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Objective:To explore the related factors and treatment effect observation of Parkinson disease(PD) accompanied by depression.Methods:Two hundred patients with PD admitted to Baoding Zhuozhou Baoshihua Hospital from March 2016 to March 2020 were selected. According the scores of Hamilton depression inventory 24-item version (HAMD-24), they were divided into the case group (PD accompanied by depression, HAMD-24≥8 scores, 98 cases) and the control group (PD without depression, HAMD-24<8 scores,102 cases). Single factor analysis and multivariate regression analysis were used to analyze the influencing factors of PD accompanied by depression. The patients in the case group were divided into psychological treatment group and non-psychological treatment group by random number table method, each group with 49 cases. The differences in depression degree, quality of life and sleep quality before and after treatment between the two groups were compared.Results:The incidence rate of PD accompanied by depression was 49.0% (98/200). The multivariate regression analysis showed that the Hoehn-Yahr classification (H-Y classification), Pittsburgh Sleep Quality Index (PSQI) scores and abnormal marital status were the influence factors of PD accompanied by depression ( P<0.05); the education years was the protective factor of PD accompanied by depression ( P<0.05). After treatment, the scores of HAMD-24 and PSQI in the psychological treatment group and the non-psychological treatment group were decreased, and the scores of HAMD-24 and PSQI in the psychological treatment group were lower than those in the non-psychological treatment group: (11.78 ± 2.94) scores vs. (15.55 ± 3.91) scores, (5.18 ± 1.05) scores vs. (5.74 ± 1.12) scores, the differences were statistically significant ( P<0.05). After treatment, the improved degree of scores of five item of HAMD-24 in the psychological treatment group were higher than those in the non-psychological treatment group, the differences were statistically significant ( P<0.05). Conclusions:PD accompanied by depression is affected by multiple factors. Strengthening psychological treatment can reduce the degree of depression in patients with PD accompanied by depression and improve the quality of sleep and life.
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Objective To investigate the indicators of thrombolytic therapy in patients with acute ischemic stroke,find out the early warning value,and provide guidance for decision-making of emergency doctors.Methods Patients with acute ischemic stroke who were treated with thrombolytic therapy from January,2010 to August,2017 in our hospital were enrolled in this study.According to the modified Rankin scale,patients were divided into the good prognosis group and poor prognosis group.Logistic regression model was used to evaluate the relative dependent risk factors.Results Totally 210 patients were enrolled in the good prognosis group and 152 patients in the poor prognosis group.Multivariate logistic regression analysis showed that NIHSS score on admission,blood glucose,systolic blood pressure before thrombolytic therapy,homocysteine,onset-to-needle time and previous history of diabetes mellitus were independent risk factor for poor prognosis (P＜0.05).Conclusions Risk factors as NIHSS score on admission,blood glucose,systolic blood pressure before thrombolytic therapy,homocysteine,onsetto-needle time and previous history of diabetes mellitus are early warning indicators of poor prognosis in patients with acute ischemic stroke treated with thrombolytic therapy.
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Objective To evaluate the reliability and clinical practicality of colony PCR in rapid detection of pathogenic fungi causing tinea capitis.Methods Totally,17 children with tinea capitis were enrolled from the Department of Dermatology of Wuxi No.2 People's Hospital between January 2016 and March 2017.Colony PCR was performed to detect pathogenic fungi.The results of colony PCR were compared with those of routine PCR and morphological identification,so as to evaluate the reliability of colony PCR in the identification of pathogenic fungi causing tinea capitis.Results After clinical specimens (broken hairs and scales) from the 17 patients were subjected to fungal culture,the mycelia were collected and successfully amplified by colony PCR.The time of clony PCR (mean,3.82 ± 0.50 days) for DNA template preparation was short than that of traditional morphological identification (14 days).Based on the results of conventional PCR,the accuracy of colony PCR for fungal identification was 100％,which was superior to that of conventional PCR (88.2％).Conclusions Colony PCR can be applied to the clinical detection of pathogenic fungi causing tinea capitis at specy level,and is a kind of rapid,economic and reliable molecular detection technique.
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Objective To reveal the incidence and types of acid-base disorder (ABD) of critically ill patients in emergency.Methods The clinical data of critically ill patients in the resuscitation room were collected prospectively from December 1,2008 to March 31,2009.Both arterial and venous blood samples were collected to detect arterial blood gas analysis and serum electrolytes simultaneously and their ABD were analyzed.Results Of totally 766 cases,the incidence of ABD was 97.3％ (745 cases).Among ABD the simple acid-base disorder ( SA BD) was 149 cases ( 20.0％ ),dual acid-base disorder (DABD) 525 (70.5％ ) and triple acid-base disorder (TABD) 71 (9.5％ ).After calculating anion gap (AG),the incidence of TABD increased from 12 to 71 cases and the missed diagnosis rate were 83.1％ (59 cases) and after calculating potential HCO3-,the incidence of TABD increased from 8 to 71 cases and the missed diagnosis rate were 88.7％ (63 cases).The age of patients with TABD (77.9 ± 10.7 years old) was older ( P ＜ 0.01 ) than that of other two groups of SABD and DABD as well as APACHEⅡ score (25.9 ± 7.1 ) and incidence (22.5％ ) of MODS in TABD were higher (P ＜0.01 ).The mortality of patients with TABD on the first,second,third and seven day were 14.1％,23.9％,26.8％ and 38.0％ respectively and significantly higher than those in SABD and DABD (P ＜0.05 or P ＜0.01 ).Conclusions The incidence of ABD was 97.3％.Calculation of AG and potential HCO3- would help find metabolic acidosis and TABD.The age and APACHEⅡ score were key factors to poor prognosis of patients with TABD.
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Objective To study the effects of APBV (airway pressure release ventilation) / BIPAP(bipha-sic positive airway pressure) on lung recmitment/open maneuvers in piglets with acute lung injury. Method The model of acute lung injury (ALI) was induced by E. coll. intraperitoneal injection in piglets. Based APRV/BI-PAP model, the different pressure combinations (Phigh/Plow) of RMs increased gradually, such as RMI(30/15),RM2(35/20), RM3(40/25), RM4(45/30),RM5(50/35), RM6(55/40), RM7(60/45) cmH2O. The effects of stepwise RMs were studied by computed tomography (CT) at iaspiratory phase. Meantime the oxygen index (PaO2/FiO2), hemodynamic parameter and mean pressure of airway (Pmean) were continuously observed. The piglets were killed when RiMs finished and pulmonary pathological examination were done routinely by optical microscope. Data was analyzed by self-contrast method, using SPSS 11.5 software package. Results were expressed as mean ± standard deviation (x±s). Multiple comparisons were made with One-way ANOVA. Pearson correlative analysis was used to describe the relativity of PaO2/FiO2 and the collapsed alveolar area. Changes were considered as statistically significant if P value was less than 0.05. Results Eight piglets with ALl model were successfully made and all of them showed different degree of alveolar collapse under chest CT scan. During RMs their PaO2/FiO2 increased obviously (P<0.05) were decreased obviously (P<0.05) too, specially after RM2 finished (P<0. 05). But the alveolar over-inflatian could be found in some non-diseased area. The heart rate (HR) increased and mean artery blood pressure (MAP) decreased significantly while the pressure combinations (Phigh/Plow) of RMs were added gradual]y ( P<0.05). Meantime the Pmean and Ppeak inspiratory pressure (PIP) of airway and central venous pressure (CVP) were increased significantly ( P<0.05). But when RMs were finished,all of these indexes were hack to the levels of pre-RMs. Even there were no barowaumas happened, such as pneumothorax and pneumomedistinum, the alveolar overdistention and interruption of the alveolar separation still could be seen by pathologic examination. Conclusions RMs could be done well by APRV/BIPAP. Phigh/Plow (35/20cmH2O) would be the best pressure combination with more efficacy of RMs and less influence on hemodynamics,airway pressure indexes and others. When the effect of RMs was satisfied enough, setting Phigh/Plow to 30/15cmH2O for 20 mitt may maintain the good efficacy of RMs.
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Objective To investigate the operative technique and treatment effect for the cerebellum he-mangioblastoma. Methods The clinical data of 18 patients with cerebellum hemangioblastoma who underwent sur-gery were analyzed retrospectively. The clinical data included imaging data,the operative approach and microsurgery method. Results In the 18 cases, 15 undertook complete remove of tumor,and the other 3 cases experienced partial remove. 16 patients were followed up for 1 to 3 years,and 2 cases experienced recurrence. No death occurred. Con-clusion The measures including sufficient preoperative imaging and gentle manipulation during the operation can significantly increase the rate of total removal of the tumors, while radioneurosurgery or γ treatment is applicable after operation.
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Objective: To study the nursing of patients with morbid obesity treated with laparoscopic vertical banded gastroplasty (LVBG). Methods: Before operation, obese degree, obesity-related conditions and mental states were examined routinely. Monitoring of respiratory tract, observing operative complications and instructing of diets were done after operation. Results: Among 6 patients, 5 were at the third degree of obese, one was at second. In obesity-related conditions, 4 patients had hypertension and acantha derma, 1 had arthritis, and all had respiratory sleeping syndrome. The operations were all successful. The food amount food and body weight both decreased significantly 1 month after operation. The common operative complications were mild bleeding (1 case), shoulder-back pain (1 case), nausea and vomiting (5 cases). Diet principle was high protein, low energy, liquid food was the first choice. Conclusion: Observing and preventing respiratory sleeping syndrome are the main points of postoperative cares. Instructing patients to establish correct diet habit is the key to reach the best efficacy of LVBG.