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Objective:To upgrade the wisdom of traditional wards through the internet of things platform to achieve intelligent and refined management of wards, and to evaluate the effect of the upgrade.Methods:In June 2020, the convenience sampling method was used to selecte two wards of the cardiology department of Shandong First Medical University as the pilot units of the affiliated provincial Hospital to implement the intelligent ward management mode. Based on the principle of easy transformation, easy construction and easy maintenance, on the basis of realizing the full coverage of the internet of things, the hardware and software system were connected to complete the intelligent upgrade of the traditional ward, and the structured observation and semi-structured interview methods were adopted to evaluate the upgraded work efficiency and the use experience of patients.Results:The time spent on vital sign collection and recording, nursing risk assessment and time spent, and signage production and hanging were (4.24 ± 0.87), (4.07 ± 0.86) and 0 min respectively, which were effectively reduced than those before the upgrade (6.50 ± 2.95), (4.73 ± 1.62) and (1.13 ± 0.43) min, with statistically significant differences ( t=8.04, 3.99, 28.96, all P<0.01). The results of semi-structured interviews showed that patients perceived the smart ward as intelligent, saving manpower and waiting time; simple to operate, improving the experience of healthcare workers and patients in using it; and untimely system updates. Conclusions:The wisdom upgrade of traditional wards can help refine patient management, improve work efficiency, and improve the experience of health care workers and patients in using them, which will be continuously improved in future development and can provide practical paths for reference for the wisdom upgrade of similar wards.
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In the context of non-alcoholic fatty liver disease (NAFLD), characterized by dysregulated lipid metabolism in hepatocytes, the quest for safe and effective therapeutics targeting lipid metabolism has gained paramount importance. Sanhuang Xiexin Tang (SXT) and Baihu Tang (BHT) have emerged as prominent candidates for treating metabolic disorders. SXT combined with BHT plus Cangzhu (SBC) has been used clinically for Weihuochisheng obese patients. This retrospective analysis focused on assessing the anti-obesity effects of SBC in Weihuochisheng obese patients. We observed significant reductions in body weight and hepatic lipid content among obese patients following SBC treatment. To gain further insights, we investigated the effects and underlying mechanisms of SBC in HFD-fed mice. The results demonstrated that SBC treatment mitigated body weight gain and hepatic lipid accumulation in HFD-fed mice. Pharmacological network analysis suggested that SBC may affect lipid metabolism, mitochondria, inflammation, and apoptosis-a hypothesis supported by the hepatic transcriptomic analysis in HFD-fed mice treated with SBC. Notably, SBC treatment was associated with enhanced hepatic mitochondrial biogenesis and the inhibition of the c-Jun N-terminal kinase (JNK)/nuclear factor-kappa B (NF-κB) and extracellular signal-regulated kinase (ERK)/NF-κB pathways. In conclusion, SBC treatment alleviates NAFLD in both obese patients and mouse models by improving lipid metabolism, potentially through enhancing mitochondrial biogenesis. These effects, in turn, ameliorate inflammation in hepatocytes.
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Humans , Mice , Animals , Non-alcoholic Fatty Liver Disease/metabolism , NF-kappa B/metabolism , Organelle Biogenesis , Retrospective Studies , Mice, Inbred C57BL , Obesity/metabolism , Liver , Inflammation/metabolism , Body Weight , Lipid Metabolism , Lipids , Diet, High-Fat/adverse effectsABSTRACT
Objective:To summarize experience of nursing in radiofrequency ablation (RFA) for adrenocortical adenoma with Cushing′s syndrome combined steroid-induced diabetes mellitus.Methods:The key of preoperative nursing was precise glucose control by using insulin pump. Focus on patients psychological intervention. It was important for closely monitor the change of blood pressure, cortisol levels and biochemical index to prevent acute complications such as adrenal crisis during RFA. Pay attention to postoperative nutrition management for reduce blood glucose fluctuation and adverse reactions of hydrocortisone at postoperative.Results:No severe complications occurred during this procedure. After twenty-day nursing and treatment, the patient′s blood glucose control was stable, and the symptoms related to Cushing′s syndrome gradually disappeared.Conclusion:The ultrasound guided radiofrequency ablation in adrenocortical adenoma with Cushing′s syndrome combined with steroid-induced diabetes mellitus was a feasible, safe, and minimally invasive treatment. The key to effectively reduce postoperative complications and ensure the success of the operation. Are adequate preoperative preparation and strict monitor.
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The influence of β-cell function on cardiovascular autonomic neuropathy (CAN), an important diabetes-related complication, is still unclear. In this study, we aimed to investigate the association between residual β-cell function and CAN in patients newly diagnosed with type 2 diabetes. We enrolled 90 newly-diagnosed type 2 diabetic patients and 37 participants with normal glucose tolerance as controls. The patients were divided into a CAN+ group (diabetic patients with CAN, n = 20) and a CAN- group (diabetic patients without CAN, n = 70) according to the standard Ewing battery of tests. Fasting and postprandial plasma glucose, insulin, and C-peptide were measured. Homeostasis model assessment-beta cells (HOMA-B) and HOMA-insulin resistance (IR) were calculated. The prevalence of CAN in this population was 22.2%. Compared with the CAN- group, the CAN+ group had significantly lower fasting plasma insulin (6.60 ± 4.39 vs 10.45 ± 7.82 μ/L, P = 0.029), fasting C-peptide (0.51 ± 0.20 vs 0.82 ± 0.51 nmol/L, P = 0.004), and HOMA-B (21.44 ± 17.06 vs 44.17 ± 38.49, P = 0.002). Fasting C-peptide was correlated with the Valsalva ratio (r = 0.24, P = 0.043) and the 30:15 test (r = 0.26, P = 0.023). Further analysis showed that fasting C-peptide (OR: 0.041, 95% CI 0.003-0.501, P = 0.012) and HOMA-B (OR: 0.965, 95% CI 0.934-0.996, P = 0.028) were independently associated with cardiovascular autonomic nerve function in this population. The patients with fasting C-peptide values < 0.67 nmol/L were more likely to have CAN than those with C-peptide levels ≥0.67 nmol/L (OR: 6.00, 95% CI 1.815-19.830, P = 0.003). A high prevalence of CAN was found in patients with newly-diagnosed type 2 diabetes. Decreased β-cell function was closely associated with CAN in this population.
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Adult , Female , Humans , Male , Middle Aged , Asian People , Blood Glucose , Diabetes Mellitus, Type 2 , Metabolism , Diabetic Neuropathies , Fasting , Physiology , Glucose , Metabolism , Insulin , Metabolism , Insulin Resistance , Physiology , Insulin-Secreting Cells , MetabolismABSTRACT
Based on the problems existing in the original specimen management process of the First Affiliated Hospital of Guangdong College of Pharmacy,the paper proposes achieving the closed-loop management process of laboratory specimens through wireless network technology,PDA,laboratory specimen bar code,QR codes of patients and interaction of multiple systems,and describes the functional design and application effect of the system.The application of the closed-loop management process for laboratory specimens can better standardize and normalize the management of specimens.
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Objective:To optimize the extraction process of Shenghua pills and establish the best method for the TLC identification and the HPLC determination of effective components to provide an effective method and reliable basis for the quantitative and qualitative analysis of Shenghua pills. Methods:TLC was used for the identification of angelica,Rhizoma Chuanxiong and Licorice. Ferulic acid was determined by HPLC,and the separation was performed on an Agilent 5 TC- C18(2)(250 mm×4.6 mm,5 μm)column using a mixture of methanol-5% acetic acid solution(25 :75) as the mobile phase with the detection wavelength at 322 nm. The flow rate was 1.0 ml·min-1and the column temperature was room temperature. Results:Angelica sinensis(Oliv.) Diels.,Ligusticum chuanxiong Hort. and Glycyrrhiza uralensis Fisch. could be detected by TLC. Ferulic acid was linear within the range of 1.28-20.51 μg·ml-1(r=0.999 9). The average recovery was 98.47% with the RSD of 0.36% (n=6).Conclusion:The method can be used to efficiently extract the active components in Shenghua pills. The method is feasible,accurate and reproducible. It can be used for the quality con-trol of Shenghua pills.
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To study the effects of timing of vitrectomy performed for open-globe injury patients on the thickness of retinal nerve fiber layer [RNFL]. A total of 120 patients with traumatic optic neuropathy [TON] were selected and divided into a treatment group and a control group by random draw [n=60]. Vitrectomy was performed within one week upon injury for treatment group and after one week for control group. The thickness of RNFL was observed by optical coherence tomography. All surgeries were conducted successfully, without severe complications. The best corrected visual acuity of treatment group surpassed that of control group one month after surgery, and treatment group had an obviously higher overall effective rate [95.0%] than control group did [81.7%]. The incidence rate of postoperative complications in treatment group [6.7%] was significantly lower than that of control group [28.3%] [P<0.05]. Logistic multivariate regression analysis showed that vitrectomy timing and postoperative complications were independent risk factors of prognosis [P<0.05]. Both groups had significantly thinner RNFLs one week after surgery [P<0.05], and treatment group almost recovered within one month [P>0.05]. Early vitrectomy effectively augmented the visual acuity of patients with TON, decreased complications, affected RNFL thickness reversibly, and improved prognosis
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AIM:TodetecthemoglobinA1c(HbA1c)andparametersofbloodglucosefluctuationinChinesenewlydiag-nosed type 2 diabetes mellitus (T2DM) patients, and further to specify the factors that were related to mean blood glucose (MBG) in this population.METHODS:Newly diagnosed T2DM patients (n=90) from 4 hospitals in Guangdong province were enrolled, and subjected to 3 d continuous glucose monitoring (CGM) after testing for HbA1c and other laboratory tests.Blood glucose data collected during CGM were used to calculate MBG and parameters of blood glucose fluctuation.RESULTS: Correlation analysis revealed that MBG was significantly related to all parameters of blood glucose fluctuation, HbA1c, fast plasma glucose ( FPG) and 2 h postprandial glucose (P<0.01), but not to sex, age or blood lipid profile.Further analysis utilizing step-wise general linear model showed that HbA1c, absolute means of daily difference ( MODD) , difference between maximal and minimal glucose ( DMMG) and FPG had the strongest relation to MBG.CONCLUSION: Factors affecting MBG of the newly diagnosed T2DMpatients in our country include HbA1c, FPG, DMMG and MODD, and thus it may be prone to misleading results that only HbA1c is applied to estimate MBG in this population.
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Objective To explore the effect of risk management on the perioperative nursing of elderly patients undergoing cardiovascular surgery. Method Sixty-two elderly patients undergoing cardiovascular surgeries were managed by management, which included establishing risk management team, identity and evatuating risk factors, applying risk manadement. Result There was no nursing risk events among them. Conclusion For elderly patients with cardiovascular surgery, risk management can enhance nurses′ability of discerning, assessing and managing the nursing risks so that it is effective in avoiding possible risks, reducing nursing adverse events during perioperative period, improving nursing quality and ensuring the safety of surgery.
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Objective To study the effect of computerized pressure hemostat on lower limb deep vein thrombosis in high-risk elderly patients.Methods From September to December 2013,36 orthopedic hospitalized patients who received operations were divided into the hemostat group and the non-hemostat group with 18 patients in each group.D-dimer changes and lower limb deep vein thrombosis were observed in both groups.Results D-dimer was significantly increased in both groups compared with that before operation,but the extent of elevation in the non-hemostat group was lower than that in the hemostat group.D-dimer and cases of lower limb deep vein thrombosis in the hemostat group was higher than those in the non-hemostat group after operation,which showed significant difference.Conclusions The use of computerized pressure hemostat will increase the risk of lower limb deep vein thrombosis in elderly patients,so the technical operation procedures should be strictly enforced accompany with safely use of computerized pressure hemostat.
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Objective To screen gastric infiltrating carcinoma from gastric high grade intraepithelial neoplasia (HGIEN) checked again by regular gastroscopy and confocal laser endomicroscopy(CLE).Methods From January 2005 to December 2010,82 patients with endoscopic biopsy and the tissue pathological diagnosed HGIEN were collected at Department of Gastroenterology,Ruijin Hospital,Jiaotong University.61 male patients and 21 female patients were collected,of which 38 patients underwent common gastroendoscopy and the other 44 patients were underwent CLE besides common gastroendoscopy.The pathological diagnosis of endoscopic biopsy tissues were compared,and patients with indications were referred to surgery and pathological examination again.Results A total of 82 patients were confirmed by repeated examination,and there were 8 cases of inflammation or benign ulcers (24.4％),12 cases of low grade intraepithelial neoplasia (14.6％),10 cases of HGIEN (12.2％),52 cases of infiltrating carcinoma (63.4％).36 cases of differentiated carcinoma and 16 cases of undifferentiated carcinoma.Of the 21 infiltrating carcinoma cases diagnosed by CLE,17 cases (81.0％) were consistent with the pathological diagnosis.The consistent parameter value of κ between CLE diagnosis and pathological diagnosis was 0.7250.Conclusion It is necessary to make differential diagnosis of infiltrating cancer in patients with endoscopic biopsy and the tissue pathological diagnosed HGIEN.
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Objective To investigate the effect of insulin and gliclazide therapy on endoplasmic reticulum (ER) stress and insulin sensitivity in the liver of type 2 diabetic rats.Methods A high fat diet plus a low-dose of streptozotocin was implemented to create a type 2 diabetic rats which were randomly divided into diabetes mellitus (DM) group,insulin treatment (INS) group and gliclazide treatment (GT)group; and healthy rats were as normal control group.Diabetic rats in INS and GT groups were given neutral protamine hagedorn (NPH) insulin and gliclazide respectively for 3 weeks.Protein expression levels of immunoglobulin binding protein (Bip),spliced X-box binding protein 1 (XBP-ls),phosphorylated c-Jun on serine 73 (p-c-Jun),phosphorylated insulin receptor substrate 1 on serine 307 (p-IRS-1),and glucose-6-phosphatase (G6Pase) in liver homogenate were detected by Western blotting.Results Compared with the normal rats,Bip and XBP-Is in the DM group were up-regulated (0.28 ±0.07 vs 0.90 ±0.10 for Bip;0.41 ± 0.07 vs 0.95 ±0.07 for XBP-1 s; both P ＜ 0.01 ) ; p-c-Jun (0.59 ± 0.18 vs 1.94 ± 0.03 ),p-IRS-1( 1.73 ± 0.18 vs 5.32 ± 0.22) and G6Pase (0.11 ± 0.01 vs 0.45 ± 0.01 ) were increased ( all P values ＜0.01 ).In the INS group,all of aforementioned changes were reversed (0.90 ± 0.10 vs 0.25 ± 0.04 for Bip; 0.95 ±0.07 vs 0.47 ±0.01 for XBP-1s; 1.94 ± 0.03 vs 0.50 ±0.10 for p-c-Jun; 5.32 ± 0.22 vs 1.59 ±0.32 for p-IRS-1 ; 0.45 ±0.01 vs 0.15 ±0.02 for G6Pase,all P values ＜0.01 ).In the GT group,all of aforementioned changes were also attenuated ( 0.90 ± 0.10 vs 0.53 ± 00.02 for Bip ; 0.95 ± 0.07 vs 0.78±0.02 for XBP-1s; 1.94 ±0.03 vs 1.33 ±0.11 for p-c-Jun; 5.32 ±0.22 vs 3.13 ±0.02 for p-IRS-1; 0.45 ± 0.01 vs 0.25 ± 0.01 for G6Pase,all P values ＜ 0.05).Furthermore,all of aforementioned protein levels were down-regulated more obviously in the INS group comparing to the GT group ( all P values ＜ 0.01 ).Conclusions Both insulin and gliclazide therapy could relieve ER stress and e-Jun N-terminal kinase activity and improved insulin sensitivity.The effect of insulin on Bip,XBP-1s,p-c-Jun,p-IRS-1 and G6Pase protein expressions is more obvious than that of glilcazide,which indicates besides lowering glucose,insulin might have protective effects of anti-inflammation,anti-oxidative stress or stimulation of lipid redistribution.
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Objective To study the effect of nursing intervention on preoperative anxiety of patients with gynecological carcinoma.Methods 60 patients with gynecological carcinoma in our hospital who were to receive operations were randomly distributed into the control group and the intervention group with 30 in each group.The control group was given routine nursing,while the intervention group received nursing intervention based upon routine nursing.Indexes such as preoperative anxiety,sleeping quality and satisfaction degree to nursing care were evaluated within them.Results Through targeted nursing intervention preoperative anxiety of patients in the intervention group alleviated,their confidence enhanced and satisfaction degree to nursing care improved compared to those of the control group.Conclusions Targeted nursing intervention can reduce preoperative anxiety of patients with gynecological carcinoma and increase satisfaction degree to nursing care.
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Objective To investigate the effect of early insulin therapy on NF-KB pathway and inflammatory cytokine responses in fiver of diabetic rat.Methods NF-KB p65 DNA binding was assayed with ELISA-based assay kit,cytokine gene expressions were quantified with real-time PCR and phosphoenolpyruvate carboxykinase(PEPCK),NF-KB and inhibitor KB(IKBα)protein levels wlere assayed with Westem blot.Results Compared with control,hepatic PEPCK protein level in the untreated diabetic rat increased by 40%.Early insulin and gliclazide treatment normalized PEPCK protein level.The abundance of IKBα protein was significantly decreased and nuclear NF-KB p65 DNA binding activity was incteased in untreated diabetic rats.IKBot protein content increased and NF-KB p65 DNA binding decreased during early intervention treatment.mRNAs encoding IL-1β and TNFα were increased,which were reduced to normal levels after insulin and gliclazide treatment.Conclusions It is suggested that early insulin treatment inhibits NF-KB activity and inflammatory cytokine responses in fiver that are involved in the aniefioration of insulin resistance in diabetic rats.Such results misht be due to indirect antiinflammatory effects of insulin thus relieving glucotoxicity and lipotoxicity in pefipherM tissues.
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Objective To explore the effects of insulation measures on blood coagulation during laparotomy in the aged patients. Methods Sixty patients were randomly divided into the experimental group and the control group with 30 cases in each group from September 2007 to August 2008. The experimental group received a series of insulation measures based on general perioperative nursing care, which was given to the control group. Patients' temperature, platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TV),fibrinogen (Fbg) were measured and these preand postoperative values together with blood loss during operation were compared between two groups. Results No significant change was seen in perioperative body temperature in the experimental group, the incidence rate of hypothermia was lower, the change in coagulation index was better than that of the control group. Conclusions These results suggested that mild hypothermia could influence aged patients' blood coagulation function and increase blood loss during laparotomy. Active insulation measures can maintain the stability of patients" temperature.
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Objective To explore influence of perioperative protection from hypothermia on surgical site infection (SSI) in patients undergoing gastroenteritic operation. Methods A retrospective study was carried out in 1536 patients undergoing gastroenteritic operation in general surgery department of our hos-pital.Patients (764 cases) admitted before July 2006 were set as the control group,while those after July 2006(772 cases) were set as the observation group. The observation group received a series of measures for protection from hypothermia besides of routine perioperative nursing.The control group only adopted routine perioperative nursing.The SSI rate was compared between the two groups. Results The SSI rate of the observation group was lower than that of the control group(P < 0.01 ). Conclusions Incidence of periop-erative hypothermia in patients undergoing gastroenteritic operation can increase the SSI rate.Appropriate measures for protection from hypothermia can prevent the incidence of hypothermia as well as SSI.
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Objective To investigate the effect of insulation during surgery on the prognosis of hy-potherrnic trauma patients. Methods Trauma patients (80 cases) with injury severity score (ISS) of 16～40 and anal temperature < 36℃,were selected and randomly divided into the insulation group and the control group with 40 cases in each group.Both operations went along under room temperature. The in-sulation group keep anal temperature ≥ 36 ℃,while the control group received no insulation interven-tion.The palinesthesia time,time length of hospital stay,infection of wound and fatality were observed in the two groups. Results The palinesthesia time and time length of hospital stay dramatically shortened,the infection rate of Wound and fatality reduced in the insulation group compared with that of the control group (P<0.05). Conclusions Insulation during surgery can significantly shorten the palinesthesia time and time length of hospital stay,reduce the infection rate of wound and fatality.
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AIM: To investigate whether or not short-term high pressur e proliferates human umbilical vein endothelial cells (HUVECs), and the role of pp60c-src in cell proliferation. METHODS: Cultured HUVECs of 3-6th passa ge were exposed to atmosphere 0 mmHg (AP), 120 mmHg (MP), 180 mmHg (HP) and interfered with cap top ril(Cap, 10 ?mol/L)or irbesartan(Irb, 10 ?mol/L) Cell proliferation was q uantified by measuring hexosaminidase activity. The content of pp 60 c-src in cells was investigated by Western blotting. RESULTS:① Hexos aminidase activities which reflected cell number increased significantly at 4 h in MP and HP(0 145?0 018 and 0 144?0 019 vs 0 118?0 003,P