目的 总结胸腔镜下二尖瓣置换术的护理配合要点。 方法 2011年7月－12月利用腔镜技术以肋间开胸方式对5例心脏疾患患者施行二尖瓣置换手术，术前充分准备和术中密切配合，确保了手术的顺利施行和完成。 结果 除1例患者因术中出血改为传统开胸手术外，其余4例均顺利完成手术。患者术中出血量平均约300 mL，术后平均引流量约100 mL，手术平均时间4 h，患者术后在监护室留观1 d后转入病房。 结论 腔镜二尖瓣置换术是一项值得推广的手术方式，护理人员要不断加强知识的学习和更新，以适应新术式发展对护理工作的挑战和要求。
Objective To investigate the expression of Th17 cells in peripheral blood of patients with sarcoidosis at different stage. Methods Flow cytometry was used to detect the Th17 cells in peripheral blood of 38 patients with sarcoidosis, including 18 cases of newly diagnosed active patients with obvious symptoms such as cough, fever, fatigue and weight loss, and 20 stable cases who were followed up regularly.15 cases of healthy volunteers were enrolled as control. Serumangiotensin-converting enzyme ( SACE) of the patients with sarcoidosis was detected by ultraviolet spectrophotometry. The cell classification and CD4 + /CD8 + T in the BALF of the newly diagnosed active patients were calculated. Results The expression of Th17 cells in peripheral blood in the patients with active sarcoidosis were higher than that in the sable patients and the controls [ ( 1. 59 ±0. 44) % vs. ( 0. 56 ±0. 32) % and ( 0. 49 ±0. 23) % , all P lt; 0. 05] . Th17 cells in peripheral blood in the patients with stable sarcoidosis and the controls were not different significantly ( P gt;0. 05) . The levels of SACE in the patients with active sarcoidosis were higher than that in the patients with stable sarcoidosis [ ( 56. 6 ±14. 6) IU/L vs. ( 35. 8 ±18. 3) IU/L, P lt; 0. 05) . There was not significant correlation between the Th17 cells in peripheral blood and SACE in the patients with sarcoidosis ( P gt;0. 05) . In the patients with active sarcoidosis, the Th17 cells in peripheral blood were not significantly correlated with lymphocyte percentages in BALF( P gt; 0. 05) , but significantly correlated with CD4 + /CD8 + in BALF ( r=0. 63, P lt;0. 05) .Conclusion In patients with active sarcoidosis, the increased expression of Th17 cells in peripheral blood may correlate with the activity of sarcoidosis.
ObjectiveTo discuss the clinical characteristics, treatment and prevention of abdominal wall endometriosis (AWE). MethodsA retrospective analysis of 295 cases of AWE from February 2007 to August 2011 in our hospital was performed. ResultsAll of the patients had abdominal operations before and 99% of them had a history of caesarean section. The mean age of the patients was (31.55±4.52) years old. The average size of the mass was (2.66±1.12) cm, significantly larger than the estimation of ultrasonography before operation which was (1.91±0.83) cm (P<0.001). No relapse was discovered five months to three years after the operation. ConclusionIt is easy to diagnose abdominal wall endometriosis through medical history, clinical characteristics, physical signs and ultrasonic assessment. The prevention of AWE is very important. Operation is still the best treatment for AWE.
Non-alcoholic fatty liver disease (NAFLD) is one of the major chronic liver diseases that endanger human health. It is characterized by hepatic steatosis and absence of other causes of hepatic fat accumulation, such as alcohol abuse. The incidence of NAFLD is increasing year by year. However, the pathogenesis is still undefined. Porphyromonas gingivalis is a major periodontal pathogen of various periodontal disease. Apart from affecting periodontal health, Porphyromonas gingivalis is also related to the incidence of many systemic diseases. In recent years, Porphyromonas gingivalis is considered to be a risk factor of NAFLD. In this paper, the relationship between NAFLD and Porphyromonas gingivalis, as well as the possible pathogenesis are discussed.
Objective To systematically review the abroad studies on patients for patient safety, and compare them with the current status of domestic studies, so as to provide suggestions for evidence-based strategic decision about how to conduct the education of patients for patient safety and improve the medical quality. Methods The databases of MEDLINE, EMbase and Chinese Biomedical Literature Database (CBM) were searched to identify the relevant studies and their references. Literatures were screened with data extraction in accordance with the predefined inclusive and exclusive criteria. The quality of literatures was assessed with the standard of Cochrane Handbook 5.0 and Critical Appraisal Skills Programme, and the data were comprehensively analyzed with qualitative research methods.Results Among 28 included studies, 5 were Chinese literatures, 1 was RCT, and the others were cross-sectional studies. The results showed that: a) Generally, the patients at home and abroad were poor in the awareness of patient safety, but they were eager to participate in the patient safety; b) Factors affecting patients’ participation were their characteristics, disease-related, and emotional feelings; c) Three studies reported the methods of involving patients in patient safety from the aspects of infection, malpractice, and medication; d) Some studies showed that patients’ participation could effectively promote the standardized operation of medical staffs, prevent unsafe events, and reduce damages; and e) The research contents of the included Chinese literatures were just related to the patients’ awareness of patient safety, attitude to participation, and influencing factors. Conclusion The limited studies relevant to patients for patient safety are short of high-quality RCTs for proving the effectiveness of patient participation methods, so it indicates that the stress should be laid on evaluating the effectiveness of patients for patient safety in future research.