Objective:To study the experience of frontline medical workers in COVID-19 quarantine points.Methods:Purposive sampling method was employed and 12 frontline medical workers in COVID-19 points of Zhaoyuan City were selected for semi-structured and in-depth interview. Colaizzi′s seven-step analysis method was adopted to analyze and categorize the data.Results:The real experience of frontline medical workers in quarantine points were classified into five themes: professional mission and pride, inadequate initial response in dealing with public health emergencies (shortage of personal protective equipment,inadequate preparation of medical workers and imperfect settings of quarantine points), having some negative emotions (worrying about being infected and feeling fearful for family members), facing complex and diverse working difficulties (repugnance and diversified demands of people quarantined, heavy workload, discomfort from personal protective equipment and occupational exposure), and gaining support and appreciation (getting support from epidemic control and prevention departments as well as medical systems and winning appreciation from people quarantined).Conclusions:The frontline medical workers are lack of experience in dealing with public health emergencies and have some psychological and working pressure. Administrative department should further complete the emergency plan of centralized isolation medical observation, strengthen the contingency management of public health emergencies, attach importance to the mental health of medical workers, optimize management methods and establish flexible work schedules.

Chromatography, Gas ; methods ; Dimethoate ; blood ; Humans ; Insecticides ; blood ; Methyl Parathion ; blood

Objective To discuss the application of minimally invasive surgery in the treatment of esophageal leiomyoma. Methods Clinical data of 26 patients with esophageal leiomyoma from September 1996 to October 2002 treated by minimally invasive surgery were reviewed retrospectively. Results Video-assisted thoracoscopic leiomyoma enucleations were performed in 23 patients, and a conversion to mini-thoracotomy was required in 3 of them because of dense pleural adhesion (2 patients) or location failure of tumor (1 patient). The remaining 3 patients underwent transjugular leiomyoma enucleation (2 patients) or esophagoscopic resection of leiomyoma (1 patient), respectively. All the procedures were completed smoothly and the postoperative recovery was uneventful, without mortality or severe complications. All the patients were pathologically diagnosed as leiomyoma after surgery. Follow-up for 2 ～ 73 months (mean,32.3months) found no recurrence. Conclusions Video-assisted thoracoscopic enucleation can be the first choice for the esophageal leiomyomas that derived from lamina propria, while esophagoscopic removal may be considered for those from muscularis mucosa.

Objective To explore the clinical and imaging features of reversible posterior leukoencephalopathy syndrome(RPLES).Methods The data of clinic five cases with RPLES were analyzed retrospectively.Results The primary diseases in this group were hypertension for one case,uraemia for three cases and lupus nephropathy for another.Clinical features of five patients include acute onset of hypertension,headache with vomiting.Neurological symptoms were conscious disturbance,seizures(in 5 cases)and visual disorder(in 3 cases).The movement of limbs were normal.The abnormal laboratery data was renal inadequacy in 5 cases.The findings of imaging of all cases included bilateral white matter of parietal and occipital lobe abnormalities,which appeared as large areas of low density on CT scan,hypo-intense in T1 and hyper-intense in T2 on MRI scan.Four cases presented clinical symptoms improvement in a short time and radiological recovery obviously after anti-hypertensive and anhydration therapy.One patient died caused on brain herniation.Conclusions Clinical features of RPLES is brain damage associated with malignant hypertension or the use of immunosuppressive agents.The most important pathogenesis is considered to be failure of the self regulation of cerebral vascular circulation.The imaging findings are bilateral symmetry cortical and subcortical edema in the posterior areas of the brain.Most patients can be recovery by timely therapy,otherwise the irreversible neuronal injury even death can be also found in very few serious cases.

Objective To investigate the effect of Danzhijiangtang capsule on serum,fat in type 2 diabetic rats.Methods The model of type 2 diabetes mellitus rats were established by injecting small does streptozotocin(STZ)into abdomen and feeding high sucrose-fat diet.All the rats were divided randomly into five groups.The level of blood glucose,serum insulin,insulin sensitivity index,blood fat(triglyceride, cholesterol,high-density lipoprotein,low-density lipoprotein),free fatty acid after treated were examined. Results Danzhijiangtang capsule could decrease the level of blood fat.Conclusion Danzhijiangtang capsule could improve the blood fat in type 2 diabetic rats.

Objective To investigate the electrophysiological characteristics of the ventralis intermedius nucleus (Vim) in order to find an easy and safe way to confirm the target in Vim-thalamotomy. Method In microelectrode-guided selective Vim-thalamotomy for 23 Parkinson's disease patients, the background activity, amplitude and discharge frequencies of Vim were compared with its surrounding structures. The response of kinesthetic neuron and tremor cell to microstimulation was also compared. Result There were differences in backgroud activity and discharge amplitude for Vim, ventralis lateralis nucleus (VL), ventralis caudalis nucleus (VC), and internal capsule. Based on the response to active or passive movement of contralateral limb tremor cells were divided into two subgroups, which were different in localization. Contralateral tremor showed different response when the two subgroups of tremor cells were mircrostimulated. Conclusion The anterior border of Vim was easily found by microrecording. Only by combining microstimulation with microrecording could the posterior border of Vim and its interior and lateral ordination of target were identified exactly and safely. Kinesthetic neurons and tremor cells which responded to the movement of contralateral limbs should be destroyed.

Objective To research the electrocardiogram (ECG) manifestations of common electrolyte disturbance and to discuss the accuracy of ECG diagnosis. Methods One hundred and sixty-nine hospitalized patients with hyperkalemia and 170 patients with hypokalemia were selected and the results of ECG were analyzed. Results In mild hyperkalemia patients (serum potassium concentration 5.5- 6.5 mmol/L), the ECG abnormal rate was 91.4% (64/70). In mild hypokalemia patients (serum potassium concentration 3.0-3.5 mmol/L), the ECG abnormal rate was 56.9% (41/72). There was significant difference (P < 0.05). The greater the deviation of serum potassium concentration, the more obvious the characteristic changes of ECG. Conclusions In addition to the blood biochemical test, ECG is also a kind of check tool that can help to diagnose abnormal blood potassium.

Objective To discuss the expression and significance of platelet ultrastructure and platelet acti-vating factor(PAF)relationship in patients with acute cerebral infarction.Methods 40 patients with cerebral infarc-tion were chosen onset in 6-24 hours as the observation group,while at the same time 20 cases of healthy adults were selected as the control group.The observation group was given 1-7d of aspirin enteric-coated metformin hydrochloride 300mg,qd,and 8-14d had worship of aspirin enteric-coated metformin hydrochloride 100mg,qd.And before and 1,7, 14 days after treatment,control group and observation group respectively preclude the use of transmission electron microscopy ultrastructure of platelets,before and 1,14 days after treatment automatic blood cell analyzer test was used to analyze the average platelet volume (MPV),platelet count (PLT),platelet volume distribution width (PDW)of the two groups.And 1,2,3,7,14 days after treatment,enzyme-linked immunosorbent determination of double clamp method was used to test the concentration of PAF.Results Before treatment,MPV,PDW and PAF in peripheral blood of the observation group were (9.22 ±1.30)fL,(17.89 ±1.23)%,(211.31 ±11.22)pg/mL,which were sig-nificantly higher than those of the control group (8.68 ±1.03)fL,(16.06 ±1.03)%,(155.49 ±8.70)pg/mL(t =2.082,2.563,14.401,all P <0.05),while PLT was (173.22 ±63.40)×109 /L,which was significantly lower than that in the control group (231.22 ±56.76)×109 /L(t =3.048,P <0.05).After treatment in patients with acute cer-ebral infarction,the MPV,PDW of peripheral blood were (8.43 ±1.28)fL,(16.66 ±1.11)%,which were signifi-cantly lower than before treatment (9.22 ±1.30)fL,(17.89 ±1.23)% (t =1.937,3.320,all P <0.05),while PLT (195.33 ±61.45)×109 /L was significantly higher than before treatment (173.22 ±63.40)×109 /L(t =1.915, P <0.05).PAF peaked in the treatment of 3 days,which was (240.12 ±13.78)pg/mL,and gradually declined after 7 days,which was (215.33 ±16.43)pg/mL,and that after 14 days was(170.27 ±11.40)pg/mL,compared with before treatment (211.31 ±11.22)pg/mL,the difference was statistically significant (t =16.24,P <0.05).Before treatment,platelet shape had irregular,increased pseudopodia,several visible platelet aggregation,and was blend together.And after 14 days treatment in the observation group,platelet ultrastructure greatly recovered.Conclusion Monitoring of MPV,PDW,PAF and PLT in peripheral blood of patients with acute cerebral infarction before and after treatment has important clinical value for disease diagnosis and treatment.

Objective To investigate the value of combined use of laparoscopic cholecystectomy (LC) and duodenoscopic procedures in the treatment of selective common bile duct stones. Methods We retrospectively analyzed clinical data of 32 cases of selective common bile duct diseases treated with laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography (ERCP) from January 2002 to December 2003. Results Of 24 cases receiving ERCP before LC, 19 cases were found having common bile duct stones, 3 cases having stricture at the lower end of the common bile duct, and 2 cases normal. These cases underwent ERCP and endoscopic sphincterotomy (EST) following by LC. Of 8 cases receiving ERCP after LC, 4 cases were found having common bile duct stones, 3 cases having stricture at the lower end of the common bile duct, and 1 case normal. Except for 1 case of conversion to open surgery because of a failed stone removal, all the cases were cured with EST. Conclusions combined use of LC and ERCP is a highly useful approach in the treatment of selective common bile duct stones, which has broadened the utilization of minimally invasive treatment for bile duct diseases.