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Objective:To compare the efficacy of Solution-focused brief therapy (SFBT) and the conventional care in the improvement of the prognosis and mental state of patients with chronic bone infection.Methods:A retrospective cohort study was conducted to analyze the clinical data of 219 patients with chronic bone infection who were admitted to the First Affiliated Hospital of the Army Medical University from January 2018 to February 2019, including 172 males and 47 females, aged 15-65 years [(42.1±3.8)years]. Infection sites were the tibia in 144 patients and the femur in 75 patients. According to the classification of Cierny-Mader bone infection, there were 44 patients with type I (intramedullary bone infection), 57 with type II (superficial bone infection), 79 with type III (local bone infection), and 39 with type IV (diffuse bone infection). The patients were divided into conventional care group (admitted from January to July 2018, n=106) and SFBT group (admitted from August 2018 to February 2019, n=113) according to their admission time. The conventional care group received the conventional care, while the SFBT group underwent SFBT on the basis of the conventional care, with an intervention period of 6 months. The Hospital for Special Surgery (HSS) knee score, 36-item Short Form Health Survey (SF-36) for somatic, emotional, role and social function, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were compared between the two groups before surgery, at discharge and at 6 months after surgery. The rates of satisfaction with the nursing care and bone healing were collected at the last follow-up. Results:All the patients were followed up for 12-36 months [(24.5±6.3)months]. The differences in HSS knee score, SF-36 for somatic, emotional, role, and social function scores, SAS score, and SDS score between the two groups were not statistically significant before surgery ( P>0.05). At discharge, the HSS knee score and SF-36 for somatic, emotional, role, and social function scores of the SFBT group were (68.6±6.9)points, (23.0±1.8)points, (23.2±1.6)points, (23.4±1.5)points, and (23.1±1.8)points respectively, which were all significantly higher than those of the conventional care group [(66.3±7.2)points, (19.7±3.3)points, (20.0±2.7)points, (19.8±3.2)points, and (20.5±2.7)points respectively] ( P<0.05); The SAS and SDS scores in the SFBT group were (40.9±6.2)points and (41.1±6.2)points respectively, which were both significantly lower than those in the conventional care group [(46.4±6.3)points and (47.3±6.4)points] ( P<0.05). At 6 months after surgery, the HSS knee score and SF-36 for somatic, emotional, role, and social function scores in the SFBT group were (81.6±6.7)points, (26.3±1.6)points, (27.9±1.4)points, (26.6±1.4)points, and (27.9±1.6)points respectively, which were all significantly higher than those in the conventional care group [(78.5±7.2)points, (17.4±2.9)points, (18.7±2.5)points, (18.3±3.0)points, and (20.0±2.5)points respectively] ( P<0.05 or 0.01); the SAS and SDS scores in the SFBT group were (32.8±4.8)points and (30.8±5.5)points respectively, which were significantly lower than those in the conventional care group [(44.2±5.5)points and (42.5±6.2)points] ( P<0.05). At the last follow-up in the conventional care group and the SFBT group, the rates of satisfaction with the nursing care were 66.0% (70/106) and 88.5% (100/113) respectively ( P<0.01), and the bone healing rates were 96.2% (102/106) and 94.7% (107/113) respectively ( P>0.05). Conclusion:Compared with the conventional care, SFBT for intervention to patients with chronic bone infection is a safe and effective mental nursing model which can improve the recovery of the function and the quality of the patients′ life, reduce their anxiety and depression, and enhance their satisfaction rate.
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OBJECTIVE@#To summarize the gene therapy strategies for neurofibromatosis type 1 (NF1) and related research progress.@*METHODS@#The recent literature on gene therapy for NF1 at home and abroad was reviewed. The structure and function of the NF1 gene and its mutations were analyzed, and the current status as well as future prospects of the transgenic therapy and gene editing strategies were summarized.@*RESULTS@#NF1 is an autosomal dominantly inherited tumor predisposition syndrome caused by mutations in the NF1 tumor suppressor gene, which impair the function of the neurofibromin and lead to the disease. It has complex clinical manifestations and is not yet curable. Gene therapy strategies for NF1 are still in the research and development stage. Existing studies on the transgenic therapy for NF1 have mainly focused on the construction and expression of the GTPase-activating protein-related domain in cells that lack of functional neurofibromin, confirming the feasibility of the transgenic therapy for NF1. Future research may focus on split adeno-associated virus (AAV) gene delivery, oversized AAV gene delivery, and the development of new vectors for targeted delivery of full-length NF1 cDNA. In addition, the gene editing tools of the new generation have great potential to treat monogenic genetic diseases such as NF1, but need to be further validated in terms of efficiency and safety.@*CONCLUSION@#Gene therapy, including both the transgenic therapy and gene editing, is expected to become an important new therapeutic approach for NF1 patients.
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Humans , Neurofibromatosis 1/pathology , Neurofibromin 1/metabolism , GTPase-Activating Proteins , Mutation , Genetic Predisposition to Disease , Genetic TherapyABSTRACT
Fibromyalgia syndrome (FMS), also known as fibromyalgia, is clinically characterized by diffuse chronic muscle and bone pain, accompanied by fatigue, sleep disturbances, depressive episodes, and cognitive and intestinal dysfunction. Due to lack of clear specific laboratory indicators and appropriate imaging examinations, FMS diagnosis is mostly based on clinical symptoms, but FMS clinical symptoms of lack specificity, and current clinical diagnostic criteria are mostly exclusive criteria, which is prone to missed diagnosis and misdiagnosis. In order to further promote the standardized diagnosis and treatment of FMS, this paper makes extensive references to laboratory-related diagnostic indexes of FMS (Tau, adiponectin, serum cathepsin S, cystatin C, serum ferritin, nitric oxide, neutrophil/lymphocyte ratio, platelet distribution width and mean platelet volume) at home and abroad, aiming to provide new ideas for early diagnosis and intervention of FMS.
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Objective To study the effect of empathetic nursing combined with solution-focused mode on sleep and psychological stress in patients with hysterectomy.Methods Totally 100 patients who underwent hysterectomy in the Gynecology Department of our hospital from August 2021 to July 2022 were selected.They were numbered according to the order of admission and divided into two groups by random envelope method.The control group was given routine nursing care intervention.The experimental group implemented the empathetic nursing combined with the solution-focused mode.The scores of Self-rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI)and General Self-Efficacy Scale(GSES)were compared between the two groups.Results On the 3rd day after operation,the SAS score and SDS score of the experimental group were significantly lower than those of the control group,the differences were statistically significant(P<0.05).The PSQI score of the experimental group 3 days after operation was significantly higher than that of the control group,the difference was statistically significant(P<0.05).The GSES score of the experimental group 3 days after operation was significantly higher than that of the control group,the difference was significantly different(P<0.05).Conclusion The application of empathetic nursing combined with solution-focused mode in the nursing of patients with hysterectomy can significantly reduce the psychological stress response of the patients,improve the self-efficacy and sleep quality of the patients,and is beneficial to postoperative rehabilitation of the patients.
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Objective@#This study aimed to investigate the correlation between brain gray matter volume(GMV) and MPD based on voxel-based morphometry(VBM) method.@*Methods@#By using principle of random sampling method, 566 students were recruited from 5 different majors in a certain university. An electronic questionnaire was used to collect the general situation and MPD. Moreover, 266 students were obtained high-resolution 3-dimensional T1 structure images by 3.0 T MRI based on voluntary principle. A multiple regression model with VBM8 was performed to detect GMV associated with MPD scores.@*Results@#Among the 266 participants, 81 students(30.5%) reported MPD. There were no statistical differences of MPD scores between different characteristics, such as gender, residential area, sibling and perceived family income, as well as academic performance(t/F=-1.04,0.40,-1.30,0.23,1.48,P>0.05). An inverse correlation was found between GMV of the anterior cingulate gyrus(ACC) and right fusiform gyrus(FFG) with MPD scores(FDR corrected, P<0.05), and no positive associations were found.@*Conclusion@#College students with higher severity of MPD have lower GMV of ACC and right FFG, and these results suggested that MPD was correlated with brain reward, executive control and emotional related GMV.
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@#Objective To explore the effect and mechanism of exercise preconditioning on neurological deficits in rats after cerebral ischemia-reperfusion. Methods Thirty-six healthy Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and exercise preconditioning group (n=12). The latter two groups were occluded middle cerebral artery for 120 minutes and reperfused with modified suture method. The rats were evaluated with Longa's score two, twelve and 24 hours after reperfusion. The expression of mitochondrial ATP-sensitive potassium (mitoKATP) channel proteins inwardly rectifying potassium channel (Kir6.2) and sulphonylurea receptor 1 (SUR1) were detected with Western blotting and the cerebral cell apoptosis was detected with TUENL assay 24 hours after reperfusion. Results Compared with the model group, the Longa's score decreased in the exercise preconditioning group 24 hours after reperfusion (P<0.05), while the expression of Kir6.2 and SUR1 decreased (P<0.05), and TUNEL-positive cells decreased (P<0.05).Conclusion Exercise preconditioning may improve neurological function after cerebral ischemia-reperfusion, which may associate with inhibiting the expression of mitoKATP channel proteins and cell apoptosis.
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OBJECTIVE:To investigate the effects and safety of Sophoraflavescens preparation combined with Fuzheng huayu capsule on hepatic hemodynamics and fibrosis indexes in patients with hepatitis B liver cirrhosis.METHODS:One hundred and two patients diagnosed as hepatitis B liver cirrhosis in our hospital during Feb.2013-Jun.2014 were divided into combination group and control group according to random number table,with 51 cases in each group.Control group was treated with Adefovir dipivoxil capsules 10 mg,po,qd;combination group was additionally given Fuzheng huayu capsules 1.5 g,po,tid+Sophora flavescens preparation (Matrine glucose injection 250 mL,ivgtt,qd,in the first 3 months,oxymatrine capsules 200 mg,po,tid,after 3 months) on the basis of control group.Both groups were treated for 12 months.The levels of HBV-DNA,liver function indexes (AST,ALT,TBIL),portal hemodynamic indexes [main portal vein inner diameter (D),mean blood flow velocity (Ⅴ)] and liver fibrosis indexes [laminin protein (LN),hyaluronic acid (HA),type Ⅳ collagen (Ⅳ-C)] were observed in 2 groups before and after treatment.The negative conversion rate of HBV-DNA and incidence of ADR were recorded.RESULTS:Three cases lost to follow up,and a total of 48 effective cases were included in control group;5 cases lost to follow up,and a total of 46 effective cases were included in combination group.Before treatment,there was no statistical significance in HBV-DNA levels,liver function indexes (AST,ALT,TBIL),liver fibrosis indexes (LN,HA,Ⅳ-C) and portal vein hemodynamic indexes (D,V) between 2 groups (P＞0.05).After treatment,above indexes of 2 groups were decreased significantly,and the combination group was significantly lower than the control group,with statistical significance (P＜0.05).The negative conversion rate of HBV-DNA in combination group was 93.5％,which was significantly higher than 79.2％ of control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Sophora flavescens preparation combined with Fuzheng huayu capsules can promote the recovery of liver function,regulate liver hemodynamics and alleviate hepatic fibrosis in patients with hepatitis B liver cirrhosis with good safety.
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Objective To investigate the application value of serum tumor necrosis factor alpha (TNF-α) expression in diagnosing colorectal cancer (CRC).Methods One hundred and thirty inpatients with CRC in our hospital from February 2015 to November 2016 were selected and divided into 90 cases of CRC confirmed by operation and histopathology(CRC group),including intestinal cancer with and without metastasis,and 40 cases of benign colorectal diseases(colonrectal benign disease group),at the same time 40 persons undergoing physical examination were selected as the healthy control group.The levels of TNF-α,carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 724 were collected in all subjects.The data of various groups were not normally distributed,and the nonparametric statistical method was used to analyze and compare.Results Serum TNF-α level in clinical TNM stage Ⅱ(median 9.47 pg/mL),Ⅲ(9.95 pg/mL) and Ⅳ(9.67 pg/mL) of the CRC group was significantly higher than that in TNM stage Ⅰ(6.59 pg/mL);which in the CRC with metastasis group (9.95 pg/mL) was higher than 8.03 pg/mL in CRC without metastasis group,the difference was statistically significant (P0.05).The area under the ROC curve in each test index:TNF-α was 0.868,CEA was 0.912,CA724 was 0.523,and which of their joint detection was 0.940.Conclusion The expression of TNF-α is increased in the occurrence and development process of CRC,its serum level detection has certain clinical application value,the TNF-α expression has no obvious difference in the subjects with different ages and different sexes and has wide suitability.The combine detection of serum TNF-α,CEA and CA724 in the patients with CRC significantly increases the level,the combined detection of 3-index can have complementary advantages to increase the sensitivity of CRC diagnosis,which serve as the significant indexes in CRC early diagnosis,therapeutic effect evaluation and prognosis monitoring.
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Objective To investigate the effect of electroacupuncture (EA) pretreatment on neurological function, and the expression of Toll-like receptor 4 (TLR4) and nuclear factorκB (NF-κB) protein in ischemic penumbra after cerebral ischemia-reperfusion (CIR) injury. Methods A total of 36 male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and EA group (n=12). The later two groups were occluded their right middle cerebral arteries for two hours and reperfused. The EA group was pretreated with EA at Baihui (GV20) for two weeks before modeling. They were assessed with modified Neurological Severity Scores (mNSS), the injury in ischemic brain was detected with HE staining, and the expression of TLR4 and NF-κB protein in ischemic penumbra were detected with Western blotting, 24 hours after reperfusion. Results The score of mNSS decreased (P<0.05), the injury of brain tissue ameliorated, and the expression of TLR4 and NF-κB decreased in ischemic penumbra (P<0.05) in EA group compared with those in the model group. Conclu-sion EA pretreatment can reduce the injury and improve the neurological function in rats after CIR by down-regulating the expression of TLR4 and NF-κB protein in ischemic penumbra.
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Objective To analyze the clinical characteristics of infective endoearditis complicated with intracranial hemorrhage.Methods The clinical characteristics,brain CT and MRI results and prognosis of 7 patients with infective endocarditis and intracranial hemorrhage admitted between January 1991 and May 2015 were retrospectively analyzed.Results All seven patients presented varying degrees of fever,cardiac murmur and neurological symptoms.The continuous fever lasted from 21 d to 227 d (average 91 d).Mitral valve (4 cases) and aortic valve (3 cases) were the most common affected ones.The brain CT or MRI scan presented intracranial hemorrhage in 6 cases.More than 2 hemorrhage locations were found in 5 patients and parietal lobe was most common one (4 cases).All patients were treated with antimicrobial agents and three patients underwent valve replacement surgery.Three patients were cured and another 2 died due to fatal hemorrhage.Conclusions Patients with long fever history and ineffective antimicrobial treatment are prone to intracranial hemorrhage.Brain CT or MRI scan need be performed in infective endocardits when neurological symptoms are present,and brain angiography should be also considered if necessary.
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OBJECTIVE:To systematically review the efficacy and safety of different doses of canagliflozin in the treatment of type 2 diabetes,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,Clinical Trails.gov,CJFD,Wangfang Database and VIP,randomized controlled trials (RCT) about different doses of canagliflozin in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extract and quality evaluation by Cachrane 5.10. RESULTS:Totally 11 RCTs were enrolled,involving 5 399 patients. Results of Meta-analysis showed,canagliflozin 300 mg/d were superior to 100 mg/d in reducing HbA1c[MD=0.14,95%CI(0.09,0.19), P<0.001],FPG[MD=0.40,95%CI(0.20,0.61),P<0.001] and reduction rate of body mass[MD=0.69,95%CI(0.42,0.96),P<0.001],the differences were statistically significant;and there were no significant differences in the incidence of total adverse reac-tions [RR=0.97,95%CI(0.94,1.01),P=0.10],hypoglycemia [RR=1.02,95%CI(0.94,1.10),P=0.67],urinary tract infection[RR=0.96,95%CI (0.78,1.18),P=0.69] in 2 groups;There was significantly different of genital mycotic infection in 2 groups[RR=0.84,95%CI(0.70,1.00),P=0.04]. CONCLUSIONS:Canagliflozin 300 mg/d is better than 100 mg/d in controlling HbA1c,fasting blood glucose and body mass of patients with type 2 diabetes,and the genital mycotic infection should be attentioned.
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Objective To evaluate the rationality of antibiotic use in the outpatient and emergency departments in some class 3A hospitals in China through International Network for Rational Use of Drugs (INRUD).Methods The antibiotic prescriptions were collected from the outpatient and emergency departments in 78 class 3A hospitals of 25 provinces through INRUD during 2014-2015.The basic information of the antibiotic prescriptions and the prescriptions rationality were evaluated.Results A total of 447 894 prescriptions of antibiotics were analyzed.From 2014 to 2015,the qualified rate the prescriptions increased from 91.52％ to 93.08％,and the antibiotic use rate was similar (11.72％ and 12.04％).The major irrational prescription type was inappropriate prescription,including inappropriate indication (32.42％,34.02％) and inappropriate usage and dosage (24.22％,18.56％).Conclusions Totally,the antibiotic use in the outpatient and emergency department reached the standard in China.However,the use of antibiotics didn' t meet the national requirements in some area.It is necessary to promote the rational use of antibiotics.
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Objective To evaluate the rationality of antibiotic use in the outpatient and emergency departments in some class 3A hospitals in China through International Network for Rational Use of Drugs (INRUD).Methods The antibiotic prescriptions were collected from the outpatient and emergency departments in 78 class 3A hospitals of 25 provinces through INRUD during 2014-2015.The basic information of the antibiotic prescriptions and the prescriptions rationality were evaluated.Results A total of 447 894 prescriptions of antibiotics were analyzed.From 2014 to 2015,the qualified rate the prescriptions increased from 91.52％ to 93.08％,and the antibiotic use rate was similar (11.72％ and 12.04％).The major irrational prescription type was inappropriate prescription,including inappropriate indication (32.42％,34.02％) and inappropriate usage and dosage (24.22％,18.56％).Conclusions Totally,the antibiotic use in the outpatient and emergency department reached the standard in China.However,the use of antibiotics didn' t meet the national requirements in some area.It is necessary to promote the rational use of antibiotics.
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<p><b>OBJECTIVE</b>To breed new varieties with better uniformity and commercial quality as well as higher saikosaponin contents.</p><p><b>METHOD</b>The excellent germplasm resources were selected from "zhongchai no. 1" population. Single plant method was applied to get better varieties. All the breeding material was investigated according to morphological characters, agronomic characters and the contents of saikosaponin a and saikosaponin d. The experiments of comparative test and varieties regional test were carried out.</p><p><b>RESULT</b>The bred new varieties of "zhongchai No. 2" and "zhongchai No. 3" had better uniformity. The dark brown roots ratios of the two varieties were 83.2%, 89.9%, respectively. The contents of saikosaponins (a + d) of the two varieties reached 1.31%, 1.02%, respectively.</p><p><b>CONCLUSION</b>"zhongchai No. 2" and " zhongchai No. 3" both had the advantages of better uniformity, darker brown roots and higher saikosaponin contents.</p>
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Breeding , Bupleurum , Chemistry , Genetics , Oleanolic Acid , Plant Extracts , SaponinsABSTRACT
Objective To discuss how to reduce the incidence of postoperative infection and am-putation of patients after earthquake.Methods The wound infection and corresponding therapeutic outcome were analyzed in 592 patients in front line hospitals and station hospitals.Results The inci-dence of infection was 30. 7% in patients treated in front hospital within 8 hours post-trauma but 79. 9% after 8 hours post-trauma. There included 1 patient(0. 2%) with amputation due to clostridial myonecro-sis and 5(1. 2%)with amputation due to serious infection. Incidelice of postoperative wound infection was 7. 1% after selective operation for close injury. The incidence of infection in patients in station hospi-tals was 50. 8%, with no amputation, because they received debridement and antibiotics in site or front line hospitals. No postoperative infection was found in patients with close injury treated with selective op-eration in station hospitals. The major bacteria of wound infection in either front line hospitals or station hospitals were enterococcus faecalis and Eschrichia Coli. Incidence of combined infection was higher than that of single infection. And Gram-Negative bacillus infection exceeded Gram-Positive bacillus infection. The major wound infection obrained effective control through treatment with sensitive antibiotics.Con-clusions After earthqiale, the incidence of infection in patients with open injury is high, with high am-putation rate due to serious infection. Therefore, we propose performing as soon as possible debridement and external fixation with antibiotic treatment but reducing internal fixation. The postoperative infection late of patients with close injury in front line hospitals is much higher than that in station hospitals;their-fore, patients with stable vital signs should be transported to station hospitals as early as possible in order to reduce incidenee of infection.
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Objective To discuss the application value and improvement of principle of multi-echelon medical care in emergent rescue of the injured in Chinese Wenchuau earthquake. Methods The author analyzed and evaluated the medical rescue that was done at disaster site, in the front line hospital and higher level hospitals during earthquake. Results A total of 4 689 patients were treated at disaster site, including 413 patients with severe injury, of whom 3 died. Different kinds of operations including debridement were performed at disaster site, with infection incidence of open wound was nearly 80%. In the front hne hospital, 1 400 patients were treated, with 200 operations done. Of all, 110 patients with severe trauma were treated emergenfly, with an amputation rate of 3.0% and postoperative infection incidence of 66.8%. In the station hospitals, 125 patients received definite surgeries, with 1-5 surgeries per injury site. There was no postoperative cross infection, amputation or death. Conclusions The multi-echelon medical care is the basic mode for medical rescue of large number of patients in natural disaster rescue. First aid at disaster site should be performed as early as possible. Transportation is crucial for successful rescue and an improved patient grading system can help increase the efficiency of rescue. The front line hospitals should mainly provide life support, debridement and fixation of simple fracture, while the specific treatment and definite surgery should be carried out in the station hospitals.
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@# Using UEDASATO’s Evaluation and MAS (Motor Assessment Scale), We analysed the effect of hemiplegic patients following stroke who received three month rehabilitation treatment early after attacks. Results showed that the function recovery of effected limbs was worse than that of lower limbs, and the difference was statistically signicant (P<0.05); the whole motor function embodied in the trunk controlling and walking ability was improving after treatment, and there was obvious difference between pre and post treatment (P>0.05); there was little function recovery in effected upper limbs, no obvious difference was found (P<0.05). We concluded that the function recovery of the lower limbs in hemiplegic patients.
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@#hemiplegic patients following stroke were devided into two groups一一group A andgroup B for this study. Rehabilitation treatment started for the patients in group A in one month,yet forthose in group B in two or three months after onset of the stroke. Compared the conditions of the twogroups of patients before their rehabilitation treatment,there was no obvious difference(P<0.05)in thefour aspects of their motor ability(Ⅰ-activity in bed;Ⅱ-aclivity in wheel-chair;Ⅲ-in-ward;Ⅳ-outdoor activity).While the result of analysis on their post-treating shift of motor ability showed that thetrend,which the proportion of patients with ability Ⅰ andⅡ decreased but the proportion of patients withability Ⅲ and Ⅳ increased,was more significant in group A than in group B(P<0.05).Thereby it indicatesthat the early starting of rehabilitation treatment is favourable for improving motor ability of hemiplegic pa-tients following stroke.