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Objective:To explore the effect of nursing team leader rotation in ICU nursing team, so as to provide reference for optimizing the allocation of nursing human resources, promoting the cooperation of nursing team and improving the quality of nursing care.Methods:The ICU nursing team leader rotation was implemented from October 2018 to June 2019, semi-structured interview method was used to understand the feeling and experience of medical staff in the department on team cooperation, workflow, nursing quality and other aspects after the implementation of the rotation, so as to evaluate the effectiveness.Results:According to the results of interviewing, by implementing the nursing team leader after rotation, most staff feel the improvement of care team, as well as the enthusiasm of learn and work. The new leader′ ability is got promoted, former leader feeled working pressure eased, some medical workers think that nursing quality was not affected, and there performance appraisal was reduced in an acceptable range.Conclusion:The implementation of the nursing team leader rotation may be able to improve teamwork, work enthusiasm,and the ability of overall leader team, alleviate the workload, future studies could evaluate its specific effect by quantitative indicators, and discusses the impact on the quality of care and patient outcomes, to further explore the feasibility and effectiveness of the system.
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Objective:By building a patient safety oriented nursing-sensitive indicator system, this study aimed to help clinical evaluation and nursing for patients in prone position, to constantly optimize management of prone position and promote patient safety.Methods:First drew up initial indicators through literature search and personal interviews, then modified and finally formed the prone position nursing indicators within two rounds of experts consultation. Verified the indicators by evaluating nursing staff satisfaction after half-year′s implementation.Results:Finally, the indicator system included 9 first level, 13 second level and 71 third level indicators. The reliability of experts and the satisfaction of nurses were both high.Conclusions:With the purpose of patient safety, the nursing indicator system of prone position ventilation for critically ill patients are comprehensively covered ever aspect of key component. Specific effect needs to be further verified in the hospital management practice.
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Objective To study the clinical characteristics,cardiac magnetic resonance (CMR)features,and genetype of hypertrophic cardiomyopathy (HCM) in neonates.Method HCM newborns diagnosed at pediatric department of Anzhen Hospital Affiliated to Capital Medical University from January 2015 to December 2018 were retrospectively collected.The clinical manifestations,imaging features and genetype were analyzed.Result During the study period,there were 11 227 deliveries and 11 397 live births.52 of the parturient women were diagnosed as HCM before or during pregnancy (0.46％,52/11 227).54 neonates were delivered from HCM mothers.Among them,5 were diagnosed as HCM (5/11 397,0.04％).In addition,there was another infant patient who was admitted from another hospital.In total,6 HCM infants were included in this study,with 4 males and 2 females.The average gestational age of the infants was (36.6 ± 1.2) weeks,with 3 preterm infants,and the others were full-term infants.The median age of diagnosis was 1 day.The clinical manifestation was that 4 patients needed rest in the course of suckling,3 of them also had accompanied symptoms,with pale face,cyanosis while crying and sweating in each case.CMR showed that the ventricular septum was (6.80 ± 1.78)mm,ejection fraction was (60.0 ± 2.8)％.All six patients showed septal thickening on CMR,including a case with right ventricular myocardial hypertrophy,another with left ventricular outflow tract obstruction and late gadolinium-enhanced.The infants were all treated with metoprolol.They were followed up until 6 months to 2 years old.Among them,4 cases had no progress in myocardial thickening.Two cases had progressive myocardial thickening,one of them was diagnosed as end-stage HCM at 2 year-old.Three MYBPC3 mutations,one MYH7 gene mutation,one MYH7 gene mutation combined with TMPO gene mutation and one RYR2 gene mutation were detected.Conclusion The neonatal HCM is characterized by thickening of ventricular septum,outflow tract obstruction and delayed enhancement of CMR.The most common HCM mutations were MYBPC3 and MYH7,the most common clinical symptoms were breast feeding interruption,followed by cyanosis,pale and sweating.It is suggested that beta-blockers should be recommended for neonates with hypoxic episodes or outflow tract obstruction.
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Objective Bushen-Qingxin decoction combined conjugated estrogen tablets of modulation perimenopausal women osteoporosis patients, explore the impact of bone mineral density and bone metabolic markers. Methods A total of 160 female patients were recruited in our hospital by the random number table method, and were divided into the control group 80 cases and the observation group 80 cases. The control group was treated with standard dose of conjugated estrogen tablets, while the observation group was treated with Bushen Qingxin decoction on the basis of the control group. Both groups were treated 3 period with 28 days per period. The enzyme-linked immunity analyzer was used to detect serum bone-specific alkaline phosphatase (BALP), C-terminal cross linked peptide (CTX-Ⅰ), tartrate resistant acid phosphatase -5b (TRACP-5b) level, and the dual-energy X-ray absorptiometry measurement method was used to detect bone mineral density values. The clinical curative effect was compared between two groups. Results The total effective rate of the observation group was 91.3%, while the control group was 78.8%, which showed the difference was statistically significant (χ 2=3.971, P=3.971). After treatment, the serum BALP levels (88.55 ± 10.33 U/L vs. 80.47 ± 8.67 U/L, t=5.399) of the observation group were significantly higher than this of the control group (P<0.01). After treatment, the serum TRACP-5b (501.31 ± 35.77 pg/L vs. 538.51 ± 37.69 pg/L, t=6.498), CTX- (130.09 ±Ⅰ17.55 ng/ml vs. 164.71 ± 19.45 ng/ml, t=11.928) of the observation group were significantly lower than those of the control group (P<0.01). After treatment, the bone mineral density of the observation group rose up from the baseline (t=3.396, P=0.010). Conclusions The Bushen-Qingxin decoction combined conjugated estrogen tablets can increase on women in the menopausal transition of osteoporosis in patients with bone mineral density values and serum BALP levels, reduce serum TRACP-5b, CTX-Ⅰ level.
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Procalcitonin (PCT) is the precursor of calcitonin related to the severity of human bacterial infection. We made a test strip by coupling anti-PCT to quantum dot, in order to develop a highly sensitive and convenient PCT testing product. The anti-PCT titer had reached 10⁷ because of the stability by coupling anti-PCT with quantum dot. The detecting linear range of the experiment was 0.15 to 120 μg/L, the sensitivity was 0.007 μg/L, the recovery range was 91% to 113%, and the intra- and inter-assay coefficient of variation was less than 8%. Comparing the homemade fluorescence-detected test strip with PCT ELISA kit on sale, we got accurate results which could mostly accomplish the test of clinical samples.
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Objective To investigate the methods and application effectiveness of micro-lecture in the clinical nursing specialty courses.Methods The micro-video was empoldered with camera tool to record,record the screen software production,PPT directly method,etc.The micro-video was applied in teaching practice of clinical nursing specialty courses.Seven class students in 2013 in Nursing of Guangxi Medical University were selected as teaching object randomly and were divided into the experimental group and the control group with 49 cases cach.The experimental group was used micro-lecture aided teaching,the control group was used traditional teaching.After the class,the teaching effect was evaluated by the examination,clinical probation appraisal and evaluation questionnaire of the experimental group students.The data were statistically analyzed by SPSS 11.5.Results The results of theory examination in the experimental group was (87.20 ± 6.50) scores and in the control group was (75.30 ± 7.89) scores,there was significant difference,t=3.20,P ＜ 0.01.The qualified result of clinical probation appraisal in the experimental group was 93.88％ (46/49),and in the control group was 81.63％(40/49),there was significant difference,x2=6.712,P＜ 0.01.The teaching satisfaction of micro-lecture in the experimental group was better.Conclusion The microlecture which based on the micro video as the main carrier used in teaching can effectively improve the effect of teaching,and is a valuable teaching method as a supplementary of the traditional teaching.
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Objective To evaluated the effectiveness and safety ofLianhua Jizhi Tablets for acute trachitis and bronchitis with syndrome of phlegm-heat obstructing.Methods A randomized double-blind, placebo-controlled and multi-center clinical trial design was selected. Totally 240 cases were randomly divided into experimental group and control group, 120 cases in each group, of which 237 cases were included in the analysis of FAS. Experimental group was givenLianhua Jizhi Tablets, while control group was given placebo, 12 tablets/day, 7 days for a course. Curative effect of acute trachitis and bronchitis, TCM syndrome and disappearance of cough, cough and sputum symptom scores and area under the curve (AUC) were observed. The safety was evaluated. Results The cure rates of disease in experimental group and control group were 66.67% (78/117) and 29.17% (35/120), respectively;cure rates of TCM syndrome in experimental group and the control group were 68.38% (80/117) and 27.50% (33/120), respectively;there was statistically significant difference in area under the curve of cough and sputum symptom score between the two groups (P<0.01). Disappearance rates (cure) of daytime cough in experimental group and control group were 52.99% (62/117) and 13.33% (16/120), respectively;disappearance rates (cure) of nocturnal cough in experimental group and control group were 76.52% (88/115) and 31.90% (37/116), respectively;there were no side effects in experimental group.ConclusionLianhua Jizhi Tablets can significantly relieve clinic symptoms in the treatment of acute trachitis and bronchitis, and have good clinical efficacy and safety.
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<p><b>BACKGROUND</b>Myocarditis is a common, potentially life-threatening disease that presents a wide rang of symptoms in children, as an important underlying etiology of other myocardial diseases such as dilated and arrhythmogenic right ventricular cardiomyopathy. The incidence of nonfatal myocarditis is probably greater than that of the one actually diagnosed, which is the result of the challenges of establishing the diagnosis in standard clinical settings. Currently, no single clinical or imaging finding confirms the diagnosis of myocarditis with absolute certainty. Historically, clinical exam, electrocardiogram (ECG), serology and echocardiography had an unsatisfactory diagnostic accuracy in myocarditis. Endomyocardial biopsy remains as a widely accepted standard, but may not be suitable for every patient, especially for those with less severe disease. Our aim was to find the changes in cardiovascular magnetic resonance (CMR) imaging of children with myocarditis diagnosed by clinical criteria.</p><p><b>METHODS</b>We studied 25 children (18 male, 7 female; aged from 5-17 years) with diagnosed myocarditis by clinical criteria. CMR included function analyses, T2-weighted imaging, T1-weighted imaging before and after i.v. gadolinium injection (early gadolinium enhancement (EGE) and late gadolinium enhancement (LGE)).</p><p><b>RESULTS</b>The T2 ratio was elevated in 21 children (84%, 11 in anterolateral (44%), 5 in inferolateral (20%), and 5 in septum (20%)), EGE was present in 9 children (36%, 3 in anterolateral (12%), 4 in inferolateral (20%), and 2 in septum (8%)), and LGE was present in 5 children (20%, 2 in anterolateral (8%), 1 in inferolateral (4%), 1 in septum (4%), and 1 in midwall of left ventricular (LV) wall). In 9 children (36%), two (or more) out of three sequences (T2, EGE, LGE) were abnormal.</p><p><b>CONCLUSIONS</b>The CMR findings in children with clinically diagnosed myocarditis vary within the groups, including regional or global myocardial signal increase in T2-weighted images, EGE and LGE in T1-weighted images. The T2 ratio elevation is the most common CMR finding. Children with mild cardiac symptoms may also appear serious myocardial injuries.</p>
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Adolescent , Child , Child, Preschool , Female , Humans , Male , Magnetic Resonance Imaging , Methods , Myocarditis , Pathology , Myocardium , PathologyABSTRACT
Objective To study the early(onset time in 1 h~7 d)rehabilitative training on the limb function of patients with acute cerebral infarction.Methods 30 patients with acute cerebral infarction(1h-7d)were intervened with early rehabilitative training on limbs for 12 weeks.Ashworth limb spasticity scale and Fugl-Meye motor function scale were used to assess the rehabilitative effect before the training as well as after the training.Results The score by Fugl-Meye motor function scale after rehabilitative training was significantly higher than before training(P<0.05),and the score by Ashworth limb spasticity scale significantly lower than before training(P<0.05).The total effective rate of rehabilitative training was 93.3%.Conclusion Early rehabilitation training in patients with acute cerebral infarction is effective for the general recovery of their limb functions.
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BACKGROUND:Human skin-derived precursors can be cultured for a long term in vitro, and differentiated into neurons, glial cel s, smooth muscle cel s, Schwann cel s and cel s with peripheral neurons phenotype. OBJECTIVE:To investigate the culture conditions and multiple differentiation capacity of multipotential stem cel s from human skin, especial y the potentials of differentiating into neurons and osteoblasts. METHODS:Human skin-derived precursor cel s were cultured with trypsin digestion method, and identified with immunocytochemistry. Cel s at passages 3-4 were induced to differentiate into neurons and osteoblasts, and underwent von Kossa staining protocol for calcium, chondrocyte induction, toluidine blue staining, immunohistochemical staining and Sudan black staining. The expression of nestin, vimentin,βIII-tubulin, S100 and col agen II in the human skin-derived precursors was detected. RESULTS AND CONCLUSION:The human skin-derived precursor cel s cultured with trypsin digestion method could proliferate and form suspending spheres, and nestin positive cel s were detected at any time point of the culture. Al the cultured cel s expressed vimentin, and some adherent cel s expressedβIII-tubulin. Human skin-derived precursor cel s were induced with Salvia miltiorrhiza to differentiate into neuron-like cel s, and expressed marker of nerve cel s. Skin-derived precursors could be induced to differentiate into osteoblasts and von Kossa staining displayed black calcified nodules in the culture dish. Skin-derived precursors could also be induced to differentiate into chondrocytes, and toluidine blue staining was strongly positive, and some cel s expressed col agen II, which suggested that, the differentiated cel s contained chondrocytes. Experimental findings indicate that, skin contains multipotential stem cel s that are capable of differentiating into osteoblasts, chondrocytes, Schwann cel s and oligodendrocytes.
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BACKGROUND:There are myoblasts in human embryonic skeletal muscle. It remains poorly understand whether myoblasts in vitro can form myotube and what are the corresponding markers for identifying myoblasts and myotubes. OBJECTIVE:To investigate whether in vitro cultured myoblasts from human embryonic skeletal muscle can form myotube and whether they can express neural markers. METHODS:Human embryonic muscle-derived myoblasts were cultured in serum-containing medium. When the primary culture was established, cultured cel s were identified with immunocytochemistry for neural markers, such asβ-tubulin markers (desmin, myogenin, smooth muscle actin and myosin). RESULTS AND CONCLUSION:A population of myoblasts could migrate from human embryonic muscle tissues. They could express the markers for skeletal muscle such as desmin and myogenin, and they could express neuron specific enolase, nestin and neurofilament 200. They could form myotubes in vitro, and myotubes expressedβⅢ-tubulin, neurofilament 200 and glial fibril ary acidic protein. The data support the hypothesis that myoblasts from human embryonic muscle express neural markers and muscle markers, and cultured myoblasts and myotubes expressed neuron specific enolase,β-tubulin Ⅲ, nestin, neurofilament 200 and glial fibrillary acidic protein. This indicates that these markers could not be used for cel identification of trans-differentiation study from muscle origin to nervous system.
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Objective To estimate the clinical value of thinprep cytologic test (TCT) in screening cervical lesion. Methods 4234 TCT samples were interpreted according to the Besthesda System (TBS), 272positive cases (ASC-US or above) were taken colposcopic examination and biopsy. Results The coincidence of the results between TCT and biopsy in low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), squamous cell carcinoma (SCC), adenocarcinoma (AC) were 85.71%(12/14), 100 % (20/20), 75 % (3/4) and 100 % (2/2), respectively. The positive rates of over ASC-H by TCT and of over CIN Ⅰ by biopsy were 23.16 % (63/272) and 24.26 % (66/272), respectively. There is no difference between two positive rates (x2 = 0.868, P = 0.581). Conclusion TCT and histopathological diagnosis had a high coincidence, a combination of both can greatly enhance HSIL and cervical cancer and reduce the incidence of missed diagnosis. TCT would be a rapid and convenient method for screening cervical cancer.
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Objective To explore the true psychological experience of youthful patients with breast cancer in the period of diagnosis. Methods Using qualitative research based on employed phenomeno-logical methods,12 young patients of breast cancer were deep-interviewed, the literal data of interview were processed and analyzed by Colaizzid analysis method. Results 5 themes were found by analysis:change of self identification, serious uncertainty, change of self role, worry about working and social value and shortage of knowledge and ability for early diagnosis. Conclusions The clinical workers should under-stand the real psychological experience of young patients with breast cancer in diagnosis period and help them overcome the difficult period in their life.
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Objective To explore the levels and clinical significance of anti-beta 2-glycoprotein 1 antibodies (β_2GP1), matrix metalloproteinase 9 (M M P-9) in the plasma of children with Kawasaki diseases (KD). Methods Serum level of anti-β_2GP1 antibody and MMP-9 was measured in 47 children with KD by ELISA, and the data was analyzed using SPSS11.5 software. Thirty age matched children with infectious diseases(sepsis or pneumonia), exclusive of heart, liver, kidney, blood diseases and autoimmune diseases such as rheumatoid were chosen in the fever control group. Results Coronary artery lesions (CAL)were found in 17 children of KD group (17/47) by Doppler ultrasound examination. Significant differences (P < 0.05) of serum level of anti-β_2GP1 antibody was showed between KD group ((7.46 ± 2.13) U/ml)and the control group ((4.38 ± 0.43) U/ml) ; serum level of MMP-9 was (886.62 ± 92.72) ng/ml and (460.06 ± 179.59) ng/ml in KD group and the control group respectively, with significant difference between the two groups(P < 0.05). In KD group, levels of anti-β_2GP1 were (8.83 ± 0.89) U/ml among children with CAL and (6.18 ± 1.42) U/ml among children without CAL, serum level of MMP-9 was (948.62 ± 81.76) ng/ml and (872.00 ± 34.74) ug/ml respectively, with significant differences(beth P < 0.05). In children with KD, the serum levels of anti-β2GP1 antibody and MMP-9 were significantly correlated (correlation coefficient r = 0.665). Conclusions Serum levels of anti-β_2GP1 antibodies and MMP-9 increased in the acute phase of KD, and were significantly higher in those KD children with CAL.Anti-β_2GP1 antibodies and MMP-9 may play a role in the pathogenesis of KD, and can be used as an important serological indicator of KD with CAL.
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Objective To discuss the influence of Breviscapine Injection on concentration of serum IGF-Ⅱ in pregnant rats and changes of fetus rat body weight, body length, and body-mass index. Methods Radio-immunity was used to determine the concentration of serum IGF- Ⅱ in mother rats and fetus rats. Body weight and body length were surveyed,the IGF- Ⅱ concentration of fetus rats in the FGR group was lower than the control group (P＜0.05) and IGF- Ⅱ concentration control group＞the FGR+intervention group＞ the FGR group, and the difference between each group was significant (P＜0.05).Breviscapine can treat fetal growth retardation effectively.
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In broad definition,diseases caused by exogenous pathogenic factors involve with respiratory system,digestive system,urinary system,and nervous system;While concerned with internal medicine of respiration,they are common cold,upper respiratory tract infection,acute tracheitis and bronchitis.Clinically,we call diseases that caused by external pathogens,showing symptoms of respiratory system in general,as FeiXi Waigan Bing(lung system diseases caused by external pathogens).In curing these diseases,we integrated traditional Chinese and western medicine and got satisfactory clinical effect.This demonstrated the advantages and features of Traditional Chinese medicine in curing lung system diseases caused by external pathogens.
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@#Objective To evaluate the clinical effect of medical gymnastics combined with no-invasive treatment on prolapse of lumbar intervertebral disc (PLID).Methods64 patients with PLID were divided into the gymnastics group and control group with 32 cases in each group. The gymnastics group was treated by no-invasive synthesize treatment combined with medical gymnastics. The control group treated only with no-invasive synthesize treatment. The therapeutic effect was evaluated when patients were out of hospital and 3 months late.ResultsClinical effect of forward term (3 months) in the gymnastics group was batter than the control group ( P<0.05).ConclusionThe no-invasive synthesize treatment combined with medical gymnastics has an obvious effect on PLID.
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Objective To develop a nonaqueous electrolyte electrochemical detector in order to solve the problems of shorter average life span and operating temperature range in aqueous electrolyte electrochemical detector for unsymmetrical dimethyl hydrazine(UDMH).Methods Nonaqueous electrolyte was utilized in this kind of electrochemical detector comprised of n-mehyl-2-pyrrolidone with conductive compatible salts,such as tetrabutyl ammonium tetrafluoroborate,which had much lower evaporating pressure and freezing point than aqueous electrolyte ones.Three-electrode potential electrochemical system was also used,composing a sensing electrode,a counter electrode and a reference electrode.The three electrodes were all teflon-bonded diffusion electrodes which were prepared by spraying the noble metal catalyst dispersion onto the Teflon film.Results The experiment result showed that the average life span could be over two years compared with the aqueous electrolyte electrochemical detector of one year life span.Operating temperature range was expanded to-20 ℃～+40 ℃.However,the response time was nearly five minutes.Conclusion The detector can be used for leakage checking in the places where a large quantities of UDMH are used or stored.
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Objective: To investigate the optimal culture conditio ns for adipose tissue-derived stromal cells(ADSCs) and for the induction of these cells to differentiate into osteogenic cells. Methods: ADSCs were cultured with routine methods,bFGF at 20 ng/ml was added into the medium and the proliferative of ADSCs was examined by cell counting. 0.1 ?mol /L of dexamethasone,10 mmol/L of ?-glycerophosphate and 50 ?mol/L of ascorbic acid were adapted to induce the cells to differentiate into osteogenic cells, ADSCs were identified by immunocytochemistry and differentiated osteogenic cells were identified by alkaline phosphatase(AP) staining and immunocytochemistry. Result: A population of ADSCs could be isolated from adul t human adipose tissue,the cells were fibroblast-like and could be maintaine d in vitro for extended periods with stable population doubling.The cells w ere expanded as undifferentiated in culture for more than 10 passages, indicati ng their proliferative capacity.bFGF stimulated the cell proliferation.Dexameth asone,?-glycerophosphate and ascorbic acid induced (40?8.6)% of ADSCs to ex press alkaline phosphatase(AP) ,(35?10.6)% of AP positive ADSCs were found to be collagen I positive. Calcification plaques were occasionally found in the cul tures. Conclusion:The data support the hypothesis that adu lt human adipose tissue contains stem cells capable of diffferentiating into ost eogenic cells.
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Objective To explore the relationship between expression of p27 and cyclin D1 protein in keratinocyte－ derived tumors. Methods Expression of p27 and cyclin D1 protein was determined in various keratinocyte－ derived tumors by immunohistochemistry techniques. Results Significantly higher expression of p27 was found in both Bowen′ s disease and actinic keratosis(AK) than that in basal cell carcinoma(BCC) and squamous cell carcinoma(SCC)（ P