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Objective:To understand patient family′s acceptance of the online medical platform, the choice of health information access and the influencing factors, and provide a more scientific reference for the construction of the online medical platform.Methods:The literature analysis method, interview method, questionnaire survey method and structural equation model were adopted for research. The subjects of the study were the family members of 204 pediatric patients who were treated at a tertiary children′s hospital. The research content included the patient family members′ acceptance and usability evaluation of the online medical platform, the patient family members′ evaluation of the access to health information, and the sense of control.Results:The system availability scale(SUS)score was 55.355 4±17.454 1, which was at the lowest F level. The patient family′s evaluation of the simplicity of the online medical platform was significantly higher than the traditional approach( P<0.01). In terms of information adequacy and trust evaluation, the patient family′s evaluation of online medical platform was significantly lower than the other two ways( P<0.01). The sense of control is an important factor influencing the acceptance of online medical platforms and the choice of access to health information( P<0.001). Conclusions:The family members of the patients have low acceptance of the online medical platform. On the one hand, medical institutions should continue to strengthen the construction of online medical platforms and adopt a multi-disciplinary strategy to improve the trust of family members in the health information of medical platforms; on the other hand, they should improve the sense of control of patients′ medical procedures.
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Objective To investigate the predictive value of D-dimer for early neurological deteriora- tion (END) in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke admitted to the Department of Neurology, the Second People ' s Hospital of Shenzhen between January 2015 and December 2017 were enrolled retrospectively. END was defined as an increase ≥2 in the National Institutes of Health Stroke Scale (NIHSS) score or an increase ≥1 in the motor function score within 7 days after admission compared with the baseline score. Demographics, baseline clinical data, and primary treatment options during hospitalization were compared between the END group and the non-END groups. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of D-dimer for END. Results A total of 625 patients were enrolled in the study, including 40 in the END group (including 3 deaths) and 585 in the non-END group. The mean hospital stay, international normalized ratio, D-dimer, uric acid, NIHSS score and modified Rankin Scale (mRS) score at admission, and the proportion of patients with complete anterior circulation infarction, large atherosclerotic stroke, and pulmonary infection were significantly higher than those in the non-END group (all P < 0. 05). There was no significant difference in the proportion of patients receiving thrombolysis, antiplatelet,anticoagulation, and statins between the two groups. ROC curve analysis showed that the area under the curve of D-dimer predicting END was 0. 810 (95％ confidence interval [CI] 0. 736-0. 884; P < 0. 001); the optimal cut-off value was 2. 35 mg/L, and the sensitivity and specificity were 54. 74％ and 96. 13％ respectively. Multivariate logistic regression analysis showed that large atherosclerotic stroke (odds ratio [OR] 1. 115, 95％ CI 1. 005-1. 390; P = 0. 003 ), D-dimer ≥2. 35 mg/L (OR 1. 055,95％ CI 1. 012-1. 150; P = 0. 001 ), NIHSS score at admission (OR 1. 191, 95％ CI 1. 006-1. 410; P <0. 001), mRS score > 1 at admission (OR 1. 755, 95％ CI 1. 139-3. 656; P = 0. 037 ), and pulmonary infection (OR 2. 598, 95％ CI 1. 132-3. 081; P = 0. 012) were the independent risk factors for END in patients with acute ischemic stroke. Conclusion D-dimer ≥2. 35 mg/L at admission has higher predictive value for END in patients with acute ischemic stroke.
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Many studies indicated meteorological factors may be independent risk factors for the onset of ischemic and hemorrhagic stroke.Meteorological factors may contribute to the onset of stroke by affecting blood pressure and blood composition,or induced infection.
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Microwave-assisted extraction (MAE) was used for extraction of effective components of sarcandra glabra (Thunb.), and then chromatographic fingerprint of sarcandra glabra (Thunb.) was studied by high performance liquid chromatography/diode array detector (HPLC/DAD). The conditions of MAE were optimized by an orthogonal experiment, and then the authentication and validation of the chromatographic fingerprint were conducted. Nine peaks were identified as common peaks in the fingerprint chromatograms, and isofraxidin was considered as a reference compound and quantified. Relative standard deviations of retention time and peak area of each component were less than 3% and 8%, respectively. Similarity and difference analysis were conducted by use of PCA and relation coefficient. Twenty batches of sarcandra glabra (Thunb.) samples from two different producing areas could be classified into two different groups in the PCA model. The results showed that MAE-HPLC/DAD method was simple, efficient and stable for the study of complex chromatographic fingerprint of sarcandra glabra (Thunb.), which could provide more reliable and precise information for quality evaluation.
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Objective To explore the influence of individualized nursing intervention on life quality of patients with rheumatoid arthritis. Methods 60 patients were divided into the intervention group and the control group with 30 cases in each group. The intervention group adopted individualized nursing projects according to the influencing factors of life quality based on routine nursing. The control group received routine nursing only. The life quality of the two groups was appraised by inventory before and after intervention. Results The status such as physiological function, mental function, social function and self-recognized health in the intervention group was greatly ameliorated and was statistically different from that in the control group(P＜0.05).Conclusion Individualized nursing intervention could dramatically improve the life quality of patients with rheumatoid arthritis
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The current problems of pharmacology teaching in nursing in 3-year program colleges lie in that the teaching ideas drop behind;course orientation is vague;the development of text books lags;the contents lack characteristics;and there is no clear aims in the practice teaching.So,it is essential to make the teaching evolution.First,according to the post needs,the orientation of the courses should be definite,and new ideas about the curriculum should be set up.Meanwhile,the development of text books should be speeded up and the teaching contents should be optimized.Then,practice teaching needs to be improved,and cultivation of their comprehensive competence should be enhanced.To improve the students’professional qualities,emphasis on the penetration of humanities should be paid attention to.
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Objective To study the neurotoxicity of chronic aluminum overload and the protective effects of nimodipine in rats.Methods The brain damage models of rats were established via intragastric administration of aluminum gluconate(element aluminum 400 mg/kg)once a day,5 d/week for 12 weeks.The step-down test and programmed Morris water maze test were used to evaluate the changes of learning and memory functions of rats.Pathomorphological changes of hippocampi of rats were observed.The activities of SOD,ChAT,AchE,MAO-B and the contents of MDA of brain tissue in rats were also measured.Nimodipine(80 mg/kg)were intragastrically administered 4 h after aluminum administration every time for 12 weeks.Results Chronic aluminum administration induced the impairment of avoidance learning and memory ability and spatial oriental ability.Consistent with the behavioral changes,neuronal death in the hippocampi,decreased activities of SOD and ChAT,increased content of MDA,and increased activity of MAO-B and AchE were detected in the aluminum-overload mice.The administration of nimodipine could significantly protect rats from the brain damage,and behavioral and biochemical changes above caused by aluminum overload were in a dose-dependent manner.Conclusion These results suggest that changes of cellular calcium overload and oxide stress and MAO-B activities are involved in pathophysiological mechanisms of brain injury induced by chronic aluminum overload.Nimodipine has a protective effect on neurotoxicity of chronic aluminum overload.
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Objective To study the bioequivalence of domestic ropivacaine mesylate in compared with imported ropivacaine hydrochloride in Beagle dogs.Methods Ropivacaine mesylate and ropivacaine hydrochloride at a dose of 10 ?mol/kg was administered intravenously in a randomized cross-over test.The plasma level of ropivacaine was measured by high performance liquid chromatography(HPLC).The pharmacokinetic parameters of ropivacaine were determined by the soft pack of Practical Pharmacokinetic Program Version 97(3P97).Results The pharmacokinetic parameters of ropivacaine mesylate were T_(1/2?)(3.83?1.89) min,T_(1/2?)(41.08?4.47) min,AUC_(0-200)(148.67?87.51) ?g?ml~(-1)?min~(-1),C_(max)(3.96?1.50) ?g/ml,CL(s)(0.030?0.014) L?kg~(-1)?min~(-1),and these parameters of ropivacaine hydrochloride were(3.09?1.19) min,(38.43?4.41)min,(125.80?81.06) ?g?ml~(-1)?min~(-1),(3.72?1.31) ?g/ml,(0.030?0.013) L?kg~(-1)?min~(-1) respectively.Conclusion The bioavailability of ropivacaine mesylate is equal to that of ropivacaine hydrochloride.
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Objective To study the clinical effect of noninva si ve positive pressure ventilation(NIPPV)on the treatment of acute exacerbations o f chronic obstructive pulmonary disease(COPD)with type Ⅱ respiratory failure.Methods Observe the data in arterial blood gas (pH,PaO2,PaCO2 ),the course of disease in the hospital ,the rate of endotracheal intubation ,the mortality of the patients in NIPPV and compare with those of the patients without NIPPV treatment before.Results The data in arterial blood gas had been improved signif icantly in NIPPV after 24h.The course of disease in hospital was significantly s horter,and the rate of endotracheal intubation and mortality of the patients wa s significantly lower in NIPPV than those in no NIPPV.There was remarkably diffe rence between two groups.In NIPPV,the rate of endotracheal intubation were sig nificantly lower in light and moderate respiratory failure than those in severe respiratory failure(P
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AIM: To explore the structural changes of brain microvasculature and mechanism in microvascular lesion after focal cerebral ischemia with reperfusion. METHODS: Using the techniques of immunohistochemical staining, in situ hybridization,optical microscopy and transmission electron microscopy, the expression of uPA, uPA mRNA, and changes in miocrovascular structure were examined in ischemic focus and perifocal areas after focal cerebral ischemia 2 hours with various time points of reperfusion in stroke-prone renovascular hypertensive rats (RHRSP). RESULTS: The brain edema and hemorrhage were severe 12 hours to 3 days after reperfusion. Ultrastructural change showed that the damage characterizations of the basement membrane were degradation, defection, and exfoliated of basement membrane, while uPA, which attack the basememt membrane around cerebral capillaries and extra-cellular matrix, and uPA mRNA expression increased significantly in ischemic and perifocal areas 12 hour to 3 day after reperfusion. CONCLUSION: The main pathologic mechanism of brain edema and hemorrhage after cerebral ischemia with reperfusion may result from the basement membrane lesion of brain microvasculature. The increase in the expression of uPA in reperfusion area may be the main cause of the basement membrane lesion .