Surgical techniques in radiation induced temporal lobe necrosis in nasopharyngeal carcinoma patients.

BACKGROUND: Radiation induced brain injury ranges from acute reversible edema to late, irreversible radiation necrosis. Radiation induced temporal lobe necrosis is associated with permanent neurological deficits and occasionally progresses to death. OBJECTIVE: We present our experience with surgery on radiation induced temporal lobe necrosis (RTLN) in nasopharyngeal carcinoma (NPC) patients with special consideration of clinical presentation, surgical technique, and outcomes. METHOD: This retrospective study includes 12 patients with RTLN treated by the senior author between January 2010 and December 2014. Patients initially sought medical treatment due to headache; other symptoms were hearing loss, visual deterioration, seizure, hemiparesis, vertigo, memory loss and agnosia. A temporal approach through a linear incision was performed for all cases. RTLN was found in one side in 7 patients, and bilaterally in 5. 4 patients underwent resection of necrotic tissue bilaterally and 8 patients on one side. RESULTS: No death occurred in this series of cases. There were no post-operative complications, except 1 patient who developed aseptic meningitis. All 12 patients were free from headache. No seizure occurred in patients with preoperative epilepsy. Other symptoms such as hemiparesis and vertigo improved in all patients. Memory loss, agnosia and hearing loss did not change post-operatively in all cases. The follow-up MR images demonstrated no recurrence of necrotic lesions in all 12 patients. CONCLUSION: Neurosurgical intervention through a temporal approach with linear incision is warranted in patients with radiation induced temporal lobe necrosis with significant symptoms and signs of increased intracranial pressure, minimum space occupying effect on imaging, or neurological deterioration despite conservative management.

A multiyear assessment of air quality benefits from China's emerging shale gas revolution: Urumqi as a case study.

China is seeking to unlock its shale gas in order to curb its notorious urban air pollution, but robust assessment of the impact on PM2.5 pollution of replacing coal with natural gas for winter heating is lacking. Here, using a whole-city heating energy shift opportunity offered by substantial reductions in coal combustion during the heating periods in Urumqi, northwest China, we conducted a four-year study to reveal the impact of replacing coal with natural gas on the mass concentrations and chemical components of PM2.5. We found a significant decline in PM2.5, major soluble ions and metal elements in PM2.5 in January of 2013 and 2014 compared with the same periods in 2012 and 2011, reflecting the positive effects on air quality of using natural gas as a heating fuel throughout the city. This occurred following complete replacement with natural gas for heating energy in October 2012. The weather conditions during winter did not show any significant variation over the four years of the study. Our results indicate that China and other developing nations will benefit greatly from a change in energy source, that is, increasing the contribution of either natural gas or shale gas to total energy consumption with a concomitant reduction in coal consumption.

Publications in ISI-indexed public health journals from mainland China, Hong Kong and Taiwan during 1999-2008.

BACKGROUND: There has been a steady increase in China's annual research output. We aimed to investigate the research output in public health from 3 major regions of China: mainland China (ML), Hong Kong (HK) and Taiwan (TW). MATERIAL/METHODS: We retrieved papers published in 105 public health-related journals from ML, HK and TW with the applications of the ISI Web of Knowledge database. The total papers, impact factor, times cited, papers published in the highest impact factor journals, and most often published journals were analyzed for quantity and quality comparisons among the 3 regions. RESULTS: Totally, 2587 papers were published during 1999-2008, including 1089 (42.1%) from ML, 471 (18.2%) from HK, and 1027 (39.7%) from TW. The total annual number of papers from the 3 regions increased significantly, from 140 in 1999 to 424 in 2008. The average impact factor of papers from TW (2.588) was higher than those from HK (2.531) and ML (1.568). The average number of times cited of each paper from TW was 8.84, followed by 8.34 from HK and 5.90 from ML. Excluding publications in Biomedical and Environmental Sciences, papers from ML had higher average IF and average times cited. TW had the most articles published in the highest impact factor journals, and HK had the highest total IF of most often published journals. CONCLUSIONS: The total number of papers in public health from China increased significantly during 1999-2008. ML contributed the highest annual paper output compared with HK and TW, but papers from ML are more often locally published and less frequently cited.

Application Value of Rehabilitation Nursing in Patients with Stroke Based on the Theory of Interactive Standard: A Randomized Controlled Study.

OBJECTIVE: To explore the application value of rehabilitation nursing based on the theory of interactive standards in stroke patients. METHODS: A total of 120 stroke patients who were treated in our hospital from December 2018 to September 2020 were selected as the research objects, and the patients were divided into a control group (60 cases) and an observation group (60 cases) according to the random number table method. The control group used routine nursing care, and the observation group used interactive rehabilitation care based on the control group. The Barthel Index, National Institute of Health Stroke Scale (NIHSS) score, Specific Quality Of Life Scale (SS-QOL) score, rehabilitation standard rate, nursing satisfaction, improvement time of limb function, and compliance with rehabilitation exercise were compared between the two groups of patients. RESULTS: After intervention, the Barthel Index of the two groups increased, and the Barthel Index of the observation group was comparatively higher (P < 0.05); the NIHSS scores of the two groups of patients reduced, and the NIHSS scores of the observation group were significantly lower than those of the control group (P < 0.05); the SS-QOL scores of the two groups of patients improved, and the increase in SS-QOL scores in the observation group was found to be significantly higher than those in the control group (P < 0.05); the compliance rate was found to be in favor of the observation group (83.33 (50/60) vs 63.33 (38/60)) (χ 2 = 6.136, P˂0.05); the total satisfaction of nursing care of patients in the observation group was superior to the control group (96.67% vs 78.33%) (χ 2 = 9.219, P˂0.05); the limb function improvement time of the observation group was significantly shorter (P < 0.05); the observation group had significantly higher rehabilitation exercise compliance scores (P < 0.05). CONCLUSION: The rehabilitation nursing based on the interactive standard theory can promote the stroke patients to complete the rehabilitation goals, improve the neurological and limb functions, and enhance the patients' daily living ability, quality of life, and nursing satisfaction, which is worthy of clinical promotion and application.

Immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy: A qualitative study.

PURPOSE: Patients with rectal cancer with a permanent colostomy often have issues in physical, psychological and social domains. Since discharge is an important transition period, the patient experience at that time is worthy of attention. The aim of this study was to explore the immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy in China. METHODS: A qualitative design was used. Semi-structured interviews were conducted with 18 patients newly living with colostomy in China, who were asked open-ended questions about their postoperative experience. The thematic analysis approach was used to analyze the data. RESULTS: Four themes and twelve sub-themes were identified from the interviews: (1) psychological reactions (stoma self-acceptance, negative emotion and social isolation), (2) daily life concern (daily life misunderstandings, sexual life compromise and work restriction), (3) stoma care consideration (strong stoma self-care willingness, decreased stoma self-care confidence and access to high-quality stoma care), and (4) support from others (enterostomal nurses, family members and stoma friends). CONCLUSION: Colostomy patients experience various obstacles in physiological, psychological, and societal aspect. Nurses should provide effective discharge guidance to correct misunderstandings about the stoma, refer patients to psychological care, and promote transitional care.

Source apportionment of fine organic carbon (OC) using receptor modelling at a rural site of Beijing: Insight into seasonal and diurnal variation of source contributions.

This study was designed to investigate the seasonal characteristics and apportion the sources of organic carbon during non-haze days (<75 µg m-3) and haze (≥75 µg m-3) events at Pinggu, a rural Beijing site. Time-resolved concentrations of carbonaceous aerosols and organic molecular tracers were measured during the winter of 2016 and summer 2017, and a Chemical Mass Balance (CMB) model was applied to estimate the average source contributions. The concentration of OC in winter is comparable with previous studies, but relatively low during the summer. The CMB model apportioned seven separate primary sources, which explained on average 73.8% on haze days and 81.2% on non-haze days of the organic carbon in winter, including vegetative detritus, biomass burning, gasoline vehicles, diesel vehicles, industrial coal combustion, residential coal combustion and cooking. A slightly lower percentage of OC was apportioned in the summer campaign with 64.5% and 78.7% accounted for. The other unapportioned OC is considered to consist of secondary organic carbon (SOC). During haze episodes in winter, coal combustion and SOC were the dominant sources of organic carbon with 23.3% and 26.2%, respectively, followed by biomass burning emissions (20%), whereas in summer, industrial coal combustion and SOC were important contributors. Diurnal contribution cycles for coal combustion and biomass burning OC showed a peak at 6-9 pm, suggesting domestic heating and cooking were the main sources of organic aerosols in this rural area. Backward trajectory analysis showed that high OC concentrations were measured when the air mass was from the south, suggesting that the organic aerosols in Pinggu were affected by both local emissions and regional transport from central Beijing and Hebei province during haze episodes. The source apportionment by CMB is compared with the results of a Positive Matrix Factorization (PMF) analysis of ACSM data for non-refractory PM1, showing generally good agreement.

[Warming Needle Moxibustion Relieves Symptoms of Lumbar Disc Herniation Patients and Upregulates Plasma ß-endorphin].

OBJECTIVE: To analyze the effect of warming needle moxibustion of Jiaji (EX-B 2), Huantiao (GB 30), etc. on lumbago and other symptoms of lumbar disc herniation (LDH) patients and changes of plasma ß-endorphin (ß-EP) content. METHODS: A total of 60 LDH patients were equally randomized into warming needle moxibustion group and conventional acupuncture group. Patients of the conventional acupuncture group were treated by puncturing lumbar Jiaji (EX-B 2), Huantiao (GB 30), Weizhong (BL 40), and Yanglingquan (GB 34) with filiform acupuncture needles. Patients of the warming needle moxibustion group were treated by puncturing the same 4 acupoints, and with the acupuncture needle in lumbar EX-B 2 attached an ignited moxa-stick segment. The treatment in both groups lasted for 30 min every time, once every other day for 15 times, with 5 times being a therapeutic course and two days' rest between every two courses. The therapeutic effect was evaluated according to the "Criteria for Evaluating the Therapeutic Effect of Disorders of Traditional Chinese Medicine". The lumbago severity was assessed using visual analogue scale (VAS), and the lumbar functional activity assessed using modified Oswestry dysfunction (in objects-lifting, sitting, standing, walking, sleeping, pain, activity of daily living, social activity, outing, etc.) index (ODI). The plasma ß-EP content was assayed using ELISA. RESULTS: After the treatment, of the two 30 cases in the conventional acupuncture and warming needle moxibustion groups, 8 (26.67%) and 12 (40.00%) were under control, 8 (26.67%) and 10 (33.33%) had a marked improvement, 3 (10.00%) and 4 (13.33%) were effective, and 11 (36.66%) and 4 (13.33%) ineffective, with the effective rates being 63.34% and 86.66%, respectively. The effective rate of the warming needle moxibustion was significantly higher than that of the conventional acupuncture (P<0.05). The VAS scores and ODI values of the two groups were gradually decreased along with the prolongation of treatment, and significantly lower in the warming needle moxibustion group than in the acupuncture group at the 1st, 2nd and 3rd course of treatment (P<0.01). The levels of plasma ß-EP were gradually increased in the two groups at the 1st, 2nd and 3rd course of treatment, and were obviously higher in the warming needle moxibustion group than in the conventional acupuncture group at each of the 3 courses (P<0.01). No obvious adverse reactions were observed in the two groups. CONCLUSION: Warming needle moxibustion has a better therapeutic effect in relieving lumbago and lumbar dysfunction, and can up-regulate blood ß-EP level.

Concentrations and spatial distribution of polycyclic aromatic hydrocarbons (PAHs) and nitrated PAHs (NPAHs) in the atmosphere of North China, and the transformation from PAHs to NPAHs.

The occurrence of polycyclic aromatic hydrocarbons (PAHs) and nitrated derivatives (NPAHs), as well as their transformation may have significant health impacts on humans. To investigate the level, spatial distribution and the transformation process of PAHs and NPAHs in North China, we performed a griddedfield passive air sampling campaign in summer of 2011. The median concentration of 25 PAH congeners and 13 NPAHs was 294 ng m(-3) (or 26.7 mg sample(-1)) and 203 ng sample(-1), respectively. Relative higher level of PAHs in Shanxi Province and NPAHs in megacities was observed. In North China, coal/biomass combustion and photochemical formation was the predominant source of PAHs and NPAHs, respectively.To investigate the relationship between these pollutants, a model incorporating NPAHs, PAHs and NO(2) was established, and the result indicated that NO(2) will promote the transformation processes from PAHs to NPAHs, which may increase the total toxicity of PAH-NPAH mixtures.

Telephone follow-up for patients returning home with colostomies: views and experiences of patients and enterostomal nurses.

PURPOSE: To explore the views of patients and enterostomal nurses regarding a telephone follow-up program for patients returning home with colostomies. METHODS AND SAMPLE: Semi-structured interviews were conducted with eleven patients who accepted a telephone intervention and seven enterostomal nurses who conducted telephone follow-ups. Qualitative data were analyzed using content analysis. KEY RESULTS: The enterostomal nurses indicated that the telephone follow-up was appreciated and well accepted by the patients. Both the patients and the enterostomal nurses perceived the telephone follow-up as efficient at solving stoma care problems in a timely manner, shortening the process of resuming normal life, and most importantly, providing psychological support. The enterostomal nurses found that telephone follow-up after a patient's hospital discharge was meaningful work. Additional nurse training and measures to overcome communication barriers are required. CONCLUSIONS: All of the patients benefited from the nurse-led telephone follow-up program as part of the continuity of nursing care. The sustainability of the service requires hospital support. Further dissemination of telephone follow-up to other discharged surgical patients might be warranted.

An evaluation of the sealing ability of a polycaprolactone-based root canal filling material (Resilon) after retreatment.

OBJECTIVE: The aim of this study was to evaluate the sealing ability of Resilon after retreatment. STUDY DESIGN: Sixty-six single-rooted mandibular premolars were enlarged to apical size 45 and then obturated with Resilon. The roots were randomly divided into 3 groups (n = 22/group). In group 1 no further treatment was done. Groups 2 and 3 were reinstrumented to apical size 60 using K-files and ProFile, respectively. In each group, 4 samples were kept for environmental scanning electron microscopy (ESEM) analysis. The remaining roots from groups 2 and 3 were refilled with Resilon. Sixteen roots from each group were then evaluated for microleakage; two roots served as controls. Data were analyzed statistically by Kruskall-Wallis test. RESULTS: There were no significant differences between the experimental groups (P > .05). The ESEM showed new attachment of resin tags on the dentin surface of retreated roots. CONCLUSION: Resilon can be used for retreatment, but it still allowed microleakage.