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Objective:To investigate the information demand level and its influencing factors of cardiac rehabilitation in patients after PCI, in order to provide scientific basis for doctors and nurses to formulate cardiac rehabilitation intervention strategies.Methods:A total of 146 patients after PCI were investigated with general data questionnaire and Cardiac Rehabilitation Inventory in the First Affiliated Hospital of Dalian Medical University from December 2019 to February 2020, and multiple linear regression was used to analyze the influencing factors of cardiac rehabilitation information demand.Results:The average scores of each dimension of Cardiac Rehabilitation Inventory after PCI were autonomy, process anxiety and result anxiety from high to low. Multiple linear regression showed that occupational type was a significant predictor of autonomy of patients after PCI, which could explain 4.6% of the variation of autonomy, and autonomy of in-service patients after PCI was higher than that of retirees ( t=2.81, P<0.05). Sex and age were significant predictors of process anxiety of patients after PCI, which could explain the variation of 8.6% of process anxiety. The occupational type, the medical insurance type and whether they had received professional rehabilitation guidance during hospitalization were significant predictors of anxiety after PCI, which could explain the 15.2% variation of anxiety, and the anxiety of in-service patients after PCI was lower than that of retirees ( t=-3.76, P<0.05). Conclusions:The level of cardiac rehabilitation information needs of patients after PCI is worthy of attention. Medical staff can give targeted, personalized and different forms of cardiac rehabilitation in the process of cardiac rehabilitation, and emphasize the implementation of health education and guidance for their cardiac rehabilitation in order to meet their cardiac rehabilitation information needs, improve their autonomy and alleviate their anxiety.
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Objective To evaluate the feasibility and safety of tracheal extubation in operating room for patients with end-stage chronic obstructive pulmonary disease (COPD) after single-lung transplantation. Methods Clinical data of 57 recipients who underwent single-lung transplantation due to end-stage COPD were retrospectively analyzed. According to the evaluation indexes of tracheal extubation in operating room established by our hospital, 17 recipients eligible for tracheal extubation in operating room were assigned into the operating room extubation group (OR extubation group) and 40 recipients receiving tracheal extubation in intensive care unit (ICU) were allocated in the ICU extubation group. The evaluation results of intraoperative tracheal extubation and postoperative recovery were compared between two groups. Results Compared with the ICU extubation group, recipients in the OR extubation group had higher oxygenation index, lower arterial partial pressure of carbon dioxide (PaCO2), lower blood lactic acid level, less fluctuation range of blood pressure and fewer cases receiving extracorporeal membrane oxygenation (ECMO) during operation (all P < 0.05). Two recipients in the OR extubation group received repeated tracheal intubation at 6 and 8 h after returning to ICU, and tracheal extubation at postoperative 6 and 9 d. In the OR extubation group, time of postoperative mechanical ventilation, length of postoperative ICU and hospital stay of the recipients were shorter than those in the ICU extubation group (all P < 0.05). The incidence of grade 3 primary graft dysfunction (PGD), atrial tachyarrhythmia, continuous renal replacement therapy and 1-year survival rate did not significantly differ between two groups (all P > 0.05). Conclusions The tracheal extubation regimen in the operating room for COPD patients after single-lung transplantation established by our hospital is safe and feasible, which shortens the time of postoperative mechanical ventilation, the length of postoperative ICU and hospital stay, whereas does not increase the incidence of postoperative complications.
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Objective:To investigate the prognosis of severe hyperbilirubinemia in full-term infants who met the exchange transfusion criteria and were treated by blood exchange transfusion and phototherapy.Methods:A total of 168 full-term infants with severe hyperbilirubinemia who met the criteria for exchange transfusion and were hospitalized in the Neonatology Department of seven tertiary hospitals in Hebei Province from June 2017 to December 2018 were retrospectively included. According to the treatment protocol, they were divided into two groups: exchange transfusion group (38 cases) and phototherapy group (130 cases). Two independent sample t-test and Chi-square test were used to compare the clinical manifestations and follow-up results between the two groups. Multivariate logistic regression was used to analyze the risk factors for poor prognosis. Results:Neonatal severe hyperbilirubinemia in the exchange transfusion and phototherapy group were both mainly caused by hemolytic disease [42.1%(16/38) and 29.2%(38/130)], sepsis [28.9%(11/38) and 11.5%(15/130)] and early-onset breastfeeding jaundice [15.8%(6/38) and 11.5%(15/130)]. Total serum bilirubin level on admission in the exchange transfusion group was significantly higher than that in the phototherapy group [(531.7±141.3) vs (440.0±67.4) μmol/L, t=3.870, P<0.001]. Moreover, the percentage of patients with mild, moderate and severe acute bilirubin encephalopathy in the exchange transfusion group were higher than those in the phototherapy group [15.8%(6/38) vs 3.8%(5/130), 7.9%(3/38) vs 0.8%(1/130), 13.2%(5/38) vs 0.0%(0/130); χ2=29.119, P<0.001]. Among the 168 patients, 135 were followed up to 18-36 months of age and 12 showed poor prognosis (developmental retardation or hearing impairment) with four in the exchange transfusion group (12.9%, 4/31) and eight in the phototherapy group (7.7%, 8/104). Multivariate logistic regression analysis showed that for full-term infants with severe hyperbilirubinemia who met the exchange transfusion criteria, phototherapy alone without blood exchange transfusion as well as severe ABE were risk factors for poor prognosis ( OR=14.407, 95% CI: 1.101-88.528, P=0.042; OR=16.561, 95% CI: 4.042-67.850, P<0.001). Conclusions:Full-term infants who have severe hyperbilirubinemia and meet the exchange transfusion criteria should be actively treated with blood exchange transfusion, especially for those with severe ABE, so as to improve the prognosis.
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Objective To explore the clinical effect of dopamine,phentolamine,recombinant interferon α combined with nasal continuous positive airway pressure(CPAP) ventilation in treating severe infantile bronchiolitis.Methods Ninety-five cases of infantile severe bronchiolitis were divided into the observation group(55 cases) and control group (40 cases).The control group was given the combined treatment scheme of dopamine,phentolamine and recombinant interferon α,while on this basis the observation group was added with NCPAP.The curative effects were compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the control group(P0.05);the recurrence rate and death rate in the observation group were significantly lower than those in the control group with statistical difference(P0.05).Conclusion Dopamine,phentolamine,recombinant interferon α combined with NCPAP has obviously clinical effect for treating infantile severe bronchiolitis,can effectively improve the blood gas analytical indexes,reduces the signs and symptoms relief time,reduces the rates of relapse and death,and has higher clinical application value.
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OBJECTIVE:To observe the efficacy and safety of azithromycin sequential therapy combined with terbutaline in the treatment of mycoplasma pneumonia. METHODS:130 children with mycoplasma pneumonia were randomly divided into control group and observation group. Control group was given azithromycin sequential therapy by using 10 mg/kg Azithromycin dispersible tablet by intravenous infusion,once a day,for continuous 3-5 d,then rested for 4 d,and then given 10 mg/kg Azithromycin dis-persible tablet at a draught,once a day,for continuous 3 d,then rested for 4 d;observation group was additionally given 2.5 mg Terbutaline injection adding into 5 ml sodium chloride injection by inhalation via oxygen atomization,twice a day,10-15 min ev-ery times,and then the children were fed with warm boiled waterafter atomization. The treatment course for both groups was 4 weeks. Clinical efficacy,and changes of cytokines levels [tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6),IL-8],disap-peared time of related symptoms and signs (wheezing,rales,coughing,fever),hospitalization time before and after treatment, and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,the effective rate in observation group was significantly higher than control group,levels of TNF-α,IL-6 and IL-8 were significantly lower than control group,disap-peared time of related symptoms and signs and hospitalization time were significantly shorter than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Azithromycin sequential therapy combined with terbutalineaerosol therapycan effectively improve the cytokines levels and clinical efficacy,with good safety.
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Objective To compare classical and molecular typing methods for Streptococcus pneumoniae,in order to provide fasty and accurate method for classification.Methods Selected the 150 strains of Streptococcus pneumoniae which isolated from the First People’s Hospital of Zhaoqing from October 2013 to February 2015 for the research objects,using the classi-cal quellung classification method and molecular typing of multiple PCR method for classification.Compared the result and the rate of the classification,used the non parametric test of two independent samples for statistical analysis several higer rate of serotypes,and calculated the total coincidence rate,sensitivity and specificity.Results The typing rate of Streptococ-cus pneumonia capsular was 53.3%,and the main serum group were 19(32.7%),6(7.3%)and 23(4%)respectively.The serotype of 19F(23.3%),19A(2.7%),6C(2%)and 23F(2.7%)respectively by single factor serum.The typing rate of the multiple PCR method was 76.0%,and the main serum group were 19(41.3%),6(10.7%)and 23(10.7%).The serotype were mainly 19F(32.7%),19A(8.0%),6(10.7%)and 23F(9.3%).Used the 2 Independent Sample Test for statistical a-nalysis,compared with the serotypes 19F,19A and 23F(P>0.05).There was no statistically significant difference in the distribution of the types of the two methods.The total coincidence rate was 74.6%.To verify the classic quellung method by multiple PCR method,sensitivity was 70.2%,and specificity was 100%.That showed the capsular swelling method was less sensitivity than the molecular typing method.Conclusion Compared with the traditional serological typing techniques,mo-lecular typing technique have the advantages of fast,accurate,sensitive and high resolution,and become the classification method which can be rely on.