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Objective To explore the degree of social support in patients after Coronary Artery Bypass Grafting(CABG) and its influence on Acute Stress Disorder (ASD), in order to provide theory evidence for nursing intervention. Methods From June 2017 to Mar 2018, 359 patients after CABG in Tangshan Workers Hospital were recruited for the study. Their general information were collected, SASRQ, SSRS and PSS-Fa were used for professional evaluation. Results The degree of social support in patients after CABG was at medium level, the total score of social support was (41.69±0.28), higher than the normal domestic value[(34.56 ± 3.73)score, n=128]; character (F=29.652), employment (t=6.526)and the type of health insurance (F=20.547)impacted on the degree of social support (P＜0.05). Total score of social support had negative correlation with SASRQ total score (r=-0.528, P＜0.05); character (β=0.262), family support (β=-0.281) and social support (β=-0.267) were picked in the regression equation (P＜0.05), the results showed that introversion was a risk factor for ASD in patients after CABG, high degree of family support and social support were protective factors for ASD in patients after CABG. Conclusions Social support of patients after CABG needs to be improved, so as to reduce the incidence of acute stress disorder.
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Objective@#To explore the degree of social support in patients after Coronary Artery Bypass Grafting(CABG) and its influence on Acute Stress Disorder (ASD), in order to provide theory evidence for nursing intervention.@*Methods@#From June 2017 to Mar 2018, 359 patients after CABG in Tangshan Workers Hospital were recruited for the study. Their general information were collected, SASRQ, SSRS and PSS-Fa were used for professional evaluation.@*Results@#The degree of social support in patients after CABG was at medium level, the total score of social support was (41.69±0.28), higher than the normal domestic value[(34.56±3.73)score, n=128]; character (F=29.652), employment (t=6.526)and the type of health insurance (F=20.547)impacted on the degree of social support (P<0.05). Total score of social support had negative correlation with SASRQ total score (r=-0.528, P<0.05); character (β=0.262), family support (β=-0.281) and social support (β=-0.267) were picked in the regression equation (P<0.05), the results showed that introversion was a risk factor for ASD in patients after CABG, high degree of family support and social support were protective factors for ASD in patients after CABG.@*Conclusions@#Social support of patients after CABG needs to be improved, so as to reduce the incidence of acute stress disorder.
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Objective To investigate the effects of enteral nutrition added with glutamine on the incidences of gastrointestinal complications,intestinal mucosal barrier function and inflammatory responses in patients with acute severe traumatic brain injury (sTBI).Methods A prospective case control study was made on 107 patients with sTBI hospitalized from January 2016 to June 2017.The patients were divided into experimental group added with glutamine (n =54) and control group without glutamine (n =53) according to the random number table.The general data of the patients were recorded.After treatment,the incidences of gastrointestinal complications in both groups were compared.The serum levels of intestinal mucosal barrier function indices,namely,diamine oxidase (DAO),Dlactate acid,and intestinal fat acid binding protein (I-FABP) were evaluated by enzymology spectrophotometer method.Meanwhile,the serum levels of C-reactive protein (CRP),tumor necrosis factor-α (TNF-α),and interleukin-6 (IL-6) were also tested with enzyme-linked immunosorbent assay (ELISA).Glasgow coma scale (GCS),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ),and hospital stay in both groups were compared.Results The two group were comparable with respect to gender,age,injury reasons,body mass index,preoperative GCS,preoperative APACHE Ⅱ,injury type and injury time (P ＞ 0.05).The experimental group had lower incidences of stress ulcer,gastric retention and diarrhea compared with the control group 14 days after treatment (P ＜ 0.05).Within 14 days after treatment,the serum levels of DAO,D-lactate acid and I-FABP were significantly decreased in the experimental group at days 7 and 14 after treatment (P ＜ 0.05).The serum levels of CRP,TNF-α and IL-6 in the experimental group were significantly decreased after treatment (P ＜ 0.05).The experimental group had better prognosis compared with the control group (P ＜ 0.05),with higher GCS scores [(9.3 ± 0.7) points vs.(8.2 ± 0.7) points],lower APACHE Ⅱ scores [(15.3 ± 1.1) points vs.(17.7 ± 1.2) points] at day 14,and shorter hospital stay [(19.1 ± 2.2) days vs.(25.3 ± 2.4) days] (P ＜ 0.01).Conclusions Enteral nutrition added with glutamine can effectively reduce the incidence of gastrointestinal complications,as well as alleviate the intestinal mucosal barrier function damage and the inflammatory responses at early stage after sTBI,which possibly improves prognosis.
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OBJECTIVE@#To investigate the function of bone marrow mesenchymal stem cells (BMSCs) with over-expressed matrix metalloproteinase 1 (MMP1) on liver fibrosis.@*METHODS@#Fifty SD male rats were randomly divided into 4 groups: recombinant adenovirus Adhuman MMP-1(hMMP-1)-enhanced green fluorescent protein (EGFP) transfected BMSCs group (Group A, n=10), Ad-EGFP transfected BMSCs group (Group B, n=10), liver fibrosis group (Group C, n=15), and a normal group (Group D, n=15). The liver fibrosis model was formed by subcutaneous injection of the mixed liquor of carbon tetrachloride (CCL4) and vegetable oil. After 10 weeks, the model of liver fibrosis was formed. Group A and B were administered the transfected BMSCs via the tail veins, while Group C and D were administered normal saline. After 3 weeks, the rats were sacrificed. The body weight, liver weight, liver function, liver fibrosis indexes and liver pathological changes were tested.@*RESULTS@#Compared with the control group, the rats administered BMSCs with over-expressed MMP1 showed a significant improvement in the body weight, liver weight and plasma albumin (ALB) (P<0.05), and a significant reduction in the plasma alanine aminotransferase, total bilirubin, hyaluronic acid, laminin and procollagen III (P<0.05). Hematoxylin-eosin staining confirmed that the degree of liver fibrosis was significantly ameliorated under average visual fields (P<0.05).@*CONCLUSION@#The repair ability of BMSCs on liver fibrosis can be enhanced by over-expression of hMMP-1.
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Animals , Male , Rats , Adenoviridae , Carbon Tetrachloride , Green Fluorescent Proteins , Hematopoietic Stem Cells , Cell Biology , Liver Cirrhosis , Therapeutics , Matrix Metalloproteinase 1 , Genetics , Metabolism , Rats, Sprague-Dawley , TransfectionABSTRACT
Objective To investigate the effect of the whole course health education on heart rehabilitation of old patients with percutaneous coronary intervention(PCI).Methods One hundred and twentyone old patients with coronary heart disease who all underwent complete PCI in Tangshan Gongren Hospital from January 2008 to December 2009 were selected as our subjects.All subjects were randomly divided into the intervention group (60 cases) and the control group (61 cases).All patients were treated by PCI ± standard drug therapy.Patients in control group were given the conventional health education,while in intervention group were given the extending health education plus the conventional health education.Questionnaire was used to collect the coronary heart disease knowledge,recovery and secondary prevention behavior.The levels of blood pressure,density lipoprotein cholesterol,fasting blood glucose (FB) were measured at 6,12,24 months at discharge hospital.Meanwhile the reaching standard rate of coronary heart disease risk factors control was also used to evaluate the effect of education.Results The scores of knowledge of coronary heart disease rehabilitation of intervention group at 6,12 and 24 months after discharge were (79.69 ± 4.66),(83.26± 8.38),(81.81 ± 9.21) respectively,higher than that of control group ((72.36 ± 8.16),(69.96 ± 10.69),(70.00 ± 11.32) respectively),and there were significant differences between groups(t =3.26,5.39 and 4.41respectively,P ＜ 0.05).The scores of the second level prevention act of intervention group were (79.00±5.65),(79.88 ± 6.34) and (79.13 ± 11.21) respectively,higher than that of control group((70.72± 7.59),(68.84 ± 5.36) and (66.52 ± 9.15) respectively),and there was significant difference between groups (t =3.75,5.99 and 3.63 respectively; P ＜ 0.05).The reach standard rate of low density lipoprotein cholesterol(LDL-C),exercise of intervention group at 6 months were 60.0％ (36/60),65.0％ (39/60),higher than that of the control group(37.7％ (23/61),32.8％ (20.61)),and there was significant difference between groups(x2 =6.045,10.871,P ＜0.05),while there was no significant difference in terms of the reach standard rate of blood pressure,FB and quit smoking(P ＞ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were 75.0％ (45/60),76.6％ (46/60),96.6％(58/60),81.7 ％ (49/60),75.0％ (45/60),higher than that of control group (49.2 ％ (30/61),32.8 ％(20/61),80.3％ (49/61),57.4％ (35/61),31.1％ (19/61),and there was significant difference between groups(x2 =8.021,28.438,8.431,10.435 and 23.128 respectively,P ＜ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were (75.0％ (45/60),81.7％ (49/60),95.0％ (57/60),86.7％ (52/60),81.7％ (49/60)),higher than that of control group (44.3％ (27/61),31.1％ (19/61),75.4％ (46/61),47.5％ (29/61),34.4％ (21/61)),and there was significant difference between groups (x2 =11.710,35.810,8.112,25.450 and 25.650 respectively,P＜0.05).Conclusion Whole course health education is proved to reach the purpose of long-term heart rehabilitation,and decrease the risk of the risk factors for PCI.Meanwhile it is a safe,effective,compliant heart rehabilitation model after PCI in old patients.
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Purpose To compare the mammography and ultrasound imaging features of triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (NTNBC), and to improve TNBC diagnosis. Materials and Methods Using immunohistochemical staining technique, 387 patients with pathologically conifrmed breast cancer were divided into TNBC group (n=54) and NTNBC group (n=333). Mammography and ultrasound ifndings as well as pathological data were retrospectively reviewed. Results TNBC was associated with higher tumor grades. There were signiifcantly more grade III inifltrating ductal carcinomas and axillary lymph node involvement in TNBC group than in NTNBC group (χ2=47.009, P<0.001;χ2=4.658, P<0.05). On mammography, TNBC most frequently presented with a mass (n=37, 69.8%) and was less associated with microcalciifcations (n=10, 18.9%). TNBC masses were mostly round or oval (n=28, 62.2%) with circumscribed margin (n=16, 35.6%). Spiculated margins were rare (n=5, 11.1%). NTNBC most frequently presented as a mass with calciifcations (n=138, 42.1%), and was more irregular in shape (n=119, 46.5%). Spiculated margins were common (n=77, 30.1%). There was statistically signiifcant difference between these two groups in mass, microcalcification, shape and margin (χ2=24.618, 19.889, 32.605 and 21.102, P<0.001). On ultrasonograhy, TNBC most frequently presented as a mass (n=52, 96.3%) with less microcalciifcations (n=5, 9.3%). TNBC masses were more frequently round or oval (n=27, 51.9%) with circumscribed margins (n=25, 48.1%). Spiculated margins were rare (n=3, 5.8%). TNBC was less likely to show attenuating posterior echoes (n=5, 9.6%);NTNBC most frequently presented as a mass (n=318, 96.1%) with microcalcifications (n=135, 40.8%). NTNBC masses were more frequently irregular in shape (n=243, 76.4%) with spiculated margins (n=76, 23.9%). NTNBC was more likely to show attenuating posterior echoes (n=78, 24.5%). There was statistically signiifcant difference between these two groups in microcalciifcation, shape, margin and posterior echo (χ2=19.006 and 18.339, P<0.001;χ2=16.170 and 8.429, P<0.05). Conclusion TNBC demonstrates round or oval mass with circumscribed margin and is less likely to show attenuating posterior echoes on mammography and ultrasound with benign imaging features. NTNBC frequently presents as irregular mass with spiculated margin, and is more associated with microcalciifcations. These imaging ifndings are useful in early diagnosis of TNBC.
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BACKGROUND:Matrix metaloproteinase-1 can degrade extracelular matrix, which is mainly colagen type I, and has the potential to reverse fibrosis tissue. OBJECTIVE:To construct the recombinant adenovirus vector containing human matrix metaloproteinase-1 (hMMP-1) gene with GatewayTM Clone Technology, and observe the capacity of degrading colagen type IIIin vitro. METHODS: The gene hMMP-1 was amplified by using PCR from the pcDNA3.1 plasmid and was cut down by the double endonuclease. The linear gene fragment was connected to the entry vector pENTERTM 1A. Then the entry clone and the destination vectors pJTI? R4 Dest CMV-N-EmGFP pA Vector recombined using the LR reaction to form the expression clone pAd-hMMP-1-eGFP. The linear pAd-hMMP-1-eGFP cut down by endonucleasePac I was transfected into HEK293A cels to packaging the Ad-hMMP-1-eGFP. The transfected situation was observed under a fluorescence microscope, the target protein expression was detected by western-blot assay and RT-PCR. Cels can be divided into three groups: blank control group: HEK293A cels, AD-EGFP group: HEK293A cels were infected by Ad-eGFP, AD-HMMP1-EGF group: HEK293A cels were infected by Ad-hMMP1-eGFP and colagen type III. The content of colagen type III was detected by ELISA kits after 24, 48 and 72 hours. RESULTS AND CONCLUSION: It was confirmed that the entry vector and the destination vector both contained hMMP-1 target gene by restriction analysis and sequencing. The green fluorescent protein was observed in the 293A cels transfected by the Ad-hMMP-1-eGFP at 4 days. The fluorescence intensity was the highest at 10 days. The virus was colected at 12 days, the viral titer was determined as 4.84 × 1010 PFU/mL, the target protein was efficient expressionvia western-blot assay. Blank control group and AD-EGFP group had no obvious change of colagen content with the extension of time. The rate of colagen degradation in AD-HMMP1-EGFP group was 24%, 56% and 81% respectively at 24, 48, 72 hours. AD-HMMP1-EGFP group degraded colagen significantly compared with the other two groups (P < 0.01). The recombinant adenovirus vector containing hMMP-1 was successfuly constructed by using the Gateway technology, this method was more efficient and specific than with the traditional methods. The hMMP1 degraded colagen type III significantlyin vitro.
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Primary intestinal NK/T cell lymphoma is extremely rare and early diagnosis is frequently difficult. The aim of this study is to investigate the clinicopathological findings, immunophenotype, and T cell receptor [TCR] gamma gene rearrangement of primary intestinal NK/T cell lymphomas in 25 Chinese cases. Clinical data of the 25 cases were analyzed. Immunohistochemistry for immunophenotype, in situ hybridization for EBER, and polymerase chain reaction for TCR y gene rearrangement were investigated. Survival curves according to clinical characteristics were analyzed. The median age was 33 years and the median survival was 7 months. The common symptoms consisted of abdominal pain, fever, marasmus, diarrhea, and hematochezia. Endoscopically, the tumors were mainly featured by focal, multifocal or diffuse irregular ulcers, which most frequently emerged in the ascending colon. Histologically, the tumors were characterized by the proliferation of pleomorphic atypical lymphoid cells [ALCs], necrosis, lympho-epithelial lesions, and mixed inflammatory infiltration. The positive frequency of CDepsilon was 88.2%, of CD56 was 84%, granzyme B was 90%, and EBER was 84.2%. A total of 12 out of 14 cases [85.7%] highly expressed Ki67. The negative prognostic factors for survival were Ann Arbor stage HIE or IVE [P = 0.039] and more than one extranodal site of disease [P = 0.019]. Primary intestinal NK/T cell lymphomas most frequently favor young people and have a poor prognosis. Due to the nonspecific clinical and endoscopic findings, it is difficult to distinguish intestinal NK/T cell lymphomas from inflammatory and infectious disorders. Histopathology, immunophenotype, and DNA study play key roles in differential diagnosis
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Humans , Male , Female , Intestinal Neoplasms , Immunophenotyping , Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor , Immunohistochemistry , In Situ Hybridization , Polymerase Chain Reaction , Herpesvirus 4, Human , LymphomaABSTRACT
Objective To evaluate the efficacy of Six Sigma management for shortening the waiting time of outpatients accepting radiography and improving patient satisfaction. Methods Six Sigma management was applied to identify the key points critical to quality in the process of radiography,analyze the factors influencing the waiting time,and take targeted measures to modify the process. Results The waiting time of patients accepting radiography was reduced by an average of 25.2min and the rate of dissatisfaction was decreased by 18%. Conclusion The application of Six Sigma management can effectively shorten the waiting time of outpatients accepting radiography and increase patient satisfaction.
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Treatment based on syndrome differentiation which is a complicated procession,is a characteristic of Chinese medical diagnosis and treatment.How to appraise the efficacy of treatment based on syndrome differentiation becomes a important question.Randomized controlled trial is called golden design of clinical trial,but it has a strict condition and a low compliance.Cohort study has a high clinical operation,but it is difficult to control bias.Stratified,polycentric and prospective cohort study can avoid the shortcomings of randomized controlled trial and cohort study.So,it can be a prospective design to appraise the curative efficacy of treatment based on syndrome differentiation.
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The theory of body and spirit is one of the basic theories of TCM; it plays an important role in the development of TCM theory system,and has guiding significance in the clinical practice.The connotation of theory of body and sprit is copious and text mining can find potential valuable information from plenty of message.We tried to use text mining to find the connotation of theory of body and sprit,and provided a new way to study the theory of TCM.
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Objective To investigate the preventive measurement of vagal reflex occurrence on patients with percutaneous transluminal coronary angioplasty (PTCA).Methods On the reason of vagal reflex occurrence,to 75 patients with PTCA adopt the measurement to prevent hypovolemia,control the excessive rebound of cavity viscera,adjust the patients mental state,and so on.Then to observe the level of patients with vagal reflex occurrence,and compare with the control group of 75 patients under common care.Results The prevent group level of patients with vagal reflex occurrence is 2.61%;the control group is 28%.Conclusion To patients with PTCA adopt the measurement to prevent hypovolemia,control the excessive rebound of cavity viscera,adjust the patients mental state,and so on.The effect to decrease the level of vagal reflex occurrence is great.