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Objective:To explore the effect of prenatal and postnatal seamless personalized nursing intervention mode on breastfeeding of pregnant women and newborns.Methods:A total of 300 healthy mothers who were examined and delivered at Jinshan Branch of Shanghai Sixth People's Hospital from April 2018 to September 2018 were selected and randomly divided into observation group and control group. The control group was given routine care, and the observation group was given perinatal seamless nursing interventions. Clinical evaluations were performed on both maternal (how much lactation, maternal breastfeeding knowledge, swelling and cleft palate, and exclusive breastfeeding within 6 months after delivery) and neonatal aspects (abnormal temperature, crying before bedtime, and jaundice).Results:In the observation group, 63.33% (95/150) of maternal in the observation group were sufficient lactation which was significantly more than 51.33% (77/150) in the control group; the rate of knowledge of breastfeeding in the observation group was 64.00% (96/150), which was significantly higher than 54.67% (82/150) in the control group; the incidence of mammary tenderness and cleft palate in the observation group was 11.33% (17/150), which was significantly lower than 28.67% (43/150) in the control group; in the observation group within 6 months after delivery, the monthly exclusive breastfeeding rate was higher than in the control group; 44 cases of neonatal jaundice in the observation group were significantly less than the control group with 61 cases, the difference was statistically significant ( χ2 values were 4.23-15.01, P<0.05). Conclusion:By implementing this seamless individualized nursing intervention for healthy adult mothers, it is possible to increase maternal milk production and allow mothers to acquire knowledge about breastfeeding, while reducing the occurrence of breast tenderness and cleft palate, which has a positive effect on improving exclusive breastfeeding Promoting effect can also reduce the incidence of jaundice for newborns.
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With the development of science and technology and the improvement of living standards, people's understanding of "health" has also changed. The patients with chronic diseases and the people who do not have obvious symptoms of disease all hope to further improve the quality of life as well as the sense of happiness, gain and security. Disabled people and the elderly people with degraded physical functions are in need of corresponding rehabilitation devices. These needs determine that the research scope of biomedical engineering should be expanded, so as to use modern scientific technology and medical methods to study related issues and improve the health of the people. As a result, the concept of "healthcare medical engineering" emerged. In this paper, the definition of healthcare medical engineering were proposed, its significance, characteristics, content, and outlook for the future were introduced. This paper is expected to broaden the horizons and inspire ideas of researchers engaged in biomedical engineering research for future research in finding solutions to many problems in the field of medical and health care, thereby improving the quality of medical services and management, and promoting the development of the national health industry.
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Objective To investigate the association between stem cell factor (SCF) expression and tubulointerstitial fibrosis in the kidney of rat model with uric acid nephropathy. Methods Thirty-six Wistar rats were randomly divided into model group and control group. The rats in the model group were fed with adenine by lavage at a dose of 150 mg·kg-1·d-1, and the rats in the control group were fed with normal saline by lavage at equal volume. Six rats from each group were sacrificed respectively at week 4, 8 and 12. The mRNA levels of SCF and ColⅠin the kidney were detected by real-time fluorescence quantitative polymerase chain reaction (PCR), and their protein levels and infiltrated Mast cell (MC) were measured by immunohistochemistry. The difference and correlation of each index among different time points and groups were compared. The differences between the two groups were tested by t-test, multiple data were tested by one-way analysis of variance (ANOVA) and the correlation was analyzed by Pearson's correlation. Results ①The serum uric acid (SUA) [week 4, 8, 12: (302 ±41))μmol/L, (424 ±61) μmol/L, (518 ±57) μmol/L], creatinine[week 4, 8, 12:(151±9)μmol/L, (219±15)μmol/L, (299±21)μmol/L], urea nitrogen [week 4, 8, 12:(26.7±3.7) mmol/L, (40.3 ±5.7) mmol/L, (61.9 ±9.4) mmol/L], urine protein/creatinine (Up/Ucr) [week 4, 8, 12: (0.71 ±0.10) mmol/L, (1.18 ±0.11) mmol/L, (1.78 ±0.13) mmol/L] and the expressions of SCF mRNA [week 4, 8, 12: (1.19 ± 0.41), (1.69 ±0.63), (2.21 ±0.97)} and SCF protein [week 4, 8, 12: (1.42 ±0.33), (6.02 ±1.81), (10.03 ±2.69)] in nephridial tissue of model group's rats were significantly higher compared to the control group (all of t value>4.59, P<0.01), and the indexes were increasing gradually as the lavage going on. ②The expression of SCF was correlated with collagenⅠ, degree of renal interstitial injury, urine nitrogen, serum creatinine and UP/Ucr(At week 4, r=0.53, 0.42, 0.40 and 0.51 respectively;at week 8, r=0.60, 0.59, 0.41 and 0.39 respectively;at week 12, r=0.74, 0.61, 0.56 and 0.39 respectively, all of P value<0.05). ③ Compared with control group, the number of infiltrated MC was significantly higher in the model group, and was positively correlated with the expression of SCF (r=0.91, P<0.01). Conclusion Compared with the control group, the expression of SCF and the number of infiltrated MC in the renal interstitium are evidently increased, and are increasing gradually as the lavage going on and the deteriorating of renal interstitial damage. These results suggest that both may play important roles in the occurrence and development of uric acid nephropathy.
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Objective To investigate the relationship between the expression of osteopontin (OPN) and the infiltration of macrophages in renal tissues of patients with lupus nephritis (LN), and provide the evidence for the pathogenesis of lupus nephritis. Methods The expression of OPN and the infiltration of macrophages (CD68+ cells) in the renal tissue of 60 LN patients and 10 normal controls were detected by immunohistoche-mical method. Statistical analysis was used to analyze the correlation between variables. Results ① Com pared with the normal control group (5.3 ±1.8), the number of macrophages infiltrated in the renal tissue of LN patients was significantly increased [(52.3 ±7.3) vs (26.1 ±7.2 ), F=105.20, P<0.05].② Compared with the normal control group, the expression of OPN in LN patients was significantly increased, and the expression level of OPN in active patients was significantly higher than that in the inactive group [(23.5 ±4.5) vs (13.3 ±2.9), (21.5 ±3.7) vs (27.0 ±2.4), F=28.65, P<0.05]. ③ There was a significant positive correlation between macrophage infiltration and renal OPN expres-sion in renal tissue of LN patients (r=0.610, P<0.01). Conclusion The high expression of OPN is an im-portant mediator of macrophage infiltration in the process of lupus nephritis development, which may be one of the potential mechanisms of lupus nephritis.
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Objective To investigate the relationship between urine neutrophil gelatinase-associated lipocalin (uNGAL) level and activity and pathological types of lupus nephritis (LN).Methods Thirty cases of biopsy proven LN patients as the initial onset were enrolled into the study.Ten healthy persons were selected as controls.The clinical and pathological data and blood, urine specimen were collected.The uNGAL was measured by enzyme linked immunosorbent assay.The relationship between uNGAL and clinical and pathological features of LN was analyzed.One-way analysis of variance (ANOVA) and Pearson's correlation analysis were used for statistical analysis.Results Nineteen cases were in the LN active group and 11 cases were in the inactive group.The level of plasma NGAL had no significant difference between the active LN group [(64±6) ng/ml] and the inactive LN group [(58±20) ng/ml] and the healthy control group [(57±20) ng/ml] (P＞0.05).The level of urine NGAL in the active LN group [(69±3) ng/ml] and inactive LN group [(66±5) ng/ml] was higher than that in the healthy control group [(64±5) ng/ml, P=0.009, 0.016, respectively].Urine NGAL level in active LN group was higher than that in the inactive group (P=0.012).Urine NGAL level was positively correlated with SLEDAI, R-SLEDAI, GAI, TLAI, AI (r=0.472, 0.521, 0.502, 0.516, 0.597, respectively, P=0.042, 0.036,0.042, 0.021, 0.007, respectively).The urine NGAL concentration after comparing to different pathological conditions were: urine NGAL's level [(69.7±2.4) ng/ml] of type Ⅳ LN was higher than type ⅢN [(65.3±3.2)ng/ml] and type Ⅴ [(64.6±5.0) ng/ml] (P=0.031, 0.028, respectively).Receiver operating characteristic (ROC) indicated that uNGAL was more sensitive(86.7％) and specific (73.3％) for the diagnose of type Ⅳ LN than type Ⅲ or type Ⅴ LN.Conclusion uNGAL is closely related with disease activity and pathological activity in LN.uNGAL enables clinician to assess the activity of LN and could be a sensitive marker for the diagnosis of type Ⅳ adult LN.
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Objective To explore the effect and factors of patellofemoral arthroplasty (PFA) for isolated patellofemoral osteoarthritis.Methods Data of 18 patients (3 males,15 females) with isolated patellofemoral osteoarthritis underwent PFA from March 2006 to December 2014 were retrospectively analyzed.There were 3 males and 15 females with a mean age of 54 years (range,46-74 years).It was strict to grasp the surgical indications according to the clinical symptoms,signs and imaging data preoperatively.11 patients were operated with AVON patellofemoral prosthesis (Stryker Inc.) and the other 7 patients were operated with the Gender Solutions patellofemoral prosthesis (Zimmer Inc.).Active and passive functional rehabilitation exercise was encouraged at the early stage after operation.Visual analogue scale (VAS) was 5.33±0.99 (range,4-7) and hospital for special surgery knee score (HSS) was 53.28±5.71 (range,44-63) before operation.Results The mean duration of follow-up was 63.98 months (range,6-104 months).VAS after operation for 1 and 3 months were 1.17±0.79 (range,0-3) and 0.72±0.67 (range,0-2),and the pain was almost relieved after 9 months.HSS after operation for 1,3,9 months were 70.06±6.33 (range,61-80),86.06±5.12 (range,77-95) and 91.39±4.83 (range,82-97).HSS score of the latest follow-up was 92.06±4.05 (range,84-97),which was improved obviously from the preoperative ones.The excellent and good rate was 100％ (excellent 15 cases,good 3 cases).The satisfactory rate was 94.4％ (17/18).Only one case got slightly knee pain when walking up and down the stairs after 2 years,and the pain was relieved after being administered with NSAIDs and rest.No incision infection,rupture,prosthesis supported bone fracture,prosthesis loosening and other complication was occurred during the follow-up period in the other patients.Conclusion The clinical outcomes of PFA are strictly related to surgical indications,implant design and appropriate surgical technique.Therefore,based on the appropriate PFA implants,strict surgical indications,appropriate patients,excellent operation skills and actively functional rehabilitation exercise,PFA could treat the isolated patellofemoral osteoarthritis effectively.
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BACKGROUND:With the improvement of hemodialysis technology, the long-term survival rate of maintenance hemodialysis patients has been increased continual y. Nowadays, how to improve the quality of life in maintenance hemodialysis patients has been aroused widespread concern, and gradual y become the reliable indicator for comprehensive evaluation of the effect of hemodialysis. OBJECTIVE: To evaluate the effect of individualized intervention and col ective intervention on quality of life in maintenance hemodialysis patients. METHODS:Eighty maintenance hemodialysis patients, who had accepted more than 3 months of dialysis, were randomly divided into two groups (40 cases in the experimental group and 40 patients in the control group). Al the patients in the control group received 6 weeks of individualized intervention according to the pre-established schedule based on the hemodialysis routine care. Patients in the experimental group also have a period of six weeks of col ective intervention according to the pre-established weekly schedule based on the hemodialysis routine care. The quality of life of the patients was evaluated with MOS 36-item short form health survey and kidney disease quality of life short form before and after intervention. RESULTS AND CONCLUSION:After the intervention, both of the experimental group and the control group achieved significantly greater improvement than before in MOS 36-item short form health survey and kidney disease quality of life short form (P<0.01). The physical impact, overal health, emotional state, emotional impact, social function and energy of MOS 36-item short form health survey in the patients of the experimental group were higher than those of the control group after intervention (P<0.01);and the social quality, sleep, social support and patient satisfaction of kidney disease quality of life short form in the experimental group were higher than those in the control group (P<0.01). The results show that both individualized intervention and the col ective intervention based on the individualized intervention are effective in improving quality of life in maintenance hemodialysis patients and the col ective intervention can better improve the quality of life from physical, psychological and social aspects.
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Objective To investigate the risk factors related to the survival time of anti-protrusion cage in acetabular revision.Methods Data of 40 patients who had received acetabular revision using antiprotrusion cages between January 2002 and June 2010 were retrospectively analyzed.There were 16 males and 24 females,aged from 22 to 77 years (average,60.3 years).All patients were followed up for 12 to 82 months (average,39.2 months).According to the AAOS classification,there were 29 cases of type C and 11 cases of type D； while according to the Paprosky classification,there were 29 cases of type ⅢA and 11 cases of type Ⅲ B.The multiple regression analysis was utilized to investigate the relationships between different factors and anti-protrusion cage failure.The corresponding factors included gender,age,bone loss classification,superior or lateral migration of acetabular center of rotation,abduction angle,fixation manners (simple flange fixation or flange fixation plus transacetabular screw fixation),bone grafting techniques and cup type.Results At final follow-up,the average Harris score was 74.5±15.4.Two patients received rerevision due to prosthetic loosening.Obvious radiological loosening of prosthesis combined with pain was found in 2 cases.The statistical analysis indicated that superior migration of acetabular center of rotation,abduction angle and fixation manners were correlated with cup failure,especially when the superior migration was more than 8.5 mm or the abduction angle was larger than 53.5°.Flange fixation plus transacetabular screw fixation could reduce risk of cup failure.Conclusion There is a higher cup failure risk in acetabular revision using an anti-protrusion cage for patients with serious bone defect.However,implanting cup at the level of the true acetabulum as far as possible,decreasing abduction angle properly and using flange fixation plus transacetabular screw fixation can reduce cup failure risk.
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OBJECTIVE To observe the effect of voriconazole on pulmonary fungals infection after renal transplantation.METHODS Nine cases of pulmanory fungals infection after renal transplantation were analyzed to evaluate the therapeutic effect of voriconazole.RESULTS Treated with voriconazole,seven in nine patients were cured,while the other two died.CONCLUSIONS For patients with pulmanory fungals infection after renal transplantation,the application of voriconazole can receive satisfactory effect.
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AIM To explore the effect of tacrolimus on maturity and allostimulatory activity of cultured dendritic cells (DC) in vitro. METHODS Twenty rats were randomly divided into 4 groups: control, tacrolimus, LPS, and tacrolimus+LPS groups. The bone marrow cells of rats were cultured with granulocyte-macrophage colony-stimulating factors and interleukin-4 (IL-4) for 6 d and the DC which adhered to the wall were harvested. No other extraneous reagents were used in control group. Tacrolimus 10 μg·L-1 was added to tacrolimus group at the beginning of culture. Lipopolysaccarides (LPS) 100 μg·L-1 were administered 18 h beforeharvest in LPS group. In tacrolimus+LPS group, tacrolimus and LPS were used in accordance with tacrolimus and LPS groups. The immunophenotypes of DC were analyzed with flow cytometry and the level of IL-12 secreted by DC was detected by ELISA. The allostimulatory activity of DC on allogeneic T cells was assessed with mixed lymphocyte reaction. RESULTS Compared with control group, LPS increased CD80 and CD86 expressions, IL-12 secretion and allostimulatory activities of DC. Compared with control and LPS groups, tacrolimus cut down the expressions of CD80 and CD86, decreased the secretion of IL-12 and reduced the allostimulatory activity of cultured DC. CONCLUSION Tacrolimus exerts a negative effect on the maturation and allostimulatory activity of cultured DC in vitro.
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BACKGROUND: Immune tolerance is regarded as the most effective measure to overcome rejection. For the past few years, the important effect of immature dendritic cells (imDCs) on immune tolerance has drawn close attention. OBJECTIVE: To study the effect of imDCs treated with tacrolimus (FK506) on imlnune tolerance in rat allograft organ transplantation and to investigate the mechanism of immune tolerance induced by imDCs. DESIGN: A randomized and controlled animal experiment. MATERIALS: The experiment was carried out at the Experimental Animal Center, the Affiliated Hospital of Medical College. Qingdao University from April 2006 to December 2006.Cervical heart transplantations were performed in which 45Wister rats were used as donors and45 SD rats as allograft recipients. The ratswere randomly divided into three groups with 15 for each. METHODS: Normal sodium, imDes. and imDCs treated with FK506 were injected via vena caudalis seven. days before the operations respectively. Mixed lymphocyte reaction (MLR) was meas ured on SD, Wistar, and Lewis rats. MAIN OUTCOME MEASURES: Heart allografi survival was monitored and one-way MLR, heart pathology and the levels of interleukin-2(IL-2),IL-4,IL-10,and interferon-Y(IFN-Y)in the serum were detected. RESULTS: In treatment group without FK506.heart allografl survival were prolonged after imDC injection(P＜0.01);while their survival were prolonged further in treatment group with FK506(P＜0.05).MLR showed that the tolerance was donor specific. Analysis of variance showed that tere was high significant difference for serum concentrations of IL-2,IFN-Y,IL-4,and IL-10 in the three groups(P＜0.01).The concentrations of IL-2 and IFN-Y expressing on Th1 were lower. and that of IL-4 and IL-10 expressing on Th2 were obviously higher in the latter two groups. CONCLUSION: ImDCs can induce immune tolerance in rat heterotopic heart transplantation successfully; ImDCs treated with FK506 can enhance the tolerance which is donor specific.ImDCs may induce the immnune tolerance bymeans of modifying the immune response type of T cells (immune deflection from Th1 to Th2), mediating the generation of regulatory T cells (T-reg)and inducing T cells disenabling.
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OBJECTIVE To investigate the manifestation,fungal spectrum,diagnosis,antifungal therapy and(outcome) of deep fungal infection(DFI) in patients with hematopoietic malignancies.METHODS Fifty-two(patients) of SFI admitted in Shandong Provincial Hospital during Oct 1998 to Sept 2004 were enrolled in this(investigation,) including 34 males and 18 females with mean age of 54 years old.Clinical data,such as manifestation,fungal(spectrum,) treatment and outcome,were observed prospectively and retrospectively.RESULTS Lower respiratory tract,gastrointestinal tract,urinary tract and blood were the main DFI infection sites by order of prevalence.The clinical manifestation was various among cases.Pathogen detection determined the subtypes of fungi were Candida albicans(57.14%),C.tropicalis(21.43%),yeast(47.14%),C.parapsilosis(7.14%),and Aspergillus((5.36%).) Nystatin,fluconazole,flucytosine,and(amphotericin) B were used alone or in(combination) to treat DFI.The rates of curing,improvement and death were 44.23%,23.08% and 32.69%,(respectively).(Among) 52 cases,25(48.08%) were occurred during Oct 2002 to Sept 2004,compared with 27((51.92%)) during Oct 1998 to Sept 2002,suggested the elevated incidence of DFI.CONCLUSIONS The incidence of DFI in patients with hematopoietic malignancies is increasing these years.The clinical manifestation of DFI may be nonspecific.It is critical to pay more attention to the fungal infection among the high-risk patients,therefore fungus detection from various(samples) should be recommended for the sake of early diagnosis of DFI. Though(C.albicans) remains the top in pathogen spectrum analysis,infection of other fungi tends to increase.The mortality of DFI is still very high thus more investigations about early diagnosis and treatment of DFI should be conducted.
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Objective:To explore the role of osteopotin in lupus nephritis (LN).Methods:Sera osteopotin( OPN )levels were measured by enzyme linked immunosorbent assay in 90 patients with systemic lupus erythematosus (SLE),15 non-SLE patients with renal impairment,and 30 healthy volunteers.OPN mRNA expression in peripheral blood mononuclear cells (PBMCs) was also investigated with reverse transcription-polymerase chain reaction semi-quantitative method.Results:The expression of OPN was significantly higher in active LN groups than in all other groups(P0.05).Conclusion:The expression of PBMCs OPN mRNA is up regulation in active SLE.Meanwhile,its expression levels are correlated with the activity of LN.