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Objective To discuss the risk factors and nursing intervention of multidrug-resistant organism (MDRO) infection in patients of traditional Chinese medicine hospital (TCM). Methods By investigating the patients admitted to Beijing Xuan Wu Hospital of Traditional Chinese medicine from June 2015 to June 2016, 756 patients of them who were confirmed with clinical diagnosis of infection and pathogen detection with positive, which were divided into MDRO group including 97cases and non-MDRO group including 659 cases, then the pathogens of MRDO infection species and distributionwere counted, and analyzed risk factors for infection. Results A total of 756 cases were detected positive strains 816 strains, including 611 strains of monitoring target strains, 116 strains of MRDO. The top three were methicillin-resistant staphylococcus aurous 30.17%(35/116), Pseudomonas aeruginosa 18.97% (22/116) and Klebsiella pneumonia 18.10% (21/116). Single factor analysis results showed that the patients' age, hospitalization days, the history of other hospital admission, invasive procedure, basic chronic disease (diabetes, cerebrovascular disease, lung disease) and combined use of antibiotics were MDRO infection risk factors (χ2=9.470-198.609, P < 0.01); multivariate Logistic regression analysis showed that the independent risk factors of MDRO infection were the history of other hospital admission (OR=2.085, 95%CI1.040-4.179), invasive procedure (OR=3.063,95% CI1.526- 6.150), diabetes (OR=2.037,95% CI1.070- 3.877), cerebrovascular disease (OR=4.349,95%CI 2.035-9.293)and combined use of antibiotics (OR=18.723,95% CI9.202-38.094). Conclusions Patients of TCM have many characteristics, such as with more basic diseases, longer length of stay, elder and so on. So we should be alert to the risk of MDRO infection and take nursing interventions to prevent and strengthen the isolation prevention.
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Objective:To observe the lipid oxidation rates in spinal cord injury (SCI) patients with different exercise intensities.Method:Thirty sedentary patients with SCI were selected to perform incremental exercise load tests (baseline test and Fatmax test) with upper limb power vehicle.Meanwhile,both tests included respiratory gas analysis.In baseline tests,the workload was started at 5W and increased by 10W every 3 min,with 60 rmp until patients exhausted.The Fatmax test included 5 stages of workload and every stage kept 6 min.The initial workload was 5W,the fifth workload was corresponded to the load when respiratory quotient was 1 in the baseline test,the other workload was set according to the average of the initial and fifth workload.All lipid oxidation rates were measured by oxygen uptake (VO2) and respiratory quotient (RQ) in the tests.Result:With the increase of exercise intensity,lipid oxidation rates in SCI patients increased at first and then decreased.The peak of lipid oxidation rates (5.46±0.75 μmol/kg/min) arrived at the intensities of 34.9％±2.3％ VO2 peak.After that the lipid oxidation rates decreased significantly as 3.92±0.69,2.85±0.61,0.58±0.19 μmol/kg/min at 41.83±2.18,52.29±1.73 and 61.32±1.98％ VO.2 peak accordingly(P＜0.05).Conclusion:During the rehabilitation of SCI patients,we should pay attention to the intervention from low intensity exercise to maximize lipid oxidation rates,reducing the incidence of obesity in SCI patients.
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BACKGROUND:For the treatment of distal tibial fractures, open reduction and plate fixation, minimal y invasive percutaneous plate fixation and intramedul ary nail fixation are effective, but each has advantages and disadvantages. OBJECTIVE:To compare the effects of intramedul ary nail combined with blocking screws versus minimal y invasive percutaneous plate fixation in treating distal tibial fractures. METHODS:Fifty-one cases of distal tibial fractures were divided into two groups. The blocking screw group (23 cases) was treated with closed reduction and internal fixation with interlocking nail combined with blocking screws. The plate fixation group (28 cases) was treated with minimal y invasive percutaneous plate fixation. Fracture healing time, recovery of tibial function and complication occurrence were observed during fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for 8 to 32 months. (1) Except one patient in the plate fixation group, the other patients had bony union. The healing time was (4.6±1.7) months in the blocking screw group and (6.9±2.3) months in the plate fixation group. Significant differences in healing time were detected between the two groups (P0.05). (4) Results suggested that interlocking intramedul ary nail combined with blocking screw fixation in the treatment of distal tibial fractures can promote fracture healing and joint function recovery.
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Objective To develop an all-in-one multifunctional thoracolumbar fixation rescue vest for land and water rescue of thoracolumbar injury and investigate its application effect.Methods According to the thoracolumbar physiological curve,type Ⅰ thoracolumbar fixation rescue vest with keel and inflatable airbag and type Ⅱ thoracolumbar fixation rescue vest with additional lifesaving balloon and inflatable cylinder were developed using thermoplastic polyurethane (TPU)-nylon composites and polycarbonate (PC) as the main materials.Clinical application of type Ⅰ thoracolumbar fixation rescue vest in 532 cases of thoracolumbar injury was discussed.Type Ⅱ thoracolumbar fixation rescue vest were tested at marine rescue and related parameters measured were automatic inflation time,buoyancy force,floating time,floating condition and victims' face orientation.Clinical outcome was quantified by the MacNab standard,and VAS for pain was recorded.Results According to the MacNab standard,excellent outcome was achieved for all cases.VAS improved from 8.2 points to 2 points after the bracing was applied,showing 100％ improvements.The brace into the water showed automatic inflation time of 3-5 seconds and maximum buoyancy force of 100 kg,and ensured a 90 kg dummy of floating over 96 hours.At marine rescue,the wounded in braced condition showed face upward with 24-hour buoyancy loss ≤5％ and freedom of movement.Conclusions The multifunctional thoracolumbar fixation rescue vest provides dual immobilization and ensures marine rescue for its automatic inflation device.This invention provides the feasibility to remove,transport and evacuate the thoracolumbar fracture patients in cabin.
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Objective To compare the clinical effects of ROI-C self-locking fusion cage and common cage+titanium plate fixation on treatment of multi-segment anterior decompression and fusion for cervical spondylotic myelopathy.Methods From March 2010 to September 2013,92 patients with multi-segment cervical spondylotic myelopathy were treated with anterior decompression and fusion.52 patients were treated with common cage plus titanium plate fixation,while 40 patients were treated with ROI-C self-locking fusion cage.Clinic data including clinical preoperative condition,operation time,intraoperative blood loss,intervertebral space height,Cobb angle of cervical spine,bone graft fusion rate,complications,and JOA score and VAS score were compared.Results Follow-up visit was conducted for all cases,with the time of 12-48 months (22 months on the average).The neurologic symptoms of patients in two groups were relieved obviously after postoperative 1 week,including chest and abdomen constriction feeling,finger pain,finger and lower limb activities.Intervertebral space height of cage +titanium plate group and ROI-C fusion cage group increased to 79.06±6.67 mm and 78.80±6.85 mm respectively after postoperative 3 months from preoperative 47.15±6.96 mm and 46.95±7.14 mm;the Cobb angle increased to 9.29°±12.90° and 8.57°±13.00° respectively after postoperative 3 months from preoperative 4.27°±11.15° and 2.80°±10.81°.In ROI-C group,the operation time,intraoperative blood loss and postoperative complications were significantly lower than those in cage+titanium plate group.The differences of two groups have statistical significance.In the last follow-up visit,JOA score of ROI-C group increased to 15.15±0.91 from preoperative 9.32±1.74,with the improvement rate of 75.82％±13.28％;JOA score of cage + titanium plate group increased to 15.29± 1.07 from preoperative 9.11 ± 1.23,with the improvement rate of 77.91％± 14.14％.The differences of two groups in the improvement rate have no statistical significance.Conclusion Curative effects of ROI-C self-locking fusion cage and common cage+titanium plate fixation on treatment of muhi-segment anterior decompression and fusion for cervical spondylotic myelopathy are similar,while ROI-C self-locking fusion cage has such advantages as short operation time,less blood loss,little injury and low complication incidence.
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BACKGROUND: Macrophage colony-stimulating factor (M-CSF)/receptor activator of nudeer kappa B ligand (RANKL), two types of cytokines co-induce myeloid stem cells to form osteoclasts, is a kind of new method to harvest ostaoclasts with high purity and quantity, but there is lack of uniform cultivation standard. OBJECTIVE: To construct an effective M-CSF/RANKL induced mice myeloid stem cells inducing osteoclast differentiation cultivation system. METHODS: Myeloid stem cells ware obtained from ICR mice and then cultured for 24 hours in a-minimum essential medium containing M-CSF, at cell density of 10~7/L, 10~8/L, 10~9/L. Then 10 μg/L M-CSF and 20, 50, 100 μg/L RANKL were added into culture medium. Tartaric-resistant acid phosphatase stained was performed to observe the transition process from stem cell to osteoclast, as well as cell morphology and stain situation after culture, and positive stained osteoclasts were counted. We compared the influence of different induction conditions to the quantity of osteoclast. RESULTS AND CONCLUSION: A small quantity of osteoclasts contained many red positive beads in the intracytoplasm were observed at 3 days. There were positive beads with hypochromatic dikeryon in cells. A large amount of positively stained osteoclests were seen after 6-day cultudng, which maintained dikaryon. After 9-day culturing, positively stained colossal multinudear cells occurred, became larger and maintained three nuclei. At certain cell density, 100 μg/L RANKL could induce to form more osteoclasts compared with other 2 concentrations (P < 0.05); at certain RANKL concentration, the osteoclasts formation at cells density of 10~8/L was dramatically greater than other 2 cell densities (P < 0.05); the number of osteoclasts was the most when the concentration of RANKL was 100 μg/L and cell density of 10~8/L (P < 0.05). When osteoclasts are induced by M-CSF/RANKL from mudne myeloid stem cells, the best concentration of RANKL is 100 μg/L and cells density is 10~8/L.
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Objective To evaluate the role of spiral CT in initial diagnosis and following up detection for patients with thoracic sarcoidosis.Methods 25 patients with thoracic sarcoidosis which had complete data were analyzed retrospectively.Radiography and CT were performed in all cases.The diagnostic accuracy of two methods were statistically compared.Results The diagnostic accuracy of CT in initial detection of thoracic sarcoidosis was 64%.Among the misdiagnosed patients,5 cases were misdiagnosed as lymphoma(n=5) and the else were misdiagnosed as thoracic tuberculosis(n=1) and metastatic tumors(n=3).Conclusion As well as it's significance in following up period,the advantage of CT in determining the diagnosis of thoracic sarcoidosis is conspicuous.CT also can be used to evaluate the therapeutic efficacy.