In the hospital where centralized treatment was applied for the victims after Yiliang earthquake (on 7th September, 2012), a holistic rehabilitation service mode which centred on supportive psychological intervention promoting was developed by the Yiliang psychological crisis intervention team designated by the National Health and Family Planning Commision of the People’s Republic of China. The pattern takes psychological nurses as liaison, bases on the integrity and continuity of medical service, roots in comprehensive health assessment and key assessment of mental trauma stress, emphasizes on solving realistic problems for patients and their caregivers, provides supportive psychological intervention, and encourages psychological nurses to offer psychological support for earthquake victims with the help of quantitative self-assessment of social psychological support service. In practice, the mode of psychological services, which could be contiuously conducted, is welcomed by hospital managers, work staff, and earthquake victims and their caregivers.
Objective To study the analgesic effect of intercostal nerve crush after thoracotomy. Methods Model of forceps crushing of intercostal nerve in 20 rabbits was made pathological changes and repairing process of the nerve were observed in order to identify the best forceps crushing degree that could be used clinically. Prospective double-blind randomized trial in 210 patients who had undergone thoracotomy was carried out from February 1996 to June 2002,and were divided into three groups. Intercostal nerve forceps crushing group (group A):before closing chest,4 routes of costal nerves(incision,above and below incision, and one for inserting drainage tube)were dissected and squeezed with forceps. Intercostal nerve forceps crushing with anaesthetic drugs infiltration group (group B):based on intercostal nerve forceps crush, the intercostal nerve in the chest tube location was infiltrated with bupivacaine hydrochloride 5ml, and control group. Postoperative incisional pain was recorded by visual analogue scales (VAS) including recording the dosage of dolantin needed, arterial oxygen saturation (SaO2) on 3,7,15,and 30 d after operation. Results Pathological changes of the axons and myelin sheaths progressed by the degree of crushing, but recovered in 4-6 weeks. The blood vessel microhemostat was locked to the third teeth and lasting for 30 seconds, the effective analgesia and quick recovery were provided. The clinical use of nerve crush was made with the same procedure which showed b analgesic effect in both group A and group B. The total effective rate in 3 d after operation was 97.1%,98.6% and 0% in group A, B, and the control group respectively, and group A, B was significantly higher than that in contral group (Plt;0.001, 0.001); dosage of dolantin administration in group A,B and control group was 40.20±4.12mg, 35.42±3.31mg and 135.10± 8.17mg respectively (Plt;0.01). There was no statistically difference in SaO2 for three groups (P=0.475). Conclusion The intercostal nerve crush is an available and lasting analgesic procedure to relieve postoperative pain of thoracotomy. The technique is simple and can improve respiratory function and accelerate sputum to be coughed up. It can also decrease the opportunity of pulmonary infection. Intercostal nerve may regenerate and recover its function although if it is temporary contused.
OBJECTIVE: To investigate the effects of nerve root compression on dorsal root ganglia. METHODS: Following the method of Kawakami, 4/0 ribbon gut were applied around left L4-6 spinal nerve roots in 50 SD rats. Just 3 mm cranial to the dorsal root ganglia, the nerve roots were secured by two ligation node. The nerve roots of right side were as control. The L4-6 spinal cord was taken out 1, 2, 4, 8, 12 weeks after surgery, respectively. The activity of fluoride resistant acid phosphatase (FRAP) was determined by the enzyme histochemistry (Gomori method) and the image analysis technique. RESULTS: In the test side, the FRAP content of spinal dorsal horn reduced 4 weeks after operation. And there were gradually more and more decreases from 4 to 12 weeks. There was significant difference between the test side and control side (P lt; 0.01). CONCLUSION: Chronic nerve root compression causes damage to dorsal root ganglia.
ObjectiveTo investigate the incidence of medical adhesive-related skin injuries (MARSI) and analyze its influencing factors among elderly patients, in order to provide reference for its prevention. MethodWe carried out a cross-sectional descriptive study in the Department of Geriatrics of a class-3 grade A hospitals in Sichuan Province between June 1 and July 31, 2015. Totally, 288 patients aged from 62 to 95 years [with the average of (82±13) years] met the inclusion criteria of the study. We analyzed the MARSI situation of the patients, and at the same time, we surveyed 126 nursing workers on their knowledge about MARSI. ResultsThe number of patients with MARSI was 37, and the incidence was 12.85%. The difference of Braden scores between patients with and without MARSI was statistically significant (P<0.001) . About 70% of the nursing staff knew little about MARSI. ConclusionsWe should pay attention to MARSI, improve nurses' knowledge and explore scientific preventive measures.
ObjectiveTo investigate the effects and mechanisms of differentiation of bone marrow mesenchymal stem cells (BMSCs) into insulin producing cells (IPCs) induced by injured pancreatic tissue extract of rat. MethodsEighty 6-week-old Sprague Dawley rats were selected. Forty rats underwent removal of 60% pancreas and the injured pancreas tissue was obtained after 48 hours to prepare the injured pancreatic tissue extract; and normal pancreatic tissue extract was prepared from the other 40 rats. The BMSCs were isolated from the tibia and femur of 4-week-old Sprague Dawley rats. BMSCs at passage 3 were co-cultured with rat injured pancreatic tissue extract as experimental group, with rat normal pancreatic tissue extract as normal control group, and with cell culture medium as blank control group for 14 days. The expressions of pancreas development related genes and proteins were detected, and cell morphological changes were observed. Then the C peptide positive cell rate was detected by flow cytometry analysis and insulin secretion levels were detected by glucose stimulation experiment at 14 days. ResultsInjured pancreatic tissue extract can induced BMSCs differentiating into IPCs. The pancreatic development related genes of pancreatic duodenal homeobox 1 (PDX-1), islet 1, Nkx6.1, glucose transporter type 2, proprotein convertase 2, neurogenin 3, and somatostatin were expressed sequentially in the differentiation process of experimental group; mature pancreatic proteins of PDX-1, insulin, C peptide, Nkx6.1 also were expressed. But there was no morphological changes and expression of pancreatic development related genes and proteins in normal control and blank control groups. The C peptide positive cell rate of experimental group (13.8%±1.8%) were significantly higher than those of normal control and blank control groups (1.6%±0.4%) (P<0.05). The insulin secretion of experimental group was significantly higher than that of normal control and blank control groups (P<0.05), but it was 1/40 and 1/47 of natural islet cells (P<0.05). ConclusionAfter pancreatic injury, injured pancreas would secrete transcription proteins related to development, differentiation, and repair of pancreas, which can promote the differentiation of BMSCs into IPCs.