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Objective To assess the clinical efficacy of vitrectomy with intravitreal ranibizumab (IVR) at different injection time for proliferative diabeticretinopathy (PDR).Methods This was a prospective,comparative,and randomized study.Ninety-seven eyes of 97 patients were enrolled and randomly assigned to three different treatment groups:30 eyes (30 patients) in the preoperative IVR group,32 eyes (32 patients) in the intraoperative IVR group and 35 eyes (35 patients) in the no IVR injection group.The best corrected visual acuity (BCVA) (F=0.18) and the grading of vitreous hemorrhage (x2 =1.39) before surgery did not differ significantly among the 3 groups,respectively (P ＞ 0.05).All eyes enrolled underwent conventional 23-gauge pars plana vitrectomy (PPV).The preoperative IVR group received intravitreal 0.5 mg/0.05 ml ranibizumab injection 3 to 7 days before PPV,intraoperative IVR group received intravitreal 0.5 mg/0.05 ml ranibizumab injection at the end of PPV and non-drug injection group received PPV only.Postoperative BCVA,fundus color photography,optical coherence tomography examination was performed in all eyes at 1 week and 1,3,6,9,12 months after surgery.Early RVH was defined as RVH occurred within 1 week to 1 month postoperatively;while late RVH was defined as RVH occurred 1 month later after the operation.Results The mean BCVA were all improved among the 3 groups compared with the preoperative vision at 1 month after operation.At the beginning of 3 months after surgery,the average BCVA of the preoperative injection group and the intraoperative injection group tended to stable;while 3 eyes in the non-drug injection group began to decreased.There was no significant difference in average BCVA at 1,3 and 12 months of follow-up periods among the 3 groups (F=1.42,1.17,0.26;P＞0.05).The incidences of early RVH were 16.7％,9.4％,28.6％ in the preoperative injection group,intraoperative injection group,and non-drug injection group,respectively (x2 =5.12,P＜0.05).The incidence of early RVH in the intraoperative injection group reduced compared to preoperative injection group and non-drug injection group (x2 =4.04,4.93;P＜0.05).The incidences of late RVH were 13.3％,9.4％,14.3％ in preoperative injection group,intraoperative injection group,and non-drug injection group,respectively (x2 =0.47,P＞0.05).The average centeral foveal thickness (CFT) decreased among the 3 groups in different degrees at 1 month when compared with that of 1 week after operation and the decreasing was statistically significant (F=59.50,P＜0.05).A subgroup pairwise analysis showed no significant difference of decreasing CFT in preoperative injection group compared with that of intraoperative injection group (t=0.23,P＞0.05).The average CFT of the 3 groups had different degrees of thickening at 3,6,9,12 months after surgery,and the increasingof CFT among the 3 groups were not differ significantly (F=2.92,2.86,3.07,3.12;P＞0.05).Conclusions The adjunctive use of IVR can reduce the incidence of early postoperative RVH in vitrectomy for PDR,decrease in macular thickness and obtain favorable visual recovery.The effect of preoperative IVR injection was slightly better than that of the intraoperative IVR injection.
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Objective To explore the application effect of critical thinking applied in the intravenous infusion.Methods To give nurses who worked in the Neurosurgery Department from January to April 2012 training lessons of critical thinking so that they could analyze,judge,formulate and implement corresponding nursing measures during the intravenous infusion process through their critical thinking.Then the successful rate of venepuncture for patients and the patients' satisfaction degree with nursing before and after the critical thinking training lessons were observed.Results The successful rate of venepuncture for patients and the patients' satisfaction degree of nursing were apparently improved after the nurses received critical thinking training.The difference was of statistical significance.Conclusions After the implementation of critical thinking training during the intravenous infusion process for nurses,nurses puncture skills is enhanced,infusion swelling and complications are reduced,and the quality of clinical nursing care and patients' satisfaction degree of nursing is improved.
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Objective To determine the molecular mechanism of berberine (BBR) inhibiting the metastasis and invasion of nasopharyngeal carcinoma 5-8F cells, and identify whether berberine suppresses the tumor-invasive action through inhibiting Ezrin or phosphate-Ezrin. Methods The non-cytotoxic concentration of berberine was detected by MTT assay. Filopodia formation of 5-8F cells was observed by electron microscope. The invasion and motility of 5-8F cells with berberine treatment were measured with Trans-well assay. Western blot was used to investigate the Ezrin and phos-Ezrin expression in 5-8F cells treated by berberine. pcDNA3.1-Ezrin and pcDNA3.1-Ezrin M were transfected into 6-10B cells. The inhibitory effect of berberine on the motility and invasion of 6-10B-pcDNA3.1-Ezrin and 6-10B-pcDNA3.1-Ezrin M was detected, respectively. Results Berberine non-cytotoxic concentration was 0-40 μmol/L. After being treated by berberine, filopodia of 5-8F cells obviously reduced, and the permeating artificial basement membrane cells largely decreased in both time- and concentration-dependent manner. There was significant difference compared with the control group (P<0.05). Berberine suppressed the phos-Ezrin expression of 5-8F cells in both time- and concentration-dependent manner (P<0.05), but the effect of berberine was weaker on 6-10B-pcDNA3.1-Ezrin M than on 6-10B-pcDNA3.1-Ezrin. Conclusion Berberine inhibits nasopharyngeal carcinoma cell invasion through inhibiting phos-Ezrin expression and filopodia formation.
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Objective To evaluate the effect of relaxation training combined with listening to music on controlling the pain of patient with intracranial aneurysm before interventional therapy.Methods To determin the pain degree and subjective reception of the patients on admission and after relaxation training combined with listening to music.Results Pain degree relieved obviously after relaxation training combined with listening to music[(7.31±2.24)vs(3.76±2.12),P＜0.01];self-made questionnaire showed the positive evaluation of relaxation training combined with listening to music was 95%.Conclusion Relaxation training combined with listening to music can relieve the pain and general malaise bacause of absolute bedrest before interventional therapy.
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Objective To improve the sleep quality of patients by evaluating the effect of relaxation training in combination with listening to music on sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy. Methods 55 patients who reached the entrance standard were divided into the observation group (28 cases)and the control group(27 cases).The control group received routine nursing measures. The observation group were given relaxation training in combination with listening to music based on routine nursing measures. The sleep quality was appraised by Pittsburgh Sleep Quality Index (PSQI) and patients subjective feeling was investigated by self-designed questionnaires. Results The relaxation training in combination with listening to music ameliorated the sleep quality in the observation group compared with that of the control group(P＜0.01).Conclusion The relaxation training in combination with listening to music could improved the sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy.
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Objective To approach the effect of bed exercise for patients with intracranial aneurysm undergoing neural interventional treatment. Methods Ninety-six patients with intracranial aneurysm were divided into the test group(50 cases) and control group(46 cases).The control group received routine nursing, while the test group carried out bed exercise base on routine nursing. The incidence of complica-tions and changes of life quality were compared between the 2 groups. Results Lower incidence of com-plications took place in the test group than the control group(P ＜ 0.05).But changes in pulse rate and blood were not significant (P ＞ 0.05).The score of life quality in the physical domain and psychological domainwere not statistically different between the two groups (P ＜ 0.01 ),but no evident difference was seen in the domain of social relationship and environmental domain (P ＞ 0.05). Conclusions Bed exercise could al-leviated the anxiety and trepidation of patients with intracranial aneurysm,decrease the incidence of compli-cations such as body pain caused by absolute bed rest,thus improve patients' life quality.
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Objective To study the effect of relaxation therapy on sleeping quality of patients with post cran- iocerebral traumatic syndrome. Methods 90 cases with sleep disorders were randomly divided into the treatment group and the control group. The control group was given routine care and the treatment group was given relaxation therapy combined with routine care. Take pittsburgh sleep quality index (PSQI) as evaluation criteria. Results There was significant difference between the two groups( P < 0.01 ). Sleep quality was more improved by relaxation therapy in the experimental group than that of the control group. Conclusion Relaxation therapy can effectively im- prove sleep quality in patients with post craniocerebral traumatic syndrome.
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Objective To investigate the influence of early rehabilitation on the recovery of patients who have undergone the low rectal cancer resection. Methods 130 patients with low rectal cancer resection were divided into the rehabilitation group and the control group randomly, there were 65 cases in each group. The control group were accepted the routine nursing care, and the rehabilitation group were accepted the early recovery intervention. Compared the time of anus exhaust, the time of stomach extubation, the incidence rate of postoperative complication, the time of bed rest and the quality of postoperative life in these two groups. Results All the indexes which have compared between these two groups were significant better in the rehabilitation group than those of in the control group, P
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OBJECTIVE To analyze the correlation factors of nosocomial infection in patients after receiving craniocerebral operation.METHODS Totally 388 hospitalized patients after receiving craniocerebral operation from Jan 2006 to Dec 2006 were studied retrospectively.RESULTS From them 45 pateints were suffering from nosocomial infection and total incidence of nosocomial infection was 11.59%.Among them,60.0% was lower respiratory tract infection,11.11% was surgical wound infection and 8.89% was upper respiratory infection.Aging,length of stay and invasive operation(deep vein needle detaining,trachea incision,tracheal intubation,urinary canal and drainage tube dwelling) were the main correlation tactors.CONCLUSIONS Minimizing invasive operation and early removing various kinds of dwelling tubes,using antibiotics correctly,improving hospitalizd environment and strengthening wards management are the measures to reduce nosocomial infection according its correlation factors.