Objective:To investigate the outcomes,complications and safety about Endoscopic thoracic sympathectomy for palmar hyperhidrosis.Methods:Analyzing the results and complications about the 336 cases,who were received Endoscopic thoracic sympathectomy for treating palmar hyperhidrosis from Jan.2005 to Sep.2008,and were followed up.Results:All of their hands became dry and warm after operation.326 patiens were followed-up for 1 to 45 months,and 25.4 months on average.The total Results:No recurrence.Compensatory hyperhidrosis was found in 42 cases(12.88%).Conclusions:It is effective,safer and mini-trauma that Endoscopic thoracic sympathectomy for treating palmar hyperhidrosis.

Lipoxins possess a wide spectrum of adjustment function for various inflammatory cell functioning and the expression of inflammatory related genes,also progressing the inflammatory response by means of various cell.Lipoxins play an important role in the pathogenesis and clinical treatment of kidney diseases.

[Objective] To observe the effect of acupoint massage and TCM featured nursing on peripheral facial paralysis. [Method] Randomly divide 90 cases into 2 groups, n=45 for each group; the control group takes general treatment and acupuncture, the observation group is added with facial acupoint massage coordinated with mental counseling, recovery training and other TCM featured nursing, 1 time/d. [Result] After 2~4w of treatment, observe their clinical effects, the results had marked difference. [Conclusion] The cure effect of the observation group was better than common acupuncture group, showing that facial acupoint massage coordinated with TCM featured nursing treating peripheral facial paralysis could promote patients ’early recovery, much reduce the sequelae.

The paper covered the selection of clinical trial diseases in the clinical pathway experiment in the hospital in the recent two years.It also introduced such management measures as making clinical pathway texts,the rate of cases into clinical pathways,emphasis of variation management,and enhanced clinical pathway data analysis.A comparison between the groups before and after clinical pathway management,found that the clinical pathway can reduce the average days of stay and total patient costs by 3.4 days and 1519 yuan respectively.Both patients and hospitals benefit from clinical pathways.The paper also advocates continuous and dynamic management at various stages of clinical pathway management.

10.3969/j.issn.2095-4344.2013.26.020

Objective To evaluate the effects of edaravone on the permeability of blood-brain barrier in septic rats.Methods Ninety male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n=30 each):control group (group C),sepsis group (group lipopolysaccharide (LPS)) and edaravone group (group E).Sepsis was induced by injection of LPS 10 mg/kg via the femoral vein in LPS and E groups.After LPS injection,edaravone 3.0 mg/kg was injected intravenously every 2h for 7 times in group E.The equal volume of normal saline was administered instead of edaravone in C and LPS groups.At 2,6 and 12h after LPS injection,5 rats were chosen and Evan's blue (EB) was injected via the femoral vein,and then the rats were sacrificed and brain tissues were removed for determination of EB and water contents.Another 5 rats were chosen and blood samples were taken from the femoral artery for measurement of serum MDA concentration,and then the rats were sacrificed and the brain tissue was harvested for microscopic examination.Results Compared with group C,brain water and EB contents were significantly increased at 6 and 12h after LPS injection,and the serum MDA concentration was increased at 2,6 and 12h after LPS injection in LPS and E groups (P ＜ 0.05).Compared with group LPS,brain water and EB contents were significantly decreased at 6 and 12h after LPS injection,and serum MDA concentrations were decreased at 2,6 and 12h after LPS injection in group E (P ＜ 0.05).Sepsis-induced pathological changes were significantly attenuated in group E.Conclusion Edaravone can decrease the permeability of blood-brain barrier,attenuate brain edema and brain injury in septic rats,and reduction of oxygen free radical production may be involved in the mechanism.

Objective To summarize the nursing care experience for right ventricular dysfunction after orthotopic heart transplantation.Methods Clinical data of 67 patients underwent heart transplantation were retrospectively analyzed from January 2007 to December 2010.Results 58 patients were discharged after they were cured,9 patients died.67 patients were affected by different degrees of increasing central venous pressure (CVP)early postoperation and right ventricular dysfunction,28 cases received extracorporeal membrane oxygenation(ECMO) assistant,6 cases received continuous renal replacement therapy(CRRT).Among 58 discharged patients,the heart function level showed class two in 54 cases and class three in 4 cases.Conclusions After heart transplantation,followed with intensive care and close observation of right heart failure symptoms,providing effective care and support,active prevention and treatment for right heart failure,maintaining vital organs function were key to successful heart transplantation.

This paper introduced the current situation of cardiac interventional therapy and put forward the fol-lowing points that medical staffs should pay attention to:the patient's right to know, right to be informed, right of communication, right of privacy, and etc. On this basis, it is suggested to solve the ethical issues in cardiac inter-ventional therapy through the implementation of clinical pathway, effective communication, humanistic care, the construction of occupational ethics, strict feedback and supervision.

Objective To evaluate the effect of edaravone on apoptosis in hippocampal cells in a rat model of endotoxic shock.Methods Thirty-six male Sprague-Dawley rats, weighing 200-250 g, aged 6 weeks, were randomly divided into 3 groups (n=12 each) using a random number table: control group (group C), endotoxic shock group (group ES), and edaravone group (group E).Lipopolysaccharide 10 mg/kg was injected via the femoral vein to establish the model of endotoxic shock in ES and E groups, while the equal volume of normal saline was given in group C.In group E, edaravone 3 mg/kg was intravenously injected immediately after establishment of the model once every 2 h until the animals were sacrificed.The equal volume of normal saline was given instead of edaravone in C and ES groups.At 6 and 12 h after administration of edaravone, 6 rats in each group were sacrificed, and the hippocampi were isolated for determination of malondialdehyde (MDA) content (using thiobarbituric acid method) , tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) contents (using enzyme-linked immunosorbent assay), and cell apoptosis in hippocampal CA1 region (by TUNEL assay).The apoptotic index was calculated.Results Compared with group C, the MDA, TNF-α and IL-6 contents were significantly increased at 6 and 12 h after administration of edaravone, and the apoptotic index was increased at 12 h after administration of edaravone in ES and E groups.Compared with group ES, the MDA, TNF-α and IL-6 contents were significantly decreased at 6 and 12 h after administration of edaravone, and the apoptotic index was decreased at 12 h after administration of edaravone in group E.Conclusion Edaravone can reduce apoptosis in hippocampal cells, and the mechanism is associated with the reduced oxidative stress and inflammatory responses in a rat model of endotoxic shock.

To investigate the changes in serum enzymes (ALP、LDH、CK) in dogs suffered from gunshot wounds in limbs in hot and humid environment, 12 dogs were divided into two groups randomly: hot and humid environment (HHE) group and normal environment (NE) group. The contents of ALP, LDH and CK in peripheral blood were assayed at 0h, 2h, 4h, 6h, 8h, 12h and 24h postinjury. The results showed that the contents of serum enzymes tended to rise after gunshot injuries, especially CK. The changes in the contents of serum enzymes in HHE group appeared earlier and more obviously than those in NE group. In conclusion, the contents of serum enzymes coincided with the severity of local tissue damage, and change in the content of CK was more sensitive after tissue injury. The results suggested that hot and humid environment would aggravate systemic reactions and tissue damage after gunshot injuries.