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Objective:To explore the effect of the intervention model based on the theory of knowledge, belief and action on the prevention of dislocation of prosthesis after hip replacement by nurses, so as to provide guidance for the management of prosthesis dislocation prevention after hip replacement.Methods:The patients were from Shenzhen Luohu People′s Hospital. From January to March 2018, 82 patients who underwent artificial total hip arthroplasty were set as the control group and received routine care. The 76 patients who underwent artificial total hip arthroplasty from May to July 2018 were set as the observation group, and the intervention model based on the theory of knowledge, belief and action was adopted. The incidence of prosthesis dislocation was compared between the two groups at 1, 3, 6 months after operation. At the same time, the Harris hip function score and the activity of daily living (ADL) score were compared between the two groups at the time of discharge, 1, 3, 6 months after operation.Results:The total incidence of prosthesis dislocation at 6 months was 1.32% (1/76) and 9.76% (8/82) in the experimental group and the control group, respectively, and the difference was statistically significant ( χ2=5.23, P<0.05). At discharge, there was no significant difference in the Harris hip function score and ADL scores between the two groups ( P>0.05). The Harris hip function score and ADL scores at 1, 3, 6 months after operation were (80.05 ± 6.72), (88.76 ± 5.84), (94.07 ± 4.43) points and (55.72 ± 16.61), (63.55 ± 14.55), (75.39 ± 12.27) points in the observation group, and (74.41 ± 6.26), (84.48±5.97), (89.30 ± 5.32) points and (47.13 ± 19.77), (56.71 ± 16.01), (63.96 ± 13.78) points in the control group, the differences were statistically significant ( t values were -6.08--2.80, all P<0.05). Conclusions:The intervention model based on the theory of knowledge, belief and action can effectively improve the Harris hip function score and ADL score of patients at 1, 3, 6 months after hip replacement, and reduce the incidence of prosthetic dislocation.
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Objective To analyze the changes of HIV‐1 viral load and virological efficacy of treatment effects for AIDS patients treated with antiretroviral therapy from 2009 to 2014 in Lincang City .Methods Monitored the HIV‐1 viral load for 13 491 cases of AIDS patients treated with highly active antiretroviral therapy(HAART) from 2009-2014 in Lincang City of Yunnan and analyze the monitoring data .If the patients had treated with HAART were still with viral load greater than 1 000 copy/mL ,the treatment was defined as a failed treatment or a virological failure .Results The total rate of virological failure was 14 .34% (1 935/13 491) . The rate of virological failure of children group was 15 .53% (50/322) ,and of adults group was 14 .31% (1 885/13 169) .There was no statistically significant difference between childeren and adults(χ2 =0 .38 ,P>0 .38) .The rate of virological failure in males was 16 .34% (1 156/7 076) ,and 12 .14% (779/6 415) in females ,the difference was statistically significant between men and female (χ2 =48 .16 ,P<0 .01) .Conclusion Antiretroviral treatment can delay the disease progression and improve the life quality .
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Objective To estimate the treatment effect of a tumor necrosis factor ? alpha antagonist (etanercept) on Stevens?Johnson syndrome induced by drugs. Methods After exclusion of tuberculosis, hepatitis, severe infections and tumors, 17 patients with drug?induced Stevens?Johnson syndrome were treated with subcutaneous injections of 25 mg(initial dose, 50 mg)etanercept once every 3 days for 6 times. Meanwhile, supportive therapies and compound glycyrrhizin injections were given to counteract inflammation and protect the liver. Results All of the patients were cured. Body temperature in 15 febrile patients gradually decreased within 24- 48 hours after the first injection of etanercept, and returned to normal in 72 hours. The number of vesicles stopped increasing, and lesion color turned from bright red to dull red within 24 hours. Skin condition was evidently controlled within 72 hours, and skin appearance almost returned to normal after 2 weeks of treatment, and was completely restored after 4- 5 weeks. The recovery of mucous membrane was slower than that of skin. Serum aminotransferase levels gradually declined after the first dose of etanercept and almost returned to normal in 2-4 weeks in 14 patients. Serum levels of urea nitrogen and creatinine began to decrease after 1- 2 weeks of treatment. The serum level of tumor necrosis factor?alpha nearly dropped into or was maintained in the normal range within 3 weeks after the start of treatment. Conclusion Early usage of tumor necrosis factor?alpha antagonists at an adequate dose is beneficial to the rapid control of Stevens?Johnson syndrome.
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From July 2013 to February 2015, 4 infant patients with complex congenital heart disease, who underwent open heart surgery in Xiangya Hospital of Central South University, were diagnosed as heparin-induced thrombocytopenia (HIT). After comprehensive treatments, such as intensive monitoring of the platelet count, close observation of thromboembolic skin lesions and close monitoring of argatroban therapy, 3 patients were cured and 1 died. HIT is rare but serious in patients who received heparin therapy. The incidence of mortality and thrombosis is very high. Early identification and diagnosis of high-risk groups can improve the prognosis.
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Humans , Infant , Anticoagulants , Cardiac Surgical Procedures , Heparin , Incidence , Pipecolic Acids , Therapeutic Uses , Platelet Count , Prognosis , Thrombocytopenia , ThrombosisABSTRACT
Objective To study the proliferation,collagen production and related gene expression in keloids and normal skin fibroblast.Methods Isolated primary cells of keloid fibroblasts (KFb,n=12) and normal human dermal fibroblasts (NFb,n=12) were identified,the cell viability and proliferating potential and the cell cycle were detected,and the difference on the collagen synthesis between KFb and NFb were compared.The expression of cell cycle-associated genes such as p21,p16,and p27 was dectected by real-time fluorescent quantitative PCR.Results The phase contrast optical microscopy imaging showed that both KFb isolated from keloid tissues and NFb from normal skin tissues possessed classic and similar fibroblast morphology.But there was a significant difference between cell proliferation,Hyp [(2.30±0.10) μg/ml vs.(1.66±0.13) μg/ml,P＜0.05] and collagen levels [(17.19±0.75) μg/ml vs.(12.37±0.94) μg/ml,P＜0.05].Compared with NFb,KFb exhibited more percentage of G2/M phase cells [(5.90±0.62)％ vs.(16.94 ％±1.93)％,P＜0.05]and less percentage of G0/G1 phase cells [(90.24 ±2.27)％ vs.(75.65±1.92)％,P＜0.05].Cell cycle related genes p16,p21 and p27 were low expressed.Collagen type Ⅰ was highly expressed at mRNA levels in KFb than that in NFb [0.84±0.11,1.32±0.2,1.69±0.12,4.33±0.27 in KFb vs.1.43±0.13,2.56±0.26,2.89±0.37,1.40±0.12 in NFb,P＜0.05].Conclusions There are cell dysfunction and abnormal cellular dynamics in keloid fibroblasts.The formation of keloid likely involves aberrant interactions of some genes that affected its development at different extents.
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AIM:To prepare a compound as the chemical reference substance of Guangjinqiancao Zonghuangtong Capsule.METHODS:To apply general column chromatography combined with preparative HPLC to isolate the target compound,to use analytic HPLC to determine the purity,stability and its content in the capsule,and to employ spectroscopic analysis (UV,IR,ESI-MS,1H-NMR,13C-NMR,DEPT,1H-13CCOSY,1H-1HCOSY,1DHOHAHA.1D.NOE,HMBC) to elucidate the structure of the isolated compound.RESULTS:The obtained compound was identified as isoschaftoside with the purity of over 99%, which was stable within 3 months at ambient temperature.As for isosehaftoside solution.it was stable within 8 h at ambient temperature.Its content in the capsule was above 3.0%.CONCLUSION:Isoschaftoside is a qualified reference substance for analytic assay ofGuangjinqiancao Zonghuangtong Capsule,and can be isolated from Desmodium styracifolium(Osb.)Merr.
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To reduce the risk of 3′-terminal mismatch between primers and template and increase the sensitivity of polymerase chain reaction (PCR) in the detection of variable region of DNA. Methods: A pair of special primer(WU,WD) was designed to amplify a fragment of HBV DNA P gene by PCR. Other 2 similar pairs of primer (MU1, MD1, MU2, MD2) were obtained by knocking off 1 or 2 bases at the 3′-terminal of WU and WD. (1) Special primers (WU, WD) and degeneracy primers(WU, WD, MU1, MU2, MD1, MD2) were used to amplify 27 samples respectively by PCR under the same condition. The sensitivity of each PCR was compared. (2) Using degeneracy primers, serum HBV DNA was amplified from 4 patients who were resistant to lamivudine. The PCR products were sequenced to evaluate the effect of the 3′-terminal mismatch of primers upon PCR. Results: (1) The sensitivity of special primers and degeneracy primers were 70.4%(19/27) and 85.2%(23/27) respectively (P<0.05). (2) The sequencing analysis of the PCR products suggested that the 3′-terminal mismatch of primers caused false negative in the PCR detection. Conclusion: When amplifying the variable region of DNA, the false negative result can be avoided by using 3′-terminus shifted degeneracy primers.
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Objective: To reduce the risk of 3'-terminal mismatch between primers and template and increase the sensitivity of polymerase chain reaction (PCR) in the detection of variable region of DNA. Methods: A pair of special primer(WU, WD) was designed to amplify a fragment of HBV DNA P gene by PCR, Other 2 similar pairs of primer (MU1, MD1, MU2, MD2) were obtained by knocking off 1 or 2 bases at the 3'-terminal of WU and WD. (1) Special primers (WU, WD) and degeneracy primers(WU, WD, MU1, MU2. MD1, MD2) were used to amplify 27 samples respectively by PCR under the same condition. The sensitivity of each PCR was compared. (2) Using degeneracy primers, serum HBV DNA was amplified from 4 patients who were resistant to lamivudine. The PCR products were sequenced to evaluate the effect of the 3'-terminal mismatch of primers upon PCR. Results: (1) The sensitivity of special primers and degeneracy primers were 70. 4%(19/27) and 85. 2% (23/27) respectively (P