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Purpose@#This study aimed to describe the clinical response to five-step systematic therapy (FSST) in the management of plugged ducts and mastitis. FSST was a comprehensive milk stasis dredging treatment, which contained five steps to make the milk out of the plugged duct. @*Methods@#This retrospective study included 922 breastfeeding women, 714 with plugged ducts, and 208 with mastitis who received FSST from June to September 2017. The breast pain score, swelling degree, and range of breast induration were recorded pre-FSST and post-FSST. @*Results@#After a single FSST, pain score and swelling degree were significantly improved (both p < .001) in all cases. After FSST, the mean breast pain relief score was 1.69 ± 0.70, whereas the mean swelling fade away degree was 1.61 ± 0.62. In the subgroup analysis, pain score and swelling degree were significantly improved (both p < .001) in the plugged ducts group and the mastitis group. The score of pain relief in the plugged ducts group was less than that in the mastitis group (1.63 ± 0.68 vs. 1.91 ± 0.70, t = 5.30; p < .001), whereas improvement of swelling fade away was greater in the plugged ducts group than the mastitis group (1.65 ± 0.64 vs. 1.48 ± 0.56, t = 3.49; p = .001). The composition ratio of changes in induration range between the two groups was statistically different (Pearson χ2 = 137.87, p < .001), of which more obvious improvement in the plugged ducts group than the mastitis group (χ2 = 25.65, p < .001). @*Conclusion@#FSST can relieve pain, reduce breast swelling and range of induration, and for plugged ducts or mastitis varied degree differently.
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Purpose@#This study aimed to describe the clinical response to five-step systematic therapy (FSST) in the management of plugged ducts and mastitis. FSST was a comprehensive milk stasis dredging treatment, which contained five steps to make the milk out of the plugged duct. @*Methods@#This retrospective study included 922 breastfeeding women, 714 with plugged ducts, and 208 with mastitis who received FSST from June to September 2017. The breast pain score, swelling degree, and range of breast induration were recorded pre-FSST and post-FSST. @*Results@#After a single FSST, pain score and swelling degree were significantly improved (both p < .001) in all cases. After FSST, the mean breast pain relief score was 1.69 ± 0.70, whereas the mean swelling fade away degree was 1.61 ± 0.62. In the subgroup analysis, pain score and swelling degree were significantly improved (both p < .001) in the plugged ducts group and the mastitis group. The score of pain relief in the plugged ducts group was less than that in the mastitis group (1.63 ± 0.68 vs. 1.91 ± 0.70, t = 5.30; p < .001), whereas improvement of swelling fade away was greater in the plugged ducts group than the mastitis group (1.65 ± 0.64 vs. 1.48 ± 0.56, t = 3.49; p = .001). The composition ratio of changes in induration range between the two groups was statistically different (Pearson χ2 = 137.87, p < .001), of which more obvious improvement in the plugged ducts group than the mastitis group (χ2 = 25.65, p < .001). @*Conclusion@#FSST can relieve pain, reduce breast swelling and range of induration, and for plugged ducts or mastitis varied degree differently.
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Objective@#To investigate the effect of motivational interviewing on functional exercise in postoperative breast cancer patients.@*Methods@#A total of 128 postoperative breast cancer patients admitted to our hospital from March 2016 to October 2017 were selected and divided into control group and observation group before and after motivational interviewing. The control group was given routine functional exercises guidance, while the observation group was given motivational interviewing on the basis of the control group. The self-efficacy and functional exercise compliance of the two groups were evaluated before intervention, on the day of discharge, and 3 months after discharge. The shoulder joint mobility of the two groups was evaluated 3 months after discharge.@*Results@#Repeated measures analysis of variance showed that there were statistically significant difference between the control group and the observation group in C-SUPPH (Fintervention=5.608, P=0.020) and Postoperative Functional Exercise Compliance Scale for Breast Cancer(Fintervention=6.776, P=0.010); The shoulder joint mobility of the observation group was superior to the control group at 3 months after discharge (U=2.128, P=0.033).@*Conclusion@#Motivational interviewing can improve self-efficacy and functional exercise compliance of postoperative breast cancer patients, and promote the recovery of shoulder joint activity function.
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Objective To investigate the effect of motivational interviewing on functional exercise in postoperative breast cancer patients. Methods A total of 128 postoperative breast cancer patients admitted to our hospital from March 2016 to October 2017 were selected and divided into control group and observation group before and after motivational interviewing. The control group was given routine functional exercises guidance, while the observation group was given motivational interviewing on the basis of the control group. The self-efficacy and functional exercise compliance of the two groups were evaluated before intervention, on the day of discharge, and 3 months after discharge. The shoulder joint mobility of the two groups was evaluated 3 months after discharge. Results Repeated measures analysis of variance showed that there were statistically significant difference between the control group and the observation group in C-SUPPH (Fintervention=5.608, P=0.020) and Postoperative Functional Exercise Compliance Scale for Breast Cancer(Fintervention=6.776, P=0.010); The shoulder joint mobility of the observation group was superior to the control group at 3 months after discharge (U=2.128, P=0.033). Conclusion Motivational interviewing can improve self-efficacy and functional exercise compliance of postoperative breast cancer patients, and promote the recovery of shoulder joint activity function.
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OBJECTIVE@#To explore the molecular basis for a Chinese family affected with neurofibromatosis type I.@*METHODS@#Peripheral blood samples were collected from the proband and his parents. Potential mutations of NF1 gene were screened by PCR and Sanger sequencing. Pathogenicity of candidate mutations was analyzed using Polyphen-2 and Provean software.@*RESULTS@#Two mutations of the NF1 gene, including c.702G>A (synonymous mutation) and c.1733T>G (missense mutation), were discovered in the proband. Neither mutation was found in his parents and 50 healthy controls. Bioinformatics analysis indicated that the c.1733T>G mutation (p.Leu578Arg) was probably damaging. The affected codon L578 is highly conserved across various species.@*CONCLUSION@#The c.1733T>C mutation of the NF1 gene probably underlies the neurofibromatosis type I in this family.
Subject(s)
Humans , Asian People , Genes, Neurofibromatosis 1 , Mutation , Neurofibromatosis 1 , Genetics , Neurofibromin 1 , Genetics , PedigreeABSTRACT
To combine more than 20 years of experience in clinical practice skills teaching of laboratory medicine, with the characteristics of laboratory medicine, the theory system of formative assessment has been constructed, to guide the clinical practice of the students.Based on the construction of network question bank, students make use of the network question bank self testing, to know whether they had got the stage goal, existing problems and future plan through self testing, so as to mobilize their enthusiasm and initiative to enhance their self-confidence.Under the formative assessment teaching system, students establish internship file information, including practice notes, weekly practice, group discussion, self testing results, the teacher and peer assessment information.Teachers set up QQ group, WeChat group with their students, the timely to get the question from students and to take appropriate measures improve teaching.Teachers had established and improved the long-term after graduation feedback mechanism, and formative assessment improved the teaching quality of the whole practice teaching benefits teachers as well as students.
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Objective To evaluate the effect of azithromycin on class Ⅰ integron-integrase gene (intI 1 )mRNA expression in biofilm-forming (BF)Pseudomonas aeruginosa (PA).Methods intI 1 of 10 PA strains isolated from a hospital were detected,1 strain with positive BF+intI 1 was selected for culture,blank control group and three az-ithromycin trial groups (divided according to 3 concentrations:16 mg/L,32 mg/L,and 64 mg/L)were set,experi-ments were repeated 5 times,expression of intI 1 mRNA were detected by RT-PCR.Results Relative expression of intI 1 mRNA in azithromycin groups of 16 mg/L,32 mg/L,64 mg/L,and control group were (1 .15 ±0.04), (12.47±3.10),(19.71 ±0.78 ),and (1 .00 ±0.00),respectively,there were significant difference among four groups(F =163.82,P 0.05),but among other groups were significantly different (P <0.05 ),intI 1 mRNA expression in azithromycin groups increased with the enhancing concentration of azithromycin in culture so-lution .Conclusion Expression of intI 1 gene mRNA in BF PA can be up-regulated by the present of azithromycin, which may improve the probability of drug-resistant genes,and promote drug-resistant gene recombination.
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Objective To discuss the promoting effect of humanistic care plus psychological cage on basis of conventional nursing on rehabilitation of patients after breast cancer surgery.Methods 460 cases of breast cancer patients from January 2008 to January 2010 were randomly divided into the control group and the observation group with 230 cases in each group.The control group received routine nursing care after surgery,while for the observation group,in addition to conventional care,they received humanistie care and psychological care.The alleviation degree of psychological barrier and degree of satisfaction of the two groups were compared.Results The alleviation degree of psychological barrier was 62.2% .and was 40.4% in the control group.The patients'satisfaction rate was 95.2% in the observation group,and 71.7% in the control group.the difference Was significant.Conclusions Humanistic care and psychological care can effectively relieve mental disorders of patients,promote their early recovery,also can improve their satisfaction degree with nursing work.
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Objective To investigate the prevalence of multidrug resistant genes in Klebsiella pncumoniae.MethodsTwenty strains of multidrug resistant Klebsiella pneumoniae were isolated from burn patients.Susceptibility of these strains to 14 antibiotics was detected by KB method.PCR was used to detect oqxA,smrKpn,qacE,tehA,mdfA and qacEΔl-sul1 genes.ResultsThe antibiotic sensitivity rates of 20 multidrug resistant Klebsiella pneumoniae isolates to antibiotics tested were ＜ 30％ except that to imipenam.The positive rates of efflux pump genes mdfA,qacEΔl-sull and oqxA were 65％,100％ and 100％,respectively; while those ofsmrKpn,qacE and tehA were 0％,0％ and 15％.ConclusionoqxA gene has been detected in multidrug resistant Klebsiella pneumoniae from burn patients with high positive rate.
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Objective To investigate the prevalence of mobile genetic elements in Acinetobacter baumannii strains isolated from burn patients. Methods Polymerase chain reaction (PCR) was used to detect the genes encoding the integron, transposon, conjugative plasmid and insertion sequence in 20 strains of Acinetobacter baumannii isolated from burn patients. Results tnpU and ISaba1 genes were detected in all 20 strains, and int Ⅰ gene was detected in 19 strains (95.0%). Other genes were all negative. Conclusion Mobile genetic elements carrying multi-drug resistant genes are found in Acinctobacter baumannii strains isolated from bum patients.
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OBJECTIVE To investigate the distribation of the AmpC enzyme in Acinetobacter baumannii isolated from burned patients. METHODS Susceptibility tests were used to detect antibiotic resistance to 20 kinds of antimicrobial drugs in 20 strains of A. baumannii isolated from burned patients, AmpC enzyme genes were detected by PCR and partial positive products were chosen to sequence. RESULTS Drug resistances to ?-lactam antibiotics in 20 strains of A. baumannii isolated from burned patients had exceeded 85% except levofloxacin or cefoperazone/sulbactam. Of ADC genes 95% were positive, but all DHA genes were negative. Through sequence and Blast analysis, partial ADC positive products were identical with that of EF546445. CONCLUSIONS The multidrug resistance of A. baumannii isolated from burned patients to ?-lactam antibiotics is serious. AmpC enzyme mediated by chromosome, ADC, prevails in A. baumannii isolated from burned patients.
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OBJECTIVE To investigate drug resistant genes associated with beta-lactamases,aminoglycosides and sulfonamides in Pseudomonas aeruginosa isolated from burned patients.METHODS Common drug resistant genes associated with beta-lactamases,aminoglycosides and sulfonamides of 20 strains of P.aeruginosa isolated from burned patients were detected by PCR.RESULTS The positive rates of genes of TEM,aac(6′)-Ⅰb,sul1 and ant(3″)-Ⅰwere 85%,85%,90% and 10%,respectively and genes of CARB and aac(6′)-Ⅱ were both positive(100%).Genes of oprD2 were all absent and genes of SHV,GES,IMP,VIM,DHA and armA were all negative.Furthermore,drug resistant genes of strains isolated from different sites of one patient on different time could be different.CONCLUSIONS Drug resistant genes of CARB and aac(6′)-Ⅱprevail in P.aeruginosa isolated from burned patients.Detections of drug resistant genes in P.aeruginosa isolated,especially continuously isolated from burned patients are essential.
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OBJECTIVE To investigate the disseminateion of the carbapenemase in Acinetobacter baumannii isolated from burned patients.METHODS Susceptibility tests of 20 strains of A.baumannii isolated from burned patients to 20 kinds of antimicrobial drugs were detected.Subsequently,seven genes encoding carbapenemase,including OXA-23,OXA-24,OXA-51,OXA-58,IMP,VIM and SIM,were detected by PCR and genes of partial positive products were sequenced.RESULTS Drug resistances to ?-lactam antibiotics of 20 strains of A.baumannii isolated from burned patients all exceeded 85% except to levofloxacin or cefoperazone/sulbactam.Nineteen strains(95%) were OXA-23 genes positive and all other genes were negative.Through sequence and Blast analysis,OXA-23 gene products were identical with that of CAB69042.1.CONCLUSIONS The multidrug resistance of A.baumannii isolated from burned patients to ?-lactam antibiotics is critical.Carbapenemase of OXA-23 prevails in A.baumannii isolated from burned patients.
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80% activity rate against E.coli included piperacillin/tazobactam(93.4%)、ceftazidime(86%),and amikacin(83.3%);The susceptible rate to piperacillin/tazobactam in K.pneumoniae was 84.6%. The susceptible rate to ceftazidime decreased from 82.3% to 69.9%, which was lower than to cefepime (77.2%). Over 50% of Enterobacter cloacae were resistant to ceftazidime, cefotaxime and ceftriaxone. Susceptible rates to piperacillin/tazobactam in E. cloacae,E. aerogenes,Citrobacter freundii and Serratia marcescens (67.7%-96.4%) were higher than those to cefepime (68.8%-77.5%), cefoperazone/sulbactam (59.7%-87.5%). Susceptibility to amikacin among these 4 species (70%-83.7%) was higher than to ciprofloxacin (48.1%-79.5%). All of Morganella morganii and Proteus vulgaris isolates were susceptible to meropenem and imipenem; Over 90% of the isolates were susceptible to cefepime, cefoperazone/sulbactam and piperacillin/tazobactam.The most active agent against Pseudomonas aeruginosa was meropenem (84%), followed by amikacin, piperacillin/tazobactam, ceftazidime and imipenem (72.5%-76.6%). Mutiple-drug-resistant Acinetobacter baumannii increased from 33% in 2003 to 48% in 2004. Resistance to carbapenems increased to 18% in this species in 2004. The most active agents against Burkholderia cepacia were meropenme (64.9%), cefoperazon/sulbactam (63.2%), ceftazidime (59.6%), piperacillin/tazobactam (56.1%) and cefepime (52.6%).Conclusions Carbapenems remained very high activity against Enterobacteriaceae. Increasing resistance to 10 antimicrobials agents tested among A. baumanni brought great concern. Meropenem was 4-to 16-fold more active against common gram-negative bacilli than imipenem.
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Objective To screen and identify B cell epitopes in SAG1, SAG2, SAG3, GRA1, GRA6 and P35 antigens of Toxoplasma gondii. Methods The indexes such as hydrophilicity, accessibility, flexibility, secondary structure and polarity of the 6 antigen moleculars above mentioned were analyzed by BioSun system. Two B cell epitopes with high antigenicity from each antigen molecular were selected, and the total twelve pairs of oligonucleotide chains were designed according to the 12 B cell epitopes’ sequence and synthesized, then cloned into plasmid pET-32c. The 12 fragment B cell epitopes were expressed and the expressed fusion proteins were identified with Western blot. Results Twelve B cell epitopes from 6 Toxoplasma antigens (two from each antigen) were predicted and selected. The epitope genes were successfully cloned into pET-32c and expressed. Western blot results showed that 3 of 12 expressed fusion proteins could be recognized by the immunized rabbit sera with soluble antigen of Toxoplasma gondii, but not by the unimmunized rabbit sera Conclusion Three B cell epitopes of Toxoplasma[with potential diagnostic value are obtained.