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Objective:To compare serum procalcitonin and fibrinogen degradation product levels between type 2 diabetes mellitus patients with Escherichia coli bloodstream and urinary tract infections. Methods:The clinical data of 82 type 2 diabetes mellitus patients with Escherichia coli infections who received treatment between December 2014 and December 2019 in the First Affiliated Hospital of Datong University (The Fifth People's Hospital of Datong) were retrospectively analyzed. These patients were assigned to bloodstream infection ( n = 40) and urinary tract infection ( n = 42) according to the way of Escherichia coli infection. Serum procalcitonin and fibrinogen degradation product levels, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein, white blood cell count, D-Dimer level, antithrombin III activity, and electrolytes were determined and compared between the two groups. Correlation between procalcitonin and other variables was analyzed. Multiple linear regression analysis was performed with procalcitonin level as a dependent variable and other relevant indexes as independent variables. Results:Body temperature, white blood cell count, neutrophil count, monocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, procalcitonin level, C-reactive protein level, fibrinogen degradation product level, and D-Dimer level in the bloodstream injection group were (39.49 ± 0.64) ℃, (14.92 ± 11.78) × 10 9/L, (13.39 ± 11.60) × 10 9/L, (0.72 ± 0.36) ×10 9/L, (14.86 ± 10.52), (199.15 ± 160.69), (22.81 ± 17.86) μg/L, (133.44 ± 63.63) mg/L, (49.71 ± 41.44) mg/L, (16.56 ± 12.20) mg/L, respectively, which were significantly higher than those in the urinary tract infection group [(37.12 ± 1.20) ℃, (9.04 ± 3.95) × 10 9/L, (6.25 ± 4.02) × 10 9/L, (0.42 ± 0.29) × 10 9/L, (3.67 ± 3.34), (120.01 ± 44.08), (4.46 ± 8.69) μg/L, (39.22 ± 22.16) mg/L, (3.81 ± 3.41) mg/L, (0.84 ± 0.75) mg/L), t = 7.356, 2.578, 3.162, 2.958, 5.538, 2.591, 2.810, 4.825, 2.902, 2.375, all P < 0.05]. Platelet count, lymphocyte count, blood sodium level and antithrombin Ⅲ activity in the bloodstream infection group were (167.50 ± 104.93) × 10 9/L, (1.06 ± 0.58) × 10 9/L, (130.89 ± 6.50) mmol/L, (57.88 ± 16.28)% , which were significantly lower than those in the urinary tract infection group [(239.40 ± 82.52)× 10 9/L, (2.14 ± 0.71) × 10 9/L, (138.46 ± 5.96) mmol/L, (90.11 ± 8.90)%, t = -2.853, -6.313, -4.046, -7.350, all P < 0.05]. Correlation analysis revealed that serum procalcitonin level was positively correlated with body temperature ( r = 0.387), white blood cell count ( r = 0.355), neutrophil count ( r = 0.368), C-reactive protein ( r = 0.605), fibrinogen degradation product level ( r = 0.616), D-Dimer level ( r = 0.486) (all P < 0.05), and it was negatively correlated with sodium level ( r = -0.319) and antithrombin Ⅲ activity ( r = -0.465) (both P < 0.05). Multiple linear regression analysis results revealed that fibrinogen degradation product level and body temperature were greatly correlated with procalcitonin level. Conclusion:Inflammatory indicators procalcitonin level, body temperature, white blood cell count, neutrophil count, C-reactive protein, fibrinogen degradation product level and D-Dimer level were remarkably higher in type 2 diabetes mellitus patients with Escherichia coli bloodstream infection than those in type 2 diabetes mellitus patients with Escherichia coli urinary tract infection. Procalcitonin level was greatly correlated with body temperature and fibrinogen degradation product level.
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Objective:To study the status and influencing factors of fertility anxiety in breast cancer patients, and analyze the relationship between social support and fertility anxiety and the mediating role of psychological resilience.Methods:From January to May, 2020, 120 young breast cancer patients were investigated by the Cancer Reproductive Anxiety Scale, the Perceived Social Support Scale, and the Self-Resilience Scale and analyze the relationship of psychological resilience, social support with fertility anxiety, as well as the mediating role of psychological resilience among them.Results:Social support, psychological resilience were significantly negatively related to fertility anxiety and all dimensions ( r value was -0.428 to -0.126, P<0.05).Social support had negative predicting effect on fertility anxiety ( β value was -0.386, P<0.001). Psychological resilience of breast cancer patients had a partial mediating role between social support and fertility anxiety, accounting for the 35.8% of the total effect. Conclusions:Psychological resilience plays an important role in alleviating the fertility anxiety of breast cancer patients. Enhancing the psychological elasticity of breast cancer patients is an effective way to alleviate the anxiety of breast cancer patients.
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Objective:To investigate the clinical characteristics of different stages of type 2 diabetic nephropathy(DN), and to explore the possible factors affecting visceral fat area (VFA).Methods:From September 2018 to March 2019, 464 patients with type 2 diabetes who were hospitalized in the First Affiliated Hospital of Datong University were selected.Among them, 315 patients with urinary albumin/creatinine ratio(UACR)<30 mg/g were selected as normal proteinuria group, 72 patients with UACR 30-299 mg/g were selected as microalbuminuria group, 45 patients with UACR>300 mg/g were selected as massive proteinuria group, and 32 patients with serum creatinine higher than the reference value were selected as renal failure group.The serum creatinine of the first three groups was in the normal range.The clinical data of these patients such as blood pressure, body mass index(BMI), VFA, subcutaneous fat area(SFA), brachial-ankle pulse wave velocity(BAPWV), blood lipid, renal function and blood sugar were collected and compared among the four groups.Using VFA as strain and other indicators as independent variables, multivariate linear regression analysis was carried out.Results:There were statistically significant differences among the four groups in age, height, weight, BMI, head circumference, neck circumference, waist circumference, hip circumference and waist-hip ratio ( F=15.580, 4.679, 6.186, 3.553, 3.153, 2.689, 5.170, 3.114, 3.535, all P<0.05). The VFA of the normal proteinuria group, microalbuminuria group, massive proteinuria group and renal failure group were (102.25±37.09)cm 2, (104.12±40.93)cm 2, (119.63±48.82)cm 2, (110.54±41.58)cm 2, respectively, and the BAPWV were (1 546.97±330.18)cm/s, (1 595.52 ±381.27)cm/s, (1 459.63±285.61)cm/s, (1 703.89±318.64)cm/s, the differences were statistically significant among the four groups( F=3.344, 4.020, all P<0.05). There were statistically significant differences in alanine aminotransferase, creatinine, uric acid, total cholesterol, red blood cell, hemoglobin, ratio of neutrophils to lymphocytes (NLR) and ratio of platelets to lymphocytes (PLR) among the four groups ( F=3.405, 15.535, 6.552, 2.803, 6.158, 15.580, 3.764, 3.262, all P<0.05). With VFA as strain, multivariate linear regression analysis showed that waist circumference, BMI, TG and BAPWV were risk factors for VFA. Conclusion:DN is associated with multiple obesity-related indicators and inflammatory indicators such as NLR, PLR; VFA is associated with BAPWV.
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Objective:To investigate the relationship between procalcitonin(PCT) and insulin resistance in diabetic foot infection.Methods:Sixty patients with diabetic foot infection hospitalized in the Fifth People's Hospital of Datong from March 2015 to March 2017 were selected and divided into three groups according to the value of PCT: slightly elevated group(L group, n=18), moderately elevated group(M group, n=21), highly elevated group(H group, n=21). Another 20 patients with type 2 diabetes mellitus were collected as control group.The PCT, C-reactive protein(CRP), white blood cell count(WBC), fasting and postprandial blood glucose, fasting insulin and insulin resistance index(HOMA-IR) were calculated and compared. Results:In the control group, the levels of PCT, HOMA-IR, CRP and WBC were (0.14±0.12)μg/L, (17.70±8.86), (32.90±24.19)mg/L, (8.01±2.21)×10 9/L, respectively, which in the L group were (0.31±0.14)μg/L, (20.42±9.71), (50.85±27.81)mg/L, (9.95±3.35)×10 9/L, respectively, which in the M group were (1.11±0.52)μg/L, (24.08±14.09), (64.31±40.21)mg/L, (10.86±2.25)×10 9/L, respectively, which in the H group were (5.31±3.04)μg/L, (31.73±14.13), (72.29±50.26)mg/L, (12.51±5.51)×10 9/L, respectively, and there were statistically significant differences among the four groups( F=50.744, 5.195, 4.303, 5.252, all P<0.01). With the increase of PCT, the levels of WBC, CRP and HOMA-IR were increased, and HOMA-IR was positively correlated with PCT( r=0.265, P=0.017). Conclusion:Serum level of PCT has correlation with infection degree of diabetic foot and is positively correlated with insulin resistance.
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Objective To assess the clinical effect of anisodamine combined with gabapentin on painful diabetic neuropathy(PDN).Methods From June 2013 to February 2017,120 patients with PDN in the Fifth People's Hospital of Datong were assigned into anisodamine group,gabapentin group and combined group according to the digital table,with 40 cases in each group,the patients were treated with anisodamine,gabapentin and combination therapy respectively.The abnormal foot plantar pressure,MCV and SCV of median nerve and common peroneus nerve,VAS and total effective rate of three groups were compared.Results After treatment,the indicators of the combined group were improved more significantly than those of the anisodamine group and gabapentin group in abnormal foot plantar pressure[(6.10 ± 1.66) vs.(10.80 ± 2.64) vs.(6.37 ± 1.44),F =14.602,P ＜ 0.01],total effective rate (92.5％ vs.62.2％ vs.75.0％,x2 =10.155,P=0.006),MCV[(50.33 ±5.54)m/s vs.(41.12 ±4.47)m/s vs.(42.32 ±4.40)m/s,F=9.404,P =0.001],and SCV of median nerve[(48.51 ±6.19)m/s vs.(41.81 ±5.72)m/s vs.(41.76 ± 7.17) m/s,F =3.728,P =0.037],MCV of common peroneus nerve [(40.60 ± 5.69) m/s vs.(32.04 ± 4.47) m/s vs.(33.52 ± 7.76) m/s,F =5.614,P =0.009] and SCV of common peroneus nerve [(42.72 ± 4.97) m/s vs.(36.21 ± 6.16) m/s vs.(35.45 ± 5.54) m/s,F =4.265,P =0.025].After treatment,the VAS scores of the three groups decreased,which were (4.49 ± 1.61) points,(5.82 ± 1.58) points,(6.37 ± 1.44) points,respectively,the difference was statistically significant (F =14.602,P =0.000),and the decrease was more significant in the combined group.Conclusion Compared with the anisodamine group and gabapentin group,the combined treatment is more effective on PDN.
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Objective To investigate the application of staged teaching method in clinical teaching of gastroenterology. Methods 64 students were randomly divided into two groups: group A (n=32) was taught by traditional teaching method and group B (n=32) by staged teaching method. The scores of clinical technique skills, comprehensive cases and total scores were compared between the two groups. SPSS 19.0 was used for t test and statistical significance was established at a P value of less than 0.05. Results The scores of technique skill in group B were higher than that in group A , but there was no statistical significance. The scores of comprehensive cases in group B were higher than that in group A, and there was statistical significance . The total scores in group B were higher than those in group A , and there was statistical significance (P=0.003). Conclusion The staged teaching method could be promoted for its advantages in encouraging the students' interest in study, improving their ability to analyze problems and elevating their ability of practice.
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Objective To study the clinical effect of fasudil plus cattle encephalon glycoside and ignotin injection in treating diabetic deafness and tinnitus.Methods From January 2016 to December 2016,60 patients with diabetic deafness and tinnitus in the Fifth People＇s Hospital of Datong were selected and randomly divided into two groups according to the digital table ,with 30 cases in each group.The treatment group received fasudil injection plus cattle encephalon glycoside and ignotin injection (iv gtt),and the control group received cattle encephalon glycoside and ignotin injection.The effective rate after treatment for 10 days and 20 days were compared between the two groups.Results Compared with the control group ,the effective rate of hearing in the treatment group was not higher at 10 days after treatment (26.7%vs.16.7%,χ2 ＝0.884,P＝0.347),while it was higher in the treatment group at 20 days after treatment (53.3%vs.26.7%,χ2 ＝4.444,P＝0.035).The effective rate of tinnitus in the treatment group at 10 days after treatment was not higher compared with the control group (30.0%vs.20.0%,χ2 ＝1.491,P＝0.222),while it was higher in the treatment group at 20 days after treatment (56.7% vs.30.0%,χ2 ＝4.344,P＝0.037).As far as hearing threshold :there were no statistically significant differences between the control group and the observation group before treatment and 10 days after treatment ( all P ＞0.05).The hearing threshold of the observation group was significantly better than that of the control group at 20 days after treatment (t＝－2.511,P＝0.02 ).Conclusion The combination therapy of fasudil injection plus cattle encephalon glycoside and ignotin injection has better efficacy for diabetic deafness and tinnitus.
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OBJECTIVE@#To evaluate the feasibility of applying intracranial lead reconstruction in deep brain stimulation (DBS) therapy for Parkinsonism.@*METHODS@#We retrospectively collected the clinical data from 27 patients with Parkinson's disease (PD), who received bilateral subthalamic nucleus (STN) DBS therapy between January, 2016 and December, 2017. According to the position of the selected optimal stimulating contact of the implanted leads, the patients were divided into group A with the stimulating contacts of the bilateral leads in the STN, group B with unilateral stimulating contacts in the STN, and group C with bilateral stimulating contacts outside the STN. All the patients were assessed for improvement using Hoehn-Yahr stage, the third part of United Parkinson's Disease Rating Scale (UPDRS Ⅲ), Schwab and England Activities of Daily Living (SE-ADL), and L-dopa equivalent daily dose (LEDD). The consistency between the optimal stimulating contact selected by lead reconstruction and that by standard postoperative programming procedure was also evaluated.@*RESULTS@#The patients in all the 3 groups showed postoperative improvements in Hoehn-Yahr stage, UPDRS Ⅲ score, SE-ADL score, and LEDD in the medication-off state. But at 12 months of the follow-up, such improvements were maintained only in the patients of group A. The optimal stimulating contacts selected by lead reconstruction and standard postoperative programming procedure had a matching rate of up to 77.78% (42/54), and the coordinates of the optimal contacts selected by the two methods showed no significant difference.@*CONCLUSIONS@#Intracranial lead reconstruction facilitates the study of the association between the implant site of the leads and the clinical outcome of DBS therapy for PD and allows the precise selection of the optimal contact of the implanted leads in postoperative programming of DBS.
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Humans , Activities of Daily Living , Deep Brain Stimulation , Parkinson Disease , Retrospective Studies , Treatment OutcomeABSTRACT
Objective@#To study the clinical effect of fasudil plus cattle encephalon glycoside and ignotin injection in treating diabetic deafness and tinnitus.@*Methods@#From January 2016 to December 2016, 60 patients with diabetic deafness and tinnitus in the Fifth People's Hospital of Datong were selected and randomly divided into two groups according to the digital table, with 30 cases in each group.The treatment group received fasudil injection plus cattle encephalon glycoside and ignotin injection (iv gtt), and the control group received cattle encephalon glycoside and ignotin injection.The effective rate after treatment for 10 days and 20 days were compared between the two groups.@*Results@#Compared with the control group, the effective rate of hearing in the treatment group was not higher at 10 days after treatment (26.7% vs.16.7%, χ2=0.884, P=0.347), while it was higher in the treatment group at 20 days after treatment (53.3% vs.26.7%, χ2=4.444, P=0.035). The effective rate of tinnitus in the treatment group at 10 days after treatment was not higher compared with the control group (30.0% vs.20.0%, χ2=1.491, P=0.222), while it was higher in the treatment group at 20 days after treatment (56.7% vs.30.0%, χ2=4.344, P=0.037). As far as hearing threshold: there were no statistically significant differences between the control group and the observation group before treatment and 10 days after treatment(all P>0.05). The hearing threshold of the observation group was significantly better than that of the control group at 20 days after treatment (t=-2.511, P=0.02).@*Conclusion@#The combination therapy of fasudil injection plus cattle encephalon glycoside and ignotin injection has better efficacy for diabetic deafness and tinnitus.
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Objective@#To assess the clinical effect of anisodamine combined with gabapentin on painful diabetic neuropathy(PDN).@*Methods@#From June 2013 to February 2017, 120 patients with PDN in the Fifth People's Hospital of Datong were assigned into anisodamine group, gabapentin group and combined group according to the digital table, with 40 cases in each group, the patients were treated with anisodamine, gabapentin and combination therapy respectively.The abnormal foot plantar pressure, MCV and SCV of median nerve and common peroneus nerve, VAS and total effective rate of three groups were compared.@*Results@#After treatment, the indicators of the combined group were improved more significantly than those of the anisodamine group and gabapentin group in abnormal foot plantar pressure[(6.10±1.66) vs.(10.80±2.64) vs.(6.37±1.44), F=14.602, P<0.01], total effective rate (92.5% vs.62.2% vs.75.0%, χ2=10.155, P=0.006), MCV[(50.33±5.54)m/s vs.(41.12±4.47)m/s vs.(42.32±4.40)m/s, F=9.404, P=0.001], and SCV of median nerve[(48.51±6.19)m/s vs.(41.81±5.72)m/s vs.(41.76±7.17)m/s, F=3.728, P=0.037], MCV of common peroneus nerve[(40.60±5.69)m/s vs.(32.04±4.47)m/s vs.(33.52±7.76)m/s, F=5.614, P=0.009]and SCV of common peroneus nerve[(42.72±4.97)m/s vs.(36.21±6.16)m/s vs.(35.45±5.54)m/s, F=4.265, P=0.025]. After treatment, the VAS scores of the three groups decreased, which were (4.49±1.61)points, (5.82±1.58)points, (6.37±1.44)points, respectively, the difference was statistically significant(F=14.602, P=0.000), and the decrease was more significant in the combined group.@*Conclusion@#Compared with the anisodamine group and gabapentin group, the combined treatment is more effective on PDN.
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Objective To analyze whether studying abroad has any influence on clinicians′scientific research ability, and study the rationality of the indicators reflecting the scientific research ability. Methods A total of 36 clinicians who studied abroad more than 3 months between 2008 and 2010 were selected as the abroad group, and the control group of 36 clinicians was selected from the clinician information database of the hospital by the method of Propensity Score Match.A comparison and analysis were made regarding the number of papers(SCI), grants and scientific and technological achievements between the two groups. Meanwhile, covariance analysis was used to compare the difference in the number of scientific research achievements between the two groups.Logistic regression analysis was used to compare the changes in scientific research achievements of clinicians before and after their abroad study. Results The number of articles( SCI) published and grants obtained in the 3 years after going abroad was significantly higher than that of the control group, and the number of grants obtained in the 4-6 years after going abroad was also significantly higher than that in the control group.The number of papers(SCI)published in the three years after going abroad was more than that in the 3 years before going abroad.The number of grants obtained in the 4-6 years after going abroad was more than that in the 3 years before going abroad.These differences were statistically significant. Conclusions Studying abroad has a beneficial effect on the improvement of clinicians′ scientific research ability. It is reasonable and practical to take the number of SCI articles published as the indicator of short-term changes and the number of funds obtained as the indicator of long-term changes in scientific research ability.
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Objective Through the investigation of the research funding status of returnees before and after their long-term (more than 3 months) study at abroad in a three class hospital,this paper analyzed the influence of the hospital level initial funding to help young talent to obtain scientific research funding,discussed appropriate measurement to enhance the scientific research capacity of hospital young talents to provide reference for management.Methods Long-term sponsored study abroad returnees from 2005 to 2015 of this hospital were recruited as subjects,divided into two groups according to whether they got the hospital-level initial funding after returning,comparative analysis was conducted to understand the influence of such funding to help obtaining subsequent research projects of these young talents.Results The number of subjects per capita returned to the obtained group was higher than that of the non obtained group,and the proportion of high-level subjects at provincial and ministerial levels was higher than that of the non-obtained group (P＜0.05),and the average time interval between the groups after returning home was less than that of the non-obtained group (P＜0.05).Conclusions The hospital-level initial funding for overseas returnee can obviously improve the quality and speed of the subsequent projects of the young talents in the hospital,and have a significant positive effect on mobilizing the enthusiasm for scientific research,improving their scientific re search ability,and improving the overall scientific research level and competitiveness of the hospital.
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Objective@#To investigate the clinical value of diagnosing hepatic fibrosis in the HBeAg negative chronic hepatitis B virus (HBV) carriers by hepatic fibrosis model of Mohamadnejad (M model) and the hepatic instantaneous elastic detector (FibroScan, FS).@*Methods@#A total of 217 patients were included: they were diagnosed as the HBeAg negative chronic HBV carriers. The value of the hepatic fibrosis was calculated by M model formula, liver stiffness measurements (LSM) was surveyed by FS, and all patients underwent liver biopsy in the same period. According to the degree of hepatic fibrosis in Knodell, one decision point was set: significant hepatic fibrosis (S ≥ 2). The Spearman correlation analysis method was used to analyze the correlation of indicators and the area under receiver operator characteristic curve (AUROC) of M model and FS was drawn.@*Results@#LSM and M model were positively correlated with the fibrosis stage of liver biopsy (r=0.64, 0.80, P=0.000, 0.000, <0.01). The diagnostic sensitivity, positive likelihood ratio, specificity and negative predictive value of M model and FS for the HBeAg negative chronic HBV carriers with significant hepatic fibrosis were 88.10%, 13.02, 93.23%, 92.50% and 82.14%, 5.20, 84.21%, 88.20%, respectively. The diagnostic AUROC of significant hepatic fibrosis were 0.927 and 0.858, respectively. It had significant statistical difference (Z=2.12, P<0.05).@*Conclusions@#M model and FS are noninvasive and ideal tools for screening HBeAg negative chronic HBV carriers with significant hepatic fibrosis. The value of diagnosing significant hepatic fibrosis in the HBeAg negative chronic HBV carriers by M model was remarkably higher than that of FS.
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Objective To evaluate the clinical effect of venenum bufonis combined with antibiotics in the treatment of bacterial liver abscess .Methods 60 patients with bacterial liver abscess were enrolled ,and all patients took percutaneous transhepatic puncture guided by ultrasound .They were randomly divided into two groups according to the digital table ,30 cases in each group .The control group received antibiotics treatment ,and the treatment group received venenum bufonis plus antibiotics intravenous drip ,once daily ,one course of treatment lasted seven days .The body temperature , blood routine , procalcitonin and other project changes of the two groups were detected .Results Compared with the control group,the effective rate of the treatment group was higher (96.7％ vs.80.0％,χ2 =4.043,P=0.044).In the treatment group,the time of body temperature returning to normal [(7.00 ±1.67)d vs. (9.00 ±1.41)d],leukocyte recovery time [(7.83 ±2.32) d vs.(9.82 ±1.94) d],procalcitonin recovery time [(7.00 ±1.67)d vs.(9.00 ±1.41)d],symptom disappearance time [(5.17 ±1.72)d vs.(7.50 ±1.87)d],disap-pearance time of abscess[(12.00 ±3.41)d vs.(16.00 ±2.37)d]were shorter than those in the control group(t=-2.601,-2.890,-2.236,-2.248,-2.362,P=0.026,0.016,0.049,0.044,0.041).Conclusion Venenum bufonis combined with antibiotics can significantly increase the curative rate and accelerate infection control , there-fore,it is worthy of popularizing in clinical practice .
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The paper presented the " Professors Evaluation System" initiated by the hospital since July 2009, which was designed for quantitative assessment of senior medical professionals of non-management category in terms of their performance in medical, teaching, research and management work. Seven periods of appraisal have witnessed a significant elevation of the rate of excellence among such professionals, proving that such a system can motivate and guide these professionals to continuously improve their competence in medical, teaching, research and management work.
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Objective To evaluate the feasibility and effectiveness of the application of IQQA (Intelligent/interactive Qualitative and Quantitative Analysis) three-dimensional reconstruction technique in precise laparoscopic or robot-assisted laparoscopic partial nephrectomy (LPN or RAPN) for renal hilar tumors.Methods The study retrospectively reviewed 11patients with hilar tunors from February 2016 to February 2017.Of the 11 patients,4 were women and 7 were men,with an average age of 51 years (range 38 to 70 years).The average tumor size was 3.1 cm (range 1.7 to 4.3 cm).For tumor stage,9 patients were in T1a stage and 2 patients were in T1b stage.Tbe average R.E.N.A.L score was 8.7 (range 7 to 10).The mean preoperative GFR was 40.6 ml/min (range 32 to 45 ml/min).IQQA three-dimensional reconstruction technique was applied for the purpose of precise navigation and resection of the tumors.Multivariate analysis was used to identify predictors of warm ischemia time,estimated blood loss,major perioperative complications,and postoperative renal function.Results All 11 laparoscopic or robot-assisted laparoscopic hilar partial nephrectomies were successfully completed without conversion to a hand-assisted or an open approach.Under the navigation of IQQA,all tumors were found precisely at the first time during surgeries.The final pathologic examination revealed that all the 11 patients were clear cell renal cell carcinomas.The mean operative time was 142 minutes (range 90 to 230 minutes),with a mean warm ischemia time of 24 minutes (range 17 to 33 minutes).The estinated blood loss was 146 ml (range 50 to 400 ml).No intraoperative complications occurred.Two patients suffered from postoperative complications.One patient with gross hematuria was recovered by consistent bladder irrigation.The other patient with postoperative hemorrhage needed transfusion.All patients had negative margins on the final pathologic examination.At a mean follow-up period of 3 months,the mean GRR is 22.5 ml/min (range 13 to 34 ml/min) without any disease recurrence.Conclusions With peculiar features,such as accurate location,complete resection and fewer perioperative complications,the application of IQQA three-dimensional reconstruction technique in precise partial nephrectomy represents a safe and effective procedure for hilar tumors.
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Objective To explore the effect of Rhodiola kirilowii Regel combined with calcium dobesilate in the treatment of early diabetic nephropathy.Methods 80 patients with early diabetic nephropathy were selected,and they were divided into treatment group and control group according to the digital table,40 cases in each group.The two groups were given diet control and appropriate exercise and positive controlled blood sugar,blood fat,blood pressure.The control group was given calcium dobesilate,based on this,the treatment group was given Rhodiola kirilowii Regel 10mL into 5％ glucose injection 250mL and 3 unit insulin to intravenous drip.The period of treatment was fifteen days.The UAER,Scr and BUN were compared between two groups before treatment and fifteen days after treatment.Results Before treatment,the Scr,BUN and UAER in the control group were (88.00 ± 18.19) μmol/L,(5.98 ± 1.92) mmol/L,(123.31 ± 60.01) μg/min respectively,which in the treatment group were (85.80 ± 18.31) μmol/L,(5.96 ± 1.94) mmol/L,(140.21 ± 62.92) μg/min respectively,there were no statistically significant differences between the two groups(t =-1.191,-0.016,0.432,all P ＞0.05).After treatment,the Scr,BUN and UAER in the control group were (84.61 ± 11.71) μmol/L,(6.30 ± 1.37) mmol/L,(97.81 ± 49.16) μg/min respectively,which in the treatment group were (75.60 ± 11.44) μmol/L,(5.25 ± 1.24) mmol/L,(39.81 ± 23.43) μg/min.There were no statistically significant differences in Scr and BUN of the two groups compared with before treatment (the control group:t =0.767,-0.657;the treatment group:t =1.947,1.219,all P ＞ 0.05).There was statistically significant difference in UAER of the two groups compared with before treatnent (t =2.850,5.402;P =0.046,0.006),but UAER of the treatment group after treatment decreased significantly.After treatment,there were no statistically significant differences in Scr and BUN between the two groups (t =-1.229,-1.236,all P ＞ 0.05),while there was statistically significant difference in UAER between the two groups (t =-2.394,P =0.044).The effective rate in the treatment group was 87.5 ％,which was higher than 57.5 ％ of the control group (x2 =9.028,P ＜ 0.05).Conclusion Rhodiola kirilowii Regel combined with calcium dobesilate can ameliorate protenuria and improve renal function of the patients with early diabetic nephropathy.
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Objective To evaluate the clinical curative effect of ulinastatin combined with CRRT in the treatment of multiple organ dysfunction syndrome(MODS).Methods Sixty eight patients with MODS who were admitted to ICU from July 2013 to July 2015 were randomly divided into three groups:control group,CRRT group,combined group;Patients' APACHE Ⅱ,SOFA scores level of inflammatory markers were recorded before treatment and after treatment of 72 hours and 7 days.The mortality of the three groups in ICU were compared.Results After 72 hours and a week of treatment,the level of IL-10,IL-6,TNF-α,WBC、PCT、CRP in CRRT group and combined group were significantly better than that of control group(P＜0.05),and combined group were significantly better than that of CRRT group.Compared with the control group,the oxygen index,lactic acid,ALT significantly im proved in CRRT group and combined group were better than control group,after 72 hours and a week of treatment(P＜0.05),and the cornbined group was the most obvious.After a week of treatment,the mortality rate of CRRT group and combined group was significantly better than the control group (P＜0.05),while there was no statistical differences between CRRT group and combined group(P＞0.05).Conclusion Ulinastatin combined with CRRT is an effective method for the treatment of MODS.
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Objective To discuss the application of the systematic nursing management of "one specialty with four standardizations" in transrectal ultrasound guided prostate Biopsy. Methods We have set up the "one specialty with four standardizations" method and accomplished the systematic nursing management in the management of transrectal ultrasound guided prostate biopsy in Changhai Hospital from September 2014 to February 2015. One specialty means to set up the prostate biopsy full-time nurses and the four standardizations means the standardization of selecting criteria, appointment procedures, working process and the post-biopsy work.Results The whole procedure of prostate biopsy has been simplified and clarified. This management helped to shorten the time for making the appointment, reduce the incidences of postoperative complications significantly and increase the patients satisfaction. It helped to build a well-defined responsibility for all the medical staff in prostate biopsy and make sure the reasonable medical resource distribution and the efficiency of medical work. It also maximized the health rights of the patients and medical safety. During the period when the "one specialty with four standardizations" nursing management was in effect, no biopsy related adverse event, disputes or protests occurred. Both the patients and the relatives satisfaction degree have been raised significantly.Conclusions The "one specialty with four standardizations" nursing management in prostate biopsy helps to simplify the appointment procedure and this management turned out to be safe and effect. It has achieved preferable results in clinical application and worth further spreading.
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Objective To evaluate the clinical effect of Shuxuetong plus external application of deproteinised calf blood serum injection on diabetic ulcer foot.Methods 60 patients with diabetic foot ulcer were enrolled:30 cases (treatment group)were randomly assigned to receive deproteinised calf blood serum injection(external use)plus Shuxuetong(iv gtt),and the other 30 cases (control group)received routine western medicine therapy.One course of treatment lasted one month.In addition,both two groups received insulin to control blood sugar and antibiotics to control infection,with foot ulcer treated with debridement,drainage,and removal of necrotic tissue etc.Results Com-pared with the control group,the effective rate was higher in the treatment group(86.7% vs.60.0%,χ2 =5.455,P =0.020).The occurrence time of granulation tissue[(6.60 ±1.14)d vs.(10.80 ±2.17)d,t =-3.834,P =0.008] and wound healing time[(23.62 ±6.14)d vs.(35.65 ±4.45)d,t =-4.405,P =0.002]were shorter in the treat-ment group.The wound area in the two groups reduced after treatment,and the wound area in the treatment group reduced significantly[(3.48 ±1.16)cm2 vs.(8.60 ±2.51)cm2 ,t =-4.143,P =0.007].Conclusion As com-pared with the routine therapy with western medicine,the combination therapy of deproteinised calf blood serum injec-tion plus Shuxuetong has better efficacy for diabetic ulcer foot.