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Objective:To explore the effect of continuous pumping normal saline at same infusion speed before flushing or sealing the tube on the hemodynamics of patients with hypovolemic shock receiving norepinephrine.Methods:A total of 56 cases of hypovolemic shock patients receiving norepinephrine via micro-pump were randomly assigned to the observation group and the control group (28 cases in each group). Patients in the control group received conventional operation method to flush or seal the tube, while patients in the observation group continued pumping normal saline at the same infusion speed, followed by flushing or sealing the tube based on the control group. The changes of hemodynamics after flushing or sealing the tube was compared between two groups.Results:After 30 s, 1 min, 2 min, 3 min, 5 min of flush or seal the tube, the systolic blood pressure were (105.4±17.4) mmHg, (106.3±21.3) mmHg, (102.1±14.5) mmHg, (100.6±16.9) mmHg, (101.0±14.3) mmHg (1 mmHg=0.133 kPa), mean arterial blood pressure were (81.1±8.6) mmHg, (82.4±9.9) mmHg, (78.6±7.3) mmHg, (76.9±6.7) mmHg, (75.7±6.5) mmHg in the observation group, lower than those in the control group [(150.6±26.7) mmHg, (151.8±30.1) mmHg, (139.7±29.8) mmHg, (125.3±25.3) mmHg, (114.4±21.6) mmHg and (107.4±11.6) mmHg, (106.1±11.5) mmHg, (98.1±11.1) mmHg, (88.9±9.6) mmHg, (79.5±8.0) mmHg], the differences were statically significant ( P<0.05). After 30 s, 1 min, 2 min, 3 min of flush or seal the tube, the diastolic blood pressure were (69.0±10.50)mmHg, (70.5±10.7)mmHg, (66.9±8.3)mmHg, (65.1±6.2)mmHg in the observation group, lower than those in the control group [(85.9±11.6) mmHg, (83.3±8.7) mmHg, (77.3±7.4)mmHg, (70.7±7.2) mmHg], the differences were statically significant ( t value was 10.199-18.464, P<0.05). Conclusions:Before flushing or sealing the tube, continue pumping normal saline at same infusion speed can reduce the risk of abnormal hemodynamics for the hypovolemic shock patients receiving norepinephrine via micro-pump.
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Objective:To evaluate the clinical significance of emergency surgical application shock index in patients with severe trauma complicated with hemorrhagic shock and its guiding first aid nursing.Methods:A total of 52 patients from the First Affiliated Hospital, Sun Yat-sen University with severe trauma complicated and hemorrhagic shock were divided into observation group and control group (each group with 26 cases) according to stratified random sampling method. The patients in the control group received the corresponding routine nursing measures, and the observation group carried out evaluating the severity of the condition by shock index based on the corresponding emergency nursing measures. The emergency time, consultation time, prognosis and the nursing satisfaction of the two groups were compared.Results:The emergency time, consultation time were (30.1 ± 3.7), (2.7 ± 0.7) min in the observation group and (39.6 ± 4.2), (3.8 ± 0.9) min in the control group, the differences were statistically significant ( t values were 8.097, 5.149, P<0.01). The cure rate was 73.1%(19/26) and effective rate was 15.4% (4/26) in the observation group, those index was 57.7% (15/26) and 23.1% (6/26) in the control group, the difference was statistically significant ( Z value was 2.969, P<0.01). The high nursing satisfaction was 65.4% (17/26) and nursing satisfaction was 26.9% (7/26) in the observation group, while 30.8% (8/26) and 53.8% (14/26) in the control group, the difference was statistically significant ( Z value was 2.493, P<0.05). Conclusions:Applying shock index to evaluate the corresponding nursing measures can shorten the time of emergency and separate diagnosis, and improve the overall nursing effect of emergency surgery.
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Objective To compare the clinical characteristics of normal body mass index (BMI) polycystic ovary syndrome (PCOS) patients with or without insulin resistance (IR) , and analyze the related factors of IR. Methods From January 2013 to January 2017, 128 patients with normal BMI (18.5-23.9 kg/m2) PCOS patients were divided into A group (56 cases with IR) and B group (72 cases without IR) according to whether they had IR. The clinical indicators, sex hormones, glucose and lipid metabolism indexes of the two groups were statistically compared, and the related factors influencing insulin resistance index (HOMA-IR) were analyzed by Pearson. Results Compared with B group, the waist-to-hip ratio (0.91 ± 0.08 vs. 0.80 ± 0.07), Ferriman-Gallway scores [(4.87 ± 1.66) scores vs. (3.31 ± 1.29) scores], fasting blood glucose (FPG) [(5.19 ± 0.60) mmol/L vs. (4.77 ± 0.56) mmol/L], fasting insulin (FINS) [(17.89 ± 5.85) mU/L vs. (9.83 ± 3.87) mU/L], total cholesterol (TC)[(5.03 ± 1.42) mmol/L vs. (4.52 ± 0.62) mmol/L], triglyceride (TG)[(1.72 ± 1.05) mmol/L vs. (0.98 ± 0.26) mmol/L], low density lipoprotein cholesterol (LDL-C) [(3.10 ± 1.19) mmol/L vs. (2.55 ± 0.82) mmol/L] in A group were significantly increased, while high density lipoprotein cholesterol (HDL-C) [(1.28 ± 0.30) mmol/L vs. (1.52 ± 0.23) mmol/L] significantly reduced, the differences were statistically significant (P < 0.05). HOMA-IR was positively correlated with waist-to-hip ratio (r=0.397), FPG (r=0.461), FINS (r=0.992), TC (r=0.371), TG (r=0.354) and LDL-C (r=0.478), but negatively correlated with sex hormone binding globulin (r=-0.231) and HDL-C (r=-0.299). Conclusions The waist-to-hip ratio, Ferriman-Gallway scores, glucose and lipid metabolism in normal BMI PCOS patients with IR are significantly altered. The waist-to-hip ratio, FPG, FINS, TC, TG, LDL-C, HDL-C and sex hormone binding globulin are all related factors of HOMA-IR.
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Background Implantable contact lens (ICL) surgery is a primary intraocular refractive corrective surgery for high myopia.However,whether there will be enough distance between ICL and anterior face of lens to avoid the occurrence of anterior capsular cataract in non-accommodated and the largest physiological accommodated state after ICL implantation is worthy of investigation.Objective The purpose of this study was to investigate the alteration of lens vault after ICL implantation and explore the relationship between accommodation and change of lens vault.Methods A observational study was carried out.Sixty-six eyes of 33 patients with high myopia who received ICL implantation were enrolled in Affiliated First Hospital of Guiyang Medical College from May to November,2012.Best corrected visual acuity (BCVA),uncorrected visual acuity (UCVA),refractive diopter were regularly examined using synthetical optometry,and crystalline lens rise (CLR) and lens vault in non-accommodative or accommodative condition were observed by the anterior segment OCT (Visante OCT) and ultrasound biomicoscopy (UBM) before operation and 1 day,1 week,l month and 3 months after operation.Data were analyzed with SPSS version 16.0.Repeated measurement one-way analysis of variance was used to compare the differences of vision and refractive diopter among various time points.The relationship between accommodation and CLR was assessed using Pearson linear correlation.The alteration of CLR with accommodation change was analyzed by linear regression equation.Lens vault was measured and compared between non-accommodation and maximal physical accommodation status by paired t test.Results The postoperative UCVA was improved in comparison with preoperative BCVA,and the postoperative diopter was significantly lower than that of preoperation,with significant differences among various time points (F =16.904,P =0.000 ; F =1.498,P =0.000),and the diopter was stable after operation.A positive correlation was found between the alteration of CLR and accommodation under the physical accommodative stimulation in high myopic eyes (R2 =0.49,P =0.00).Under physiological accommodation,CLR elevated 20 μm for per 1.0 D accommodation.In addition,the difference of lens vault values within postoperative 3 months was statistically significant (F=16.025,P=0.000).The lens vault values lowed with the enlargement of accommodation in 48.5％ eyes,and the lens vault values increased with the enlargement of accommodation in 50.0％ eyes.However,1.5％ of the lens vault were in a stable state under the maximal physiological accommodated condition 3 months after operation.Lens vault were greater than zero in 97.0％ eyes (64/66),and only 3.0％ eyes (2/66) were zero under the maximalphysiological accommodated condition.Significant differences were seen in the lens vault between nonaccommodated and the maximal physiological accommodated state 1 day or 1 week after operation (t =4.755,P =0.000 ;t =3.327,P =0.001) ; but there was no statistical significance in 1 month or 3 months after operation (t =1.544,P=0.127,t=0.621,P=0.537).Conclusions During physiological accommodation,the alteration of CLR with accommodation in high myopic eyes.The location of ICL in the eyes is unstable within 3 months after operation.Majority of operative eyes remain enough vault in the maximal physiological accommodated state,but minority of operative eyes occur contact of ICL with the anterior surface of lens.Whether this contact causes anterior capsular cataract still needs to study.
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Objective To evaluate the influence of chronic urticaria on the quality of life in patients by the DLQI, and to assess the factor structure and reliability of the DLQI. Methods The DLQI (Chinese version) was used to evaluate the quality of life of outpatients with CU. The reliability and factor structure of the DLQI were evaluated by reliability analysis and factor analysis. Results Eighty-five patients were asked to complete the DLQI and 13 patients were excluded for other complicated disorders or unanswered items in the DLQI. The mean age was 33.43 ± 0.90 years in the 72 patients with a median clinical course of 6 months. The DLQI score, which varied from 1 to 23 with an average of 9.46 ± 0.61, was uncorrelated to the patients' age,sex, or clinical course of CU (all P ＞ 0.05). The impact of CU was observed mainly on the "synptoms and feeling" (50%), followed by "work and study" (40.67%). Factor analysis indicated that there were two dimensions with eigenvalues greater than 1.0, accounting for 53.7% of the variances. Reliability analysis showed that the Cronbach's α value was 0.836, and reached 0.849 if the item 1 in the DLQI was deleted. An analysis of variance showed that the F value was 31.88 (P ＜ 0.01 ), and Hotelling T2 test yielded an F value of 29.87 (P ＜0.01 ). Conclusions CU has a moderate impact on the quality of life in patients. DLQI can be applied to the evaluation of quality of life in patients with CU with a high reliability, but more attention should be paid to the interference from item 1 to the reliability of the assessment.
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This study aimed to investigate the effects of concentration, intestinal section and borneol on the intestinal absorption of salvianolic acids. The experiment not only studied the intestinal absorption properties of three concentrations of rosmarinic acid, salvianolic acid B and salvianolic acid A at duodenum, jejunum and ileum, but also of salvianolic acids compatible with borneol at different concentrations using single-pass intestinal perfusion model in rat with phenol red as the marker. The results showed that salvianolic acids was stable under weak-acid condition and affected by metabolism enzyme; The Peff and Ka significantly different among three concentrations of rosmarinic acid and salvianolic acid B, whose intestinal absorption were saturated in high concentration, suggesting that the transport mechanisms of rosmarinic acid and salvianolic acid B were similar to active transport or facilitated diffusion; However, there was inconspicuousness in the Peff and Ka of salvianolic acid A at different concentrations, whose absorption was not saturated in high concentration, indicating that the transport mechanisms of salvianolic acid A was passive diffusion; The Peff and Ka in the ileum obviously higher than those in the duodenum and jejunum, namely the ileum was the best absorption section; When concentration of borneol increased, the enhancing effect of intestinal absorption of salvianolic acids increased, but significantly decreased when borneol increased to some degree. The enhancing effect of medium borneol concentration was the optimum. This implied that borneol can enhance the intestinal absorption of salvianolic acids, and the capacity of enhancing effect was influenced by the concentration of borneol.