A longitudinal study of posttraumatic growth and rehabilitation outcome in patients after renal transplantation / 中国实用护理杂志

Objective The aim of the longitudinal was to explore the level of posttraumatic growth (PTG) and the effect on rehabilitation outcome in patients who received renal transplant. Methods A questionnaire survey was carried out in patients after renal transplant in one month (T1) and six months (T2) in China during hospitalization. PTG was measured by the Posttraumatic Growth Inventory (PTGI), depression by the Patient Health Questionaire (PHQ-9), anxiety by the Generalised Anxiety Disorder Questionaire (GAD-7). Totally 180 patients were recruited, and 160 completed the follow-up measure. Data were analyzed using IBM SPSS 20.0. Results There were 88.3% (158/180) patients reported positive PTG in T1, and 94.3% (151/160) in T2. The mean score of posttraumatic growth at T1 and T2 had no significant difference (T1:77.96 ± 16.36,T2:79.54 ± 17.58;t=-1.302,P=0.195). PTG was not significant to the recovery of physical symptoms (χ2Creatinine=0.504,P=0.841,χ2recover=0.609,P=0.777, χ2complication=6.131,P=0.150), while it affected the incidence of anxiety (χ2=7.541, P=0.021), but not related with the incidence of depression (χ2=3.926,P=0.130). Conclusions There is no difference in the level of PTG in time. PTG has no obvious effect on body health recovery for patients with renal transplantation after six months, while for the mental health, PTG has no effect on depression symptoms, but can reduce the occurrence of anxiety symptoms.

Efficacy observation of PFNA in treatment of femoral intertrochanteric fracture / 中国现代医生

Objective To analyze and discuss the efficacy of proximal femoral nail antirotation (PFNA) in the treatment of femoral intertrochanteric fractures. Methods A total of 144 patients with femoral intertrochanteric fractures treated in our hospital from January 2013 to August 2014 were randomly divided into the control group and the observation group, with 72 patients in each group. The control group was given dynamic hip screw (DHS) internal fixation and the obser-vation group was given PFNA internal fixation. The surgical indicators, treatment effects and incidences of postoperative complications of the two groups were compared. Results The observation group was significantly shorter than the control group in the surgical time, length of hospital stay, weight bearing time and fracture healing time, and was significantly less than the control group in the intraoperative bleeding amount, with statistically significant differences (P<0.05). The postoperative hip joint Harris score of the observation group was (90.8±6.2) points and that of the control group was (81.5±7.2) points; the observation group was significantly higher than the control group in the hip joint Harris score, with statistically significant difference(P<0.05). The treatment effective rate of the observation group was 97.22% and that of the control group was 76.39%;the observation group was significantly higher than the control group in the treat-ment effective rate, with statistically significant difference(P<0.05). The incidence of complications of the observation group was 4.17%and that of the control group was 13.89%;the observation group was significantly lower than the con-trol group in the incidence of complications, with statistically significant difference(P<0.05). Conclusion In the treat-ment of patients with femoral intertrochanteric fractures, the application of PFNA internal fixation has the advantages of small trauma, ideal effects and high safety, which is worthy of clinical promotion and application.

Influence of fine management on hospital infection prevention of obstetric rooming-in / 中国实用护理杂志

Objective To investigate the preventive effect of fine management of hospital infection quality of obstetric rooming-in,in order to reduce the incidence of hospital infection.Methods Fine management run through each link of the hospital infection control from 2010,including a sound management system,strict implementation of the regulations for the operation and management of hand hygiene system,improvement of the building layout and work flow,strengthening the company staff and the ward environment management and monitoring,and make the management of hospital infection more standard.Results The obstetric rooming-in nosocomial infection rate decreased from 3.90％ in 2010 to 0.78％ in 2012.Fine management significantly reduced the incidence of nosocomial infection in our hospital.Conclusions The implementation of fine management in obstetric rooming-in is conducive to the effective control of nosocomial infection and promotion of maternal and child safety.

A randomized prospective study of early steroid withdrawal in middle aged and elderly renal transplant patients / 中华老年医学杂志

Objective To evaluate the safety and validity of an early steroid withdrawal protocol including cyclosporine (CsA) and mycophenolate mofetil (MMF) in middle aged and elderly renal transplant patients. Methods Between September 2000 and April 2008, the prospective, randomized study design was used in 80 middle aged and elderly renal transplant patients. Steroid withdrawal group (n=39) with primary cadaveric kidney transplants received a protocol consisting of CsA 4～6 mg·kg~(-1)·d~(-1) beginning at postoperative day 3, MMF 0. 75 g twice a day from the next postoperative day, and methylprednisolone (MP) 500 mg daily from day 0 to 3. Then prednisone (Pred) 20 mg daily was gradually tapered and withdrawn after postoperative day 30. Conventional steroid treatment group (control group, n=41) received a regimen consisting of CsA, MMF and MP, and Pred 20 mg daily. Pred was tapered to 5 mg daily over a period of 6 months, then maintained thereafter. Outcome parameters were patient and graft survival rates, renal function, acute rejection ( AR), arterial hypertension, hyperlipidemia or diabetes mellitus, weight gain and infection. Results The incidence of AR in the steroid withdrawal group was similar to the control group (23. 1% vs. 19. 5%, χ~2=0. 15,P>0. 05). Patient survival rates at 12, 24, 36 months were 97. 4%, 94. 8% and 88.0% in the steroid withdrawal group and were 97.6%, 97.6 and 87.8% in the control group, respectively (χ~2=0. 17, P>0. 05). And graft survival rates were 94. 9%, 88. 6% and 83. 7% in the steroid withdrawal group and were 95. 1%, 91. 5% and 79. 5% in control group, respectively (χ~2 = 0.07, P>0. 05). Conclusions In middle aged and elderly renal transplant patients, early steroid withdrawal is feasible and may not significantly increase the risk of acute rejection episodes.

Noninvasive positive pressure ventilation for patients with acnte respiratory distress syndrome as a result of CMV pneumonia after renal transplantation / 中华泌尿外科杂志

Objective To discuss the clinical application of noninvasive positive pressure ventila-tion for patients with acute respiratory distress syndrome (ARDS) as a result of cytomegalovirus (CMV) interstitial pneumonia after renaltransplantation. Methods There were 371 renal transplan-tation from March 2003 to October 2006, 27 patients were diagnosed as CMV pneumonia postopera-tion. Ten patients were treated with noninvasive positive pressure ventilation within the 11 patients who aggravated to ARDS. The clinical data of before and after mechanical ventilation were reviewed. Results Among patients received noninvasive positive pressure ventilation, 1 died of complication. Seven patients were cured by noninvasive positive pressure ventilation. Significant difference of the physiological index presented between the 7 patients cured with noninvasive positive pressure ventila-tion before and after the use of ventilation(P<0.05), and significant difference of the renal function also existed(P<0.05). Conclusion The major value of noninvasive positive pressure ventilation is to correct the hypoxemia.

Familial papillary thyroid carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features of familial papillary thyroid carcinoma (FPTC) and the criteria for its diagnosis and surgical treatment.</p><p><b>METHODS</b>One hundred and forty-five patients with PTC were investigated randomly between January 1999 and November 2001, and 17 of them were from 7 families. Of the 17 patients, 14 were operated on at this hospital, and 3 were operated elsewhere. The specimens from the 17 patients were confirmed pathologically. They accounted for 9.3% (14/145) of all PTC patients.</p><p><b>RESULTS</b>The patients were aged from 30 to 74 years (mean 45 years). The diameter of original focuses ranged from 0.8 to 2.8 cm (mean diameter 1.7 cm). Of the 17 patients with PTC, 8 (47.5%) had bilateral carcinoma. In 3 families, 3 patients suffered from PTC (42.8%). In 4 families, other members suffered from benign thyroid tumor or non-tumorous thyroid disease. Among the 17 patients, 10 had nodular goiters. Thyroidectomy, unilateral thyroidectomy plus isthmusectomy, and combined radical operation were performed in 8, 9, 14 patients, respectively. Early metastatic spread to local regional lymph nodes was noted in 14 patients (82.3% or 14/17).</p><p><b>CONCLUSIONS</b>In this study, a FPTC rate of 10% was found. Almost 50% of FPTC patients had bilateral carcinoma. The frequency of metastatic spread to local-regional lymph nodes was high. Follow-up survey of family members should be performed in a long period of time.</p>

Effect of monocyte/macrophages activated by CpG-oligodeoxynucleotides of bacteria on K562 cells / 中国病理生理杂志

AIM: To study the effect of monocyte/macrophages treated with CpG-oligodeoxynucleotides on leukemic K562 cells. METHODS: The monocytes/macrophages from peripheral blood cells were isolated and induced. The expressions of CD14 and CD16 on monocytes/macrophages were detected by means of flow cytometry. After treated with synthetic CpG-oligodeoxynucleotides, and nonCpG-oligodeoxynucleotides for 24 hours respectively, the inhibiting effect of monocyte/macrophages on K562 cells were detected using MTT method. The secretions of TNF-? and IL-12 from monocytes/macrophages were determined using ELISA method. RESULTS: The monocytes/macrophages treated with CpG-oligodeoxynucleotides enhanced their antitumor effect on K562 cells and increased the secretion levels of TNF-? and IL-12. Whereas, there was no significant difference between antitumor effect and cytokine secretion of the monocytes/macrophages treated with nonCpG-oligodeoxynucleotide. CONCLUSION: CpG-oligodeoxynucleotides increases the cytotoxicity of macrophages on K562 cells in vitro, as well as facilitates the IL-12 and TNF-? secretion. It provides a new approach for immunologic treatment of leukemia.