ABSTRACT
OBJECTIVE@#To investigate the clinical value of hemoglobin to serum creatinine ratio (Hb/SCr) combined with blood uric acid (SUA) in predicting in-hospital mortality after emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).@*METHODS@#The clinical data of AMI patients who underwent emergency PCI in the First Affiliated Hospital of Kangda College of Nanjing Medical University from January 2017 to December 2021 were retrospectively analyzed. The general information, underlying medical history, blood routine, liver and kidney function, blood coagulation routine, SUA and other indicators were collected from patients. The primary composite endpoint was defined as in-hospital death, including in-hospital all-cause death during PCI and 15-day post-procedure hospitalization. Multivariate Logistic regression was used to analyze factors associated with in-hospital death after emergency PCI in patients with AMI. Multivariate Logistic regression was used to analyze the independent related factors and construct a risk prediction model. The Hosmer-Lemeshow method and receiver operator characteristic curve (ROC curve) were used to test the goodness of fit and predictive effect of the model and correlates, respectively.@*RESULTS@#A total of 1 976 patients were enrolled, 92 died in hospital and 1 884 survived. SUA was higher in the death group than that in the survival group (μmol/L: 476.88±132.04 vs. 354.87±105.31, P < 0.01), and the Hb/SCr ratio was significantly lower than that in the survival group (13.84±5.48 vs.19.20±5.74, P < 0.01). Pearson analysis showed a linear negative correlation between SUA and Hb/SCr ratio (r = -0.502, P < 0.01). Logistic regression risk model analysis finally included age [odds ratio (OR) = 0.916], Hb/SCr ratio (OR = 0.182), white blood cell count (WBC, OR = 2.733), C-reactive protein (CRP, OR = 3.611), SUA (OR = 4.667), blood glucose (Glu, OR = 2.726), homocysteine (Hcy, OR = 2.688) 7 factors to construct a risk prediction model, which were independent correlation factors for in-hospital death in AMI patients after emergency PCI (all P < 0.05). Hosmer-Lemeshow test verified the fitting effect of the model, and the result showed P = 0.447. The area under the ROC curve (AUC) of the model for predicting in-hospital death in AMI patients after emergency PCI was 0.764 [95% confidence interval (95%CI) was 0.712-0.816, P = 0.001]. When the cut-off value was 0.565 8, the sensitivity was 70.7%, the specificity was 70.2%, and the Yoden index was 0.410. When Hb/SCr ratio+SUA, SUA, Hb/SCr ratio, Hb and SCr were used to predict in-hospital death in AMI patients after emergency PCI, the AUC of Hb/SCr ratio+SUA was the largest, which was 0.810. When the optimal cut-off value was -0.847, the sensitivity was 77.7%, the specificity was 74.5%, and the Youden index was 0.522.@*CONCLUSIONS@#Age, SUA, Hb/SCr ratio, WBC, CRP, Glu, and Hcy are independent risk factors for in-hospital death after emergency PCI in AMI patients. The lower the Hb/SCr ratio and the higher the SUA at admission, the higher the risk of in-hospital death after emergency PCI in AMI patients. Hb/SCr ratio combined with SUA has a higher predictive value for in-hospital death after emergency PCI in AMI patients than single index, which is helpful for early identification of high-risk patients.
Subject(s)
Humans , Hospital Mortality , Uric Acid , Creatinine , Percutaneous Coronary Intervention , Retrospective Studies , Myocardial Infarction/therapy , PrognosisABSTRACT
Objective To investigate and analyze the personality characteristics and situation of mental health in patients with sudden deafness,and discuss the relationship between the two,so as to provide basis for the auxiliary diagnosis and mental health intervention.Methods Eighty-eight patients with sudden deafness(sudden deafness group) were evaluated by Symptom Checklist 90 (SCL-90) and adult Eysenck Personality Questionnaire (EPQ).The survey results were compared with the norm of healthy people (norm group).The correlation analysis was performed between SCL-90 results and EPQ score.Results The SCL-90 total score in sudden deafness group was higher than that in normal group,but there was no significant difference,P>0.05.The scores of somatization,depression,anxiety,panic,psychosis and positive number,positive projects split were (1.58±0.46),(1.71±0.43),(1.59±0.44),(1.38±0.39),(1.46±0.51) scores,(32.65±15.81) nubmers,(2.96±0.65) scores in sudden deafness group,which were higher than those in normal group (1.37±0.48),(1.50±0.59),(1.39±0.43),(1.23±0.41),(1.29±0.42) scores,(24.92±18.14) nubmers,(2.60±0.59) scores,and there were significant differences,t=3.640,2.996,3.855,3.045,3.314,3.562,5.033,P＜0.01.The standard T points of psychotic,neurotic and emotional stability dimensions were (54.63±10.37),(45.59±8.67) scores in sudden deafness group,which were higher than those in normal group (48.14±9.74),(41.27±9.42) scores,and there were significant differences,t=8.207,3.811,P＜0.01.The standard T points of internal and external dimensions,hide were (52.28±11.67),(48.68±8.57) scores in sudden deafness group,which were lower than those in normal group (57.75±8.26),(51.27±10.43) scores,and there were significant differences,t=5.455,2.066,P＜0.01 or 0.05.Neurotic and emotional stability dimension,psychotic part dimension were a positive correlation with SCL-90 factor points.Multi-factor stepwise regression analysis showed that the neurotic or emotional stability were correlated with interpersonal relationship,depression,anxiety,hostility,terror.Conclusions Patients with sudden deafness overall mental health status is poorer,the somatization,depression,anxiety,terror,psychoticism of various factors on negative emotions is more obvious.Sudden deafness patients have emotional instability and psychotic personality characteristics.The personality characteristics of sudden deafness patients have a correlation with the mental health.In the process of comprehensive treatment for patients with sudden hearing loss,individual psychological health intervention is necessary.
ABSTRACT
Objective To study shorten the time of initial oral intake and fluid intake after general anesthesia in patients receiving oral and maxillofacial surgery,and to reduce the patient′s discomfort and adverse reactions and promote the postoperative recovery. Methods A total of 160 patients were divided into control group and observation group with 80 cases each by random digits table method from April to September in 2014. Patients in control group were allowed to take food orally 6 h after they emerged from anesthesia; while those in observation group were allowed to drink water after 2 h at emergence from anesthesia and take liquid food after 4 h. The mis-aspiration,the fasting glucose,blood pressure,heart rate and the rate of thirst,hunger,nausea,vomiting were observed. Results The rate of thirst, hunger, nausea, vomiting in observation group were significantly lower than those in control group(4 cases vs. 73 cases, 15 cases vs. 76 cases, 10 cases vs. 29 cases, 1 case vs. 7 cases), and there were significant differences, P0.05, the t value of systolic blood pressure, diastolic blood pressure were-2.73,-2.56. Conclusion Shorten the time of taking food for patients undergoing the oral and maxillofacial surgery,in order to relieve uncomfortable symptoms,prevent hypoglycemia and the hemodynamic disturbance after anesthesia, and promote recovery,early postoperative feeding should be suggested on the premise that they are fully awake.
ABSTRACT
Objective Through the analysis of the characteristics of serum lipids metabolism and plasma fi‐brinogen levels in patients with sudden hearing loss ,to investigate the relationship between them with sudden deaf‐ness .Methods A retrospective analysis of 180 cases of patients with sudden deafness (SHL group) ,depending on the type of auditory threshold curve divided into low intermediate frequency drops group (low intermediate frequency group) and 40 cases ,the high frequency drop group (high frequency) 90 cases ,all frequency drop group (group all frequency) 50 cases ,and drawing 180 cases in the same period of hospitalization deviated septum ,vocal cord polyp patients as control group .All patients'triglyceride (TG) ,total cholesterol (TC) ,low -density lipoprotein choles‐terol (LDL -C) ,high density lipoprotein cholesterol (HDL -C) ,glucose (Glu) ,plasma fibrinogen (FIB ) levels were analyzed .Then a meaningful factor multivariate Logistic regression analysis was made .Results There was a statistically significant difference between the two groups'TC ,HDL -C ,LDL -C ,Glu ,and FIB(P0 .05) .There was a statistically significant difference between the groups'all frequency and low frequency group and control group TC ,HDL -C ,LDL -C ,FIB(P0 .05) .The Logistic regression analysis showed that the LDL ,FIB was the major risk factors associated with the onset of sudden deafness .Conclusion Lipid levels in patients with sudden hearing loss is higher than that of in the normal hearing group .High levels of LDL - C and FIB have close correlations with the patients with sudden deafness ,and the related risk factors for the onset of sudden deafness ,according to threshold curve type ,should choose targeted treatment options .
ABSTRACT
OBJECTIVE@#Through the analysis of coagulation convention and blood routine parameters of sudden hearing loss (SHL) patients, further prove the correlation of sudden deafness and the the inner ear microcirculation, to guide clinical diagnosis and treatment.@*METHOD@#Select 424 patients (448 ears) with sudden deafness in our department to SHL group. According to hearing curve is classified into low intermediate frequency descent group, high frequency drop and full frequency group, and drawing 244 cases in the same period of hospitalization deviated septum, vocal cord polyp patients as control group. All patients' coagulation detection, D-dimer, blood leukocytes, neutrophils and platelet count percentages were analyzed. Then a meaningful factor multivariate Logistic regression analysis was made.@*RESULT@#There was a statistically significant difference between the two groups' prothrombin time, international normalized ratio, activated partial thromboplastin time, thrombin time measurement, fibrinogen, D-dimer, platelet count, white blood cell, neutrophil ratio(P<0.05); Logistic regression analysis showed that the prothrombin, thrombin time measurement, fibrinogen, D-dimer, neutrophil incidence of sudden hearing loss associated risk factors.@*CONCLUSION@#SHL in patients with coagulation dysfunction may be involved in the occurrence of SHL development mechanism, and there is a correlation of the SHL and the dysfunction of inner ear microcirculation.
Subject(s)
Humans , Blood Coagulation Disorders , Ear, Inner , Fibrin Fibrinogen Degradation Products , Fibrinogen , Hearing Loss, Sudden , Blood , Incidence , Risk FactorsABSTRACT
Objective To explore ways to decrease peripheral vascular complications during parenteral nutrition through peripheral veins. Methods According to the support sequences of giving peripheral parenteral nutrition, ninty perioperative cases were randomly divided into low(20. 3 kPa·h-1 ),medium(27. 1 kPa·h-1 ) and high(33. 9 kPa·h-1 ) osmotic pressure rates(n=30 in each group). The infusion pump was used to control the rate of infusion. The total parenteral nutrient was infused through BD24G venous indwelling needles. The pain ratings at injection sites were evaluated after parenteral nutrition everyday,the incidences of phlebitis were observed three days later after removing the indwelling needles. ResultsUnder the low osmotic pressure,the pain was mild,while for the medium osmotic pressure,the pain became more obvious. The pain was aggravated obviously under high osmotic pressure. There were only two cases of over grade-II phlebitis under low osmotic pressure rate,9 cases under medium osmotic pressure rate and 14 cases under high osmotic pressure rate, in which a grade-Ⅲ phlebitis developed. Conclusion Decreasing the osmotic pressure rate through peripheral venous is an effective method to avoid or reduce the incidences of peripheral vascular complications with the peripheral parenteral nutrition support.
ABSTRACT
Objective To explore the perioperative nutritional support and nursing countermeasures for laryngeal cancer patients. Methods 28 cases of hospitalized laryngeal surgery patients, in accordance with the working method of clinical pathway, finished product and homemade homogenate enteral nutrition was fed through nasogastric tube. Nutrition evaluation was finished by use of body mass index (BMI), blood biochemical indicators on 1d preoperation and 14 d postoperation, All indexes were compared between preoperation and postoperation. Results Nutrition assessment with BMI showed incidence of mild malnutrition as 10.7% and 14.3% on 1d preoperation and 14 d postoperation. Nutrition evaluation index such as HB, BUN was statistically significant, and BMI、 TLC、ALB、TP showed no statistical sisnificant difference between 1d preoperation and 14 d postoperation. Conclusions Clinical pathway in accordance with the working method, using the reasonable meal is laryngeal cancer patients homogenate perioperative enteral nutrition support a more scientific and deserves popularization of nursing countermeasures.
ABSTRACT
Objective To know the remote quality of life of patients with tumor of larynx when ab-scised by different type, and then summarize proper countermeasures of nursing. Methods Selected 82 laryngocarcinoma patients with exacte]y diagnosis. There were 40 cases had received total laryngectumy, 42 cases had received partial laryngectomy. Evaluated the level of remote quality of life of 82 patients by QLQ-H&N65, and then analyzed the datum. Results The level of quality of life of patients with total laryn-gectomy were worse than those in patients with partial laryngectomy in the aspects such as general health, swallow, language, emotional function, social function, body fuction and so on. Conclusions The quality of life of patients with tumor of larynx is influenced by several factors, their remote quality of life should be emphasised by nurses.