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Objective To compare the effects of different blood purification methods on blood lipid metabo-lism and malnutrition in maintenance hemodialysis patients. Methods From January 2015 to May 2017,80 patients with maintenance hemodialysis admitted in Wuyi Traditional Chinese Medicine Hospital of Jiangmen were selected. The patients were divided into study group and control group according to the random number table method,with 40 cases in each group. The control group was treated with hemodialysis,the study group was treated with hemoperfusion combined with hemodialysis,all patients were treated for 12 weeks. The levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol(LDL - C),hemoglobin(Hb),total protein(TP),albumin(Alb),transferrin (TRF),interleukin 6(IL - 6) and tumor necrosis factor α(TNF - α) were compared before and after treatment. The incidence of complications at the same time were observed. Results After treatment,the levels of TC,TG,LDL - C in the study group were (4. 39 ± 0. 91) mmol/ L,(1. 41 ± 0. 20) mmol/ L,(2. 55 ± 0. 31) mmol/ L,respectively,which were lower than those in the control group [(6. 21 ± 0. 55)mmol/ L,(1. 83 ± 0. 50)mmol/ L,(3. 05 ± 0. 63)mmol/ L] (t = 10. 825,4. 933,4. 504,all P < 0. 05). After treatment,the levels of Hb,TP,Alb,TRF in the study group were (106. 83 ± 22. 05)g/ L,(62. 14 ± 22. 50)g/ L,(38. 30 ± 6. 48) g/ L,(19. 70 ± 2. 20) g/ L,respectively,which were higher than those in the control group [(94. 28 ± 13. 17)g/ L,(52. 38 ± 12. 37)g/ L,(33. 17 ± 6. 80)g/ L,(16. 24 ± 1. 54)g/ L] (t = 3. 090,2. 404,3. 454,8. 146,all P < 0. 05). After treatment,the levels of IL - 6,TNF - α in the study group were (124. 52 ± 107. 23)ng/ L,(72. 13 ± 12. 55)ng/ L,respectively,which were lower than those in the control group [(294. 14 ± 108. 92) ng/ L, (112. 45 ± 21. 29) ng/ L] ( t = 7. 019,10. 318, all P < 0. 05). The incidence rate of complications of the study group was 5. 00％ ,which was lower than 22. 50％ of the control group (χ2 = 5. 165,P < 0. 05). Conclusion Hemoperfusion combined with hemodialysis in maintenance hemodialysis patients can improve their blood lipid metabolism and malnutrition,reduce inflammation and the risk of complications.
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Objective To investigate the clinical application of Morse Fall Scale by primary nurses.Methods Morse Fall Scale was used to assess the falling risk in 21,378 patients by the primary nurses.The application of the Morse Fall Scale, choices of right time for assessment and the occurrence of falls in patients with risks of falling were evaluated by a self-designed questionnaire.Results Among 21,378 patients, 222 patients were at risk of falling.In terms of the items like the history of falls,more than one diagnosis,intravenous injection,the accuracy of assessment was above 91.6%.In terms of the items like aided walking,gait,cognitive state,the assessment accuracy is below 86.0%.The accuracy of assessment timing selection in the situations like admission,the score by Morse fall scale over 24at admission and the accuracy in choosing right time for assessment was was above 90.2% after transferring to other deparments and falling.The accuracy in choosing the right time for fall assessment was below 67.9% under such conditions as apostasies,and oral administration of drugs probably leading to fall. Conclusions It is acceptable that the primary nurses use the Morse fall scale to assess patients with risky falls and for the right choice of assessment.Attention should be paid to strengthen the nurses training to improve the accuracy of the scale,to make sure to choose right time for the assessment so as to prevent the falls of patients to the greatest extent.
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Objective To observe the clinical efficacy of alprostadil combined with valsartan in treatment of chronic glomerulonephritis proteinuria.Methods 78 patients with chronic glomerulonephritis proteinuria were randomly divided into two groups,and each group had 39 cases.The control group was given conventional treatment,while the observation group was given alprostadil combined with valsartan on the basis of the control group.The clinical outcomes were compared between the two groups.Results The total effective rate of the observation group was 92.31％,which was significantly higher than 74.36％ of the control group (x2 =9.825,P ＜ 0.05).After treatment,the 24h Upro,BUN and SCr of the observation group were (1.00 ± 0.39) g/24h,(7.11 ± 0.15) mmol/L and (80.86 ± 0.65) μmol/L,which were significantly lower than those of the control group [(1.30 ± 0.48) g/24h、(9.18 ± 2.21) mmol/L and (98.71 ± 4.34) μmol/L],the differences were statistically significant (t =9.32,7.83,7.12,all P ＜ 0.05).Conclusion Alprostadil combined with valsartan in the treatment of chronic glomerulonephritis proteinuria has significant effect,and it can significantly alleviate clinical symptoms,improve renal function,which should be widely applied in clinical.
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Objective To discuss operative treatment of old fractures of pelvis. Methods Since February 2000, 14 cases with old fracture of pelvis have been treated in our hospital with operative scar or callus settlement, traction and reduction, and internal fixation. Results All patients were followed up from 6 months to 3 years and 6 months. According to such indexes as pelvic shape, length difference between lower limbs, gait, and radiogram, the scores were excellent in 8 cases, fine in 4 and poor in 2, with the excellent and good rate being 85.7%. Conclusion With reasonable design and appropriate method, operative treatment is fit for old fractures of pelvis because it can avoid severe disability and improve the quality of life of the patients.