stress, Mechanical