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Objective To explore the effect and significance of electronic account books on the management of anesthesia and psychotropic drugs. Methods The data of electronic account books from January 2020 to June 2020 in the inpatient pharmacy of the hospital (observation group), and manual account books from July 2019 to December 2019 (control group) were collected respectively. The data of daily accounting time, monthly settlement accounting time and accounting accuracy between the two groups were compared and analyzed. Results The daily average time for pharmacists to manually accounting was (162.8±22.5) min, and the daily average time for pharmacists to make accounts electronically was (33.2±7.0) min. It took (245.5±7.2) min for manual accounting of monthly settlement and (46.8±2.5) min for electronic accounting of monthly settlement. The accuracy rate of daily counting records, special account books, special register and empty ampoule waste paste recovery records included in electronic accounting is up to 100%. Conclusion The implementation of electronic account books not only significantly improved the work efficiency of pharmacists, but also strengthened drug supervision, formed a comprehensive traceability system, which could ensure the safety of clinical medication, and make the management of narcotic psychotropic drugs more efficient and standardized.
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Objective:To investigate the blood-brain barrier (BBB) permeability changes in the deep white matter (DWM) during hypoperfusion caused by asymptomatic cerebral artery stenosis.Methods:The CT perfusion weighted imaging (CTP) images of 36 patients with asymptomatic severe stenosis and unilateral internal carotid artery or middle cerebral artery, admitted to our hospital from January 2017 to April 2020, which revealed the prolongation of contrast medium delayed contrast medium max-time (Tmax), were analyzed. The regions of interest (ROIs) in the DWM of CTP images at the body of lateral ventricle and centrum semiovale, were drawn respectively: the anterior DWM (ROIa), middle DWM (ROIm), and posterior DWM (ROIp) in the stenotic side of maximum intensity projection maps; DWM with normal-appeared Tmax (ROI1), DWM with relatively delayed Tmax (ROI2), and DWM with obviously delayed Tmax (ROI3) in the stenotic side of Tmax maps; and their mirrored ROI on the healthy side. Statistical analysis was used to compare the value differences of Tmax, cerebral blood flow (CBF) and transfer constant (Ktrans) between/among the ROIs.Results:As compared with the mirrored ROI in the healthy side, respectively, the ROIa and ROIm in the stenotic side had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans at the body of lateral ventricle ( P<0.05). As compared with the mirrored ROI in the healthy side, respectively, the ROIa and ROIp in the stenotic side had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans at the centrum semiovale ( P<0.05). As compared with the mirrored ROI in the healthy side, respectively, the ROI2 and ROI3 in the stenotic side had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans at the body of lateral ventricle and centrum semiovale ( P<0.05). In the stenotic side at the body of lateral ventricle, as compared with the mirrored ROIp, the ROIa and ROIm had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans ( P<0.05). In the stenotic side at the body of lateral ventricle and centrum semiovale, as compared with the mirrored ROI1, the ROI2 and ROI3 had significantly prolonged Tmax, significantly decreased CBF, and significantly increased Ktrans ( P<0.05). Conclusion:The BBB permeability of DWM in the regions with delayed contrast medium Tmax is augmented when asymptomatic cerebral artery stenosis causes cerebral hypoperfusion.
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Muscle fatigue has widespread application in the field of rehabilitation medicine. The paper studies the muscle fatigue using surface electromyogram (sEMG) in the background of rehabilitation training system. The sEMG and ventilatory threshold of vastus lateralis, rectus femoris and erector spinae are collected synchronously and the electromyogram fatigue threshold (EMG ) of different sEMG was analyzed by increasing load cycling experiments of 10 healthy subjects. This paper also analyzes the effect of isotonic and isometric contraction on EMG . Results showed that the appeared time of EMG was earlier than that of ventilatory threshold in the incremental load cycling. While the differences were subtle and EMG was verified to be effective. EMG has been proven effective for different muscle contraction by comparing the EMG of vastus lateralis and erector spinae. EMG could be used to keep muscle injuries from overtraining in the process of rehabilitation. Therefore, EMG has a great significance for femoral shaft fractures's fatigue monitoring in rehabilitation training.
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Objective The antimicrobial peptide LL-37 ( LL-37) is the mature form of Human Cationic Antimicrobial Pep-tide of 18kD (hCAP18) and play a certain regulation role in the pathogenesis of asthma .However, the mechanism is unclear.The aim of this study was to investigate the role of inflammatory release from human eosinophils induced by the antimicrobial peptide LL -37 in the pathogenesis of asthma and the underlying mechanisms . Methods Sixteen mild or medium allergic asthma patients from January 2015 to January 2016 in Panzhihua college affiliated hospital were enrolled .Another 16 healthy volunteers were enrolled as control .Pri-mary eosinophils were isolated from peripheral blood .The cells were divided into two groups:asthma group and healthy control group . Cells were divided into blank , PAF, LL37, single cytokine ( IL-5, GM-CSF) and cytokines combined with LL-37 group based on in-tervention (cell treating factors) difference;Cells were divided into PTx, WRW4, suramin, and LL-37 combined with inhibitors group based on inhibitors difference;Cells were grouped into LTD 4 and LTB4 treatment based on leukotrienen difference;ELISA was applied to analyze cysteinyl leukotrienes ( cys-LTs) level in various treatment groups;Western blot was used to detect change of cPLA 2, p-cP-LA2, ERK1/2, p-ERK1/2 in the cells from the control group after PTx and WRW 4 treatment and the level of hCAP 18 after leukot-riene treatment. Results Compared with the control 15 μg/mL LL-37 sub group, the expression of Cys-LTs was increased in the control 30μg/mL LL-37 sub group 15 and 30 minutes after the LL-37 treatment [(54.02±7.15) pg/105 vs (37.86±6.33) pg/105, (53.30±6.99) pg/105 vs (36.27±6.46) pg/105, P<0.05].Compared with the control IL-5 sub group (26.18±4.86) pg/105, the ex-pression of Cys-LTs was increased in the control IL-5+15 μg/mL LL-37 sub group (59.97±6.83) pg/105 and the control IL-5+30μg/mL LL-37 sub group (81.44±13.70) pg/105(P<0.05).Compared with the control sub group , the expression of Cys-LTs was in-creased in the asthma 15 μg/mL LL-37 sub group and the asthma 30μg/mL LL-37 sub group ( P<0.05) .Compared with the control LL-37 sub group, the expression of Cys-LTs was decreased in the control PTx sub group , control WRW4 sub group, control suramin sub group, control PTx +LL-37 sub group, and control WRW4+LL-37 sub group (P<0.05).Western blot results indicated that LL-37 treatment induced the activation and phosphorylation of ERK 1/2 in eosinophil, and PTx and WRW4 blocked the upregulation of pERK1/2 induced by LL-37.Treatment with PD inhibited the phosphorylation of cPLA 2 and the release of Cys-LTs induced by LL-37. hCAP18 was higher in the asthma groups than the healthy control . Conclusion LL-37 was identified as an eosinophil-activating pep-tide that could trigger the release of inflammatory mediators , which might be involved in occurrence and development of asthma through regulating ERK1/2 phosphorylation, inducing cPLA2 phosphorylation and finally initiate synthesis of cys-LTs.This suggests that LL-37/hCAP18 and its signaling pathway might be potential therapeutic targets for asthma .
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Objective To investigate the invasion situation of cardinal ligaments(CL) in stage Ⅰ A2 - ⅡA2 cervical cancer and to find the high risk clinicopathological factors affecting its invasion .Methods The retrospective analysis was performed on the clinicopathological data in 2 982 patients with cervical cancer treated by operation extracted in 5 hospitals from January 2004 to De‐cember 2014 .Results (1) Totally 855 cases according with the research condition were included .The CL invasion was found in 20 cases(2 .3% ) .No CL invasion occurred in the stage ⅠA2 ,the CL invasion rate in the stage ⅠB1 was 1 .7% ,in the stage ⅠB2 was 1 .2% ,in the stage ⅡA1 was 5 .7% and in the stage ⅡA2 was 2 .9% .With the increase of FIGO staging ,the CL invasion rate had no significant increase(P=0 .269) .(2) The infiltration rate of left CL and right CL had no statistical difference among the stageⅠA2- ⅡA2(P=1 .000) .And the invasion rate of the left CL with different FIGO stages had no statistical difference(P=0 .286) , while the right one had statistical difference(P=0 .005) ,in which the highest was in the stage ⅡA1 (4 .3% ) .(3)The univariate a‐nalysis found that lymph‐vascular invasion ,cervical stroma infiltration depth ,pelvic lymph node metastasis ,uterus body infiltration and vaginal fornix infiltration were the risk factors of CL invasion(P<0 .01);the further multivariate analysis determined that the invasion of uterine body(OR=11 .858) ,pelvic lymph node metastasis(OR=6 .359 ,) ,vaginal fornix infiltration(OR=6 .012 ,) were the risk factors for CL invasion(P<0 .05) .Conclusion The invasion rate of CL invasion in early stage cervcial cancer is low .The invasion of uterine body ,pelvic lymph node metastasis and vaginal fornix filtration are the risk factors for CL invasion in the stageⅠA2- ⅡA2 cervical cancer .
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Objective To study effect of TCM-based syndrome differentiation combined with diet nursing and point massage on insomnia.Methods Five hundred and twelve patients with insomnia were randomized into control group(n=85)and intervention group (n=67).The patients in both groups received treatment by TCM-based syndrome differentiation.Besides,the control group was given conventional nursing while those in the intervention group received diet nursing and point massage.The two groups were compared in three months in terms of sleep quality and curative effect.Results In comparisons of sleep quality index,the two groups both had statistically significant improvements respectively(both P<0.05).In terms of time to sleep, duration of sleep an sleep efficacy and Pittsburg sleep quality index,the intervention group scored significantly lower than the control group(all P<0.05).In terms of curative effect,the intervention group was significantly higher than the control group(P<0.05).Conclusion The method of TCM-based syndrome differentiation combined with diet nursing and point massage is effective in improving the sleep quality of those with insomnia.
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ObjectiveTo discuss the effect of preoperative psychological communication on psychological state of elderly patients before destined operation.Methods136 cases of elderly patients underwent elective operation were divided into the observation group and the control group with 68 cases in each group,the control group was given routine nursing of general surgery,the observation group received targeted psychological communication based upon routine nursing for consecutive 3 days before surgery.The psychological state such as anxiety,depression and fear was compared between two groups.ResultsThe anxiety,depression and fear in the observation group was significantly improved compared with the control group.ConclusionsPreoperative appropriate and targeted psychological communication can alleviate the anxiety,depression and fear of the elderly patients with elective operation,and contribute to the smooth operation.
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Objective To explore the clinical curative effect of combined liposuction and direction areolar incision on gynecomastia. Methods Fourty-three patients,aged 14-36 years,were involved in this study,including fat type (n=15) and mixed fat and gland type (n =28).The hypertrophic mammary tissues were incised through a small incision (1.0-1.5 cm) after the tumescent liposuction.And tumescent liposuction technique was used again to make sure of the transition-layer more smooth.The incision was in compression bandage after surgery area and stitches taken out after 7 days.Results All the patients with gynecomastia were treated.The nipple-areola complex were all alive.The scar of incision was not obvious.Follow-up was done for 3 years,showing that configuration of the breasts was good.Conclusions The surgical procedure is simply,less haemorrhage and quick recovery,with good aesthetic effects,which deserves wide application.
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Objective To discuss the reduction mammaplasty procedures by reserving the T4 nerve and blood vessels and by repairing the ligament for macromastia patients. Meths Eighteen cases of macromastia were enrolled in this study. The supeior and inferior polar portions on the median line of the breast were dissected to form a central pedicle. Outside deep and fleet branches of the ligament were repaired and the lateral deep and fleet branches of the 4th intercostal nerve reserved in the pedicle. The pedicle was revolved and fixed, the fundus of breast was reduced and the tensile force of the ligament was enhanced. The operation of two-flap rotated flaps reduced the breast volume from inside to the outside. The corium where T4 intercostal nerve distributed skin was reserved to protect the fleet branches of the nerve, and then rotated and fixed to act as a fibrous septum. Results After the operation, the blood vessel and feeling of nipple-areola complex were all satisfactory and the profile of breast was tall and straight. Follow-up from 3 months to 2 years (7 months in average) showed that the scar was unconspicuous, the appearance of the breast was not evidently changed and the patients were satisfactory. Conclusion It is a simple and well-designed procedure of reduction mammaplasty for macromastia with repaired ligment and reserved 4th intercostal nerve. The breast profile is tall and straight after the operation.
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Objective To introduce the clinical design of the portable and moveable laser light for simulation immobilization.Methods According to the theory of the laser immobilization system,the setting is designed by using current material,such as a ruler of ?-shape and pillar-shape laser light etc.After installation and adjustment,it is used in clinic.Results Patient can be immobilized by CT and this setting.Being simple to operate and convenient to use,this setting can act for the expensive laser position system.Conclusion The material and creation of this setting are rougher,so it needs improvement to insure the accuracy of position.
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Objective To discuss the three-dimensional conformal radiotherapy(3D-CRT) plan for pancreatic tumors.Methods The 3D-CRT plan of 30 cases of primary pancreatic cancer were designed according to the request of the doctors for PTV and the restricted receiving dose of the peripheral normal sensitive organs.The best plan was chosen referring the dose-volume histogram.Results By using ICRU dose reference point(the central point of target)as theunitary dose,95% dose line could be surrounded above 95% of the PTV.Conclusion The focus in different localization can be treated with different design in treating the pancreatic tumors.The reaction to radiotherapy is directly influenced by the volume and dosage of radiation to the normal hepatic tissues.
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The quality assurance method for the medical linear accelerator of large-scale radiotherapy equipment is introduced,whose periodic detection and adjustment are discussed.
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The precision radiotherapy adopts the accurate fixation,immobilization,spacial orientation and 3-dimensional calculation & display methods.On three-dimensional direction,stereotactic conformal or intensity modulated radiation therapy with conventional or non-conventional segmentation method is used.So the high dose area is identical with the target on three-dimensional and the dose intensity modulated in the target.It aims to decrease or not increase the radiation dose in the normal organs and tissues around the target when increasing the radiation dose in the tumor target.The technology can improve the partial control rate and the living quality of the patients.
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Objective To explore the methods and effects of body fractionated stereotactic radiotherapy(X-knife) in the treatment of lung metastases.Methods There were 50 cases with lung metastases were treated by fractionated stereotactic radiotherapy using CT orientation and WiMRT model body X-knife.The diameter of the metastases was 1.0cm-5.0cm.The linear accelerator was 6Mv X-ray.The dose per fraction was 5-12Gy,and the total prescribed dose was 30-52Gy at the margin of the PTV enveloped by 90% insodose curve.Results The metastases complete regression was found 21 fo-cus(18.3%)in CT image,partial regression in 70 focus(60.9%),and the overall effective rate was 79.1%.The effective rate for the focus with diameter less than 3cm was 88.5%,and 59.4% equal or more than 3cm,there was significan differ-ence(P
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The cuniform gene of arbitrary angle cuniform board is computed through electric standard cuniform board.
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AIM: To investigate the dynamic expression of Rho kinase(ROCK I) and transforming growth factor ?1(TGF-?1) in pulmonary arterioles of rat with chronic thromboembolic pulmonary hypertension.METHODS: Sixty-four male Wister rats were randomly divided into eight groups: beginning control group,embolism for 3 d,1 week,2 weeks,4 weeks,8 weeks,12 weeks groups and end control group.The pulmonary thromboembolism(PTE) model was established by injecting thrombin into jugular vein two times in two weeks and each rat underwent peritoneal injection with tranexamic acid one time a day during experiment to prevent thrombolysis.The mean pulmonary artery pressure(mPAP),right ventricular hypertrophy index(RVHI),relative medial thickness of small pulmonary arteries(PAMT) and vessel wall area/total area(WA/TA) were measured.The levels of ROCK I mRNA and TGF-?1 protein in rat pulmonary artery were determined by in situ hybridization,immunohistochemistry and image analysis,respectively.RESULTS: mPAP,PAMT and WA/TA were higher respectively in embolism from 4 weeks group to 12 weeks group than those in beginning control group(mPAP: all P