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Objective To explore the effect of family cohesion and adaptability on coping with fatigue in patients suffered high paraplegia caused by cervical spine fracture.Methods 96 patients suffered high paraplegia caused by cervical spine fracture were questionnaired by family cohesion and adaptability scale and bricf fatiguc assessment scale after 1 week of operation.And they were divided into the fatigue group and non-fatigue group,the scores of family cohesion and adaptability were compared between the two groups,and thepearson correlation analysis and multivariate linear regression analysis were used to explore the effect of family cohesion and adaptability on coping with fatigue.Results ①65.63％ (63/96) patients suffered coping with fatigue in high paraplegia patients caused by cervical spine fracture.②The scores of teal family cohesion and real family adaptability in the fatigue group were significantly lower than those in the non-fatigue group(P＜0.05) ; the scores of dissatisfaction of family cohesion and dissatisfaction of family adaptability in the fatigue group were significantly higher than those in the non-fatigue group(t=-2.630,-3.359,10.469,17.821,P＜ 0.05).③Pearson correlation analysis showed that the score of coping with fatigue was negatively correlated with the real family cohesion(r=-0.463,P=0.015) and real family adaptability(r=-0.486,P=0.021),and positively correlated with the score of dissatisfaction of family cohesion (r=0.395,P=0.036) and dissatisfaction of family adaptability (r=0.524,P=0.020).④Multivariate linear regression analysis showed that the real family cohesion,real family adaptability,dissatisfaction of family cohesion and dissatisfaction of family adaptability were the influencing factors of coping with fatigue in patients suffered high paraplegia caused by cervical spine fracture.Conclusions Family cohesion and adaptability was correlated with the coping with fatigue in patients suffered high paraplegia caused by cervical spine fracture.
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Objective To observe the effect of intra-articular injection of CM-chitosan on nuclear factor κB (NF-κB) activation and nitric synthase expression in rat osteoarthritis cartilage,and to explore the mechanism of inhibition of joint destruction.Methods Thirty-six SD rats were randomly divided into three groups:A,B,C,12 in each group.Group A was the sham group,group B,C rats had the medial collateral ligaments cut off and part of medial meniscus were removed to establish osteoarthristis model.Group C rats were injected with 3％ carboxymethyl chitosan intra-articularly 0.15 mg/kg 5 weeks later,and then repeated injection every 1 week.Animals were sacrificed 11 weeks after surgery.The gross changes of cartilage and the expression of NF-κB (P65) were compared by immunohistochemistry,the protein expression of I-κB and P65 in nucleus were detected by Western-bloting.Inducible nitric oxide synthase (iNOS) mRNA and protein expres-sion were analyzed by reverse transcription polymerase chain reaction (RT-PCR) and western blot.The general score of cartilage was analyzed by H test,the rest data was analyzed by one-way ANOVA.Results The cartilage degeneration scores pf group C (intra-articular injection of CM-chitosan group) were significantly less than those of group B.The protein expression of NF-κB of the articular cartilage in group C (106±7)was significantly lower than group B (147±8),the I-κB degradation was inhibited significantly in group C,and the expression of iNOS mRNA and iNOS protein were reduced in OA art~icular cartilage of arthritis rat chondrocytes,therefore,it had protective effect on articular cartilage.Conclusion CMC may inhibit NF-κB signaling pathway by inhibiting the degradation of I-κB in cartilage,which reduces iNOS mRNA and protein expression in rat osteoarthritis cartilage,thereby protects rat osteoarthritis cartilage cells.
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Objective To explore the relationship between family care and postoperative cognitive dysfunction(POCD) in patients undergoing spinal surgery.Methods Patients undergoing spinal surgery were questionnaired by Family APGAR Index and Mini-Mental State Examination (MMSE) 1 week after operation.They were divided into the POCD group and non-POCD group,and the scale of Family APGAR Index was compared between the two groups.Then the pearson correlation analysis and multivariate linear regression analysis were used to explore the effect of family care on POCD.Results ①35％ (35/100) patients undergoing spinal surgery sufferd POCD.②The partnership,affection,resolve and the total score of Family APGAR Index in the POCD group ((1.25 ± 0.45),(1.36 ± 0.41),(1.27 ± 0.42),(5.85 ± 1.30)) were significantly lower than that in the nonPOCD group((1.63 ± 0.56),(1.63 ± 0.52),(1.65 ± 0.51),(6.74 ± 1.56)) (P ＜ 0.05).③Pearson correla tion analysis showed that the MMSE was negatively correlated with the partnership,affection and resolve(r=-0.426,-0.382,-0.482,P ＜ 0.05).④Multivariate linear regression analysis showed that the resolve,partnership,affection were the influence factor of POCD in patients undergoing spinal surgery.Conclusions The decline of family care can lead to POCD.
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Objective To compare target-controlled infusion of propofol combined with remifentanil total intravenous anesthesia and intravenous combined with inhalation anesthesia in hemodynamic changes and side effects in elderly patients with laparoseopic cholecystectomy.Methods 56 ASA Ⅰ-Ⅱ patients aged ＞60 Y undergoing elective laparoscopie cholecystectomy were randomly divided into propofol-remifentanil target controlled infusion group (observation group)(n=28)and inhalation anesthesia group(using intravenous anesthesia was maintained with isoflurane inhalation)(n=28).HR,SBP,DBP,PETCO2,initial consciousness time,extubation time,side-effects were recorded at each time points.Results The change extent of HR and blood pressure in observation group was lower than inhalation anesthesia group.The initial recovery time,recovery time of spontaneous breathing and extubation time in the observation group Was better than anesthesia group(all P＜0.05).The side-effects in observation group were significantly lower than inhalation anesthesia group(all P＜0.05).Conclusion Laparoscopic cholecystectomy in elderly patients by target-controlled infusion of propofol combined with remifentanil total intravenous anesthesia could significantly inhibit the stress response,and effectively maintain the stability of hemodynamic,and rapid postoperative recovery,fewer adverse reactions.It Was an ideal anesthesia methods in elderly patients with laparoscopic cholecystectomy.