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Objective@#To explore the application effect of standardized video combined with feedback method in health education for patients with urinary calculi after double J tube indwelling operation, and to provide basis for improving the effect of clinical health education.@*Methods@#One hundred and fourteen patients were selected from October 2018 to March 2019 for the first time after the operation of urinary calculi with double J-tube indwelling after holmium laser lithotripsy. Fifty-six patients were selected as the control group and 58 cases as the experimental group by random number table method. The control group was given routine nursing and oral health education, while the experimental group was given standardized video combined with feedback education on the basis of routine nursing. The level of knowledge, belief and behavior, the incidence of complications and satisfaction with nursing health guidance were compared between the two groups after intervention.@*Results@#The scores of knowledge, belief and action in the experimental group were (7.14 ± 1.39), (30.17 ± 2.62) and (67.50 ± 3.40) respectively, which were higher than those in the control group (5.39 ± 1.29), (28.54 ± 2.29) and (62.23 ± 4.39). The difference was statistically significant (t=5.83, 3.55, 7.18, P<0.01). The incidence of complications was 34.48% (20/58) in the experimental group, which was significantly lower than 62.50% (35/56) in the control group (χ2=8.957, P<0.01). The average rank of satisfaction with nursing health guidance in the experimental group was 66.03, which was significantly higher than that in the control group. The difference was statistically significant (Z=-3.157, P=0.02).@*Conclusions@#Standardized video education combined with feedback method can improve patients′ awareness of vascular behavior after double J tube indwelling for urinary calculi, reduce complications related to double J tube indwelling, and improve patients′ satisfaction with nursing education.
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Objective@#To explore the relationship between genotype and phenotype of ABCB11 deficiency.@*Methods@#Clinical data of two siblings with ABCB11 deficiency were retrospectively analyzed. Related literature from PubMed, CNKI and Wangfang databases was reviewed to date (up to August 2017) with 'ABCB11 gene’ or 'bile salt export pump’, 'cholestasis’ and 'child’ as key words.@*Results@#The patients were siblings. Both of them presented as jaundice, pruritus and hepatosplenomegaly since 3 days after birth. Significant laboratory findings on admission of the older sister included high total bilirubin, 170 µmol/L;conjugated bilirubin, 115.8 µmol/L;alanine aminotransferase, 168 U/L;total bile acid 186.3 µmol/L and normal gamma-glutamyl transpeptidase. While routine laboratory data of the younger brother were as follows: total bilirubin, 148.8 µmol/L;conjugated bilirubin, 96.3 µmol/L;alanine aminotransferase, 232.8 U/L;total bile acid 226 µmol/L, and normal gamma-glutamyl transpeptidase.Both received ursodeoxycholic acid and fat-soluble vitamins. Liver pathology of the younger brother showed giant hepatocytes with ballooning degeneration, focal necrosis and intrahepatic cholestasis. Both the patients harbor the same compound heterozygous mutations in ABCB11 gene, c.145C>T (p.Q49X) and c.1510G>A (p.E504K). The sister is 9 years old now, with normal liver function. Jaundice faded around 3 months after birth, pruritus relieved at age 5, and medications was stopped since then. The brother progressed to liver failure after an operation on perianal abscess when he was 8-month-old, and received living-related liver transplantation when he was 9 month and 20 days old (from his mother). Now he is 1 year and 5 months old, with normal liver function. Both are under our follow-up. Literature review revealed 18 ABCB11 deficiency patients from 7 families who had apparent different prognoses, within each family the siblings had the same ABCB11 gene mutation. Seven cases relieved after ursodeoxycholic acid therapy and/or partial external biliary diversion, 5 received orthotopic liver transplantation, 2 developed hepatocellular carcinoma and 4 cases died in childhood.@*Conclusions@#The clinical manifestations of ABCB11 deficiency may vary greatly in patients carrying the same genotype, even in siblings. Patients should be managed in individualized maner.
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Objective To explore the effectiveness of mindfulness-based four-step approach to obsessive compulsive disorder. Methods A total of 82 patients with obsessive compulsive disorder were divided into control group and study group with 41 cases each by admission order. The patients in control group were given routine drug treatment and nursing, and the patients in study group were given mindfulness-based four-step approach based on control group. The indexes were evaluated by Yale-Brown Obsessive Compulsive Scale, Hamilton Depressive Scale, Hamilton Anxiety Scale, Short Form 36 questionnaire before and after intervention. Results After 12 weeks treatment, the score of Yale-Brown Obsessive Compulsive Scale, compulsive thinking, compulsive behavior were (6.16 ±4.38), (3.23 ±1.93), (2.98 ± 2.01) points in study group and (10.81 ± 3.26), (6.05 ± 2.02), (4.09 ± 2.15) points in control group, and there were significant differences(t=5.386, 6.384, 2.385, all P < 0.05). The score of anxiety and depress were (1.98 ± 1.91), (2.16 ± 1.38) points in study group, and (4.05 ± 2.01), (5.11 ± 2.26) points in control group, and there were significant differences(t=4.722, 7.045, all P<0.05). The score of total life quality, physiological function, physiological function, body pain, general health, vitality, social function, emotional function, mental health were (77.32 ± 6.26), (89.11 ± 14.27), (78.19 ± 26.36), (82.33 ± 25.22), (60.18 ± 20.39), (55.31 ± 19.68), (80.13 ± 25.76), (72.13 ± 20.16), (60.12 ± 20.88) points respectively in study group, and (71.43 ± 5.62), (82.19 ± 13.36), (55.11 ± 23.27), (70.18 ± 25.71), (49.01 ± 20.13), (45.22 ± 18.11), (62.19±25.63), (45.23±23.02), (44.16±21.08) points in control group, and there were significant differences (t=2.134-6.621, all P<0.05). Conclusions The mindfulness-based four-step approach intervention can obviously relieve anxiety and depressive negativity mood in obsessive compulsive disorder patients. It can improve patient′s obsessive compulsive symptom, enhance the patient′s quality of life. It has important significance for obsessive compulsive disorder patients during their recovering period.
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Objective To investigate the scintigraphic features of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) and to explore the clinical significance of 99Tcm-EHIDA hepatobiliary scintigraphy.Methods Hepatobiliary scintigraphy with 99Tcm-EHIDA was performed in 28 genetic confirmed NICCD cases (16 males,12 females,1-8 months).Normal dynamics (i.e.,time-activity curve) of the tracer in heart,liver and kidneys was defined as normal hepatic uptake function.Decreased liver uptake of the tracer and/or prolonged heart and kidneys radioactivity retention was defined as impaired hepatic uptake function.Normal or delayed biliary excretion was defined as radioactivity appearing in the bowel within 60 min or after 60 min.Occluded biliary excretion was defined as absent bowel radioactivity within 24 h.The characteristics of hepatobiliary scintigraphy and their relationship with levels of serum total bilirubin (TB),direct bilirubin(DB),ALT,total bile acid (TBA) were retrospectively analyzed.Statistical analysis was performed using Kruskal-Wallis rank sum test.Results Of 28 NICCD patients,20 showed normal uptake while 8 had impaired hepatic uptake.Ten of twenty patients with normal uptake function showed normal biliary excretion and the others showed delayed biliary excretion.Four of eight cases who presented impaired hepatic uptake function were with delayed biliary and the rest displayed biliary excretion occlusion.Compared with the patients with normal hepatic uptake function,patients with impaired hepatic uptake had significantly higher levels of TB and DB (TB:183.6(128.7-280.9) mmol/L vs 105.5(80.0-141.7) mmol/L,Z=-2.25;DB:135.6 (95.7-212.6) mmol/L vs 73.1(53.9-97.9) mmol/L,Z=-2.73; both P＜0.05).Compared with the cases with normal biliary excretion function,patients with delayed biliary excretion had significantly higher levels of TB,DB and TBA (TB:137.5 (122.0-170.9) mmol/L vs 81.7(65.7-93.5) mmol/L,Z=-3.92;DB:96.5 (81.1-108.0) mrrol/L vs 54.1(45.3-72.6) mmol/L,Z=-3.74; TBA:245.6(183.9-299.2) mmol/L vs 136.0(73.5-163.2) mmol/L,Z=-2.57; all P＜0.05).The levels of TB (262.0(152.1-542.8) mmol/L) and DB (192.7(118.1-407.2) mmol/L; both Z=-2.82; both P＜0.05) were the highest in patients with occluded biliary excretion.Compared with the patients with delayed excretion,the occluded excretion subgroup had significantly higher levels of ALT (71.5 (48.5-144.8) U/L vs 20.0(16.5-27.7) U/L,Z=-2.66,P＜0.05).Conclusion 99Tcm-EHIDA hepatobiliary scintigraphy may evaluate hepatic uptake and excretion function of the NICCD infants.When the hepatic uptake is remarkably decreased,the occluded biliary excretion can be shown.
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BACKGROUND: Therapeutic effect on pterygium mainly focuses on studying surgical technique, assistant therapy methods,and recurrence rate following excision of pterygium; however, whether race factor is associated with occurrence, development, and recurrence of pterygium remains still unknown.OBJECTIVE: To compare the therapeutic outcomes in different race patients with pterygium treated using corneal limbal stem cell autograft combining with excision of pterygium.DESIGN, TIME AND SETTING: Retrospective case analysis, performed in the Department of Ophthalmology, Zhongshan Hospital Affiliated to Xiamen University between January 2000 and June 2006. PARTICIPANTS: 1 44 (152 eyes) primary cases were collected from Xiamen and 54 (54 eyes) relapsed Negroes were from Africa. There were no significant differences in age, sex, and pterygium length between the two groups (P 0.05).METHODS: 198 subjects were treated by excision of pterygium under a microscope, in which pterygium tissue was not found on the surface of cornea. A free transplantation of the superotemporal limbus with an adjacent piece of thin conjunctiva was placed in the excision area. All cases were followed-up to grade the appearances of the sites 6 weeks, 6 and 12 months after excision (grade 1 implied normal appearance, and grade 4 implied the relapse). MAIN OUTCOME MEASURES: Relapse, pterygium grading, and complication after corneal limbal stem cell autograft combining with excision of pterygium. RESULTS: No relapse was found at 6 weeks after operation. The recurrence rate of Chinese Han people and Africa black people were 6.6% and 14.8% respectively at 6 months, and 11.8% and 24.5% at 12 months. There was significant difference in the recurrence rate between the two races (t=4.607, P= 0.032). In addition, there were significant differences in the pterygium grading between the two groups at 6 weeks (x2=15.608, P < 0.01 ), and Chinese people recovered better. Contrarily, there was no statistical difference at 6 months and 12 months (x2=4.401, 6.206; P 0.05). Few complications were found except superficial scar of cornea and persistent irritation of ocular surface. CONCLUSION: Limbal stem cell autograft combining with excision of pterygium under a microscope can completely remove pterygium with minimal invasion, light postoperative response and low rate of recurrence. The relapse of black cases is higher than Chinese patients.
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Objective To study the relationship between the six-minute walking test (6-MWT) and pulmonary function in the diagnosis course of chronic bronchitis converting into chronic obstructive pulmonary disease (COPD). Methods Pulmonary function was detected in 360 patients with chronic bronchitis.Based on the results and diagnosis standard of COPD by Chinese Medical Association in 2002, the patients were divided into COPD group and pulmonary function normal group.Tbe walking distance in 6-MWT (6-MWD) was measured, and the mean value of twice tests was calculated to study the correlation between 6-MWT and pulmonary function, and 50 healthy volunteers were selected as control group. Results Most 6-MWD in COPD group were less than 420 meters(95.95%, 142/148 ), but those in pulmonary function normal group were more than or equalled to 420 meters mostly (97.17%, 206/212 ). However in patients with the 6-MWD more than or equalled to 420 meters , pulmonary function indexes such as the ratio of forced expiratory volume in one second and forced vital capacity( FVC ), FEV_1%, maximal ventilatory volume(MVV)were all significantly greater than those in patients with 6-MWD less than 420 meters, and there were significant differences (P<0.05). Compared with chronic bronchitis, the results of 6-MWD in control group was more than or equalled to 420 meters, but there was no significant difference (P>0.05 ). Conclusions 6-MWT is simple and feasible. However, it is a better indicator of the patients pulmonary function. The test would be an effective selecting examination for chronic bronchitis patients who are not willing to do puhnonary function test.
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Objective To study the effect of lumbrokinase treatment on hemorheology, glucose and lipids of type 2 diabetes mellitus (T2DM). Methods 76 cases with T2DM whose blood glucose was controlled at FPG0.05). Conclusions Lumbrokinase can decrease the levels of the blood rheology and triglyceride in T2DM. It may prevent and cure the complication of diabetes mellitus
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AIM: To study the inhibition of the Bax inhibitor-1(bi-1) gene expression induced with RNA interference in HO8910PM and HO8910 cell lines in addition to the apoptotic induction.METHODS: After transfection of recombinant plasmid which expresses bi-1shRNA into HO8910PM and HO8910 cells,bi-1 mRNA and protein levels were detected by reverse transcription-polymerase chain reaction(RT-PCR) and Western blotting.Apoptotic HO8910PM and HO8910 cells were detected by Hoechst 33258/PI fluorescent staining and flow cytometry.RESULTS: Compared with the control group,the expressions of bi-1 gene at mRNA and protein levels were declined evidently in the cells transfected with four candidate siRNA plasmids(P