ABSTRACT
Objective To explore the application effect of ICU checklist of medical cooperation on prevention of ventilator-associated pneumonia. Methods Totally 728 patients with mechanical ventilation from July 2015 to July 2016 in ICU were assigned to the experimental group with using of the checklist; and 685 patients with mechanical ventilation from June 2014 to June 2015 were set as the control group who did not use the checklist. The incidence of ventilator-associated pneumonia and medical cooperation were compared before and after the implementation of the checklist. Results The incidence of ventilator associated pneumonia were 6.72% (46/685) and 3.02% (22/728), the intervention strategy execution rates were 63.36% (434/685) and 84.89% (618/728) before and after the application of checklist, there was significant difference between two groups (χ2=10.51, 86.03, P<0.01). Medical cooperation (doctors and nurses) and satisfaction scored 18.53 ± 2.39, 21.91 ± 2.16, 30.93 ± 2.18 and 26.71 ± 2.21, 28.64 ± 2.55, 45.33 ± 1.74 before and after the application of checklist, there was significant difference between two groups (t=6.14, 14.25, 2.39, P<0.01 or 0.05). Conclusions The application of checklist can improve the medical cooperation on prevention of ventilator-associated pneumonia management, reduce the incidence of ventilator-associated pneumonia, improve medical cooperation, nursing satisfaction and the management efficiency, which is worthy of popularization and application.
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Objective To use thrombelastography (TEG) and conventional coagulation tests (CCTs) to diagnose disseminated intravascular coagulation (DIC) and find a better diagnostic method.Methods Patients with potential DIC factors,DIC clinical manifestation or DIC patients suspected by laboratory tests were included after their admission into our hospital.TEGs and CCTs were detected,respectively.DIC score was evaluated.The single factor logistic regression was used to evaluate the correlation between TEG and CCTs as well as the diagnostic accuracy.Results The international normalized ratio (INR) in CCTs of the DIC patients were significantly higher,the reaction rime (R),clot formation time (K),angle rate of clot formation (α),maximum amplitude (MA),and composite index (CI) figures in TEG were significantly increased (P ＜ 0.05).The sensitivity and specificity of TEG were 82.4％,and 62.2％,which were significantly higher than 21.6％ and 47.2％ in CCTs (P ＜ 0.05).Single factor logistic regression results show that odd ratio (OR) in prothrombin time (PT) and INR of CCTs was 1.23 and 1.27,respectively.The OR in R,K,α,MA,and CI of TEG was 5.13,6.14,1.37,1.25,and 3.02,respectively.Conclusions Compared to CCTs,TEG is more indicative of the conditions of DIC patients and it might be a better way to predict the DIC risks,which is of greater value in clinical diagnosis.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the metabolic profile of hydrocortisone-induced 'Kidney-yang deficiency syndrome'in rats and the intervention effects of Morinda officinalis.</p><p><b>METHOD</b>Proton nuclear magnetic resonance (1H-NMR) technique was used to analyze the rat metabonome in serum. Orthogonal partial least squares discriminant analysis (OPLS-DA) were processed to analyze the metabonome difference between the control and hydrocortisone treated samples. Twelve potential biomarkers were selected, via the parameter of variable importance in the projection (VIP). Principal components analysis (PCA) was employed to process the data from the M. officinalis. treatment group and the intervention effects of M. officinalis, was investigated through the selected potential biomarkers.</p><p><b>RESULT</b>After hydrocortisone treatment, the energy metabolism, amino acids metabolism and gut microflora environment were seriously disturbed and transmethylation was surpressed. M. officinalis could effectively alleviate the disturbance of energy and amino acids metabolism and enhance transmethylation, but could not modulate the gut microflora environment.</p><p><b>CONCLUSION</b>The results obtained suggested that metabonomic studies could better reflect the whole status of metabolism in bio-systems, and could be treated as a potential powerful approach in pharmacological studies and investigation of the essence of 'syndrome' in traditional Chinese medicine.</p>