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Objective:To explore the value of case analysis combined with role revelation in cultivating thinking ability of surgical nursing training.Methods:A total of 87 newly recruited nurses who needed to rotate in the surgical system of Fenyang Hospital, Shanxi Medical University from January 2019 to October 2020 were selected as the study subjects. They were divided into control group ( n=43) and study group ( n=44). The control group used traditional teaching, and the study group used case analysis combined with role revelation. The clinical thinking ability of nurses was evaluated by written examination of clinical thinking ability and clinical thinking ability score table. SPSS 22.0 was used for t-test. Results:The scores of written examination of clinical thinking ability (history collection, preliminary clinical diagnosis, preliminary nursing measures, auxiliary examination interpretation, comprehensive analysis of diagnosis and treatment process, nursing and discharge diagnosis, and health education) of nurses in the study group were significantly higher than those in the control group ( P<0.05). The scores of clinical thinking ability (critical thinking ability, system thinking ability and evidence-based thinking ability) of nurses in the study group were higher than those in the control group, and the difference was statistically significant ( P<0.05). Conclusion:Case analysis combined with role revelation in the surgical nursing training of new nurses is helpful to improve the trainees' clinical thinking ability.
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Objective:To analyze the characteristics of lung function in patients with spinal muscular atrophy (SMA) to provide evidence for multidisciplinary management of SMA.Methods:A total of 30 patients with SMA treated in the SMA multidisciplinary clinic of the Children′s Hospital, Zhejiang University School of Medicine from July 2019 to March 2021 were enrolled, including 1 child with type I, 18 patients with type Ⅱ and 11 children with type Ⅲ.There were 17 males and 13 females; the age ranged from 4 years to 21 years and 10 months old.A retrospective study was conducted to analyze the clinical features, spinal imaging findings and lung functions of patients with different clinical types of SMA and explore the factors influencing the lung functions of patients with SMA.Pulmonary function was measured by forced expiratory flow-volume curve.Forced vital capacity (FVC), forced expiratory volume in one second (FEV 1), FEV 1/FVC and peak expiratory flow (PEF) were measured.The results were expressed as the percentage of the measured value to predicted value.The Cobb angle was measured to evaluate scoliosis. Pearson correlation analysis and multiple linear regression analysis were used to evaluate the relationship between lung function and age and Cobb angle in patients with type Ⅱ SMA. Pearson correlation analysis and univariate linear regression analysis were used to evaluate the relationship between Cobb angle and age in patients with type Ⅱ SMA. Results:Pulmonary function in 1 type I patient showed decreased FVC and FEV 1; Among 18 patients with type Ⅱ, 14 cases had abnormal lung function (77.8%): FVC decreased in 12 patients (66.7%), FEV 1 decreased in 10 patients (55.6%), PEF decreased in 12 patients (66.7%). Among 11 patients with type Ⅲ, one had decreased FVC (9.1%). FVC, FEV 1 and PEF of patients with type Ⅱ were significantly lower than those of patients with type Ⅲ [(62.4±31.8)% vs.(90.8±11.0)%, (66.3±33.3)% vs.(97.8±9.9)%, (65.3±30.1)% vs.(98.6±21.1)%, all P<0.01]. Pearson correlation analysis showed that FVC of patients with type Ⅱ SMA was correlated with age and Cobb angle ( r=-0.864, -0.865, all P<0.001), FEV 1 was correlated with age and Cobb angle ( r=-0.878, -0.863, all P<0.001), PEF was correlated with age and Cobb angle ( r=-0.831, -0.783, all P<0.001), and Cobb angle was related to age ( r=0.922, P<0.001). Multiple linear regression analysis indicated that FVC of patients with type Ⅱ SMA was linearly correlated with Cobb angle ( R2=0.748, P<0.001), FEV 1 was linearly correlated with age ( R2=0.770, P<0.001), PEF was linearly related to age ( R2=0.690, P<0.001). Univariate linear regression analysis revealed that Cobb angle of patients with type Ⅱ SMA was linearly related to age ( R2=0.851, P<0.001). Conclusions:FVC, FEV 1 and PEF may decrease in patients with SMA.The degree of lung function damage is different in different types of SMA patients.With the increase of age, Cobb angle increases and FVC, FEV 1 and PEF decrease in patients with type Ⅱ SMA.Understanding the factors influencing the pulmonary function damage in patients with SMA is conductive to carrying out individual multidisciplinary management.
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ObjectiveTo explore the material basis for the difference in the efficacy of different parts of mulberry based on molecular connectivity index （MCI）. MethodBy referring to the relevant literature at home and abroad and traditional Chinese medicine systems pharmacology database and analysis platform （TCMSP） database， the chemical composition database of mulberry-source medicinal materials was established. Venn analysis was carried out on the components among mulberry-source medicinal materials. The components in the database were divided into 10 categories， and the composition information was analyzed. According to MCI value， all components of mulberry-source medicinal materials were divided into different groups. The angle cosine method was used to calculate the MCI similarity. The average MCI values of the common component group from 0-8 orders and CI of mulberry-source medicinal materials were calculated. ResultThe components with high similarity such as （+）-cycloolivil， 1′-methoxy-2′-hydroxydihydromollugin， kuwanon， morusin and 1-deoxynojirimycin were selected as potential pharmacodynamic components. Mulberry-source medicinal materials could be divided into five component groups. The similarity between component groups and total components was 0.760-0.999， and the similarity between component groups was 0.248-0.999. In Mori Ramulus， Mori Folium， Mori Cortex and Mori Fructus， the average MCI values of their flavonoids from 0-8 orders were 4.57， 4.59， 6.41， 4.24， respectively. The average MCI values of alkaloids from 0-8 orders were 2.65， 4.55， 2.58， 2.78， respectively. The average CI values from 0-8 orders were 5.51， 5.49， 5.44 and 2.88， respectively. ConclusionIt is preliminarily concluded that there are differences in the flavonoids and pathways of hypoglycemic effects between Mori Cortex and the other three mulberry-source medicinal materials. The MCI values of alkaloids from 0-8 orders in Mori Folium and Mori Fructus were higher， but their inhibitory activity of α-glucosidase were lower than those of Mori Ramulus and Mori Cortex. The structural characteristics of the total components of Mori Fructus represented by CI were quite different from the other three mulberry-source medicinal materials.
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Asthma is a common chronic airway inflammatory disease in children.Currently, symptomatic control can be achieved in the majority of patients through a combination of β 2 receptor agonists for rapid relief of symptoms and inhaled corticosteroids for long-term control.As the only causal treatment modality at present, allergen-specific immunotherapy (AIT) may modify the natural course of asthma, and can control the symptoms, reduce airway hyperresponsiveness and improve lung function.In order to provide evidence for improving the effect of AIT on asthma, the mechanism of AIT in asthma and its effect on lung function were discussed in this paper.
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We developed a universal probe based microRNA detection assay and applied it to detect microRNA-146a in human brucellosis,testing the possibility of using it as diagnosis signature.By using orthogonal design,the annealing temperature,probe concentration and commercial kits were optimized and the assay was developed.Total RNAs were isolated from plasma of human brucellosis and healthy control,and microRNA-146a was detected and compared.Results reveal that the optimized universal probe assay was established,which was more specific than the SYBR GreenI assay,and had a wider range of amplification.Compared with healthy control,the application of universal probe assay for the detection of serum microRNA146a in patients with brucellosis was significantly inhibited (P＜0.01).Implying the potential of microRNA-146a as biomarker in diagnosis of brucellosis.It is suggested that universal probe based assay is a universal,specific and sensitive method for microRNA detection.MicroRNA-146a represents a potential biomarker for human brucellosis diagnosis.
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Objective To develop the contents of Family Type Integration of Medical Care and Health Services in Hangzhou based on the Guiding Opinion on Promoting Integration of Medical Care and Pension issued by the State Council,Promotion Measures of Integration of Medical Care and Health Services in Hangzhou issued by the municipal government,and needs of health services for the elderly living in community.Methods The draft was formulated based on literature review,semi-structured interviews and expert meeting.Then,Delphi technique was used to identify the indicators through two rounds of expert consultation among 16 experts.Results The experts' authority coefficient was 0.790,the coefficient of determination was 0.906,and the familiar coefficient was 0.675.The contents of the Family Type Integration of Medical Care and Health Services in Hangzhou consisted of 8 firstlevel indicators,47 second-level indicators.The coordination coefficients of indicators were 0.341,0.222,and 0.426.Coordination of experts opinion had statistical significance (P＜0.01).Conclusion The contents of the Family Type Integration of Medical Care and Health Services in Hangzhou is reliable and scientific,which can be used as a basis for the formulation of items of the family type integration of medical care and health services in Hangzhou.
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Objective To investigate the relationships between patients′self- management behaviors and self- efficacy with lower extremity arterial disease, and supply evidence for effective management and intervention of lower extremity arterial disease for clinical medical workers. Methods In August 2014 to January 2015,a total of 110 cases of hospitalized patients with lower extremity arterial disease of two hospitals′vascular surgery from Guangzhou completed questionnaires, including the General Information Questionnaire, Chronic Disease Self- management Behavior - Chinese version, Chronic Disease Self- efficacy -Chinese version. Results The total score of self- management behavior of patients with lower extremity arterial disease ranged from 0 to 69, with an average score of 18.93 ± 6.79, the overall level was not high. Self- efficacy score ranged from 6 to 60, with an average score of 32.25 ± 9.65, the overall level was moderate. Self -management behavior was positively correlated with self- efficacy and its dimensions, and negatively correlated with the dimensions of communication with doctors and Common disease management. Conclusions The clinical staff should strengthen education and guidance of self- management behaviors in patients with lower extremity arterial disease, promote the level of self- management behaviors and self- efficacy, improve the confidence of disease treatment and prevention, in order to achieve the purpose of health promotion.
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Objectives To explore the relationship between illness perceptions and health behavior in the subjects. Methods Revised illness perception questionnaire and health promoting lifestyle profileⅡ (HPLPⅡ) were used to measure 101 patients′illness perception and health behavior between the groups. Results The HPLPⅡscore of LEAD was(2.17 ± 0.29) with the score of dimension. The course of disease, prognosis and perception of emotion were negatively related to health behaviour; personal control and primaty congtion of drsease were postively related to health behaviour (all P<0.01). Conclusion Medical personnel should pay attention to the relationship between illness perceptions and health behavior in patients with LEAD and effective measures should be taken to improve the patients′illness perceptions, promote their choices and persistence in health behavior and improve the quality of life.
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Objective To study the quality of life of patients with lower extremity artery disease (LEAD) and explore the effect of demographic and clinical factors on their quality of life. Method A self-designed demographic and clinical data questionnaire and the MOS 36 items short form health survey were used to investigate the life quality of 90 LEAD patients. Results The scores on the dimensions of life quality of the LEAD patients were significantly lower than those of common population (P<0.001). The marriage status and education affected patients′physical function, general health and social health;the longer the course of disease, the worse the general health;the complications, exercise and kind of disease affected patients'physical responsibility, physical function and emotion;the kind of disease affected patients'vitality; patients with exercise had higher general health (all P<0.05). Conclusions The life quality of LEAD patients is in general lower. The life quality of patients with different demographic and clinical data factors is varied. Therefore, doctors and nurses should correctly assess the life quality of LEAD patients and instruct those with problems so as to improve their quality of life.
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Objective To analyze the clinical results of modified N-butyl 2-cyanoacrylate skin adhesive in the application of facial trauma.Methods A total of 687 patients had been analyzed retrospectively from August 2009 to July 2014,and all the wounds of these patients had not obtained the anatomical repositioning after pure manual reduction with tissue glue or pure stitches.Improved tissue adhesive method was as follows:point coating,decomposition and glue with stitches.Results Anatomical repositioning was obtained in 685 wounds of 687 cases with improved tissue adhesive method.Infection occurred in the wounds of 2 cases (0.29％),but no other complications occurred in all patients.During postoperative 3 months of follow-up,clinical results were satisfactory for all patients.Conclusions The improved method of tissue glue has fewer postoperative complications,beautiful and more satisfatory appearance,economic,safer and reliable in the application of facial trauma.
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Objective To analyze the efficacy and safety of pramipexole in treating restless legs syndrome (RLS) to different races.Methods A search for randomized,double-blind,and placebocontrolled clinical trials of pramipexole in treating RLS using Pubmed was carried out.A meta-analysis of included clinical trials was performed with Revman 5.2.The efficacy was calculated based on the change of the weighted mean difference (WMD) with International Restless Legs Syndrome Study Group rating scale (IRLS) and the relative risk (RR) of response with Clinical Global Impression-Improvement (CGI-I) scale.Safety was assessed with RR of the adverse event (AE).Subgroup analysis was conducted in the white race subgroup and the yellow race subgroup,separately.Results A total of 6 clinical trials were included in this meta-analysis.The records of patients were pooled.Overall,WMD of the change in IRLS score was-4.72 (Z =6.57,P ＜ 0.01),which was-4.33 in white race subgroup (Z =3.90,P ＜ 0.01) and-4.52 (Z =42.28,P ＜0.01) in yellow race subgroup.Overall RR of response based on CGI-I was 1.64 (Z =10.39,P ＜0.01),which was 1.60 (Z =4.66,P ＜0.01) in white race subgroup,and 1.51 (Z =4.42,P ＜ 0.01) in yellow race subgroup.Overall RR for AE was 1.26 (Z =5.11,P ＜ 0.01),which was 1.26 (Z =2.27,P =0.02) in white race subgroup and 1.36 (Z =2.98,P =0.003) in yellow race subgroup.Conclusion To treat RLS,pramipexole is an effective and safe drug.The results are similar for both the white race and the yellow race.
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Background Corneal walleye formation is a result of excessive corneal wound healing.Controlling the corneal trauma or excessive healing reaction after operation of penetrating corneal trauma is a focus in the study of corneal wound healing.Objective This study was to investigate the changes of corneal strength and the expression of keratocan,a marker of corneal stroma,after corneal penetrating injury operation,and to determine the optimal removal time of corneal suture.Methods Full-thickness incisions of 5 mm along the vertical diameter were done at the central cornea on 80 eyes of 80 six-month-old New Zealand rabbits in this study.Then the incisions were interruptedly sutured with 10-0 nylon thread to establish the corneal wound healing models.Each 4 rabbits were sacrificed in 1 week,2,3,4,5,6,7,8 weeks after operation,respectively,and the central corneal stripes were prepared with the size of 7 mm×5 mm.The mean maximal strength of the corneal bands was measured by uniaxial tensile test with electroforce3220-AT biomachanics machine.Then,each 6 whole corneas were obtained at the above time points,and the dynamic changes of keratocan mRNA expression in the specimens were detected by reverse trancription PCR (RT-PCR).The care and use of the animals followed the rules of ARVO.Results The mean maximal strength of corneal stripes was 0,(1.007 ± 0.041),(1.991 ± 0.034),(2.512 ± 0.030),(3.630 ± 0.049) and (4.935 ± 0.004)M Pa in 1 week,2,3,4,5,6 weeks after modeling,and the corneal strength values from 3 weeks through 6 weeks were significantly enhanced in comparison with the value at the adjacent before timepoint (q =6.35,7.54,8.21,5.86,all at P＜0.01).The relative expression levels (absorbance) of keratocan mRNA in the corneas were 0.869±0.015,0.779 ± 0.065,0.621 ± 0.027,0.460 ± 0.018,0.393 ± 0.057 and 0.255 ± 0.045 in 1 week,2,3,4,5,6 weeks after operation,and each value was lower than that of the adjacent before timepoint (q =5.24,5.61,7.49,4.75,5.47,all at P＜0.01).The intensity of corneal stripes and the expression levels of keratocan mRNA in the corneas were stable in 7 weeks and 8 weeks after operation.Conclusions The dynamic change of corneal strength during the repair of penetrating corneal injury is associated with the down-regulation of keratocan in cornea.Rabbit cornea reaches a maximal strength capacity in 6 weeks after penetrating injury,therefore,it is the optimal time to remove suture.
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[ABSTRACT]AIM:Toinvestigatetheeffectofover-expressionofsmall-conductancecalcium-activatedpotassium channel subtype 2 (SK2) in the paraventricular nucleus (PVN) of hypothalamus on heart rate(HR), mean arterial pres-sure (MAP) and renal sympathetic nerve activity (RSNA) of the rats with chronic heart failure (CHF).METHODS:Adenovirus vector encoding SK2 (pDC316-mCMV-EGFP-rKCNN2) was constructed.The CHF model of the male Sprague Dawley ( SD) rats was established by the ligation of anterior descending coronary artery .Echocardiogram was used at the 6th week after the operation to identify the CHF model .Adenovirus vector encoding SK 2 ( pDC316-mCMV-EGFP-rKCNN2) or control adenovirus vector ( pDC316-mCMV-EGFP) were transfected into the PVN in vivo.The cardiac func-tion was monitored by echocardiogram .The expression of SK2 at mRNA and protein levels was determined by RT-PCR, Western blotting and immunofluorescence .The HR, MAP and RSNA were measured by PowerLab 8/30 in anesthetized rats with bilateral PVN microinjection of SK channel blocker apamin .RESULTS:Treatment with pDC316-mCMV-EGFP-rKC-NN2 significantly decreased the renal sympathetic nerve activity in the rat with CHF .Injection of pDC316-mCMV-EGFP did not change the renal sympathetic nerve activity in the rats in sham group .CONCLUSION:The expression and func-tion of SK channels in PVN in the heart failure rats were decreased , suggesting a reduced negative regulation of sympathetic activity in central neural system .Increased expression of SK 2 in the PVN leads to a reduction in sympathetic outflow under the condition of CHF , which may provide a new target for the treatment of heart failure .
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OBJECTIVE:To provide reference for standardized dispensation of chemotherapy drugs in PIVAS.METHODS:Cautions for the dispensation of chemotherapy drugs and process steps of emergency were introduced as well as the disposal of waste and liquid after dispensing.RESULTS & CONCLUSIONS:Centralized and standardized dispensation of chemotherapy drugs in PIVAS improves the quality of the dispensation of chemotherapy drugs.And it ensures the safety of drug use and strengthens the occupational protection of staff.
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Serum levels of testosterone (T), free testosterone (T_f), dehydroepiandrosterone sulfate, estradiol and sex hormone binding globulin were measured in patients with pregnancy-induced hypertension syndrome (PIH). Results showed that the levels of T and T_f and mean arterial pressure were significantly higher in the PIH group than those in the control group (all P
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OBJECTIVE : To prepare the sustained release tablets of salbutamol sulfate,and to establish the method of quality control.METHODS: The sustained release tablets were prepared by using salbutamol sulfate, lactose, sodium carboxymethyl starch, HPMC, EC, and MCC and coated with enteric soluble acrylic resin.HPLC was employed to determine the content of salbutamol sulfate, while at the same time dissolution grade in vitro was determined, and stability was investigated.RESULTS: : The detectable concentration of salbutamol sulfate showed a good linear correlation with peak area in the range of 1.25～20.00?g/ml.The average recovery of salbutamol sulfate was 98.60% (RSD=0.66%).The prepared tablets showed a timing release 5 hours after administration.No evident changes in dissolution were found in all tests of stability.CONCLUSION: The formulation of the preparation is reasonable; the preparation technique is simple and feasible, and the quality is stable and controllable.