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AIMS AND OBJECTIVES: To establish an early warning model of hepatic encephalopathy in patients with liver cirrhosis based on psychological testing. METHODS: Data including patient demographics, number connection test-A (NCT-A), digit symbol test (DST), Model for End-Stage Liver Disease (MELD) scores were collected for patients admitted to a tertiary hospital in Shanghai with liver cirrhosis between January and December 2019. Patients were divided into two groups based on the development of hepatic encephalopathy (the hepatic encephalopathy group and non-hepatic encephalopathy group). Risk factors for hepatic encephalopathy in patients with liver cirrhosis were determined by using the binary logistic regression. We developed a predictive model in accordance with the STARD statement criteria (Supplementary File S1) with a cut-off value determined by receiver operating characteristic (ROC) curve analysis and calculation of the Youden index. RESULTS: A total of 417 patients with liver cirrhosis were included in the present study. Of these, 33 out of 66 patients with abnormal psychological tests had hepatic encephalopathy during hospitalisation. In contrast, 6 out of 317 patients with normal psychological tests had hepatic encephalopathy. Logistic regression analysis identified age, MELD score, and abnormal psychological tests as risk factors for hepatic encephalopathy in patients with liver cirrhosis. The area under the ROC curve for our prediction model for hepatic encephalopathy in patients with liver cirrhosis was 0.950 and the largest calculated Youden index was 0.804, which corresponds to a cut-off value is 0.0307. CONCLUSION: Greater age, higher MELD score and abnormal psychological tests were significantly associated with increased risk of hepatic encephalopathy indicating early warning systems and identification of abnormal psychological tests are important components of the clinical nursing care process for cirrhotic patients. Our early warning model based on psychological testing can provide a basis for nursing observation and prevention of hepatic encephalopathy. RELEVANCE TO CLINICAL PRACTICE: Risk assessments for hepatic encephalopathy according to liver function and psychological tests, in addition to traditional neurological observations and dietary guidance, have utility in decreasing the incidence of hepatic encephalopathy.
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End Stage Liver Disease , Hepatic Encephalopathy , Humans , End Stage Liver Disease/complications , Severity of Illness Index , China , Hepatic Encephalopathy/etiology , Hepatic Encephalopathy/complications , Liver Cirrhosis/complications , Liver Cirrhosis/psychology , Psychological TestsABSTRACT
Objective:To establish the fingerprints of Microctis Folium by ultra high performance liquid chromatography (UPLC); To determine the contents of three flavonoids in the Microctis Folium; To evaluate the quality difference of Microctis Folium from different producing areas. Methods:The fingerprints were performed on Agilent ZORBAX SB C18 column (2.1 mm×150 mm,1.8 μm). The mobile phase was acetonitrile - 0.1 % acetic acid solution with gradient elution at a flow rate of 0.30 ml/min. The column temperature was 30 ℃ and the detection wavelength was 315 nm. The common fingerprint peaks were identified by UPLC-mass spectrometry, and the identification results were confirmed by comparison of reference materials. Waters Cortecs T3 C18 chromatographic column (2.1 mm × 100 mm,1.6 μm) was used for content determination. The mobile phase was methanol-0.1 % formic acid solution with gradient elution at a flow rate of 0.35 ml/min. The column temperature was 30 ℃ and the detection wavelength was 339 nm. The contents of vitexin, isovitexin and narcissoside in 15 batches of Microctis Folium from different habitats were determine. Results:There were 11 common peaks in the fingerprint of Microctis Folium. Identified by mass spectrometry and confirmed by reference substance,10 chemical components were identified, including caffeic acid, p-hydroxycinnamic acid, ferulic acid, vitexin, isovitexin, kaempferol-3-O-rutoside, astragaloside, narcissoside, isorhamnetin-3-O-glucoside and linden glycoside. The similarity between the fingerprints of 15 batches of Microctis Folium and the control fingerprint was greater than 0.95, indicating that the overall similarity of the fingerprints of Microctis Folium from different producing areas was high. The total contents of three active components were 3.23-5.64 mg/g in Yangjiang City, Guangdong, 3.60-5.78 mg/g in Zhanjiang City, Guangdong, 4.68-5.73 mg/g in Yulin City, Guangxi and 3.87-5.21 mg/g in Wuzhishan City, Hainan . There was no significant difference in the content of three active components in different producing areas. Conclusion:The fingerprints and the determination method established in the study are stable and feasible, which can be used for the quality evaluation of Microctis Folium.
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Objective:To explore the cognition and attitude of urological nurses towards patients′ sexual health education, and to provide basis for the development of urological patient sexual health education.Methods:The research was based on the phenomenology research method. Qualitative research were used to conduct semi-structured personal in-depth interviews with 18 nursing staff who are from 5 tertiary general hospitals in Shanghai, Shandong, Hainan, Anhui and Xinjiang Uygur Autonomous Region using a purposive sampling, data were analyzed by claizzi phenomenological data 7-step analysis method.Results:After refining, two categories and five themes were obtained, including vague concepts (confusion of concepts, lack of roles, lack of theoretical knowledge), neglect and avoidance (respect for patients′ wishes, low priority).Conclusions:Urological nurses have low ability to evaluate the needs of patients′ sexual health education, and the content of sexual health education was one-sided, the form was single, and the degree of preparation was low, so they can not provide personalized and standardized health education for patients. We should carry out education in multiple ways for urological nurses, develop a tool for assessing the needs of urological patients′ sexual health education in China as soon as possible, formulate a standardized and personalized sexual health education standard, and provide comprehensive, systematic and consistent sexual health education for patients, so as to improve the sexual health level of urological patients.
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Objective:To develop a novel sustained-release local anesthetic microspheres and evaluate the effects on sciatic nerve block in rabbits.Methods:The magnetic lidocaine microspheres were prepared by W 1/O/W 2 compound emulsion method, investigating their external morphology, measuring the magnetic response characteristics by the VSM and draw the hysteresis loop.The encapsulation efficiency and drug-loading rate were calculated, and the cumulative release curves in vitro were drawn.Fifteen healthy rabbits (half male and half female), aged 5-6 months, weighing 3.0-3.5 kg, were selected for sciatic nerve block and divided into 3 groups ( n=5 each) using a random number table method: magnetic response lidocaine microspheres group (PL group), normal saline control group (C group) and lidocaine group (L group). Magnetic response lidocaine microsphere buffer 2 ml, normal saline 2 ml and 2% lidocaine 2 ml were injected around the rabbit sciatic nerve through a catheter in PL, C and L groups, respectively.The applied magnetic field was withdrawn at 60 h after injection.Before injection (T 0) and at 30 min and 2 , 8, 16, 24, 48, 60, 62 and 64 h after injection (T 1-9), the compound action potentials and conduction velocities of bilateral sciatic nerve trunks were measured, and block was assessed using toe reflex score and modified Tarlov score. Results:The magnetic lidocaine microspheres were brown in color and observed as monodisperse, regular spheres with a diameter of (9±3) μm, an encapsulation rate of 46.18%, a drug loading of 6.02%, and a superparamagnetic release rate of 97% in vitro at 60 h. The hysteresis loop passed through the origin and no hysteresis occurred with the absence of an external magnetic field.Compared with C group, the action potentials and conduction velocities of the sciatic nerve, toe reflex score and modified Tarlov score were significantly decreased at T 1-T 8 in PL group ( P<0.05). Compared with L group, the action potentials and conduction velocities of the sciatic nerve were significantly increased at T 1, the action potential was decreased at T 2-T 8, the conduction velocity was decreased at T 3-T 8, the toe reflex score was increased at T 1 and decreased at T 3-T 8, and the modified Tarlov score was increased at T 1 and T 2 and decreased at T 3-T 8 in PL group ( P<0.05). Conclusions:Magnetic response lidocaine microsphere is successfully developed with good magnetic responsiveness and release and can prolong the sciatic nerve block time in rabbits.
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Neonatal sepsis is a common infectious disease in the neonatal period, and its morbidity and mortality are increasing year by year.Its etiology and pathogenesis have not been fully elucidated.In recent years, studies have confirmed that plasma soluble CD14 subtype(sCD14-ST)plays a certain role in the pathogenesis of neonatal sepsis, and has a certain value in its diagnosis and prevention.The study found that sCD14-ST could be used as an indicator for early auxiliary diagnosis of neonatal sepsis, and the expression of sCD14-ST was positively correlated with the degree of neonatal sepsis.Early detection of sCD14-ST can predict neonatal sepsis.This article reviews the research on sCD14-ST and its application in neonatal sepsis.
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Objective:To analyze the clinical features of post-pancreaticoduodenectomy hemorrhage, and explore effective and practical nursing strategies.Methods:Clinical data of 62 patients with post-pancreaticoduodenectomy hemorrhage from Jan 2014 to Dec 2019 in the First Affiliated Hospital of Naval Medical University were retrospectively analyzed. The bleeding time, location, vital signs, accompanying symptoms and surgical treatment measures and clinical outcomes were analyzed.Results:Among the 62 cases, early (within 24 h) hemorrhage occurred in 19/62 patients (30.6%), and late hemorrhage occurred in 43/62 patients (69.4%). 36/62 patients (58.1%) had arterial bleeding; And 43/62 patients (69.4%) had abdominal hemorrhage. Grade C hemorrhage occurred in 32/62 patients (51.6%). Sentinel hemorrhage occurred in 8/62 patients (12.9%). The manifestation of hemorrhage in 42 patients was bloody fluid from abdominal drainage tube (67.7%). Hemorrhage occurred in 23 patients with pancreatic fistula(37.1%), 12 patients with abdominal infection and other complications (19.4%). Shock symptoms occurred in 41 cases (66.1%) with postoperative hemorrhage. Pancreaticoduodenectomy hemorrhage were early detected in 0.3 h and last detected in 869 h, with a median time of 192.00 (14.63, 297.00) h. 30/62 cases (48.4%) of hemorrhage patients occurred 1 hour before and after nursing shift. When hemorrhage was found, emergency treatments such as blood transfusion to maintain blood volume ( n=47, 75.8%), hemostasis ( n=35, 56.5%) and vasoactive drugs to increase blood pressure ( n=32, 51.6%) were usually given immediately. 31/62 patients (50.0%) underwent emergency secondary surgery within 4 h of hemorrhage, and 45/62 patients (72.6%) were cured by emergency surgical treatment. A written treatment pre-plan for surgical nurses was established. Conclusions:Surgical nurses should be familiar with the clinical manifestations of post-pancreaticoduodenectomy hemorrhage, and improve the alarming ability of identifying the complications of post-operative hemorrhage. The establishment of an emergency pre-plan for surgical nurses could help to treat such patients timely and effectively.
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OBJECTIVE：To compare the chemical components in Sinapis alba before and after stir-frying. METHODS ： UPLC-Q-Exactive Obitrap MS was adopted to analyze chemical constituents of S. alba before and after stir-frying. The determination was performed on Waters CORTECS T 3 column with mobile phase consisted of methanol- 0.1％ formic acid solution （gradient elution ）at the flow rate of 0.25 mL/min. The column temperature was 30 ℃ and the sample size was 2 μL. High resolution MS adopted heating electrospray electron source ，positive ion scanning mode ，scanning range m/z 120-1 000. The chemical constituents of S. alba before and after stir-frying were identified by Compound Discover 3.2 software combined with relevant database ，and the content changes of chemical constituents were analyzed by using peak area. Chemometrics analysis was performed for the content changes of chemical constituents using peak area as variable. RESULTS ：A total of 54 chemical components were identified in S. alba ，mainly fatty acids （represented by erucic acid ），alkaloids（represented by sinapine ）， flavonoids. After stir-frying ，the contents of 19 chemical components changed significantly ，of which the contents of 10 components decreased significantly and those of 9 components increased significantly （P＜0.05）. Principal component analysis and orthogonal partial least squares discriminant analysis could clearly distinguish S. alba from stir-fried S. alba . CONCLUSIONS ：The contents of some chemical components of S. alba change significantly after stir-frying ，which may be one of the important reasons for the change of efficacy after stir-frying.
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Kawasaki disease is an acute, self-limited vasculitis, which mainly affects infants and children under the age of 5 years.The main complication is coronary artery disease.Untreated Kawasaki disease leads to varying degrees of coronary artery damage in about 15%-25% of patients.The incidence of Kawasaki disease is increasing year by year, which has become one of the main causes of acquired heart disease in children and has a serious impact on the quality of life for children and adults.The cause of Kawasaki disease is not clear.In recent years, it has become a hot topic for pediatric cardiomyovasculopathy.With the development of molecular biology and gene technology, more and more sensitive biomarkers of Kawasaki disease have been found.This article will review the sensitive biomarkers of Kawasaki disease.
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Congenital heart disease(CHD) in children refers to a group of clinical syndromes in which fetal heart and blood vessels develop abnormally due to various factors, which further affect normal structure and function.The clinical mortality rate of CHD in children ranks the first among non-infectious diseases, which brings great mental pressure and economic burden to the families of children.Most scholars believe that genetic factors and environmental factors alone or both cause CHD.In recent years, with the development of molecular genetics research, the genetic factors of children′s CHD have become the focus of study, mainly including single gene mutation, polygene mutation and chromosome abnormality, these mutations or abnormalities have no absolute one-to-one relationship with clinical phenotypes of CHD in children.Genetic research of CHD can provide theoretical basis for primary prevention of the disease and help prenatal counseling to reduce the occurrence of birth defects.
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Kawasaki disease is an acute,self-limited vasculitis,which mainly affects infants and children under the age of 5 years.The main complication is coronary artery disease.Untreated Kawasaki disease leads to varying degrees of coronary artery damage in about 15％-25％ of patients.The incidence of Kawasaki disease is increasing year by year,which has become one of the main causes of acquired heart disease in children and has a serious impact on the quality of life for children and adults.The cause of Kawasaki disease is not clear.In recent years,it has become a hot topic for pediatric cardiomyovasculopathy.With the development of molecular biology and gene technology,more and more sensitive biomarkers of Kawasaki disease have been found.This article will review the sensitive biomarkers of Kawasaki disease.
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Functional electronic stimulation (FES) may provide a means to restore motor function in patients with spinal cord injuries. The goal of this study is to determine the regions in the spinal cord controlling different hindlimb movements in the rats. Normalization was used for the regions dominating the corresponding movements. It has been verified that FES can be used in motor function recovery of the hindlimb. The spinal cord was stimulated by FES with a three-dimensional scan mode in experiments. The results show that stimulation through the electrodes implanted in the ventral locations of the lumbosacral enlargement can produce coordinated single- and multi-joint hindlimb movements. A variety of different hindlimb movements can be induced with the appropriate stimulation sites, and movement vectors of the hindlimb cover the full range of movement directions in the sagittal plane of the hindlimb. This article drew a map about spinal cord motor function of the rat. The regions in the spinal cord which control corresponding movements are normalized. The data in the study provide guidance about the location of electrode tips in the follow-up experiments.
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Lower limb neuroprostheses for motor function rehabilitation, especially the drop foot stimulator, uses sensors to turn on or off stimulus pulse sequence during hemiplegic patient's locomotion. This triggering method with fixed stimulus pulse output control may result in uncoordinated limb movement in the lower limb rehabilitation training. The purpose of this paper was to investigate the reliability of stimulus onset determination using inertial measurement units (IMUs), and a dynamic control algorithm based on gait event detection and walking speed was proposed. In our study, two different equipments were employed to record surface EMG (sEMG) of synergist muscles (tibialis anterior and medial gastrocnemius) and IMU sensor signals. Several detection methods for muscle activity onset-time were compared and analyzed to obtain a suitable onset detection method. A dynamic "Delay" time between heel strike event and muscle activity onset was obtained through an algorithm, and its relationship with walking speed was determined using data fitting.
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Lower Extremity , Electromyography , Gait , Gait Disorders, Neurologic , Humans , Muscle, Skeletal , Reproducibility of ResultsABSTRACT
Objective To study the role of quality control circle(QCC) in reducing operation-related acute pressure ulcer.Methods The QCC activity group composed by 13 nursing staff analyzed the current situation and causality of operation-related acute pressure ulcer,and made the pointed counter measures to reducing the incidence rate.Results Following the development of QCC activity,the incidence rate of operation-related acute pressure ulcer decreased from 1.83% to 0.73%. The sense of responsibility,communication,teamwork,motivation,quality control ability and harmony of all the group members were improved significantly after the activity.Conclusions The QCC activity could not only effectively reduced the incidence rate of operation-related acute pressure ulcer,but also consolidated our team spirit and enhanced the quality management capability of all team members.
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Objective To evaluate evidence-based practice of catheter removal strategy in patients with short-term indwelling catheter after partial nephrectomy. Try to apply the best evidence into practice, and further to improvethe quality of clinical nursing through quality review. Methods Two rounds of quality review were carried out in the 2 wards from July to December in 2016. Using the 5 review criteria of best evidence, we reviewed baseline of catheter removal strategies for patients with short-term indwelling catheter after partial nephrectomy and developed appropriate evidence-based practice. Further, the best evidence was integrated into clinical nursing practice, and the prognosis was reviewed after then. Results In the baseline review, the compliance of the 5 review criteria was 0. However, after introducing the best evidence into nursing practice,the compliance was up to 100%. The mastering of evaluation knowledge of catheter removal of nurses increased from 73.00 ± 9.35 to 94.81 ± 3.38 with significant difference (t=12.72, P<0.01). The indwelling time of catheter shorted from (5.69±0.79) d to(4.24±0.82) d. The difference was significant (t=5.47, P<0.01). Conclusions Evidence-based nursing practice improvesthe strategies of short-term catheter removal after partialnephrectomy, while closer cooperation between nurses and doctors are still needed to promote the continuous improvement of nursing quality.
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Objective: To establish a method for determining the contents of hesperidin and arctiin in the root of Arctium lappa L.from different habitats.Methods: The chromatographic separation was performed on an Acquity UPLC BEH C18 column (50 mm×2.1 mm, 1.7 μm).The mobile phase consisted of acetonitrile (A)-0.1% formic acid (B) with gradient elution at the flow rate of 0.3 ml·min-1.The detection wavelength was 280 nm, and the temperature of column was 25℃.Results: The linear range of hesperidin and arctiin was 4.950-29.700 μg·ml-1 and 6.250-37.500 μg·ml-1(r=0.999 9), respectively.The average recovery of hesperidin and arctiin was 99.0% and 98.5%, respectively.Conclusion: The developed method is sensitive, rapid and accurate, which can be used for the quality control of the root,of Arctium lappa L.
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Objective To evaluate the effectiveness of professional nurses in atrial fibrillation (AF) anticoagulation management system.Methods 217 consecutive patients with nonvalvular AF were enrolled.All patients received warfarin therapy for 3-6 months after catheter ablation for AF,who were divided into experimental group (n=102) and control group (n=115) by random digits table.The patients of control group adjusted their warfarin doses by following doctor's advice when discharged and by visiting the outpatient clinic regularly after discharged.The patients of treatment group adjusted their warfarin doses under the guidance of one well-trained nurse.Days of the international normalized ratio (INR) value achieved therapeutic anticoagulation range (2.0-3.0) for the first time,the effective anticoagulation rate that defined as more than 70％ of INR values between 2.0-3.0 after titration period,the ratio of times of INR value 2.0-3.0 to total times after titrating and INR monitoring frequency were compared between the 2 groups.Results In treatment group,days of the INR value achieved therapeutic 2.0-3.0 for the first time were less than that in control group (8 d vs.15 d,P＜0.01),the effective anticoagulation rate [45.1％(46/102)] and the ratio of times of INR value 2.0-3.0 to total times after titrating (67.6％±18.5％) was significantly higher than that in control group [31.3％(36/115) and 62.0％±23.1％ respectively,P＜0.05].INR monitoring during the whole period and after titrating were more frequently in treatment group [(9.4±2.2)times vs.(8.4±2.7) times,P＜0.05;(7.9±2.4) times vs.(6.3±2.8) times,P＜0.01].The number of patients in treatment group who monitor INR less than 3 times after titrating was larger than that in control group (18 vs.1,P＜0.01).Conclusions The participation of professional nurses in atrial fibrillation anticoagulation management system was helpful not only in achieving INR 2.0-3.0 more quickly but also in improving the effective anticoagulation rate.
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A Device to detect for the bladder which is full with urine is designed. The device can measure bladder pressure. The pressure signals are processed. When the pressure exceeds 40cm water column, Pressure signal exceeds a fixed voltage. At the same time, Oscillator sends a signal and the signal transmits to the body surface. The receiver accepts the oscillating signal. Then, the alarm alerts. Liquid pressure sensor is used to measure bladder pressure. Signal transmits through a pig bladder to pigskin to verify the feasibility of the program.
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Clinical Alarms , Pressure , Prostheses and Implants , Urinary Bladder , Urine , Animals , Monitoring, Physiologic/instrumentation , SwineABSTRACT
TiN coating has been demonstrated to improve the biocompatibility of bare NiTi alloys; however, essential biocompatibility differences between NiTi alloys before and after TiN coating are not known so far. In this study, to explore the underlying biological mechanisms of biocompatibility differences between them, the changes of bare and TiN-coated NiTi alloys in surface chemical composition, morphology, hydrophilicity, Ni ions release, cytotoxicity, apoptosis, and gene expression profiles were compared using energy-dispersive spectroscopy, scanning electron microscopy, contact angle, surface energy, Ni ions release analysis, the methylthiazoltetrazolium (MTT) method, flow cytometry and microarray methods, respectively. Pathways binding to networks and real-time polymerase chain reaction (PCR) were employed to analyze and validate the microarray data, respectively. It was found that, compared with the bare NiTi alloys, TiN coating significantly decreased Ni ions content on the surfaces of the NiTi alloys and reduced the release of Ni ions from the alloys, attenuated the inhibition of Ni ions to the expression of genes associated with anti-inflammatory, and also suppressed the promotion of Ni ions to the expression of apoptosis-related genes. Moreover, TiN coating distinctly improved the hydrophilicity and uniformity of the surfaces of the NiTi alloys, and contributed to the expression of genes participating in cell adhesion and other physiological activities. These results indicate that the TiN-coated NiTi alloys will help overcome the shortcomings of NiTi alloys used in clinical application currently, and can be expected to be a replacement of biomaterials for a medical device field.
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Biocompatible Materials/chemistry , Nickel/chemistry , Titanium/chemistry , Alloys , Anti-Inflammatory Agents/chemistry , Cell Adhesion , Cell Proliferation , Endothelial Cells/cytology , Flow Cytometry/methods , Humans , Ions , Materials Testing , Microscopy, Electron, Scanning/methods , Polymerase Chain Reaction , Tetrazolium Salts/pharmacology , Thiazoles/pharmacology , Umbilical Veins/cytologyABSTRACT
The channel bridging, signal regenerating, and functional rebuilding of injured nerves is one of the most important issues in life science research. In recent years, some progresses in the research area have been made in repairing injured nerves with microelectronic neural bridge. Based on the previous work, this paper presents a neural signal detection and functional electrical stimulation (FES) driving system with using high performance operational amplifiers, which has been realized. The experimental results show that the designed system meets requirements. In animal experiments, sciatic nerve signal detection, regeneration and function rebuilding between two toads have been accomplished successfully by using the designed system.
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Amplifiers, Electronic , Biomimetic Materials , Electric Stimulation Therapy/instrumentation , Electrodiagnosis/instrumentation , Sciatic Neuropathy/diagnosis , Sciatic Neuropathy/rehabilitation , Therapy, Computer-Assisted/instrumentation , Animals , Bufo bufo , Equipment Design , Equipment Failure Analysis , Signal Processing, Computer-Assisted/instrumentation , Systems IntegrationABSTRACT
We developed the natural hydroxyapatite/chitosan composite that could be molded into any desired shape. The powder component consists of natural hydroxyapatite, which is epurated from bone of pigs. The liquid component consists of malic acid and chitosan. To study the possibility of the composite on repairing bone defects, 15 white rabbits were each operated on left tibias to create two square bone defects. One of the defects was reconstructed with the composite; the other was not repaired as a blank control. 3 of the animals were killed at the end of 2 weeks, 4 weeks, 8 weeks, 12 weeks and 16 weeks respectively to be evaluated with anatomy and histology. No apparent reject reaction was found, except for a mild inflammatory infiltrate found at postoperative 2 weeks. Fibrous tissue became thinner at postoperative 2-8weeks and bony connection was partly shown at postoperative 12 weeks. The new bone was the same as the recipient bone at postoperative 16 weeks. The hydroxyapatite/chitosan composite has good biocompatibility and osteoconduction. It is a potential repairing material for clinical application.
