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Objective To explore the anxiety status and coping strategies of clinical postgraduates,and to provide practical approaches to promote their mental health.Methods Using the phenomenological research method of qualitative research,12 subjects were interviewed in a semi-structured way.Using the 7-step analysis method of Co-laizzi phenomenology,the original data were analyzed and summarized.Results Five themes were extracted,in-cluding stress sources and psychological condition,interpersonal relationship,adjustment to cope with stress,self-understanding,career understanding and future vision.Clinical work,scientific research and economic pressures were the main causes of anxiety to the interviewees,who made cognitive,psychological,attitudes and behaviors ad-justments,they hope to achieve a good work-life balance in the future.Conclusions Effective measures should be taken in view point of individual,school,family and social dimensions to alleviate anxiety and promote their physi-cal and mental health.
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Mucinous tubular and spindle cell carcinoma of the kidney is a rare subtype of renal carcinoma. In July 2019, one case of mucinous tubular and spindle cell carcinoma of the kidney was admitted to our hospital, The laparoscopic partial nephrectomy was performed, and there was no recurrence or metastasis during the follow-up period of 13 months. The disease has no obvious clinical manifestations and its diagnosis depends on pathological and immunohistochemical features. Surgical treatment is the main treatment for this disease, and most patients have a good prognosis.Howerer, the possibility of progression remains in the late stage of the disease.
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Objective To evaluate systematically the effect of ventilator circuit changes on incidence of ventilator-associated pneumonia(VAP).Methods Literatures about the effect of ventilator circuit changes on occurrence of VAP were searched from PubMed,Cochrane Library,CNKI,VIP,and Wanfang database,incidence of VAP in pa-tients who received circuit changes at different intervals was compared,odds ratio (OR)and 95%CI were as effect index of the study,RevMan 5.2 software was used for data analysis.Results A total of 12 literatures were included,including 18003 patients using ventilators.According to the interval of ventilator circuit changes,patients were divided into 1-day group (n=191),2-day group(n=8932),3-day group(n=228),and 7-day group(n=8652).Meta analysis showed that circuit changed every 7 days had a lower risk of VAP than that changed once ev-ery day (OR,3.72[95%CI,1.50,9.23]),there was no significant difference in risk of VAP between 7-day group and 2-day group (OR,1.17[95%CI,1.00,1.37])as well as 7-day group and 3-day group(OR,0.77 [95%CI, 0.49,1 .23]).Conclusion Patients who received circuit changes every 7 days have a lower risk of developing VAP than those who received circuit changes once per day,so change the ventilator circuit in patients with mechanical ventilation every 7 days is more reasonable.
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Objective To study the inhibitory effect of curcumin on the proliferation,migration and invasion of non-small cell lung cancer cell A549,and to discuss further if it is closely related to the expression of c-Jun N-terminal kinase (JNK) and relative protein p38.Methods A549 cells were cultured by conventional method,and then treated with different concentration of curcumin (10,20,40,80 μmol · L-1).The proliferation,migration and invasion of A549 cells were measured by real-time cellular analysis (RTCA).The expression levels of JNK,p-JNK,p38 and P-p38 were detected by real-time PCR and Western blotting.Results Curcumin showed an antiproliferation effect against A549 cells with IC50 =40 μmol · L-1,and curcumin exhibited obviously inhibitory effect on the migration and invasion of A549 cells.Additionally,compared with control group,curcumin suppressed the expression of JNK and p38 at the gene level,and significantly inhibited the expression of JNK,P-JNK,p38 and p38 (P<0.05) at the protein level.Conclusion These results demonstrated that curcumin can inhibit the proliferation,migration and invasion of A549 cells via reducing the level of JNK,p38 phosphorylation,and blocking JNK signal transduction pathway.
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Objective To make an evidence-based rehabilitation plan for a patient with osteogenesis imperfecta after external fixation. Methods Based on a comprehensive assessment for the patient's condition, the clinical problems were listed. Related articles were searched from National Guideline Clearinghouse (NGC), The Cochrane Library, PubMed, CBM, CNKI and Wanfang databases. And the reference list of each eligible article was also included. Finally the optimum rehabilitation program was designed with optimal clinical evidence, patient's conditions and relatives' willingness. Results 1 randomized controlled trial and 4 case reports were included. A progressive exercise program was developed and implemented. No new fractures occurred during the intervention. Muscle strength, gait, activities of daily living had been greatly improved. 20 weeks later, the Berg score was 43 and the Barthel index was 80. Conclusion The progressive rehabilitation exercise program developed from evidence-based practice is safe, effective and feasible.
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BACKGROUND:The peri-implant bone absorption is closely related to the repair effect. OBJECTIVE:To compare the effects of three kinds of dental implant systems on the peri-implant bone absorption. METHODS:116 patients who underwent the dental implant systems were col ected, including 46 cases with 3I implant system, 40 cases with ITI implant system and 30 cases with BLB implant system. The peri-implant bone absorption, sulcus bleeding index and periodontal probing depth of three groups were detected at 1, 3, 6, 9 and 12 months after implantation, respectively. RESULTS AND CONCLUSION:The peri-implant bone absorption of three groups within 1 year after implantation was in a rise, and the bone absorption of BLB group was significantly higher than that of ITI and 3I groups at 3 and 12 months after implantation (P<0.05). Compared with the natural teeth, the gingival sulcus bleeding index of three groups were al increased at different time points after implantation;the gingival sulcus bleeding index of BLB group was significantly higher than that of natural teeth at 6 months after implantation (P<0.05);the gingival sulcus bleeding index of three groups were significantly higher than that of natural teeth at 9 months after implantation (P<0.05). The periodontal probing depth of three groups showed an ascending trend at 6 months after implantation;the periodontal probing depth of three groups was higher than that of natural teeth at different time points after implantation, which exhibited significant differences at 6 and 9 months after implantation (P<0.05). In conclusion, three kinds of dental implant systems exhibit differet effects on the peri-implant bone absorption, but al achieve excel ent clinical efficacies.
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Based on the Hunan province research site, from the egalitarian concrete analysis of the province since the new reform of basic medical insurance of urban and rural reform and the fairness of the situation, think the current reform of insurance of primary medical treatment to a certain extent, promote the economy of the basic medical service accessibility and equity, but rural population and urban population in the benefit of insurance of primary medical treatment is still a gap, should be by advancing the basic medical insurance system of urban and rural integration manage-ment, gradually promote the fairness of health care among different populations.
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Objective To investigate the preoperative effects of exercise-based interventions for people awaiting joint replacement surgery of the hip.Methods Seven computer databases(PubMed,EMBASE,SCI,Cochrane Library,CNKI,CBM,VIP,Wanfang) were searched before July 2013 about the RCTs of the preoperative effects of exercise-based interventions for people awaiting joint replacement surgery of the hip,software for data analysis was RevMan5.1.Results Finally 10 RCTs were included,the intervention group was better than the control group in pain(2 weeks post-operation),time of beginning to get out of bed,hip function(after 2 weeks and 3 months post-operation),lower limb muscle strength(2 weeks and 3 months postoperation).Conclusions Preoperative exercise-based interventions can favor the early rehabilitation for patients awaiting joint replacement surgery of the hip.
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Objective: To evaluate the safety and anticoagulant efficacy of domestic bivalirudin injection during emergent percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 75 STEMI patients were randomly divided into 2 groups according to anticoagulant used in emergent PCI procedure. Bivalirudin group, the patients received intravenous domestic bivalirudin, n=40 and Heparin group, n=35. The activated clotting time (ACT) was tested at pre-PCI, 5 minutes after medication, immediately after PCI, 30 minutes, 1 hour and 2 hours after medication respectively. The activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and ifbrinogen (FIB) level were measured at before medication and 6, 24, 72 hours after medication. Results: All patients in Bivalirudin group had ACT>225s at 5min after medication as PCI requirement, while 1 patient in Heparin group could not reach the requirement and the extra dose was added. Both groups maintained ACT>225s during PCI procedure. Bivalirudin group had the lower ACT levels than those in Heparin group at 30 min, 1-and 2-hour after the medication, P0.05. The no-cardiac event surviving rate at 30 days after PCI in Bivalirudin group and in Heparin group were similar P>0.05 and the mild bleeding at 24 hours after PCI in Bivalirudin group was lower (0 vs 11.43)%, P Conclusion: Compared with heparin, domestic bivalirudin may take faster effect, with shorter half-life period for anticoagulation during emergent PCI procedure in STEMI patients.
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In clinical practice, confidentiality is always the ethical criterion and conduct for clinicians. But the principle is not absolute, once someone is in great danger because he or she does not know some medical information, doctors should take actions to avert or minimize the harm. In other words, doctors should take anticipatory-measures to protect him or her against uncertain but plausible risks for patients. In such context, clinical confidentiality is facing the challenge of the precautionary principle.
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Objective: To examine the parents’rearing and educating patterns and their relationship to the characteris- tics of self- concept of adolescents. Methods: A sample of 313 adolescents was tested by the Self- concept Scale and the revised EMBU. Results: Physical self and character self of boys are higher than those of girls. Family self of adolescents whose father has high education level is higher than that of adolescents whose father has low education level(P
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Objective:To examine the difference of undergraduates' gender belief in sex and gender role stereotype.Methods:A sample of 552 undergraduates was tested by BSRI and gender belief stereotype scale.Results:①Traditional gender belief of academic,occupation and family has difference on sex and gender role stereotype.②Men college students have higher traditional gender belief of academic,occupation and family than women college students.③College students of masculinity and undifferentiation have higher traditional gender belief of academic and occupation than college students of androgynous and femininity.College students of masculinity have higher traditional gender belief of family than college students of femininity,androgynous and undifferentiation.Conclusion:College students of men and masculinity have higher gender belief of academic,occupation and family.