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2021 Vol. 46, No. 7
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2021, 46(7): 841-845.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.001
Abstract:
ObjectiveTo investigate the influence of interleukin 10(IL-10) and CYP3A5 genetic polymorphism on the dose-adjusted trough blood concentrations(C0/D) of tacrolimus in Chinese renal transplant recipients during the stable period. MethodsA total of 149 renal transplant recipients were enrolled in the analysis.Kompetitive allele specific PCR was used to detect the IL-10-819 C/T, -592 C/A, -1082 G/A and CYP3A5 6986 A/G gene polymorphisms.Tacrolimus trough level(C0) was determined by chemiluminesent immunoassay assay. ResultsAmong 149 renal transplant patients, IL-10-592 C/A and -1082 G/A gene polymorphisms had no significant effect on C0/D of tacrolimus.But there was a significant correlation between -819C/T and tacrolimus C0/D, C0/D of tacrolimus for patients with IL-10-819 TT was higher than that of those with -819 TC/CC(P < 0.05).And C0/D of tacrolimus in the CYP3A5 non-expressing group(6986 GG genotype) was higher than those in the CYP3A5 expressing group(6986 GA/AA genotype)(P < 0.05).Moreover, C0/D of tacrolimus of IL-10-819 TT genotype was higher than that of -819 TC/CC genotype in the CYP3A5 expressing group, which showed the similar results in the CYP3A5 non-expressing group(P < 0.05). ConclusionsIL-10-819 C/T and CYP3A5 6986 A/G gene polymorphisms are associated with the C0/D of tacrolimus in renal transplant patients during the stable period, and IL-10-819 TT has the greater effect on the C0/D of tacrolimus in CYP3A5 6986 GG patients.
2021, 46(7): 846-850.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.002
Abstract:
ObjectiveTo analyze the structural changes of default mode network(DMN) in patients with traumatic brain injury(TBI) in the acute phase, and explore the application value of DMN in the early diagnosis of attention disorder after TBI. MethodsForty-five patients with TBI were set as the TBI group, the structural integrity of DMN was evaluated using diffusion tensor imaging(DTI) during the acute phase, and the attention scale was used to evaluate the patient's attention disorder during convalescence.Thirty healthy volunteers were set as the control group.The MRI-related parameters of TBI patients were analyzed, and compared with the control group.The correlation between the parameters of DTI and cognitive function score was explored. ResultsCompared with the control group, the fractional anisotropy(FA) of brain region decreased(P < 0.01), and the apparent diffusion coefficient(ADC) of genitals of corpus callosum(gCC) increased in the acute phase(P < 0.01).In the convalescence period, the scores of attention scale in TBI patients were significantly longer than those in control group(P < 0.01).The results of the scores of DMN structure changes in the acute phase and scores of convalescence attention scale in the TBI patients showed that the sum of FA value of Cing, gCC and superior occipitofrontal fascicle(SFOF) were negatively correlated with the sumup time of each part of Stroop colour word scale Victoria version(P < 0.05, R2=0.291), and the FA value of SFOF was negatively correlated with the time of part C in VST(P < 0.05, R2=0.396). ConclusionsThe interruption of fiber connection in TBI patients is the key factor of damage of DMN structure.The damage of DMN structure can be used as a useful marker for the early diagnosis of attention disorder.
2021, 46(7): 851-853, 857.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.003
Abstract:
ObjectiveTo evaluate the clinical curative effects of endoscopic varices ligation(EVL) and tissue adhesive combined with sclerosing agent injection in the treatment of esophageal and gastric varices in patients with cirrhosis. MethodsEighty-three patients treated with esophageal and gastric varices were selected, and divided into the EVL group(42 cases treated with endoscopic varices ligation), and combined group(41 cases treated with tissue adhesive combined with sclerosing agent injection).The short-term complications in two groups after treatment were observed, and the reduction of esophageal and gastric varices after 1 and 6 months of treatment was reexamined using gastroscopy. ResultsThe incidence rates of choking sensation and local ulcer in combined group were higher than those in EVL group, and the incidence rate of throat pain in combined group was lower than that in EVL group(P < 0.05).The differences of the incidence rates of fever, recent bleeding and chest pain were not statistically significant between two groups(P>0.05).The results of the gastroscopy reexamination after 1 month showed that the total effective rates of improvement of the varices of esophagus and stomach fundus in the combined group and EVL group were 80.5% and 85.7%, respectively, and the difference of which was not statistically significant(P>0.05).The results of the gastroscopy reexamination after 6 months showed that the total effective rates of improvement of the varices of esophagus and stomach fundus in the combined group and EVL group were 87.9% and 69.1%, respectively, and the difference of which was statistically significant(P < 0.05). ConclusionsThe endoscopic varices ligation and tissue adhesive combined with sclerosing agent injection can effectively alleviate the esophageal and gastric varices.The long-term therapeutic effect of tissue adhesive combined with sclerosing agent injection is superior to endoscopic varices ligation.
2021, 46(7): 854-857.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.004
Abstract:
ObjectiveTo construct the prediction model of macrosomia in pregnant women with gestational diabetes mellitus. MethodsOne hundred and twenty pregnant women with gestational diabetes mellitus were divided into the macrosomia group(n=33) and normal group(n=87) according to the different birth body mass of newborns.The general clinical data of two groups were collected, the logistic regression was used to construct the prediction model of macrosomia in pregnant women with gestational diabetes mellitus, and the receiver operating characteristic(ROC) curve of subjects was drawn. ResultsThe differences of the weight gain during pregnancy, pre-pregnancy body mass index, gestational age, fasting blood glucose, OGTT 0 h blood glucose and insulin resistance index between two groups were statistically significant(P < 0.01).The results of logistic regression analysis showed that the weight gain during pregnancy, fasting blood glucose, insulin resistance index were the independent risk factors of the delivery of macrosomia(P < 0.05).The weight gain during pregnancy, fasting blood glucose and insulin resistance index were taken as covariates X1, X2 and X3, respectively, and the prediction model expression was obtained as follows: Logit(P)=-10.522+0.521X1+0.337X2+0.216X3.The optimal critical value, sensitivity, specificity and area under the ROC curve of model were 0.522, 73.68%, 93.90% and 0.856(0.614-0.977), respectively. ConclusionsThe prediction model based on multiple factors has a high value in the prediction of macrosomia of pregnant women with gestational diabetes mellitus.
2021, 46(7): 858-862.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.005
Abstract:
ObjectiveTo observe the effects of recombinant human thrombopoietin(rhTPO) combined with high dose dexamethasone on the expression levels of CD4+CD25+Foxp3+regulatory T cells(Treg), T-helper 1(Th1) cells and T-helper 2(Th2) cells in primary immune thrombocytopenia(ITP) patients. MethodsEighty-two patients with ITP were divided into the control group(40 cases) and observation group(42 cases) according to the random number table method.The control group was treated with high-dose dexamethasone, and the observation group was treated with rhTPO on the basis of the control group.The therapeutic effects were compared between two groups.The expression levels of Treg cells, Th1 cells and Th2 cells, and the ratio of Th1/Th2 in two groups before and after treatment were detected using flow cytometry. ResultsThe total effective rate in observation group was significantly better than that in control group(P < 0.05).Before treatment, there was no statistical significance in the expression levels of Treg cells, Th1 cells and Th2 cells, and the ratio of Th1/Th2 between two groups(P>0.05).After treatment, the levels of Treg cells and Th2 cells were significantly up-regulated (P < 0.01), and the ratio of Th1 cells and Th1/Th2 decreased significantly compared with before treatment(P < 0.01).After treatment, the expression levels of Treg cells and Th2 cells in observation group were significantly higher than those in control group(P < 0.01), and the Th1 cells and Th1/Th2 ratio in observation group were significantly lower than those in control group(P < 0.01). ConclusionsThe rhTPO combined with high dose dexamethasone in the treatment of ITP can improve the clinical therapeutic effects through increasing the number of Treg cells and correcting the balance of Th1/Th2 cells.
2021, 46(7): 862-865.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.006
Abstract:
ObjectiveTo explore the efficacy and short-term prognosis of Xinmailong injection in the treatment of chronic heart failure. MethodsEighty-six patients with chronic heart failure were randomly divided into the study group(43 cases) and control group(43 cases).The control group was treated with the ACE inhibitor, angiotensin Ⅱ receptor antagonist, diuretic, cardiotonic agent, and β-receptor blocker.On the basis of the medication of the control group, the study group was additionally treated with Xinmailong injection.The 6-miniute walking distance, NT-probNP level, left ventricular ejection fraction(LVEF/%), MLHFQ score and MACE incidence were compared between two groups. ResultsAfter two courses of treatment, the 6-minute walking distance and LVEF/% in study group were significantly higher those in control group(P < 0.01).The NT-proBNP level in study group was significantly lower than that in control group(P < 0.01).The treatment efficiency in study group was higher than that in control group(P < 0.05), and the MLHFQ score in study group was lowher than that in control group(P < 0.05).The incidence of major adverse cardiovascolar events in study group after 2 months of discharge was less than that in control group(P < 0.01). ConclusionsXinmailong injection in the treatment of chronic heart failure has good curative effect and short-term prognosis of patients, which can provide a basis for clinical treatment.
2021, 46(7): 866-869.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.007
Abstract:
ObjectiveTo analyze the correlation between the levels of urinary Alzheimer's disease-related neurofilament protein(AD7C NTP) and serum C-reactive protein(CRP), and vascular mild cognitive impairment in elderly patients with lacunar cerebral infarction. MethodsTwo hundred and sixty-eight elderly patients with lacunar cerebral infarction were selected as the research objects.Among them, 117 patients with vascular mild cognitive impairment and other 151 patients were divided into the observation group and control group, respectively.The demographic characteristics, past medical history, AD7C NTP, CRP and other biochemical indicators were recorded, and the scores of Montreal Cognitive Assessment Scale(MoCA), CAMCOG-C and MMSE, and other clinical data in two groups were analyzed. ResultsThe proportion of male patients, proportion of diabetes history, and the concentrations of triglyceride, AD7C-NTP and CRP in observation group were higher than those in control group(P < 0.05 to P < 0.01).The MOCA score, CaMCOG-C score and MMSE score in observation group were lower than those in control group(P < 0.05).The results of multivariate logistic regression analysis showed that diabetes history, levels of AD7C-NTP and CRP increasing were the risk factors of cognitive impairment in elderly patients with lacunar cerebral infarction(P < 0.05 to P < 0.01).The results of correlation analysis showed that the levels of AD7C-NTP and CRP were significantly negatively correlated with MOCA score(r=-0.717, -0.656, P < 0.01). ConclusionsThe levels of AD7c-NTP and CRP are positively correlated with cognitive impairment in elderly patients with lacunar infarction.Early monitoring of AD7c-NTP and CRP indicators can help predict the vascular mild cognitive dysfunction, so as to achieve early diagnosis and early treatment.
2021, 46(7): 870-872, 877.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.008
Abstract:
ObjectiveTo investigate the clinical application value of endoscopic small axillary incision for breast-conserving and sentinel lymph node biopsy under laparoscopy in early breast cancer. MethodsOne hundred and three patients with early breast cancer were divided into the endoscopic group(n=41) and traditional open group(n=62) according to the surgical methods.The number and detection rate of sentinel lymph nodes, perioperative indexes, breast appearance satisfaction and postoperative complications were compared between two groups. ResultsThe operations of all patients were successfully completed.No transfer case was found in endoscopic group, and the success rate of the endoscopic group was 100%.The differences of the number and detection rate of sentinel lymph nodes, perioperative indexes and postoperative complications between two groups were not statistically significant(P>0.05).The postoperative breast appearance satisfaction of the endoscopic group was 100.0%, which was significantly higher than that of traditional open group(83.87%)(P < 0.05).Two groups were followed for 6 to 11 months, and the median follow-up time was 8.5 months.No transfer case was found in endoscopic group.The upper limb movement were good, and there was no local recurrence or distant metastasis in two groups. ConclusionsThe clinical effects of the endoscopic small axillary incision for breast conserving combined with sentinel lymph node biopsy in treating early breast cancer is similar to that of traditional open surgery.In addition, the surgical incision is concealed, the cosmetic effect of breast is better, the quality of life is higher, and which is worthy of clinical promotion.
2021, 46(7): 873-877.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.009
Abstract:
ObjectiveTo evaluate the effectiveness of drug cupping combined with tradional Chinese medicine heat compress in the treatment of lumbar disc herniation with Qi stagnation and blood stasis type. MethodsOne hundred and two lumbar disc herniationwith Qi stagnation and blood stasis type patients treated with conservative method were divided into the control group(36 cases), group test A(32 cases) and group test B(34 cases) according to the random number table method.The control group was treated with intravenous infusion and conventional physiotherapy(medium frequency physiotherapy, ear acupoint embedding, etc.), the group test A were treated with traditional Chinese medicine cupping and traditional Chinese medicine hot compress on the basis of the control group, and the group test B were treated with traditional Chinese medicine cupping and tradional Chinese medicine hot compress medicine on the basis of the control group.Three groups were treated for 2 weeks.The visual analogue scale(VAS) score, Oswestry disability index(ODI) score, tradional Chinese medicine(TCM) syndrome score and clinical efficacy among three groups were compared. ResultsThe differences of the VAS score and ODI score among three groups before treatment were not statistically significant(P>0.05).After 3 days, 1 week and 2 weeks of treatment, the VAS score and ODI score in group test B were significantly lower than that in control group and group test A(P < 0.05).After 2 weeks of treatment, the TCM syndrome score in group test B were significantly lower than that in control group and group test A(P < 0.01).The total effective rate in group test B(97.10%) was significantly higher than that in control group and group test A(P < 0.05). ConclusionsThe medicine cupping combined with tradional Chinese medicine heat compress in the treatment of lumbar disc herniation with Qi stagnation and blood stasis type is effective, and which can alleviate pain, relieve TCM symptoms, and improve limb movements.
2021, 46(7): 878-883.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.010
Abstract:
ObjectiveTo explore the relationship between the programmed cell death ligand-1(PD-L1) expression in the tissues of non-small cell lung cancer(NSCLC) and clinical and chest imaging features. MethodsThe clinical features and chest imaging features of 187 NSCLC patients who received PD-L1 detection were retrospectively analyzed.According to the expression of PD-L1, the patients were divided into the high expression group(40 cases), low expression group(65 cases) and negative group (82 cases), and the high expression group and low expression group were regarded as the positive group.The relationship between PD-L1 expression and clinical and imaging features were analyzed and compared among three groups. ResultsThere was no statistical significance in gender, age, smoking history and pathological type among three groups(P>0.05), but there was statistical significance in TNM staging(P < 0.01).The chest CT findings showed that the who patients with lobulation, tracheobronchial invasion, burr sign and pleural effusion in high expression group were more than those in low expression group(P < 0.05 to P < 0.01).The differences of the pulmonary fibrosis, lesions close to the pleura, pleural pull sign, pleural thickening, multiple nodules and burr sign in the positive group were statistically significant(P < 0.05 to P < 0.01). ConclusionsThe TNM staging and imaging features of NSCLC patients with different PD-L1 expressions show the differences in pleural traction sign, pleural thickening, burr sign, multiple nodules, fibrosis, and pleural proximal manifestations.
2021, 46(7): 883-886.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.011
Abstract:
ObjectiveTo explore the predictive value of serum estradiol (E2) and anti-müllerian hormone (AMH) for pregnancy failure risk in vitro fertilization-embryo transfer (IVF-ET) patients diagnosed with diminished ovarian reserve (DOR). MethodsA total of 86 DOR patients with IVF-ET pregnancy were enrolled in this study.According to pregnancy outcomes, they were divided into non-pregnancy group (n=40) and pregnancy group (n=46).The baseline data and pregnancy outcomes were comparel between two groups.Univariate and multivariate logisitic regression analysis and ROC curve analysis were used to evaluate the value of serum E2 and AMH in predicting pregnancy failure risk. ResultsIn non-pregnancy group, the incidence of FSH/LH ≥ 1.8, the number of antral follicle less than 5, the number of retrieved oocytes less than 8, serum AMH lower than 0.6 ng/mL and serum E2 lower than 34.06 pg/mL were higher than those in pregnancy group(P < 0.01).And the factors such as FSH/LH ≥ 1.8, serum AMH lower than 0.6 ng/mL and serum E2 lower than 34.06 pg/mL were independent risk factors for pregnancy failure in DOR patients (P < 0.05 to P < 0.01).In the meanwhile, the area under the ROC curve of serum AMH combined with E2 in predicting IVF-ET pregnancy failure was significantly higher than that with AMH and E2 alone (P < 0.01).The cutoff values of serum AMH and E2 in predicting IVF-ET pregnancy failure were 0.609 ng/mL and 31.63 pg/mL, respectively. ConclusionsFor DOR patients, the levels of serum AMH and E2 can be used to predict the risk of IVF-ET pregnancy failure.And the combination of serum AMH and E2 has a better evaluation value in predicting the pregnancy outcome of DOR patients.
2021, 46(7): 887-892.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.012
Abstract:
ObjectiveTo compare the dosimetry, acute adverse reactions and short-term therapeutic effects of helical tomotherapy(HT) and intensity-modulated radiation therapy(IMRT) for locally advanced nasopharyngeal carcinoma, and observe the dosimetric advantage, short-term efficacy and adverse reactions of HT in the treatment of locally advanced nasopharyngeal carcinoma. MethodsThe clinical data of 140 patients with locally advanced nasopharyngeal carcinoma from February 2017 to October 2019 were retrospectively analyzed, which included 70 patients treatment with HT and 70 patients treatment with IMRT.The target area of tumor was delineated according to the magnetic resonance imaging(MRI) of head and neck.The prescription doses of the primary nasopharyngeal carcinoma, metastatic lymph node, high-risk area and low-risk area were 69.96 Gy/33F, 66-70 Gy/33F, 60 Gy/33F and 50-54 Gy/33F, respectively.Two groups were treated with cisplatin based on concurrent chemotherapy at the same time of radiotherapy, with cisplatin dose of 80 mg/m2 for a 3-week cycle.The acute adverse reactions of radiotherapy were evaluated according to RTOG/EORTC criteria.The efficacy of solid tumors was evaluated according to RECTST 1.1 criteria.The differences of radiophysical dosimetry, short-term efficacy of patients from the beginning of radiotherapy to 1 month after the end of radiotherapy, and acute adverse reactions related to radiotherapy and chemotherapy were statistically analyzed between two groups. ResultsIn the prescribed dose, there was no statistical significance in the homogeneity index of target area between the HT group and IMRT group(P>0.05).Among other variables, the conformation number and homogeneity index of target area in HT group were better than that in IMRT group(P < 0.05 to P < 0.01).The short-term efficacy in two groups was similar(P>0.05).The tinnitus and acute parotid gland injury in HT group were less severe than that in IMRT group(P < 0.05). ConclusionsCompared with IMRT, HT has a better dosimetry advantage in radiotherapy of locally advanced nasopharyngeal carcinoma.Although the short-term efficacy is similar in both groups, HT has less adverse reactions on acute parotid injury and hearing loss.
2021, 46(7): 893-896.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.013
Abstract:
ObjectiveTo investigate the effects of early ultrasound-guided abdominal puncture and drainage on intestinal bacterial translocation and inflammatory mediators in patients with severe acute pancreatitis(SAP). MethodsOne hundred SAP patients were selected as the research objects.According to the time from onset to admission, the SAP patients were divided into the observation group(within 48 hours from onset to admission) and control group(more than 48 hours from onset to admission)(50 cases in each group).Two groups were treated with ultrasound-guided abdominal puncture and drainage.The number of intestinal flora(including lactobacilli, bifidobacteria, staphylococci and Escherichia coli) and serum levels of interleukin(IL)-6, tumor necrosis factor-α(TNF-α), IL-4 and IL-10 were compared between two groups. ResultsCompared with the control group, the number of pathogenic Escherichia coli and Staphylococci were significantly reduced, and the number of beneficial bacteria(lactobacilli and bifidobacteriza) significantly increased in the observation group after treatment(P<0.01).Compared with the control group, the serum levels of IL-6 and TNF-α significantly decreased, and the serum levels of IL-4 and IL-10 significantly increased in the observation group after treatment(P<0.01). ConclusionsThe early ultrasound-guided abdominal puncture and drainage can reduce the intestinal bacterial translocation and inflammatory response in SAP patients.
2021, 46(7): 897-899, 903.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.014
Abstract:
ObjectiveTo investigate the correlation between vertebral artery dominance(VAD) and incidence rate of posterior circulation infarction(PCI), and risk factors of VAD patients complicated with PCI. MethodsTwo hundred and eighty-six patients with acute cerebral infarction were divided into the anterior circulation infarction(ACI) group(178 cases) and posterior circulation infarction(PCI) group(98 cases).The incidence rate and occurrence side of VAD, and risk factors of ischemic cerebrovascular disease were compared between two groups.The infarction sites of PCI group were classified, and the incidence rate of PCI of different areas was compared between VAD and non-VAD patients.The correlation between bilateral vertebral artery diameter difference and NHISS score in posterior circulation infarction patients with VAD were analyzed. ResultsThe differences of the age, gender and risk factors of common ischemic cerebrovascular disease were not statistically significant(P>0.05), the difference of the incidence rate of VAD between two groups was statistically significant(P<0.01), and the difference of the occurrence side of VAD was not statistically significant(P>0.05).In PCI group, the incidence rates of the infarction of posterior inferior cerebellar artery supply area and basilar artery supply region in VAD patients were higher than those in non-VAD patients(P<0.01 and P<0.05).Among the PCIS patients complicated with VAD, the diameter difference of bilateral vertebral artery was positively correlated with NHISS score(r=0.466, P<0.01). ConclusionsWhen coexisting with other common cerebrovascular disease risk factors, VAD can be considered as a risk factor for PCI.Patients with VAD are more prone to infarction in the blood supply area of posterior inferior cerebellar artery and basilar artery.The greater the difference of bilateral vertebral artery diameter is, the worse the prognosis is.
2021, 46(7): 900-903.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.015
Abstract:
ObjectiveTo explore the choice of delivery mode and safety of vaginal delivery in the second pregnancy after cesarean section. MethodsEighty women with second pregnancy after cesarean section were studied.Thirty-eight pregnant women with vaginal delivery and 42 pregnant women with cesarean section were divided into the observation group and control group A, respectively.Fifty primiparas in the same period were set as the control group B.The delivery outcome and general clinical situation among three groups were compared. ResultsThe success rate of trial delivery in observation group was lower than that in control group B, and the vaginal delivery rate in observation group was higher than that in control group B(P < 0.05).The amount of bleeding during delivery and postpartum, length of hospital stay and incidence rate of postoperative complications in observation group were lower than those in control group A(P < 0.05 to P < 0.01).The differences of the postpartum blood loss, length of labor, length of hospital stay and Apgar score between the observation group and control group B were not statistically significant(P>0.05).The differences of the lower uterine thickness and pelvic adhesion among three groups were statistically significant(P < 0.01).After 7-10 years of cesarean section, the lower uterine segment of pregnant women became significantly thin, and the difference of the lower uterine segment between the pregnant woman with cesarean section for 7-10 years and pregnant woman with cesarean section for 2-6 years, control group B were statistically significant(P < 0.01).The lower uterine segment in the control group B became significantly thinner compared with pregnant woman with cesarean section for 2-6 years(P < 0.01).The pelvic adhesion ratios in the pregnant woman with cesarean section for 7-10 and 2-6 years increased compared with the control group B(P < 0.05 to P < 0.01). ConclusionsCompared with the cesarean section, vaginal delivery for the second pregnancy in pregnant women with cesarean section have obvious advantages in the amount of intraoperative blood loss and postoperative recovery.Therefore, the prenatal monitoring should be strengthened, and the indications and clinical indications of vaginal delivery should be strictly controlled in order to improve the success rate and safety of vaginal delivery.
2021, 46(7): 904-906, 912.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.016
Abstract:
ObjectiveTo detect the expression changes of peripheral blood lymphocyte subsets, immunoglobulin quantity, lactate dehydrogenase(LDH) and lactate(LAC) in children with infectious mononucleosis(IM) infected by EB virus, and analyze their clinical significance. MethodsNinety children with IM caused by EB virus were investigated.Forty-four children with IM, who could not be controlled by routine antiviral support therapy or had severe complications, were set as the observation group, and 46 patients with IM, who were successfully relieved by routine antiviral support therapy, were set as the control group.The lymphocyte subsets(CD3+, CD4+, CD8+, CD3- CD19+ and NK cells), immunoglobulin(IgG, IgA and IgM), LDH and LAC in peripheral blood in two groups were detected after 1-2 days of admission. ResultsCompared with the control group, the expression of CD3+, CD8+ and LDH in the peripheral blood increased, while the expression of CD4+ and NK cells decreased in the observation group(P<0.05 to P<0.01).The differences of the expression of the CD3-CD19+, LAC, IgG, IgA and IgM between two groups were not statistically significant(P>0.05). ConclusionsPaying attention to the lymphocyte subsets in the peripheral blood of children with IM, especially the expression of CD3+, CD4+, CD8+, CD3-CD19+, NK cells and LDH, can help to identify the severity of disease in children with IM at an early stage, guide active and reasonable treatment, and avoid missing the best treatment opportunity.
2021, 46(7): 907-912.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.017
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ObjectiveTo explore the correlation of the body mass gain and blood lipid level during pregnancy with target organ damage of pregnancy hypertension and pregnancy outcome. MethodsA total of 85 pregnant women with hypertension during pregnancy were set as the study group, and 60 normal pregnant women during the same period were randomly selected as the control group.The general data of two groups were statistically compared, and the risk factors of hypertension during pregnancy were investigated.The body mass gain and blood lipid level during pregnancy of patients with different target organ damage in study group were compared, and the correlation between the body mass gain, blood lipid level during pregnancy and target organ damage were analyzed.The study group was followed up to the end of pregnancy, and the pregnancy outcome of the study group was counted.The baody mass gain and blood lipid level during pregnancy were compared between patients with good and poor pregnancy outcomes and the efficacy of body mass gain and blood lipid level during pregnancy in assessing target organ damage and predicting poor pregnancy outcome were explored. ResultsBefore pregnancy, the body mass index(BMI), body mass gain during pregnancy, family history of hypertension, and levels of triglyceride(TG), total cholesterol(TC) and low-density lipoprotein cholesterol(LDL-C) in study group were higher than those in control group(P<0.01), and the high-density lipoprotein cholesterol(HDL-C) level in study group was lower than that in control group(P<0.05).The BMI before pregnancy, body mass gain during pregnancy, family history of hypertension, and levels of TG, TC, HDL-C and LDL-C were the influencing factors of hypertension during pregnancy(P<0.05 to P<0.01).The body mass gain during pregnancy, and levels of TG, TC and LDL-C were positively correlated with the target organ damage(P<0.01), and the HDL-C level was negatively correlated with target organ damage(P<0.05).The area under the curve (AUC) of body mass gain during pregnancy, and levels of TG, TC, HDL-C and LDL-C in the combined assessment of target organ damage was 0.879, which was greater than a single assessment of each index, and the best evaluation sensitivity and specificity were 73.82% and 92.40%, respectively.The body mass gain during pregnancy, and levels of TG, TC and LDL-C in patients with poor pregnancy outcome were higher than those in patients with good pregnancy outcome(P<0.05), and the HDL-C level in patients with poor pregnancy outcome was lower than that in patients with good pregnancy outcome(P<0.05).The AUC of body mass gain during pregnancy, and levels of TG, TC, HDL-C and LDL-C in the combined assessment of poor pregnancy outcome was 0.932, which was greater than a single assessment of each index, and the best evaluation sensitivity and specificity were 88.89% and 88.06%, respectively. ConclusionsThe body mass gain and blood lipid level during pregnancy are closely related to the onset of pregnancy-induced hypertension and target organ damage, and can assist the clinical assessment of target organ damage and predict the risk of adverse pregnancy outcome.
2021, 46(7): 913-916, 920.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.018
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ObjectiveTo analyze the clinical features of epilepsy complicated with Alzheimer's disease(AD). MethodsAmong 230 epilepsy patients, 17 patients with epilepsy complicated with AD were divided into the observation group, and 213 patients without AD were set as the control group.The clinical manifestations, electroencephalogram, imaging, laboratory examination, treatment and prognosis in two groups were analyzed. ResultsIn the observation group, 6 cases occurred in early AD, 3 cases occurred in middle AD, and 8 cases occurred in late AD.For the epileptic seizure type, 8 cases were systemic tonic-clonic seizure, 12 cases were complex partial seizure, and 1 case was simple partial seizure.Three patients developed epileptic status.The abnormal rate of electroencephalogram in observation group was 82.35%(14/17), which was higher than that in the control group(43.19%, 92/213) (P<0.01).The incidence rate of brain atrophy in observation group(70.59%) was significantly higher than that in control group(4.69%) (P<0.01).The age of onset in observation group was significantly higher than that in control group(P<0.01).In the observation group, the Aβ42 decreased, total tau protein increased, and phosphorylated tau protein increased in 12 cases.In the observation group, the effects of antiepileptic drugs was not good, and the epileptic seizures increased with the aggravation of AD. ConclusionsEpilepsy can occur at any stage of AD.Epilepsy and AD are correlated in pathology and pathogenesis.Temporal lobe hippocampal sclerosis is the pathological basis of epileptic seizures in AD patients.
2021, 46(7): 917-920.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.019
Abstract:
ObjectiveTo analyze the correlation between the levels of glycosylated hemoglobin(HbA1c), 2-hour postprandial blood glucose(2hPG) and degree of coronary artery disease in patients with coronary atherosclerotic heart disease(CHD). MethodsA total of 80 patients with CHD were set as the observation group, and divided into the mild disease group(26 cases), moderate disease group(38 cases) and severe disease group(16 cases) according to the Gensini score.During the same period, 80 patients with normal coronary angiography(CAG) were set as the control group.The metabolic indexes between the observation group and control group were compared, and the levels of HbA1c and 2hPG among the CHD patients with different degrees of coronary lesions were compared.The correlation between HbA1c and 2hPG in patients with CHD was analyzed.The correlation between the levels of HbA1c and 2hPG, and between the levels of HbA1c, 2hPG and severity of CHD disease were analyzed. ResultsThe serum levels of HbA1c and 2hPG in observation group were significantly higher than those in control group(P<0.01).The levels of HbA1c and 2hPG gradually increased with the aggravation of severity of coronary artery lesions in CHD patients(P<0.01).There was a significant positive correlation between HbA1c level and 2hPG level in CHD patients(r=0.332, P<0.01).There was a significant positive correlation between the degree of coronary lesions and levels of HbA1c, 2hPG in CHD patients(rs=0.546, P<0.01;rs=0.437, P<0.01). ConclusionsThe levels of HbA1c and 2hPG in patients with CHD significantly increase, which is significantly positively correlated with degree of coronary lesions.
2021, 46(7): 921-924, 929.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.020
Abstract:
ObjectiveTo explore the current situation and influencing factors of turnover intention of basic public health service personnels in three provinces(cities), and provide the reference for the government to stabilize the basic public health personnel team and ensure the smooth implementation of basic public health service projects. MethodsA questionnaire survey was conducted among 439 basic public health service personnels selected by multi-stage sampling method from Zhejiang, Anhui and Chongqing, and the data were analyzed using the factor analysis, χ2 test and binary logistic regression methods. ResultsAmong the 439 people, 147 people(33.5%) had turnover intention, and the differences in the age, education level, basic public health work pressure, basic public health work years, relationship with residents and regional basic public health service personnel's turnover intention were statistically significant(P<0.05 to P<0.01).The results of regression analysis showed that the job satisfaction, job burnout, areas, physical exercise, relationship with residents and years of basic public health work were the influencing factors of turnover intention of basic public health service personnels(P<0.05 to P<0.01). ConclusionsThe turnover intention in basic public health pesonels is high.The government should take active measures against the relevant influencing factors to improve the job satisfaction, relieve job burnout, and reduce their turnover intention.
2021, 46(7): 925-929.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.021
Abstract:
ObjectiveTo monitor and analyze the physical development and nutritional status of premature infants aged 0-36 months under the management of the child health care system, to provide the basis for optimizing the systematic health care management of premature infants. MethodsA total of 163 premature infants who were born from January 2014 to June 2017 and received the management service of child health care system within 3 years old were set as the observation group, and subdivided into the small for gestational age (SGA) group (n=15) and appropriate for gestational age (AGA) group (n=148).Another 170 full-term infants of the same age were selected as the control group.The growth and development, and incidence of nutritional diseases of preterm infants and full-term infants were compared. ResultsThe body weight in observation group was lower than that in control group at 1 month, 6 months and 36 months of birth (P<0.05 to P<0.01), and the body height was significantly lower than that in control group at 1 month, 6 months, 12 months, 18 months, 24 months, 30 months and 36 months of birth (P<0.01).The weight-for-age Z-score (WAZ) in observation group was lower than that in control group at 1 month, 6 months and 36 months of birth (P<0.05 to P<0.01), and the height-for-age Z-score (HAZ) was significantly lower than that in control group at 1 month, 6 months, 12 months, 18 months, 24 months, 30 months and 36 months of birth (P<0.01).The WAZ in SGA group was lower than that in AGA group at 1 month to 18 months of birth (P<0.05 to P<0.01), and the HAZ was lower than that in AGA group at 1 month to 30 months of birth (P<0.05 to P<0.01).There was no significant difference in malnutrition rate and overweight rate between the observation group and the control group (P>0.05).The malnutrition rate of preterm infants in SGA group and AGA group decreased gradually with the increase of month age, but the difference was not statistically significant (P>0.05). ConclusionsThe trend of catch-up growth and development of preterm infants is good from 0 to 36 months of age, but it still lags behind that of full-term infants at 36 months of age, and 1 to 12 months of age is a growth peak.The catch-up growth rate of premature infants in SGA group was lower than that in AGA group, and 24 to 36 months of age is the second growth peak, and more attention should be paid to the guidance of child health care in this period.
2021, 46(7): 930-932, 936.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.022
Abstract:
ObjectiveTo observe the ultrasonic characteristics of smart three-dimensional superb microvascular imaging (Smart 3D SMI) in thyroid nodule, and explore the application value of Smart 3D SMI in the evaluation of thyroid nodule blood flow. MethodsFrom March 2018 to December 2019, 107 patients(107 nodules) were detected using the color Doppler Flow Imaging(CDFI), 2D SMI and Smart 3D SMI to observe the blood vessels line and blood flow spatial distribution of the nodules.The vascular perfusion characteristics of nodules were evaluated using Alder semi-quantitative classification, perforator vessels and vascular distribution morphology. ResultsThe blood flow evaluation of Smart 3D SMI for thyroid nodule was better than that of CDFI, and the difference of blood flow classification between benign and malignant nodule was statistically significant(P<0.01).The results of three methods in the evaluation of malignant nodules penetrating into blood vessels showed that the detection rates of CDFI, 2D SMI and Smart 3D SMI were 14.3%, 25.4%, 38.1%, respectively, and the detection rates of Smart 3D SMI was the highest.According to the vascular distribution assessment, there were 5 benign nodules.The results of 2D SMI showed that 5 benign nodules were blood flow type, and the results of Smart 3D SMI showed that 3 benign nodules were peripheral type, and 2 benign nodules were mixed type.Among 2 malignant nodules, the results of 2D SMI showed that 2 malignant nodules were no blood flow type, and the results of Smart 3D SMI showed that 1 malignant nodule was penetrating type, and 1 malignant nodule was central type. ConclusionsSmart 3D SMI has high clinical application value in the evaluation of the microvascular perfusion characteristics of thyroid nodule, which is worthy of further promotion and practice in clinic.
2021, 46(7): 933-936.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.023
Abstract:
ObjectiveTo investigate the clinical effects of endovascular stent in the treatment of iliofemoral post-thrombosis syndrome(PTS). MethodsThe clinical data of 27 patients with iliofemoral PTS were analyzed retrospectively.After venous recanaliztion and self-expandable stenting, the patients were followed up for 6 months.The severity of PTS and quality of life before and after treatment were evaluated using Villalta score and chronic venous insufficiency questionnaire(CIVIQ-20) scale. ResultsAll patients were successfully recanalized after operation.After 6 months fo following-up, the primary patency rate, assisted patency rate and secondary patency rate were 66.7%(18/27), 77.8%(21/27) and 88.9%(24/27), respectively.The Villalta score decreased from(17.44±5.49) before operation to(5.78±3.31) after operation(P<0.01), while the CIVIQ-20 scores increased from(37.26±10.89) to(58.93±12.91)(P<0.01).The severity of postoperative half-year follow-up was significantly lower than that before surgery(P<0.01).The results of logistic regression analysis showed that the preoperative Villalta and CIVIQ-20 scores, and age were the independent factors related to the Villalta gain, and the preoperative Villalta was the independent factors related to the CIVIQ-20 gain. ConclusionsThe endovascular stent in the treatment of iliofemoral PTS is effective, which can reduce the severity of PTS and improve the quality of life.
2021, 46(7): 937-939.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.024
Abstract:
ObjectiveTo explor the value of the multi-evaluation system based on real clinical practice in the training of rational application of antibacterials. MethodsSixty graduate students who participated in the standardized training for resident physicians were randomly divided into the observation group and control group(30 cases each group), and the training and teaching of rational application of antibiotics of 2 months in two gorups were completed.For the observation group, the diversified evaluation system based on real diagnosis and treatment practice were applied in teaching rounds and practice, and the repeated real-time assessment was conducted around each case.The control group were taught according to the previous classroom teaching style of ward rounds, the classroom teaching of theory and practice for each disease was performed by the teaching doctor, and, the students' mastery of relevant knowledge was not checked after the ward rounds.After the training, the rational application of antibiotics was tested and evaluated, and the test scores between two groups were compared. ResultsThe test scores of the level of medical history collection, physical examination ability, doctor-patient communication ability and standard degree of operation skills in observation group were significantly higher than those of in control group(P<0.01).The scores of theoretical knowledge and diagnostic ability of infectious diseases in observation group were significantly higher than those in control group(P<0.01), and the scores of rational use of antibiotics in observation group were also significantly higher than those in control group(P<0.01). ConclusionsThe multi-evaluation system based on real clinical practice is effective in the training of rational application of antibacterials, it is worthy of further promotion.
2021, 46(7): 940-942, 947.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.025
Abstract:
ObjectiveTo observe the application effect of compound lidocaine cream in indwelling urethral catheter after buried penis surgery in children. MethodsSixty children with buried penis surgery were divided into the observation group and control group by random number table method, 30 cases in each group.The observation group used compound lidocaine cream to lubricate the catheter, and the control group used liquid paraffin oil to lubricate the catheter.The mean arterial pressure (MAP) and heart rate (HR) were recorded at the time point of before anesthesia induction (T0), after catheterization (T1), after laryngeal mask removal (T2), after being transferred into recovery room (T3) and after directional force recovery (T4) in the two groups.The operation time, anesthesia time and stay time in recovery room were recorded.Ramsay sedation score and catheterization-induced agitation score at T4, one-time success rate of catheterization and urine routine on the first day after operation were compared between the two groups. ResultsThe one-time success rate of catheterization in the observation group and control group was 90.00% and 93.33%, respectively, and the difference of which was not statistically significant (P>0.05).The stay time in observation group was shorter than that in control group (P < 0.05).MAP and HR in the two groups changed with time, and the difference of which was statistically significant (P < 0.01).At T4, MAP and HR in observation group were significantly lower than those in control group (P < 0.01).Ramsay sedation score in observation group was significantly higher than that in control group(P < 0.01), and catheterization-induced agitation score was significantly lower than that in control group (P < 0.01).There was no significant difference in the incidence of agitation between the two groups (P>0.05).There was no significant difference in white blood cell, red blood cell and bacterial count between the two groups (P>0.05). ConclusionsCompound lidocaine cream as a lubricant for indwelling urethral catheter after buried penis surgery in children can reduce agitation caused by catheter stimulation and stress reaction.
2021, 46(7): 943-947.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.026
Abstract:
ObjectiveTo explore the application effects of the trans-theoretical model of change(TTM) intervention of stage 3-4 pressure ulcer for pressure ulcer awareness changes of primary caregivers in the care behavior of pressure ulcer patients. MethodsFifty-six primary caregivers of patients with stage 3-4 pressure ulcer from July 2018 to January 2020 were selected as the research objects.Twenty-eight primary caregivers of patients with stage 3-4 pressure ulcer from July 2018 to March 2019 were set as the control group, and 28 primary caregivers of patients with stage 3-4 pressure ulcer from April 2019 to January 2020 were set as the intervention group.The cognition, care behavior, recurrence rate and healing time of pressure ulcer before TTM intervention and after 6 months of TTM intervention were compared between two groups. ResultsBefore intervention, the total cognitive score, knowledge related to pressure ulcer, perceived severity and susceptibility score of pressure ulcer in intervention group were significantly higher than those in control group(P < 0.01).Except for the dimensions of knowledge related to pressure ulcer and perceived susceptibility in control group, the scores of the other dimensions increased compared with before intervention, and the increasing of which in the intervention group was more obvious(P < 0.01).The total score of care behavior, turn over behavior, skin care, nutritional support and wound care scores in intervention group after intervention were higher than those in control group(P < 0.01).Except for the dimensions of skin care and nutritional support in control group after intervention, the scores of other dimensions increased compared with before intervention, and the increasing of which in the intervention group was more obvious(P < 0.01).The recurrence rate of pressure ulcer and wound healing time in intervention group were significantly less than those in control group(P < 0.01). ConclusionsTTM can effectively change the awareness of the primary caregivers of pressure ulcer, improve the care behavior of pressure ulcer, reduce the recurrence rate of pressure ulcer and shorten the wound healing time, which is worthy of promotion.
2021, 46(7): 948-952.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.027
Abstract:
ObjectiveTo construct a home care management program based on early exercise-nutritional support-sleep management (ENS), and evaluate its effects on acute exacerbation chronic obstructive pulmonary diseases(AECOPD) patients. MethodsThe home care management program based on ENS was established.Sixty patients with AECOPD were randomly divided into the observation group and control group(30 cases in each group).The control group received the routine care of AECOPD, and the observation group received the home care based on ENS.The knowledge and skills of COPD of core family members, patients' self-management ability, 6-min walk test(6MWT), readmission rate and mortality rate at 28 and 90 days were compared between two groups. ResultsThere was no statistical significance in the scores of disease knowledge and coping skills of core family members between two groups at admission(P>0.05).The scores of disease knowledge and coping skills in two groups at discharge were significantly higher than those at admission(P < 0.01), and which in observation group were significantly higher than those in control group (P < 0.01).After 1 month of discharge, the scores of symptom management, information management, emotion management and daily life management in observation group were significantly higher than those in control group(P < 0.01), and the 6MWT in observation group was significantly higher than that in control group(P < 0.01).After 28 and 90 days of discharge, the readmission rates in observation group were lower than that in control group(P < 0.01 and P < 0.05), and there was no statistical significance in the mortality rate between two groups(P>0.05). ConclusionsThe home care management program based on ENS can improve the self-management ability of AECOPD patients and reduce their readmission rate, which is worthy of clinical application.
2021, 46(7): 952-954.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.028
Abstract:
ObjectiveTo investigate the clinical effects of appropriate perineal protection technique in reducing the rate of lateral perineal resection among primiparas. MethodsA total of 350 primiparas who delivered vaginally and performed traditional delivery techniques were selected as the control group, and 366 primiparas who delivered vaginally and performed moderate perineal protection techniques were selected as the observation group.The incidence rate of perineal laceration, rate of lateral perineectomy, second stage of labor and postpartum 2 h blood loss were compared between two groups. ResultsThe degree of perineal laceration in observation group was significantly better than that in control group(P < 0.01), the rate of perineal lateral resection in observation group was significantly lower than that in the control group(P < 0.01), and the duration of the second stage of labor and postpartum 2 h blood loss in observation group were significantly higher than that in the control group(P < 0.01).No neonatal asphyxia occurred in two groups. ConclusionsThe implementation of moderate perineal protection technology can effectively reduce the rate of perineal laceration and lateral perineectomy of primiparas, the second stage of labor time and postpartum 2h blood loss are within the normal range, and will not increase the incidence rate of neonatal asphyxia, and which is worthy of clinical promotion.
2021, 46(7): 955-958.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.029
Abstract:
ObjectiveTo observe the effects of acupressure therapy combined with Lei huo moxibustion moxibustion nursing on the limb function rehabilitation of hemiplegia patients with ischemic stroke of Qi-deficiency and blood-stasis. MethodsSixty hemiplegia patients with ischemic stroke of Qi-deficiency and blood-stasis were divided into the control group and observation group according to random number table method.The control group was treated with conventional treatment and nursing, while the observation group was treated with conventional treatment combined with acupressure therapy and Lei huo moxibustion moxibustion treatment and nursing.The recovery of limb function, improvements of traditional Chinese medicine(TCM) syndrome efficacy and abilities of daily activities in two groups were observed after treatment. ResultsAfter treatment, the total effective rate in observation group was significantly higher than that in control group(P < 0.01).The score of various points of TCM syndrome in observation group after treatment was lower than that before treatment(P < 0.05).The scores of hemiplegia, mouth skew, paresthesia, shortness of breath, fatigue, pale complexion and spontaneous sweating in observation group were lower than those in control group(P < 0.05 to P < 0.01).After treatment, the difference of the muscle strength of affected limb was significant between two groups(P < 0.05).The number of grade 5 muscle strength of affected limb in observation group was more than that in control group(P < 0.05).After treatment, the Fugl-Meyer score and Barthel index in two groups were higher than those before treatment(P < 0.05), and the Fugl-Meyer score and Barthel index in observation group were significantly higher than those in control group(P < 0.05). ConclusionsAcupressure therapy combined with Lei huo moxibustion moxibustion nursing can effectively promote the functional recovery of affected limb of hemiplegia patients with ischemic stroke, and significantly improve the patients' quality of life.
2021, 46(7): 959-962.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.030
Abstract:
ObjectiveTo analyze the effects of the nursing model based on disease trajectory framework on self-care ability and rehabilitation effects of patients with cerebral infarction complicated with hemiplegia. MethodsNinety patients with stroke complicated with hemiplegia were andomly divided into the study group(n=45) and control group(n=45).The control group was nursed with routine care plan, and the study group was nursed with the nursing model based on disease trajectory framework.The functional recovery and self-care ability in two groups were compared between before and after intervention. ResultsBefore intervention, the differences of the Brunnstrom scores of upper and lower limbs, FM-B scores of Fugl-Meyer scale, modified Barthel index(MBI) and exercise of self-care agency(ESCA) scores between two groups were not statistically significant(P>0.05).After intervention, the Brunnstrom scores of the upper and lower limbs, FM-B scores, MBI and ESCA scores in two groups increased compared with before intervention(P < 0.05), the Brunnstrom scores of the upper and lower limbs, FM-B scores and ESCA scores in study group were higher than those in control group(P < 0.05 to P < 0.01), and there was no statistical significance in MBI score between two groups(P>0.05). ConclusionsThe nursing model based on chronic disease trajectory framework can significantly improve the self-care ability, and enhance the effects of functional rehabilitation of stroke patients with hemiplegia.
2021, 46(7): 963-966.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.031
Abstract:
ObjectiveTo explore the application effect of side limb functional exercise combined with acupressure on nursing after implantation of permanent pacemaker. MethodsA total of 68 patients in the Department of Cardiology were selected as the research objects, and the 68 patients were randomly divided into the observation group and the control group, 34 cases in each group.The control group adopted the routine nursing method after operation, and the observation group adopted the method of operative side limb function exercise combined with acupoint massage intervention on the basis of routine nursing.Postoperative comfort, complication rate, pain, anxiety and patient satisfaction were compared between the two groups. ResultsCompared with the control group, the observation group had higher comfort and nursing satisfaction, low back pain, incision pain score, anxiety score and the incidence of complications at 24 h after operation, salt bag compression and salt bag relief (P < 0.05 to P < 0.01). ConclusionsCompared with routine nursing, operation side limb function exercise joint point massage is applied in patients with cardiac pacemaker implantation can effectively improve the postoperative comfort, ease pain of incision and the waist ache, reduce the incidence of complications, relieve patients' anxiety, promote postoperative patients recover at an early date, improve the hospitalized patients' satisfaction, is worth promoting in the clinical practice.
2021, 46(7): 967-969, 973.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.032
Abstract:
ObjectiveTo explore the effects of respiratory patch combined with changing body position nursing in the treatment of pediatric pneumonia. MethodsA total of 300 pediatric patients with pneumonia were randomly divided into the control group and observation group(30 cases in each group).The control group received the conventional treatment and position nursing, and the observation group were treated with respiratory patch combined with changing position nursing based on the conventional measurements.The symptom resolution time, efficacy, incidence rate of adverse reactions and parent's satisfaction were compared between two groups. ResultsThe cough disappearance time, lung murmur disappearance time, fever reduction time, asthma disappearance time and hospital stays in observation group were significnatly shorter than in control group(P < 0.01).The C reactive protein level in observation group significantly decreased compared with the control group (P < 0.01).The total effective rate in observation group(98.67%) was significantly better than that in control group(89.33%)(P < 0.01).The incidence rate of adverse reactions in observation group was lower than that in control group(P < 0.05), and the patient's satisfaction in observation group was higher than that in control group(P < 0.05). ConclusionsThe respiratory patch combined with changing position nursing has significantly clinical effects and high safety in children with pneumonia, which can significantly improve patient's satisfaction, and is worthy of clinical promotion and application.
2021, 46(7): 970-973.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.033
Abstract:
ObjectiveTo evaluate the effect of local acupoint pressing combined with aromatherapy on chemotherapy-induced nausea and vomiting in patients with malignant blood diseases. MethodsSixty-five patients with malignant blood diseases who received chemotherapy in the hematology department were selected by convenient sampling and divided into control group(n=35) and intervention group(n=30) according to the treatment time.The control group was treated with routine drug intervention and health education, and the intervention group was treated with local acupoint pressing combined with aromatherapy such as lemon tablet, ginger and mint on the basis of the control group.The degree of chemotherapy-induced nausea and vomiting, quality of life and anxiety were compared between the two groups within 24 hours after chemotherapy. ResultsThe degree of chemotherapy-induced nausea and vomiting and anxiety in intervention group within 24 hours after chemotherapy were significantly lower than those in control group, and the quality of life was significantly higher than that in control group(P < 0.01). ConclusionsThe non-drug intervention measure of local acupoint pressing combined with aromatherapy can effectively alleviate the symptoms of chemotherapy-induced nausea and vomiting in patients with malignant blood diseases, improve the patients' quality of life and sense of comfort, and reduce anxiety and other psychological burdens.
2021, 46(7): 974-978.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.034
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ObjectiveTo explore the effects of health management intervention based on Health as Expanding Consciousness(HEC) on health promoting lifestyle in patients with acute pancreatitis. MethodsA total of 90 patients with acute pancreatitis were randomly divided into the health management group and control group(45 cases each group).The control group were given the routine treatment and nursing intervention for pancreatitis, while the health management group were given the systematic health management intervention on the basis of routine treatment and nursing.The changes of health promoting lifestyle in two groups were compared between before and after intervention. ResultsThere was no statistical significance in all dimensions of health promotion lifestyle between two groups before intervention(P>0.05).After 1 month of discharge, the scores of health responsibility, exercise, nutrition and stress management in health management group were higher than those in control group(P < 0.05 to P < 0.01), and there was no statistical significance in the scores of self-realization and interpersonal relationship between two groups(P>0.05).After 3 months of discharge, the scores of all dimensons in health management group were higher than those in control group(P < 0.01).In the health management group, the scores of each dimension in after 3 months of dischargep were higher than that after 1 month of discharge, and which after 1 months of dischargh was higher than that before intervention(P < 0.01). ConclusionsThe HEC-based health management intervention has a positive time effects on the health promotion lifestyle in patients with acute pancreatitis.
2021, 46(7): 978-981.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.035
Abstract:
ObjectiveTo analyze the effects of the hierarchical care scheme based on need theory on hemodialysis patients. MethodsOne hundred and twenty patients treated with hemodialysis were divided into the study group and control group according to number table method(60 cases in each group).The control group was given the hierarchical nursing intervention, and the study group was given the hierarchical nursing intervention based on the need theory.The psychological status, quality of life, nursing satisfaction and incidence rate of complications were compared between two groups. ResultsAfter nursing intervention, the scores of social relations, environment, physiology and psychology in study group were significantly higher than those in control group(P < 0.05).The anxiety and depression scores in study group were significantly higher than those in ontrol group(P < 0.01).The incidence rate of complications in study group was significantly lower than that in control group(P < 0.05), and the nursing satisfaction in study group was significantly better than that in control group(P < 0.05). ConclusionsThe hierarchical care scheme based on need theory can significantly improve the quality of life and psychological state of patients, reduce the occurrence of complications, and improve the patient's nursing satisfaction.
2021, 46(7): 982-987.
doi: 10.13898/j.cnki.issn.1000-2200.2021.07.036
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ObjectiveTo explore the effect of nursing intervention guided by tracer? methodology on optimism tendency and complication rate of patients with acute myocardial infarction (AMI) complicated with heart failure (HF). MethodsEighty patients with AMI complicated with HF were divided into experimental group and control group (40 cases in each group).Both groups underwent percutaneous coronary intervention, the control group was given routine nursing, and the experimental group was given nursing intervention guided by tracer methodology on the basis of the control group for a consecutive one month.The complications after radial artery puncture, nursing satisfaction, and the life orientation test-revised (LOT-R) score, post-traumatic growth inventory (PTGI) score, exercise of self-care agency scale (ESCA) score and health promoting lifestyle profile (HPLP Ⅱ) score before and after intervention were compared between the two groups. ResultsThe total incidence of complications after radial artery puncture in the experimental group was 5.00%, which was lower than that (20.00%) in the control group (χ2=4.11, P < 0.05).One month after the intervention, the scores of LOT-R, PTGI, ESCA and HPLP Ⅱ in the two groups were significantly higher than those before the intervention (P < 0.01), and which in experimental group were significantly higher than those in control group (P < 0.01).The total satisfaction rate of nursing in experimental group was higher than that in control group (P < 0.05). ConclusionsThe application of nursing intervention guided by tracer methodology in patients with AMI complicated with HF is helpful to reduce the complications after radial artery puncture, improve optimism tendency, promote post-traumatic growth, enhance self-care ability, urge to adopt healthy behavior actively, and improve nursing satisfaction.
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