Short-term clinical effect of arthroscopic all-suture anchor nail in the treatment of rotator cuff injury / 中国运动医学杂志

Objective To evaluate the short-term clinical effect of arthroscopic repair of rotator cuff injury with all-suture anchor using a prospective and single-cohort clinical trial.Methods Twenty-five patients with rotator cuff injuries(1.5 cm<tear size<6 cm)and admitted to the Department of Sports Medicine and Ambulatory Surgery Centre of Jiangsu Provincial Subei People's Hospital between July and September 2022 were used as the study subjects.Two cases were excluded for not meeting the in-clusion criteria,while another one was withdrawn halfway due to inconvenience of follow-up.Finally,22 patients were included in the study,consisting of 8 males and 14 females,with the average age of 59.1±10.9 years and rotator cuff tear size of 3.2±1.2 cm of 10 left and 12 right shoulders.Be-fore as well as 3 and 6 months after operation,all patients were evaluated using the pain visual ana-logue scale(VAS),the American Shoulder and Elbow Surgeons(ASES)score,Constant-Murley Shoul-der Functional(Constant)Score,Simple Shoulder Test(SST),bilateral shoulder abduction muscle strength ratio(affected/healthy),and mobility of the affected shoulder joint.Six months after operation,the healing of rotator cuff and the formation of cyst around the all-suture anchor were evaluated by us-ing the magnetic resonance imaging(MRI).According to whether there was cysts around the all-suture anchor,the patients were divided into the cyst group and the cyst-free group.Their age,sex,the side affected,trauma history,course time,tear size and operation time of the two groups were com-pared and analyzed to find the correlated factors.The average VAS,ASES and Constant scores,and the range of motion of the affected shoulder joint and the healing grade of rotator cuff were compared between the two groups 6 months after operation.Results Twenty-two patients were granted 6.2±0.3 months of follow-up after surgery.Three and six months after the operation,their average VAS scores(1.3±1.2 and 0.7±0.4),ASES scores(79.7±12.3 and 88.9±6.5),Constant scores(65.4±12.4 and 73.7±9.6),SST scores(7.6±0.2 and 10.5±0.2)and bilateral shoulder abductor muscle strength ratio(affected side/healthy side)(71.3±9.6 and 90.3±5.9)were significantly higher than the values before the opration(4.2±1.1,51.5±11.2,46.2±12.8,3.5±0.3 and 21.9±15.8),respec-tively(P<0.05).There were also significant differences in the range of motion of shoulder joint 3 months and 6 months after surgery(P<0.05).Postoperative MRI revealed 1 patient with rotator cuff re-tear.There was significant difference in age between the cyst group and the cyst free group(P<0.05).However,there was no significant difference in VAS score,ASES score,Constant score,range of mo-tion of shoulder joint and healing grade of rotator cuff between the two groups 6 months after surgery(P>0.05).Conclusion Arthroscopic rotator cuff repair with all-suture anchor is feasible and safe,and has good short-term clinical effect.

Predictive value of the expression levels of YY1 and miR-181a-5p in peripheral blood mononuclear cell for the adverse pregnancy outcomes in gestational diabetes mellitus / 国际检验医学杂志

Objective To investigate the predictive value of the expression levels of YY1 transcription fac-tor(YY1)and microRNA(miR)-181a-5p in peripheral blood mononuclear cell for adverse pregnancy out-comes in gestational diabetes mellitus(GDM).Methods A total of 200 patients with GDM were enrolled as the GDM group.100 healthy pregnant women who underwent prenatal examinations during the same period were selected as the control group.The expressions levels of YY1 and miR-181a-5p in peripheral blood mono-nuclear cell were detected by fluorescent quantitative PCR.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of YY1 and miR-181a-5p for adverse pregnancy outcomes in GDM pa-tients.Results Compared with the control group,the expression levels of YY1 and miR-181a-5p in peripheral blood mononuclear cell of GDM group were obviously decreased(P＜0.05),and the incidence rates of post-partum hemorrhage,macrosomia and neonatal hypoglycemia in GDM group were obviously higher(P＜0.05).Multivariate Logistic regression analysis showed that age and poor blood glucose control were inde-pendent risk factors for adverse pregnancy outcomes in GDM patients(P＜0.05),and the expression levels of peripheral blood mononuclear cell YY1 and miR-181a-5p were independent protective factors for adverse preg-nancy outcomes in GDM patients(P＜0.05).ROC curve results showed that the area under the curve(AUC)of the expression levels of YY1 and miR-181a-5p in peripheral blood alone and in combination in predicting ad-verse pregnancy outcomes in GDM patients was 0.717,0.751 and 0.832,respectively,and the AUC of their combination was obviously higher than that of the two alone(P＜0.05).Conclusion The decreased expres-sion levels of YY1 and miR-181a-5p in peripheral blood mononuclear cell of GDM patients could increase the risk of adverse pregnancy outcomes,YY1 and miR-181a-5p are closely related to adverse pregnancy outcomes in GDM patients,and both could be used as predictors of adverse pregnancy outcomes in GDM patients.

A multicenter survey on nurses'knowledge and practice of children's sleep management in pediatric ICU / 中华护理杂志

Objective To investigate the current status of nurses'knowledge,attitude and practice regarding sleep management of critically ill children in pediatric ICU,and to analyze its impact factors.Methods A self-designed questionnaire on general information and a questionnaire on knowledge and practical behaviors of pediatric ICU nurses on child's sleep management were used.In March 2023,902 pediatric ICU nurses from 24 hospitals in China were surveyed using a convenient sampling method,and the impact factors were analyzed using multiple stepwise linear regression.Results 893 valid questionnaires were collected and the recovery rate of valid questionnaires was 99.00％.Nurses in pediatric ICU scored(33.71±7.76)in knowledge dimension,(37.38±4.86)in attitude dimension and(80.60±16.78)in practice dimension,with a total score of(151.78±24.27).The scores of knowledge and attitude,knowledge and practice,attitude and practice are all positively correlated(r=0.393,P＜0.001;r=0.495,P＜0.001;r=0.320,P＜0.001).The results of multiple stepwise linear regression analysis showed that gender,region,whether they had received sleep management training were the influencing factors of pediatric ICU nurses'total score of knowledge,attitude and practice towards children's sleep management(P＜0.05).Conclusion Nurses in pediatric ICU are positive about sleep management for critically ill children,but their knowledge and practice levels need to improve.Nursing managers should strengthen the theoretical knowledge and practical behavioral training of pediatric ICU nurses on child sleep management,develop scientific sleep management plans,and guide nurses to make reasonable evaluation and interventions to improve children's sleep quality.

Evidence summary of non-pharmacological sleep management measures in critically ill children / 中华护理杂志

Objective To retrieve,appraise and integrate the relevant evidence of non-pharmacological sleep management measures in critically ill children.Methods We conducted a systematical search on the topic of non-pharmacological sleep management measures in critically ill children across multiple databases,including BMJ best practice,UpToDate,International Guidelines International Network,National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,Registered Nurses'Association of Ontario,Joanna Briggs Institute Library,the American Academy of Sleep Medicine,International Pediatric Sleep Association,CNKI,WanFang database,VIP database,SinoMed,Cochrane Library,PubMed,Web of Science,and CINAHL.The literature retrieval time limit was from the establishment of the database to February 2023.The study design includes clinical practice guideline,evidence summary,clinical decision-making,expert consensus,and systematic review.The evidence was extracted and summarized according to the subject after the independent literature quality evaluation by 2 researchers.Results 10 relevant pieces of literature were identified,including 2 guidelines,1 consensus statement,4 systematic reviews,2 evidence summaries,and 1 top clinical decision.These sources provided a total of 28 pieces of evidence across 5 key themes,including sleep assessment,management principles and education,environmental management and sleep promotion.Conclusion This study summarizes the best available evidence on non-pharmacological sleep management measures in critically ill children.It is recommended that healthcare professionals should consider the clinical context when implementing evidence-based interventions,aiming to reduce nocturnal awakenings,extend sleep duration,and improve sleep quality in critically ill children.

Reservation versus sacrifice of remnants in the footprint area in arthroscopic repair of rotator cuff tear / 中华创伤骨科杂志

Objective:To compare the clinical efficacy between reservation and sacrifice of remnants in the footprint area in arthroscopic repair of rotator cuff tear.Methods:A retrospective study was conducted to analyze the clinical data of 32 patients with rotator cuff tear plus remnants in the footprint area (2 cm < tear size <5 cm) who had been admitted to Department of Sports Medicine, The People's Hospital of Northern Jiangsu from May 2020 to July 2021. The patients were divided into 2 groups according to reservation or sacrifice of remnants in the footprint area in arthroscopic repair of rotator cuff tear. In the remnant-reservation group (16 cases): 5 males and 11 females with an age of (61.8±9.9) years, 9 left and 7 right shoulders affected, and (3.7±1.1) cm in size of rotator cuff tear; in the remnant-sacrifice group (16 cases): 4 males and 12 females with an age of (61.3±8.8) years, 8 left and 8 right shoulders affected, and (3.9±0.9) cm in size of rotator cuff tear. The 2 groups were compared in terms of visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley shoulder function score (Constant score), and range of motion of the affected shoulder before surgery, 3 months after surgery and at the last follow-up. The ratio of bilateral abductor muscle strengths (affected side/healthy side) was analyzed and compared between the 2 groups, and the healing of the rotator cuff was evaluated by MRI at the last follow-up.Results:The 2 groups were comparable because there were no significant differences in all their preoperative demographic data ( P>0.05). The 32 patients were followed up for (14.3±3.5) months after surgery. At 3 months after surgery, the VAS score in the remnant-reservation group [1.0 (0.0,1.0) point] was significantly lower than that in the remnant-sacrifice group [1.0 (1.0,1.0) point] ( P<0.05), but there was no significant difference between the 2 groups in ASES score, Constant score or range of motion of the affected shoulder ( P>0.05). At the last follow-up, the ASES score, forward flexion, abduction and ratio of bilateral abductor muscle strengths (affected side/healthy side) in the remnant-reservation group [(96.1±4.8) points, 170.0 (170.0,170.0)°, 160.0 (160.0,170.0)°, and 85.5%±13.8%]were significantly better than those in the remnant-sacrifice group [(91.4±5.9) points, 160.0 (160.0,170.0)°, 150.0 (140.0,155.0)°, and 72.6%±16.9%] ( P < 0.05), but there were no statistically significant differences between the 2 groups in VAS score, Constant score, neutral external rotation angle, or body-side internal rotation ( P>0.05). The Sugaya grading for MRI rotator cuff healing was significantly different between the 2 groups at the last follow-up ( P<0.05). Conclusion:In arthroscopic repair of rotator cuff tear, reservation of remnants in the footprint area can significantly relieve postoperative shoulder pain, and has obvious advantages in restoration of shoulder forward flexion, abduction and abductor muscle strength, leading to better healing of the rotator cuff and the large nodule than the remnant-sacrifice technique.

Experience on prevention and control management in PICU during the epidemic of novel coronavirus Omicron variant in Shanghai / 中国小儿急救医学

Objective:To summarize the experience of the precise prevention and control strategy of novel coronavirus infection in the pediatric intensive care unit(PICU)during the epidemic of the Omicron variant.Methods:A retrospective analysis was performed on the strategies and management experience of precise prevention and control of novel coronavirus infection in PICU at Pediatric Hospital of Fudan University from March 1 to May 10, 2022.Results:According to the national and Shanghai novel coronavirus infection prevention and control standards, the PICU in our hospital, in accordance with the specialty characteristics of PICU, cooperated with the hospital′s department of infection and medical department to jointly construct a precise ward management strategy for the outbreak of the omicron mutants infection.Precise prevention and control management strategies were formulated from four aspects: the admission process of critically ill children, the division of PICU ward areas and nosocomial infection protection, the reception management system for children′s family members, and the " bubble management" system for PICU staff, and run them for 3 months.During the epidemic, there was no nosocomial infection of novel coronavirus infection in children or medical staff.During the period, a total of 140 critically ill children were admitted, including 87 cases transferred from the general ward in the hospital, 48 cases from the emergency department(non-febrile, 3 cases transferred by the transfer team), four cases from fever clinic, and one case from control ward.Four of the critically ill children had no emergency nucleic acid test report when they were admitted to the PICU.Among the 140 critically ill children, 54 patients received mechanical ventilation, 18 patients received blood purification, and two patients were monitored after liver transplantation.Seventy-eight (55.7%) children had underlying diseases.Conclusion:During the current round of novel coronavirus epidemic in Shanghai, PICU in our hospital formulated the admission and ward management procedures for critically ill children, which ensured the prevention and control of nosocomial infection of novel coronavirus, and at the same time ensured the treatment of critically ill children to the greatest extent.

Implementation study of Evidence-based Nursing Practice Guideline for Enteral Nutrition of Infants with Congenital Heart Disease application / 中国实用护理杂志

Objective:To evaluate the effectiveness of Evidence-based Nursing Practice Guideline for Enteral Nutrition of Infants with Congenital Heart Disease application on improving the nutritional status of infants with congenital heart disease (CHD) in the target population, and to explore the effective strategies of evidence implementation in the process of dissemination, implementation and integration into clinical practice. Methods:This was an implementation study. Promoting Action on Research Implementation in Health Services Integrated Framework (i-PARIHS) was used as a theoretical model. Infants with CHD who received cardiac surgery from the heart ICU of Children ′s Hospital of Fudan University from January 2019 to February 2020 were selected as the study subjects. January to June 2019 and September to February 2020 were the pre and post implementation phase respectively. For medical staff, communication strategy, implementation process strategy, integration strategy and capacity-building strategy were used to advance the implementation process. According to the implementation strategy of children, the 26 best practice recommendations in the guide were translated into operable nursing processes and enteral nutrition programs, which were implemented in four stages: admission to the hospital, pre operation, post operation cardiac care room, post operation ward recovery, and pre discharge. Implementation Results Variable Assessment Form was used to evaluate effectiveness of the implementation strategies; hospitalization weight and upper arm circumference, serum albumin and pre-albumin before discharge were used to evaluate effectiveness of the interventions. Results:Scores of eight aspects of Implementation Results Variable Assessment reached more than 75% of the total score. Pre-albumin of post-implementation was (166.53 ± 42.57) g/L, which was statistically significantly higher than (148.41 ± 30.66) g/L before discharge ( t=-3.21, P<0.01); the weight loss of pre-implementation was 0.00 (0.41) kg, while the weight change of post-implementation was -0.10 (0.40) kg, the difference was statistically significant ( Z=-2.90, P<0.01). Conclusions:The strategies of diffusing, implementing, integrating the CHD enteral nutrition protocol based on guide could improve the implementation results and the nutrition status of infants with CHD.

Effects of preemptive nasogastric tube placement on improving nutrition and feeding status of infants with congenital heart disease / 中国实用护理杂志

Objective:To evaluate the effectiveness and safety of preemptive nasogastric tube placement for improving nutritional status and clinical outcomes in hospitalized infants with congenital heart disease.Methods:Children from 0 to 12 months with congenital heart disease hospitalized in cardiovascular center of Children's Hospital of Fudan University from February to July 2018 were selected as control group through continuous sampling. Children hospitalized were selected from September 2018 to February 2019 as intervention group. The control group followed the current feeding method, the intervention group used preemptive nasogastric tube placement. The nutritional indicators, feeding indicators and clinical outcomes of the two groups were compared to evaluate the intervention effect.Results:The serum albumin and prealbumin of the children in the intervention group were (36.81±4.59) g/L and (162.74±48.17) g/L, which were higher than those in the control group (34.80±5.21) g/L and (142.98± 33.96) g/L, the difference between the two groups was statistically significant ( t values were -2.721, -3.169, both P<0.05); the daily enteral intake, calorie intake and single enteral calorie intake of children in the intervention group were (124.93±27.97) ml·kg -1·d -1, (376.48±88.53) kj·kg -1·d -1, (48.39±9.13) kj·kg -1·time -1, higher than the control group (114.74±30.63) ml·kg -1·d -1, (330.01±90.75) kj·kg -1·d -1, (44.24±13.31) kj·kg -1·time -1, the difference between the two groups was statistically significant ( t values were -2.511, -3.750, -2.382, all P<0.05). the incidence of feeding difficulties in the intervention group was 4.95% (5/101) lower than 14.68% (16/109) of the control group, the difference between the two groups was statistically significant ( χ2 value was 5.513, P<0.05); the proportion of children in the intervention group reaching the target feeding amount when discharged from the hospital was 97.03% (98/101), higher than 84.40% (92/109) of the control group, the difference between the two groups was statistically significant ( χ2 value was 9.699, P<0.05). Conclusions:Preemptive nasogastric tube placement is safety and effectively for patients with congenital heart disease in clinical infants. but it still needs a large sample for a long time to confirm its effectiveness.

Genetic testing of chorionic villi from abortuses during early pregnancy / 中华医学遗传学杂志

OBJECTIVE@#To explore the prevalence and characteristics of chromosomal abnormalities in abortuses during early pregnancy with single nucleotide polymorphism microarray (SNP-array).@*METHODS@#For 520 abortuses, copy number variations (CNVs) in chorionic villi were analyzed with SNP-array.@*RESULTS@#In 510 (98.1%) of the samples, the analysis was successful. Among these, 57.6% (294/510) of the samples were found to harbor clinically significant chromosomal abnormalities. 38.8% of the samples (198/510) had a normal result. 2.4% (12/510) of the samples harbored benign CNVs, and 1.2% (6/510) harbored variants of uncertain significance (VOUS). Aneuploidies, polyploidies, pathogenic CNVs and uniparental disomies (UPD) had accounted for 75.2% (221/294), 13.9% (41/294), 8.2% (24/294), and 2.7% (8/294) of the samples, respectively. 45,XO was the most common finding, which was followed by trisomy 16 and trisomy 22. 69,XXY was the most common polyploidy.@*CONCLUSION@#Chromosomal abnormalities are the main cause for early miscarriage, among which aneuploidies are most common. The prevalence of aneuploidies is significantly increased among women over 35. SNP-array analysis has the advantage of high success rate, high resolution and great accuracy, but the clinical significance of microdeletions/microduplications found by SNP-array can be difficult for interpretation.

Percutaneous piercing cortical bone at fracture ends and local injection of autologous concentrated bone marrow aspirate and platelet rich plasma for treatment of delayed fracture union / 中华创伤骨科杂志

Objective To evaluate the clinical efficacy of percutaneous piercing cortical bone at fracture ends and local injection of autologous concentrated bone marrow aspirate (cBMA) and platelet rich plasma (PRP) in the treatment of delayed fracture union.Methods A retrospective study was performed on the clinical data of 34 patients with delayed fracture union who had been treated at Department of Orthopaedics,Luoyang Zhenggu Hospital of Henan Province from April 2014 to February 2017.They were 26 males 8 females,aged from 18 to 63 years (average,36.7 years).There were 15 femoral,11 tibial,5 humerus and 3 ulnar fractures.According to the Weber-Crech classification,14 cases belonged to the type of rich blood supply-active end hypertrophy and 20 to the type of poor blood supply and malnutrition.There were 28 closed and 6 open fractures.Of this cohort,21 cases had their primary fixation,7 had revision once,4 had revision twice,and 2 had revision more than thrice;19 cases had intramedullary fixation,12 had plate fixation and 3 had external fixation.Autologous iliac bone grafting was performed previously in 19 cases.Kirschner wire was used under fluoroscopy to pierce percutaneously the cortical bone at fracture ends;bone marrow blood and peripheral venous blood were collected to prepare autologous cBMA and PRP which were to be injected locally at the fracture ends after mixture.At the last follow-up,the patients were evaluated by visual analogue scale (VAS),SF-36 health survey summary scores and modified Radiographic Union Score for Tibia (RUST).Results The patients were followed up for 12 to 42 months (average,21.5 months).Thirty-one patients healed after surgery,yielding a healing rate of 91.2％.The healing time averaged 5.3 months (from 4 to 10 months).No patient reported such complications as infection or neurovascular injury.At the last follow-up,the VAS scores of the 34 patients were 1.3 ± 0.6 points,significantly lower than the preoperative 5.4 ± 3.6 points (P ＜ 0.05);the postoperative SF-36 scores 74.8 ± 16.5 points,significantly increased than the preoperative 44.8 ± 15.6 scores (P ＜ 0.05);the RUST scores 3.3 ± 0.4 points,significantly higher than the preoperative 1.6 ± 0.8 points (P ＜ 0.05).Conclusions Minimally invasive percutaneous piercing of K-wire on the cortical bone at the fracture ends may result in fluid leakage and restart bone healing process.At the same time,local injection of autologous cBMA and PRP may increase the number and concentration of local bone marrow mesenchymal stem cells and growth factors,promoting fracture healing.

Clinical study on post-stroke urinary retention treated with acupuncture at the twelve-well points and bladder function training / 中国针灸

<p><b>OBJECTIVE</b>To explore the methods for the therapeutic effect improvement in the treatment of post-stroke urinary retention.</p><p><b>METHODS</b>Sixty-three patients of post-stroke urinary retention were randomized into an observation group (32 cases) and a control group (31 cases). The routine clinical medication of neurology and basic rehabilitation were adopted in the two groups. Additionally, in the control group, the intermittent urinary catheterization and bladder function training were applied. The duration and frequency of catheterization were determined by the autonomic urination and residual urine volume every day. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to the twelve-well points in the sequence offlowing among the twelve meridians [Shaoshang (LU 11), Shangyang (LI 1), Lidui (ST 45), Yinbai (SP 1), Shaochong (HT 9), Shaoze (SI 1), Zhiyin (BL 67), Yongquan (KI 1), Zhongchong (PC 9), Guanchong (TE 1), Zuqiaoyin (GB 44) and Dadun (LR 1)]. Acupuncture was given once a day, 20 treatments were required. In 20 treatments, the clinical therapeutic effects and the residual urine volume were observed.</p><p><b>RESULTS</b>The total effective rate was 90.6% (29/32) in the observation group, better than 67.7% (21/31) in the control group (<0.01)). After treatment, the residue urine volume was all reduced apparently in the patients of the two groups (both<0.01). The result of the residue urine volume in the observation group was lower apparently than that in the control group (<0.01).</p><p><b>CONCLUSION</b>Acupuncture at the-well points in the sequence offlowing among meridians combined with bladder function training achieve the apparent therapeutic effects on post-stroke urinary retention. The results are better than those achieved by the routine western medicine with bladder function training involved.</p>

Current Living Situation of Survival Patients with Spinal Cord Injury 40 Years after Tangshan Earthquake / 中国康复理论与实践

Objective To survey the survival status, functional status, marital status and the present situation of the survival patients with spinal cord injury 40 years after Tangshan earthquake. Methods From February to May, 2016, a total of 216 patients with spinal cord injury were surveyed with questionnaire, in which 139 cases lived centralized and 77 cases lived scattered. The questionnaire was self-designed and included eleven items and 51 questions, which related to ability of daily life, marital status, employment status and socioeconomic status and so on. Results A total of 960 (25.15%) patients with spinal cord injury survived 40 years after Tangshan earthquake. In 216 surveyed pa-tients, the employment rate was 9.3%, the married rate was 53.2%, and 44.9%earned less than 500 yuan every month. The incidence was 25.9%for pressure score, 50.50%for neuralgia (severe pain accounted for 23.51%), and 19.40%for urinary tract stones. 56%of patients could take their own basic self-care. Conclusion There were many problems such as high complication rate, low employment rate and poor economic condition in the spinal cord injury group 40 years after Tangshan earthquake.

Effect of Living Mode on Quality of Life and Life Satisfaction of Patients with Spinal Cord Injury Survived Tang-shan Earthquake / 中国康复理论与实践

Objective To explore the effect of living mode on quality of life and life satisfaction of patients with spinal cord injury who survived Tangshan earthquake. Methods From February to May, 2016, 76 patients with spinal cord injury survived the earthquake were in-vestigated, among whom 38 patients lived in the nursing home or rehabilitation village and the other 38 patients discretely lived at home. Their quality of life and life satisfaction were assessed with WHO Quality of Life-BREF (WHOQOL-BREF) and Life Satisfaction Assess-ment respectively. Results The scores of physical, psychological, social adaptation and environment field in WHOQOL-BREF were signifi-cantly higher in the concentrated living group than in the scattered living group (t>8.97, P<0.001), as well as the life satisfaction (t=6.55, P<0.001). Conclusion The concentrated living mode could improve the quality of life and life satisfaction of the patients with spinal cord inju-ry survived Tangshan earthquake.

Femoral neck fractures fixed with intramedullary cannulated screws: factors for postoperative functional recovery / 中国组织工程研究

BACKGROUND: Hip arthroplasty and internal fixation with intramedullary cannulated screws are mainly used for senile femoral neck fractures. However, osteoporosis can usually lead to failure in internal fixation.OBJECTIVE: To analyze the joint function after fixed with intramedullary cannulated screws in elderly patients with femoral neck fractures, and to explore the factors related to functional recovery.METHODS: Clinical data of 89 patients with femoral neck fractures undergoing internal fixation with intramedullary cannulated screws after 2-year follow-up were analyzed retrospectively. The sex, age, Garden type, bone mineral density, body mass index, screw distribution, reduction index, operation time, bearing time and Harris hip scores were analyzed. Rank related analysis and accumulative Logistic regression analysis were performed on SPSS18.0 software. RESULTS AND CONCLUSION: (1) Normal Q-Q plot and normality test results indicated that the Horris scores in all patients after 2-year follow-up presented with skewed distribution (P=0.000). (2) Rank related analysis showed that age,Garden type, bone mineral density, and reduction index were related with Harris score (P < 0.05 or P < 0.01). (3) Accumulative Logistic regression analysis showed that the independent variables including age, Garden type, bone mineral density, and reduction index made significant effect on Harris hip scores. (4) To conclude, age, Garden type,bone mineral density, and reduction index are important factors for functional recovery of the hip after fixed with intramedullary cannulated screws.

The reliability and validity of the Chinese version of Infant Feeding & Nutrition Checklist For Congenital Heart Disease / 中华护理杂志

Objective To translate the English version of Infant Feeding & Nutrition Checklist For Congenital Heart Disease (IFNC:CHD) into Chinese,and to test the reliability and validity of the Chinese version of IFNC:CHD.Methods After obtaining authorization from the developer,the IFNC:CHD was translated and culturally adapted into Chinese version.The reliability and validity of the Chinese version of IFNC:CHD were tested in 168 patients.Results The Cronbach's α coefficient was 0.804.Two nurses used the scale to evaluate the consistency of the results,and the Kappa coefficient was 0.812.The content validity index of item ranged from 0.80 to 1.00,and the average index was 0.90 for the total scale.The correlations coefficients between each dimension score and the total score ranged from 0.339 to 0.474 (P＜0.01),and the correlations coefficients between each dimension score ranged from 0.198 to 0.861(P＜0.01,P＜0.05),Three factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 72.66％.Conclusion The Chinese version of IFNC:CHD has been proved to have good reliability and validity.It can be used to assess infant feeding and nutritional risk of congenital heart disease in the Chinese settings.

Clinical study of post-stroke speech apraxia treated with scalp electric acupuncture under anatomic orientation and rehabilitation training / 中国针灸

<p><b>OBJECTIVE</b>To compare the differences in the clinical efficacy on post-stroke speech disorder between scalp electric acupuncture (EA) under anatomic orientation combined with rehabilitation training and simple rehabilitation training.</p><p><b>METHODS</b>Sixty patients of post-stroke speech apraxia were randomized into an observation group and a control group, 30 cases in each one. In the observation group, under anatomic orientation, the scalp EA was adopted to the dominant hemisphere Broca area on the left cerebrum. Additionally, the speech rehabilitation training was combined. In the control group, the speech rehabilitation training was simply,used. The treatment lasted for 4 weeks totally. The speech movement program module in the psychological language assessment and treatment system of Chinese aphasia was used for the evident of efficacy assessment. The scores of counting, singing scale, repeating phonetic alphabet, repeating monosyllable and repeating disyllable were observed in the patients of the two groups. The assessment was done separately on the day of grouping and 4 weeks after treatment.</p><p><b>RESULTS</b>In 4 weeks of treatment, the scores of counting, singing scale, repeating phonetic alphabet, repeating monosyllable and repeating disyllable were all improved as compared with those before treatment in the two groups (all P<0. 001). The results in the observation group were better than those in the control group (all P< 0. 05). The total effective rate was 100. 0% (30/30) in the observation group, superior apparently to 53. 3% (16/30) in the control group (P<0. 001).</p><p><b>CONCLUSION</b>The scalp EA under anatomic orientation combined with' speech rehabilitation training obviously improves speech apraxia in stroke patients so that the speech disorder cani be relieved. The efficacy is better than that in simple rehabilitation training.</p>

The status quo investigation of nurses′cognitive and attitude of adverse event reporting / 重庆医学

Objective To calculate the probability of nurses in a city experiencing adverse event and investigate nurses′cognitive and attitude of adverse event reporting ,and to improve the adverse event reporting system for care .Methods Three hundred and seventy five nurses were selected from 15 hospitals in our city and investigated by questionnaire survey .Results There were not statistically significant difference in the probability of nurses experiencing adverse event among all the different levels hospitals (P>0 .05) .There were statistically significant difference among three factors influencing the probability of nurses experiencing adverse event ,including professional title ,different age ,length of service(P<0 .05) .There were statistically significant difference of actively reporting the adverse event among nurses with different length of service (P<0 .05) .Conclusion Nurses′cognitive and attitude to‐wards adverse events report is positive .The length of service ,punishment environment and management expectation are the factors influencing the executive intention of adverse events .Investigating safety problems from the systematic perspective and improving adverse events reporting system could get more information and synthetically analyze the information to avoid nursing risk events e‐ventually .

Influence of risk management on nursing work in chest surgery department / 中国实用护理杂志

Objective To discuss the risk factors existing in clinical nursing of the chest surgery department and the corresponding nursing measures.Methods 395 patients were divided into the research group ( 199 cases) and the control group ( 196 cases),the control group received routine nursing,while the research group was given nursing risk management.The nursing effect was compared.Results After implementation of nursing risk management,the research group was better in the aspects of risk prevention consciousness,nursing risk events,complications,satisfcation degree of patients than the control group.Conclusions Risk management is the effective measures to decrease the nursing risk,and it is useful for elevating nursing quality and patients' satisfactory degree.

Study of pathogen aetiology and drugs resistance in neonatal septicemia / 中国综合临床

Objective To study pathogen aetiology and distribution of drug resistance in neonatal septice-mia. Methods A retrospective study of positive organisms of blood cultures and the results of antimicrobial suscep-tibility testing was conducted from January 2000 to December 2006 in 1293 cases of neonatal septicemia;The results were divided into three groups:the earlier group,the middle group and the later group. The strains were identified by VITEK-AMS and antibiotics susceptibility was tested by K-B method, results were interpreted according to NCCLS. inant in three groups(76.3% ,74.1% and 65.7% ) (P <0.05). Among Gram-pesitive coccus,the most prevalent strains was staphylococcus, Gram-negative bacilli increased gradually,accounting for 21.3% ,21.3% and 28.4% in cpidermids to erythromycin and sulfamethoxazole/trimethoprim were rather higher:93.3% ,73.7% vs 87.8% vs 100.0%, respectively, the resistance -rates to penicillin were less,but to susceptible to vancomyein,piperacill/tazo-batam,amikacinand ciprofloxacin;gram-negative bacilli were only sensitible to imipenem, cefepime, and cefopera zone/sulbactam;multiresistances of drug strains was commonly seen. Condusions It is important for using antibi-otics rationally according to drug sensitivity test, because multiresistant strains and opportunistic pathogen are com-monly seen.

Biological characteristics of bone marrow-derived mesenchymal stem cells cultured by density gradient centrifugation combined with adherence in adult rats / 中国组织工程研究

BACKGROUND: It is important to study the methods of culturing bone marrow-derived mesenchymal stem cells (MSCs) to obtain a great amount of high purity MSCs for applying ocular tissues constructed by tissue engineering technique to treat eye diseases.OBJECTTVE: To separate and culture in vitro MSCs from bone marrow of the adult rats by density gradient centrifugation combined with adherence culture, and observe the growing characteristics and the possibility of mass multiplication.DESIGN: A completely randomized grouping design/repetitive measuring experiment.SETTING: Pathological laboratory, Zhongshan Ophthalmic Center, Sun Yat-sen University.MATERIALS: Four six-week-old SD rats about 250 g, grade Ⅱ of cleaning, were provided by the Animal Center of Sun Yat-sen University [certificate number: SCSK(Yue)2004/0011], about 250 g each rat and there was no limit to the sex. The main reagents and instruments included low sugar Dulbecco modified Eagle culture medium (DMEM/F12, American Gibco Corporation), trypsin (fetal bovine serum (FBS, Hangzhou Sijiqing Bio-Engineering Material Research Institute), American Gibco Corporation), disodium edetate, lymphocyte separating medium, fibronectin, CD44, CD34, CD31 monoclonal antibodies, two-step-method kit for immunohistochemistry (Beijing Zhong shan Biotechnology Corporation).METHODS: This experiment was conducted at the Key laboratory of Ophthalmology (Sun Yat-sen University), Ministry of ethanol (750 g/L) for 10 minutes. Under aseptic condition, the medullaris cavitas was exposed, the syringe containing application m edium was directly punctured into the femoral cavity, the cells in the medullaris cavitas were washed out with the culture medium containing heparin and taken as the cell suspension. The bone marrow-derived MSCs were separated and purified by density gradient centrifugation combined with adherence culture, and the growing conditions of the wells. When the cells had generally connected with each other, they were fixed with methanol or dimethy ketone in situ for 10 minutes, and then hematoxylin eosin (HE) staining or immunohistochemical staining. Antibodies against fiinoculated to 96-well culture plate by a cell density of 4.25×107/L, with 200 μL every well; then put the culture plate into culture box. Then from the next day to the sixth day, 5 g/L MTT solution was added into two rows (20 μL every well) every day, continuously cultured for 4 hours, then the supernatant was removed, and 200 μL DMSO was added to each well, agitated for 5 minutes, then detected the absorbance (A) values at 570 nm wave length, and a growth curve was drawn.branes were clear and the cell bodies were lucent. Being cultured for 2 days, there appeared adherent cells. 3 days later,most of the adherent cells extended and appeared to be in polygon, star or long-shuttle shapes. 4 days later, the cells showed to be in division growth stage; and about 12 days later, the cell clones were connected to each other, appearing curve of subcultured MSCs was in S shape. Cells began growing fast on the 2nd day after being passaged, and they entered the growth period for 3-4 days followed by saturation period, and then cells stopped growing.CONCLUSION: It is a simple and practical method to separate MSCs from the bone marrow of adult rats by means of density gradient centrifugation and adherence. MSCs can greatly proliferate in vitro and offer seed cells for the application of tissue engineering technique to treat eye diseases.