Construction and clinical effects of endocrinology nursing subspecialty group / 中国实用护理杂志

Objective:To construct endocrinology nursing subspecialty model and explore its clinical effect.Methods:In December 2018, the organization structure of endocrinology nursing subspecialty was constructed in the Drum Tower Hospital Affiliated of Nanjing University Medical School and applied in clinic. In this model, the data of 2018 were taken as the data before application and the data of 2020 were taken as the data after application. The comprehensive ability of nurses, nurse satisfaction, related nursing workload and scientific research ability of nurses were compared before and after the application of the model.Results:After the application of subspecialty nursing mode, nurses′ comprehensive ability score was (92.00 ± 2.36) points. Compared with (84.25 ± 3.24) points before implementation, the difference was statistically significant ( t=-9.46, P<0.01); nurses′ satisfaction evaluations including specialty development (7.92 ± 1.41), self-quality improvement (8.00 ± 1.69), work pressure (6.42 ± 2.67), salary and welfare (3.96 ± 0.85), compared with (5.79 ± 2.31), (6.17 ± 2.82), (8.33 ± 1.50), (2.88 ± 1.59) before implementation, the difference was statistically significant ( t values were -3.86--2.73, all P<0.05). The annual workload of related nursing increased and the scientific research ability of nurses was improved. Conclusions:The application of endocrinology nursing subspecialty mode is beneficial to improve nurses′ comprehensive ability of clinical work, improve the level of specialized nursing, improve the quality of nursing service and promote the improvement of economic benefits, which is worthy of clinical promotion.

Research of correlation between limb heaviness and muscle strength, post-stroke fatigue in stroke patients / 中国实用护理杂志

Objective To explore the correlation between limb heaviness and muscle strength, post-stroke fatigue (PSF) in stroke patients. Methods A total of 110 stroke patients were selected. The general information scale, Modified Rankin Scale (MRS), Modified Barthel Scale, Fatigue Severity Scale (FSS) were used to assess limb heaviness and muscle strength, PSF, and functional status. And to research the relationship of limb heaviness and muscle strength, PSF in stroke patients. Results The incidence of limb heaviness in stroke patients was 40.91％(45/110). FSS and Modified Barthel Score showed significant difference in whether patients have limb heaviness (t=-3.244, P=0.002; t=2.019, P=0.046). Spearman correlation analysis results showed that the FSS score was positively related with limbs heaviness ( r=0.384, P=0.000), but muscle strength, Modified Barthel Score, Modified Rankin Score had no correlation with limbs heaviness (r=0.091, P=0.346;r=0.185, P=0.053;r=0.132, P=0.132). Conclusion A higher incidence of stroke patients with limb heaviness. The change of muscle strength won′t promote limbs heaviness, but patients with PSF were easier to concurrent limbs heaviness, also affect the ability of the patients life, should be highly valued by medical workers, and have to intervention.

Curative effects and prognosis of endoscopic papillary large balloon dilatation on the treatment of choledocholithiasis / 中华消化内镜杂志

Objective To evaluate the curative effect and prognosis of endoscopic papillary large balloon dilatation ( EPLBD) in the treatment of choledocholithiasis. Methods A total of 153 patients with choledocholithiasis (>1. 0 cm in stone diameter) admitted and treated in Shanxi People's Hospital from August 2016 to November 2017 were randomly divided into two groups according to the random number table: the EPLBD group ( n=83) and the small endoscopic sphincterotomy plus large balloon dilatation ( ESLBD) group ( n=70) . The success rate of stone removal, the rate of lithotripsy, and the incidence of short-term and long-term complications were compared between the two groups. Results There were no statistical differences between the EPLBD group and the ESLBD group in total stone removal rate [ 95. 2％( 79/83) VS 97. 1％ ( 68/70) ,χ2=0. 388, P=0. 533] and one-time stone removal rate [ 92. 8％ ( 77/83) VS 90. 0％ ( 63/70) ,χ2=0. 375, P=0. 540] . The lithotripsy rate between the two groups had no statistical difference [ 25. 3％ ( 21/83 ) VS 35. 7％ ( 25/70 ) , χ2 = 1. 958, P= 0. 162 ] . There was no statistical difference in the incidence of recent complications between the two groups [ 43. 4％ ( 36/83 ) VS 40. 0％(28/70), χ2=0. 178, P=0. 673]. No postoperative perforation was found in either group. The follow-up time was 22. 7 ± 4. 3 months in the EPLBD group, and 20. 8 ± 6. 3 months in the ESLBD group. The cumulative recurrent rate of choledocholithiasis in the two groups were 2. 4％ ( 2/83) and 15. 7％ ( 11/70) , respectively, and the difference was significant ( P=0. 003) . Conclusion Simple EPLBD in the treatment of choledocholithiasis is equivalent to ESLBD in the success rate of stone removal, utilization rate of lithotripsy, and incidence of recent complications, but the long-term stone recurrence rate of EPLBD is lower than that of ESLBD. EPLBD is effective and safe on the treatment of choledocholithiasis.

Role of NLRP3 in the development of silicosis pulmonary fibrosis and the effect of its inhibitor MCC950 / 中国职业医学

OBJECTIVE: To investigate the mechanism of nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3( NLRP3) inflammasome in the development and progression of silicosis pulmonary fibrosis,and to explore the effect of NLRP3 inhibitor MCC950 on silicosis pulmonary fibrosis. METHODS: The specific pathogen free Wistar male rats were randomly divided into control group,model group and inhibitor group,with 20 rats in each group.The rats in the model group and the inhibitor group were given a 1. 0 m L of free silica suspension at a concentration of 50 g/L by the non-exposure endotracheal intubation method. Rats in the control group were given an equal volume of sterilized 0. 9% sodium chloride solution. Rats in the inhibitor group were given 10 mg/kg body weight of MCC950 once every other day by gavage,while rats in the model group and the control group were given an equal volume of sterilized0. 9% sodium chloride solution. Five rats were randomly sacrificed at 7,14,28,and 56 days after model establishment.The body weight of the rats was weighed,and the degree of pulmonary alveolitis and pulmonary fibrosis was observed. The enzyme-linked immunosorbent assay was used to detect the levels of interleukin( IL)-1β,IL-18 and transforming growth factor-β1( TGF-β1) of lung tissues. Western blotting was used to detect the relative expression of NLRP3 and Caspase-1protein. RESULTS: The body mass of rats increased with increasing observation time( P < 0. 01). The scores of pulmonary fibrosis and the levels of IL-1β,IL-18 and TGF-β1 in lung tissue had statistical significance in the main effect of dust treatment( P < 0. 01),and the order from high to low was model group,inhibitor group and control group( P < 0. 01). At the time points of 7,14,28,and 56 days after model establishment,the score of pulmonary alveolitis and the relative expression of NLRP3 and Caspase-1 protein in lung tissues in the inhibitor group were lower than that of the model group( P < 0. 01),but higher than that of the control group( P < 0. 01). CONCLUSION: The NLRP3/IL-1β/TGF-β1 signaling pathway plays an important role in the development of silicosis pulmonary fibrosis. MCC950 can inhibit the development and progression of pulmonary fibrosis of silicosis by inhibiting the activation of NLRP3 inflammasome.

Expression and significance of NLRP3/IL-1β/TGF-β1 signal axis in rat model of silicosis pulmonary fibrosis / 中华劳动卫生职业病杂志

Objective@#To investigate the expression and significance of NLRP3/IL-1β/TGF-β1 signal axis in a rat model of silicosis and pulmonary fibrosis.@*Methods@#Eighty healthy Wistar male rats of SPF grade were randomly divided into 4 groups: high (100 mg/ml) , medium (50 mg/ml) , low (25 mg/ml) concentration SiO2 dusting group and normal negative control. Group, 20 in each group. Five rats were sacrificed at 7 d, 14 d, 28 d and 56 d after SiO2 dusting. The degree of alveolitis and the degree of pulmonary fibrosis were observed. The enzyme-linked immunosorbent assay (ELISA) was used to detect IL-1β in lung tissue. The expressions of NLRP3 and Caspase-1 in lung tissue of rats were detected by Western Blot.@*Results@#The alveolitis score and fibrosis degree of the rats in the dust-receiving group were significantly higher than those in the control group at 7 d, 14 d, 28 d and 56 d, and the difference was statistically significant (P<0.01) . The concentrations of IL-1β, IL-18 and TGF-β1 in 14 d, 28 d and 56 d were significantly higher than those in the control group (P<0.01) . The expressions of NLRP3 and Caspase-1 in lung tissue of rats exposed to dust were 7 d and 14 d, 28 d, 56d were higher than the control group (P<0.01) ; the expression levels of NLRP3, Caspase-1, IL-1β, IL-18 and TGF-β1 in the low, medium and high concentration SiO2 dusting group were 7 d, 14 d and The difference between the two groups was statistically significant (P<0.05) , and both showed a time-effect relationship with the increase of dusting time.@*Conclusion@#NLRP3 and its downstream factors Caspase-1, IL-1β, IL-18 and TGF-β1 are highly expressed in the lung tissue of rats with silicosis and pulmonary fibrosis, suggesting that the NLRP3/IL-1β/TGF-β1 signal axis may be associated with silicosis. Pulmonary fibrosis has a close relationship and plays a role in the formation of silicosis.

A study on the status and problem countermeasures of key occupational disease monitoring in Shandong, China, from 2015 to 2017 / 中华劳动卫生职业病杂志

Objective@#To analyze the completion status, monitoring results, and existing problems of key occupational disease monitoring in Shandong, China, from 2015 to 2017, and to provide reference materials for improving monitoring quality and carrying out occupational disease prevention and control.@*Methods@#The monitoring situation including project coverage, data collection, monitoring results, and monitoring quality of key occupational diseases in Shandong from 2015 to 2017 were described and comparatively analyzed.@*Results@#In the past three years, the uncoverage rate of monitored counties (38.69% in 2015, 10.95% in 2016, and 5.11% in 2017) , the non-work rate of occupational health examination institutions (41.67% in 2015, 18.02% in 2016, and 8.72% in 2017) , and the non-work rate of occupational disease diagnosis institutions (42.31% in 2015, 38.46% in 2016, and 38.46% in 2017) in Shandong decreased year by year. The number of institutions with key occupational hazard factors reported to the safety supervision and management department increased year by year (it was 24140 in 2017, with an increase of 40.50% compared with 2016 and an increase of 114.62% compared with 2015) ; the key occupational hazard factors in enterprises were mainly noise (72.76%) , followed by benzene, silica dust, and coal dust. The number of workers exposed to key occupational hazard factors reported to the safety supervision and management department increased year by year; in 2017, it was 729245, with an increase of 39.78% compared with 2016 and an increase of 84.81% compared with 2015. The ratio of people exposed to key occupational hazard factors identified by the medical examination to the total people in the safety supervision system in a year decreased year by year (40.87% in 2015, 23.86% in 2016, and 17.95% in 2017) .@*Conclusion@#In Shandong, the supervision of enterprises with key occupational hazard factors and the responsibility of enterprise protection should be strengthened. The occupational health examination rate of workers should be improved. It is suggested that we should carry out the special investigations and occupational health risk assessment for key enterprises and key populations.

The anti-inflammatory effect of hesperetin on lung damage induced by paraquat in rats / 中华劳动卫生职业病杂志

Objective@#To investigate the anti-inflammatory effect of hesperetin (HSP) on lung damage induced by paraquat (PQ) in rats by detecting the levels of inflammatory makers in rat lung tissues.@*Methods@#140 Wistar male rats were randomly divided into negative control group, HSP control group, HSP control group, paraquat model group, pirfenidone (PDF) positive control group, and 100, 200, 400 mg/kg HSP treatment groups. All groups were exposed to 50mg/kg paraquat by oral gavage except for the negative control group and HSP control group. After 24 hours, the rats in each group were given drug intervention once daily. 10 rats were randomly sacrificed at 7th day and 28th day after exposure to paraquat respectively. 3 rats were randomly selected from them and HE, Masson staining were used to observe the pathological changes in the lungs of each group. Each group randomly selected 6 rats at two time points to detect the levels of TGF-β1, TNF-α, IL-4, IL-10, IL-1β and IFN-γ in rat lung tissues.@*Results@#Histopathological examination found that the lung injury were reduced in the rats of PDF positive control group and all HSP treatment groups. Compared with the negative control group, the levels of TGF-β1, IL-1β, TNF-α, IL-4, and IL-10 in rat lung tissues were significantly increased (P<0.05, P<0.01) after PQ exposure at two points in time, and there was no significant difference in the level of IFN-γ in lung tissues compared with the negative control group (P>0.05) . The levels of TGF-β1, IL-1β, IL-4, IL-10 and TNF-α in the lung tissues of rats on the 7th day in different dose treatment groups of HSP were reduced compared with those in the PQ model group with varying degrees (P<0.05, P<0.01) . The level of IFN-γ in lung tissues of rats were not significantly different from that of model group (P>0.05) . The levels of TGF-β1 and TNF-α in lung tissue of rats on the 28th day in PDF positive control group and different dose treatment groups of HSP were reduced compared with those in the PQ model group with varying degrees (P<0.05, P<0.01). The levels of IFN-γ in the rat lung tissues were increased compared with those in the PQ model group (P<0.05). Besides, there were no significant in the levels of IL-1β, IL-4 and IL-10 in lung tissues compared with PQ model group (P>0.05).@*Conclusion@#HSP can reduce lung damage induced by PQ in rats by inhibiting the release of inflammatory factors and promoting the secretion of anti-inflammatory factors.

Effect of dexmedetomidine on acute kidney injury in septic rats: the relationship with HMGB1 mRNA in renal tissues / 中华麻醉学杂志

Objective To evaluate the effect of dexmedetomidine on acute kidney injury (AKI) and the relationship between the mechanism and expression of high mobility group protein B1 (HMGBl) mRNA in renal tissues of septic rats.Methods Fort-eight healthy adult male Sprague-Dawley rats,aged 8-12 weeks,weighing 240-270 g,were divided into 3 groups (n =16 each) using a random number table method:control group (C group),sepsis group (S group) and dexmedetomidine group (D group).AKI was induced by cecal ligation and puncture.The concentrations of serum cystatin C (Cys C) were measured by immunoturbidimetry at 24 and 48 h after operation.The rats were sacrificed after blood sampling,and kidney tissues were removed for determination of the expression of HMGB1 mRNA (by fluorescent quantitative real-time polymerase chain reaction) and for examination of the pathological changes.The damage to the renal tubules was scored.Results Compared with group C,the renal tubular damage score and serum Cys C concentrations were significantly increased,and the expression of HMGB1 mRNA was up-regulated in S and D groups (P＜0.05).Compared with group S,the renal tubular damage score and serum Cys C concentrations were significandy decreased,the expression of HMGB1 mRNA was down-regulated (P＜0.05),and the pathological changes of renal tissues were significantly attenuated in group D.Conclusion Dexmedetomidine can attenuate AKI in septic rats and the mechanism may be related to inhibiting the expression of HMGB1 mRNA in renal tissues.

Effect of heat preservation on the recovery of BIS and the concentration of propofol in the recovery of propofol in elderly patients / 中国生化药物杂志

Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.ResultsTwo groups at T0, T1 esophageal temperature no significant difference, study group t2-t6 esophageal temperatures were significantly higher than those of the control group (P<0.05), maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference (P<0.05), and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference (P<0.05).ConclusionThe surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.

Clinical efficacy of cather ablation on tachycardia-induced cardiomyopathy / 实用医学杂志

Objective To explore the baseline echocardiographic characteristics and the time course and recovery of left ventricular systolic function in patients with tachycardia-induced cardiomyopathy. Methods Fif-teen patients received radiofrequency cather ablation for tachycardiarrhymias from November 2012 to April 2017 were screened in this study.All 15 patients were examined by intracardiac electrophysiology and treated by RFCA under the guidance of three dimensional mapping system.All Patients received transthoracic echocardiography for 3-month follow-up.Levels of NT-proBNP before and after the ablation were compared. Results Successful abla-tion was performed in 14 of 15 patients. There was significant improvement in left ventricular ejection fraction (35.33 ± 6.11 vs. 57.93 ± 9.38%;P < 0.001). The LVEDD after treatment had significant differences(55.47 ± 8.06 vs.49.87 ± 8.99 P<0.001)after 3-month follow-up;the LAD after treatment decreased significantly(38.87 ± 3.27 mm vs. 35.20 ± 2.46;P < 0.001)and the levels of NT-proBNP decreased after ablation from 3 474.07 ± 3 400.59 pg/mL to 497.33 ± 437.84 pg/mL(P = 0.005). Conclusions Restoration of left ventricular systolic func-tion and reversal of LV remodeling can be achieved with successful elimination of tachycardia in the majority of pa-tients.NT-proBNP level elevates in subjects with TCM and decreases sharply after ablation.

Effects of preemptive analgesia with tramadol on stress reaction in patients with ovarian cancer after radical resection / 中国基层医药

Objective To study the effect of preemptive analgesia with tramadol on ovarian cancer patients with stress reaction.Methods 80 cases with ovarian cancer undergoing elective surgery under general anesthesia were divided into the observation group and the control group according to the computer randomly generated control table,40 cases in each group.Patients in the observation group with PECA were pumped into tramadol after anesthesia induction,while the control group was in the same conditions of pumping tramadol after operation.Patients were all treated with intravenous patient -controlled analgesia with sufentanil after waking up.The blood concentrations of cortisol (COR),adrenal cortical hormone (ACTH),angiotensin Ⅱ (AT Ⅱ)were determined by radioimmunoassay, and the blood concentrations C reactive protein (CRP)was determined by immune turbidity method.The adverse reactions and the VAS score of patients after 2h,6h,12h,24h,48h were recorded.Results The COR,ACTH,AT Ⅱ, CRP concentrations of the two groups had no significant differences (all P >0.05)before operation.After each time point,COR[(208.5 ±31.6)ng/mL vs (446.3 ±19.8)ng/mL],ACTH[(35.7 ±8.2)pg/mL vs (63.5 ±9.1)pg/mL],AT Ⅱ[(46.8 ±10.9)pg/mL vs (75.9 ±12.5)pg/mL],CRP[(3.9 ±0.7)mg/mL vs (40.5 ±2.9)mg/mL] concentrations were significantly higher than those of pre -operation (all P 0.05);At the time of coughing,the two groups were significantly differ-ent only at the 6h[(2.5 ±0.6)vs (3.1 ±0.8)]and 12h[(2.1 ±0.6)vs (2.9 ±0.4)]time point (t =13.406, P =0.012;t =12.625,P =0.025).Conclusion Preemptive analgesia with tramadol and sufentanil for postoperative analgesia can effectively reduce the radical resection of postoperative pain and the stress reaction after surgery.It is a safe and effective analgesic method.

Comparison of therapeutic effect of kaluohuangna and anjiahuansuan in treating hemoptysis induced by pul-monary tuberculosis / 中国综合临床

Objective To discuss the therapeutic effect of kaluohuangna and anjiahuansuan in treating pa-tients with hemoptysis induced by pulmonary tuberculosis. Methods The therapeutic effect of kaluohuangna and an-jiahuansuan was compared. 163 eases of patients with hemoptysis of pulmonary tuberculosis were divided into group A ( n = 81 ) and B ( n = 82 ), and treated with kaluohuangna and anjiahuansuan respectively. Results Overall effec-tive rates of group A and B were 90. 1% ( 73/81 ) and 89.0% ( 73/82 ) respectively ( P > 0.05 ). The time in stop-ping blood in group A ( 5.8±2.9 ) h was shorter than in group B ( 6.0±3.0) h ( P > 0.05 ). Side effects of group A (0/163 ) were lower than group B(24/163 ) ( P < 0.05 ). Conclusions Kaluohuangrta is the first choice for treating patients with a little and middle hemoptysis induced by pulmonary tuberculosis, with less side effect.

Environment Protection for Relieving Acute Radiation Sickness Patients / 中华医院感染学杂志

OBJECTIVE To save the acute radiation sickness patients by preventing nosocomial infection and implementing environment protection of the wards.METHODS The results of air and the object surface in the wards,the workers′ hands detecting and sampling after improving environment protection were compared with those four days before improving it.RESULTS The problems were solved by the improverent of the new systems,rigorous training of the workers,air disinfecting,object surface management and their working process.CONCLUSIONS Discovering problems,seeking causes and solutions and the standardized administration of the environment in the wards are important to save the acute radiation sickness patients by environment protecting and keep safety of patients.