Aged ; Catheter Ablation ; adverse effects ; Echocardiography ; Heart Atria ; Humans ; Male ; Postoperative Complications ; diagnostic imaging ; Tachycardia, Supraventricular ; diagnostic imaging ; surgery ; Thrombosis ; etiology

Objective To understand head nurse's leadership behavior and analyze the influence of it on nurse's involvement and self-efficacy.Methods General information questionnaire was taken,and the data of 280 nurses to head nurse's leadership behavior,involvement and self-efficacy were investigated.Results There were differences in nurse's involvement and self-efficacy between head nurse's transformation and transaction leadership behavior (F=4.39,2.37,2.94,2.17,P ＜0.05).The transformation leadership behavior dimensions were positive correlation with nurse's involvement and self-efficacy,P＜0.05.Conclusion Head nurse should fully play a positive role of transformation leadership behavior,in order to promote involvement and improve self-efficacy.

Adult ; Heart Aneurysm ; congenital ; Heart Atria ; pathology ; Humans ; Male

OBJECTIVETo investigate the relationship between right ventricular (RV) mechanical delay and RV dysfunction in patients with pulmonary hypertension (PH).

METHODSA total of 51 patients with PH were divided into mild, moderate and high PH groups and 30 healthy volunteers served as control group. RV mechanical delay (defined as the difference in time to peak systolic annular velocity between the RV free wall and the ventricular septum) and RV fractional area change were obtained on apical four chamber view with Quantitive Tissue Velocity Imaging (QTVI).

RESULTSRV mechanical delay increases in proportion to pulmonary pressure. RV fractional area change was similar between control and mild PH patients while significantly reduced in moderate and high PH patients compared to controls. RV mechanical delay significantly correlated to RV fractional area change in all PH groups (r = -0.79; r = -0.66; r = -0.80, all P < 0.05).

CONCLUSIONRV mechanical delay measured by QTVI can be used to evaluate RV dysfunction in patients with pulmonary hypertension.

Adolescent ; Adult ; Aged ; Case-Control Studies ; Echocardiography, Doppler, Color ; Female ; Humans ; Hypertension, Pulmonary ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ventricular Function, Right

Objective To investigate the feasibility and clinical value of anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV in chest CT scan.Methods A total of 60 patients of clinical diagnosis with lung tumor were enrolled.Those patients were randomly divided into test group and control group.Control group underwent a scan protocol with lateral scout scan combined with Care Dose 4D and Care kV,while anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV were performed in test group.The signal-to-noise ration (SNR),contrast-to-noise ratio (CNR),and overall image quality of two groups of images and diseased tissues were analyzed and evaluated by two high-grade radiologists using double-blind method.Effective doses (E) were also calculated.Results All the 60 patients had successfully completed the chest CT scans.Test group overall image quality (4.57 ± 0.45) and control group overall image quality (4.73 ± 0.45) had no statistically significant difference (P ＞ 0.05).The control group image SNR,CNR and diseased tissue SNR,CNR compared with test group had no statistical significance difference (P ＞ 0.05).The difference of the volume CT dose index (CTDIvol),dose-length product (DLP) and effective dose (E) of test group and control group was statistically significant (t =8.514,8.464,8.464,P ＜ 0.001).Compared with control group,the effective dose of test group decreased by 33.3％.Conclusions Compared with lateral scout scan,the technology of anteroposterior and lateral scout scan combined with Care Dose 4D and Care kV can decrease radiation dose without reducing the image quality.This technology can therefore be considered as a regular imaging modality for chest CT scan.

BACKGROUNDTissue Doppler imaging (TDI) has provided an objective means to quantify global and regional left ventricular (LV) and right ventricular (RV) function with improved accuracy and greater reproducibility than conventional echocardiography. This study was conducted to assess RV myocardial systolic activation by TDI in subjects with pulmonary arterial hypertension (PAH).

METHODSA total of 30 patients with PAH and 30 healthy volunteers, all comparable in age and sex, underwent standard Doppler echo and TDI. Using pulsed Doppler echocardiography combined with TDI, the following regional parameters were evaluated in three different myocardial segments (RV basal lateral wall, basal septal, and LV basal lateral) on apical 4-chamber view: systolic (Sm), early- and late-diastolic (Em and Am) peak velocities. RV myocardial systolic activation delay was defined as the difference in time to peak TDI systolic velocities between the RV basal lateral wall and basal septal. In addition, RV end-diastolic and end-systolic areas were measured to calculate RV fractional area change from the same apical 4-chamber view.

RESULTSCompared with the control group, patients with PAH showed increased RA and RV end-diastolic diameter (RA: (4.5 +/- 1.2) cm vs (3.0 +/- 0.8) cm, P < 0.05 and RV: (4.8 +/- 1.9) cm vs (3.4 +/- 0.5) cm, P < 0.05) and reduced RV fractional area change; (35 +/- 14)% vs (56 +/- 9)%, P < 0.05. These PAH patients showed lower myocardial peak velocities and a significant activation delay compared with controls (P < 0.05). Moreover, a strong correlation between RV myocardial systolic activation delay and RV fractional area change was shown in patients with pulmonary arterial hypertension (r = -0.82).

CONCLUSIONSIn PAH, RV myocardial systolic activation was markedly delayed, which was directly related to the RV fractional area change. RV myocardial systolic activation delay assessed by TDI could offer a unique approach to predict RV dysfunction.

Adolescent ; Adult ; Diastole ; Echocardiography, Doppler ; Female ; Humans ; Hypertension, Pulmonary ; physiopathology ; Male ; Middle Aged ; Systole ; Ventricular Dysfunction, Right ; etiology ; Ventricular Function, Right

OBJECTIVETo investigate the aortic elastic properties and its clinical significance in intracranial aneurysms (IAs).

METHODSOne hundred and seven IAs patients (57 with hypertension) and 108 healthy subjects were recruited. The internal aortic diameters in systole and diastole were measured by the M-mode echocardiography, the aortic elasticity indexes were calculated and compared.

RESULTSThe aortic distensibility (DIS) was lower and the aortic stiffness index (SI) was higher in IAs patients than those in controls (both P <0.001). DIS was lower and SI was higher in IAs patients with hypertension (IAs-HP) than those in IAs with no hypertension (P <0.001). Similar results were obtained when the aortic elasticity index were adjusted for body surface area and body mass index.

CONCLUSIONAbnormal aortic elasticity is a common finding in IAs patients and hypertension is closely related to the severity of aortic elasticity.

Adult ; Aged ; Aorta ; diagnostic imaging ; physiopathology ; Case-Control Studies ; Elasticity ; Female ; Humans ; Intracranial Aneurysm ; physiopathology ; Male ; Middle Aged ; Ultrasonography

OBJECTIVETo investigate the factors affecting clinical therapeutic effect on acute tetramine poisoning.

METHODSUsing Logistic regression to analyze the relationships among the degree of tetramine poisoning, time of onset, time of admission, exposure history, sex, age, unithol, gastric lavage, etc with the death of poisonded patients.

RESULTSThe fatality rate of patient with tetramine poisoning who got gastric lavage was less than that who did not (5.85% vs 38.00%, P < 0.01). In patients who got gastric lavage, the fatality rates were increased with the degree of tetramine poisoning (control: 0%, mild poisoning: 3.07%, severe poisoning: 9.14%, P < 0.05). There was no significant difference in fatality between using unithol and not using patients (7.22% vs 8.25%, P > 0.05).

CONCLUSIONUnithol has no significant influence of clinical therapeutic effect on tetramine poisoning patients and dose not reduce the fatality rate of patient with tetramine poisoning, but gastric lavage and the degree of tetramine poisoning do. Logistic regression analysis showed that gastric lavage is the main factor affecting the therapeutic effect on tetramine poisoning.

Acute Disease ; Adolescent ; Adult ; Antidotes ; therapeutic use ; Bridged-Ring Compounds ; poisoning ; Child ; Female ; Gastric Lavage ; methods ; Humans ; Insecticides ; poisoning ; Logistic Models ; Male ; Poisoning ; mortality ; therapy ; Retrospective Studies ; Survival Rate ; Time Factors ; Treatment Outcome ; Unithiol ; therapeutic use

Objective To evaluate the consistency among the results of preoperative midstream urine culture (PMUC), renal pelvis urine culture (RPUC) and renal stone (RSC) culture in patients undergoing percutaneous nephrolithotomy (PNL) and their relationship with postoperative infection. Methods This was a multicenter prospective study. From September 2014 to November 2017, 115 patients undergoing standard channel PNL or microchannel PNL in the First Affiliated Hospital of Soochow University and Yancheng Hospital of Traditional Chinese Medicine were selected. The PMUC, RPUC and RSC were detected. Samples for RPUC and RSC were obtained during PNL. The clinical data, stone configuration, stone burden and results of cultures were recorded. Results In the 115 patients, PMUC positive was in 4 cases (3.5%), RPUC positive was in 17 cases (14.8%), and RSC positive was in 16 cases (13.9% ); both RPUC and RSC positive were in 7 cases (6.1% ), among whom consistent pathogenic bacterium was in 6 cases, and inconsistent pathogenic bacterium was in 1 case; all the 3 cultures were positive in 1 case, but the types of pathogenic bacterium of PMUC were totally different with RPUC and RSC. At least one positive of the 3 cultures was in 29 cases (25.2% ). The types of pathogenic bacterium of PMUC were multidrug susceptible Escherichia coli and Staphylococcus aureus , and the types of pathogenic bacterium of RPUC and RSC were multidrug resistant pathogens and/or fungus. The consistency of pathogenic bacterium between PMUC and RPUC, RSC was very low; while the consistency of pathogenic bacterium between RPUC and RSC was very high (6/7). Postoperative infection occurred in 8 of 115 patients (7.0% , 5 cases of infective fever and 3 cases of urinary sepsis). In the 8 patients, PMUC was negative, PRUC positive in 4 cases, RSC positive in 7 cases, and both PRUC and RSC positive were in 3 cases. Conclusions PMUC can not accurately reflect the true situation of upper urinary tract renal calculi and pyelo-urine pathogenic bacterium. In patients with PNL postoperative infectious complications, the result of PMUC is often negative, but the results of RPUC and RSC are mostly positive. RPUC and RSC are helpful to detecting pathogenic bacterium in time, guiding the application of sensitive antibiotics, preventing and treating PNL postoperative infection.

[Absract] Objective This paper was designed to reveal the new mechanism on ASI Ⅱ triggered CD4+T cells activation via regulating CD45 molecular and provide a basis for the theoretical foundation of antitumor immunotherapy of Astragalus.Methods The CD4+T cells were randomly divided into negative group,stimulated control group,ASI Ⅱ group,CD45 inhibitor group,and the combination of ASI Ⅱ and CD45 inhibitor group.Besides negative group,the cells from other groups were activated by anti-CD3/CD28 antibody.ASI Ⅱ group was treated with 10 nmol/L ASI Ⅱ,CD45 inhibitor group was treated with 0.8 μmol/L CD45 inhibitor,and the combination group were treated with 10 nmol/L ASI Ⅱ and 0.8 iμmol/L CD45 inhibitor.After 36h culture,the proliferation of CD4+T cells was detected by Ki-67 intracellular staining assay.Cytokine production of Th1 and Th2 were examined ELISA method.The proportion of surface marker (CD44 and CD25)and Th1 intracellular cytokines (IFN-γ) were detected by flow cytometry.Results Compared with stimulated group,Astragaloside Ⅱ group in CD4+Ki67+T positive proportion (5.37％ ± 0.92％ vs.1.19％ ± 0.23％),in CD4+CD25+ positive proportion (50.23％ ± 4.65 ％ vs.15.89％ ± 1.13％),in CD4+CD44+ positive proportion (33.16％ ± 6.08％ vs.15.36％ 4 1.45％),in CD4+IFN-γ+ positive proportion (1.42％ ± 0.44 ％ vs.0.38％ ± 0.06％) were significntly increased.And the secretion of IFN-γ,IL-4 and IL-2 in ASI Ⅱ group were higher than stimulated group.The anti-mouse CD45 Ab treatment markedly blocked the proliferation and Th1 cytokines production which induced by ASI Ⅱ.Furthermore,the anti-mouse CD45 Ab treatment significantly decreased the expression of surface marker (CD44 and CD25).Conclusions Activating CD45 protein tyrosine phosphatase may be involved in ASI Ⅱ triggered CD4+T cells activation.This study will provide a basis for antitumor immunotherapy of Astragalus.