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Objective:To observe the influence of multi-disciplinary cooperation and optimization management mode on the negative situation and rehabilitation effect of patients with affective disorder after coronary heart disease and cerebrovascular disease.Methods:A total of 188 patients with emotional disorders caused by coronary heart disease and cerebrovascular disease from January 2017 to December 2018 to our hospital were selected. According to the random number method, 94 cases in the control group adopted the conventional management model, and 94 cases in the experimental group adopted the multidisciplinary collaborative optimization management model. The negative emotions [evaluated by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale(SDS) ] scores before and after management, the coping style (Jalowies) scores, and quality of life [evaluated by World Health Organization Quality of Life-Brief (WHOQOL-BREF) ] scores were compared between the two groups. The clinical rehabilitation effect and satisfaction rate of related management between the two groups were compared.Results:There were no significant differences between the two groups before management of SAS scores, SDS scores, Jalowies scores, and WHOQOL-BREF quality of life scores ( P> 0.05). After management, the SAS scores and SDS scores of the two groups were significantly reduced, and the Jalowies scores and WHOQOL-BREF quality of life scores were significantly increased. After management, the SAS score and SDS score of the experimental group were 47.32±5.68, 49.93±6.49 and 54.95±6.59, 55.33±8.30 in the control group, the difference was significant between two groups ( t value was 8.503, 4.969, P<0.01). The Jalowies scores and WHOQOL-BREF scores of the experimental group were higher than those of the control group ( t value was -27.662--4.290, P<0.01). The total effective rate of rehabilitation in the experimental group was 98.94%(93/94), which was significantly higher than 90.43%(85/94) in the control group, the difference was statistically significant ( χ2 value was 6.760, P <0.05). The total satisfaction rate of the experimental group for management intervention was 100.00%(94/94), which was significantly higher than the total satisfaction rate of the control group, 91.49%(86/94), the difference was statistically significant ( χ2 value was 6.397, P <0.05). Conclusions:In the patients with affective disorder caused by coronary heart disease and cerebrovascular disease, multi-disciplinary cooperation and optimization management mode can significantly reduce the negative emotions of patients after management, improve the way of patients to deal with the disease, effectively improve the clinical rehabilitation effect and the quality of life of patients, improve the satisfaction rate of patients with management, shorten the distance between nurses and patients, and achieve ideal results.
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Objective To investigate the clinical value and effect of spinal nerve medial branch ablation through transforaminal endoscopic in treatment of lumbar zygapophysial joint pain. Methods From August 2008 to October 2013 ,96 patients diagnosed as lumbar zygapophysial joint pain were included in the research. 36 patients were treated by spinal nerve medial branch ablation through transforaminal endoscopic ,while 60 patients received conservative treatment. The visual analogue scale (VAS) and Japanese Orthopedics Association(JOA) scores before treatment,1,3,6 and 12 months after treatment were recorded and analyzed. The MacNab scores were recorded and analyzed 12 months after treatment. Results The VAS and JOA scores of surgical treatment group showed significant improvement compared with that before operation (P < 0.05),and there were no significant difference at each time point after surgery. The VAS and JOA scores of conservative treatment group in showed significant improved at 1 months after treatment compared with that before treatment(P<0.05),but there were no significant difference at each time after treatment compared with pretreatment. The VAS and JOA scores of surgical treatment group showed significant improvement compared with conservative treatment group at each time after treatment(P<0.05). The MacNab scores of surgical treatment group(94.44%)was significantly higher than that of conservative treatment group(33.33%). Conclusion The spinal nerve branches ablation under transforaminal endoscopic is an effective and safe minimally invasive spine surgery technique with important clinical value in the treatment of lumbar zygapophysial joint pain.
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Objective To detect the expression levels of urokinase-type plasminogen activator (uPA), matrix metalloproteinase-3 (MMP-3),MMP-9,MMP-13 and MMP-14 in the patients with osteoarthritis(OA)before and after arthroscopic debridement,and to explore the influence of arthroscopic debridement in the expressions of uPA, MMP-3,MMP-9,MMP-13, and MMP-14.Methods 420 cases of synovial fluid from knee OA patients undergoing arthroscopic debridement were obtained before operation. After six months follow-up, 350 cases of synovial fluid samples were obtained and according to inclusion and exclusion criteria, 228 synovial fluid were selected to analyze.The expression levels of uPA,MMP-3,MMP-9,MMP-13,and MMP-14 were measured by ELISA assay.Pain intensity of these patients before operation and six months after operation were recorded using the Visual Analogue Scale/Score(VAS).The differences of the expression levels of uPA,MMP-3,MMP-9, MMP-13,and MMP-14 between before operation and after operation were compared.The relationship between the expression levels of uPA, and MMP-3, MMP-9, MMP-13, MMP-14 and VAS was analyzed with Spearman analysis.Results All the patients were followed up for 36.5 months. Compared with before operation, the expression levels of uPA and MMP-3 in the synovial fluid of the patients after arthroscopic debridement were significantly decreased(P<0.01),the expression levels of MMP-9 and MMP-13 were also decreased (P<0.05), but the MMP-14 expression level showed no significant change.The expression levels of uPA,MMP-3,MMP-9, MMP-13,MMP-14 were positively associated with VAS before arthroscopic debridement (r=0.361,r=0.417, r=0.136,r=0.514,r=0.156,P<0.05 );uPA and MMP-3 were positively correlated with VAS after arthroscopic debridement(r=0.981,r=0.831,P<0.01),as well as the expression level of MMP-13 and VAS, but there were no significant differences between the expression levels of MMP-9, MMP-14 and VAS. Conclusion The decreased levels of uPA,MMP-3 and MMP-13 in synovial fluid may contribute to the pain-relief effects of arthroscopic debridement.
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Objective To compare the effects of sodium hyaluronate (SH) and celecoxib (CO) administration on the treatment of knee osteoarthritis (OA) and to investigate their influences on levels of uPA and MMP-3 in synovial fluid. Methods One hundred and thirty-six knee osteoarthritis (OA) patients from January 2010 to October 2011 were randomly enrolled into two groups: the SH group and the CO group. In the SH group, patients were injected with 2 mL sodium hyaluronate intra articulation once a week for 5 weeks. In the CO group , patients were given oral administration of celecoxib daily at a dosage of 200 mg for 5 weeks. Before and at 1 ,6 months after treatment, Lequesne′s index and VAS-pain were detected to assess the clinical results of these two drugs. The levels of uPA and MMP-3 in synovial fluid were measured by using ELISA assay. Results All patients were followed up for 6 months to 12 months. The Lequesne′s index and VAS-pain score were lowered at 1 and 6 moths after treatment in both the SH group and the CO group(P0.05). Dramatic reduction of the levels of uPA and MMP-3 in synovial fluid were observed in the SH group after treatment(P0.05). Conclusion The redueced levels of uPA and MMP-3 in synovial fluid after treatment of sodium hyaluronate may contribute to its longer-lasting effect than that of celecoxib. Therefore , the combination of sodium hyaluronate with celecoxib may lead to better therapeutic effect on OA patients.
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Ranolazine hydrochloride sustained-release tablet (RH-ST) was prepared and its release behavior in vitro was studied. The pharmacokinetic characteristics and bioavailability in six Beagle dogs after oral administration of RH-ST and ranolazine hydrochloride common tablets (RH-CT) as reference were compared. Three kinds of matrix, hydroxypropylmethylcellulose (HPMC K4M), ethylcellulose (EC 100cp) and acrylic resins (Eudragit RL100) were selected as functional excipients to keep ranolazine hydrochloride (RH) release for 12 hours. Through orthogonal designs, the polymers were quantified and the optimized cumulative release profile was obtained. The single oral dose of RH-ST 500 mg and RH-CT 333.3 mg was given to six dogs using a two way crossover design. Plasma levels were determined by LC-MS and the absorption fractions were calculated according to Loo-Riegelman formula. The steady-state concentration of RH in plasma of six dogs and its pharmacokinetics behaviors after continuous oral administration of RH-ST and RH-CT at different time intervals were studied by LC-MS. The steady-state pharmacokinetic parameters were computed by software program BAPP2.0. With the increase of the amount of the matrix, the drug release was decreased. The most important factor influencing drug release is the quantity of HPMC K4M. Drug release within the period (from 0 h to 12 h) fitted well into Higuchi model. The correlation coefficient (r) between the dissolution in vitro in release media of the distilled water and the absorptin fraction in vivo was 0.9550. To compare with RH-CT, RH-ST in vivo has a steady and slow release behavior, Tmax was obviously delayed (3.00 +/- 0.50) h and the relative bioavailability was over 80 percentage. The combined use of multiple polymers can decrease the tablet weight effectively, and the drug release rate can be decreased both in vitro and in vivo.
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Background mental imagery is a multi-componential process involving different mental operations. Objective The present study investigated the subsystems of visual mental imagery processing and their interactions. Methods: Four experimental tasks were done: (1) object, the ability to generate global mental images; (2) resolution, the ability to generate vivid,high-resolution mental images; (3) transformation,the ability to mentally rotate patterns in images, and (4) spatial imagery,spatial cognition. 91 university students (77 males, 14 females) participated in this study. Results: Object task was highly correlated with resolution task, and the same the tendency was found between transformation task and spatial task. Conclusion: The results indicate there are different subsystems of visual mental imagery and corresponding operative strategies, but with strong correlation among these processes and abilities.