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Objective To investigate the clinical efficacy of multidisciplinary integrated treatment and management model in the medical management of elderly patients.Methods 226 elderly patients treated in our hospital from October 2014 to December 2015 were randomly divided into observation group and control group,113 cases in each group.Patients in the control group were treated with traditional medical management model,while patients in the observation group were treated with multidisciplinary integrated treatment and management model.The therapeutic effect,hospital stay,incidence of complications,treatment satisfaction,MMSE score,FCA score and Tinetti score between the two groups were compared.Results The total effective rate (95.58%) in the observation group was significantly higher than that in the control group (79.65%) (χ2=13.21,P=0.000).The mortality rate in the observation group (1.77%) was significantly lower than 7.96% in the control group (χ2=4.68,P=0.004).The satisfaction rate of the observation group (92.04%) was significantly higher than 77.88% of the control group (χ2=8.86,P=0.003).The MMSE score[(25.17±4.43)points],FCA score[(77.35±8.35)points]and Tinetti score[(26.45±4.25)points]of the observation group were significantly higher than those in the control group[(20.13±3.07) points,(65.32±8.88) points and (21.03±3.30) points,t=-2.93,-3.11,-3.18;P=0.025,0.014,0.006].Conclusion Multidisciplinary integrated treatment management model can significantly increase the therapeutic effect,shorter hospital stay,reduce the incidence of complications,improve patients' satisfaction,and improve the quality of life,so it is a new type of efficient and rational therapeutic management model and worthy of clinical promoting.
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Objective To investigate the treatment of noninvasive ventilator in chronic obstructive pulmonary disease merge chronic type Ⅱ respiratory failure and to analysis its clinical efficacy and safety.Methods According to the random number table,115 cases were randomly divided into two groups,the observation group (n =59)and the control group(n =56).The control group received conventional symptomatic treatment,while the observation group therapy was combined with non -invasive ventilation in the basis of the control group.The changes of HR,RR, PaCO2 ,PaO2 ,Forced expiratory volume in one second 1 (FEV1 ),Forced expiratory volume in one second 1 (Forced expiratory volume in one second 1,FEV1 /FVC)were compared between the two groups before and after treatment 48h.Results Before treatment,there were no significant differences in HR,PaCO2 ,RR,FEV1 ,PaO2 ,FEV1 /FVC (P >0.05).After the treatment,in the control group,HR,RR,PaCO2 ,PaO2 ,FEV1 and FEV1 /FVC were respectively (90.16 ±4.15)beats/min,(23.17 ±1.63)beats/min,(59.68 ±5.85)mmHg,(69.16 ±5.26)mmHg,(2.65 ± 0.25)L and(65.47 ±1.97)%.In the observation group,HR,RR,PaCO2 ,PaO2 ,FEV1 and FEV1 /FVC were respectively (82.93 ±3.76)beats/min,(19.02 ±1.57)beats/min,(50.82 ±6.53)mmHg,(78.06 ±5.48)mmHg,(2.96 ± 0.31)L and (72.38 ±2.15)%.The difference was statistically significant(t =9.800,13.907,7.649,8.877,5.917, 17.942,all P <0.05).No adverse reactions occurred during the treatment.Conclusion The clinical efficacy of non-invasive ventilator in the treatment of COPD associated with chronic type Ⅱ respiratory failure is significant,safe and reliable,which has important research value,and is worthy of further application.
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Objective:To identify the healing effect of electrospun silk fibroin-BMP-2 as a biologic pulp capping agent to inflammatory pulp in rat caused by lipopolysaccharide ( LPS) .Methods:A total of 30 healthy adult male Wistar rats were randomly divided into five groups:(1) normal control group without operation;(2) blank control group without capping agents;(3) calcium hydroxide capping group;(4) electrospun silk fibroin capping group;(5) electrospun silk fibroin-BMP-2 capping group .Bilateral up-per first molars of each rat in group 2-5 were drilled to expose the pulp to LPS which was used to estab-lish a model of inflammatory pulp .The exposed pulp was capped with different capping agents or without capping agents.Then the hole was sealed.The animals were sacrificed on days 3, 7, and 14 post-opera-tion and histological analysis was carried out , including HE stain and CD 14 immunohistochemical stain . Results:On day 7 and 14 , the lowest inflammatory reaction score in HE stain among pulp capping groups was that of silk fibroin-BMP-2 group .The next were calcium hydroxide group and silk fibroin group .That of blank control group was the highest .The ranking of reparative dentine scores of those groups was just reversed.The D values of immunohistochemical stain of CD 14 were not significantly different in groups applied pulp capping agents but significantly lower than blank control group on days 3 and 7.However, the D value of silk fibroin-BMP-2 group ( 0 .145 ±0 .011 ) was significantly lower than blank control group (0.287 ±0.019), calcium hydroxide group (0.170 ±0.017) and silk fibroin group (0.175 ± 0 .018 ) on day 14 .Conclusion:Electrospun silk fibroin compounded with BMP-2 promoted wound hea-ling of exposed pulp and had better potential to stimulate formation of reparative dentine to establish a suitable environment for pulp recovery .