Application effects of hospital-to-community model-based case managment in patients with atrial fibrillation / 中国实用护理杂志

Objective:To explore the effects of hospital-to-community model-based case management on outcomes and life quality of patients with atrial fibrillation.Methods:By convience sampling method, a total of 90 cases of atrial fibrillation patients admitted to Changzhou Second People′s Hospital from January 2019 to May 2020 were randomly divided into control group and experimental group, with 45 cases in each group. The patients in the control group received routine nursing care, the experimental group implemented hospital-to-community model-based case management. The beliefs about medicine, medication compliance, quality of life and readmissions of cardiovascular events were compared between 2 groups before and 6 months after intervention.Results:Finally, 41 cases were included in the experimental group and 38 cases in the control group. Before intervention, there were no significant differences in various indexes between the two groups ( P>0.05). After 6 months of intervention, the scores of specific-necessity in Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) and Morisky Medication Adherence Scale-8 (MMAS-8) were (16.98 ± 4.22) and (7.15 ± 0.69) points in the experimental group, higher than in the control group (14.95 ± 4.33) and (6.32 ± 1.07) points; the scores of specific-concerns in BMQ-Specific were (6.83 ± 1.91)points in the experimental group, lower than in the control group (8.42 ± 2.73) points. The differences were statistically significant ( t = 2.11, 4.07, 2.98, all P<0.05); the scores of physical function, role-physical, pain, general health, mental health dimensions and total scores in SF-36 were (80.37 ± 3.46), (46.63 ± 14.54), (90.37 ± 5.78), (70.07 ± 9.98), (84.20 ± 8.73) and (584.88 ± 25.71) points in the experimental group, higher than in the control group (70.13 ± 11.20), (37.34 ± 10.25), (83.37 ± 6.89), (59.55 ± 7.98), (77.58 ± 9.09) and (533.87 ± 31.62) points, the differences were statistically significant ( t values were 3.30-7.89, all P<0.05). At 6 months after discharge, the re-admission of cardiovascular events were 5 cases (12.2%) in the experimental group and 12 cases (31.6%) in the control group, the difference was statistically significant ( χ2=4.74, P<0.05). Conclusions:Hospital-to-community model-based case management can effectively promote beliefs about medicine and medication compliance, improve quality of life and decrease re-admission of cardiovascular events of patients with atrial fibrillation.

Research Progress of PNI and CONUT in Breast Cancer / 肿瘤防治研究

Breast cancer has overtaken lung cancer as the most common malignancy in women. Although the early diagnostic rate has continuously improved, recurrence and metastasis remain a problem to be solved. Therefore, scientists should search for effective prognostic markers for breast cancer patients and adopt individualized programs for different patients. Studies have shown that cancer prognosis, to a certain extent, is related to the nutrition inflammation index. Preoperative prognostic nutritional index (PNI) and controlled nutritional status (CONUT) are indicators that comprehensively reflect the nutritional level and inflammatory state of patients, respectively. Different from other cancers, the incidence of breast cancer is related to nutritional status, and an extremely high or low score is not conducive to the prognosis of breast cancer patients. This paper reviews the research progress of PNI and CONUT in breast cancer.

Application of ACMMM management model in elderly patients with unsafe events / 中国实用护理杂志

Objective To explore the application of ACMMM management model in elderly patients with unsafe events. Methods A retrospective analysis of elderly patients who had been hospitalized for more than three months at the Chinese People′s Liberation Army General Hospital from May 2017 to May 2018 was performed. According to the patient′s hospitalization time, they were divided into group A and group B. Group A was hospitalized between May 2016 and May 2017 (n=1 258), and group B was hospitalized between June 2017 and May 2018 (n=1 309). Patients in group A were given routine nursing intervention, and patients in group B were combined to implement ACMMM management model intervention on the basis of routine nursing intervention. The incidence of various types of unsafe events in the two groups of patients was compared. The severity of the fall in the two groups of patients was compared. Comparison of nursing satisfaction between the two groups of patients. Results In group A, 47 patients had unsafe events, 11 patients in group B had unsafe events, and group A had higher incidence of unsafe events than group B (χ2=24.358, P<0.05). In group A, the frequency of pressure sores and burns was higher than that of group B (χ2=7.966, 4.353, 5.800, P<0.05). There was no statistically significant difference in the frequency of occurrence of falling, suffocation, self-injury, and misuse between the two groups (P>0.05). The severity of patients with falls in group A was higher than that in group B (Z=-2.124, P<0.05). The satisfaction of nursing in group B was 79.53% (1 041/1 309), the satisfaction of nursing in group A was 57.15%(719/1 258), and the satisfaction degree in group B was better than that in group A. The data were statistically significant (Z=-15.238, χ2=148.962, P <0.05). Conclusions The use of ACMMM management model for long-term hospitalized elderly patients with nursing intervention can effectively reduce the incidence of unsafe events in elderly patients, reduce the severity of falls and other related injuries, and effectively improve patient care satisfaction.

Application of ACMMM management model in elderly patients with unsafe events / 中国实用护理杂志

Objective@#To explore the application of ACMMM management model in elderly patients with unsafe events.@*Methods@#A retrospective analysis of elderly patients who had been hospitalized for more than three months at the Chinese People′s Liberation Army General Hospital from May 2017 to May 2018 was performed. According to the patient′s hospitalization time, they were divided into group A and group B. Group A was hospitalized between May 2016 and May 2017 (n=1 258), and group B was hospitalized between June 2017 and May 2018 (n=1 309). Patients in group A were given routine nursing intervention, and patients in group B were combined to implement ACMMM management model intervention on the basis of routine nursing intervention. The incidence of various types of unsafe events in the two groups of patients was compared. The severity of the fall in the two groups of patients was compared. Comparison of nursing satisfaction between the two groups of patients.@*Results@#In group A, 47 patients had unsafe events, 11 patients in group B had unsafe events, and group A had higher incidence of unsafe events than group B (χ2=24.358, P<0.05). In group A, the frequency of pressure sores and burns was higher than that of group B (χ2=7.966, 4.353, 5.800, P<0.05). There was no statistically significant difference in the frequency of occurrence of falling, suffocation, self-injury, and misuse between the two groups (P>0.05). The severity of patients with falls in group A was higher than that in group B (Z=-2.124, P<0.05). The satisfaction of nursing in group B was 79.53%(1 041/1 309), the satisfaction of nursing in group A was 57.15%(719/1 258), and the satisfaction degree in group B was better than that in group A. The data were statistically significant (Z=-15.238, χ2=148.962, P <0.05).@*Conclusions@#The use of ACMMM management model for long-term hospitalized elderly patients with nursing intervention can effectively reduce the incidence of unsafe events in elderly patients, reduce the severity of falls and other related injuries, and effectively improve patient care satisfaction.

Clinical efficacy and ultrasonographic evaluation of anti-thyroid drugs in the treatment of primary hyperthyroidism / 中国生化药物杂志

Objective To investigate the clinical efficacy and ultrasonographic changes treated with anti-thyroid drugs ( ATD ) in patients with primary hyperthyroidism(PHT).Methods 83 cases of PHT patients admitted to the department of ultrasound from February 2013 to August 2015 in Zhuji People's Hospital of Zhejiang Province were selected, the patients were divided into two groups according to the results of ultrasonography, echo nonuniform group 41 cases and echo uniform group 42 cases.ATD therapy was administered to the both groups (were treated with methimazole).The thyroid related indexes and hemodynamics of thyroid right superior diagnosed by color doppler ultrasound, and the curative efficacies of the two groups were analyzed.Results After treatment, the systemic vascular resistance index(RI) of echo uniform group was (0.62 ±0.17), and the echo nonuniform group was (0.65 ±0.18), there was no significant difference between the two groups.The echo uniform group of thyroid artery diameter on the right lobe(D), the peak systolic velocity(Vmax), minimum diastolic blood flow velocity(Vmin), thyroid volume(V) and blood flow volume(Q) were significantly lower than the echo nonuniform group, the difference was statistically significant (P <0.05).The total effective rate of the echo nonuniform group (48.78%) was significantly lower than that in the echo uniform group (85.71%), the difference was statistically significant(P <0.05).Conclusion ATD has a good effect in treating PHT, and can significantly improve the thyroid hemodynamics in patients, it has a positive effect on the regulation of thyroid-related parameters in patients, the clinical treatment is effective, and the effect is better especially in patients with uniform echo.

Application of 18F-FDG/99mTc-MIBI dual-isotope SPECT and gated myocardial imaging in early diagnosis of diabetes-induced myocardial damage / 实用医学杂志

Objective To explore the diagnostic value of 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging in early diagnosis of diabetes-induced myocardial damage. Methods 32 patients with diabetes and 26 healthy volunteers received 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging for assessing myocardial ischemia, viability status, and cardiac function. Results Myocardial perfusion abnormalitieswere observed in 47 regions on myocardial perfusion imagingin 21 of 32 (65.6%)patients with diabetes, showing perfusion/metabolism mismatched and suggesting viable myocardium. All the volunteers were normal on DISA. As compared with the normal control group, the positive rate of DISA in diabetic patients was significantly higher (P < 0.01). Left ventricular ejection fraction (LVEF) was (54.3 ± 7.2%) and (67.3±4.9%) respectively, the difference was statistically significant (P < 0.05). Conclusions 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging can assess myocardial ischemia ,viability and cardiac function in diabetic patients, and it is helpful for the early diagnosis of cardiac damage in patients with diabetes mellitus.

Diagnostic value of dual-phase 99Tcm-MIBI scintigraphy in patients with ectopic secondary hyperparathyroidism / 中华核医学与分子影像杂志

Objective To compare the diagnostic value of dual-phase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for localizing ectopic parathyroid lesions in patients with HPT secondary to chronic renal failure (CRF-HPT).Methods Medical records of 368 CRF-HPT patients (204 males,164 females,age range:12-76 years) from January 2011 to April 2015 were retrospectively analyzed.Pathological results was used as the gold standard for the diagnosis of HPT.The sensitivity and specificity of dualphase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for the diagnosis and localization of ectopic parathyroid lesions were studied and compared by x2 test.Results A total of 1 398 positive lesions were found in 356 patients by dual-phase 99Tcm-MIBI scintigraphy,and 54 ectopic lesions occupying 3.9％(54/1 398) of positive lesions were detected by delayed planar imaging or SPECT/CT fusion imaging in 45 patients.Most of them (n =53) were confirmed by pathology.While only 966 positive lesions were found in 254 patients and no ectopic lesions were identified by color Doppler ultrasonography.The diagnostic sensitivity and specificity of dual-phase 99Tcm-MIBI scintigraphy for CRF-HPT lesions were 97.2％(1 375/1 415) and 53.1％(26/49),respectively.The corresponding parameters of color Doppler ultrasonography were 66.4％ (940/1 415) and 46.9％ (23/49),respectively.The specificity of ectopic lesion localization by radionuclide imaging was 98.1％ (53/54).The accuracy of dual-phase 99Tcm-MIBI scintigraphy was significantly higher than that of color Doppler ultrasound in lesion localization (x2 =20.8,P ＜ 0.05).Conclusion Compared to color Doppler ultrasonography,99Tcm-MIBI scintigraphy is more sensitive in identifying the positive lesions and more specific in localizing the ectopic parathyroid lesions in patients with CRF-HPT.

Establishment and application effects of nursing personal performance appraisal program / 中国实用护理杂志

Objective To explore and build a real, objective, comprehensive clinical nursing individual performance indicators architecture model,and check the rationality and validity for prize distribution by clinical application. Methods The methods included that discuss new ideas of nursing performance management by multi- disciplinary experts,developed clinical personal nursing staff performance evaluation program,worded out indicators and methods for the clinical assessment of individual nurses and nurse managers respectively,then applied research in the pilot departments and hospital step by step. Results A personal performance evaluation framework model was constructed, which include clinical nurses and nursing managers. Experimental results show that the nursing staff in this regard performance program have a high degree of recognition, 98.82% (1 741/1 762) nursing staff understanding of the purpose and significance, 97.15%(1 712/1 762) nurses think the performance model structure is reasonable. After the implementation of the performance program, the outstanding rate of personal performance appraisal of nurses was 93% (1 639/1 762). Conclusions The application of scientific performance appraisal programs can play a positive role in helping improve the quality of clinical care, and promote the stable development of the care team.

Evaluation of the diagnostic value of 99mTc-MIBI SPECT positive tumor imaging and MRI in the recurrence or postoperative residual lesions of glioma / 实用医学杂志

Objective To evaluate the value of 99mTc-MIBI SPECT positive tumor imaging and MRI in the diagnosis of recurrence and postoperative residual of glioma. Methods Of 30 cases of glioma, 21 cases were residual or recurrent of glioma, while 9 cases were not, confirmed by pathology or follow-up. 99mTc-MIBI SPECT positive tumor imaging and MRI were performed on all patients. Results The sensitivity of 99mTc-MIBI SPECT positive tumor imaging (80.1%)was lower than that of MRI (90.5%) (χ2 = 0.006 4,P = 0.035), while the specificity of 99mTc-MIBI SPECT(88.9%) was much higher than that MRI(77.8%)(χ2= 3.827,P = 0.006). The accuracy in diagnosing residual or recurrent glioma between the two imaging has no significant difference. The sensitivity, specificity and accuracy were 95.2%, 100% and 93.3% when the two imaging methods were combined. Conclusions 99mTc-MIBI SPECT positive tumor imaging has higher specificity in the diagnosis of recurrence and postoperative residual of glioma. The combination of 99mTc-MIBI SPECT positive tumor imaging and MRI has great clinical significance.

Correlation between levels of liver fibrosis and liver fibrosis biochemical pa-rameters of advanced schistosomiasis patients / 中国血吸虫病防治杂志

Objective To explore the correlation between the levels of liver fibrosis and liver fibrosis biochemical parameters of advanced schistosomiasis patients. Methods A total of 48 advanced schistosomiasis patients were investigated and they were examined by the liver biopsy and B ultrasound imaging. At the same time,the liver fibrosis biochemical parameters,including glu-tamine transpeptidase(GGT),alkaline phosphatase(AKP),procollagenⅢ(PC-Ⅲ),collagen typeⅣ(Ⅳ-C),hyaluronic acid (HA)and laminin(LN),were detected. The liver fibrosis levels were classified by the liver biopsy and B ultrasound imaging,re-spectively,and the correlation between the levels of liver fibrosis and liver fibrosis biochemical parameters were analyzed statisti-cally. Results There was no correlation between the liver fibrosis levels classified by the liver biopsy and all the liver fibrosis bio-chemical parameters;there was a weak correlation between the liver fibrosis levels classified by the B ultrasound imaging and GGT,AKP,LN and PC-Ⅲ,respectively;there was a significant correlation between the liver fibrosis levels classified by the B ul-trasound imaging and HA andⅣ-C,respectively. Conclusions B ultrasound examination is a better,noninvasive fibrosis in-spection method. Liver fibrosis biochemical parameters combined with the B ultrasound examination may better reflect the overall condition of liver fibrosis.

Combined endoscopic-laparoscopic techniques for one-stage treatment of concomitant cholelithiasis and choledocholithiasis / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the clinical effects of combined endoscopic-laparoscopic technique for one-stage treatment of cholelithiasis with concomitant choledocholithiasis.</p><p><b>METHODS</b>A retrospective analysis was conducted of the clinical data of 30 patients (Group A) with cholelithiasis and choledocholithiasis receiving one-stage laparoscopic cholecystectomy (LC) combined with intraoperative encoscopic retrograde cholangio-pancreatography (ERCP) and 32 patients (Group B) receiving LC combined with 1aparoscopic common bile duct exploration. The operative time, blood loss, conversion to open surgery rate, time to postoperative ambulation, calculi residual rate, hospitalization cost and length of hospital stay were analyzed comparatively.</p><p><b>RESULTS</b>There were statistically differences between the two groups in hospitalization cost and length of hospital stay (P<0.05) but not in the other indices (P>0.05).</p><p><b>CONCLUSION</b>Combined endoscopic-laparoscopic techniques can be a safe and feasible option for one-stage treatment of concomitant cholelithiasis and choledocholithiasis to allow rapid postoperative recovery with a shortened hospital stay.</p>

Early treatment of ruptured intracranial aneurysms / 国际脑血管病杂志

The rebleeding rate,morbidity and mortality of the ruptured intracranial aneurysms are very high.Early treatment is very important to reduce the rebleeding rate.However,there are still a lot of controversies for its indications.The early treatment modalities of the ruptured intracranial aneurysms are mainly including craniotomy and interventional treatment.This article reviews the indications of early treatment of ruptured intracranial aneurysms and the selection of treatment modalities.

Endovascular treatment of vertebral artery dissecting aneurysms / 国际脑血管病杂志

Objective To investigate the feasibility and efficacy of endovaseular treatment of vertebral artery dissecting aneurysms (VADAs).Methods The clinical data of 7 patients with VADAs underwent endovascular treatment were analyzed retrospectively.Results Seven patients with VADAs successfully received endovascular treatment.Two patients with the onset of subarachnoid hemorrhage were treated with aneurysm embolization and parent artery embolization.Immediate postoperative angiography showed VADAs disappeared completely.The other 5 patients with unruptured VADAs were treated with stent-assisted coil embolization.Immediate postoperative angiography showed that 2 patients had complete occlusion,3 had almost complete occlusion.Angiographic follow-up of patients showed that VADAs did not develop.No recurrence and bleeding were observed.Conclusions The endovascular treatment of VADAs is safe and feasible.

Overview of studies on detoxification effect of smilacis glabrae rhizoma on mercury poisoning / 中国中药杂志

Mercury-containing preparations are widely used in surgery department of traditional Chinese medicine and have made remarkable achievements. But they are toxic to human kidney, nerve, immune, etc. Smilacis Glabrae Rhizoma is sweet, tasteless and neutral in nature and able to enter liver and stomach channels and detoxify mercury poisoning. This article summarizes the mercury poisoning and the detoxification effect of Smilacis Glabrae Rhizoma in ancient records, pharmaceutical studies and clinical application, in order to provide ideas and methods for the safe use of mercury-containing preparations in surgery department of traditional Chinese medicine.

Long-term efficacy of splenectomcy for patients with advanced shistosomiasis japonica / 中华肝胆外科杂志

Objective To study the long-term efficacy of splenectomy for patients with advanced shistosomiasis japonica.Methods Levels of WBC,RBC,PLT,EOS,ALT,ALP,GGT,A,TB,HA,LN,Ⅳ-C,PCⅢ,IGG,IGA,C3,C4,CD3,CD4,CD8,CD19 in periphetral venous blood were determined in 239 patients with advanced shistosomiasis.Meanwhile,the liver,gallbladder and spleen were examined with ultrasonography.Results The levels of WBC,PLT,EOS,ALT,ALP,IGG,IGA,LN,Ⅳ-C,CD19 increased in splenectomy group,the levels of A,TB,CD3,CD4,C3,C4 decreased in splenectomy group,while RBC,HA,PCⅢ,CD8 were not changed.Conclusion Splenectomy is a danger to hepatic function.Humoral immunity increases while cellular immunity decreases in splenectomy group.Splenectomy may aggravate the hepatic fibrosis in patients with advanced shistosomiasis.

Envelope Extraction of Heart Sounds Based on Hilbert-Huang Transform / 航天医学与医学工程

Objective Based on the analysis of time domain of heart sound with envelop to extract the envelope character of heart sounds.Methods The envelope extraction of heart sounds based on Hilbert-Huang Transform was given.Firstly,the original heart sounds signal was preprocessed by Huang Transform.Secondly,the envelope of heart sounds was got with Hilbert Transform.Results The first heart sound and the second heart sound were extracted,and all kinds of characters in time domain of heart sound were acquired more accurately.Conclusion The envelope of heart sound is extracted correctly.The foundation for further analysis of heart sounds is established.

Rapid propagation and seed germinating condition of Bupleurum chinense / 中草药

Objective For selecting and developing the excellent Bupleurum chinense to mass-produce seedlings and seeds in high quality.Methods B.chinense was picked from eight different areas,such as Lingchuan and Wanrong county in Shanxi Province,Longxi county in Gansu Province,and Shangluo in Shaanxi Province,etc.Rapid propagation was done.The testa of Zhongchai No.1 was scrapped or seeds were soaked in different phytohormones.The effects on germination rates of seeds were compared.ResultsThe optimum medium for bud propagation was B5supplemented with 1.0 mg/L 6-BA and 0.2 mg/L KT.The optimum medium for root induction of test-tube plantlets was 1/2 MS added with 0.1 mg/L NAA,0.5 mg/L IBA,and 1.0 mg/L DSC.The annual propagation coefficient of B.chinense plants was more than 1?108,and the survival rate of transplantation reached to 94%—97%.The phytohormone has little effect on seed germination of B.chinense,but scraping the testa could increase the germination percentage of seeds to 20% and shorten the germinating time greatly.Conclusion By tissue culture of excellent B.chinense,a great deal of plants and seeds could be produced in short time.By scrapping testa in a certain extent,the germination of seeds could be increased.

Clinical characteristics of schistosomiasis japonica liver fibrosis and its prophylaxis and treatment countermeasures / 中国血吸虫病防治杂志

Objective To explore the occurrence and development of schistosomiasis japonica hepatic fibrosis, and the treatment countermeasure. Methods Three groups of patients,including advanced schistosomiasis (splenectomy involved), non-advanced schistosomiasis splenomegaly and advanced schistosomiasis with hepatitis, were followed up. Biochemical tests including hepatic fibrosis indexes, liver ultrasonography,lymphocyte subcluster, and membrane CD35 were examined. Immunohistochemical tests of liver cells were performed in some patients. Results A total of 94.06% of 1212 patients took various anti-schistosome treatments. The difference was significant for positive antigen and antibody to schistosome, LN and HA ,and the ultrasonic indexes of liver fibrosis among the three groups. The degree of liver substance pathohistological examinations showed inflammation had a positive correlation with hepatic fibrosis. The contents of C-Ⅰ, C-Ⅲ in portal regions, central vein and hepatic sinusoid were increased in advanced schistosomiasis hepatic fibrosis. In hepatic fibrosis, hepatic sinusoid showed two pathological changes of dilation and stricture. Conclusions In schistosomiasis japonica, hepatic sinusoid changes play a great role in hepatic fibrosis.Hepatic fibrosis would still develop even after the thorough anti-schistosome therapy. So, anti-fibrosis therapy is necessary.