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【Objective】 To compare the clinical efficacy of minimally invasive percutaneous approach with Wiltse approach in the treatment of thoracolumbar fracture without neurological deficit in young and middle-aged patients. 【Methods】 A prospective study was conducted in 108 patients with thoracolumbar fracture without neurological symptoms treated in Department of Orthopedics， The First Affiliated Hospital of Xi’an Jiaotong University from March 2015 to March 2018. We randomly assigned 54 patients to minimally invasive percutaneous approach group （Group A） and 54 ones to Wiltse approach group （Group B）. We compared the operation time， intraoperative blood loss， incision length， the number of intraoperative fluoroscopy times， and postoperative hospital stay of Group A and Group B. We also compared the VAS scores of the two groups before and 3 days after surgery and at each review， the vertebral frontal height compression ratio and Cobb Angle before and immediately after surgery， 3 months 1 year and 3 years after surgery， and ODI index before surgery and 3 months， 1 year and 3 years after surgery. 【Results】 All the 108 patients were followed up. There were no significant differences in operation time， intraoperative blood loss or postoperative hospital stay between the two groups （P>0.05）. The number of intraoperative fluoroscopy times was significantly smaller in Group B than in Group A （P0.05）， after operation， or at follow-up， while the anterior vertebral body height ratio and Cobb angle were significantly lower in Group B than in Group A （P<0.0125）. 【Conclusion】 Minimally invasive percutaneous approach and Wiltse approach are both safe and effective in the treatment of thoracolumbar fracture without neurological deficit. However， the number of intraoperative fluoroscopy times of Wiltse approach was significantly reduced， the incision length was smaller than that of the percutaneous pedicle group， and the postoperative anterior vertebral compression rate and Cobb Angle were lower than those of the percutaneous group， indicating better clinical efficacy.
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Objective@#To explore the effects of hnRNP E1 and both early genes E2 and E6 of HPV16 as well as their interactions in the progression of cervical carcinogenesis.@*Methods@#Subjects of this study included 56 women with normal cervix (NC), 58 patients with low-grade cervical intraepithelial neoplasm (CINⅠ) and 50 patients with high-grade cervical intraepithelial neoplasm (CINⅡ/Ⅲ) who were all recruited from the 'Cervical Lesions Study Cohort Project’ in Jiexiu of Shanxi province from June to September, 2014. Another 40 patients with cervical squamous cell carcinoma (SCC) were from the Shanxi Tumor Hospital during the same period. Information related to cervical lesions were collected, using a structured questionnaire, with cervical tissues and cervical exfoliated cells gathered from all the participants. HPV infection was detected by flow-through hybridization, while the levels of expression on hnRNP E1, HPV16 E2 and E6 protein were measured by Western Blot. Kruskal-Wallis H test, χ2 test, trend χ2 test were analyzed by SPSS 22.0 software, while interaction was evaluated by generalized multifactor dimensionality reduction (GMDR).@*Results@#The overall infection rates of HPV16 related to CINⅠ (15.52%, 9/58), CINⅡ/Ⅲ (40.00%, 20/50) and SCC (67.50%, 27/40) groups were all higher than that of the NC group (8.93%, 5/56) and with an increasing trend on the severity of cervical lesions (trend χ2=43.613, P<0.001). The levels of expression on hnRNP E1 protein were significantly different in the groups with different cervical lesions (H=9.98, P=0.019), showing a decreasing trend with the severity of cervical lesions (trend χ2=9.495, P=0.002). The levels of expression on HPV16 E2 (H=16.20, P=0.001) and HPV16 E6 (H=15.44, P=0.001) were significantly different in groups with different cervical lesions. Results of GMDR showed that the best interaction model in both groups of CINⅡ/Ⅲ and SCC appeared as hnRNP E1 low expression, HPV16 E2 low expression and HPV16 E6 high expression. However, no similar interaction was seen in CINⅠ (P>0.05).@*Conclusions@#Both low expressions of hnRNP E1 and abnormal expression of HPV16 E2 and E6 could increase the risk of high-grade CIN and cervical cancer. It seemed that they might have an important synergistic effect on the progression of cervical cancer.
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Objective To investigate the effect of continuous nursing based on transtheoretical model (TTM) on elderly patients with knee osteoarthitis (KOA). Methods A total of 120 elderly patients with KOA from January 2015 to December 2016 were selected and divided into observation group and control group by the random digits table method , with 60 cases in each. The observation group was given continuous nursing based on TTM, while the control group was given continuous nursing. The functions and symptoms of knee joint of the 2 groups were evaluated by Lysholm Knee Scale Scores (LKSS) and Lequesne's Indexes (LI) after 6 months of implementation and compared. The compliance of rehabilitation training, the distribution of different behavior stages and the quality of life were compared after 6 months of implementation. Results The score of LKSS of the observation group was (78.04±8.55) points, and that of the control group was (69.22 ± 7.90) points, and there was significant difference between the 2 groups (t=6.780, P<0.05). The LI of the observation group was (5.37±1.05) points, and the control group was (6.09 ± 1.60) points, and there was significant difference between the 2 groups (t =3.356, P<0.05). There were significant differences in the distributions of the compliance of rehabilitation training and different behavior stages between the 2 groups (Z=5.814, 6.910, P<0.05). The rate of completely compliance, the percentage of action and maintenance stages of the observation group was 85.00%(51/60), 53.33% (32/60), and the control group was 55.00% (33/60), 28.33% (17/60) , and there was a significant difference between the 2 groups (χ2=12.857, 7.761, P<0.05). The physical condition, symptom and other 5 life quality scores and the total score of the observation group was (26.37±3.08), (11.80±2.15), (18.66± 2.27), (14.98±2.52), (6.93±0.94), (78.69±10.36) points, and the control group was (24.22±3.32), (9.44± 1.29), (17.24±3.07), (14.06±2.07), (6.56±1.05), (71.62±12.15) points, and there was significant difference between the 2 groups (t =2.034-7.291, all P<0.05). Conclusions The application of continuous nursing based on TTM on elderly patients with KOA can significantly change the stages of healthy behavior, improve the patients' compliance of rehabilitation training and quality of life, improve the function and symptom of knee joint.
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Objective: To explore the effect of application of standardized communication mode in doctor -nurse communication. Methods:Using stratified cluster sampling method, 96 nurses and 49 doctors from 10 nursing units were invited to participate in this study. The standardized communication mode training was carried out for nurses, which was implemented by communication guide and electronic medical interaction system. The doctors′satisfaction to nurses′job was evaluated before and after the implementation, and the nursing staffs′attitude toward standardized communication mode was investigated. Results:After 1 year, doctors′satisfaction to nurses′job was higher than that of before, the difference was statistically significant. Nursing staffs′acceptance toward standardized communication mode presented a high level. Conclusions:The standardized communication mode is beneficial to improve the doctor′s satisfaction to the nurses′work, especially in understanding of the disease condition, profes-sional knowledge and cooperation with the doctors. This communication mode is worthy popularizing in the clinical situation.
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Objective To explore the effect of four-color personality analysis (FPA) in teaching of neurology nursing. Methods Fifty-five student nurses of 3-year courses were assigned into the control group from June 2011 to May 2012 , and another 55 students from June 2012 to May 2013 into the experiment group. For the teaching of neurology nursing, the traditional teaching methodology was used in the control group and FPA teaching methodology in the experiment group. The two groups were compared in terms of their internship coping capacity and critical thinking ability before and after the nursing internship. The evaluation from them over teaching effectiveness was analyzed. Results The experiment group gained significantly higher scores on ability in solving problems, asking for help and rationalization than the control group did (P<0.05), and significantly lower scores on self-reproach (P<0.05) at the end of the internship. The experiment group gained significantly higher scores on critical thinking ability, confidence and knowledge learning than the controls did (P<0.05). The student nurses in the experiment group all believed that the four-color personality analysis helped them understand themselves, better their personality, make them a adapt to the clinical settings better, and enhance their ability in communication. Conclusion FPA applied in the teaching of neurology nursing can effectively improve coping capacity and critical thinking ability of student nurses, help them better their personality and be more adaptive to different clinical environment and tasks, and ultimately improve the teaching quality.
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Food allergy is a anaphylactic disease which is very common among children and its morbidity is rising in many countries.Food allergy could cause various diseases among different systems of the body,and it could also have a direct impact on patients' quality of life,even on life threatening.This article mainly focuses on the diagnosis technology of anaphylactic disease among children and the research progress of its treating methods.It will briefly introduce the risk factors and protective measures of anaphylactic disease among children,and also provide abundant theoretical foundation for clinicians to make diagnoses and give treatment correctly as well as to guide children's diet.
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Objective To explore the mediation effect of the peer attachment between the self-esteem and the school adjustment of the children affected by AIDS/HIV.Methods 250 children affected by the AIDS/HIV were investigated in the research in a district affected by AIDS/HIV in the Henan province.Self-esteem scale,peer attachment questionnaire and school adjustment questionnaire was adopted in the study.Results ①Self-esteem had a positive significant effect on the school adjustment (β=0.227,P＜0.01).(②)self-esteem had a positive significant effect on the peer attachment (β=0.236,P＜ 0.01).(③When controlled the indirect effect of peer attachment,the effect of the self-esteem on the school adjustment had still been significant (β =0.145,P＜0.05),it proved that the peer attachment played a partly mediation between the relationship of the self-esteem and the school adjustment.Conclusion Self-esteem has a positive significant effect on the school adjustment; and self-esteem can not only affect the school adjustment directly,but also affect the school adjustment through the peer attachment.
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Objective To evaluate the feasibility and safety of double-lumen balloon catheter applied in patients with achalasia of cricopharyngeal muscle. Method Fifty patients with achalasia of cricopharyngeal muscle were randomly divided into experimental group and control group. All the patients received routine drug treatment,swallowing function training,feeding training and low frequency VitalStim electric stimulation. In addition,double-lumen balloon catheter and #14 urinary catheters were applied to patients in the experimental group and control group,respectively. The swallow water tests and video fluoroscopy swallowing study(VFSS) were used to evaluate the treatment effects,the electron-nasopharyngolaryngoscope was used to assess bleeding and swelling of mucous membrane,and VRS-5 was used to assess pain. Result After treatment,the scores of swallow water tests and VFSS were significantly better than those before treatment in both groups(P<0.05). There was no significant difference between the two groups(P>0.05). However,the incidence of complications was significantly higher in the control group than that of experimental group(P<0.05). Conclusion Both treatment methods can effectively relieve the achalasia of cricopharyngeal muscle,but modified double-lumen balloon catheter can reduce the incidence of complications.
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The chiral separation of three triazole pesticides, i.e. diniconazole, triadimefon and triadimenol was studied on a Chiralcel OJ-H and a Chiralcel OD-H HPLC chiral columns. The optical rotation quality of diniconazole and triadimefon enantiomers was measured and the absolute configurations of individual enan-)tiomers) were further concluded. On this basis, the absolute configurations of the four triadimenol stereoisomers were deduced via the reductive experiment of triadimefon to triadimenol. Furthermore, the chiral stability of the three triazole pesticides in organic solvents and buffer solutions was investigated. The results showed the obvious enantiomerization was observed as for triadimefon in methanol, ethanol and water, whereas dinicona-)zole) and triadimefon were chiral stable in organic solvents and water. The enantiomerization of triadimefon would be accelerated at higher temperature and in alkaline media.