Construction and feasibility study of the intervention model of advance care planning for patients with advanced cancer / 中国实用护理杂志

Objective:To test whether the constructed intervention model of advance care planning (ACP) for patients with advanced cancer can be successfully implemented and the preliminary intervention effect, which provides reference for empirical research.Methods:32 cases of advanced cancer patients and 25 cases of their families at the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai were selected. The patients were subdivided into the experimental group and the control group by random number table method. The control group received routine nursing, while the experimental group adopted the intervention model of "VIP for future care" on the basis of customary nursing. We measured the main outcome indicators: enrollment rate, consent rate, completion rate and loss of follow-up rate and secondary outcome indicators: decision-making certainty, end-of-life care preference and post-intervention satisfaction of patients and their families, within 1 week and 1 month after intervention.Results:The enrollment rate, consent rate and loss of follow-up rate were 74.6% (206/276), 36.9% (76/151)and 15.6% (5/32), respectively. After intervention, the completion rates of the experimental group and the control group were 16/16 and 15/16 within one week, and 14/16 and 13/16 within one month. All of the family members were conducted during the follow-up period. The intervention mode of "VIP for future care" had a statistically significant difference in decision-making certainty between the two groups of patients ( β=0.63, 95% CI 0.08-1.18, P<0.05), no statistically significant difference in end-of-life care preference between the two groups of patients and their families ( P>0.05), and had a statistically significant difference in "whether to recommend this project to others" between the two groups ( χ2 value was 4.167 , P<0.05). Conclusions:On the premise of sufficient preparation, the "VIP for future care" intervention mode can be successfully implemented in advanced cancer patients in mainland China, can improve the decision-making certainty of patients and the satisfaction of patients and their families, and it is recommended. And should be applied to ACP intervention for patients with advanced cancer.

Morphology character and reduction methods of sagittally unstable intertrochanteric fractures / 北京大学学报(医学版)

Objective:To investigate the morphology character of sagittally unstable intertrochanteric fractures and reduction methods.Methods: A retrospective study was used to analyze the clinical data of sagittally unstable intertrochanteric fractures cases,which were treated with proximal femoral nail anti-rotation (PFNA) fixation from March 2009 to June 2016.In the study,36 cases were followed up completely,in which 17 cases accepted open reduction,and the other 19 cases accepted minimally invasive reduction.The operation time,amount of bleeding,the fluoroscopy times,postoperative radiographic measurements,such as tip-apex distance (TAD) and sliding distance of the spiral screw,and hip Harris scores were analyzed.The morphology character of the fractures was documented and investigated.Results: The average follow-up time was 15 months.The amount of bleeding of the open reduction group was (170.5±19.7) mL,and the amount of bleeding of the minimally invasive group was (54.7±12.5) mL.The amount of bleeding of the minimally invasive group was significantly less than that of the open reduction group (P<0.001).Between the two groups,there were no significant differences in other evaluation parameter,including operation time (P=0.054),the fluoroscopy times (P=0.053),fracture healing time (P=0.305),postoperative radiographic measurements,such as TAD (P=0.317) and sliding distance of the spiral screw (P=0.206),and hip Harris scores (P=0.459).In regard to morphology character of the fractures,the proximal anterior unstable fractures with separation displacement were more common than the proximal posterior unstable fractures with impaction.The characteristic feature of the proximal anterior unstable fractures was the proximal anterior and medial long oblique fracture,and a V shape cortical defect in the distal fracture fragment on the externally rotation X-ray.Conclusion: Sagittally unstable intertrochanteric fractures can be divided into the proximal anterior unstable fractures with separation displacement,and the proximal posterior unstable fractures with impaction.The two types have their own morphology character individually.The reduction should be performed by minimally invasive techniques.

Laboratory evaluation and field trial of activation indigenous microbial displacements in the reservoirs after polymer flooding / 生物工程学报

Most main oilfields in China have already entered a "double high" development stage (high water cut, high recovery degree). To further enhance oil recovery in reservoirs after polymer flooding (RAPFs), an efficient activator formulation for promoting metabolism of endogenous microorganism was studied by aerogenic experiments, physical simulation experiments, electron microscopy scanning and pyrophosphate sequencing. Results show that the activator could activate the endogenous microorganisms in the injected water and make the pressurized gas reach 2 MPa after 60 d static culture of the activator in a high pressure vessel. The oil recovery efficiency of natural core physical simulation flooding can be improved by more than 3.0% (OOIP) in RAPFs when injected 0.35 PV activator with 1.8% mass concentration, and a lot of growth and reproduction of activated endogenous microorganism in the core was observed by electron microscopy scanning. Field trial with 1 injector and 4 producers was carried out in the east of south II block of Sa Nan in December 2011. By monitoring four effective production wells, changes of carbon isotope δ13C (PDB) content of methane and carbon dioxide were -45 per thousand to -54 per thousand and 7 per thousand to 12 per thousand. Compared with east II of Sa Nan block, the oil amount increased by 35.9%, water cut stabled at 94%. The incremental oil was 5 957 t during the three and a half years, which provides an alternative approach for further improving oil recovery in similar reservoirs.

Decrease in γδV 2T cells correlates with severity of liver injury and fibrosis in patients with chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the characteristics and clinical significance of changes in gamma delta T cells in patients with chronic hepatitis B (CHB), including during the immune tolerant (IT) phase and the immune activated (IA) phase.</p><p><b>METHODS</b>Flow cytometry was used to analyze the frequencies and absolute numbers of γδT cells and their subsets in peripheral blood and in liver from 80 CHB cases, including 20 IT carriers and 60 IA patients. Blood samples were obtained from all CHB cases and 5 healthy controls (HCs). Liver biopsies were collected from 22 IA patients and 5 IT carriers undergoing diagnosis, and from the 5 HCs.</p><p><b>RESULTS</b>Compared to HCs and IT carriers, the IA patients displayed significantly lower levels of peripheral and intrahepatic γδT cells as well as the Vδ2 subsets. The levels of peripheral and intrahepatic VγδT cells were closely associated with the liver histological activity index and serum alanine aminotransferase levels.</p><p><b>CONCLUSION</b>γδT cells, especially the Vδ2 subsets, may play a protective role in decreasing liver damage in CHB patients.</p>

Prognostic value of APACHE Ⅱ score in patients with severe acute organophosphorus poisoning / 重庆医学

Objective To explore the prognostic value of APACHE Ⅱscore in patients with Severe acute organophosphorus poi-soning .Methods 42 patients with Severe acute organophosphorus poisoning ,in which 34 cases survived ,8 cases dead ,were select-ed .The APACHE Ⅱscores of patients in first 24 h of admission were collected ,and receiver operating characteristic curves (ROC curve) were drawn .Results APACHE Ⅱ score of the 42 patients with Severe acute organophosphorus poisoning was 18 ~30 (20 .11 ± 6 .32) ,in which the survival group was(16 .10 ± 3 .12) ,the dead group was(28 .01 ± 4 .46) (P<0 .01) .With the increase of APACHE Ⅱ score ,the fatality rate gradually increased .The total area under the ROC curves of APACHE Ⅱ score for death judgment was 0 .922 ,APACHE Ⅱ score of 21 .2 was the best diagnostic point ,the sensitivity was 95% ,and specificity was 89% . Conclusion The APACHE Ⅱscore could predict severity of patients with Severe acute organophosphorus poisoning ,and APACHEⅡscore ≥21 .2 could be used as the prognosis for death of the patients .

Effects of head peripheral nerve block on remifentanil consumption and postoperative pain in patients undergoing craniocerebral surgery / 实用医学杂志

Objective To investigate the effects of the head peripheral nerve block on remifentanil consumption and postoperative pain in patients undergoing craniocerebral surgery. Methods 80 patients under general anesthesia undergoing supratentorial craniocerebral surgery were randomly divided into two groups:the head peripheral nerve block combined intravenous anesthesia group (group S, 40 cases) and the simple intravenous anesthesia group (group C, 40 cases). After anesthesia induction intubation, the patients in group S received the head peripheral nerve block with 0.596% ropivacaine mesylate injection,including supraorbital nerve, supratrochlear nerve , auriculotemporal nerve , great occipital nerve and lesser occipital nerve , as well as regional nerve on the corresponding position of the bilateral head nails. Haemodynamic index of the operations was measured;drug consumption during operation and VAS pain score at 0. 5, 2, 6, 12, 24 and 48 h after surgery were recorded. Results Compared with group C, the values of SBP, DBP, HR had a significant decrease at head-nail insertion and the latter stage in group S(P<0.05). The remifentanil consumption and VAS scores had a significant decrease in group S (P < 0.05). Conclution Head peripheral nerve block before operation could enhance anesthesic analgesia, reduce the remifentanil consumption and postoperative pain in patients undergoing craniocerebral surgery.

Phosphoproteomic investigation of Clostridium acetobutylicum / 生物工程学报

Protein phosphorylation in bacteria is important for signaling and metabolic activity. Clostridium acetobutyicum can synthesize high yield of organic solvent under acidic condition. How solventogenesis is regulated at molecular level in this bacterium, is not clearly elucidated yet. We used two dimensional electrophoresis (2-DE) and mass spectrometry to have a differential analysis of the bacterial proteins from Clostridium acetobutylicum at acedogenic and solventogenic stage. We focused on these iso-spots with similar molecular mass and different pI values. Totally, eight string spots were identified, which displayed significant changes of pI values as well as spot volumes in response to solventogenic development. The data acquired from mass spectrometry demonstrated that all of the iso-spots contained the phosphrylated peptides. Bioinformatic analysis revealed that these proteins partake in the pathways of solvent synthesis.

Features of circulating Th17 cells in chronic HBV infection patients whole responsed to pegylated in-terferon α-2a treatment / 中国医师杂志

Objective To invetigate the feature of Th 17 cells in chronically HBV-infected patients whole responsed to pegylated interferon α-2a treatment.Methods Serum and PBMCs were obtained from enrolled CHB patients and health controls and monitored for ALT , HBV DNA, HBV Markers as well as the frequency of IL-17 +T cells.Results The frequency of IL-17 +,IL-17 +IFN-γ+and IL-17 +IFN-γ-T cells increased in whole response time point and decreased in followed 6 month ;and lower than that of health controls at any group .Conclusion Tteatment with pegylated interferon α-2a minght effect the fre-quency and composition of Th 17 cells, which effect the immune regulation in the disease .

Open acromioplasty for acromion impingement syndrome combined with rotator cuff injury / 中华创伤骨科杂志

Objective To evaluate open acromioplasty for treating acromion impingement syndrome combined with rotator cuff injury. Methods From March 2004 to August 2007, 20 cases of acromion impingement syndrome combined with rotator cuff injury were treated in our department. During open acromioplasty, we repaired the rotator cuff, and reconstructed the insertion site with anchor screws for patients who had been diagnosed as complete rupture of superspinatus tendon. Postoperative rehabilitation program was conducted and all patients were followed up at our outpatient clinic. ASES (American Shoulder and Elbow Surgeons) scoring system was used to assess the outcome of the patients. Results Eighteen patients were followed up regularly for an average of 11 (6 to 13)months. The mean ASES score was 90. 5 postoperatively. A significant difference was found between the preoperative and postoperative ASES scores in this group (t= 13.865, P<0.01). Conclusion Open acromioplasty can achieve good outcome in treatment of acromion impingement syndrome combined with rotator cuff injury, and can be carried out by primary hospitals.

Determination of insulin resistance index and its clinical significance in chronic liver disease related to hepatitis B virus / 解放军医学杂志

Objective To investigate the role of insulin resistance index (HOMA-IR) in premonishing hepatogenous diabetes subsequent to chronic liver disease related to hepatitis B virus. Methods Fasting plasma glucose (FPG) and fasting serum insulin (FINS) were measured in 176 patients, including 80 patients with chronic hepatitis B (CHB), 66 patients with liver cirrhosis (LC) and 30 patients with chronic severe hepatitis B (CSHB). In addition 30 healthy subjects served as control (group HC). None of the subjects in the study had a history of diabetes. FPG and FINS were measured in all the subjects to exclude impaired glucose tolerance and diabetes. Then HOMA-IR was calculated. Results Among the HC and CHB, LC and CSHB patients, both FINS and HOMA-IR levels gradually elevated. FINS and HOMA-IR in CHB patients (10.58?6.48, 2.35?1.55) were significantly higher than those in group HC (8.06?2.14,1.68?1.53), while lower than those in LC (12.73?5.88, 2.91?1.41) and CSHB (18.30?14.17, 4.35?3.17) patients (P0.05), while the values of FINS and HOMA-IR were significantly higher in severe patients than those in moderate patients (P0.05), while the values of FPG were significantly higher in LC and CSHB patients than those in group HC (P