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Objective To explore the cognition, practice and attitude of palliative department nurses to palliative care. Methods With the method of intention sampling, 12 nurses from Xinjiang Cancer Hospital were enrolled in the study. With the phenomenological method, the nurses were interviewed with semi-structured interviewing, the acquired data analyzed. Result 4 themes were extracted from the data:understanding of palliative care,implementation of palliative care,intervention on family members and problems at implementation of palliative care. Conclusion Palliative care nurses have a positive attitude towards palliative care. The promotion of palliative care should be strengthened.
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Objective To deeply understand the cognition and attitude of neoplasm departmentnurses toward palliative care. Methods With qualitative research phenomenological method as the guidance, purposive sampling method was adopted, from September to October 2017, ten nurses in a grade three class a tumor hospital in Xinjiang were interviewed with deep semi-structured. Colaizzi analytical method was adopted to analyze the materials which were then organized in to themes. Results Four themes were extracted from analyzing the interview materials: including the cognition of palliative care. The implementation of palliative care.The intervention of family members;The problems faced in the implementation of palliative care. Conclusions The interviewees have a positive attitude towards the implementation of palliative care.Suggestions on strengthening the construction of related disciplines and personnel training.
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Objective To design the risk and difficulty degree of common clinical nursing operation items with the purpose of offering much fair and scientific theoretical basis for the performance evaluation. Methods Self-designed questionnaires of risk and difficulties of nursing operation items were applied on 270 clinical nurses from 5 Third-level Grade A hospitals and 15 nursing training experts from different domains. Using the methods of clustering methodology to evaluate the risk and difficulty degree of nursing operation items. Results The risk and difficulties of 45 items of common nursing technical operations were ranked into 3 levels of rank and difficulties, in which the high level included 15 risk indexes (4.0 to 10.0 points) and 14 difficulty indexes (4.0 to 10.0 points), the middle level includes 18 risk indexes (0.9 to 3.0 points) and 17 difficulty indexes (0.5 to 3.0 points), low level includes 12 risk indexes (-10.0 to-0.8 points) and 14 difficulty indexes (-10.0 to-0.4 points). Conclusions The risk and difficulty of nursing operation are ranked in this study. What′s more, it is applied on the basis of nursing performance evaluation. Thus, it is offered much fair and scientific basis for the performance evaluation and human resources arrangement of nursing. And it also benefits for clinical nursing quality and the satisfaction of nurses.
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Objective To approach the clinical curative effect of retroperitoneal laparoscopic adrenalectomy.Methods 120 adrenal tumors patients clinical data of urinary surgery in our hospital were analyzed,who was divided into detection group(80 cases) and control group(40 cases).Results The operation time,bleeding volume,postoperative exhaust time,hospitalization time,incision infection,pulmonary infection,intestinal injury of detection group were lower than those of control group (t =5.59,21.17,26.32,6.01,x2 =7.79,7.79,5.13,all P ＜ 0.05).Conclusion Retroperitoneal laparoscopic adrenalectomy has some advantages:the small incision,less trauma,faster postoperative recovery,less complication,,which was worth of applying.
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Objective To explore the clinical effect of laparoscopic radical nephrectomy by retroperitoneal in 65 cases.Methods 65 patients who received retroperitoneal laparoscopic radical nephrectomy were selected as the observation group,and their clinical data were analyzed.At the same period,S0 patients treated by open operation were selected as the control group.The clinical effect was compared between the two groups.Results The operation time,intraoperative blood loss,hospital stay,incision infection,pulmonary infection,hypercapnia,intestinal injury of observation group were lower than those of control group (t =7.60,8.38,8.83,x2 =8.33,6.19,4.08,4.08,all P ＜0.05).The positive margin rate,local recurrence rate,distant metastasis rate of two groups were not significantly different (P ＞ 0.05).Conclusion Laparoscopic radical nephrectomy by retroperitoneal has advantages of small wound,quicker recovery,less complications and good prognosis,which is worthy of clinical application.
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Objective: To investigate the value of the trigeminocervical response (TCR) for revealing bulbar involvement in patients with spinal and bulbar muscular atrophy (SBMA). Methods: Thirty patients with SBMA and 30 healthy male controls were included in this study. In all of the normal controls, stimulation of the infraorbital nerve on one side produced bilateral short latency waves consisting of a positive/negative wave, p19/n31, the mean latency of which was measured. The mean square root of the ratio between the amplitude of p19/n31 and the mean rectifi ed surface electromyography (EMG) activity preceding the stimulus, the A value, was estimated. The parameters of the TCR were compared between the two groups. Results: Among the patients with SBMA, 21 (70.0%) had delayed latencies of p19/n31 (P < 0.01) and all (100%) had reduced A values (P < 0.01) relative to the normal controls. Conclusions: All parameters of the TCR were signifi cantly different between the patients with SBMA and the normal controls. T
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Objective To evaluate clinical efficacy of retroperitoneal laparoscopic adrenalectomy in patients with adrenal disease.Methods 21 cases of adrenal disease undergoing retroperitoneal laparoscopic adrenalectomy from Jun.2006 to Oct.2010 were retrospectively reviewed.Results All operations were performed successfully except 2 cases were converted to open surgery due to peritoneal rupture,which resulted in difficult exposure of retroperitoneal cavity.The operation time ranged from 55 to 300 minutes,with 90 minutes as the medium.Blood loss volume ranged from 10 to 100 ml during operation (30 ml as the medium ).No blood transfusion was given.No complication such as massive hemorrhage,infection,abdominal visceral injury etc.occurred.19 patients were treated successfully and followed up from 3 to 55 months with 12.3 months as the medium.No tumor recurrence and metastasis was found in the 19 cases.Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages of high safety,less complications and satisfactory efficacy in patients with adrenal diseases.
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<p><b>OBJECTIVE</b>To investigate the early clinical detection and new method for the treatment of congenital dislocation of hip in infants.</p><p><b>METHODS</b>From 2006 to 2010, 95 infants with congenital dislocation of hip were treated with self-made pygal cloth sling, including 25 males and 70 females, with an average age of 3.2 months old ranging from 0 to 6 months. Some patients were detected incidentally for the symptoms like asymmetric muscle strength or lower limbs range of motion, and all the patients got diagnosed with dislocation.</p><p><b>RESULTS</b>After the treatment, all of the patients received outpatient view once a month and taken X-ray examination bimonthly. Pygal cloth sling was removed after 2 months. According to the assessment criteria made by LIU Yuan-zhong, 90 patients got an excellent result, 2 good, 2 fair and 1 poor.</p><p><b>CONCLUSION</b>Treatment of congenital dislocation of hip in infants with self-made pygal cloth sling promotes the development of acetabulum and femoral head, and worthy further clinical applications.</p>
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Female , Humans , Infant , Infant, Newborn , Male , External Fixators , Hip Dislocation , TherapeuticsABSTRACT
Objective:To investigate the mechanism of indoleamine 2,3-dioxygenase(IDO)in HepG2 cells contributing to tumor immune escape.Methods:T-lymphocyte and HepG2 cell were cocultured,and 1-methyl-tryptophan(1-MT)was added to make an intervening experiment.The expression of IDO mRNA in HepG2 cell cocultured with T-lymphocyte was detected by RT-PCR;the apoptosis rate of HepG2 cell cocultured with T-lymphocyte was analyzed by flow cytometer;The cytotoxicity of T-lymphocyte against HepG2 cell was examined by MTT assay.Results:In combine reaction system,the expression of IDO mRNA was strongly induced in HepG2 cell cocultured with T-lymphocyte and faintly induced when cultured with 1-MT;the earlier apoptosis rate of HepG2 cell in control group and experiment group(1-MT:1.25 mmol/l,2.5 mmol/l,5mmol/l)was respectively(3.48?0.34)%,(7.82?0.41)%,(18.62?0.42)%,(25.32?0.40)%(P
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Objective To establish the method of contact heat evoked potential(CHEP)and to explore the value of this evoked potential in pain testing of patients with cerebral infarction.Methods A total of 100 healthy volunteers and 30 patients were examined.The healthy volunteers were divided into 3 groups according to the length of their arms:(Group A:56.0～65.0 cm ;Group B :65.5～74.0 cm ;Group C :74.5～83.0 cm).A recently de- veloped heat-foil technique with a rapid temperature rising rate at 70℃/s was used to elicit pain and contact heat e- voked potentials.Contact heat was delivered via one circular thermode(diameter 27 mm,area 573 mm~2)and set at two intensity levels(49.5℃and 54.5℃)to three body sites:the thenar eminence,the dorsum of hand and proximal volar forearm.The subjects were asked to rate the pain with numerical rating scale after each stimulus and CHEP was recorded from Cz and Pz.The association between stimulus intensities and pain rating was explored,the main compo- nents of the evuked potential were watched.CHEP,sensory conduction velocity(SCV)and somatosensory evoked potentials(SEP)were performed in patients with hemi-anesthesia caused by cerebral infarction.Results The pain intensity ratings were 3.2?0.3 and 4.4?0.5 at thenar eminence,5.0?0.7 and 6.3?0.8 at the dorsum of hand and 5.3?0.6 and 7.2?0.5 at the proximal volar forearm when the temperature of 49.5℃and 54.5℃was applied, respectively;Three components,Cz/N550,Cz/P750 and Pz/P1000,were identified in the evoked potentials.Cz/ N550 and Cz/P750 appeared when the dorsum of hand and proximal volar forearm were stimulated.In contrast,Pz/ P1000 could be identified when nociceptors of thenar eminence and proximal volar fbrearm were excited.In the pa- tients with cerebral infarction,CHEP disappeared or became abnormal on one side,while SCV and SEP were normal on that side.Conclusion It was suggested that CHEP could be elicited reliably in the controls.CHEP is helpful in the assessment of analgesia in patients with cerebral infarction.
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Objective To investigate the dynamic changes of the spinal cord during neck flexion in Hirayama disease for diagnosis.Methods MRI examinations in neutral neck position and a fully flexed neck position were performed on 18 cases of Hirayama disease and 31 young normal control subjects.We measured an antero-posterior diameter(APD)and transverse diameter(TD)of the cervical cord at the superior margin of the C6 vertebral body for each position,and investigate the dynamic changes.The different in frequency of these findings between the control and patient groups was examined by means of the x~2 test.The group means were compared by independent-sample t-test.Significance was defined as P
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Objective To evoke cerebral potentials by stimulating nociceptive fibers with contact heat evoked potentials stimulator (CHEPS)and estimate the nerve conduction velocities of peripheral nerve fibers mediating these responses.Methods Subjects were set in supine position.A heat-foil technology with a rapid rising speed at 70 ℃/s was used to elicit pain and contact heat evoked potentials(CHEP).Contact heat was delivered via one circular thermode (diameter 27 mm,area 573 mm~2).Thermal stimuli were sent at two intensity levels (49.5 ℃ and 54.5 ℃) to three body sites:thenar eminence,the dorsum of hand and proximal volar forarm.Contact heat evoked potentials were recorded from Cz and Pz.A systemic effect between stimulus intensities and pain rating were observed,the main components of this evoked potential were observed.Nerve conduction velocity was calculated from latency difference of CHEP and center to center distance of distal and proximal stimulus arrays.Results The pain intensity rating was 3.2?0.3 and 4.4?0.5 when thenar eminence was stimulated at the temperature of 49.5 ℃ and 54.5 ℃ respectively;the rating was 6.3?0.8 and 7.2?0.5 when the dorsum of hand and proximal volar forarm were stimulated at the temperature of 54.5 ℃ respectively.Three components,Cz/N550,Cz/P750 and Pz/P1000,were found in the evoked potentials.Nerve conduction velocities of the fibers were (12.9?7.5) and (1.7?0.4) m/s respectively,which were corresponding to those of A8 fiber and C fiber.Conclusions CHEPs can be elicited reliably and stably.Velocities of peripheral nerve fibers demonstrate that A8 fiber and C fiber mediate the response.
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Objective To diagnose Kennedy's disease (KD) via molecular analysis of the androgen receptor gene with suspected KD.Methods Two patients with suspected KD were reported.We analyzed their clinical features and investigated the number of CAG repeats in the androgen receptor genes. Results Both of the patients were characterized by slow progression of predominant proximal and bulbar muscle weakness.Patient 2 had oligospermatism.Serum creatine kinase and triglyceride levels were found markedly increased.The exact number of CAG was 52 in patient 1 and 48 in patient 2,respectively.These 2 patients were finally diagnosed as Kennedy's disease through the analysis of androgen receptor gene by PCR and direct sequencing.Conclusions The method of molecular analysis for KD had been copied in China.The clinical and molecular biological features of 2 Chinese patients with KD had been discussed.KD is a neurodegenerative disorder by proximal limb muscular atrophy and weakness with lower motor neuron signs,bulbar involvement.Dyscrinism and metabolic abnormalities may also be observed.Gene analysis is the unique and reliable methods to diagnose KD.