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Objective:To understand the current situation of the head nurses of orthopedics department on bleeding risk assessment and management in the prevention of DVT, to provide a reference for future clinical practice of bleeding risk assessment.Methods:Using phenomenological research methods, five head nurses of orthopedics department were interviewed one-on-one and analyzed by Colaizzi ′s phenomenological analysis. Results:Four themes were refined for the awareness and management of bleeding risk assessment in DVT prevention, mainly focusing on risk assessment, choice of assessment timing, multiple risk assessment methods, and unclear grading attitudes.Conclusions:The bleeding risk assessment work needs to be further explored. It is necessary to further scientifically clarify the timing and methods of bleeding risk assessment, effectively guide clinical practice, strengthen nurses ′ awareness of bleeding risk classification, and promote clinical nursing practice, so as to better conduct bleeding assessment and Care.
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Objective To explore the application effectiveness of medical team resource management model in the first aid green channel of acute ischemic stroke (AIS). Methods A total of 215 patients with acute ischemic stroke who underwent intravenous thrombolysis were enrolled from November 2015 to October 2017 as an observation group.The observation group adopted AIS first aid green channel based on medical team resource management mode.A total of 61 patients with acute ischemic stroke who underwent intravenous thrombolysis were enrolled from November 2013 to October 2015 as a control group.The control group adopted three districts and four treatment procedures.The time course of intravenous thrombolysis was compared between the two groups and to compare the satisfaction of the two groups with different AIS procedures. Results Application of medical team resource management model to establish a dedicated first aid green channel, the key links were significantly shortened,Door-to-Needle Time (DNT) decreased from (114.84 ± 8.05) minutes prior to establishment to (57.63 ± 6.30) minutes, the difference was statistically significant (t=51.263, P<0.05), the satisfaction degree of the medical staff was improved,the overall satisfaction increased from (2.86 ± 0.20) before establishment to (4.27 ± 0.20) points, the difference was statistically significant (t=-34.368,P<0.05).Conclusions The medical team resource management model applied to the treatment of AIS patients, the establishment of multidisciplinary integration of first aid green channel, to strengthen the team to effectively improve the timeliness of the key aspects of intravenous thrombolysis, shorten DNT, improve the quality of treatment of patients.
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BACKGROUND:The effect of advanced glycation end products (AGEs) on bone resorption is controversial. Our previous study has shown that bone resorption is significantly inhibited when AGEs present with pre-osteoclast cells RAW 264.7, while the effect of AGEs on osteoclastic acidification remains unknown. OBJECTIVE:To investigate the effect of AGEs on osteoclastic acidification and the underlying mechanism. METHODS:RAW 264.7 cells were induced by RANKL (15μg/L;normal group) to generate osteoclasts, and AGEs (50-400 mg/L;experimental group) or bovine serum albumin (100 mg/L;control group) were added at the beginning of the induction. The effect of AGEs on bone resorption was evaIuated by anaIyzing the area of bone resorption on the Osteo Assay Surface plates, and the effect of AGEs on osteoclastic acidification was evaluated by acridine orange staining. Furthermore, the expression levels of V-ATPase a3 and CIC-7 were detected to investigate the underlying mechanism. RESULTS AND CONCLUSION:The bone resorption area in the AGEs group was significantly decreased compared with the normal group (P<0.05). Acridine orange staining reveaIed that the red fluorescence (620 nm) intensity in the AGEs group was significantly decreased compared with the normal group (P<0.05), and this inhibitory effect became obvious with the increase of AGEs concentration. Immunocytochemistry, western blot assay and PCR findings showed that the expression levels of V-ATPase a3 and CIC-7 in the AGEs group were decreased significantly compared with the normal group (P<0.05). To conclude, AGEs exert inhibitory effect on osteoclastic acidification, probably by inhibiting the expression of V-ATPase a3 and CIC-7.
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BACKGROUND:Periprosthetic infection after artificial joint replacement is a disastrous complication for a patient. Currently, during treating for the periprosthetic infection, most of patients need two-stage revision, which bring about enormous physical and psychological pain for patients, and a heavy burden for the families and society. To make matters worse, the effect is not very perfect, and some of these cases require multi-stage revision, even amputation. OBJECTIVE:To investigate the therapeutic effect of vacuum sealing drainage combined with iodophor douche for the infection after artificial joint replacement. METHODS:Nine cases (six knees and three hips) of infection after artificial joint replacement were col ected, with an average age of 63.4 years. Infection occurred at 7 days-14 months, and a median time of 1 month after replacement. Al patients suffered from purulent or purulent blood secretion. Fistula formed in two cases and incision and drainage sites were not healed in one case. According to the bacterial culture results, above symptoms were accorded with clinical diagnosis of prosthesis infection. The prosthesis was remained for debridement. Vacuum sealing drainage was performed. Iodophor douche (30-50 mL) was conducted every day. The drainage tube at proximal end was occluded for 30 minutes, and then vacuum sealing drainage was performed. Al patients were regularly fol owed up to assess the therapeutic effects of vacuum sealing drainage combined with prosthesis infection after replacement. RESULTS AND CONCLUSION:(1) Except that one case was stil in treatment, one case was dead, and one case of tumor prosthesis was failure and final y amputated, the remaining six patients were healed. (2) The time of vacuum sealing drainage and iodophor douche was 10 to 84 days, with the median time of 57 days. No adverse reactions or complications occurred. Al healed patients were fol owed up for 12-60 months, without recurrence. (3) These results indicated that vacuum sealing drainage combined with iodophor douche retained the prosthesis to the greatest degree, is simple, safe, and effective for the infection after artificial joint replacement, needs a low cost, and is a kind of therapy for prosthesis infection after artificial joint replacement.
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BACKGROUND:Adipose-derived stem cels are a kind of mesenchyam stem cels with multipotent differentiation capacity, which have more advantages than bone marrow mesenchymal stem cels in tissue engineering research. OBJECTIVE: To establish a method to isolate and purify adipose-derived stem cels from human subcutaneous adipose tissues folowed byin vitro amplification and osteoblastic/adipogenic differentiation. METHODS: Adipose-derived stem cels were isolated from human subcutaneous adipose tissue and cultured by density gradient centrifugation and adherent culture. Cel morphology and growth features were observed under inverted microscope. Adipose-derived stem cels at passages 2 and 5 were selected for viability measurement using cel counting kit-8 method, and then cel growth curves were drawn. The immunophenotype identification was analyzed by flow cytometry. Passage 5 cels underwent osteoblastic/adipogenic induction to confirm the multi-differentiation potential. RESULTS AND CONCLUSION: (1) Using density gradient centrifugation and adherent culture method, high-purity human adipose-derived stem cels can be successfuly isolated from human adipose tissues. (2) The growth process of human adipose-derived stem cels includes stagnant phase, logarithmic phase and plateau phase, which meets the growth rhythm of normal cels. Moreover, the population doubling time is shorter. (3). Human adipose-derived stem cels are positive for stem cel-related antigens, with low immunogenicity and the multi-differentiation potential. (4) Labeling human adipose-derived stem cels with DAPI is a simple efficient labeled method, and the labeling rate is high but the cytotoxicity is low