Prevalence of Hematuria among Emergency Department Healthcare Workers

Background: In Taiwan, emergency departments are so busy that it is not uncommon for staffs (doctors and nurses) to be deprived of their lunch breaks or breaks to go to the restroom. As a consequence, during their busy shifts some emergency department healthcare workers choose to limit their water intake and no time to micturate which are both risk factors of urinary tract infection or urolithiasis. Hematuria is a common laboratory finding due to urinary tract infection and urolithiasis. Objective: To assess the prevalence of hematuria among the emergency department healthcare workers, we conducted a retrospective study in a district hospital in Taiwan. Documented data included those of healthcare workers who worked in the emergency department, as well as other departments of the same hospital. Methods: We reviewed the three-year records of general body checkup of hospital staffs who served in the emergency room and other departments of the same hospital between January 1, 2009 and December 31, 2011. Statistical software SPSS statistical analysis of survey data recovery is applied;data and test results by the questionnaire analysis patterns are associated with the urinary system abnormalities to ANOVA analysis to explore the hospital group whether there is a significant sex differences, and the other to analyze and verify the correlation analysis to the Scheffe post-hoc comparison method. Results: A higher prevalence of hematuria was observed among emergency department healthcare workers when compared with their colleagues who work in other departments of the same hospital. Female workers have higher risk of urinary system abnormalities than male workers. Nurses in the urinary system abnormalities are higher than other positions category. Shift work system has a negative effect on the urinary system. Conclusion: In conclusion, hematuria is more prevalent among emergency department healthcare workers than healthcare workers working in the inpatient wards. Hematuria might well be due to urinary tract infection which in turns caused by the overwhelmingly busy nature of the emergency department duty that deprived the emergency department healthcare workers from frequent voiding and sufficient intake of fluid.

Dilemma and Path for Rural Mutual Aid Elderly Care Model in Underdeveloped Areas——A Case Study of Dazhou City in Sichuan Province

Rural mutual aid elderly care,as an emerging elderly care model,has become an exploration and attempt to rebuild rural communities in the process of rural social transformation.At present,in the vast underdeveloped rural areas,the rural mutual aid elderly care model is faced with such problems as imperfect policies and regulations,insufficient funds,single service items,lack of professional services,and limited functions of civil organizations.It is necessary to strengthen the formulation and improvement of laws and regulations,and to ensure the stable source of funds,enhance the level of specialization,and give full play to the functions of social organizations in the rural mutual aid elderly care model,so as to promote the sustainable development of the rural mutual aid elderly care model.

Immunomodulatory activity of butanol fraction of Gentiana olivieri Griseb. on Balb/C mice

Objective:To explore the immunomodulatory properties of 80% ethanol extract and butanol fraction of Gentiana olivieri(G. olivieri) Griseb on Balb/C mice.Methods:The study was performed with basic models of immunomodulation such as the humoral antibody response(hemoglutination antibody titres), cell mediated immune response(delayed type hypersensitivity and in vivocarbon clearance or phagocytosis). Ethanol(80%) extract of flowering aerial parts of G.olivieriand its butanol fraction were administered p.o.(orally) to the mice. Levamisole, 2.5 mg/kg was used as standard drug.Results:There was a potentiation of immune response to sheep red blood cells by cellular and humoral mediated mechanisms comparable to levamisole(2.5 mg/kg) by both 80% ethanol extract and the butanol fraction at doses of 50-200 mg/kg in male Balb/C mice. Both significantly(P<0.01) potentiated the humoral immune response in cyclophosphamide(250 mg/kg)immunosupressed mice at 100 and 200 mg/kg of each extract and fraction as compared to control.The potentiation of delayed type hypersensitivity response was statistically significant(P<0.01) at200 mg/kg of ethanol extract and 100, 200 mg/kg of butanol fraction as compared to control. The phagocytosis was significant at 200 mg/kg with butanol fraction ofG. olivieri.Conclusions:The results reveal the immunostimulant effects of plantG. olivieriin mice by acting through cellular and humoral immunity in experimental models of immunity in mice. Butanol fraction is the most effective at a dose level of 200 mg/kg.

Impact of high glucose on metastasis of colon cancer cells

AIM:To investigate the possible mechanism of how glucose promotes invasion and metastasis of colon cancer cells.METHODS:CT-26 rat colorectal cancer cells were cultured in different concentrations of glucose environments(10,20,and 30 mmol/L).Wound healing assay and transwell chamber invasion assay were utilized to test the migration and invasion,respectively.In order to understand the role of signal transducer and activator of transcription 3(STAT3)in the process,STAT3 inhibitors,including Stattic(an STAT3 specific inhibitor)and small interfering RNA targeting STAT3,were used to block STAT3 function to evaluate their impact on CT-26 cell motion.To verify whether STAT3 and matrix metalloproteinase-9(MMP-9)protein expression is associated with glucose-induced cell movement,Western blot was used to compare the differences in the expression of MMP-9 and STAT3 in cells incubated with and without STAT3 inhibitors in high glucose condition.RESULTS:In both wound healing and invasion assays,the migration and invasion of CT-26 cells increased gradually with the increase in glucose concentration.However,the glucose-induced migration and invasion were obviously inhibited by STAT3 inhibitors(P<0.05).Similarly,in Western blot assessment,both MMP-9and STAT3 expression increased under a high glucose environment and the highest expression was achieved when 30 mmol/L glucose was used.However,in cells treated with 30 mmol/L mannitol,either MMP-9 or STAT3expression did not increase(P>0.05).When STAT3inhibitors were added in the 30 m M glucose group,not only STAT3 but also MMP-9 expression decreased significantly(P<0.05).CONCLUSION:Our study provides evidence that glucose can promote both migration and invasion of CT-26 cells,and that the STAT3-induced MMP-9 signal pathway is involved in this process.

Adjacent segment disease following Dynesys stabilization for lumbar disorders:A case series of mid-and long-term follow-ups

BACKGROUND Radiologic adjacent segment degeneration(ASDeg)can occur after spinal surgery.Adjacent segment disease(ASDis)is defined as the development of new clinical symptoms corresponding to radiographic changes adjacent to the level of previous spinal surgery.Greater pre-existing ASDeg is generally considered to result in more severe ASDis;nonetheless,whether the ASDeg status before index surgery influences the postoperative risk of revision surgery due to ASDis warrants investigation.AIM To identify possible risk factors for ASDis and verify the concept that greater preexisting ASDeg leads to more severe ASDis.METHODS Data from 212 patients who underwent posterior decompression with Dynesys stabilization from January 2006 to June 2016 were retrospectively analyzed.Patients who underwent surgery for ASDis were categorized as group A(n=13),whereas those who did not were classified as group B(n=199).Survival analysis and Cox proportional hazards models were used to compare the modified Pfirrmann grade,University of California-Los Angeles grade,body mass index,number of Dynesys-instrumented levels,and age.RESULTS The mean time of reoperation was 7.22(1.65–11.84)years in group A,and the mean follow-up period was 6.09(0.10–12.76)years in group B.No significant difference in reoperation risk was observed:Modified Pfirrmann grade 3 vs 4(P=0.53)or 4 vs 5(P=0.46)for the upper adjacent disc,University of California-Los Angeles grade 2 vs 3 for the upper adjacent segment(P=0.66),age of<60 vs>60 years(P=0.9),body mass index<25 vs>25 kg/m2(P=0.3),and sex(P=0.8).CONCLUSION Greater preexisting upper ASDeg was not associated with a higher rate of reoperation for ASDis after Dynesys surgery.Being overweight tended to increase reoperation risk after Dynesys surgery for ASDis.

Innovative chest wall reconstruction with a locking plate and cement spacer after radical resection of chondrosarcoma in the sternum: A case report

BACKGROUND Chondrosarcoma,a cartilage matrix producing tumor,is the second most commonly observed primary bone tumor after osteosarcoma,accounting for 15%of all chest wall malignancies.We herein report the case of a patient with chondrosarcoma of the sternum and our management of the chest wall defects that presented following radical tumor resection.CASE SUMMARY A 31-year-old patient presented to our hospital with dull pain and a protruding mass overlying the chest for 3 mo.The presence of nocturnal pain and mass size progression was reported,as were overhead arm elevation-related limitations.Computed tomography showed a focal osteoblastic mass in the sternum with bony exostosis and adjacent soft tissue calcification.Positron emission tomography-computed tomography revealed hypermetabolic activity with a mass located over the upper sternum.Magnetic resonance imaging showed a focal illdefined bony mass of the sternum with cortical destruction and periosteal reaction.Preoperative biopsy showed a consistent result with chondrosarcoma with immunohistochemical positivity for S100 and focal positivity for IDH-1.The grade II chondrosarcoma diagnosis was confirmed by postoperative pathology.The patient underwent radical tumor resection and chest wall reconstruction with a locking plate and cement spacer.The patient was discharged 1 wk after surgery without any complications.At the 1-year follow-up,there was no local recurrence on imaging.The functional scores,including Constant Score,Nottingham Clavicle Score,and Oxford Shoulder Score,showed the absence of pain in the performance of daily activities or substantial functional disabilities.CONCLUSION The diagnosis of chondrosarcoma must be considered when chest wall tumors are encountered.The surgical reconstructive materials,with a locking plate and cement spacer,used in our study are cost-effective and readily-available for the sternum defect.

The relationships among critical thinking disposition, caring behavior, and learning styles in student nurses

The purpose of this study was to identify the relationships among disposition toward critical thinking, learning styles, and caring behaviors in student nurses enrolled in three 5-year junior nursing colleges in Southern Taiwan. Methods: This cross-sectional study used a convenience sample that comprised 777 nursing students from two cities. The data were obtained through the Critical Thinking Disposition Inventory, Chinese Version (CTDI-CV), Index of Learning Styles (ILS), and the Caring Behavior Scale (CBS). The sample ranged in age from 16 to 22 years (M = 18.21). Results: Students scored highest on the inquisitiveness subscale and lowest on the truth-seeking subscale. Additionally, some dimensions of disposition toward critical thinking differed significantly by learning style. There was a positive relationship between overall critical thinking dispositions and caring behaviors (r = 0.23, p < 0.01). Finally, dimensions of caring behavior, with the exception of the maturity dimension, were significantly positively related to most dimensions of the disposition toward critical thinking (p < 0.05). Conclusion: The findings indicate that not only is learning style related to critical thinking disposition but also to caring behaviors. However, the cause of these relationships warrants further study.

Distant metastasis in choroidal melanoma with spontaneous corneal perforation and intratumoral calcification: A case report

BACKGROUND Uveal melanoma is the most common primary intraocular malignancy in adults,but its incidence is low in Asian populations.Spontaneous corneal perforation and intratumoral calcification are rare presentations of choroidal melanoma(CM),and reports regarding these presentations have been limited.Even after complete surgical treatment,the prognosis of CM patients is usually poor if distant metastasis is present.We here present a case of CM with unique presentations and early distant metastasis to the liver.CASE SUMMARY A 63-year-old Asian woman presented to our hospital with complaint of pain and brownish discharge from her left eye for 3 d.Imaging studies revealed intratumoral calcification within the left eye with eyeball rupture.Enucleation of the left eye was performed and pathological examination confirmed the diagnosis of CM.Systemic surveillance revealed no metastatic diseases.However,the patient was lost to follow-up 3 mo after surgery.At 1.5 years after the operation,she presented to our emergency department with complaint of dull epigastric pain that radiated to the back for 1 d.Imaging studies revealed a large mass at the upper abdomen abutting the pancreatic neck and body as well as several nodular lesions in the liver.Fine needle biopsy was performed and findings confirmed liver and pancreatic metastases.CONCLUSION This case highlights the importance of continued follow-up of patients with CM.

Effects of Electroacupuncture Combined Psycho-intervention on Cognitive Function and Event-Related Potentials P300 and Mismatch Negativity in Patients with Internet Addiction

Objective： To observe the effects of comprehensive therapy （CT） with electroacupuncture （EA） in combination with psycho-intervention （PI） on the cognitive function and event-related potentials （ERP）, P300 and mismatch negativity （MMN）, in patients with internet addiction （IA） for a preliminary exploration of the possible mechanism of the therapy. Metheds： One hundred and twenty patients with IA were randomly divided into three groups, and a total of 112 subjects reached the final analysis of the trial, the EA group （39 patients）, the PI group （36 patients） and the CT group （37 patients）. EA was applied at acupoints Baihui （GV20）, Sishencong （EX-HN1）, Hegu （LI4）, Neiguan （PC6）, Taichong （LR3） and Sanyinjiao （SP6）, once every other day; PI with the cognition- behavior mode was implemented every 4 days; both EA and PI were used in the CT group. The treatment course for all patients was 40 days. Changes before and after treatment in terms of scoring by the IA self-rating scale, short-term memory capacity, short-term memory span, and the latency and amplitude of P300 and MMN in patients were observed. Results： After treatment, in all groups, the IA score was lowered significantly （P〈0.05） and scores of short-term memory capacity and short-term memory span increased significantly （P〈0.05）, while the decreased IA score in the CT group was more significant than that in the other two groups （P〈0.05）. ERP measurements showed that P300 latency was depressed and its amplitude raised in the EA group; MMN amplitude increased in the CT group （all P〈0.05）. Cenclusien： The EA in combination with PI could improve the cognitive function of IA patients, and its mechanism might be related to the speedup of cerebral discrimination on external stimulus and the enhancement of effective resource mobilization during information processing of the brain.

Apoptotic Effect of Cisplatin and Cordycepin on OC3 Human Oral Cancer Cells

Objective： To evaluate apoptotic effects of cisplatin and cordycepin as single agent or in combination with cytotoxicity in oral cancer cells. Methods： The influences of cisplatin （2.5 μg/mL） and/or cordycapin treatment （10 or 100 μmol/L） to human OC3 oral cancer cell line were investigated by morphological observation for cell death appearance, methylthiazoletetrazolium （MTT） assay for cell viability, flow cytometry assay for cell apoptosis, and Western blotting for apoptotic protein expressions. Results： Data demonstrated that co-administration of cisplatin （2.5 μg/mL） and cordycepin （10 or 100μmol/L） resulted in the enhancement of OC3 cell apoptosis compared to cisplatin or cordycapin alone treatment （24 h）, respectively （P〈0.05）. In flow cytometry assay, percentage of cells arrested at subG1 phase with co-treatment of cordycepin and cisplatin （30%） was significantly higher than cisplatin （5%） or cordycepin （12%） alone group （P〈0.05）, confirming a synergistically apoptotic effect of cordycepin and cisplatin. In cellular mechanism study, co-treatment of cordycepin and cisplatin induced more stress-activated protein kinase/dun terminal kinase （JNK）, the expressions of caspase-7, and the cleavage of poly ADP-ribose polymerase （PARP） as compared to cisplatin or cordycepin alone treatment （P〈0.05）. Conclusion： Cisplatin and cordycepin possess synergistically apoptotic effect through the activation of JNK/caspase-7/PARP pathway in human OC3 oral cancer cell line.