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BACKGROUND:The treatment of post-stroke dysphagia with Lipopharyngeal Qibi Formula has achieved good efficacy,and 5-hydroxytryptamine in peripheral serum and neurotransmitters in the nucleus tractus solitarius are closely related to swallowing.Therefore,this study was conducted to explore the modulatory effects of peripheral serum and nucleus tractus solitarius neurotransmitters in swallowing by using modern medical experimental methods such as molecular biology,thereby developing new ideas for the exploration of their mechanisms. OBJECTIVE:To verify the therapeutic effect of Lipopharyngeal Qibi Formula on post-stroke dysphagia and to investigate its mechanism of action. METHODS:Thirty-eight Sprague-Dawley rats were randomly divided into model group(n=14),treatment group(n=14)and sham-operated group(n=10).Animals in the model and treatment groups were modeled by reperfusion after 90 minutes of transient cerebral ischemia by wire bolus method.At 6 hours after modeling,neurological function was scored,and rats with a score of 2 were selected for subsequent experiments.The treatment group was given compound Lipopharyngeal Qibi Formula by gavage starting from the 2nd day after modeling and the remaining two groups were given normal saline by gavage.Changes in body mass,24-hour food and water intake were recorded on days 2,7,14 and 30.The swallowing initiation response time and the number of swallows were detected using a biosignal collector and a tonic transducer on days 14 and 30.After the swallowing test,the ischemic area of the brain in each group was measured by TTC staining.The expression of 5-hydroxytryptamine in the nucleus tractus solitarius of the medulla oblongata was measured by immunohistochemistry.The mRNA and protein expression levels of BCL-2 and BAX in the insula,premotor cortex,cingulate cortex and thalamus of rats in each group were measured by RT-PCR and Western blot,respectively. RESULTS AND CONCLUSION:Compared with the sham-operated group,the body mass,24-hour food intake and water intake were reduced,the swallow initiation response time was prolonged,and the number of swallows was reduced in the treatment and model groups at day 14 of gavage(P＜0.05).Compared with the model group,the body mass,24-hour food intake and water intake of rats were increased in the treatment group at day 30 of gavage(P＜0.05),but were still lower than those in the sham-operated group.Compared with the model group,the swallow initiation reaction time was shortened and the number of swallows increased in the treatment group,but the number of swallows was still significantly lower than that in the sham-operated group(P＜0.05).Cerebral ischemia area was reduced in the treatment group compared with the model group,and the number of 5-hydroxytryptamine-positive cells in the nucleus tractus solitarius of the medulla oblongata was increased in the treatment group compared with the model group,but it was still significantly lower than that in the sham-operated group(P＜0.05).Compared with the model group,the expression of BCL-2 mRNA and protein in the insula,cingulate cortex and thalamus of rats in the treatment group were significantly increased,the expression of BAX mRNA and protein were significantly decreased,and the BCL-2/BAX ratio was significantly increased(P＜0.05).To conclude,the Chinese herbal compound Lipopharyngeal Qibi Formula could improve the number of swallows and swallowing initiation response time,as well as 24-hour food intake,body mass and other swallowing-related indexes in rats with post-stroke dysphagia.The mechanism of action may be achieved by improving the area of cerebral ischemia,inhibiting the apoptosis of neuronal cells in the insula,cingulate cortex and thalamus of rats,thus improving the regulation of the higher centers on the medulla oblongata swallowing center,and regulating the level of 5-hydroxytryptamine in the nucleus tractus solitarius.
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Objective To investigate the effect of sensitive indicators of nursing quality in the management of elderly inpatients in neurology department. Methods A total of 160 inpatients in the department of neurology who were admitted between January 2016 and December 2017 were selected as study subjects. The patients were divided into pre-implementation (January to December 2016) and post-implementation (2017 Month-December) with 80 cases each. Traditional nursing Quality Management mode was adopted before implementation, and the management mode of nursing quality sensitive index was adopted after implementation. These two with priority improvement indicators, adverse events in nursing care, patient satisfaction and so on were compared. Results After the implementation, the correct rate of risk assessment, the implementation rate of nursing specifications, the correct rate of drug delivery, the rate of graded care execution, and the rate of individualized rehabilitation training were significantly higher than before implementation.The difference was statistically significant (χ2=4.103-5.769, P<0.05). The incidence rate of adverse events such as stress injury was 3.75% (3/80), which was significantly lower than that before implementation 20.0% (16/80). The difference was statistically significant (χ2=7.206, P<0.05). The patient satisfaction rate was 96.25%(77/80), which was significantly higher than 87.50% (70/80) before implementation.The difference was statistically significant (χ2=4.103, P<0.05). Conclusion The implementation of the sensitive index of nursing quality can improve the nursing quality of elderly inpatients in the department of neurology, reduce the occurrence of nursing adverse events and improve the satisfaction of patients.
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Objective To evaluate the effects of the two methods of propaganda and education, conventional training method and that combined with hand contamination survey method, on the medical and nursing staffs' hand hygiene compliance. Methods From October 2017 to April 2018, all medical and nursing staffs in 6 Departments:General Surgery Ⅰ, General Surgery Ⅱ, Orthopedics Ⅰ, Orthopedics Ⅱ, Internal Medicine Ⅰ and Internal Medicine Ⅲin Cangnan Second People's Hospital receiving health education were divided into two groups; both groups received routine training, while in the observation group, on the basis of routine training, the hand hygiene pollution investigation training mode was added, In the combined training method, when the wrong hand hygiene mode occurred, the hand specimens were collected and the correct hand washing method was instructed on the spot, and then the following hand specimens were taken to investigate the contaminated condition. One month before the training, the real situations of hand hygiene compliance in the two groups were investigated. In the 1st month after the beginning of training, both groups were cultivated by conventional propaganda and training methods. From the second month to the sixth month, the observation group was additionally trained to investigate hand hygiene pollution situation on the basis of conventional propaganda and training methods. After 6 months, the compliance rates of hand hygiene in the two groups were observed. Results Before training, there was no significant differences in the compliance rate of hand hygiene in the observation group and the routine trainning group [37.14% (52/140) vs. 36.36% (48/132), P > 0.05]. The compliance rates of hand hygiene after 1, 2, 3 months of training in the observation group were 56.61% (77/136), 60.61% (80/132) and 61.20% (82/134), respectively, and those in the routine trainning group were 56.25% (72/128), 59.26% (80/135) and 58.70% (81/138), which were all significantly higher than those before the training (all P < 0.05), but there were no statistical significant differences between the two groups (all P > 0.05). From the 4th month to the 6th month after training, the compliance rates of hand hygiene in the observation group were significantly higher than those in the observation group [61.97% (88/142) vs. 49.23% (64/130), 62.50% (80/128) vs. 47.73% (63/132), 62.31% (81/130) vs. 46.03% (58/126)], the differences between the two groups being statistically significant (all P < 0.05). Conclusion The routine training combined with hand contamination investigation survey training for consecutive 3 months can nicely promote the improvement of hand hygiene compliance of medical and nursing staffs.
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Objective To investigate the constituents and analgesic and anti‐inflammatory effects of leaves essential oil in Schef fleraoctophylla .Methods SOLEO was dilated by water vapor .The mouse acetic acid‐induced twisting test and mouse auricle swelling test induced by xylene were employed to evaluate the anti‐ inflammation and analgesia effects of SOLEO . Results 55 constituents of SOLEO were identified by GC‐MS .The major constituents ,4‐terpenol ,(‐)‐spthulenol ,caryo‐phllene oxide andβ‐linalool with total percent of 51 .86% were found .The twisting number and relieve swollen auricle of mice induced by xylene were significantly reduced by SOLEO .Conclusion SOLEO was the major active components of anti‐inflam‐mation and analgesia .