ObjectiveTo explore the features and assessment for far space neglect in left spatial neglect patients after right brain stroke. MethodsFrom January to October, 2021, 30 left unilateral spatial neglect (USN) patients after right stroke (patients, n = 30) from Beijing Bo'ai Hospital and healthy volunteers matching with gender, age and level of education (controls, n = 30) were evaluated with line cancelation (LC), star cancelation (SC) and line bisection (LB) tests, nearly and far away. The 25 controls were evaluated with LB on the second day. ResultsNo line or star was omissed in the controls. Both the deviation and percentage were more in the patients than in the controls (|t| > 4.319, P < 0.001). Both the deviation and percentage were less different for all the test (|Z| < 1.638, t = -1.282, P > 0.05) between nearly and far away, except the deviation of LB (t = -4.994, P < 0.001). The ICC of test-retest was above 0.462 (P < 0.01). ConclusionRight brain stroke patients with USN may present far spatial neglect, which can be assessed with LB.

Objective To study the psychological experience of the primary caregivers of patients with lower extremity deep vein thrombosis in Department of Neurosurgery, and to provide the basis for the establishment of nursing intervention measures under the cultural background of China. Methods By using qualitative phenomenological research method, 13 caregivers of patients with lower extremity deep vein thrombosis in Department of Neurosurgery were semi structured interviewed from May to October in 2017, and data were analyzed by using Colaizzi method. Results In the end, 4 themes were generated. They were psychological response at the beginning of diagnosis, the pressure in the process of care, changes in social adaptation ability and coexistence of difficulties and hopes. Conclusions The mood of caregivers is directly related to the physical and mental health of patients with lower extremity deep vein thrombosis. When interviewing patients, medical staff should give more knowledge of disease and psychological counseling to their caregivers to reduce the uncertainty of disease, release the burden of primary caregivers and ultimately promote them recovery.

Objective To explore the effect of doctor-nurse integration mode health education on the compliance of patients with breast cancer treated with Fulvestrant injection. Methods A total of 89 patients with breast cancer who received Fulvestrant injection in Breast Center of the Affiliated Hospital of Qingdao University were selected from October 2015 to June 2016 by convenient sampling method and they were divided into observation group (n=46) and control group (n=43) using randomly number table method. Patients in the control group received routine outpatient clinic medication treatment, while patients in the observation group received extra doctor-nurse integration mode health education during the treatment circle. Endocrine therapy compliance questionnaire for breast cancer patients was applied to assess treatment compliance of patients in two groups. Results After the implementation of doctor-nurse integration mode health education, scores of treatment compliance and each dimension of observation group were significantly higher than those of the control group (P<0.05). Conclusions For patients with breast cancer treated with endocrine therapy for a long time, the implementation of doctor-nurse integration mode health education could improve the compliance of patients, ensure the completion of the treatment cycle and promote the rehabilitation of patients.

Objective To investigate the characteristics of executive function in patients with brain injury. Methods From March 1st, to June 30th, 2015, 44 patients with brain injury were investigated with Wisconsin Card Sorting Test (WCST), the indexes including Responses Answer, Categories Completed, Correct Responses, Errors Responses, Trials to Complete First Category, Percent Conceptual Level Respons-es Percentage, Perseverative Responses Errors, Nonperseverative Responses Errors, Failure to Maintain Set, and Learning to Learn. Results The abnormal rates were the most in Nonperseverative Responses Errors and Percent Conceptual Level Responses Percentage (61.36%), and then in Responses Answer/Categories Completed/Correct Responses (59.09%), Correct Responses (43.18%), Trials to Complete First Category (38.64%), Perseverative Errors (29.51%), Learning to Learn (25.00%), and Failure to Maintain Set (9.09%). The patients with trau-matic brain injury were different from those with stroke in Responses Answer, Errors Responses, Perseverative Responses Errors, Catego-ries Completed, Percent Conceptual Level Responses Percentage, and Learning to Learn (Z>2.444, t>2.156, P<0.05). The patients injured in frontal lobe were different from those in other areas in Perseverative Responses Errors (t=2.595, P=0.015). Conclusion Executive function damaged generally in patients with brain injury, which related to concentration, abstract, shifting attention, working memory, etc. The frontal lobe damage may associate with the disorder of shifting attention.

Diabetic peripheral neuropathy is one of the microvascular complications of diabetes. traditional Chinese medicine (TCM) attributed it to theXiaoke disease andBizheng, with the views ofLuo disease and its TCM patterns differentiation. Based on the treatment for deficiency,Tongluo drugs were added and they made good curative effect. Recently the TCM researches on it have been deepened in the etiology, pathogenesis, treatment, experimental and clinical research, which showed some new under standings. Thus, this paper summarized the relevant researches.

Objective To investigate the efficacy of nicergoline combined with hyperbaric oxygen treatment on vascular cognitive impairment.Methods 120 patients with vascular cognitive impairment were randomly divided into 3 treatment groups:nicergoline,hyperbaric oxygen,and both treatment (n=40,each) for 8 weeks.Mini mental state examination (MMSE),Wechsler memory scale (WMS) and activities of daily living scale (ADL) were used as assessing items.The efficacy of treatment in each group was evaluated.Results There were no significant differences in clinical data among the three groups(x2=0.324,t=0.265 and 0.861,P=0.764,0.784 and 0.386).After 8 weeks of intervention,scores of MMSE,WMS and ADL were significantly improved in the combined treatment groups compared with pre-treatment (all P＜0.01),and the improvements were observed in nicergoline group (all P＜0.05),while only MMSE and ADL were improved in hyperbaric oxygen group (both P＜0.05).There were significant differences in scores of MMSE,WMS and ADL between combination therapy group and nicergoline group,hyperbaric oxygen group after treatment (all P＜0.05).But only MMSE had significant difference between niccrgoline group and hyperbaric oxygen group after treatment.No significant side effects were observed in the three groups.Conclusions Combination treatment of nicergline and hyperbaric oxygen has better efficacy on vascular cognitive impairment.It can markedly improve the activities of daily living and cognitive function without significant side effects,which is worthy of application in clinical medicine.

Objective To discuss the effect and safety about large dosage of tilofiban injection into coronary artery in patients with ST-segment elevated myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods A prospective study was conducted. Two hundred and eighteen patients with STEMI admitted into Cardiology Department of Taizhou Central Hospital were enrolled. According to the difference in dosage, they were divided into a large dosage tilofiban group (102 cases) and a routine dosage tilofiban group (116 cases). In both groups, they received the injection of load dosage of tilofiban into coronary artery during they underwent primary PCI, the load dosage being 25μg/kg in the large dosage group, and 10μg/kg in the routine dosage group. Afterwards, the dosage was kept on 0.15μg·kg-1·min-1 in both groups lasting for 18-24 hours. The flow of thrombolysis in myocardial infarction (TIMI) immediately after PCI, the return of ST-segment after operation for 2 hours, the rate of bleeding events, the rate of major adverse cardiac event [MACE, including death, re-infarction and target vessel revascularization (TVR)] and prognosis after operation for 30 days were observed. Results The ratios of the immediate reflow of TIMI 3 grade after operation and the return of ST-segment after operation for 2 hours in the large dosage tirofiban group were higher than those in the routine dosage tirofiban group [the ratio of the reflow of TIMI 3 grade:92.16%(94/102) vs. 81.90%(95/116), the ratio of the return of ST-segment after operation for 2 hours:89.22%(91/102) vs. 73.28%(85/116), both P < 0.05]. The ratios of re-infarction, TVR and the total MACE in 30 days after operation in large dosage tirofiban group were lower than those in the routine dosage tirofiban group [re-infarction: 0.98% (1/102) vs. 2.59% (3/116), TVR: 0.98% (1/102) vs. 2.59% (3/116), total MACE: 1.96% (2/102) vs. 6.03% (7/116), all P < 0.05]. There were no statistically significant differences in mortality and the bleeding events between the large dosage tirofiban group and routine dosage tirofiban group [mortality:0 (0/102) vs. 0.86%(1/116), bleeding events:1.96%(2/102) vs. 0.86%(1/116), both P>0.05]. Conclusion The injection of a large dosage of tilofiban into a coronary artery in patients with STEMI undergoing primary PCI is an effective and safe method to allow them to get more clinical benefits.

BACKGROUNDPreoperative incisional local anaesthesia with ropivacaine is a common method of providing post-laparoscopy pain relief. The pulmonary recruitment manoeuvre also provides pain relief, but the combined effect of these two methods on pain following laparoscopic procedures has not been reported. We investigated the efficacy of combining local anaesthetic infiltration of ropivacaine with pulmonary recruitment manoeuvre on postoperative pain following diagnostic hysteroscopy and laparoscopy.

METHODSThis prospective, randomized, controlled study involved 60 patients divided into two groups (n = 30, each). Group 1 received 20 ml of 0.5% ropivacaine injected peri-incisionally preoperatively, with intra-abdominal carbon dioxide removed by passive deflation. Group 2 received 20 ml of 0.5% ropivacaine injected peri-incisionally with five manual inflations of the lungs with a positive-pressure ventilation of 40 cmH2O at the end of surgery. The last inflation was held for 5 seconds. The intensity of postoperative incisional and shoulder pain was evaluated using a numerical rating scale at 0, 2, 4, 8, 12, 24 and 48 hours postoperatively by an independent blinded anaesthesiologist. Tramadol was given postoperatively for analgesia.

RESULTSCompared with group 1, incisional ropivacaine infiltration combined with pulmonary recruitment manoeuvre significantly reduced dynamic pain at 0 hour, 4 hours, and 24 hours postoperatively (4.1 ± 2.2 vs. 2.1 ± 1.9, P = 0.002; 2.7 ± 2.7 vs. 1.2 ± 1.3, P = 0.035; and 3.5 ± 2.1 vs. 2.1 ± 1.8, P = 0.03, respectively). Static incisional pain was significantly relieved at 0 hour, 2 hours, and 24 hours postoperatively (3.1 ± 1.7 vs. 1.6 ± 1.3, P = 0.001; 1.4 ± 1.3 vs. 0.5 ± 0.8, P = 0.012; and 2.3 ± 1.9 vs. 1.0 ± 1.5, P = 0.038, respectively). Group 2 had more patients without shoulder pain (P < 0.05) and fewer requiring tramadol (P < 0.05).

CONCLUSIONRopivacaine with pulmonary recruitment manoeuvre provided simple and effective pain relief after diagnostic hysteroscopy and laparoscopy.

Adolescent ; Adult ; Amides ; therapeutic use ; Anesthetics, Local ; pharmacology ; Female ; Humans ; Hysteroscopy ; methods ; Laparoscopy ; methods ; Middle Aged ; Pain, Postoperative ; drug therapy ; Positive-Pressure Respiration ; Shoulder Pain ; drug therapy ; Young Adult

Objective To research the relationship between high temperature and population death in cardio-cerebrovascular diseases in Shijiazhuang.Methods The time series of maximum daily temperature and daily death number of cardio-cerebrovascular diseases were described,and the relationship between daily maximum temperature and daily mortality of cardio-cerebrovascular diseases in summer was analyzed.The impact of daily highest temperature in summer from 2009 to 2011 on daily death of cardio-cerebrovascular diseases was analyzed.Results In summer,the highest temperature which could reach to 41.7℃ emerged mostly in July and August,and when the highest temperaiure was higher than 34℃,cardio-cerebrovascular diseases death increased obviously as the temperature increasing.The relative humidity was more than 70％ in most time of the year round.The excessive death in hot days accounted for 10.9％ in which the old people occupied the majority.Conclusion The extreme high temperature may obviously increase the cardio-cerebrovascular death in Shijiazhuang.

Objective To investigate the diagnosis and surgical treatment for the intracardiac leiomyomatosis (ICL).Methods Retrospectively reviews the data of 18 cases of ICL from February 1995 to June 2011 in Anzhen Hospital.Preoperative diagnosis of right atrial myxoma in 2 cases,right atrium/ventricular thrombus in 2 cases,pulmonary embolism in 2 cases,the inferior vena cava and right atrial tumor in 3 cases,the inferior vena cava lesions in 9 cases.18 cases of ICL were diagnosed by echocardiography,magnetic resonance imaging ( MRI ),computer tomography (CT) and angiography.ICL were recected under anesthesia,cardiopulmonaray bypass surgery,he incisions were respectively through the chest,thoraco-abdominal or abdominal incision,cardiopulmonary bypass method were respectively at room temperature,mid-low temperature with cardiac arrest,lowflow,deep hypothermic circulatory arrest.Results There was no operative death.Right atrium,inferior vena cava,bilateral renal vein,bilater alIliac vein vascular were not found leiomyoma by vascular ultrasound.Follow-up time was 5 ～ 106 (49 ± 42 )months,1 patient died of the leiomyoma recurrence after 5 months after the primary operation,the remaining 17 patients were followed up asymptomatically.10 were in NYHA functional class Ⅰ,and 7 in class Ⅱ.The 5yrs survival rate calculated by the Kaplan-Meier survival curve was (93 ±5 )％.Conclusion The ICL preoperative diagnosis is difficult,surgical treatment of ICL can get a good mid-long term survival rate and living quality.