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Objective To investigate the efficacy of real-time visual feedback on improving the quality of manual chest compression in ambulance.Methods Ten pre-hospital doctors with cardiopulmonary resuscitation experience,aged under 40 years,were recruited to this randomized,crossover,manikin research and randomly assigned into control group (n=5) and feedback group (n=5) by the sealed envelope method.The setting place was a moving ambulance with the velocity of 25～50 km/ h.The whole process consisted of two sessions.In control group,which received feedback in the second session,chest compressions were performed without interruption during each of the three 2 min phases per session,resting for 2 min between phases and for 5 min between sessions.In feedback group,which received feedback in the first session,chest compressions were performed without interruption during each of the three 2 min phases per session,resting for 2 min between phases and for 5 min between sessions.Data of compression rate,compression depth,compression detention and compression accuracy rate were collected.Results In control group,the compressions rate was lower and compression detention was shorter during the second session compared with those during the first session [(109.8±±4.7) r/min vs.(121.2± 10.1) r/min,(6.5±2.1) r/min vs.(10.4±2.8) r/min,all P＜0.05],while the compression accuracy rate during the second session was higher than that during the first session [(28.2±±14.3) ％ vs.(16.8±9.9) ％,P＜0.05].There was no significant difference in compression rate between the two sessions in control group;Compression frequency,compression depth,compression detention and compression accuracy rate did not significantly change between the two sessions in feedback group (all P＞0.05).In the whole process,the compression rate was lower and compression detention was shorter in the feedback group compared with the control group [(111.1±5.1) r/min vs.(115.5±9.7) r/min,(6.5±1.8) vs.(8.4±4.6) r/min,all P＜0.05],and the compression accuracy rate in the feedback group was higher than that in the control group[(22.5±13.4) ％ vs.(26.7±16) ％,P＜0.05].There was no significant difference in compression rate between the two groups during whole process (P＞0.05).Conclusions Although real-time visual feed back improved the quality of manual chest compression in ambulances,which demonstrated more reasonable compression rate,less compression detention and higher compression accuracy,the overall quality of reuscitation was still not enough to achieve effective treatment.This implies that more optimal methods are required to transfer the patients suffering cardiac arrest.
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Objective To investigate the impact on the endothelial cell function and renal blood flow through effective treatment for elderly patients with hypertension. Methods 64 cases of elderly hypertensive patients over 70years old with effective treatment, according to pre-treatment blood pressure, were divided into two groups: hyptension level-2 group(30cases) and hypertension level-3 group(34cases), and 30 cases of elderly people with health physical examination during the same period were setlected as the control group. Endothelial cell function was detected, including the endothelin-1 (ET-1)、 nitrous oxide (NO), thromboxane B2 (TXB2)、 6-keto-prostaglandinF1α (6-K-PDGF1α) in plasma. Renal blood flow was explored by color doppler ultrasonic instrument ,involving peak velocity in systole(PSV) and lowest velocity in end-diastole(EDV) of renal arteries, segmental arteries and interlobar arteries.After indicators had reached the standard 1 month in the hypertension level-2 and hypertension leve1-3 patients with effective antihypertensive therapy, the difference of ET-1, NO, TXB2,6-k-PGF1o and PSV, EDV among the three groups were compared. Results The differences were statistically significant in ET-1, NO, TXB2,6-k-PGF1α, PSV and EDV before treatment among three groups (P ＜ 0.05). After blood pressure treated had reached the standard 1 month,indicators were no statistically meaningful difference among the three groups (P ＞ 0.05). Conclusion After effective clinical treatments, the endothelial cell function and renal blood flow of the elderly hypertensive patients can be improved. At the same time, to delay renal damage in elderly patients with hypertension provide a theoretical basis.
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BACKGROUND: The nomination of undifferentiated spondyloarthropathy (USpA) has provided clues for the early diagnosis of spondylitis ankylopoietica and other subsets of SpA, thereby avoiding possible wrong treatments.OBJECTIVE: To investigate the prevalence of SpA in the workers and their adult relatives aged over 16 years old from a factory in Beijing urban district, as well as the results of human major histocompatibility complex (MHC) B27 and X-ray inspection on sacroiliac joint.DESIGN: Systematic sampling investigation.SETTING: Department of Internal Medicine, Chenghai District People's Hospital of Shantou City; Rheumatism Research Institute, Medical College of Shantou University; Department of Internal Medicine, Beijing Chaoyang Hospital.PARTICIPANTS: A survey was conducted among 1982 workers and their adult relatives aged over 16 years from a factory in Beijing urban district between May and October 1999; there were 1,025 males and 957 females.They all volunteered into this study after informed of the experiment.METHODS: All examinees were surveyed door to door with the modified Chinese-International Anti-rheumatic Alliance Rheumatism Questionnaire,those with positive results were subjected to physical examination and those suspicious cases were subjected to MHC-B27 and X-ray examination.MAIN OUTCOME MEASURES: The prevalence of SpA in the workersand their adult relatives aged over 16 years from a factory in Beijing urban district, as well as the results of MHC-B27 and sacroiliac joint X-ray inspection.RESULTS: Totally 1,982 subjects were enrolled in this study and all entered the result analysis. The prevalence of spondyloarthropathy was 1.61%(32/1 982), amongst which the prevalence of ankylopoietic spondylitis,USpA, and psoriastic arthritis was 0.31% (6/1 982), 1.21% (24/1 982),and 0.10% (2/1 982), respectively. No other subsets of SpA were observed. USpA was mainly presented by inflammatory lumbago and asymmetric arthrosteitis [83% (20/24), 62% (15/24)], while rheumatoid factor was negative in all subjects. Meanwhile, MHC-B27 was proved positive in 25% (6/24) subjects with the male-to-female ratio of 1.2:1.CONCLUSION: The prevalence of SpA is 1.61% in Beijing urban area,and SpA mainly consists of ankylopoietic spondylitis and USpA.
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<p><b>OBJECTIVE</b>To evaluate the prevalence of primary gout in the Shantou area, China, and to understand its clinical features.</p><p><b>METHODS</b>Samples from three surveys of the Chenghai across ten years were studied. Clinical, laboratory and radiology data of 419 cases of primary gout were collected and analyzed.</p><p><b>RESULTS</b>Prevalence of primary gout in the three surveys were 0.17%, 0.15% and 0.26%, respectively. Among the clinical patients, the ratio of male to female was 21:1; the average age of onset of women was significantly higher than that of men. The number of cases in the last ten years has been increasing. In the first wave of cases, the first metatarsophalangeal joint was involved in 82.1% of all cases; no fourth metatarsophalangeal joint involvement had been observed. Hyperlipemia was the most common accompanying abnormal laboratory test (57.1%). Radiographic bone erosion was found in 49.4% patients, most of them with disease duration more than 5 years.</p><p><b>CONCLUSIONS</b>The prevalence of primary gout in Shantou area has been increasing in the last ten years. Changes in diet and lifestyle may be responsible for this rapid increase.</p>