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2021 Vol. 46, No. 11
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2021, 46(11): 1495-1499.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.001
Abstract:
ObjectiveTo observe the changes of early cerebral microcirculation after subarachnoid hemorrhage (SAH) and the effect of nitric oxide (NO) expression on early brain injury (EBI) and cerebral microcirculation after SAH. MethodsEighty New Zealand white rabbits were divided into the operation group and sham operation group, then the two groups were further divided into 4 subgroups including 1 h, 6 h, 24 h and 72 h after operation, with 10 rabbits in each subgroup.SAH model was established by injecting autologous blood into cisterna magna in operation group, and injecting 0.9% sodium chloride solution with the same method in sham operation group.The CT perfusion imaging of whole brain was performed to compare the cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT), time to peak (TTP) and NO content in each group, and the correlation between NO and CBV, CBF, MTT, TTP was analyzed. ResultsCBV and CBF in operation group were significantly lower than those in sham operation group at 1 h, 6 h, 24 h and 72 h after operation (P<0.01), and MTT was higher than that in sham operation group(P<0.05 to P<0.01);TTP in operation group was higher than that in sham operation group at 24 h and 72 h after operation(P<0.01 and P<0.05).There was no significant change in the NO content at 1 h, 6 h, 24 h and 72 h after operation in sham operation group(P>0.05), but the NO content increased at 24 h and 72 h after operation in operation group(P<0.01);at 1 h, 6 h, 24 h and 72 h after operation, the NO content in operation group was significantly lower than that in the corresponding sham operation group(P<0.01).Linear correlation analysis showed that NO was negatively correlated with MTT(r=-0.854, P<0.05) and positively correlated with CBF(r=0.786, P<0.05). ConclusionsCT perfusion can detect the focal cerebral ischemia after SAH in early stage, which reflects the pathological progress of EBI after SAH.NO affects the microcirculation changes and the progress of EBI after SAH to some extent.
2021, 46(11): 1500-1506.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.002
Abstract:
ObjectiveTo investigate the cytotoxicity and mechanism of astragaloside-Ⅳ(AS-Ⅳ) on L929 cells, and provide the experimental basis for the application of AS-Ⅳ in treating skin wounds. MethodsThe L929 cells were cultured in vitro, and the cell morphology of each group was observed under inverted microscope.The cell proliferation was detected using CCK8, and the apoptosis was detected using Annexin V-FITC/PI double staining.The expression levels of cleaved Caspase-3 and γ-H2AX protein were detected using Western blotting, and the cell migration ability was detected using cell scratch test. ResultsCompared with the control group, the L929 cells were treated with 30, 60 and 120 μmol/L AS-Ⅳ for 12 h and 24 h, with the increasing of drug concentration and time, the number of round cells, suspended cells and dead cells increased gradually.The OD value of L929 cells treated with 30, 60, 90 and 120 μmol/L AS-Ⅳ for 12 h and 24 h were lower than that of control group(P < 0.05 to P < 0.01).At the same treatment time, with the increasing of drug concentration, the OD value decreased gradually(P < 0.05 to P < 0.01).The OD value of L929 cells treated with the same concentration of AS-Ⅳ for 12 h and 24 h were lower than that of L929 cells treated for 6 h(P < 0.05 to P < 0.01).The apoptosis rate of L929 cells treated with 30, 60 and 120 μmol/L AS-Ⅳ for 24 h were higher than that of control group(P < 0.05 to P < 0.01).Compared with the control group, the expression levels of cleaved Caspase-3 and γ-H2AX protein in L929 cells treated with 60 μmol/L AS-Ⅳ for 6 h, 12 h and 24 h increased(P < 0.05 to P < 0.01).Compared with the control group, the expression levels of cleaved caspase-3 and γ-H2AX protein in L929 cells treated with 30, 60 and 120 μmol/L AS-Ⅳ for 12 h increased(P < 0.05 to P < 0.01).Compared with the control group, the relative mobility of L929 cells treated with 30, 60 and 120 μmol/L AS-Ⅳ for 12 h and 24 h decreased(P < 0.05 to P < 0.01). ConclusionsWhen the concentration of AS-Ⅳ is higher than 30 μmol/L, it can inhibit the proliferation and migration, and induce the apoptosis of L929 cells.
2021, 46(11): 1507-1509.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.003
Abstract:
ObjectiveTo study the effects of water extracts from clove on the antimicrobial activities and the tissue preservation. MethodsThe extraction products of clove were obtained by water extraction, then the bacteriostatic ring size and tissue preservation effect were compared with 10% formalin group and distilled water group.The minimum inhibitory concentration was determined by double dilution method. ResultsWater extracts from clove has no obvious irritating odor which has an inhibitory effect on both E.coli and Staphylococcus aureus.The minimum inhibitory concentrations were 125 mg/mL and 62.5 mg/mL, respectively.No bacteria in the water extracts from clove as preservative solution were detected in 12 weeks. ConclusionsThe water extracts from clove has the certain bacteriostatic effect, which exerts a better preservation influence on the tissue specimen in a certain time.
2021, 46(11): 1510-1512, 1516.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.004
Abstract:
ObjectiveTo study the role of bifidobacteria in FOLFOX6 chemotherapy for gastric cancer. MethodsEighty patients with gastric cancer were randomly divided into the observation group and control group according to random number table method.The control group were treated with FOLFOX6 chemotherapy, and the observation group were additionally treated with bifidobacteria on the basis of the control group.The total number of lymphocytes(TLC), white blood cell count(WBC), neutrophils (N), intestinal flora, gastrointestinal symptom rating scale(GSRS), clinical efficacy and adverse reaction were compared between two groups. ResultsAfter chemotherapy, the levels of TLC, WBC and N in two groups increased in different degrees compared before chemotherapy(P < 0.05), the levels of TLC and N in control group were lower than those in observation group(P < 0.01), and there was no statistical significance in the level of WBC between two groups(P>0.05).After chemotherapy, the level of lactobacillus in control group was lower than that in observation group(P < 0.01), and the levels of enterobacter, enterococcus and GSRS were higher than those in observation group(P < 0.05 to P < 0.01).There was no statistical significance in total remission rate between two groups(P>0.05).The incidence rate of adverse reactions in observation group was lower than that in control group(P < 0.05). ConclusionsBifidobacterium can improve the body's immunity and gastrointestinal flora distribution and symptoms, and thereby which reduces the adverse reaction of FOLFOX6 chemotherapy.
2021, 46(11): 1513-1516.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.005
Abstract:
ObjectiveTo study the influencing factors of hemorrhage after endoscopic submucosal dissection(ESD) for early gastric cancer and precancerous lesions. MethodsEighty-six patients with early gastric cancer and precancerous lesions treated with ESD from January 2017 to September 2019 were investigated.All patients were treated with ESD.The occurrence of hemorrhage in patients with early gastric cancer and precancerous lesions after ESD were observed, and the general data and laboratory examination indexes of patients were counted.The independent influencing factors of hemorrhage in patients with early gastric cancer and precancerous lesions after ESD were analyzed using multivariate logistic regression analysis. ResultsAmong the 86 patients treated with ESD, 16 patients, accounting for 18.60%, experienced hemorrhage.There was no hemorrhage in 70 patients, accounting for 81.40%.The results of multivariate logistic regression analysis showed that the lesion location for cardia-gastric fundus(OR=3.714, 95% CI=1.252-10.909), tumor size ≥ 3 cm(OR=3.802, 95% CI=1.538-9.646), and early cancer(OR=2.746, 95% CI=1.133-6.867) were the independent risk factors of hemorrhage after ESD for early gastric cancer and precancerous lesions(P < 0.05 to P < 0.01). ConclusionsThe hemorrhage of patients with early gastric cancer and precancerous lesions after ESD is related to the location, size and pathological type of the lesion.The larger tumors, lesions locating in the cardia-gastric fundus and early gastric cancer are more prone to hemorrhage during treatment.
2021, 46(11): 1517-1519.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.006
Abstract:
ObjectiveTo investigate the effects of unilateral thyroid tumor resection under endoscopic thyroidectomy through axillary approach without aeration. MethodsThe clinical data of 69 patients treated with unilateral thyroid tumor resection were analyzed.Thirty-nine patients treated with unilateral thyroid tumor resection under endoscopic thyroidectomy through axillary approach without aeration and 30 patients treated with unilateral thyroid tumor resection were divided into the observation group and control group, respectively.The operation time, intraoperative blood loss, 48-hour postoperative drainage volume, postoperative hospital stay, postoperative complications and surgical incision satisfaction were compared between two groups. ResultsThe operation time and postoperative hospital stay in observation group were longer than that in control group(P < 0.01).The postoperative incision satisfaction in observation group was significantly higher than that in control group(P < 0.01).The differences of the intraoperative blood loss and drainage volume after 48h of operation and postoperative complications were not statistically significant between two groups(P>0.05). ConclusionsThe unilateral thyroid tumor resection under endoscopic thyroidectomy through axillary approach without aeration has clear clinical effect and good cosmetic effect.
2021, 46(11): 1520-1522, 1526.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.007
Abstract:
ObjectiveTo explore the application of feedback health management in patients with ischemic stroke in rehabilitation period. MethodsEighty cases of ischemic stroke patients in rehabilitation period were selected and randomly divided into control group and observation group (40 cases in each group).The control group was given general nursing, and the observation group was given feedback health management.The compliance of functional exercise, self-management scale score and quality of life score were compared between the two groups after intervention. ResultsThe compliance of functional exercise in observation group was higher than that in control group (P < 0.05).After the intervention, the scores of each item in self-management scale (rehabilitation exercise management, emotion management, diet management, medication management, disease management, social and interpersonal management, life management) in observation group were significantly higher than those in control group (P < 0.01).After the intervention, the scores of each item in comprehensive quality of life questionnaire (material life, physical function, psychological function, social function) in observation group were significantly higher than those in control group (P < 0.01). ConclusionsThe feedback health management mode can improve the compliance of functional exercise and self-management ability of patients with ischemic stroke in rehabilitation period, so as to promote the recovery of various functions and improve the quality of life, which is worthy of clinical application.
2021, 46(11): 1523-1526.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.008
Abstract:
ObjectiveTo analyze and evaluate the correlation between encephlogram pain index(PI) and bispectral index(BIS) during procedural sedation and analgesia. MethodsA total of 100 patients scheduled by plastic surgery under procedural sedation and analgesia, aged 18-53(grade Ⅰ or Ⅱ the American Society of Anesthesiologists were selected.All patients were anesthetized with intravenous injection of single 0.04 mg/kg of midazolam at the beginning of anesthesia, and continuous intravenous infusion of dexmedetomidine(loading dose for 1 μg/kg, followed by 0.4 to 0.7 μg·kg-1·h-1) and remifentanil(0.1 μg·kg-1·min-1) at the same time.After the BIS value was sustained from 60 and 80, the dilating fluid was injected into the surgical site for local anesthesia.The PI and BIS value in all patients were measured and recorded at the beginning of local anesthesia and surgery(T1 and T2), after 30 min and 60 min of anesthesia induction(T3 and T4), immediately after turning off dexmedeto midine infusion(T5) and at the end of surgery(T6) using BIS VISTA monitor and HXD-I multi-function combined monitor, respectively.The correlation between PI and BIS at each time-point was analyzed. ResultsAt the time points of T1-T6, the PI value was significantly positively correlated with BIS value(r=0.633-0.798, P < 0.05). ConclusionsDuring procedural sedation and analgesia, the PI value is significantly correlated with BIS value.The PI value increases or decreases with the increasing and decreasing of BIS value(lightening or deepening of sedation), which suggests that the PI value can be used as a good monitor to assess the effectiveness of procedural sedation and analgesia.
2021, 46(11): 1527-1530, 1537.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.009
Abstract:
ObjectiveTo evaluate the effects of different pressure control mask ventilation on gastric distension during the induction of general anesthesia. MethodsForty-five patients scheduled by laparoscopic total hysterectomy were divided into the P10 group, P15 group and P20 group according to different ventilation pressure(15 cases in each group).The P10 group, P15 group and P20 group were given 10, 15 and 20 cmH2O pressure during mask ventilation, respectively.The SpO2 and tidal volume were recorded before anesthesia induction(T0), and at 30 s(T1), 60 s(T2), 90 s(T3) and 120 s(T4) of the locking mask ventilation, and the PETCO2 was recorded immediately after laryngeal mask placement(T5).The endoscopic grading of gastric morphology was recorded at the beginning of surgery.At T0 and T5, the anterior-posterior axis diameter and left-right axis diameter of gastric antrum were measured by ultrasound, and the cross-sectional area(CSA) of gastric antrum and the percentage of gastric distension were calculated. ResultsAll patients completed the study except 1 patient with laryngeal mask leakage in P20 group.At T0, there was no statistical significance in the gastric antrum CSA among three groups(P>0.05).At T5, the difference of CSA in P20 group was higher than that in P10 group and P15 group(P < 0.05), and which in P15 group was higher than that in P10 group(P < 0.05).At T0, the differences of the percentage of flatulence and grading of stomach morphology among three groups were statistically significant(P < 0.05).At T5, the PETCO2 in P20 group was lower than that in P10 group and P15 group(P < 0.05), and which in P15 group was lower than that in P10 group(P < 0.05).At T0, the differences of the SpO2 among three groups were not statistically significant(P>0.05).From T1 to T4, the SpO2 in P15 group and P20 group was higher than that in P10 group(P < 0.05).At T2 and T3, the SpO2 in P20 group was higher than that in P15 group(P < 0.05).From T1 to T4, the tidal volume in P20 group was higher than that in P10 group and P15 group(P < 0.05), and which in P15 group was also higher than that in P10 group(P < 0.05). ConclusionsDuring the laparoscopic total hysterectomy, the mask ventilation with 10-15 cmH2O pressure mode can reduce the gastric distention while ensuring adequate lung ventilation.The ultrasonographic measurement of gastric antrum area is feasible to evaluate gastric distension.
2021, 46(11): 1531-1537.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.010
Abstract:
ObjectiveTo explore the effects of different doses of dexmedetomidine on coagulation function in elderly patients with tibiofibular fractures, and analyze the influencing factors of postoperativem recovery. MethodsOne hundred and seventy-one sacral fractures patients treated with open reduction internal fixation were randomly divided into the group A, group B and group C(57 cases in each group).The group A was treated with continuous epidural anesthesia, the group B was treated with continuous epidural anesthesia combined with 0.5 μg·kg·-1·h-1 dexmedetomidine intravenous infusion, and the group C was treated with continuous epidural anesthesia combined with 1.0 μg·kg·-1·h-1 dexmedetomidine intravenous infusion.The changes of coagulation function and stress response index among three groups were compared, and the influencing factors of postoperative recovery were analyzed. ResultsAll patients were anesthetized successfully, and the operations were successfully completed.The differences of the analgesia time, anesthesia satisfaction, hemodynamic change and postoperative lower limb function recovery among three groups were not statistically significant(P>0.05).The differences of the ratios of healing, delayed healing and non-healing were statistically significant(P < 0.01).After 2 months of operation, the ankle function scores in group A, group B and group C showed the progressive phenomenon(P < 0.01).The differences of the APTT, PT, TT, Fib, SOD, MDA, NE and COR among three groups before operation were not statistically significant(P>0.05).After operation, the levels of APTT, PT, TT, MDA, NE and COR in group A and group B increased(P < 0.05), the levels of Fib and SOD in A and B groups decreased, and there was no change in group C(P>0.05).The level of SOD was positively correlated with the levels of APTT, PT and TT(P < 0.05 to P < 0.01), and negatively correlated with Fib(P < 0.01).The levels of MDA, NE and COR were negatively correlated with the levels of APTT, PT, TT(P < 0.05 to P < 0.01), and positively correlated with Fib(P < 0.05 to P < 0.01).The results of univariate and logistic regression analysis showed that fracture type, difference of coagulation index(APTT, PT, TT and Fib) between before and after operation, and difference of stress response index(SOD, MDA, NE, COR) between before and after operation were the risk factors affecting postoperative recovery(P < 0.05 to P < 0.01). ConclusionsThe post-anesthesia stress response affects the coagulation function in elderly patients with tibiofibular fractures, which together affect fracture healing.The inhibitory effects of dexmedetomidine on stress response and postoperative coagulation function are correlated with dose.Compared with low dose of 0.5 μg·kg·-1·h-1, the effects of high dose of 1.0 μg·kg·-1·h-1 is better.
2021, 46(11): 1538-1540, 1545.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.011
Abstract:
ObjectiveTo explore the effect of mouthplate on the positioning error of head and neck tumor by using the positioning data obtained from helical tomotherapy system, to provide reference for preventing and reducing the adverse reactions of radiotherapy for head and neck tumor. MethodsTwenty-five patients with head and neck tumor were selected and divided into observation group (13 cases) and control group (12 cases).The observation group was fixed with thermoplastic film and mouthplate, and the control group was fixed with thermoplastic film.MVCT images were used to analyze the positioning errors of the two groups in X-axis, Y-axis, Z-axis and ROLL direction. ResultsThe positioning error in X-axis and ROLL direction in observation group was significantly less than that in control group (P < 0.01), and the positioning error in Z-axis was higher than that in control group (P < 0.05).There was no significant difference in positioning error in Y-axis between the two groups (P>0.05).In the X-axis and Y-axis, the positioning error was 0-2 mm, and the low error distribution in X-axis and Y-axis in observation group was higher than that in control group (P < 0.01 and P < 0.05).The positioning error in Z-axis mainly distributed in the range of >2.1 mm, and the high error distribution in observation group was significantly higher than that in control group (P < 0.01).The positioning error in ROLL direction mainly distributed in the range of 0-1.0 mm, and the low error distribution in observation group was significantly higher than that in control group (P < 0.01). ConclusionsThe mouthplate can reduce the positioning error to a certain extent.For patients with no obvious difficulty in opening mouth and good tolerance, mouthplate can be used to reduce the radiotherapy-related adverse reactions in head and neck tumor patient.
2021, 46(11): 1541-1545.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.012
Abstract:
ObjectiveTo investigate the effects of the preemptive analgesia timing of flubiprofen axetil and celecoxib on restlessness and postoperative analgesia in orthopedic general anesthesia patients. MethodsThree hundred and five patients treated with orthopaedic surgery under general anesthesia were randomly divided into the FE1, FE2, CE1, CE2 and C groups(61 cases in each group).The FE1 group was treated with 1 mg/kg of flubiprofen axetil before 30 min of operation, and the FE2 group was treated with 1 mg/kg of flubiprofen axetil before 15 min of operation.The CE1 group was given 200 mg celecoxib before 12 h and 1 h of operation, respectively.The CE2 group was given 200 mg celecoxib before 3 d of operation, once every 12 h, and the C group was not given flurbiprofen axetil or celecoxib before operation.The agitation score(RS) before extubation, visual analog pain score(VAS) after 1, 3, 6, 12 and 24 h of operation, and incidence rate of adverse reactions were compared among five groups. ResultsThe differences of the RS scores of extubation among five groups were statistically significant(P < 0.01).The RS score of extubation in C group was significantly higher than that in FE1, FE2, CE1 and CE2 groups(P < 0.01), while there was no statistical significance among FE1, FE2, CE1 and CE2 groups(P>0.05).The VAS scores in C group after 1, 3, 6, 12 and 24 h of surgery were significantly higher than that in other 4 groups(P < 0.01), and the VAS score in C group after 24 h of surgery was significantly higher than that in CE1 and CE2 groups(P < 0.01).At 1 and 3 h after operation, the VAS scores in FE1, FE2 and CE2 groups were significantly lower than that in CE1 group(P < 0.01).After 12 h of surgery, the VAS scores in FE1 group and FE2 group were significantly higher than that in CE2 group(P < 0.01).After 24 h of surgery, the VAS scores in FE1 and FE2 groups were significantly higher than those in CE2 and CE1 groups(P < 0.01).There was no statistical significance in the incidence rate of adverse reactions among five groups(P>0.05). ConclusionsThe continuous administration of celecoxib before 3 days of operation has good effects on short-term and medium- and long-term analgesia, does not increase the adverse reactions, and has good safety, so it is worth popularizing and applying in clinic.
2021, 46(11): 1546-1550.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.013
Abstract:
ObjectiveTo investigate the effects of different carbon dioxide pneumoperitoneum pressure on the arterial blood gas, hemodynamics and stress status of patients treated with laparoscopic gynecological surgery. MethodsNinety patients scheduled by laparoscopic gynecological surgery were divided into the group A, group B and group C according to the random number table method(30 cases in each group).During laparoscopic gynecological surgery, the group A, group B and group C were inflated with 11 mmHg, 13 mmHg and 15 mmHg of carbon dioxide pneumoperitoneum pressure, respectively.The arterial blood gas index, heart rate(HR), mean arterial pressure(MAP), central venous pressure(CVP), peripheral vascular resistance(SVR), cardiac output(CO), and serum levels of orepinephrine(NE), cortisol(COR) and prostaglandin E2(PGE2) in three groups were recorded at 5 min after anesthesia, 5 min after aeration, 15 min after aeration and 5 min after pneumoperitoneum stop. ResultsThe levels of PaCO2, HR, MAP, SVR, COR, NE and PGE2 in group C were significantly higher than those in group A and group B at 5 min and 15 min after inflation(P < 0.05 to P < 0.01), and the levels of CVP and CO were significantly lower than those in group A and group B(P < 0.01).The level of HCO3- in group C at 15 min after inflation was significantly lower than those in group A and group B(P < 0.01). ConclusionsThe medium and low carbon dioxide pneumoperitoneum pressure has little effect on the arterial blood gas, hemodynamics and stress status of patients treated with gynecological laparoscopic surgery, which is suitable for gynecological laparoscopic surgery.
2021, 46(11): 1551-1554.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.014
Abstract:
ObjectiveTo investigate the pulmonary function after positive end-expiratory pressure(PEEP)in patients treated with ureterolithotomy through retroperitoneal laparoscopic ureterolithotomy under protective ventilation. MethodsSeventy patients treated with laparoscopic ureterolithotomy under protective ventilation were divided into the control group and observation group(35 cases in each group).All patients were treated with intermittent positive pressure ventilation from anesthesia-induced intubation to pneumoperitoneum, the tidal volume for 10 mL/kg, ventilation frequency for 15 times/min, respiratory ratio for 1:2 and oxygen concentration for 60% in observation group were implemented, and the tidal volume for 7 mL/kg, ventilation frequency for 25 times/min, respiratory ratio for 1:1.5 and PETCO2 for 35-45 mmHg in control group were implemented.The PEEP was additionally set in observation group on the basis of the control group, and the parameter was 5 cmH2O.The blood gas analysis of arterial blood sample was performed.Before 10 min of pneumoperitoneum, after 10, 30 and 60 min of pneumoperitoneum, at the end of pneumoperitoneum and before 10 min of extubation, the peak pressure(Ppeak) and mean airway pressure(Pmean) were observed, the intraoperative and postoperative dynamic lung compliance(Cdyn), oxygenation index(PaO2/FiO2), dead space rate(VO/VT) and alveolar-arterial oxygen partial pressure difference(A-aDO2) were analyzed. ResultsCompared with the control group, the Pmean from 10 to 60 min of pneumoperitoneum increased, and the differences of the Ppeak and Cdyn at each time-point were not significant in observation group.Compared with before 10 min of pneumoperitoneum, the Pmean increased after 10 to 60 min and at the end of pneumoperitoneum, and the Ppeak increased, and the Cdyn decreased in observation group after 10 to 60 min of pneumoperitoneum(P < 0.01).Compared with the control group, the PaO2/FiO2 increased, the A-aDO2 and RI decreased(P < 0.05 to P < 0.01), and the difference of the VD/VT was not statistically significant in observation group after 30 min of pneumoperitoneum and before 10 min of extubation(P>0.05).Compared with before 10 min of pneumoperitoneum, the PaO2/FiO2 decreased, and the A-aDO2 and RI increased in control group before 10 min of extubation and in observation group after 30 min of pneumoperitoneum(P < 0.05 to P < 0.01). ConclusionsThe application of PEEP in patients treated with laparoscopic ureterolithotomy under protective ventilation is beneficial to the improvement of pulmonary function.
2021, 46(11): 1555-1559.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.015
Abstract:
ObjectiveTo analyze the risk factors of central lymph node metastasis in cN0 papillary thyroid microcarcinoma (PTMC). MethodsThe clinical data of 200 patients with cN0 PTMC were collected, which included gender, age, preoperative TSH, BRAF gene mutation or not, tumor diameter, multiple lesions, unilateral/bilateral, combining chronic lymphocytic thyroiditis or not, envelope invasion or not, extragland invasion or not, and postoperative pathology.The patients were divided into lymph node positive group and lymph node negative group according to the central lymph node metastasis or not, and the risk factors of central lymph node metastasis of cN0 PTMC were analyzed. ResultsUnivariate analysis showed that age, tumor diameter, multiple lesions, envelope invasion, extragland invasion, BRAF gene mutation were associated with central lymph node metastasis in patients with PTMC(P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that age, tumor diameter, multiple lesions, envelope invasion, and BRAF gene mutation were the independent risk factors for central lymph node metastasis(P < 0.05 to P < 0.01). ConclusionsFor PTMC patients, if there are clinical features of younger age, larger tumor diameter, multiple lesions, envelope invasion, and positive BRAF gene mutation, the risk of central lymph node metastasis is higher.Even if the preoperative assessment of central lymph node is negative, the scope of surgery should also include the dissection of central lymph nodes to reduce the risk of residual cancer and recurrence.
2021, 46(11): 1559-1563.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.016
Abstract:
ObjectiveTo explore the effect of different timing of epidural analgesia on labour analgesia after combined spinal-epidural block in parturient. MethodsOne hundred and sixty cases of full-term primipara were selected, and treated with combined spinal-epidural block when the uterine orifice was opened to 2-3 cm.The parturients were divided into 3 min group, 30 min group, 60 min group and 90 min group(40 cases in each group) by random number table method, which received continuous epidural administration at 3 min, 30 min, 60 min and 90 min after combined spinal epidural block, respectively.The labour duration, neonatal Apgar score, umbilical artery blood gas analysis, times of using patient-controlled analgesia(PCA), use rate of oxytocin, rescue dose and total dose of ropivacaine and adverse reactions were compared between the two groups. ResultsThe degree of motor nerve block in four groups was grade 0.There were no significant differences in systolic blood pressure, diastolic blood pressure and heart rate between the four groups before analgesia, 30 min after analgesia, 2 h after analgesia, 4 h after analgesia and when uterine orifice being fully opened(P>0.05).There were no significant differences in labour duration, neonatal Apgar score, use rate of oxytocin, use times of PCA, umbilical artery pH, base excess, partial pressure of xygen and partial pressure of carbon dioxide among the four groups(P>0.05).The times of using PCA in 60 min group and 90 min group was higher than that in 3 min group and 30 min group(P < 0.05).The rescue dose and total dose of ropivacaine in 60 min group and 90 min group were higher than those in 3 min group and 30 min group(P < 0.05).There was no significant difference in the incidence of adverse reactions among the four groups(P>0.05). ConclusionsEpidural analgesia within 30 min after combined spinal-epidural block can reduce the times of using PCA and dosage of ropivacaine.
Study on the influencing factors of nonspecific low back pain and its relationship with dyslipidemia
2021, 46(11): 1564-1567.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.017
Abstract:
ObjectiveTo explore the influencing factors of nonspecific low back pain(NLBP), and its relationship with dyslipidemia. MethodsThe clinical data of 86 NLBP patients were retrospectively analyzed, and set as the observation group, and 72 healthy people in the same period were set as the control group.The relevant clinical data of the subjects were collected, and the related influencing factors of NLBP, and relationship between NLBP and lipid metabolism were analyzed. ResultsThe TC and TG levels in observation group were significantly higher than those in control group(P < 0.01).The results of univariate analysis showed that the differences of the occupation, main source of family income, work intensity, exercise, residence, hypertriglyceridemia and WHOQOL-BREF score between two groups were statistically significant(P < 0.01).The results of logistic regression analysis showed that the occupation, family main source of family income, work intensity, exercise, hyper cholesterolemia and WHOQOL-BREF score were the influencing factors of NLBP(P < 0.05 to P < 0.01). ConclusionsThe occupation, family main source of income, work intensity, exercise, hypercholesterolemia and WHOQOL-BREF score can affect the occurrence of NLBP, and the abnormal lipid metabolism can aggravate patients' lumbar disc degeneration to increase the risk of NLBP.
2021, 46(11): 1568-1572.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.018
Abstract:
ObjectiveTo analyze the effect of laparoscopic ovarian cystectomy on ovarian reserve function and stress response level, so as to provide theoretical basis for patients to choose reasonable operation mode. MethodsA total of 80 cases of ovarian cyst patients were selected and randomly divided into observation group and control group(40 cases in each group).The observation group was treated with laparoscopic surgery, and the control group was treated with open surgery.The changes of B-ultrasound examination indicators, serum hormone levels and stress response indicators before and after operation were compared between the two groups. ResultsThe peak systolic velocity(PSV) and end diastolic velocity(EDV) of the ovarian stromal artery after operation in the two groups were higher than that before operation(P < 0.05), the pulsatility index(PI) and resistance index(RI) were lower than that before operation(P < 0.05).The levels of PSV, EDV and antral follicle count in observation group were significantly higher than those in control group(P < 0.01), and the levels of PI and RI were significantly lower than those in control group(P < 0.01).The serum estradiol level at three months after operation in the two groups was lower than that before operation(P < 0.05), which in observation group was higher than that in control group(P < 0.05);the serum levels of follicle-stimulating hormone and luteinizing hormone in observation group were significantly lower than those in control group(P < 0.01).The serum levels of norepinephrine, hypersensitive C-reactive protein and cortisol at five days after operation in the two groups were higher than those before operation(P < 0.05), which in observation group was significantly lower than that in control group(P < 0.01). ConclusionsLaparoscopic ovarian cystectomy has less effect on ovarian function, can significantly improve the level of sex hormone, accelerate the recovery of ovarian reserve function, and has less effect on stress response, which is helpful for the early recovery of patients.
2021, 46(11): 1572-1575.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.019
Abstract:
ObjectiveTo detect the expression levels of microRNA-186(miR-186) in the peripheral blood of patients with idiopathic azoospermia(IA), and investiagte its diagnostic value for IA. MethodsThe peripheral blood samples from 140 IA patients from 2015 to 2017 in urology department and 140 normal fertile men were divided into the IA group and control group, respectively.The DNA and RNA in two groups were routinely extracted from peripheral blood, and the microdeletion of azoospermia factor(AZF) in two groups were detected using multiplex PCR.The expression levels of miR-186 in two groups were detected using quantitative real-time PCR.The correlation between miR-186 expression and AZF microdeletion in peripheral blood was analyzed.The diagnostic value of miR-186 for IA in peripheral blood was evaluated by ROC analysis. ResultsThe differences of the age, body mass index, testosterone level and smoking status were not statistically significant between two groups(P>0.05).Eight patients with AZF microdeletion in the IA group were found, and the microdeletion rate of which was 5.71%(8/140), while no AZF microdeletion was detected in the control group(P>0.05).The expression level of miR-186 in IA group was significantly higher than that in control group(P < 0.01).The miR-186 expression in peripheral blood was not correlated with AZF microdeletion(P>0.05).The miR-186 had a higher diagnosis value for IA, and the area under the ROC curve was 0.84(95% CI: 0.79 to 0.87).The expression level of miR-186 at 0.52 was the best diagnostic cut-off point, and the sensitivity and specificity were 71.86% and 80.39%, respectively. ConclusionsThe expression level of miR-186 is high in the peripheral blood of IA patients, but its expression is not correlated with AZF microdeletion.High expression of miR-186 in peripheral blood may serve as a new diagnostic biomarker for IA.
2021, 46(11): 1576-1578.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.020
Abstract:
ObjectiveTo investigate the occurrence and risk factors of stroke of community residents in Fuyang city in order to formulate effective guidance programs and prevention and treatment measures. MethodsA cluster random sampling method was used to investigate the population of 6 000 residents ≥ 40 years old in Yingxi and West Lake communities in Fuyang.The high-, medium- and low-risk stroke populations were screened, and the homocysteine level and carotid duplex ultrasound examination in high-risk population were performed. ResultsAmong the 5 924 cases, 1 078 cases were the high-risk population(18.2%), and the detection rate of the male high-risk population(5.9%)was lower than that in female high-risk population(20.2%)(P < 0.01).The hypertension, smoking and exercise insufficiency were the most common risk factors of stroke(P < 0.01), and the rates of dyslipidemia, smoking and obesity/overweight exposure in male high-risk population were higher than those in female high-risk population(P < 0.01).The homocysteine and carotid artery color doppler ultrasound in 1 078 high-risk population were performed, the abnormal rate of cervical blood vessel color doppler ultrasound was 25.8%(278/1 078), and the rates of intimal thickening and vascular stenosis in male were higher than those in female(P < 0.01 and P < 0.05).The increasing rate of homocysteine in male(67.2%)was higher than that in female(38.1%)(P < 0.01). ConclusionsThe main risk factors in community residents can be understood through screening, and the targeted prevention and control and intervention can effectively control the incidence of stroke.
2021, 46(11): 1579-1583, 1587.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.021
Abstract:
ObjectiveTo analyze the clinical effects and rehabilitation strategy of posterior wedge osteotomy in the treatment of severe scoliosis deformity. MethodsEighty patients with severe scoliosis were selected and randomly divided into the observation group and control group(40 cases in each group).The observation group was treated with posterior lumbar wedge osteotomy combined with rehabilitation training, and the control group was treated with transpedicular vertebral osteotomy.The Cobb angle correction, Oswestry dysfunction index(ODI), activity of daily living(ADL)score, Frankle grade of spinal nerve function in two groups before and after operation were observed.The operation time, intraoperative bleeding volume, hospital stay after operation, average number of fixed segments and complications were compared between two groups. ResultsThe differences the Cobb angles in two groups between before and after operation were statistically significant(P < 0.01), the Cobb angle in two groups after operation were significantly lower than that before operation(P < 0.01), and the differences the Cobb angles between two groups before and after operation were not statistically significant(P>0.05).The differences the scores of ODI and ADL in two groups between before and after operation were statistically significant(P < 0.01), the differences the scores of ODI and ADL between two groups after 6 and 12 months of operation were statistically significant(P < 0.05 to P < 0.01).The difference of the Frankle grade between two groups before operation was not statistically significant(P>0.05), and the difference of the Frankle grade between two groups after 12 months of operation was statistically significant(P < 0.01).The intraoperative blood loss and postoperative hospital stay in observation group were significantly lower than those in control group(P < 0.01).There was no statistical significance in the operation time and the average number of fixed segments between two groups(P>0.05). ConclusionsThe posterior wedge osteotomy of lumbar spine has less trauma, and which combined with rehabilitation training after operation can improve the lumbar spine function, spinal nerve dysfunction and quality of life of patients, and is worthy of clinical promotion.
2021, 46(11): 1584-1587.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.022
Abstract:
ObjectiveTo explore the relationship between clinical asthenia scale(CFS) and short-term prognosis in elderly patients with coronary heart disease(CAD). MethodsOne hundred and twenty elderly CAD patients were treated with intervention, and the CFS scores of the patients before treatment were evaluated.According to the short-term prognosis, the patients were divided into the good prognosis group(survivors without events) and poor prognosis group(death or serious adverse event patients).The CFS score between two groups was compared, and the receiver operating characteristic curve(ROC) was drawn to analyze the predictive value of CFS score for the poor short-term prognosis of elderly CAD patients, and the area under the curve(AUC) and optimal boundary value were determined.According to the CFS score, the patients were divided into the weak group and nonweak group, and the relationship between frailty and patients' clinical characteristics were analyzed. ResultsAmong 120 patients, the prognosis of 28(23.33%)patients were poor, and the prognosis of 92(76.67%) patients were good.Among 28 patients with poor prognosis, 4 cases(14.29%) died in hospital(including 3 cases with heart failure and 1 casewith cardiogenic shock), 9(32.14%) cases were urinary tract infection, 5(17.86%) cases were severe bleeding, and 10(35.71%) cases were upper respiratory tract infection.The CFS score in good prognosis group(4.13±0.56) was significantly lower than that in poor prognosis group(6.02±1.61)(P < 0.01).The AUC of CFS was 0.704(standard error=0.055, P < 0.01, 95% CI=0.597-0.811), and the optimal boundary value was 5.475.The differences of the types of disease and number of lesions between the weak group and nonweak group were statistically significant(P < 0.01), and the proportios of unstable angina pectoris, double-branch lesions and three-branch lesions in weak group were higher than those in nonweak group(P < 0.01).The differences of the lesion site, hyperlipidemia rate, diabetes rate, hypertension rate and smoking rate between weak group and nonweak group were not statistically significant(P>0.05). ConclusionsCompared with the patients with good short-term prognosis, the CFS scores of e patients with poor prognosis significantly increase.The CFS score has a certain predictive value for the short-term prognosis of the elderly patients with CHD, and the CFS score may be affected by the type of CHD and number of lesions.
2021, 46(11): 1588-1592.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.023
Abstract:
ObjectiveTo investigate the prevalence and related risk factors of caries in deciduous teeth among preschool children in Bengbu city, and provide the reference in the prevention and treatment of deciduous tooth caries. MethodsA total of 934 preschool children from 6 kindergartens in Bengbu city were selected for a health survey, and the number of deciduous tooth caries cases, caries incidence rate and caries were counted and analyzed. ResultsThe prevalence of primary teeth caries in 934 preschool children was 42.4%(396/934), the mean decayed-missing-filled-teeth(DMFT) index was 1.5.The caries prevalence and mean DMFT in boys and girls were 40.7% & 1.5 and 44.3% & 1.4, respectively.There was no statistical significance in the caries prevalence among the same sex children(P>0.05), and the differences of the caries incidence and DMFT among different age groups were statistically significant(P < 0.05 to P < 0.01).The results of multivariate logistic regression analysis showed that the age, education level of mother, eating snacks before sleeping, toothache over the past year, see dentist over the past year, KAP score of the guardians and intake frequency of sweetened beverages had significant influence on the incidence rate of caries in preschool children(P < 0.05 to P < 0.01). ConclusionsThe incidence rate of deciduous tooth caries in preschool children aged 3-6 years in Bengbu is increasing with age.In order to reduce the incidence rate of deciduous tooth caries, it is necessary to correct children's bad living habits, reduce the intake of sweet drinks, pay attention to oral health and strengthen the oral health education of guardians.
2021, 46(11): 1592-1594, 1599.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.024
Abstract:
ObjectiveTo understand the present situation of basic health literacy of inpatients with coronary heart disease(CHD) in Bengbu city, and analyze its main influencing factors, so as to provide the theoretical basis for health education of patients with CHD. MethodsA total of 403 inpatients diagnosed with CHD in three tertiary A hospitals in Bengbu city from April to October 2019 were investigated using the self-made "general situation questionnaire" and "three-item short literacy survey", and the influencing factors of the health literacy in patients with CHD were analyzed. ResultsAmong the 403 inpatients, the basic health literacy score was(10.73±1.16)points, and 35.73% of patients had the basic health literacy.The results of multivariate logistic regression analysis showed that high age, low education level and low per capita monthly family income were the risk factors of basic health literacy level in CHD patients(P < 0.05 to P < 0.01). ConclusionsThe basic health literacy of inpatients with CHD disease in Bengbu city is at a low level.The age, education level and economic situation are the main influencing factors of the health literacy level.The intervention schemes should be designed to improve the health literacy level of patients with CHD.
2021, 46(11): 1595-1599.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.025
Abstract:
ObjectiveTo investigate the application value of multislice spiral computed tomography(MSCT)tri-phase dynamic enhanced scanning in the preoperative staging of gastric cancer and diagnosis of lymph node metastasis. MethodsSixty gastric cancer patients scheduled by operation from January 2015 to January 2018 were selected, and the data of preoperative MSCT tri-phase dynamic enhanced scanning and postoperative pathology in all patients were recorded.The postoperative pathological diagnosis was set as the gold standard, the accuracy of MSCT tri-phase dynamic enhanced scanning in the diagnosis of preoperative staging and lymph node metastasis of gastric cancer was analyzed.The diagnostic efficiency of MSCT tri-phase dynamic enhanced scanning in preoperative staging and lymphatic metastasis of gastric cancer was analyzed using ROC curve. ResultsThe results of MSCT tri-phase dynamic enhanced scanning in diagnosing the T1-T4 staging, lymph node metastasis and M staging were consistent with the pathological diagnosis of gastric cancer(P < 0.01).The overall accuracy rate of MSCT tri-phase dynamic enhanced scanning in preoperative T staging of gastric cancer was 80.00%(48/60), and the accuracy rates of T1-T4 staging were 75.00%(6/8), 63.64%(7/11), 86.36%(19/22)and 84.21%(16/19), respectively.The discriminating accuracy rates of T1 and T2, T2 and T3, and T3 and T4 were 68.42%(13/19)and 78.79%(26/33)and 85.37%(35/41), respectively.The overall accuracy rate of MSCT tri-phase dynamic enhanced scanning in the diagnosis of lymph atic metastasis was 85.96%(49/57).The overall accuracy of MSCT tri-phase dynamic enhanced scanning in preoperative M staging of gastric cancer was 89.83%(53/59), and the accuracy of M0 and M1 stages was 92.00%(46/50)and 77.78%(7/9), respectively.The ROC curve analysis showed that the area under the curve of MSCT tri-phase dynamic enhanced scanning in the diagnosis of T1-T4 staging, lymphatic metastasis and M staging was 0.865, 0.788, 0.853, 0.870, 0.850 and 0.797, respectively, and which was accurate. ConclusionsMSCT tri-phase dynamic enhanced scanning has important value in preoperative staging, selecting treatment schemes and diagnosing prognosis of gastric cancer, and it is worthy of clinical promotion.
2021, 46(11): 1600-1603.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.026
Abstract:
ObjectiveTo analyze the minimum dose of contrast media in cardiac enhanced CT scan at 70 kV tube voltage. MethodsA total of 96 infants with critical congenital heart disease received cardiac enhanced CT scan were selected and randomly divided into group A, group B and group C (32 cases in each group).Non-ionic iodine contrast media (iodine concentration 320 mg/mL) was used, and the dose of contrast media in group A, B and C was 1.0, 1.5 and 2.0 mL/kg, respectively.Another 100 children less than 2-month old with endocardial macrovascular enhancement were randomly divided into group E and group F (50 cases in each group), with 80 kV and 100 kV tube voltage, respectively, at the same other scanning conditions.The noise, signal-to-noise ratio, subjective score, diagnostic accuracy, CT value of left and right ventricle and enhancement value (ΔHU) of ventricular septal were observed in group A, B and C; the radiation dose in experimental group, group E and F was compared; and the linear relationship between ΔHU of ventricular septum and contrast media dose was analyzed. ResultsThere were no significant differences in subjective score, noise, signal-to-noise ratio and diagnostic accuracy among group A, B and C(P>0.05).The CT value of left ventricle and right ventricle and ΔHU of ventricular septum in group A, B and C increased gradually, the difference of which was statistically significant(P < 0.05).Compared with the experimental group, the radiation dose in group E and F increased gradually with the increase of tube voltage(P < 0.05).The linear regression formula between the ΔHU of ventricular septum and the dose of contrast media was: ΔHU=89.71+2.3×dose of contrast media, at the condition of ΔHU of ventricular septum ≥ 100 HU, the minimum dose of contrast media was 0.75 mL/kg. ConclusionsThe minimum dose of contrast media for cardiac enhanced CT scan at 70 kV in infants was 0.75 mL/kg.
2021, 46(11): 1604-1607.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.027
Abstract:
ObjectiveTo znalyze the relationship between the career benefits and turnover intention of clinical nurses, and provide the reference for reducing the turnover of nurses. MethodsThrough cluster sampling, 721 clinical nurses from five hospitals in Wuhu City were selected.The career benefits and turnover intention of all nurses were investigated using a questionnaire, and the correlation between them was analyzed. ResultsThe 73.37% of clinical nurses had "higher or more higher" turnover intention.In the experience of professional benefit of clinical nurses, the harmonious relationship between nurses and patients was the best, and the positive occupational perception was the worst.The differences of the various dimensions of the levels of clinical nurses' turnover intention and occupational benefits were statistically significant(P < 0.01).The higher the turnover intention of clinical nurses, the lower the perceived experience of professional benefit were(P < 0.05 to P < 0.01).The turnover intention of nurses were negatively correlated with all dimensions of the sense of professional benefit(P < 0.05 to P < 0.01).The positive occupational perception and sense of belonging of the team were the greatest correlation with the dimension of turnover intention, which was an important factor in the turnover intention. ConclusionsThere was a negative correlation between career benefits and turnover intention of clinical nurses.The nursing managers should take active measures to cultivate good sense of professional benefits to stabilize the clinical nursing team.
2021, 46(11): 1608-1611.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.028
Abstract:
ObjectiveTo investigate the rehabilitation effects of quadriceps stretch training on symptoms and different incentives of anterior knee pain(AKP). MethodsForty-two patients with AKP were randomly divided into the control group and observation group(21 cases in each group).Two groups were treated with routine rehabilitation method, and the observation group was additionally treated with quadriceps stretch training.The Kujala score(Anterior Knee Pain Scale, AKPS) and VAS scores of common functional movement-induced pain were evaluated before and after treatment. ResultsThe differences of AKPS scores, and pain VAS scores of daily life, knee-bending sedentary, up stairs, down stairs and squatting, jogging movements between two groups were not statistically significant before treatment(P>0.05).The differences of the AKPS scores and VAS scores in control group between before treatment and after 6 weeks of treatment were not statistically significant(P>0.05).After treatment, the AKPS score in the observation group increased compared with before treatment(P < 0.05), and which was significantly higher than that in control group(P < 0.01).Except for the knee-bending sedentary, the other items' scores in observation group after treatment decreased compared with before treatment(P < 0.05), and which was significantly lower than that in control group(P < 0.01). ConclusionsThe quadriceps stretch training has a good effect on the improvement of clinical pain and function limitation in AKP patients, and also has a positive intervention effect on common incentives, so it can be used as the choice of clinical rehabilitation treatment for AKP patients.
2021, 46(11): 1611-1615.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.029
Abstract:
ObjectiveTo analyze the risk factors that affect the occurrence of delirium in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD), establish a nomogram prediction model and evaluate it. MethodsA retrospective analysis of the clinical data of 382 COPD mechanically ventilated patients from January 2018 to August 2019 was performed.The patients were divided into delirium group and non-delirium group according to the occurrence of delirium.The risk factors of delirium in COPD patients with mechanical ventilation were screened by single factor and multivariate logistic regression models.The risk factors were incorporated into R software to establish a nomogram prediction model, and the area under the ROC curve was used to evaluate the discrimination of the model and test the goodness of fit. ResultsThe incidence of delirium in COPD mechanically ventilated patients was 29.58%(113/382).Multivariate logistic regression showed that APACHEⅡ score(OR=1.075, 95% CI: 1.008-1.146), use of sedatives(OR=2.013, 95% CI: 1.185-3.420), use of physical restraint(OR=2.673, 95% CI: 2.673-5.362), mechanical ventilation time(OR=1.134, 95% CI: 1.064-1.207), ICU stay(OR=1.154, 95% CI: 1.075-1.239) were the independent risk factors that affect the occurrence of delirium in COPD patients with mechanical ventilation(P < 0.05 to P < 0.01).A nomogram prediction model was established and evaluated based on the relevant risk factors affecting the occurrence of delirium.The area under the ROC curve was 0.859(95% CI: 0.813-0.904);the slope of the nomogram calibration curve was close to 1;the model fitted well(χ2=4.73, P>0.05). ConclusionsThe nomogram prediction model based on the risk factors of delirium in COPD patients with mechanical ventilation has good discrimination and consistency, which can provide some guidance for the prevention of delirium in COPD patients with mechanical ventilation.
2021, 46(11): 1616-1618, 1622.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.030
Abstract:
ObjectiveTo analyze the related factors of mechanical ventilation in emergency intensive care unit (EICU) patients with severe respiratory disease at different age, and to provide basis for the formulation of mechanical ventilation treatment plan for EICU patients with severe respiratory disease at different ages. MethodsA total of 148 EICU patients with severe respiratory disease were selected and divided into groups according to their age.The mechanical ventilation time, success rate of one-time weaning and mortality were compared among the groups. ResultsThe intubation time decreased gradually with the increase of patients' age, and the intubation time in 50-59 year-old group and ≥ 90 year-old group was relatively short(P < 0.05).There was no significant difference in intubation time between different gender patients in the same group(P>0.05).The success rate of one-time weaning was the lowest(50.0%) and the mortality was the highest (35.7%) in the < 39 year-old group; the success rate of one-time weaning in 40-49 year-old group and 60-69 year-old group was higher, which was 83.3% and 83.9%, respectively; the mortality of weaning in 40-49 year-old group and 50-59 year-old group was lower, which was 8.3% and 9.5%, respectively; but there was no significant difference in the success rate and mortality of one-time weaning in each group(P>0.05). ConclusionsThe age of 40-59 years old is the best age for the application of mechanical ventilation, and patients under 39 years old have a higher risk of mechanical ventilation weaning.This study provides a reference for the formulation of mechanical ventilation treatment plan and clinical nursing of EICU patients with severe respiratory diseases at different ages.
2021, 46(11): 1619-1622.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.031
Abstract:
ObjectiveTo explore the effects of microvideo combined with situational experience health education on psychological stress response and self-care ability of patients treated with laparoscopic common bile duct exploration. MethodsNinety-six patients treated with laparoscopic choledocholithotomy were divided into the observation group(52 cases)and control group(44 cases)according to the operation time of patients.The control group was given the regular health education, and the observation group was given microvideo combined with situational experience education on the basis of the control group.The psychological stress state and self-care ability between two groups were compared. ResultsBefore intervention, there was no statistical significance in the scores of SAS and SDS between two groups(P>0.05).After intervention, the scores of SAS and SDS in two groups were significantly lower than those before intervention(P < 0.01), and the SAS and SDS scores in observation group were significantly lower than those in control group(P < 0.01).Before intervention, there was no statistical significance in the score of each dimension of self-care ability between two groups(P>0.05).After intervention, the scores of self-care ability in two groups were significantly higher than those before intervention(P < 0.01), and the scores of health knowledge, self-responsibility and self-care skills in observation group were significantly higher than those in control group(P < 0.01). ConclusionsThe microvideo combined with situational experience health education can alleviate the psychological stress response of patients treated with laparoscopic common bile duct exploration to promote the development of self-care ability.
2021, 46(11): 1623-1626.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.032
Abstract:
ObjectiveTo analyze the risk factors of sharp instrument injury in emergency department nurses, and to provide protection suggestions. MethodsRetrospective survey was conducted on the sharp instrument injury of 166 emergency department nurses for the near one month by questionnaire.According to whether sharp instrument injury occurred, the subjects were divided into occurrence group and non-occurrence group.Factors affecting sharp instrument injury in emergency department nurses were determined by univariate and multivariate logistic regression analysis. ResultsThe rate of sharp instrument injury was 16.86% in 166 emergency department nurses for the near one month.There were no statistically significant differences between the two groups in the composition ratio of gender, age, marital status, education, professional title, sharp instrument operation with gloves, and returning the syringe cap after use(P>0.05).The composition ratio of nurses with working experience in emergency room less than 5 years, informal nurses, often performing invasive operation for uncooperative patients, breaking ampoule with no gauze, insufficient light in the working environment, noisy working environment, no reporting system for sharp instrument injury, and thinking sharp instrument injury inevitable in occurrence group was higher than that in non-occurrence group(P < 0.05).Logistic regression analysis showed that working experience in emergency room less than 5 years, informal nurses, often performing invasive operation for uncooperative patients, breaking ampoule with no gauze, insufficient light in the working environment, and noisy working environment were the risk factors of sharp instrument injury for emergency department nurses(OR=3.955, 6.481, 7.478, 2.906, 2.627, 2.321, P < 0.05 to P < 0.01), while reporting system for sharp instrument injury, thinking sharp instrument injury evitable were the protective factors of sharp instrument injury for emergency department nurses(OR=0.557, 0.652, P < 0.05). ConclusionsThe incidence of sharp instrument injury is high in emergency department nurses, and there are many risk factors affecting sharp instrument injury, so more attention should be paid to it.It is important to improve working environment, strengthen protection knowledge and awareness, to avoid sharp instrument injury as far as possible.
2021, 46(11): 1627-1633, 1638.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.033
Abstract:
ObjectiveTo understand the nurses' cognition of "online nurse appointment" under the background of "Internet+ nursing service" and the factors influencing nurses' willingness to do "online nurse appointment". MethodsTwo thousand two hundred and forty-one nurses from 12 hospitals in Southern Anhui province were selected.A self-designed questionnaire was used to investigate the cognition and intention of online nurses. ResultsThe differences of the willingness to work as "online nurse appointment" among different age groups, working years, marital status, children's status, professional titles and whether like to do nurse were statistically significant(P < 0.05 to P < 0.01).The 34.6% of nurses with more than 50 years old, 28.6% of nurses with more than 20 years of working experience, 43.1% of nurses with associate chief nurse and above, 26.0% of nurses with children, 35.3% of other nurses with marital status and 24.5% of nurses liking to do nurse were very willing to be "online nurses".The differences of the effects of hearing the policy of "online nurse appointment", degree of understanding "online nurse appointment", whether approving the implementation of "online nurse appointment" and outlook of "online nurse appointment" on the willingness to do "online nurse appointment" were statistically significant(P < 0.01).The 506(22.6%)nurses indicated that they were very willing to work as "online nurse appointment", 811(36.2%) nurses were generally willing, 801(35.7%)nurses were uncertain, 73(3.3%)nurses were unwilling, and 50(2.2%)nurses were very unwilling.The 1 159(51.7%)nurses did not hear the online nurse policy, the understanding degree on "online nurse appointment" in 621(27.7%)nurses was general, the 858(38.3%)nurses did not understand the "online nurse appointment".The 896(40.0%)nurses were generally in favor of the implementation of "online nurse appointment", 878(39.2%)nurses were uncertain about the implementation of "online nurse appointment", and 1 171(52.3%)nurses viewed the prospect of "online nurse appointment" as general. Conclusions"Online nurse appointment" has not been promoted in China at present.Most nurses in third-tier and fourth-tier cities and regions are cautious about "online nurse appointment", and which needs to be further promoted.Senior caregivers can be guided into the community as a priority.Through the market economy, the reasonable economic income can better reflect the professional value of nurses, and reduce the rate of nurse turnover.The work with more autonomy and flexibility has great attraction for nurses to do "online nurse appointment".The low recruitment rate and high turnover rate of nurses can be better maintained if the nursing profession is given more choice.
2021, 46(11): 1634-1638.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.034
Abstract:
ObjectiveTo explore the nursing effects of the mind mapping combined with quantitative prediction model in patients with ischemic stroke complicated with dysphagia. MethodsA total of 357 patients with ischemic stroke were divided into the modeling set(n=283) and validation set(n=74).The clinical data of the modeling set were retrospectively analyzed, the risk factors of dysphagia after stroke were analyzed, and the relevant nomogram prediction model and mind mapping were established. ResultsThe age ≥ 60 years, hypertension, diabetes, brainstem infarction, NHISS score ≥ 12 and GCS score < 10 were the independent risk factors of dysphagia after ischemic stroke(P < 0.05 to P < 0.01).A nomogram prediction model was established according to the screening out risk factors, the C-index indexes of the modeling set and validation set were 0.816(95% CI: 0.761-0.849) and 0.782(95% CI: 0.736-0.818), respectively.The calibration curves fit well with the standard curve, and the AUC were 0.882 and 0.822, respectively.These indicated that the nomogram model had good predictive ability, and the mind mapping could clearly show the risk indicators and risk stratifications. ConclusionsThere are many risk factors for dysphagia after ischemic stroke.The nomogram model established in this study based on the risk factors has good predictive ability, and which combined with the mind mapping can help nurses remember and understand the clinical significance of the model.
2021, 46(11): 1639-1642.
doi: 10.13898/j.cnki.issn.1000-2200.2021.11.035
Abstract:
ObjectiveTo explore the correlation between psychological resilience and psychogeny after traumatic brain injury. MethodsTwenty-three patients with traumatic brain injury(TBI group) were selected, and compared with healthy volunteers with similar education, religion and ethnicity(control group).The differences of the scores of Connor-Davidson mental resilience scale(CD-RISC) and Hamilton depression rating scale(HAMD) between two groups were comapred.The correlation of psychological resilience with GCS score and total score of HAMD-24 scale in TBI group were analyzed using Pearson linear correlation analysis. ResultsThe scores of self-improvement and optimism dimensions and total score of CD-RISC in TBI group were significantly lower than those in control group(P < 0.05 to P < 0.01), and the HAMD-24 score in TBI group was significantly higher than that in control group(P < 0.01).The total score of CD-RISC, tenacity dimension score, self-improvement dimension score and optimism dimension score were significnatly correlated with the GCS score and total score of HAMD-24 scale(P < 0.01). ConclusionsPsychological resilience can be used as evidence-based nursing proof for patients with TBI, and provide some theoretical support for the clinical care of such patients.
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