Nursing of patients with hyperthyroidism-induced liver injury combined with type 1 diabetes complicated by Wernicke encephalopathy / 中国实用护理杂志

Objective:To summarize the nursing experience of a patient with hyperthyroidism-induced liver injury combined with type 1 diabetes complicated by Wernicke encephalopathy.Methods:Patients with hyperthyroidism-induced liver injury, type 1 diabetes and Wernicke encephalopathy co-existing consciousness disorders, contradiction between medication and dietary care, separation anxiety, and specificity of drugs shared by the above three diseases were given appropriate care and discharged health education and continued care.Results:After active treatment and nursing, the patient′s consciousness became clear, nausea and vomiting improved, and liver function and thyroid function indexes gradually returned to normal. The patient was treated with oral 131I and discharged without any adverse effects. Conclusions:The patient′s condition is complex and the clinical care is different from that of ordinary patient. The nurses detect the change of the condition early, adopt a personalized nursing plan for the contradiction between medication and diet of the patient, pay attention to psychological care, reduce the occurrence of complications, and ensure the smooth discharge of the patient.

Increased expression of Siglec-1 on peripheral blood monocytes and its relationship with inflammatory reaction in autoimmune thyroiditis / 中华内分泌代谢杂志

Objective To investigate the expression of sialic acid-binding immunoglobulin-like-lectin-1 (Siglec-1)in the peripheral blood mononuclear cell (PBMC) of patients with autoimmune thyroiditis ( AIT) and its relationship with AIT. To explore the moduratory role of activated Siglec-1 on the differentiation of T cells and the promotion of in flammation after PBMC culture. Methods The peripheral whole blood and serum samples were collected from 30 AIT patients with normal thyroid function and 30 sex-and age-matched controls. The expression of sSiglec-1 in serum was detected by ELISA. The expression of Siglec-1 in PBMC was detected by RT-PCR and WB. The expression of Siglec-1 in CD14+ monocytes and the proportion of Th1 and Th17 cells in each group were detected by flow cytometry. The PBMC in AIT or control was stimulated with NaI in the presence or absence of LPS for 72 h. The expression of Siglec-1 in CD14+ monocytes and the proportion of Th1 and Th17 cells were detected by flow cytometry. Results sSiglec-1 in serum, Siglec-1 mRNA, and Siglec-1 protein in AIT patients'PBMC were higher than those in control group ( P＜0. 01). The expression of Siglec-1 in CD14+ monocytes by flow cytometry and differentiation of Th1 and Th17 cells were significantly higher than that in control group ( both P＜0. 01). The expression of Siglec-1 in control and AIT patients was up-regulated by 5×10-5 mmol/L to 1×10-2 mmol/L stimulated with NaI in the presence or absence of LPS for 72 h (P＜0.01), but the differentiation of Th1 and Th17 cells was up-regulated only in patients (P＜0.01), and in a dose-dependent manner. Conclusion Elevated Siglec-1 expression in PBMCs and monocytes can potentially serve as a biomarker for AIT. Iodine may affect Th1 and Th17 cell differentiation by activating Siglec-1 to adjust the AIT immune response.

Specific labeling method in improving mixed placing of medical waste in neonatal intensive care unit / 中国感染控制杂志

Objective To explore the effect of specific labeling method in improving the mixed placing of medical waste in neonatal intensive care unit(NICU).Methods Medical waste classification of 34 trash cans in the NICU of a hospital between July and December 2014 were investigated,July-September was pre-implementation phase of spe-cific labeling,October-December was post-implementation phase,mixed placing of medical waste between pre-and post-implementation phase was compared.Results A total of 504 cases of medical waste classification in NICU were investigated,252 cases respectively in pre-and post-implementation phase,74 cases of mixed placing were found. Mixed placing rates before implementing specific labeling was higher than after implementing (25.40%[64/252]vs 3.97%[10/252],χ2 =46.187,P <0.001 );before implementing specific labeling,57 cases of infectious waste and non-infectious waste were mixed placing,after implementing specific labeling,only 8 cases of infectious waste and non-infectious waste were mixed placing.Mixed placing were mainly performed by trainees for in-service training and interns,accounting for 39.06% before implementing and 50.00% after implementing.Conclusion The specific labeling for standardizing and managing of medical waste can improve the classification of medical waste in NICU, significantly improve the compliance of all kinds of health care workers to the standard handling of medical waste.

The diagnostic value in bronchoalveolar lavage galactomannan antigen detection of invasive pulmonary aspergillosis in patients without granulocyte deficiency / 实用医学杂志

Objective To study infection of the lung tissue by bronchoalveolar lavage for BALF and explore whether GM can help improve the he diagnosis efficiency in patients without granulocyte deficiency with IPA, and find the threshold of GM values. Methods Between January 2011 and December 2011, 173 cases of patients were considered possible invasive pulmonary aspergillosis in parallel BALF GM detection in the center of the respiratory endoscopic examination.. According to the diagnostic criteria at home and abroad, all the cases were divided into four groups, including group of IPA, group of tuberculosis, group of bacterial pneumonia and group of non-infection. Using ELISA method for determination of serum and BALF GM. The diagnostic value was made by statistical methods in BALF GM detection without patients of granulocyte deficiency with IPA. Results There were 11 cases in the group of IPA, 23 cases in the group of tuberculosis, 90 cases in the group of bacterial pneumonia and 49 cases in the group of non-infection. In patients without granulocyte deficiency with IPA,BALF GM value was higher comparing with the patients without IPA. There were significant difference between the two groups; Comparing the GM value in the serum, the detection of BALF GM was higher in IPA. ROC curve analysis found that when the BALF GM test value was 0.95 or higher, there was highest possible with IPA. Conclusion BALF GM testing is beneficial to patients of invasive pulmonary aspergillosis without granulocyte deficiency in early identification with IPA. This study found that BALF GM best value is 0.95 or higher.

The using status quo and analysis of POCT glucose meter / 中华检验医学杂志

Objective To investigate the problems during using, standard and quality management of the POCT glucose meters in hospital, to analyze the solutions, and to provide reference data for improving the test level of POCT in hospital.Methods The amount, brand and application of portable glucose meters in the hospital were obtained by 3 rounds of surveillance from May to July in 2013.All of those glucose meters were taken part in external quality assessment of Clinical Laboratory Center of National Health and Family Planning Commission.The test results of those glucose meters were compared with that of automatic biochemical analyzer, the comparison results were then analyzed.Results The POCT glucose meters possessed 5 brands in our hospital, and the amount and type of glucose meters in some clinical departments were often changed.When 4 brands which were detected as quality control samples by ministry of health, the accuracy of detection results of 3 concentration of brand Ⅲ were substandard, the CV% of two levels were 11.9%and 10.1%respectively, the remaining 3 brands were in line with the requirements.The qualified percentages of 3 times of comparison were 85.0%, 92.0%and 97.4%.Conclusions The hospital should select the brand of portable glucose meters reasonably, correct use of glucose meters, and it is very necessary to build indoor and interstitial quality evaluation system, at the same time, suggesting the hospital to establish the POCT quality management team, to carry out the instrument comparison periodically, so to guarantee the accurate, reliable results of POCT in hospital.

The Diagnosis of Hashimoto Thyroiditis: A Report of 45 Cases / 中国医师杂志

Objective To investigate the clinical manifestation and diagnosis of Hashimoto thyroiditis (HT). Methods 45 HT patients diagnosed by fine needle aspiration cytology (FNAC) were enrolled in this study. Their medical history, clinical parameters, data of laboratory examination, colour doppler ultrasonic image and FNAC were analyzed. Results This disease was more common in women than in men, and most of cases occurred during 35～50 years old. Almost all cases had the symptoms of thyromegaly and laryngopharynx malaise. The patients had normal thyroid function, hypothyroidism or hyperthyroidism. The levels of both antithyroid globulin antibody and antithyroid microsome antibody increased in 39 cases. The ultrasonic imaging features of thyroid were such as following: diffusive nonhomogenous hypoecho pattern in 19 cases, numerous hypoecho micronodes in 15 cases, hyperecho micronodes in 3 cases, and hyperecho bandlike echo pattern with swelling of neck lymph nodes in 8 cases. Conclusion Diagnosis of HD should put emphasis on a complete medical history, physical examination and necessary laboratory tests. Antithyroid auto-antibody assay and thyroid ultrasonic examination were very important for diagnosis of HD, and FNAC may be indispensable in suspected cases.