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Objective To compare the efficacy and safety of humidified high-flow nasal cannula (HHFNC)and nasal continuous positive airway pressure (nCPAP) for moderate and severe bronchiolitis treatment in infants.Methods Thirty-two infants who were diagnosed as moderate and severe bronchiolitis admitted to Department of Pediatric Critical Care Medicine,the Affiliated Hospital of Qingdao University from September 2016 to May 2017 were selected,and they were randomly assigned into HHFNC group(17 cases) and nCPAP group(15 cases).The heart rate,breathing,oxygen saturation (SpO2),arterial partial pressure of oxygen [Pa (O2)],partial pressure of carbon dioxide [Pa (CO2)],pH value after treatment for 12 h,the duration of non-invasive ventilation and the incidence rates of invasive ventilation use,complications were compared between the 2 groups.Results After the treatment for 12 h,in HHFNC group,the heart rate was (130.88 ± 2.87) times/min,respiratory rate was (37.35 ± 3.55) times/min,SpO2 was(97.06 ± 1.43)％,pa(O2) was (99.65-±8.07) mmHg,pa(CO2) was (35.88 ±4.27) mmHg,pH was 7.42 ± 0.03;while in the nCPAP group,the heart rate was (135.73 ± 6.29) times/min,respiratory rate was (41.40 ± 4.40)times/min,SpO2 was (96.00 ± 1.13) ％,Pa (O2) was (91.33 ± 9.45) mmHg,pa (CO2) was (40.13 ± 3.72)mmHg,pH was 7.39 ± 0.03.The breathing,heart rate,oxygen saturation and arterial blood gas in both groups after treatment were improved significantly compared with those before treament,and the differences were statistically significant (all P ＜ 0.05);after treatment for 12 h,the heart rate,breathing,oxygen saturation and arterial blood gas of HHFNC group were improved more than those of the nCPAP group,and the differences had statistical significance (all P ＜ 0.05).The duration of non-invasive ventilation was (45.88-± 6.49) hours in HHFNC group,and (49.33 ± 8.99) hours in nCPAP group,so there was no difference between the 2 groups (t =1.254,P =0.219).There was 12 cases (80.0％) of mild complication in nCPAP group and 5 cases(29.4％) in HHFNC group,while the incidence rate of invasive ventilation use was 3 cases(20.0％) in nCPAP group and 1 case (5.9％) in HHFNC group.Conclusion The efficacy and security of HHFNC on moderate and severe bronchiolitis are better than those of nCPAP,and it is recommended for clinical application widely.
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Objective To compare the efficacy and safety of humidified high-flow nasal cannula (HHFNC)and nasal continuous positive airway pressure (nCPAP) for moderate and severe bronchiolitis treatment in infants.Methods Thirty-two infants who were diagnosed as moderate and severe bronchiolitis admitted to Department of Pediatric Critical Care Medicine,the Affiliated Hospital of Qingdao University from September 2016 to May 2017 were selected,and they were randomly assigned into HHFNC group(17 cases) and nCPAP group(15 cases).The heart rate,breathing,oxygen saturation (SpO2),arterial partial pressure of oxygen [Pa (O2)],partial pressure of carbon dioxide [Pa (CO2)],pH value after treatment for 12 h,the duration of non-invasive ventilation and the incidence rates of invasive ventilation use,complications were compared between the 2 groups.Results After the treatment for 12 h,in HHFNC group,the heart rate was (130.88 ± 2.87) times/min,respiratory rate was (37.35 ± 3.55) times/min,SpO2 was(97.06 ± 1.43)％,pa(O2) was (99.65-±8.07) mmHg,pa(CO2) was (35.88 ±4.27) mmHg,pH was 7.42 ± 0.03;while in the nCPAP group,the heart rate was (135.73 ± 6.29) times/min,respiratory rate was (41.40 ± 4.40)times/min,SpO2 was (96.00 ± 1.13) ％,Pa (O2) was (91.33 ± 9.45) mmHg,pa (CO2) was (40.13 ± 3.72)mmHg,pH was 7.39 ± 0.03.The breathing,heart rate,oxygen saturation and arterial blood gas in both groups after treatment were improved significantly compared with those before treament,and the differences were statistically significant (all P ＜ 0.05);after treatment for 12 h,the heart rate,breathing,oxygen saturation and arterial blood gas of HHFNC group were improved more than those of the nCPAP group,and the differences had statistical significance (all P ＜ 0.05).The duration of non-invasive ventilation was (45.88-± 6.49) hours in HHFNC group,and (49.33 ± 8.99) hours in nCPAP group,so there was no difference between the 2 groups (t =1.254,P =0.219).There was 12 cases (80.0％) of mild complication in nCPAP group and 5 cases(29.4％) in HHFNC group,while the incidence rate of invasive ventilation use was 3 cases(20.0％) in nCPAP group and 1 case (5.9％) in HHFNC group.Conclusion The efficacy and security of HHFNC on moderate and severe bronchiolitis are better than those of nCPAP,and it is recommended for clinical application widely.
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Objective To analyze the cognition, utilization and satisfaction on pregnancy health management of basic public health services. and to find out potential problems and provide suggestions for promoting equality in rural basic public health. The Weishan Lake area was selected as the sample point and the left behind pregnant women in the countryside as control. Methods In the period from May 2016 to July, questionnaires were designed for the pregnancy health management of basic public health services, 330 left-behind pregnant women and 300 rural immigrating pregnant women were selected as our target interviewees. The average age of rural immigrating pregnant women and the left-behind pregnant women was (28.6 ± 3.7) years, and (28.3 ± 3.4) years old, respectively; the degree of education of rural immigrating pregnant women and the left-behind pregnant women was secondary specialized school or high school and junior middle school, respectively. The occupation of rural immigrating pregnant women was mainly workers;accounting for 31.4%, while the occupation of the left-behind pregnant women was farming, accounting for 36.7%. Results The awareness rate ofgeneral pregnancy examination and gynecological examinationin health management items of rural immigrating pregnant women and left-behind pregnant women was the highest, which were 77.7% and 78.3%, respectively, and the lowest awareness rate of the 2 prenatal follow-up was the lowest in the third trimester, which was 22.6% and 23.0%, respectively. The difference was not statistically significant. The maternal health management service understanding rate of rural immigrating pregnant women and left-behind pregnant women were 24.7% and 17.9% respectively , the difference was statistically significant (Z=-1.993, P=0.046);the awareness rate of delivery and breastfeeding in late pregnancy were 36.2% and 47.6% respectively, and the difference was statistically significant (χ2=7.933, P=0.005). The rate of the registering of the maternal health care handbook of rural immigrating pregnant women and left-behind pregnant women were 40.4%and 54%respectively, and the difference was statistically significant (χ2=11.065, P=0.001), Among them, the rate of registering in township hospitals was 46.6% and 73.3% respectively, and the difference was statistically significant (χ2=21.104, P=0.0000); the utilization rate of 3 or more antepartum examination and follow-up services was 8.4%and 23%respectively, and the difference was statistically significant (χ2=23.878, P=0.000). The growth and development of the health of pregnant women and fetal assessment and utilization rates were 9.8% and 23.6%, the difference was statistically significant (χ2=20.460, P=0.000); prenatal guidance (childbirth preparation, breastfeeding) utilization rate were 8%, 13.7%, the difference was statistically significant (χ2=5.011, P=0.027);abnormal or critical maternal referral utilization rate were 22%and 34.8%, the difference was statistically significant (χ2=12.133, P=0.001). Conclusion Imbalance exists in acquiring basic public health services of the two pregnant women cohort, the left-behind pregnant women are better than the rural immigrating pregnant women. Therefore, the government should propagate this service by multi-channel to improve their cognition and utilization of this policy implemented, and to promote the development of the services.
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Objective To explore the clinical features and treatment strategy of severe anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in children. Methods The clinical data and follow-up information of 4 children with severe anti-NMDAR encephalitis were retrospectively analyzed. Results Four patients (one male and 3 females) were 10 to 13 years old and one child had teratoma combined. In all patients symptoms at onset mainly were psychiatric syndrome and movement disorder, and then progressed to seizures, disturbance of consciousness and central hypoventilation respiratory failure in one month. The anti-NMDAR antibodies in cerebrospinal fluid were positive in all patients. The EEG showed focal or diffuse slow waves. The brain MRI showed no pathological changes at the diagnosis. The treatment included methylprednisolone and large doses of intravenous immunoglobulin (IVIG), ventilator for 5-95 days, and tracheotomy in 2 cases. One case died because of serious infection. In 21-27 months of the follow-up, one case had clinical recovery; 2 cases had the sustained use of immunosuppressive agents and anti-epileptic drugs and the clinical symptoms were significantly improved. The EEG and anti-NMDAR antibodies continued abnormal in the patient combined with teratoma. One patient relapsed. Conclusions The severe anti-NMDAR is more likely in older female children. The central hypoventilation respiratory failure occurs in the early course of the disease. Combination with tumor is high risk factor. Conventional hormone therapy and ventilator treatment is effective. The recovery is slow. It may be relapsed even one year later.
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Objective To investigate the feasibility of low-tube-voltage in combination with the three-dimensional adaptive iterative dose reduction (AIDR-3D) algorithm in performing lower extremity computed tomography angiography (CTA).Methods A total of 60 patients suspicious of lower extremity arterial occlusion were randomized into control group (120 kV,a =30) and experimental group (100 kV,n =30).The CTA was undertaken with a 320-row scanner (Toshiba Aquilion ONE),and the images was reconstructed with filtered back projection (FBP) algorithm in control group and FBP as well as the AIDR-3D algorithm in experimental group.The subjective image quality,vascular density (VD),noise,signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),and dose length product (DLP) were compared between two groups.Results The DLP was significantly lower in experimental group than that in control group [(503.5± 104.7) vs.(1 099.4 ± 151.7) mGy·cm,t =15.7,P ＜0.05].The images in experimental group with 100 kV and FBP protocol had significantly increased VD and noise (t =-3.13,-3.61,P ＜ 0.05) than that in the control.The images in experimental group with AIDR-3D had significantly lower noise and higher SNR and CNR than that with FBP (t =13.59,2.14,P ＜ 0.05),also significantly lower noise and significantly higher VD,SNR,and CNR than that in the control (t =-3.75,-4.19,-4.15,P ＜ 0.05).Conclusions Low-tube-voltage (100 kV) combined with AIDR-3D reconstruction could significantly improve the image quality and reduce radiation dose in lower extremity CTA with a 320-row CT scanner.Trial registration Chinese clinical trial registry,ChiCTR-DPD-16008054.
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OBJECTIVE@#Study on the correlation between chronic sinusitis with nasal septum deviation.@*METHOD@#Randomly selected 722 patients with coronal sinuses CT, statistics the number of cases of nasal septum deviation, cases of nasal septum deviation with chronic sinusitis, the wide and narrow side cases of nasal septum deviation complicated with sinusitis. The number of sinusitis without deviation, and paired test.@*RESULT@#The incidence of sinusitis between deviation of nasal septum and non deviation were 54. 13% and 44. 66%, the difference between two groups was statistically significant (P0. 01). The incidence of sinusitis high deviation and non high deviation were 59. 54% and 46. 97%, the difference between the two groups was statistically significant (P0. 05).@*CONCLUSION@#The deviation of nasal septum is associated with the formation of chronic sinusitis, the high deviation is more prone to sinusitis, The incidence of sinusitis and nasal septum deviation on both sides was no different.
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Humans , Chronic Disease , Incidence , Nasal Septum , Pathology , Sinusitis , Tomography, X-Ray ComputedABSTRACT
Objective To analyze the correlation between chronic diseases,depression and activities of daily living (ADL) in the elderly,and to explore the risk factors of depressive symptoms and ADL.Methods Randomized multi-stage sampling method was used to select 504 elderly (aged ≥65 years old) in Jining City.The participants were then investigated and assessed by using Geriatric Depression Scale15,Katz-Activity of Daily Living (Katz-ADL) and Lawton instrumental ADL (Lawton-IADL).Results The prevalence of chronic diseases was 74.01％ among the elderly who lived in Jining City.The positive rate of depressive symptom was 7.14％ and the rate of ADL or IADL limitation was 19.05％ and 66.67％,respectively.The positive rate of depressive symptom and the rate of ADL or IADL limitation of the male were lower than those of female (x2 values were 18.15,12.31 and 30.18,respectively; all P＜ 0.05).The number of chronic diseases was a risk factor of depressive symptom and ADL limitation (odds ratio (OR) =1.71 or 1.53,respectively).ADL and IADL limitations were also the risk factors of depressive symptom (OR =3.15 or 9.36,respectively).Over adjustment of gender and age,the impact of the number of chronic diseases on depressive symptom,ADL and IADL and the influence of ADL and IADL limitations on depressive symptom showed no statistical significance.Conclusions Gender and age may be fundamental risk factors of depressive symptom and ADL and IADL limitations in the elderly.Family members and society workers should improve ADL and positive emotion and reduce the likelihood of depressive symptom among aging population.
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ObjectiveTo observe the status and related factors of depression symptoms in elders.MethodsRandomized multi-stage sampling method was used to select subjects.504 elders ( aged ≥65 years) in Jining were investigated and assessed by using the scales of Geriatric Depression Scale15 ( GDS-15 ),Katz-activity of daily liying (Katz-ADL) and Lawton instrumental ADL (IADL).ResultsThe GDS scores of males (2.24 ±2.12 ) were significantly lower than that of females ( 3.35 ± 3.49) ( t '=4.236,P ＜ 0.01 ).There were significant differences in GDS scores among different subgroups of age,single or not,physical activity,sleep quality,self-reported health,living condition,economic status and lonely feeling.GDS scores were significantly correlated to lonely feeling,IADL,living condition,economic status,self-reported health and age (F =27.47,P ＜ 0.001 ; R2 =0.372,R'2 =0.358 ),with the total contribution of 35.8％.ConclusionAmong elders,the main factors influencing depression symptoms are lonely feeling,IADL,female,health condition,economic condition and single,respectively.Enhancing IADL of elders can contribute to reduce the risk factors of depression.
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As a pilot program of teaching reform,some excellent undergraduates majoring in nursing were selected to take specialized courses in ICU in order to cultivate the intensive care specialized nurses.The teaching team of specialized courses in ICU was established to guarantee the teaching quality.The team was in charge of the ICU specialized curriculum building,textbooks selection and teaching content examination.The high leveled teaching team of specialized courses in ICU was organized by taking teaching and researching section as a unit to improve theoretical teaching level,using clinical department as training base to enhance practice skill and participating in special subject classes and in-service study to promote specialized quality.
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Objective Through the investigation of nurses'situation of fatigue and perceived social support, to know about the status of nurses' fatigue and the degree of perceived social support, and influenc-ing factors for a preliminary regression analysis of nurses in order to further the prevention of the occurrence of chronic fatigue for reference. Methods By using fatigue assessment scale (FAI), fatigue scale (FS-14)and perceived social support scale (PSSS) to investigate 200 female nurses in Jining city, 191 valid questionnaires were got, the reclaimed efficiency was 95.5%. The results underwent analysis. Results Nurses who had accounted for 69.11 percent of fatigue, had more severe fatigue than nurses who had less fatigue, and they had tense response to rest or sleep. Nurses' physical fatigue and mental fatigue were significantly higher than the general healthy population. Nurses received higher scores of social support. Age and other factors and perceived social support went through regression analysis: the degree of job tension exacerbated the severity of fatigue, however, social support to some extent, mitigated or alleviated the situation of nurses in the total fatigue. Conclusions Nurses are high-risk population for fatigue. The degree of job stress is the main influencing factor. And social support and care for nurses, especially home care support, adequate rest, in-creasing the number of nurses, good working environment can effectively reduce fatigue.
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Objective To assess the clinical value of multi-slice helical CT perfusion on the post-operative follow-up of glioma.Methods CT perfusion image was applied to 32 patients with glioma after operation.Various perfusion parameters,include cerebral blood volume(CBV),permeability surface(PS),relative cerebral blood volume(rCBV)and relative permeability surface(rPS)were measured on recurrent area,nonrecurrent area and normal cerebral area respectively.SPSS 12.0 statistical software was used.Independent t test was used to compare the differences.Results In the recurrent group(16 cases),the value of CBV in creased in 12 cases and was normal in the other 4 cases.The value of PS increased in all the cases of recurrent group.The value of rCBV exceeded 2.6 in 10 cases,among which the biggest value of rCBV was 4.01.The mean value of rCBV was 2.67 and the mean value of rPS was 6.32;In the non-recurrent group(16 cases),the value of CBV was nearly normal in 7 cases,increased in 2 cases and decreased in the remaining 7 cases.The value of PS was nearly normal in 11 case,decreased in 3 cases and increased in the remaining 2 cases.The values of rCBV were all less than 2.6 and the biggest value of rCBV was 2.14.The mean value of rCBV was 0.99 and the mean value of rPS was 1.42.The statistic significance was obtained for all the parameters when compared the recurrent group with the non-recurrent group(P＜0.01)and with the normal cerebral area(P＜0.01).When compared the non-recurrent group with the normal cerebral area,none of the parameters had statistic significance(P＞0.05);The statistic significance was obtained for rCBV and rPS when compared the recurrent group with the non-recurrent group(P＜0.01).Conclusion CT perfusion image is valuable in determining glioma recurrence after operation.
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BACKGROUND: The existence of minimal residual leukemia cells is the main cause for the recurrence of acute leukemia in children, and immunological biological therapy has attracted more and more attentions in the various methods from eliminating minimal residual disease. Previous studies have found that interferon α-2b can effectively inhibit the increase of tumor cells in vivo in children with neuroblastoma and malignant lymphoma, whether it can inhibit the increase of leukemia cells?OBJECTIVE: To investigate the effects of interferon α-2b in vitro on leukemia cells.DESIGN: A comparative observation taking human promyelocytic leukemia HL-60 cell line as the material.SETTING: Cell Culture Room; Immunological Laboratory; Cell Room, Institute of Pediatrics, Affiliated Hospital,Medical College of Qingdao University.MATERIALS: HL-60 cell line was provided by Shandong Institute of Basic Medical Sciences. Interferon α-2b was purchased from Megagene Company Fluorescein isothiocyanate (FTTC) rabbit-anti-rat Ig solution (CatEK001) and CD13 anti-human monoclonal antibody solution (Cat. DK013Y) were purchased from Union Stem Cell & Gene Engineering Co.,Ltd.METHODS: The experiments were carried out in the Institute of Pediatrics, Affiliated Hospital, Medical College of Qingdao University from March to September 2005. HL-60 cells culture system was established in vitro, and the oncentration was adjusted to 1×109 L-1. The cells were divided into control group and experimental group. In the experimental group, each well was added by interferon-α-2b with the terminal concentration of 5×105, 1×106, 2×106,5×106 and 1×107 U/L, respectively. In the control group, each well was added by saline of the same volume. The cells were cultured continuously for 48 hours. The morphological changes of HL-60 cells were observed using Wright's staining under light microscope; Cell apoptosis was observed using acridine orange/ethidium bromide double staining; Antigen expression and maturation and differentiation on cell membrane were observed by determining CD13 protein expression; Proliferation and activity of HL-60 were detected with methyl-thiazol-tetrazolium (MTT) assay.MAIN OUTCOME MEASURES: The occurrence of apoptosis was judged according to the uniformity and staining of HL-60 nuclear chromatin; HL-60 cell proliferation was judged according to the absorbance (A) value; The maturation of HL-60 cells was judged according to the number of positive CD13 cells.RESULTS: ① HL-60 cell apoptosis: The cells were cultured for 48 hours. When the concentration of interferon α-2b was 5×105 U/L, there were mainly early apoptotic HL-60 cells; When the concentration was 1×107 U/L, there were mainly late apoptotic cells, and the apoptotic rate was significantly higher than those in the control group (P ＜ 0.01 ).② HL-60 cell proliferation: The A values in the experimental groups treated with interferon α-2b of 2×106 U/L and 1 ×107 U/L were significantly lower than that in the control group (P ＜ 0.01). ③ Maturation of HL-60 cells: The percentages of positive CD13 cells in the experimental groups treated with interferon α-2b of 1 ×106 and 1 ×107 U/L were significantly lower than that in the control group (P ＜ 0.01).CONCLUSION: It is concluded that interferon α-2b can enhance the apoptosis, inhibit the proliferation and promote maturation and differentiation of HL-60 cells.
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BACKGROUND: Learning and memory is a very complex biological phenomenon. Although quite a few researches on the substances participate in learning and memory and the brain areas related with learning and memory,its mechanism is still not completely clarified.OBJECTIVE:ro study the difference of antioxidase activity at different brain area in rats with different ability of learning and memory to reveal the relationship between the ability of learning and memory and the activity of antioxidase in specific brain area.DESIGN: A randomized controlled trial based on the experimental animals.SETTING: Department of Biochemistry in Jining Medical College.MATERIALS: The study was conducted in the Laboratory of Biochemistry of Jining Medical College and Suzbeu Medical College between March 2001 and January 2004. Forty 15-month old male Wistar rats with a body mass between 580 g and 650 g were selected.INTERVENTIONS: The detection of learning memory ability was carried out in MG-2 trisection radiation maze. Correction response was that the rats escaped to safe area after electric shock. Standard of master was that the rats had 9 out of 10 times continuously of correction. Observatory indicators included times of response required reaching the standard and the correct response rate. Good learning. ability meant 40 or less than 40 times of responses to reach standard; otherwise, poor learning ability was considered. Detection was repeated after 24 hours to observe the memory. Good memory meant 3 times continuously of correct response; otherwise, poor memory was considered. Rats with good learning ability and memory were included into group 1 (n= 10) and the rats with poor learning ability and memory were included into group 2( n = 12). The rest rats were washed out.MAIN OUTCOME MEASURES: Activities of superoxide dismutase (SOD), catalase(CAT) and glutathione-peroxidase(GSH-Px) of five brain areas including cerebral cortex, cerebella, striatum, hippocampus and hypothalamus in rats of two groups.RESULTS: To compare the rats with poor learning and memory ability with rats with good learning and memory ability: SOD activity in cortex, hippocampus and striatum significantly reduced ( t = 3.82, 4. 50, 6. 76, P ＜0.01); CAT activity in cortex, hippocampus, striatum and hypothalamus significantly reduced(t =4.75, 7.06, 10. 88, 17.28, P＜0.001); and GSH-Px activity was similar in each brain area without statistical significance.CONCLUSION: Hippocampus, cortex, striatum and hypothalamus all might participate in learning memory process, and the activities of antioxidases in these areas are closely related with learning memory.