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Objective@#To analyze the status of sleep disorders and their influencing factors among Tibetan secondary school students in high altitude areas in China, so as to provide a reference for the improvement and intervention of sleep quality among Tibetan secondary school students in high altitude areas.@*Methods@#From April to July, 2022, a questionnaire survey on demographic factors, sleep disorders, and lifestyle was conducted on 5 486 Tibetan secondary school students in the Lhasa, Shigatse, and Nagqu regions of Tibet, China, using stratified whole-group sampling. Descriptive statistics and Logistic regression analysis were used to analyze the sleep disorders of Tibetan secondary school students and their influencing factors.@*Results@#The average score of PSQI for Tibetan secondary school students at high altitude was (5.67±3.23), and the detection rate of sleep disorders (PSQI>7) was 24.72% . There were significant differences in the prevalence of sleep disorders among different grades ( χ 2=23.95, P <0.01). Logistic regression analysis showed that interpersonal sensitivity, depression, anxiety, academic stress, falling asleep after midnight, sleep environment, and parental sleep disorders were positively associated with the occurrence of sleep disorders among Tibetan secondary school students ( OR =2.74, 1.68, 2.62, 1.32, 2.02, 1.85, 2.61, 1.31, 2.19, 2.88, 4.91, 2.94, 2.51, 1.36, P <0.05).@*Conclusion@#Tibetan secondary school students in high altitude areas have poor sleep quality and widespread sleep disorder problems, which should be given intervention and improvement. Schools and families should give secondary school students more guidance on appropriate exercise, and reduce academic stress to improve sleep quality and ensure healthy physical and mental development for secondary school students.
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Objective:To investigate the feasibility of using spectral CT chest enhancement venous phase images to obtain virtual non-contrast (VNC) images and virtual arterial phase images to achieve one phase scan instead of three phase scans.Methods:Imaging data of 100 patients who underwent spectral CT chest plain and dual-phase enhancement scans at the First Affiliated Hospital of Kunming Medical University from January to May 2022 were analyzed retrospectively. The venous phase images of all patients were post-processed to obtain virtual non contrast (VNC) and 40 keV virtual mono-energy images (VMI) for simulated arterial phase images (Vart). Image quality and lesion detection were compared between true non-contrast (TNC) and VNC images, and conventional arterial phase (CIart) and Vart images by paired t-test, Wilcoxon test and McNemar test. Objective evaluation indexes of image quality included thoracic aorta, all levels of pulmonary artery, T4 vertebral bone cancellous, chest wall fat CT value, background noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR); the subjective score of image quality was assessed by double-blind method on a 5-point scale; the assessment of lesion detection included the detection rate of calcified foci and pulmonary nodules size, density, volume, percentage of solid components and imaging characteristics. Results:Except for chest wall fat and T4 vertebral bone cancellous, the differences in CT values between VNC and TNC images were not statistically significant ( P>0.05); Except for right upper pulmonary artery and right lower pulmonary artery, the differences in background noise values and SNR between TNC images and VNC images were statistically significant ( P<0.05). Compared with CIart images, the CT values of chest wall fat were lower in Vart images ( P<0.05), and the CT values of the remaining sites were significantly higher ( P<0.05); the background noise values of all sites on Vart images were smaller than those on CIart images, and the SNR and CNR values were higher than those on CIart images ( P<0.05).The differences of subjective scores of images quality were not statistically significant between TNC and VNC images, between CIar and Vart images ( P>0.05). Taking TNC as the standard, the overall detection rate of VNC for calcification was 88.53% (301/340). Except for the short diameter of partially solid nodules, the differences of qualitative and quantitative assessment indexes of lung nodules between TNC and VNC images were not statistically significant ( P>0.05). Conclusions:Spectral CT chest venous phase 40 keV VMI can simulate arterial phase images in the diagnosis of vascular lesions, and venous phase VNC basically meets the standard of conventional plain scan, so it is feasible to replace plain scan, arterial phase and venous phase images in a certain range.
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Objective:To retrieve and summarize the best evidence related to the management of insulin injection-related sharps waste disposal in diabetic patients at home and abroad, so as to provide reference for clinical healthcare professionals.Methods:This was a evidence-based research. Evidence on insulin injection-related sharps waste management in patients with diabetes, including guidelines, expert consensus, evidence summaries, best practice information sheet, recommended practices, clinical decisions and systematic reviews was systematically searched from domestic and international databases and professional websites, and the search time frame was from the establishment of the database to December 2021. Evidence was extracted and summarized following a quality evaluation of the literature that met the criteria.Results:A total of 15 papers were included, summarizing 25 pieces of best evidence on four areas including risk assessment and management of sharps waste associated with insulin injections, education and training, and the use of safe devices and sharps containers.Conclusions:Best evidence on the management of insulin injection-related sharps waste disposal provides evidence to support clinical practice for healthcare professionals to standardized sharps waste disposal practices in patients with diabetes.
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Objective:To understand the causes of improper disposal of discarded insulin pen needles at home in diabetic patients.Methods:Using descriptive phenomenological research method, semi-structured interviews were conducted in November 2021 with 18 patients with diabetes from the outpatient department of Shanghai University of Medicine & Health Sciences Affiliated Sixth Peoples Hospital South Campus (Shanghai Fengxian District Central Hospital), and Colaizzi seven-step analysis method was used to extract the themes.Results:The reasons for improper disposal of discarded insulin pen needles at home by diabetic patients included misconceptions about methods for safe disposal of needles, low awareness of safe disposal of needles, fear of needle stick injuries, lack of social support, time and distance conflict and economic burden.Conclusions:Medical staff should pay attention to health education to increase patients′ knowledge about safe disposal of needles. The collection program was optimized to alleviate patients′ fear of safe disposal of needle. At the same time, multiple support should be given to improve patients′ compliance with safe disposal of needle.
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AIM To develop a UPLC-MS/MS method for the simultaneous content determination of adenosine,salidroside,chlorogenic acid,calycosin-7-O-β-D-glycoside,specnuezhenide,calycosin,formononetin,quercetin,apigenin and astragaloside Ⅳ in Zhenqi Fuzheng Capsules (Ligustri lucidi Fructus and Astragali Radix).METHODS The analysis of methanol extract of this drug was performed on a 40 ℃ thermostatic Inertsutain C18 column (75 mm × 3.0 mm,2 μm),with the mobile phase comprising of methanol-acetonitrile-4 mmol/L ammonium acetate flowing at 0.5 mL/min in a gradient elution manner.RESULTS Ten constituents showed good linear relationships within their own ranges (r≥0.996 0),whose average recoveries were 95.1％-104.3％ with the RSDs of less than 4.20％.CONCLUSION This sensitive and specific method can be used for the rapid quality control of Zhenqi Fuzheng Capsules.
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Objective To explore the application effect of interactive health education in insulin injections of aged patients with type 2 diabetes in the incipient stage of diagnosis and treatment. Methods 100 cases of aged patients with type 2 diabetes were hospitalized into endocrinology department from January 2014 to December 2014, the pen insulin injections were conducted for them at the beginning. They were equally divided into experimental group and control group through random number method. And, the general education guidance was conducted in control group. Meanwhile, the diabetes health education team was established in observation group on the basis of control group. Then, it was educated through the interactive lectures, interviews, teaching, repeated teaching, psychological intervention and individual assessment. Before and after education, the KAP survey of standard insulin injections were used for the patients in two groups to evaluate their degree of proficiency in the knowledge and skills about insulin injections, and the incidence of glucose metabolism level and low blood sugar. Results After intervention, the insulin injection skill in observation group was better than that of in the control group, (64.6%,31/48 vs. 24.5%, 12/149,χ2=16.441, P<0.01), while the level of glycosylated hemoglobin was reduced from (7.95±0.65)%to (6.58±0.62)%(t=7.85, P<0.01). Conclusions In the incipient stage of diagnosis and treatment, the ability of aged patients with type 2 diabetes in learning new knowledge and technology was improved through interactive health education mode. Besides, the insulin injections were standardized. Also, the glucose metabolism was improved, and the incidence of hypoglycemia was significantly reduced to ensure the patients′safety when the insulin was injected outside hospital, which was worth being clinically applied and promoted.
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Objective To develop a new high performance liquid chromatography (HPLC ) coupled with Evaporative Light Scattering Detector (ELSD) method for simultaneous determination of two indicative components (peimine and peimi-nine) in Xiaoer Baotaikang granules .Methods The analysis was performed on a Thermo C18 column (250 mm × 4 .6 mm , 5 μm) by using a mobile phase consisted of acetonitrile-water and diethylamine (65 ∶ 35 ∶ 0 .03) ,and the flow rate was 1 .0 ml/min;ELSD parameters :the temperature of drift tube was 85 ℃ and the carrier gas flow rate was 2 .2 L/min .Results The linear ranges of peimine and peiminine were 0 .586~5 .860 μg (r=0 .999 6) and 0 .564~5 .640 μg (r=0 .999 9) ,respec-tively .The average recovery rate for peimine and peiminine was 99 .44% (RSD was 0 .7% ) and 98 .56% (RSD was 1 .0% ) , respectively .Conclusions The method is sample ,accurate and reproducible ,which could be used for the quality control of Xiao-er Bao taikang g ranules .
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Objective To understand the experiences and suggestions for clinical practice training of emergency nurses in suburb of Shanghai City,and to provide theoretical basis for further improving clinical practice training of nurses in emergency department.Methods Using the phenomenological methods and Colaizzi 7 step analysis method to refine the theme,11 interviews were conducted.Results Respondents believed emergency nurses in clinical practice training was important; Training content should follow the training outline and needed appropriate extension according with the demand of the regional students,and help to improve the students' practical ability to work.The students hoped to gain more knowledge.PBL teaching method and situational simulation assessment mode were used.The teachers' solid professional knowledge,skills,and teaching ability and professional dedication were strong.Conclusions We should listen to the voices of training students,adopt relevant suggestions,and gradually improve the clinical practice training of emergency nurses mode.
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Objective To discuss the effect of transplanting autogenous rib cartilage in correction of short and upwardly rotated nose.Methods A piece of autogenous rib cartilage was transplanted into the front of nasal septa to lengthen it,leading to the nasal tip moving forwards and correcting the short and upwardly rotated nose.For low nose cases,simultaneous implants was used into the nasal back.Results The nasal tips were prolonged 0.75 cm on average after operation in 56 patients with short and upturned noses.The nasolabial angle and extent of nostril exposure were normal after operation.The operational consequences were fine in 54 patients,while 2 case were not satisfactory.Efficacy was stable during one year follow-up.Conclusions This method is reliable,and it can be recommended in rhinoplasty of patients with short and upwardly rotated nose.
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Objective To evaluate the role of autologous septal cartilage in the rhinoplasty of the wide and bulbous nasal tip. Methods A big piece of autologous nasal septal cartilage was removed and transplanted to the front of nasal septum, acting as a septal extender to fix the nasal alar cartilage,and then the shape of nasal tip was reconstructed by middle crus suture technique, excessive soft tissue under skin of tip and a part of lateral crura cartilage were removed to stand out the shape of the nasal tip. Results After one year follow-up, 118 of 126 cases achieved satisfied effects, but 8 cases dissatisfied because of their undue thick skin. Conclusions This method is reliable in the correction of the wide and bulbous nasal tip.
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.All patients cured.Three-lumen nasogastrojejunal tube placed under X-ray monitoring proves to be a safe, convenient, highly tolerable and effective procedure.
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Objective To study the clinical significance for the establishment of diagnosis of small bowel obstruction by selective small bowel enterography through a nasointestinal decompression tube. Methods Tirty-five patients with small bowel obstruction, with no strangulation or other contraindications, were intubated with a 300 cm nasointestinal decompression tube till upper jejunum under X-ray monitoring. The patients firstly underwent intra-small-intestinal suction therapy. When the tube reached the diseased region, a selective small bowel enterography was performed. Under X-ray inspection, 20-100 ml of 76% meglumine diatrizoatis and 50-200 ml of air were slowly injected via the decompression tube to perform double contrast intestinal radiography. Results Intubation was successful in all the 35 patients. Mter the small intestinal decompression therapy. Obstruction was cured in 20 cases, alleviated in 15 cases, and 10 cases received operation. Small bowel enterography in this series was all of high quality, there were 6 cases in which no abnormal X-ray findings, adhesive small bowel obstruction was suggested in 15 cases, small bowel tumor was identified in 4 cases (3 metastatic tumor, 1 small bowel cancer), small bowel Crohn's disease in 3 cases, radioactive enteritis in 3 cases, enteric intussusception in 2, polyp of the small intestine in one, and carcinoma of the ascending colon in one. Conclusions The nasointestinal decompression intubation with X-ray monitoring serves a dual function for the patients with intestinal obstruction, it decompresses the small bowel and does small intestinal radiography, in this way the locale of obstruction was found and the cause of the obstruction identified.
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Objective To study one simple, safe and effective method of periorbital rhytidectomy. Methods With turgescent anesthesia, 1 cm -extent was dissected laterally deep under musculus orbicularis oculi at the approach of eyebrow area. The musculus orbicularis oculi was fixed to the deep temporal fascia and frontal periosteum. The superciliary corrugator muscle and depressor muscle were exposured and cut. Then the eyelid blepharoalasty was performed through the skin incision, meanwhile the lateral pars orbitalis muscle was liberated to form an orbitalis muscle flap under the orbitalis muscle and the fat pad, which was fixed to the os orbitale periost by lifting tight to lateral and upper side. For patients with generous pars buccalis and obvious nose lip ditch, the cheekbone fat cushion was also hanged and fixed. Results 65 middle age female patients were followed up for 3～16 months. The scar was no obvious, glabellar wrinkle and canthal wrinkle disappeared at static state, relaxed upper eyelid and eyebrow prolapse reached to complete correct, nasolabial groove wrinkle obvious lessened. 95 % patients were satisfacted with the appearance. Conjunctival edema was found in 4 cases, and disappeared within 1 months. There were no facial nerve injury and other complications. Conclusions It is a new incisional approach that avoids the facial nerves and lessens fossa orbitalis retrogradation. The operative procedure is simple and safe, and its incision is occult. The wound is small and restores rapidly, but the effect is reliable and lasting. It proves to be an ideal approach for face rejuvenation.
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Objective:To study the clinical application of X-ray assisted placement of nasojejunal feeding tube in early enteral nutrition of critical illness. Methods:The feeding tube affiliated wire guide was inserted to jejunum under X-ray observation and affirmanced by the examination with contrast medium. Results:All the feeding tubes were inserted to jejunum successfully.The time was 10-40 minutes,averagely 20 minutes.Conclusion:The placement of the nasojejunal feeding tube under X-ray is simple and safe and offer an effective route of early enteral nutrition for critical illness.
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Using indirect immunofluorescent technique and immunohistochemical staining method,we detected 14 patients with progressive Mooren's ulcer for T lymphocyte suhpopulations(Pan-T,Th,Ts)and the ratio of Th/Ts in peripheral blood as well as in the limbus conjunctiva near the corneal ulcer.It was found that Pan-T,Th,Ts and Th/Ts ratio in con- junctiva were significantly higher than that in normal control,whereas these parameters in peripheral blood showed no differences from that in the control group.From the above data,we may conclude that the intensive immune activities due to the increased local Th/Ts ratio play an important role in the process of Mooren's ulcer.