Objective To explore the satisfaction of nurses on the work and patients on the nursing service after implementing the model of continuous scheduling and group-responsibility system,so as to to provide theories for improving nursing quality and human management.Methods Self-designed satisfaction questionaire was used to investigate nurses and patients before and after implementing the model of continuous scheduling and group-responsibility system,and nurses'satisfaction on the work and patients'satisfaction on the nursing care were observed and compared.Results The comprehensive satisfaction of nurses on the work in sixth,ninth,twelfth month after implementing the model of continuous scheduling and group-responsibility system was 91.0％,91.6％,92.3％,respectively which was higher than 80.6％ before implementing,and the difference was statistically significant ( x2 =4.74,5.56,6.40,respectively ; P ＜ 0.05 ).The satisfaction of patients on nursing increased from 90.1％ to 95.7％ after the model was implemented three to twelve months,which was significantly higher than 78.5％ before implementing( P ＜ 0.01 ).Night shift period was shortened and the nurses' satisfaction was decreased from 76.2％ to 61.8％ after the model was implemented ( x2 =6.95,P ＜ 0.01 ),while there was no difference in the situation of their mental pressure.Conclusions The scheduling revolution and group-responsibility system can provide no-gap and excellent nursing,and stimulate nurses' potential,and improve the nursing quality.But the situation of nurses' mental pressure is not improved for the lack of clinical nurses.

Objective To investigate the impact of age on patients with metabolic syndrome (MS) and normal persons. Methods Data was gathered from 8280 persons including 4873 males and 3407 females who were randomly selected. All subjects were devided into normal group and MS group. According to the interval of ten years, the subjects were devided into seven age groups, to calculate the difference of impaired fasting glycaemia (IFG) between patients with diabetes mellitus (DM) and normal people, as well as the related portions. Results (1) The risk of IFG and DM appeared to be different among age groups among the target subjects as well as in the normal and the MS groups (P<0.05). (2) Among the whole subjects, the overall prevalence of IFG was increasing with age. The prevalence of DM had an increasing trend with age augment in 20-79 years group, whereas a decreasing trend appeared in people over 80 years of age. (3) For normal persons, the prevalence of IFG and DM were all increasing with age augment in 20-79 years group, and then decreasing with age augment in the over-80-years group. (4)For MS patients, the prevalence of IFG had an increasing trend with age augment in 20-69 years group, whereas a decreasing trend appeared in people over 70 years of age. There was no tendency of variation with age augment in DM.Conclusions (1) For normal persons, high prevalence rates of IFG and DM were correlated to age augment, especially in senior persons. (2) For MS patients, high prevalence of IFG was also correlated to age augment, but no association between prevalence of DM and age augment was seen. (3)Age from 70 to 79 years appeared to be in high risk with MS.

OBJECTIVETo evaluate the effect and results of short and medium periods of follow-up of percutaneous balloon pulmonary valvuloplasty for critical pulmonary stenosis of neonates and infants under 6 months of age.

METHODSBetween January 2002 and December 2008, 34 consecutive patients aged from 13 to 175 days with critical pulmonary valvular stenosis underwent percutaneous balloon valvuloplasty. Patients records, catheterization data, angiograms and echocardiograms were reviewed. Patients were followed up for 6 months to 4 years (mean 25.5 months) by means of clinical examination and Doppler echocardiography.

RESULTSThe pulmonary valvuloplasty was accomplished in 32 (94%) of 34 attempts. Immediately after dilation, right ventricular systolic pressure (RVSP) decreased from (96 ± 28) mm Hg (1 mm Hg = 0.133 kPa) (49 ± 20) mm Hg (P < 0.01), the transvalvular peak to peak systolic gradient (ΔP) decreased from (89 ± 25) mm Hg to (25 ± 12) mm Hg (P < 0.01), and the right ventricular/aortic systolic pressure ratio decreased from 1.2 ± 0.5 to 0.7 ± 0.3 (P < 0.01). One patient died because of cardiac tamponade following rupture of the pulmonary valve annulus, 2 patients developed pericardial effusion, 3 patients had infundibular spasm, 3 patients had a pre-dilation by small balloon and 1 patient had weakened femoral artery pollex. After a follow up period of 6 months to 4 years 3 of 31 patients lost to follow-up. Repeat valvuloplasty was performed in 5 patients (3 neonates), no patient required surgery, and the other 23 patients did not undergo further intervention, a mean peak systolic Doppler gradient of (20 ± 13) mm Hg was found and no significant pulmonary regurgitation was seen.

CONCLUSIONSPercutaneous balloon pulmonary valvuloplasty was effective and safe for the treatment of critical pulmonary stenosis of neonates and infants under 6 months of age with good short and medium term results.

Catheterization ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Lost to Follow-Up ; Male ; Pulmonary Valve ; Pulmonary Valve Stenosis ; therapy ; Treatment Outcome

AIMTo investigate the molecular mechanisms of saponins from the rhizome of Anemarrhena asphodeloides Bunge.

METHODSOligonucleotide microarrays consisting of 87 probes representing 87 human cardiovascular disease-related genes were constructed. Effects of saponins on gene expression in human umbilical vein endothelial cells were analyzed by comparing hybridization of Cy 5-labeled cDNAs from saponins-treated human umbilical vein endothelial cells and Cy 3-labeled cDNAs from untreated human umbilical vein endothelial cells.

RESULTSThe results indicate that angiotensinogen gene, alpha 2A-adrenoceptor gene and endothelin-converting enzyme 1 gene were downregulated 2.8, 1.9 and 3.1 folds respectively after human umbilical vein endothelial cells were incubated in medium containing 80 mg.L-1 saponins.

CONCLUSIONThese results suggest that saponins may have beneficial effect on cardiovascular diseases by modulating the function of vein endothial cells and microarray can be used to investigate the biological action of extracts from traditional Chinese medicine.

Anemarrhena ; chemistry ; Angiotensinogen ; genetics ; metabolism ; Aspartic Acid Endopeptidases ; genetics ; metabolism ; Cells, Cultured ; Down-Regulation ; drug effects ; Endothelin-Converting Enzymes ; Endothelium, Vascular ; cytology ; metabolism ; Gene Expression ; drug effects ; Humans ; Metalloendopeptidases ; Oligonucleotide Array Sequence Analysis ; Plants, Medicinal ; chemistry ; Receptors, Adrenergic, alpha-2 ; genetics ; metabolism ; Rhizome ; chemistry ; Saponins ; isolation & purification ; pharmacology ; Umbilical Veins ; cytology ; metabolism

OBJECTIVETo evaluate the early outcomes of children with congenital scoliosis treated by one-stage transpedicular hemi-vertebra resection.

METHODSFrom July 2005 to June 2006, 27 consecutive cases of congenital scoliosis managed by one-stage transpedicular hemi-vertebra resection with instrumentation were investigated retrospectively. There were 11 girls and 16 boys, with a mean age of 5.5 years at surgery (range 1.3 - 10.0 years). Location of the hemi-vertebra was in the thoracic spine in 12 cases and in the lumbar spine in 15 cases. Radiographic evaluations were performed on the preoperative, postoperative, and latest follow-up standing posteroanterior and lateral radiographs.

RESULTSThe average operation time was 4 hours (range 3-6 hours), and the mean blood loss during operation was 750 ml (range 300 - 2200 ml). The mean fusion level was 2 to 7 segments, average 4.4 segments. The average follow-up period was 16 months (range 12 - 34 months). Mean Cobb angle of the total main curve was 40.0° before surgery, 12.6° after surgery, and 15.2° at latest follow-up. Mean Cobb angle of the segmental main curve was 35.6° before surgery, 11.6° after surgery, and 12.1° at latest follow-up. The trunk shift was improved from 16.5 mm before operation to that of 7.5 mm after the operation and 7.6 mm at the latest follow-up. Compensatory cranial curve improved from 19.4° before surgery to 8.9° after surgery, and compensatory caudal curve improved from 26.3° to 12.8°. The angle of segmental kyphosis was 26.4° before surgery and 14.6° after surgery in cases with thoracic hemivertebrae, and averaged 11.2° before surgery and 3.9° after surgery in cases with lumbar hemivertebrae. Peri-operative complications included two pedicle screws malpositioning and one case with pelvic tilt. There was no neurological complication.

CONCLUSIONOne-stage transpedicular hemi-vertebra resection with instrumentation has a good capability of correcting deformity on the frontal and sagittal planes, which is available in children with middle or lower thoracic or lumbar hemivertebrae.

Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Lumbar Vertebrae ; abnormalities ; surgery ; Male ; Retrospective Studies ; Scoliosis ; congenital ; surgery ; Thoracic Vertebrae ; abnormalities ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the efficacy of preoperative Halo-femoral traction in the treatment of rigid idiopathic scoliosis.

METHODSSixteen patients with rigid idiopathic scoliosis treated with Halo-femoral traction before posterior spine fusion from July 2003 through May 2006 were studied retrospectively. There were 4 male and 12 female, with a mean age of 16 years (range, 12-20 years). The coronal Cobb angles of coronal major curve and the thoracic kyphosis (T(5)-T(12)) were 111 degrees and 64 degrees, respectively. All the patients underwent preoperative Halo-femoral traction. After the maximum weight traction for 2-3 weeks, a posterior instrumentation and fusion was performed. The correction rate of coronal major curve on preoperative side bending film, on supine film after Halo-femoral traction and after surgery was compared.

RESULTSThe maximum traction weight averaged 19 kg. All patients had an at least 12-month follow-up. One patient experienced transient brachial plexus palsy and complete recovery was achieved after reducing the traction weight. No neurologic complication, death and respiratory failure occurred after surgery. In comparison to the correction rate of 18.7% on preoperative side bending film, the correction rate of coronal major curve after Halo-femoral traction increased by 13.2% (P < 0.05). The postoperative correction rate of coronal major curve and thoracic kyphosis was 48.6% and 51.9%, respectively. At the final follow-up, the coronal and sagittal correction loss averaged 2.0% and 5.8%, respectively.

CONCLUSIONSPreoperative Halo-femoral traction combined with intraoperative posterior spinal release can significantly enhance the correction rate for rigid idiopathic scoliosis. However, the traction complications should be worthy of vigilance.

Adolescent ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Scoliosis ; surgery ; Spinal Fusion ; Traction ; methods ; Young Adult

OBJECTIVETo investigate the impairment pattern and the influencing factors of pulmonary function in patients with Marfan and Marfanoid syndrome associated scoliosis (MS).

METHODSIn this retrospective study, totally 25 MS patients (aged 11 - 20 years, 11 boys and 14 girls) who received posterior instrumentation and fusion (Group A) and 38 adolescent idiopathic scoliosis (AIS) patients (Group B) (aged 10 - 19 years, 11 boys and 27 girls) were included from February 1998 to September 2007. The curve pattern was matched in both groups. The preoperative pulmonary function test (PFTs) were compared in two groups. And the parameters influencing the preoperative pulmonary function were analyzed in group A.

RESULTSIn Group A, the Cobb angle of thoracic curve was negatively correlated with the percentage of predicted pulmonary volumes (VC%, FVC% and FEV1%) (r = -0.514, -0.503, -0.464, P < 0.05). And the reduction of lung function parameters (VC%, FVC%, FEV1% and MMEF%) was more severe in Group A than in Group B with compared magnitude of thoracic curve (P < 0.05). In Group A, the extent of impairment of pulmonary function in patients with the number of vertebrae involved ≥ 8 were more severe than those involved < 8 vertebrae (P < 0.05). However, there was no significant difference of deterioration of lung function between the higher apex (T₄₋₈) subgroup and lower apex (T₉₋₁₂) subgroup. And no correlation was found between thoracic kyphosis and the degrees of impairment of respiration function.

CONCLUSIONSPatients with MS have mixed ventilation dysfunction, which is more severe than AIS patients with matched age and Cobb angle. The pulmonary dysfunction in MS patients can be influenced by the severity of thoracic curve and the number of involved vertebrae.

Adolescent ; Child ; Female ; Humans ; Lung ; physiopathology ; Male ; Marfan Syndrome ; complications ; physiopathology ; Respiratory Function Tests ; Retrospective Studies ; Scoliosis ; complications ; physiopathology ; Young Adult

OBJECTIVESTo find out the radiologic factors predicting the outcomes of reduction of lumbar spondylolisthesis.

METHODSForty two patients were treated with pedicle screw fixation with posterolateral fusion because of lumbar spondylolisthesis, with the average age of 56.0 years. There were 11 males and 31 females; 20 degenerative spondylolisthesis cases, and 22 isthmic spondylolisthesis cases; 1 L(3,4) case, 26 L(4,5) cases and 25 L(5)S(1) cases; 23 grade I patients and 19 grade II ones. All patients were taken the X-ray examination before operation and one week after operation. Measurements of slip ratio, percentage disc height, slip angle, lumbar lordosis angle and sacral slope angle were based on pre-operation X-rays. Measurements of the post-operation slip ratio were based on post-operation X-rays. Multivariate regression analysis was used to analysis the correlation between reduction ratio and pre-operation slip ratio, slip angle, percentage of disc height, lumbar lordosis angle and sacral slope angle.

RESULTSThe average pre-operation slip ratio was (22.5 +/- 10.6)%. The pre-operation percentage disc height was 0.23 +/- 0.10, the slip angle was 4.4 degrees +/- 5.4 degrees , the lumbar lordosis angle was 43 degrees +/- 13 degrees and the sacral slope angle was 34 degrees +/- 10 degrees . The reduction ratio was (63.2 +/- 27.9)%. No correlation was found among reduction ratio with pre-operation slip ratio, slip angle and sacral slope angle, but a positive correlation between reduction ratio and the pre-operation percentage of disc height (P < 0.05), a positive correlation between reduction ratio and the pre-operation lumbar lordosis angle (P < 0.05) was found.

CONCLUSIONThe percentage disc height and the lumbar lordosis angle can predict the outcomes of reduction of lumbar spondylolisthesis.

Adult ; Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; Male ; Middle Aged ; Multivariate Analysis ; Radiography ; Regression Analysis ; Spinal Fusion ; Spondylolisthesis ; diagnostic imaging ; surgery ; Treatment Outcome

OBJECTIVETo evaluate and analyze the misplacement patterns of the pedicle screws in surgical correction of patients with adolescent idiopathic scoliosis.

METHODSFor this study, 70 consecutive cases of patients with adolescent idiopathic scoliosis treated by posterior instrumented spinal fusion with pedicle screws were investigated from July 2008 to September 2008. Postoperative CT scans were performed in all cases. The patients included 58 girls and 12 boys, with a mean age of 14.5 +/- 2.7 years at surgery (range 12 - 19 years). Pedicle screws were inserted using anatomic landmark with free hand technique. A number of parameters were measured using PacsClient software (PACS) on workstation, which included distances of the penetration of medial, lateral pedicle cortex and anterior vertebral cortex. The distance between edge of aorta and tip of screw should be measured if left pedicle screw penetrated lateral pedicle cortex or anterior vertebral cortex. Misplacement screws with > 2 mm of either pedicular cortex perforation and grievous screws with >4 mm of medial pedicle perforation or contour of aorta were defined. The influencing factors for misplacement screws were analyzed.

RESULTSA total of 1030 pedicle screws were inserted, 773 in thoracic pedicle and 257 in lumbar pedicle. There were 108 (10.5%) misplacement screws, 35 of which penetrated lateral pedicle cortex, 56 of which penetrated medial pedicle cortex, 33 of which penetrated vertebral anterior cortex. Misplacement screw rate of apical vertebra, 5 segments above apical vertebra (AV-5s) and 4 segments below apical vertebra (AV + 4s) were higher than other levels. Most of grievous screws were placed in apical vertebra region.

CONCLUSIONSThe risk factors for misplacement screws included Cobb angle > 90 degrees and vertebrae rotation extent up to III-IV. Care should be exercised during pedicle screw instrumentation in the apical region of the main thoracic curve, AV-5s region and AV + 4s region.

Adolescent ; Bone Screws ; Child ; Female ; Humans ; Male ; Risk Factors ; Scoliosis ; surgery ; Spinal Fusion ; instrumentation ; methods ; Treatment Outcome ; Young Adult

Myxoid adrenocortical neoplasms are rare. Surgical resection of the mass is the first-line therapy. Here we reported a total of four patients, aged 44–66 years, diagnosed with myxoid adrenocortical tumor. The clinical characteristics and immunohistochemical features of the tumor are discussed in the current literature.
Adrenal Cortex Neoplasms ; diagnosis ; metabolism ; surgery ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Female ; Humans ; Male ; Middle Aged