To explore the measures of nursing management in the treatment of large number of infants with urinary calculi. The nursing management measures included launching the preparedness and response project for sudden public health events, formulating scientific and standardized nursing management system,optimizing work flow,strengthening nurse training,focusing on the details in nursing management,implementing disinfection and isolation system seriously,and paying close attention to health education for the parents of minority infants. Scientific nursing management can ensure the treatment effectiveness and nursing safety for the infants with urinary calculi.

Objective To summarize the treatment experiences in gastrointestinal leaJcage atter gastrectomy for gastric cancer. Mehods From January 1997 to December 2006 the clinical data of 37 cases of gastrointestinal leakage including anastomotic leakage in 19 cases and duodenal stump leakage in 18 after gastrectomy for gastric cancer in People's Liberation Army General Hospital were analyzed retrospectively. Results All of the Cases were treated with abdominal drainage,continuous gastrointinal decomnression and parenteral nutrition combined with enteral nutrition.There were 32 cases receiving glutamine enrichment nutrition support,31 ases used somatostatin,13 cases received supplemented recombinarlt human growth hormone.Fistula healed in 21～30 d in 9 cases after gastrectomy,in the other 24 cases fistula healed in 30-60 d,while it healed in 60～81 d in the remaining 2 cases.Two died of leakage associated complications after gastrectomy for gastric cancer including anastomotlc leakage follwing esophagojejunostomy complicated by severe thoracic and lung infection in one and duodenal stump leakage complicated by severe abdominal cavity sepsis and hemorrhage in the other. Conclusion Patent and effective abdominal cavity drainage,continuous gastrointestinal decompression,parenteral nutrition combined with enteral nutrition,glutarnine,somatostafin and recombinant human growth hormone are the'mportant factors for the healing of gastrointestinal leakage after gastrectomy tor gastric cancer.

Objective To investigate the imaging diagnosis and surgical treatment of intestinal malrotation in adult patients. Methods The clinical data of 11 adult patients with intestinal malrotation who had been admitted to General Hospital of PLA from January 2003 to December 2007 were retrospectively analyzed. Multiple imaging modalities, including barium enema, gastrointestinal radiography, B sonography, computed tomography (CT) scan and mesenteric angiography were applied for diagnosis. All patients received Ladd procedure. Results Two patients were diagnosed by gastrointestinal radiography +B sonography, 4 by gastrointestinal radiography +CT scan, 1 by angiography, 1 by B sonography + CT scan, 1 by iodine radiography + CT scan and 2 by intraopera-tive examination. After the operation, 2 had renal insufficiency, 1 had intestinal fistula and 1 had short bowel syndrome and died at the third month after operation. Conclusion Combined application of multiple imaging modalities can improve the diagnostic rate, and Ladd procedure is effective and safe for adult patients with intes-tinal malrotation.

Objective To evaluate the clinical effectiveness of perioperative fast-track surgery(FTS)program and nutrition support in the elderly patients with gastric cancer.Methods Totally 42 patients were equally randomized into FTS group(receiving perioperative FTS program)and control group(receiving a conventional therapy).The postoperative first defecation time,postoperative hospital stay,hospitahzation expenditure,and postoperative complications were compared between these two groups.Results The postoperative first defecation time and postoperative hospital stay were(75.4±24.3)hours and(11.2±3.2)days in FIS group and(98.0±22.6)hours and(14.4±4.6)days in control group(P=0.0165,P=0.0004;respectively).The hospitalization expenditure was significantly lower in FTS group than in control group[(3.66±0.48)×104 vs.(4.56±0.78)×104 RMB yuan;P=0.0001].The incidence of postoperative complications in FTS group was also significantly lower than that in control group(9.5% vs.28.6%,P=0.0422).Conclusion Perioperative FTS program can accelerate postoperative rehabilitation,shorten hospital stay,lower hospitalization expenditure,and reduce the incidence of postoperative complications.

[Objective] To observe the therapeutic effect of spleen-invigorating and lung-nourishing therapy and its influence on nutritive index and quality of life (QOL) in patients with chronic obstructive pulmonary disease (COPD) at stationary phase. [ Methods ] Ninety cases of COPD were randomized into three groups. Group A was given routine symptomatic treatment; groups B and C were given oral use of Jianpi yifei Granules and routine symptomatic treatment and group C was additionally treated with garlic-partition moxibustion and acupoint injection of Shenmai Injection on bilateral Zusanli (ST 36) point alternatively. The treatment lasted 2 months. [Results] The effective rate was 93.33% in group C, 86.67% in group B and 56.67% in group A (P 0.05) compared with those before treatment. Scores of activity of daily life (ADL) , depression and anxiety and the total score of QOL were obviously decreased in groups B and C (P

Objective To evaluate and eliminate the potential bias between data obtained from dry and liquid biochemical assays,making data obtained by different assays matchable.Methods Bias estimation was performed based on document EP9-A2.Simple data comparison and methodology validation were performed after the experiment methods were modified with the estimated correction factors and interception.All the collected data were analyzed by EXCEL2007 software.Results The predicted bias of 4 of the 10 compared items exceeded their corresponding acceptable bias.After being adjusted by the coefficient and interception obtained from linear regression analysis,the four bias was improved and was within the acceptable range.The results of simple data comparison further confirmed this comparability.Conclusion Based on EP9-A2,we have established a protocol to obtain a consistency of data from different biochemical analyzers,which makes it possible that the detection results of the same patient from different detection systems can be used directly.The protocol has been approved by the experts during the medicinal laboratory accreditation of ISO15189.

Objective:To investigate the correlation between lumbar bone mineral density (BMD), musculoskeletal perfusion andmuscle mass.Methods:From May 2019 to August 2020, totally 91 patients who applied for CT perfusion (CTP) examination of abdomen (the scan range included the vertebral body of L1－L3) in Shanghai Tenth People′s Hospital of Tongji University were retrospectively analyzed. The mean BMD of L1－L3 vertebral body was measured by quantitative CT (QCT) at the same time of CT plain scan. According to BMD, the subjects were divided into normal BMD group ( n=33), osteopenia group ( n=41) and osteoporosis (OP) group ( n=17). The L3 level perivertebral muscle mass index and fat fraction were calculated based on QCT examination. The lumbar vertebral and perivertebral muscle perfusion parameters were measured based on CTP images. The parameters of QCT and CTP among three groups were analyzed by Kruskal-Wallis H test or one-way ANOVA. The correlation analysis was conducted between these parameters using Pearson or Spearman analysis. Results:The differences of the perivertebral muscle mass index and fat fraction among three groups were statistically significant ( P<0.05). The differences of the lumbar vertebral perfusion parameters including blood flow (BF), blood volume (BV) and flow extraction product (FE) among three groups were statistically significant ( P<0.05), and BF, BV and FE were positively correlated with BMD ( r=0.444, 0.312 and 0.266 respectively, all P<0.05; adjusted for age and gender r=0.437, 0.340 and 0.337 respectively, all P<0.05). There was no statistically significant difference in perivertebral muscle perfusion parameters among three groups ( P>0.05). Perivertebral muscle mass index was negatively correlated with fat fraction ( r=-0.599, P<0.001; adjusted for age and gender r=-0.404, P<0.001), and there was no correlation between perivertebral muscle mass index and muscle perfusion parameters, as well as perivertebral muscle fat fraction and muscle perfusion parameters. Conclusions:With the changes of BMD, bone mass and perivertebral muscle mass at L3 level are synchronous. Decreased vertebral bone mass is accompanied with reduced perivertebral muscle mass, increased muscle fat and decreased bone perfusion. The changes of vertebral perfusion and perivertebral muscle perfusion at L3 level are asynchronous, which implies that reduced perfusion in OP patients may be confined to the bone.

The present study was aimed to investigate the effect of electroacupuncture (EA) on learning-memory of rats with low estrogen-induced cognitive impairment and the possible mechanism. The rat model was established by ovariectomy, which resulted in low estrogen-induced cognitive impairment. EA was applied continuously for 3 months 2 weeks after ovariectomy. Morris water maze was used to test the ability of spatial learning and memory. Enzyme-linked immunosorbent assay (ELISA) and real-time quantitative RT-PCR were used to detect the concentration of serum estradiol (E2) and relative expression of choline acetyltransferase (ChAT) mRNA in hippocampus, respectively. The result showed that, compared with the sham group, the ovariectomy model group exhibited longer escape latency, reduced number of platform-crossing, lower concentration of serum E2, and decreased expression of ChAT mRNA in hippocampus. EA shortened the escape latency and increased the number of platform-crossing in the ovariectomy model group. Moreover, the concentration of serum E2 and the hippocampal expression of ChAT mRNA in the ovariectomy model group were significantly elevated by EA treatment. These results suggest EA is capable of improving learning and memory in ovariectomized rats, and the mechanism involves the up-regulation of the expression of ChAT mRNA in hippocampus induced by the increase of the serum concentration of estrogen.
Animals ; Choline O-Acetyltransferase ; metabolism ; Cognition Disorders ; therapy ; Electroacupuncture ; Estradiol ; blood ; deficiency ; Female ; Hippocampus ; enzymology ; Learning ; Memory ; Ovariectomy ; RNA, Messenger ; Rats

Objective To investigate the pathogens,drug resistance and outcomes of continuous ambulatory peritoneal dialysis(CAPD) patients with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers. Method Data including clinical manifestations,pathogens,treatment,outcome of 93 CAPD cases with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers were retrospectively analyzed.Results Dialysate culture of 75cases was positive with a positive rate of 80.2％,including 45 cases of gram-positive cocci,21cases of gram-negative bacilli,2 cases of fungi and 5 cases of mixed infection.Coagulase-negative staphylococci were the most common gram-positive cocci.All the gram-positive cocci were sensitive to vancomycin,but the resistance rate to cefazolin was 60.0％ with an increasing tendence year by year.Resistance rate of gram-negative bacilli to ceftazidime was 46.1％.All the gram-negative bacilli were sensitive to imipenem.The withdraw rate of CAPD was 17.2％(16/93) because of peritonitis. Noobviousside-effectofperitonealadministrationofvancomycinwasfound.Conclusions Gram-positive cocci are major pathogens in CAPD-related peritonitis.Now cefasolin is not suitable for the empiric initial treatment.Peritoneal administration of vancomycin should be recommended for peritonitis caused by gram-positive cocci.

Objective To evaluate the effects of different doses of dexmedetomidine on median effective end-tidal concentration of sevoflurane (EC50) inhibiting responses to tracheal intubation in pediatric patients.Methods Sixty-seven ASA physical status Ⅰ or Ⅱ patients,aged 3-8 yr,with body weight not exceeding 150％ of the ideal weight,scheduled for elective surgery under general anesthesia,were randomly divided into 3 groups using a random number table:control group (group C,n =22) and different doses of dexmedetomidine groups (group D1,n =23 ; group D2,n =22).Before induction of anesthesia,dexmedetomidine 1.0 and 2.0 μg/kg was infused intravenously over 10 min followed by infusion at a rate of 0.5 and 1.0 μg·kg-1 ·h-1 in D1 and D2 groups,respectively.Anesthesia was induced with inhalation of 5 ％ sevoflurane.After eyelash reflex disappeared,the end-tidal sevoflurane concentration was adjusted to achieve the target concentration and maintained at this level for 15 min.Tracheal intubation was then performed and the response to intubation was scored.The initial end-tidal sevoflurane concentration was 3.5％,2.5％ and 1.5％ in C,D1 and D2 groups,respectively.Up-and-down sequential trial was used to determine the EC50.Each time the concentration of sevoflurane increased/decreased in the next patient depending on whether or not the response to intubation was positive.The positive response to intubation was defined as intubation score ＞ 1.The ratio of concentrations between the two consecutive patients was 1.2.The EC50 and 95％ confidence interval of sevoflurane were calculated.The development of adverse cardiovascular events was recorded after dexmedetomidine administration.Results The adverse cardiovascular events were not observed in D1 group.The incidence of hypotension and brachycardia was 14％ and 9％ in D2 group.The EC50 (95％ confidence interval) of sevoflurane was 3.54％ (3.39％-3.69％),2.37％ (2.24％-2.46％) and 1.41 ％ (1.37％-1.46 ％) in C,D1 and D2 groups,respectively.Compared with group C,the EC50 of sevoflurane was significantly decreased in D1 and D2 groups (P ＜ 0.01).Compared with group D1,the EC50 of sevoflurane was significantly decreased in group D2 (P ＜ 0.01).Conclusion The optimum dose of dexmedetomidine is 1.0 μg/kg (loading dose) and 0.5 μg· kg-1 · h-1 (maintenance dose) when combined with sevoflurane for induction of anesthesia in pediatric patients.