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Objective:To examined the effects of the evidence-based nursing teaching mode for undergraduate nursing students on evidence-based practice ability, critical thinking and creativity.Methods:From July 2019 to November 2021, 79 undergraduate nursing students from 14 groups who practiced in Department of Colorectal Surgery/Thyroid Surgery of Qilu Hospital of Shandong University were randomly assigned to evidence-based nursing teaching group (33 cases) and traditional teaching group (46 cases) by random number method. The traditional teaching group conducts one-to-one teaching according to the general clinical practice plan, the teaching plan of the department, and the list of training items; the evidence-based nursing teaching group, on the basis of traditional teaching, implements three courses and corresponding practice guidance of evidence-based nursing teaching for 4 weeks. The evidence-based practice ability, critical thinking and creativity tendency of undergraduate nursing students were evaluated by the Evidence-Based Practice Competence Questionnaire, Critical Thinking Disposition Inventory-Chinese Version, and Williams Creativity Tendency Scale before and immediately after the intervention. Generalized linear models (repeated measures) were used in the analyses.Results:After the intervention, the scores of evidence-based practical knowledge, truth seeking (the dimension of critical thinking) and creative tendency in evidence-based nursing teaching group were 22.09 ± 3.15, 39.61 ± 5.26, and 109.88 ± 11.76, respectively, the traditional teaching group was 20.56 ± 3.00, 37.93 ± 4.38, and 109.37 ± 10.78, respectively. Before the intervention, the scores of evidence-based practical knowledge, truth seeking (the dimension of critical thinking) and creative tendency in evidence-based nursing teaching group were 19.54 ± 3.54, 39.24 ± 3.54 and 104.88 ± 10.97, respectively, the traditional teaching group were 19.89 ± 3.15, 40.48 ± 4.12, and 108.72 ± 10.72, respectively. The increased scores of evidence-based practical knowledge, truth-seeking (dimension of critical thinking), and creativity tendency after the intervention in the evidence-based nursing teaching group were significantly higher than those of the traditional teaching group ( F=4.51, 10.03, 4.21, all P<0.05). Conclusions:The evidence-based nursing teaching mode is conducive to the increase of evidence-based practical knowledge, improvement of the critical thinking ability and creativity of undergraduate nursing students.
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Clinical phenotypes and gene characteristics of a patient diagnosed with Mowat-Wilson syndrome (MWS) with Hirschsprung′s disease (HSCR) and vaginal atresia in the Department of Neonatal Surgery, Beijing Children′s Hospital, Capital Medical University in March 2021 were analyzed retrospectively.The eight-month-old girl was admitted to the hospital with symptoms of constipation for nine days and abdominal distension for two days.Lower digestive tract radiography and rectal mucosa biopsy results suggested HSCR.The child also had specific facial features and motor development delay.Whole exome test showed a de novo heterozygous mutation, ZEB2 gene c. 2761C>T (p.R921*). After laparoscopic-assisted Soave procedure, the child had normal bowel movements, and no surgery-related compli-cations occurred during the follow-up period.The child′s motor development improved after rehabilitation treatment.According to literature review, 2 female cases show similar clinical manifestations to this girl, but the genotypes were different.This patient expands the clinical phenotype of ZEB2 gene pathogenicity.
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Objective:To compare the quantitative measurements of the retinal capillary nonperfusion areas in a cohort of proliferative diabetic retinopathy (PDR) patients with fluorescein fundus angiography (FFA) and swept source optical coherence tomography angiography (SS-OCTA), and to determine the intrapersonal variability between examiners.Methods:A cross-sectional study. Eighteen eyes of eleven PDR patients diagnosed in Department of ophthalmology of Henan Provincial People's Hospital from September 2019 to January 2020 were included in this study. FFA was performed using Spectralis HRA+OCT (Germany Heidelberg Company) from and SS-OCTA was performed using VG200D (China Vision Micro Image Corporation). SS-OCTA was used to collect images of retinal layer, superficial capillary plexus (SCP) and deep capillary plexus (DCP). The same observation area was 80°×60° for SS-OCTA and 55° for FFA with both setting centered on the fovea. The forty-nine retinal capillary nonperfusion areas were observed. The area measurement was completed independently by three examiners. Paired sample t test or paired sample Wilcoxon test were used to compare the measured values of retinal capillary nonperfusion areas between the two examination methods and among the three examiners. Results:There was no significant difference in the retinal layer, SCP and DCP nonperfusion area measured by FFA and SS-OCTA among the three examiners ( P>0.05), and the consistency is good (consistency correlation coefficient> 0.9, P<0.05). The nonperfusion area measured by FFA was 0.786 mm 2. The median nonperfusion area of retinal layer and SCP measured by SS-OCTA were 0.787 mm 2 and 0.791 mm 2, respectively, and the average nonperfusion area of DCP was 0.878±0.366 mm 2. The nonperfusion area of retinal layer and SCP measured by FFA and SS-OCTA showed no statistically significant difference ( P=0.054, 0.198). The nonperfusion area of DCP measured by SS-OCTA was significantly larger than that of FFA, and the difference was statistically significant ( P<0.001). The results of repeatability analysis showed that 93.88% (46/49) of the DCP nonperfusion area data measured by SS-OCTA were greater than those measured by FFA. Conclusion:The retinal nonperfusion area of DCP in PDR patients measured by SS-OCTA is larger than that of FFA.
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Objective:To explore the clinical characteristics of plastic bronchitis (PB) in children after pneumonia and the value of electronic bronchoscopy in diagnosis and treatment of PB after pneumonia.Methods:A total of 3 865 children with lower respiratory infectious diseases who had been treated by bronchoscope and met the diagnosis and treatment criteria of bronchoscope in the Department of Respiratory, Children′s Hospital Affiliated to Soochow University from June 2017 to May 2019 were studied.The children were divided into 3 groups, the PB group, the phlegm embolism blockage group, and the control group [including children with no secretion blocking the bronchial cavity under bronchoscope and no plastic secretion found in bronchoalveolar lavage fluid (BALF)]. The results of laboratory examinations such as clinical characteristics, etiology, immune function and imaging were compared and analyzed.Results:There was no significant difference in the gender distribution among the 3 groups ( P=0.382). The average age of the PB group and phlegm embolism blockage group was significantly older than that of the control group.All the 3 groups had cough.The proportions of coughing children with asthma in the control group and phlegm embolism blockage group [25.06% (924/3 687 cases) and 21.00% (21/100 cases), respectively] were significantly larger than that in the PB group [5.13% (4/78 cases)]. The PB group had the highest ratio of children with fever [93.59% (73/78 cases)], followed by the phlegm embolism blockage group [83.00% (83/100 cases)] and the control group [71.93% (2 652/3 687 cases)] successively.The difference among the 3 groups was significant( χ2=23.571, P<0.05). The fever peaks of the PB group, phlegm embolism blockage group and control group were (39.65±0.6)℃, (39.57±0.64)℃ and (39.27±0.76)℃, respectively; the fever duration of the above 3 groups were (10.32±3.87) days, (9.46±5.13) days and (6.89±4.06) days, respectively.The PB group had a higher fever peak and longer fever duration than the control group (all P<0.01). Before the electronic bronchoscopy, 3 865 children′s chest imaging examination showed pneumonia.The proportions of patients with lobar pneumonia and pleural effusion were the highest in the PB group [79.49% (62/78 cases) and 41.03% (32/78 cases), respectively], followed by the phlegm plug group [65% (65/100 cases) and 27% (27/100 cases), respectively]. C reactive protein (CRP) and D-dimer levels were the highest in the PB group, followed by the phlegm embolism blockage group and the control group successively.The difference was significant.In T lymphocyte subsets, the PB group had a significantly lower percentage of CD4 + lymphocytes and a significantly higher percentage of CD8 + lymphocytes than the control group.The first pathogen detected in the 3 groups was Mycoplasma pneumonia (MP), but the detection rate of MP in the PB group [84.62% (66/78 cases)] was significantly higher than that in the phlegm embolism blockage group [60% (60/100 cases)] and that in the control group [55.68% (2 053/3 687 cases)]. Conclusions:Older children are prone to PB after pneumonia and fever in the course of disease.The imaging manifestations are lobar pneumonia, pleural effusion, atelectasis, elevated CRP and D-dimer in venous blood laboratory examinations.MP is the first pathogen detected in children with PB after pneumonia.Bronchoscopic alveolar lavage is an effective and safe treatment for PB in clinical practice.
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OBJECTIVE: To observe the effect and mechanism of crotonaldehyde sub-chronic exposure-induced pyroptosis in pulmonary inflammatory reaction in male rats. METHODS: Specific pathogen-free male Wistar rats were randomly divided into control group and low-, medium-and high-dose groups, with 10 rats in each group. Rats were treated with crotonaldehyde at concentrations of 0.0, 2.5, 4.5, and 8.5 mg/kg body weight by intra-gastric administration, once per day for 120 consecutive days. Rats′ body mass was recorded during exposure. After exposure, the rats were sacrificed, and the lung tissues were isolated. The relative expression of reactive oxygen species(ROS) in lung tissues was detected by fluorescent probes at the end of crotonaldehyde exposure. The fluorescent staining of the nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3(NLRP3) and Caspase-1 in lung tissues was observed by immunofluorescence microscope. The protein expression of NLRP3, apoptosis-associated spot-like protein(ASC), Caspase-1 precursor(pro-Caspase-1), Caspase-1, interleukin(IL)-1β and IL-18 in lung tissues was determined by Western blotting. RESULTS: At the end of exposure, the body weight gain of rats decreased with the increasing doses of crotonaldehyde(P<0.01). Among them, the body weight gain in the medium-and high-dose groups was lower than that of the control group(P<0.05). After exposure, the lung tissue of each group showed severe inflammatory change with the increasing doses of crotonaldehyde. Immunofluorescence staining showed that the expression of NLRP3 and Caspase-1 in the lung tissues of rats increased in a dose-dependent manner. The relative expression of ROS and the protein of NLRP3, ASC, pro-Caspase-1, Caspase-1, IL-1β and IL-18 in lung tissue of each group increased with the dose of crotonaldehyde(P<0.01). The above indexes of lung tissue in the medium-and high-dose groups were higher than that in the control group(P<0.05). CONCLUSION: Sub-chronic exposure to crotonaldehyde may cause pyroptosis by up-regulating ROS expression in the lung tissues of rats. The up-regulation of Caspase-1 classic dependent pathway leads to pyroptosis, thereby causing inflammatory responses in the lungs.
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OBJECTIVE: To observe the conditions of sub-chronic crotonaldehyde exposure-induced pulmonary inflammation,oxidative stress and apoptosis in male rats,and to explore the related mechanisms. METHODS: The specific pathogen free Wistar male rats were randomly divided into control group,low-,medium-and high-dose crotonaldehyde groups,with 10 rats in each group. Rats were treated with crotonaldehyde at the concentrations of 0. 0,2. 5,4. 5 and 8. 5 mg/kg body weight by intra-gastric administration,once per day for 120 consecutive days. After the end of treatment,rats were sacrificed,the lungs were weighed and histopathological examination was performed. The levels of malondialdehyde( MDA),superoxide dismutase( SOD) and glutathione peroxidase( GSH-Px) in the serum of rats were determined by colorimetry. The relative expression of reactive oxygen species in lung tissues was detected by fluorescence probe. The apoptosis rate was detected by Tunel staining. The relative expression of B-cell lymphoma( Bcl)-2,Bcl-2 associated X protein( Bax) and cysteine aspartic acid protease-3( Caspase-3) proteins in lung tissue was detected by western blotting.RESULTS: The body weight of the rats in the high-dose group began to decrease after 30 days of exposure( P < 0. 05),and the body weight in the low-and medium-dose groups began to decrease at 90 days exposure( P < 0. 05),when compared with that of the control group at the same time. The body weight of the high-dose group was lower than that of the low-and medium-dose groups began to decrease at 90 days exposure( P < 0. 05). After exposure,the lung tissue of the three doses groups showed different degrees of inflammatory change in a dose-effect relationship. The level of serum MDA in rats increased with the treatment of crotonaldehyde( P < 0. 01). The activities of serum SOD and GSH-Px decreased with the treatment of crotonaldehyde( P < 0. 01). The relative expression of ROS and apoptosis rate in rat lung tissue increased with the treatment of crotonaldehyde( P < 0. 01). The relative expression of Bcl-2 protein and the ratio of Bcl-2/Bax in the lung tissue of rats decreased with the treatment of crotonaldehyde( P < 0. 01). The relative protein expression of Bax and Caspase-3 increased with the treatment of crotonaldehyde( P < 0. 01). CONCLUSION: Crotonaldehyde sub-chronic exposure can cause apoptosis in lung tissue by altering the oxidative balance,leading to inflammatory pathological changes in the lung.
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Objective@#To evaluate the safety and efficacy of helical tomotherapy using simultaneously integrated boost and simultaneous integrated protection technique in the treatment of unresectable biliary tract cancers.@*Methods@#The data of 23 patients with unresectable biliary tract cancer who received tomotherapy-based hypofractionated radiotherapy at Comprehensive Cancer Centre of Drum Tower Hospital,the Affiliated Drum Tower Clinical College of Nanjing Medical University between February 2015 and October 2017 were analyzed. There were 10 males and 13 females, aged from 40 to 85 years(median:58 years). Pathological type included intrahepatic cholangiocarcinomas(n=11), gallbladder cancers(n=6),extrahepatic cholangiocarcinomas(n=6). The irradiated sites covered primary tumors and areas of local invasion,including metastatic lymph nodes which were confined to the abdominal or retroperitoneal space. Dose escalation was achieved using simultaneously integrated boost(SIB) technique, and simultaneous integrated protection(SIP)technique was used to protect gastrointestinal tracts and other adjacent organs. Cox regression modal and Kaplan-Meier analysis were used to analyze the associations between patients′ characteristics and overall survival(OS).@*Results@#The median total radiation dose was 54 Gy(range: 28-72 Gy)and median biologically effective dose(BED)was 74.4 Gy(range: 37.8-115.2 Gy).The median planning target volume(PTV)was 445.79 cm3(range:126.02-950.12 cm3). Based on the various PTV,patients received 2.4-6.0 Gy/fraction with 8-28 fractions. The local control rate was 65.2% and the median OS was 11.3 months(range:2.1-31.9 months).The most common cause of death was out-field failure and only 3 patients died of in-field failures. The longest survival was 31.9 months. BED≥70 Gy significantly improved OS,compared to BED<70 Gy(16.8 months vs.5.1 months)(HR=0.146, 95%CI:0.028-0.762, P=0.022). No patients developed grade ≥4 toxicities.@*Conclusions@#Helical tomotherapy-based hypofractionated radiotherapy is effective and well tolerated for patients with unresectable biliary tract cancer. The dose escalation with higher BED could improve the survival for such patients.
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Objective@#To investigate the effect of subchronic exposure to crotonaldehyde on reproductive damage and oxidative stress in male rate.@*Methods@#Forty male SPF Wistar rats were randomly divided into four group: a control group and 3 exposure groups, 10 per group. The rats in each group were continuously administrated with crotonaldehyde (normal saline) for 1 time/d. For 128 d, the doses were 0.0, 2.5, 4.5, 8.5 mg/kg. After the end of the exposure, the body weight, the weight of the testis and epididymis was measured, and calculating organ coefficient. The left spermatozoon tail was used to determine sperm motility, number and testicular tissue marker enzyme activity : LDH, SDH, ACP, γ-GT; blood biochemical related index concentration: FSH, LH, T; oxidative stress-related indicator concentrations: MDA, SOD, GSH-Px and CAT.@*Results@#Compared with the control group, the weight gain, testicular and epididymis weight, and organ coefficient of the rats in the 4.5 and 8.5 mg/kg groups were decreased, the difference was statistically significant (P<0.05) . In the exposed group, the testicular tissue volume was reduced, the color was dark, and the number of germ cells in some seminiferous tubules was reduced. Compared with the control group, the sperm count and sperm motility of the 4.5 and 8.5 mg/kg groups were significantly lower (P<0.05) ; compared with the control group, 4.5 and 8.5 mg/kg. The activities of serum ACP, LDH, SDH and γ-GT in the exposed group were significantly lower (P<0.05) . Compared with the control group, the serum levels of T in the 8.5 mg/kg group were decreased. The levels of LH and FSH in the 4.5 and 8.5 mg/kg exposure groups were significantly lower (P<0.05) . Compared with the control group, the rats in the 4.5 mg/kg and 8.5 mg/kg exposure groups were compared. The activity of MDA in serum increased, SOD, GSH-Px and CAT activity decreased, the difference was statistically significant (P<0.05) .@*Conclusion@#Crotonaldehyde may cause subchronic reproductive damage and oxidative damage in rats by altering the hormone of the reproductive system, the expression of antioxidant enzymes, and destroying the oxidative balance of the rat.
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Objective@#To explore the influence of cluster nursing intervention on inadequate drainage in vacuum sealing drainage (VSD) for inpatients in burn unit.@*Methods@#From October to December 2016, 60 patients, aged (43.6±2.8) years admitted to our department, receiving VSD treatment and conforming to the inclusion criteria, were included in the routine nursing group, and among the patients, 37 cases were male and 23 cases were female. From May to July 2017, 58 patients, aged (44.2±3.2) years admitted to our department, receiving VSD treatment and conforming to the inclusion criteria, were included in the cluster nursing group, and among the patients, 36 cases were male and 22 cases were female. The patients′ medical records were retrospectively analyzed. After VSD treatment, patients in routine nursing group received routine nursing, and patients in cluster nursing group received cluster nursing. A cluster intervention group was formed and headed by a chief surgeon. The cluster nursing plan was formulated and implemented strictly from the following six aspects of material preparation, negative pressure value control and negative pressure mode setting, drainage tube nursing, semi-permeable membrane reinforcement, standardizing changing process and timing of drainage capsule, and health education. During VSD treatment, the incidence of inadequate drainage, reasons of inadequate drainage and the occurrences, occurrences of inadequate drainage of wounds in different types and sites, and satisfaction of patients in two groups were observed and calculated. The patient satisfaction items included procedure of drainage capsule replacement, the method of tube fixation, the content and form of health education. Data were processed with independent sample t test and chi-square test.@*Results@#(1) During VSD treatment, the incidence of inadequate drainage of patients in routine nursing group was 43.33% (130/300), which was significantly higher than 17.24% (50/290) in cluster nursing group (χ2=43.350, P<0.01). (2) During VSD treatment, the incidences of inadequate drainage caused by blockage of drainage tube due to scabbing of drainage, low negative pressure, air leakage of semi-permeable membrane, improper changing process of drainage capsule, shedding, compression, reversal of drainage tube of patients in cluster nursing group were 7.93% (23/290), 4.48% (13/290), 1.72% (5/290), 1.03% (3/290), and 2.07% (6/290), respectively, significantly lower than 16.67% (50/300), 11.67% (35/300), 4.33% (13/300), 4.00% (12/300), and 6.67% (20/300) in routine nursing group (χ2=10.379, 22.951, 4.832, 7.840, 7.399, P<0.05 or P<0.01). (3) During VSD treatment, the incidences of inadequate drainage of burn wounds, trauma wounds, pressure ulcer, venous ulcer in lower limbs, and diabetic foot of patients in cluster nursing group were significantly lower than those in routine nursing group (χ2=17.835, 6.809, 9.478, 4.939, 8.631, P<0.05 or P<0.01). During VSD treatment, the incidences of inadequate drainage of wounds in different types of patients in the same group were close (χ2=0.434, 0.057, P>0.05). (4) During VSD treatment, the incidences of inadequate drainage of wounds in limbs, trunk, buttocks, and sacrococcyx of patients in cluster nursing group were significantly lower than those in routine nursing group (χ2=31.892, 9.588, 4.939, 4.549, P<0.05 or P<0.01). During VSD treatment, the incidences of inadequate drainage of wounds in different wound sites of patients in the same group were close (χ2=0.071, 0.069, P>0.05). (5) The satisfaction scores in changing process of drainage capsule, method of tube fixation, content and form of health education of patients in cluster nursing group after VSD treatment were significantly higher than those in routine nursing group (t=5.166, 4.471, 7.958, 8.975, P<0.01).@*Conclusions@#Cluster nursing intervention on patients receiving VSD treatment could reduce the incidences of inadequate drainage of wounds in different types and sites caused by various reasons. It also can improve patient satisfaction.
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Objective@#To observe the lung injury of male rats induced by sub-chronic exposure to crotonaldehyde, and to explore the possible mechanism of injury.@*Methods@#Forty SPF male Wistar rats were randomly divided into control group and 3 groups in each group, and each group received 0.0, 2.5, 4.5, 8.5 mg/kg body weight crotonaldehyde solution for continuous intragastric administration. 120 d, once a day. After the end of the exposure, the body weight of the rats was measured, and the lung tissues were quickly separated after cervical dislocation. The organ coefficients were calculated and histopathological examination was performed to determine malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione. Peroxidase (GSH-Px) content; ELISA was used to measure interleukin (IL) -6, IL-1β, and tumor necrosis factor (TNF) -α in lung tissues.@*Results@#Compared with the control group, the weight gain of the rats in the 4.5 and 8.5 mg/kg exposure groups was small, and the lung weight and organ coefficient of the exposed group decreased, the difference was statistically significant (P<0.05). In the exposed group, the lung tissue structure was disordered, the alveolar wall was thickened, and inflammatory cell infiltration was observed. Compared with the control group, the MDA activity in the serum of the rats in the 4.5 mg/kg and 8.5 mg/kg groups increased, and the SOD and GSH-Px activities decreased, the difference was statistically significant (P<0.05). TNF-α levels in the lung tissues of rats exposed to 4.5 mg/kg and 8.5 mg/kg, and levels of (IL) -6 and IL-1β in the lungs of rats in the 2.5, 4.5, and 8.5 mg/kg groups. Significantly increased, the difference was statistically significant (P<0.05) .@*Conclusion@#Crotonaldehyde may induce inflammatory and oxidative stress damage in rats by up-regulating the expression of inflammatory factors in lung tissue and changing the oxidative balance.
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Objective@#To explore the effects of multidisciplinary comprehensive intervention in integrated treatment of patients with extremely severe burns.@*Methods@#One hundred and ten patients hospitalized in our center from July 2013 to August 2017 met the criteria for inclusion in this study, and their medical records were retrospectively analyzed. According to the medical model at that time, 56 patients hospitalized from July 2013 to July 2015 received routine comprehensive treatment led by doctors, and they were included in the conventional intervention group. From August 2015 to August 2017, 54 patients were treated with integrated multidisciplinary interventions performed by a team consisting of physicians, intensive care nurses, burn nurses, intravenous infusion nurses, wound stoma nurses, and rehabilitation therapists, and they were included in the integrated intervention group. Acute Physiological and Chronic Health Assessment Ⅱ (APACHE Ⅱ) scores on admission and 4 weeks after treatment, incidences of pressure injury, wound sepsis, lung infection, and catheter-related infection during hospitalization, length of stay in intensive care unit (ICU) and total length of hospital stay, and Abbreviated Burn Specific Health Scale (BSHS-A) scores at discharge and 3 months after discharge were analyzed. Data were processed with t-test and chi-square test.@*Results@#The APACHE Ⅱ scores of patients in the two groups were close on admission (t=0.573, P>0.05). Four weeks after treatment, the APACHE Ⅱ scores of patients in the two groups were obviously lower than those on admission within the same group (t=5.697, 4.853, P<0.01), and the score of the integrated intervention group was obviously lower than that of the conventional intervention group (t=2.170, P<0.05). No pressure injury was observed in patients of any group during hospitalization. The incidences of wound sepsis, lung infection, and catheter-related infection of patients in the integrated intervention group were 18.5% (10/54), 3.7% (2/54), and 9.3% (5/54), respectively, significantly lower than 42.9% (24/56), 21.4% (12/56), and 26.8% (15/56) of the conventional intervention group, χ2=4.073, 6.075, 3.962, P<0.05. The length of stay in ICU of patients in the integrated intervention group was (50±5) d, obviously shorter than (62±4) d of the conventional intervention group (t=2.852, P<0.01). The total length of hospital stay of patients in the integrated intervention group was (115±8) d, obviously shorter than (140±7) d of the conventional intervention group (t=16.885, P<0.01). At discharge and 3 months after discharge, the scores of BSHS-A, physical function, psychological function, and general health status of 50 patients in the integrated intervention group were significantly higher than those of 48 patients in the conventional intervention group (t=2.886, 3.126, 2.416, 2.544, 2.033, 3.471, 2.588, 2.210, P<0.05 or P<0.01), while the scores of social function of patients in the two groups were close (t=1.570, 1.350, P>0.05).@*Conclusions@#Integrative treatment of patients with extremely severe burns by multidisciplinary comprehensive intervention can significantly alleviate the severity of burns, reduce the incidences of wound sepsis, lung infection, and catheter-related infection, shorten the length of stay in ICU and total length of hospital stay, and improve the quality of life.
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Objective@#To observe the effect of long term crotonaldehyde exposure on heart damage in male rats, and to explore the possible mechanism of toxic action.@*Methods@#24 specific pathogen free healthy male wistar rats were randomly divided into 4 groups with 6 rats in each group. Rats were treated with with 8.5, 4.5, 2.5 and 0.0 mg/kg body weight crotonaldehyde by gavage, once a day for consecutive 150 days. After the last treatment, they were anesthetized and collected blood samples by cardiac puncture. The heart was rapidly separated after cervical dislocation. The cardiac organ coefficient was calculated and the histopathology changes in heart were observed by HE staining. At the same time, the activities of creatine kinase (CK) , lactate dehydrogenase-L (LDH-L) in serum were determined by automatic biochemical analyzer. Moreover, the levels of cardiac troponin (cTnT) , Angiotensin Ⅱ (Ang Ⅱ) , Brain natriuretic peptide (BNP) , Aldosterone (ALD) and interleukin (IL) -6, 8, 1β, interferon (IFN) -γ and tumor necrosis factor (TNF) -α in heart were determined by enzyme linked immunosorbent assay.@*Results@#At the 90d, 120 d, and 150 d exposure, compared with the control group, the body weight gain in 4.5 and 8.5 mg/kg groups were decreased. Moreover, the heart weight in 4.5 and 8.5 mg/kg groups, and heart coefficient in 8.5 mg/kg group were decreased (P<0.05) . With the increasing dosage of crotonaldehyde, the degree of pathological changes in the heart of exposed rats were aggravated. The major pathological changes of heart in 4.5 and 8.5 mg/kg groups could be summarized as lymphocyte infiltration, abnormal cardiac muscle fiber arrangements, necrosis and fibrous connective tissue hyperplasia. Compared with the control group, the serum CK activity in 4.5 mg/kg group, CK and LDH-L activitivies in 8.5 mg/kg group were increased (P<0.05) ; Compared with the control group, the levels of ALD and ANGII in the heart of 4.5 and 8.5 mg/kg groups were increased, BNP level were decreased, and cTNT level in 8.5 mg/kg group were increased (P<0.05) . Compared with the control group, the levels of IL-1β、IL-6、IL-8 in 4.5 mg/kg group and IL-1β、IL-6、IL-8、TNF-α、IFN-γ in 8.5 mg/kg group were increased (P<0.05) .@*Conclusion@#Crotonaldehyde could up-regulate cardiac inflammatory cytokines and alter the balance ofangiotensin-aldosterone-brain natriuretic peptide causing heart damage.
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Objective@#To establish a method for the determination of diethyl phthalate by gas chromatography in the air of workplaces.@*Methods@#Diethyl phthalate in the air of workplace was collected throμgh glass fiber filter, eluted with methylbenzene, and detected by gas chromatography coupled with FID detectors.@*Results@#The linear range of diethyl phthalate determined by this method was 14.0~1 400 μg/ml, y=2.09801x-3.66229, and the coefficient correlation was 0.999 99. The detection limit was 1.10 μg/ml, and the minimum detection concentration was 0.18mg/m3 (collected sample volume was 30 L) . The within-run precisions were 1.04%~2.75%, and the between-run precisions were 0.34%~1.30%. The recovery rates were 98.72%~103.21%, and sampling efficiency was 97.2%~100.0%. The elution efficiencies were 97.25%~98.68%. The samples could be stored at room temperature for 15 days.@*Conclusion@#The indicators established in this study were conformed with the requirements of GBZ/T210.4-2008, "The Guidelines for the Development of Occupational Hygiene Standards Methods Part 4: Determination of Chemical Substances in the Air of Workplaces" . Diethyl phthalate in the workplace air could be rapidly collected, accurate separated and determinated. This method is applicable to the determination of diethyl phthalate in the workplace air.
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Objective@#To put forward the suggestion of the occupational contact limit of tributyl phosphate in the air of the workplace.@*Methods@#Data of production and usage, workers' basic information, occupational history, and physical examinations were collected, and the environmental and individual levels of exposure were monitored using fixed-point and individual sampling. The results of the questionnaire and health examination were statistically analyzed using exact probability method of Fisher in the workers exposed to tributyl phosphate and the control group.@*Results@#The results showed that tributyl phosphate was widely distributed in the workplace of production and using enterprises, and the concentration of tributyl phosphate in packaging area was highest at 2.47 mg/m3, and in feeder nose was highest at 2.13 mg/m3. The discomfort symptoms were classified and results showed that tributyl phosphate exposure group of 136 people, all symptoms of 128 people, accounting for 94.44% of the total, the remaining 5.56% of the staff report had psychiatric symptoms or lethargy and irritability skin itching, the control group had no symptoms. There is or not discomfort symptoms in the tributyl phosphate exposure group and the control group was compared with the exact probability of Fisher, and the difference was statistically significant (P<0.05) . The results of healthy physical examination of workers exposed to tributyl phosphate and control group were statistically analyzed by the exact probability method of Fisher. The results showed that there was no significant difference in the results of routine internal medical examination, nervous system examination, skin examination, five senses examination, blood routine, urine routine, lung ventilation, and X ray chest fluoroscopy between the tributyl phosphate exposure group and the control group (P<0.05) .@*Conclusion@#The workplace permissible time-weighted tributyl phosphate and short-term exposure limit concentrations in China were set at 2.5 mg/m3 and 5 mg/m3, respectively.
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Objective@#To observe the effect of crotonaldehyde long-term exposure on kidney injury in male rats, and to explore the specific mechanism of toxic action.@*Methods@#32 specific pathogen free healthy adult male wistar rats were randomly divided into 4 groups with 8 rats in each group: high-, moderate-, low-dose groups and a control group. Rats were treated with 8.5, 4.5, 2.5 and 0.0 mg/kg body weight crotonaldehyde by gavage, once a day for consecutive 128 days. After the last treatment, they were sacrificed and separated bilateral kidney. Kidney organ coefficients were calculated and the histopathology changes in kidney were observed by HE staining. The activities of malondialdehyde (MDA) , superoxide dismutase (SOD) , glutathion peroxidase (GSH-Px) and the levels of malaondialdehyde uric acid (UA) , urea nitrogen (BUN) , creatinine (CR) in serum were determined in the same time. Moreover, the levels of interleukin (IL) -6, 8, interferon (IFN) -γ and tumor necrosis factor (TNF) -α in kidney were determined by enzyme linked immunosorbent assay.@*Results@#Bilateral kidneys in the 8.5 mg/kg group were reduced in size and dark in color. Under the microscope, the major pathology changes of kidneys could be summarized as summarized as protein cast renal tubule, inflammatory cells and lymphocytes infiltration among kidney cortex. Compared with the control group, the weight gain of rats in 8.5 mg/kg group were smaller, and the weight and organ coefficient of kidney in each groups were significant decreased (P<0.05) . With the increasing dosage of crotonaldehyde, the serum BUN and UA levels in 8.5, 4.5 mg/kg groups, CR level in 8.5 mg/kg group were significant increased (P<0.05) .Compared with the control group, the serum MDA level in 8.5 mg/kg group was significant increased (P<0.05) . However, serum SOD activity in 8.5 mg/kg group and GSH-PX activity in 8.5, 4.5 mg/kg groups was significant decreased (P<0.05) . With the increasing dosage of crotonaldehyde, there are upward trend in the kidney IL-6, IL-8, TNF-α, IFN-γ, β-2 microglobulin levels. Compared with the control group, IL-6, TNF-α, IFN-γ, β-2microglobulin levels in 8.5, 4.5 mg/kg groups and IL-8 level in 8.5 mg/kg group in kidney were significant increased (P<0.05) .@*Conclusion@#Crotonaldehyde could develop the inflammatory factors levels and change the oxidation balance condition in the kidney of male rats, causing the inflammatory and oxidative injures of renal tissues.
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The disability and mortality of acute ischemic stroke are very high,which brings great burden to family and society.Timely and effective vascular recanalization is possible to make a good prognosis for patients.Since 2008,the intravenous thrombolytic therapy for patients with acute ischemic stroke within the time window has become the recommended treatment scheme of the guidelines in different countries.However,intravenous thrombolysis has the disadvantages of low vascular recanalization rate,narrow treatment time window,and relatively more contraindications,which limits its clinical application.In recent years,with the appearance of stent-like thrombectomy devices,mechanical thrombectomy within the time window has gradually become the mainstream treatment scheme for acute ischemic stroke.The latest guidelines for stroke treatment recommend the use of intravenous thrombolytic bridging endovascular thrombectomy within the time window.However,it is still unclear whether intravenous thrombolysis will increase the rate of vascular recanalization,improve clinical outcome,and increase the risk of intracranial hemorrhage before thrombectomy.This article reviews the vascular recanalization rate,clinical outcome,and intracranial hemorrhage risk of bridging therapy and direct mechanical thrombectomy.
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Haplotype is the combination of a series of genetic mutations that coexist on a single chromosome, each of which has its own unique haplotypes. As a common data analysis method, the analysis of haplotype is effective for the localization of heterozygosis SNPs on single chromosome, the excavation of disease genes and the search of maladies treatments. It mainly includes indirect computational inferential method and direct experimental method. In this review we introduced various haplotype analysis methods and applications, especially two important ones: single-molecule dilution and contiguity-preserving transposition sequencing common technology. Meanwhile, further research prospects on haplotype sequencing were proposed.
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Objective To establish CRRT nursing quality evaluation index system based on the structure-process-outcome theory, so as to guide clinical nursing and evaluate CRRT nursing quality. Methods Based on structure-process-outcome theory,the evaluation index system was established by literature review,expert group discussion, Delphi method and semi-structural interviews with 10 nursing staff. Results The returning rates of questionnaires in the first and second round expert consultation were 94.29％(33/35) and 97.14％(34/35), respectively. The authority coefficient of the experts was 0.89, and the coordination coefficient of experts' opinion was 0.294. The program included 3 first indexes, 15 second index and 73 items. Conclusions The result of the study can provide evaluation for the clinical nursing operation.
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Radiomics,as a noninvasive method of image analysis,had been confirmed through numerous studies in predictive value for esophageal cancer in staging,treatment response and radiation pneumonia.The research background of radiomics,its clinical application,challenges,and future research direction in esophageal cancer were summarized in this review.
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Objective To analyze the factors related to surgical caused infections in children for reducing the infection of operative site.Methods A total of 120 case-times of operation in this hospital were selected.The dynamical air colony number and colony number of surgical instruments were performed the dynamic monitoring.The bacterial colony in air and surface of operative instruments were performed the bacterial species analysis.Results The dynamical air colony number in class 100,1 000,10 000 operating room all presented as "N" character pattern distribution;at 1 h after operation beginning,the variation of air colony number in class 100 operating room was significantly higher than that in class 1 000 and 10 000 operating rooms(P＜0.05).The surface colony increase rate of sterile towel wrapped sterile operating instruments was significantly slower than that of the operating instruments directly exposing to air(P＜0.05).The surface colony increase rate of operating instruments scrubbed by 1％ povidone-iodine was significantly slower than that of operating instruments without scrubbing bloodstain and with scrubbing bloodstain by normal saline(P＜0.05).The bacterial species distribution in operating room air was consistent with that in operating instrument surface.Conclusion The operation caused infection in children is significantly correlated with the operating room bacterial colony number and operation time.