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Objective:To acquire more scientific, accurate and efficient unplanned extubation (UEX) quality management data by using information technology to directly take the quality index data of unplanned extubation from the nursing medical record system.Methods:From June 2019 to August 2019, a knowledge base of pipeline management including the name of pipeline, pipeline evaluation, pipeline care measures, and reasons for unplanned extubation of pipeline was established in Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine. Through the analysis of each node of pipeline management, pipeline management system was established. And the non-planned pipeline management data set was directly collected to the nursing quality management system for statistics and analysis, which was verified.Results:In clinical application from September 2019 to september 2020, the direct collection of unplanned extubation quality index data saved 496 hours of nursing labor costs per month, and the accuracy of direct data collection increased from 95.8% (161/168) in trial operation to 100.0% (494/494). The underreporting rate of adverse events decreased to 0. Satisfaction with the application of the quality index management system for unplanned extubation was (4.35 ± 0.73) points.Conclusions:The direct collection of quality index data for unplanned extubation improves the accuracy of the data. Nurses no longer need to report unplanned extubation incidents. The clinical nursing information system and the nursing management system are interconnected to improve the management efficiency of unplanned extubation. It is worthy of application and promotion in clinic.
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Objective To investigate the optimum compatibility of ropivacaine and sufentanil for isobaric spinal anesthesia in caesarean section.Methods A total of 160 nulliparous parturients who were at full term with a singleton fetus,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,scheduled for elective caesarean section under subarachnoid block,were divided into 4 groups (n =40 each) using a random number table method:1％ ropivacaine 1.5 ml (15 mg)-normal saline 3.5 ml group (group A),1％ ropivacaine 1.2 ml (12 mg)-sufentanil 0.5 mi (5 μg)-normal saline 3.3 ml group (group B),1％ ropivacaine 1 ml (10 mg)-sufentanil 0.5 ml (5 μg)-normal saline 3.5 ml group (group C),and 1％ ropivacaine 0.8 ml (8 mg)-sufentanil 0.5 ml (5 μg)-normal saline 3.7 ml group (group D).Drugs were injected in cephalad direction at a rate of 0.1 ml/s.The upper spread of sensory block,degree of motor block,abdominal muscle tension,traction response,requirement for atropine and ephedrine and neonatal Apgar scores were recorded.Results Neonatal Apgar scores were all within the normal range.A,B and C groups had similar upper spread of sensory block which was higher than that in group D.The onset time of block was significantly prolonged,and the requirement for atropine and ephedrine was increased in group A as compared with B,C and D groups (P＜0.05).The degree of intraoperative pain,abdominal muscle tension and traction response was significantly lower in A,B and C groups than in group D (P＜0.05),however,there was no significant difference among A,B and C groups (P＞0.05).The requirement for supplemented epidural local anesthetics was 30％ (12 cases) in group D.The recovery time to ambulation was significantly shorter in C and D groups than in A and B groups (P＜0.05).The duration of spinal anesthesia was significantly longer in B and C groups than in A and D groups (P＜0.05),however,there was no significant difference between group B and group C (P＞0.05).Conclusion One percent ropivacaine 1 ml (10 mg)-sufentanil 0.5 ml (5 μg)-normal saline 3.5 ml is the optimum compatibility of ropivacaine and sufentanil for isobaric spinal anesthesia in caesarean section.
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Objective To investigate health-related quality of life of the empty-nest elderly in Hangzhou and its influencing factors.Methods A total of 1000 empty-nest elderly were selected to participate the questionaire survey, using a stratified cluster sampling method,and the five-dimensional European quality of health scale(EQ-5D)was used to measure the health status of the empty-nest elderly. Chi square test and univariate ANOVA analysis were used to identify potential influencing factors.Results A total of 992 participants were involved in this study. The proportions of participants who had difficulties or problems in mobility,self-care,usual activities,pain/discomfort,and anxiety/depression were 16.13%,11.09%,19.76%,48.49% and 29.84% respectively. In terms of usual activities, pain/discomfort,and anxiety/depression,the proportions of empty-nest elderly who had difficulties or problems in those three dimensions were significantly higher in urban areas than in rural areas(P<0.05). The range of EQ-5D utility value was -0.11 to 0.85,with an average value of 0.75±0.13. The study showed that the elderly without chronic diseases, tending to pour out their feelings or ask for help when they were in trouble,participating activities held by political parties or communities,with lower personal incomes,and depending on children to support their life after retirement were more likely to have higher EQ-5D utility values(all P<0.01).Conclusion The health-related quality of life of empty-nest elderly in Hangzhou is at a low level,and is influenced by several soci-demographic factors. Encouraging the elderly to ask for help,improving the management of chronic diseases and providing more social supports could improve the health-related quality of life of the elderly.
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Objective To learn the pension willingness and influencing factors of empty-nest elderly in Hangzhou City. Methods A total of 1000 empty-nest elderly in Hangzhou, taking a formal hosusehold registration, living≥1 year, age≥ 65 years old, were selected from two urban districts and three suburbs by multi-stage simple random sampling, and were surveyed with questionnaires. The data was analyzed by logistic regression model to study the influencing factors of pension willingness. Results A total of 992 valid questionnaires were collected and the effective rate was 99.20%. There were 407 (41.03%) , 365 (36.79%) , 208 (20.97%) and 12 (1.21%) people in the 992 empty-nest elderly, choosing their children's support, social pension insurance, personal pension and other old-age methods. Multivariate logistic regression analysis showed that, the empty-nest elderly who worried about pension costs (OR=3.007, 95%CI:1.751-5.155), and the greatest wish was physical health (OR=4.404, 95%CI:1.461-13.276), family harmony (OR=7.724, 95% CI: 2.158-27.646), children work smoothly (OR=4.811, 95%CI: 1.203-19.246) . The lower health score (OR=0.982, 95% CI: 0.965-0.999), choosing their children's support as their pension willingness were relatively high, and the empty-nest elderly who worried about pension costs (OR=2.058, 95%CI: 1.267-3.344), the original occupation for the staff (OR=2.353, 95% CI: 1.091-5.078) , city household registration (OR=0.546, 95% CI:0.349-0.856) . The lower the health score (OR=0.979, 95%CI: 0.966-0.993) choose social pension insurance as their pension willingness would be relatively high pension. Conclusion The influencing factors of the pension willingness of the empty-nest elderly were worried about pension costs, the greatest wish, and health status, urban and rural household registration.
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AIM:To investigate the safety and effect of femtosecond laser-assisted cataract surgery with Cionni modified capsular tension ring (MCTR) implantation in the management of traumatic lens subluxation.METHODS: Totally 11 patients (11 eyes) with traumatic lens subluxation were divided into three groups according to the severity of lens dislocation, ranging from 90° to 120° (4 eyes), 120° to 180° (5 eyes) and 180° to 270° (2 eyes).The contact LenSx femtosecond laser cataract surgery platform was applied to create the capsulotomy, prepare nuclear fragmentation and make corneal wound creation.Anterior vitrectomy was performed in some patients during the surgery.After capsular retractors insertion and phacoemulsification, the MCTR was inserted to the capsular bag and fixed to the sclera.Finally, the IOL was implanted into the capsular bag.Postoperative visual acuity, intra-and post-operative complications, anterior capsular opening, IOL and MCTR position and intraocular pressure (IOP) were assessed.RESULTS:The duration of follow-up was 2mo.All the operations were completed successfully.Five eyes underwent cataract surgery combined with anterior vitrectomy.Four eyes had been inserted with 2-eyelet MCTR and seven eyes with 1-eyelet MCTR.The best corrected visual acuity (BCVA) after operation was better than 0.5 in 4 eyes, between 0.3 and 0.5 in 3 eyes, between 0.1 and 0.3 in 3 eyes, and less than 0.1 in 1 eye.Compared with preoperative BCVA, the difference was statistically significant (P<0.05).All the IOLs were stably centered and the eyelet of MCTR was fixated steadily between the iris and the anterior capsule.The common intra-and post-operative complications were subconjunctival hemorrhage, incomplete capsulotomy, residual cortex, secondary glaucoma and posterior capsular opacification.CONCLUSION:Femtosecond laser-assisted cataract surgery can improve the success rate of capsulorhexis, and reduce the difficulty of nuclear fragmentation.Femtosecond laser-assisted cataract surgery combined with MCTR implantation is an ideal surgical method for traumatic lens subluxation.
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Recently, novel Psidium meroterpenoids were reported in the guava leaves. According to careful analysis of the spectral data of literatures, the spectroscopic characteristics and biosynthetic pathway of Psidium meroterpenoids were summarized in this paper. The results showed that Psidium meroterpenoids had distinct spectroscopic features and reasonable biosynthetic routines, however the number order of carbon atoms was not consistent in the reported literatures. It was concluded that Psidium meroterpenoids were the characteristic chemical constituents of Psidium guajava Linn.
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Magnetic Resonance Spectroscopy , Plant Leaves , Chemistry , Psidium , Chemistry , Spectrum Analysis , Terpenes , ChemistryABSTRACT
Objective To develop a scientific evaluation index system and promote the health unit construction.Methods The framework of evaluation index system was developed using the method of Delphi expert consultation and focus group discussion.The weights at all levels of the index were calculated by Delphi expert consultation and the analytic hierarchy process to develop the evaluation index system.Results The response rates of 2 round consultation including 15 experts were both 100. 00%.The authority coefficient was 0. 825 and the coefficient of variation was less than 0. 30.The P values of coordination coefficient were less than 0. 01.Conclusion This evaluation index system covered major factors of the health unit construction,and could be widely used to evaluate the health unit construction.
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Objective To evaluate the effects of alcohol dependence (AD) on the expression of spinal neuronal K+-Cl cotransporter 2 (KCC2) in rats.Methods Forty-eight healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 2 groups (n =24 each) using a random number table:control group (group C) and group AD.An orogastric tube was inserted and alcohol was administered through the tube into the stomach to establish the model of AD.The concentration of ethanol was 5％,10％ and 20％ at 1st,2nd and 3rd weeks,respectively,and the concentration of ethanol was 35％ at 4th week and later.Alcohol was given at 10 ml · kg-1 · d-1,lasting for 8 weeks.The rats received drinking water containing no ethanol at 10 ml · kg-1 · d-1 instead of alcohol in group C.All the rats were allowed ad libitum access to food and water.Before the last administration,an elevated plus-maze test was performed for all the rats to observe their state of anxiety,which was used to evaluate the success of AD model.At the end of the last administration,the model of incisional pain was established.A 1-cm longitudinal incision was made through skin,fascia and muscle of the plantar aspect of the hindpaw in sevoflurane-anesthetized rats.At 2,6,24 and 48 h after operation,the mechanical and thermal paw withdrawal thresholds were measured.At 48 h after operation,the lumbar segment of the spinal cord was removed for determination of the expression of KCC2 by using immunofluorescence and Western blot.Results Compared with group C,the number of open arm entries was significantly reduced,the time spent on the open arms was shortened,the number of closed arm entries was increased,the time spent on the closed arms was prolonged,the mechanical and thermal paw withdrawal thresholds were decreased,and the expression of KCC2 was down-regulated in group AD.Conclusion Down-regulated expression of spinal neuronal KCC2 is involved in the mechanism of hyperalgesia in rats with AD.
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Natural products especially flavonoids are being explored for their therapeutic potentials in reducing bone loss and maintaining bone health. The present study is to investigate the effects of isoquercitrin from Craibiodendron yunnanense with different concentrations at 1 x 10(-4), 1 x 10(-5), 1 x 10(-6), 1 x 10(-7) mol x L(-1) on proliferation, differentiation and mineralization of MC3T3-E1. Cell proliferation was assessed by CCK-8 kit at 1, 3, 5 and 7 days of culture. Alkaline phosphatase (ALP) activity were performed qualitatively and quantitatively on day 7, and alizarin red S staining was employed to access the mineralization of cells on day 21. The osteogenic markers ALP, collagen type I (COL 1A1), runt-related transcription factor 2 (Runx-2) and Osterix were detected to analysis early osteogenic differentiation of cells on day 3 by RT-PCR. The results showed that isoquercitrin had a dose-dependent effect on the proliferation, osteogenic differentiation, mineralization and gene expression of MC3T3-E1 in the range from 1 x 10(-7) to 1 x 10(-5) mol x L(-1). At concentrations above 1 x 10(-4) mol x L(-1) isoquercitrin showed cytotoxicity, while 1 x 10(-6) mol x L(-1) is the optimal concentration of isoquercitrin to improve the osteoblastic activity. All these results implied that isoquercitrin might be the major composition of traditional Chinese medicine C. yunnanense to treat bone fractures.
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Animals , Mice , Alkaline Phosphatase , Metabolism , Cell Line , Collagen Type I , Metabolism , Drugs, Chinese Herbal , Pharmacology , Ericaceae , Chemistry , Osteoblasts , Cell Biology , Metabolism , Osteogenesis , Quercetin , PharmacologyABSTRACT
Objective To evaluate the gender differences in dose-response curve with cisatra-curium in epileptics.Methods Eighty ASA grade Ⅰ or Ⅱ epileptics were enrolled in this study.All patients were divided into male and the female groups and received the method of single dose injection under midazolam-fentanyl intravenous anesthesia.Each patient received intravenous bolus of 20,30, 40,50μg/kg of cisatracurium respectively.The neuromuscular block was measured by Neuromuscular Transmission Monitor and the responses were defined in terms of the percentages of maximum sup-pression in T1 of TOF of the adductor pollicis muscle.According to log-probit transformation of the data of dose and response,the dose-response curve of cisatracurium was established through linear re-gression.The onset time of cisatracurium was also observed.Results The ED50 ,ED75 ,ED90 ,ED95 values of cisatracurium in male epilepsy patients were 37.2±9.7,48.1±11.3,60.4±12.8,69.3± 14.0 μg/kg and that of female epilepsy patients were 36.6±4.3,47.5±7.7,60.5±14.0,70.1± 19.4 μg/kg.There was no significant difference between the two gender groups.No significant change in onset time was observed among 4 dose groups.Conclusion No gender differences are ob-served in dose-response curve of cisatracurium in epileptics.
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Objective To study more effective treatment and care measures to release postpartum refractory urinary retention.Methods From January 2011 to December 2012,312 cases hospitalized single head delivery of perineum after episiotomy with maternal urinary retention were selected and divided into Group A,B and C stochastically,each group contained 104 cases.Group A was given phentolamine warm uterus paste on Qihai acupuncture point,Group B was given phentolamine treatment,Group C as control group was given warm uterus paste on Qihai acupuncture point.The treatment effects and treatment time were observed in three groups.The clinical outcomes and related indexes of medical resources consumption among 3 groups were compared.Results After intervention treatment on urinary retention of the 3 groups,the treatment time and effects on Group A was significantly better than Group B and C to relieve maternal urinary retention.The comparison among 3 groups had significant differences.While the postpartum hemorrhage,urinary tract infection caused by retention of urine and length of hospital stay and hospital costs were lower than Group B and C,the differences had statistical significance.Conclusions Phentolamine warm uterus paste on Qihai acupuncture point in treatment of postpartum refractory urinary retention is quick to work,simple,economic and safe,it has significant effects,and can significantly reduce complications,hospitalization time and cost of hospitalization.
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Objective To evaluate the effect of propofol post-conditioning on hippocampal neuronal K+-Cl-co-transporter 2 (KCC2) expression in the rats with cerebral ischemia/reperfusion (I/R) injury.Methods Seventy-two male Sprague-Dawley rats,aged 7-8 weeks,weighing 250-280 g,were randomly divided into 3 groups (n =24 each):sham operation group (group S),cerebral I/R (group I/R) and propofol post-conditioning group (group PP).The model of focal cerebral I/R injury was established by occlusion of the right middle cerebral artery.Propofol 20 mg· kg-1 · h-1 was infused over 2 h starting from the onset of reperfusion through the femoral vein in group PP.The equal volume of normal saline was given in S and I/R groups.Modified neurological severity score (mNSS) was used to evaluate the impairment of neurological function.The animals were then sacrificed and brains were removed for determination of the number of neurons (by Nissl' s staining) and expression of KCC2 (by immunofluorescence and Western blot) in hippocampal CA3 region.Results Compared with group S,the scores of mNSS were significantly increased,and the number of neurons and expression of KCC2 in hippocampal CA3 region were decreased in I/R group,and mNSS scores were increased,and no significant changes were found in the other parameters in group PP.Compared with group I/R,the mNSS scores were significantly decreased,and the number of neurons and expression of KCC2 in hippocampal CA3 region were increased in group PP.Conclusion The mechanism by which propofol post-conditioning reduces cerebral I/R injury is related to up-regulated expression of hippocampal KCC2 in rats.
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Objective To evaluate the effect of propofol post-conditioning on synaptic transmission in neurons in CA1 region during oxygen-glucose deprivation and restoration (OGD/R) in hippocampi rats .Methods Hippocampi were isolated from male Wistar rats ,aged 15-20 days ,weighing 50-60 g ,and sliced at 350μm thick . The hippocampal slices were divided into 3 groups ( n=12 each ) using a random number table :control group (group C) ,OGD/R group ,and propofol post-conditioning group (group P) .In group C ,the hippocampal slices were cultured in normal artificial cerebro-spinal fluid (nACSF ) for 7 min + 1 h . In OGD/R group , the hippocampal slices were incubated in glucose-free ACSF aerated with 95% N2 for 7 min followed by restoration of O2-glucose supply for 1 h .In group P ,the hippocampal slices were incubated in glucose-free ACSF aerated with 95% N2 for 7 min followed by incubation with normal ACSF containing propofol 1.2μg/ml for 1 h .The intensity and frequencies of spontaneous excitatory postsynaptic currents (sEPSC ) and spontaneous inhibitory postsynaptic current (sIPSC ) in neurons in CA1 region were recorded by whole-cell patch-clamp technique .Results Compared with group C ,the intensity and frequency of sEPSC were significantly increased ,while the intensity and frequency of sIPSC were decreased in OGD/R and P groups ( P<0.05) .Compared with group OGD/R ,the intensity and frequency of sEPSC were significantly decreased ,while the intensity and frequency of sIPSC were increased in group P ( P<0.05) .Conclusion The mechanism by which propofol post-conditioning attenuates OGD/R injury to hippocampi is related to inhibition of excitatory synaptic transmission and enhancement of inhibitory synaptic transmission in neurons in CA1 region .
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<p><b>OBJECTIVE</b>To assess the value of multi-tumor markers protein biochip in the diagnosis and therapy of pulmonary carcinoma.</p><p><b>METHODS</b>Twelve tumor markers (CA199, NSE, CEA, CA242, Ferrtin, β-HCG, AFP, f-PSA, PSA, CA125, HGH, and CA153) were detected using protein chip in 308 patients with pulmonary carcinoma, 218 with benign lung lesions and 250 healthy subjects.</p><p><b>RESULTS</b>The positivity rate was 72.4% in pulmonary carcinoma cases, obviously higher than that in the benign cases (22.0%, P<0.01) and healthy subjects (5.6%, P<0.01). The positivity rates differed significantly between the pulmonary carcinoma cases of different pathological types. The positivity rates of CEA, CA125, and CA153 were significantly higher in adenocarcinoma cases than in squamous carcinoma cases (P<0.05), and also higher in cases with lymph node metastasis than in those without (71.9% vs 52.1%, P<0.05).</p><p><b>CONCLUSION</b>Protein biochip containing multiple tumor markers provides valuable assistance in the diagnosis and therapeutic effect monitoring of pulmonary carcinoma.</p>