Investigation on sleep quality and mental health of nurses in public health emergencies / 中国实用护理杂志

Objective:To understand the sleep quality and mental health status of nurses in public health emergencies, and analyze the correlation between them.Methods:A total of 128 first-line nursing staff participating in public health emergencies on February 22-23, 2020 in Tianjin Beichen Hospital, Tianjin First Central Hospital, Tianjin Fourth Central Hospital were investigated by the general data questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Symptom Checklist 90 (SCL-90).Results:70.3%(90/128) of nursing staff had poor sleep quality, and the total score of PSQI was (9.71±4.01) points, which was statistically significant compared with the domestic norm ( t value was 16.479, P<0.01). The total score of SCL-90 was 1.59±0.52, which was statistically significant compared with the domestic norm ratio ( t value was 4.505, P<0.01). One-way ANOVA showed that the nursing staff's age had a significant impact on sleep quality, and the difference was statistically significant ( F value was 4.092, P<0.05). Pearson correlation analysis showed that the Pittsburgh sleep quality scale index scores and symptom self-assessment scale and somatization, force, sensitive interpersonal relationship, depression, anxiety, hostile, terrorist, paranoia, and psychosis were positively correlated( r values were 0.292-0.444, P< 0.01). Conclusions:The sleep quality and mental health status of nurses in public health emergencies are poor, and the sleep quality is correlated with mental health status.

Antibiotic resistance ofKlebsiella pneumoniae through ß-arrestin recruitment-induced ß-lactamase signaling pathway.

Overuse and misuse of antibiotics leads to rapid evolution of antibiotic-resistant bacteria and antibiotic resistance genes. Klebsiella pneumoniae has become the most common pathogenic bacterium accountable for nosocomial infections due to its high virulence factor and general occurrence of resistance to most antibiotics. The ß-lactamase signaling pathway has been suggested to be involved in antibiotic resistance against ß-lactams in Klebsiella pneumoniae. In the present study, the molecular mechanism of the antibiotic resistance of Klebsiella pneumoniae was investigated and the results indicated involvement of the ß-arrestin recruitment-induced ß-lactamase signaling pathway. Antimicrobial susceptibility of Klebsiella pneumoniae was assessed using automated systems and extended-spectrum ß-lactamase (ESBL) and ß-arrestin expression levels in Klebsiella pneumoniae were analyzed by reverse-transcription quantitative PCR. ß-lactam resistance in Klebsiella pneumoniae was determined using ß-lactam agar screening plates. The results demonstrated that ß-arrestin recruitment was increased in Klebsiella pneumoniae with antibiotic resistance (AR-K.P.) compared with that in the native Klebsiella pneumoniae strain (NB-K.P.). Increased production of ESBL was observed in AR-K.P. after treatment with the ß-lactam penicillin. Of note, inhibition of ß-arrestin recruitment significantly suppressed ESBL expression in AR-K.P. and in addition, genes encoding ß-arrestin and ESBL were upregulated in Klebsiella pneumoniae. Restoration of endogenous ß-arrestin markedly increased antibiotic resistance of Klebsiella pneumoniae to ß-lactam. Knockdown of endogenous ß-arrestin downregulated antibiotic resistance genes and promoted the inhibitory effects of ß-lactam antibiotic treatment on Klebsiella pneumoniae growth. In conclusion, the present study identified that ß-arrestin recruitment was associated with growth and resistance to ß-lactams, which suggested that ß-arrestin regulating ESBL expression may be a potential target for addressing antibiotic resistance to ß-lactams in Klebsiella pneumoniae.

Microvascular decompression for hemifacial spasm induced by vertebral artery dissecting aneurysm: one case report / 浙江大学学报·医学版

A 61-year-old female presented with 4 years history of left-sided hemifacial spasm. Head MRI and angiography indicated left vertebral artery dissecting aneurysm which compressed ipsilateral cranial nerves Ⅶ and Ⅷ. Microvascular decompression was performed. The dissecting aneurysm was pushed apart and the distal part of the parent artery was adhered to the dura on the petrosum. The compressed nerves were totally decompressed. The symptom of facial spasm was completely resolved immediately after surgery and did not recur during 6 months of follow up.

The role of lumbar drainage in symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage / 中华急诊医学杂志

Objective To investigate the risk factors of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and evaluate the effect of lumbar drainage of cerebrospinal fluid on vasospasm.Methods In this retrospective controlled-cohort study, 175 patients with aneurysmal subarachnoid hemorrhage met our study criteria between January 2012 and December 2013.By multi-factor regression analysis, gender, age, Hunt-Hess grade, modified Fisher grade and lumbar drainage were analyzed.The outcomes were assessed by the presence or absence of symptomatic cerebral vasospasm and vasospasm-related infarction, and the mean days of hospital stay and score of Glasgow Outcome Scale at 1-month follow-up.Results Several factors affected the prognosis of subarachnoid hemorrhage.Lumbar drainage was a protective factor of symptomatic cerebral vasospasm (OR =0.243, 95％ CI: 0.119-0.497) and vasospasm-related infarction (OR =0.305, 95％ CI: 0.154-0.604).The patients with lumbar drainage had higher score of Glasgow Outcome Scale (P ＜ 0.05).But the patients with lumbar drainage had longer hospital stay (P ＜ 0.05).Conclusions Lumbar drainage of cerebrospinal fluid after aneurysmal subarachnoid hemorrhage markedly reduced the risk of symptomatic cerebral vasospasm and improved outcome.

Early and non- early surgery for ruptured intracranial aneurysms: analysis of 184 cases / 中华急诊医学杂志

Objective To compare the therapeutic efficacy between emergency and non-emergency operation for ruptured intracranial aneurysms. Method A retrospective analysis of 184 patients with ruptured intracranial aneurysms the Second Affiliated Hospital Zhejiang University College of Medicine, admitted from Dec 2008 to Sep 2009, was carried out to evaluate the efficacy of operation to be done earlier. The patients were divided into 2groups according to the time of surgery. In the early operation group ( n = 102), the patients were operated on within 3 days of rupture of aneurysms, and in the delayed operation group ( n = 82), the patients were operated on after 3 days. The comparison in the rate of rebleeding before surgery, rate of complete occlusion of the ruptured aneurysm and rate of major complications such as cerebral infarction and hydrocephalus between two groups was made. The Glasgow outcome scale (GOS) scores of these patients were also evaluated by 6- 12 months follow-up after operation. Results Preoperative re-bleeding happened in 2 patients of the early operation group and in 7 patients of the delayed operation group. The rates were significantly different ( P ＜ 0.05). The complete occlusion rate in the early operation group was 91.2 % ( 93/102 ), while was 80.5 % ( 66/82 ) in the delayed operation group (P＜0.05). There were no statistically significant differences in post-operative cerebral infarction rate, post-operative hydrocephalus rate or GOS scores on follow-up between two groups. Conchusions Early operation can significantly reduce the re-bleeding before surgery, reducing the risk of death and disability. In early operation, the continuous lumbar drainage by cannulation and other methods can be used to reduce intracranial pressure, significantly increasing the rate of complete occlusion, and promoting rehabilitation.

Effect of Composite Radix Sophora Flavescentis Injection on Immunological Function in Patients with Lung Cancer / 中国药房

OBJECTIVE:To test and verify the function of Composite Radix Sophora Flavescentis injection in immunologic enhancement.METHODS:A total of 121 patients with lung cancer were randomly assigned to 2 groups:the treatment group(n=61)received common chemotherapy for 6wk plan in combination with Composite Radix Sophora Flavescentis injection(20mL,iv gtt)qd for the first 10 to 14 days,while the control group(n=60)received common chemotherapy alone for 6wk.The indexes of immunity in both groups were detected before and after treatment.RESULTS:The index of immunity in the treatment group increased significantly as compared with before treatment(P