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OBJECTIVE@#To investigate the development present situation of the department of critical care medicine in Inner Mongolia Autonomous Region (hereinafter referred to as Inner Mongolia), in order to promote the standardized and homogeneous development of critical care medicine in Inner Mongolia, and also provide a reference for discipline construction and resource allocation.@*METHODS@#A survey study was conducted in comprehensive intensive care unit (ICU) of tertiary and secondary hospitals in Inner Mongolia by online questionnaire survey and telephone data verification. The questionnaire was based on the Guidelines for the Construction and Management of Intensive Care Units (Trial) (hereinafter referred to as the Guidelines) issued by the National Health Commission in 2009 and the development trend of the discipline. The questionnaire covered six aspects, including hospital basic information, ICU basic information, personnel allocation, medical quality management, technical skill and equipment configuration. The questionnaire was distributed in September 2022, and it was filled out by the discipline leaders or department heads of each hospital.@*RESULTS@#As of October 24, 2022, a total of 101 questionnaires had been distributed, 85 questionnaires had been recovered, and the questionnaire recovery rate had reached 84.16%, of which 71 valid questionnaires had been collected in a total of 71 comprehensive ICU. (1) There were noticeable regional differences in the distribution of comprehensive ICU in Inner Mongolia, with a relatively weak distribution in the east and west, and the overall distribution was uneven. The development of critical care medicine in Inner Mongolia was still lacking. (2) Basic information of hospitals: the population and economy restricted the development of ICU. The average number of comprehensive ICU beds in the western region was only half of that in the central region (beds: 39.0 vs. 86.0), and the average number of ICU beds in the eastern region was in the middle (83.6 beds), which was relatively uneven. (3) Basic information of ICU: among the 71 comprehensive ICU surveyed, there were 44 tertiary hospitals and 27 secondary hospitals. The ratio of ICU beds to total beds in tertiary hospitals was significantly lower than that in secondary hospitals [(1.59±0.81)% vs. (2.11±1.07)%, P < 0.05], which were significantly lower than the requirements of the Guidelines of 2%-8%. The utilization rate of ICU in tertiary and secondary hospitals [(63.63±22.40)% and (44.65±20.66)%, P < 0.01] were both lower than the bed utilization rate required by the Guidelines (75% should be appropriate). (4) Staffing of ICU: there were 376 doctors and 1 117 nurses in tertiary hospitals, while secondary hospitals had 122 doctors and 331 nurses. There were significant differences in the composition ratio of the titles of doctors, the degree of doctors, and the titles of nurses between tertiary and secondary hospitals (all P < 0.05). Most of the doctors in tertiary hospitals had intermediate titles (attending physicians accounted for 41.49%), while most of the doctors in secondary hospitals had junior titles (resident physicians accounted for 43.44%). The education level of doctors in tertiary hospitals was generally higher than that in secondary hospitals (doctors: 2.13% vs. 0, masters: 37.24% vs. 8.20%). The proportion of nurses in tertiary hospitals was significantly lower than that in secondary hospitals (17.01% vs. 24.47%). The ratio of ICU doctors/ICU beds [(0.64±0.27)%, (0.59±0.34)%] and ICU nurses/ICU beds [(1.76±0.56)%, (1.51±0.48)%] in tertiary and secondary hospitals all failed to meet the requirements above 0.8 : 1 and 3 : 1 of the Guidelines. (5) Medical quality management of ICU: compared with secondary hospitals, the proportion of one-to-one drug-resistant bacteria care in tertiary hospitals (65.91% vs. 40.74%), multimodal analgesia and sedation (90.91% vs. 66.67%), and personal digital assistant (PDA) barcode scanning (43.18% vs. 14.81%) were significantly higher (all P < 0.05). (6) Technical skills of ICU: in terms of technical skills, the proportion of bronchoscopy, blood purification, jejunal nutrition tube placement and bedside ultrasound projects carried out in tertiary hospitals were higher than those in secondary hospitals (84.09% vs. 48.15%, 88.64% vs. 48.15%, 61.36% vs. 55.56%, 88.64% vs. 70.37%, all P < 0.05). Among them, the placement of jejunal nutrition tube, bedside ultrasound and extracorporeal membrane oxygenation were mainly completed independently in tertiary hospitals, while those in secondary hospitals tended to be completed in cooperation. (7) Equipment configuration of ICU: in terms of basic equipment, the ratio of the total number of ventilators/ICU beds in tertiary and secondary hospitals [0.77% (0.53%, 1.07%), 0.88% (0.63%, 1.38%)], and the ratio of injection pump/ICU beds [1.70% (1.00%, 2.56%), 1.25% (0.75%, 1.88%)] didn't meet the requirements of the Guidelines. The equipment ratio was insuffcient, which means that the basic needs of development had not been met yet.@*CONCLUSIONS@#The development of comprehensive ICU in Inner Mongolia has tended to mature, but there is still a certain gap in the development scale, personnel ratio and instruments and equipment compared with the Guidelines. Moreover, the comprehensive ICU appears the characteristics of relatively weak eastern and western regions, and the overall distribution is uneven. Therefore, it is necessary to increase efforts to invest in the construction of the department of critical care medicine.
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Humans , Intensive Care Units , Critical Care , Surveys and Questionnaires , Tertiary Care Centers , ChinaABSTRACT
Objective To observe the serum levels of Gal-3,Hs-CRP,IL-6 and TNF-α,and discuss the correlation between those indicators and the severity of coronary lesion and major adverse cardiac events( MACE). Methods Serum levels of Gal-3,Hs-CRP,IL-6 and TNF-α were detected in 126 patients with coronary heart disease and 54 patients with non-coronary heart disease. To analyze the correlation between those indicators and the severity of cor-onary lesion and MACE. Results Serum levels of Gal-3 and inflammatory factors of in the coronary heart disease group were significantly increased compared with the control group(P<0. 01),and serum levels of Gal-3 and in-flammatory factors in the multi-vessel disease group and the severe coronary disease stenosis group higer than that of the double-vessel disease group,the single-vessel disease group and the mild coronary disease stenosis group ( P<0. 05). Serum levels of Gal-3,inflammatory factors and Gensini scores were positively correlated(P<0. 01). Ser-um levels of Gal-3 , inflammatory factors were significantly higher with MACE compared to without MACE ( P <0. 05). Conclusion The serum levels of Gal-3 and Hs-CRP,IL-6,TNF-α,Gensini scores in patients with coronary heart disease are positively correlated,serum Gal-3 has great potential to become effective clinical indicators,which could be used to preliminary predict the severity of coronary artery disease and evaluate the short-term prognosis of patients with coronary heart disease.
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Objective To investigate the different components of Acorus tatarinowii and Polygala tenuifolia(volatile oil, aqueous extract)on the expression of phosphorylated Tau protein at site Ser396 and Tau-5 in the hippocampus of rats with Alzheimer′s disease(AD). Methods Male Sprague Dawley rats were randomly divided into 8 groups:normal control group, model control group,low-,middle-,and high-dose groups of volatile oil of Acorus tatarinowii and Polygala tenuifolia,and low-, middle-,and high-dose groups of aqueous extract of Acorus tatarinowii and Polygala tenuifolia. The subacute aging model was established by intraperitoneal injection of D-galactose( D-gal). Rats were given different components of Acorus tatarinowii and Polygala tenuifolia(crude drug dosage,0.6,1.2,1.8 g·kg-1 )in experimental groups,and 0.9% sodium chloride solution in normal control group and model control group,by gavage for 28 days.The levels of phosphorylated Tau protein at site Ser396 and Tau-5 were detected in hippocampal tissues by Western blotting and immunohistochemistry. Results The levels of phosphorylated Tau protein at site Ser396 were significantly enhanced in the model control group,as compared with those in normal control group (P0.05). Conclusion Acorus tatarinowii and Polygala tenuifolia could promote the dephosphorylation of Ser396 site of Tau protein in the hippocampus of AD rats,with the aqueous extract component having better effects.
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ObjectiveTo investigate the clinical effect of nape acupuncture on post-stroke dysphagia by a meta-analysis.Method Domestic literature on clinical randomized controlled trials of nape acupuncture treatment of post-stroke dysphagia published from Jun. 2004 to Jun. 2014 were obtained by a computer search ofChina National Knowledge Internet(CNKI), Wanfang Data medical information system (WF), VIP information resource system (VIP) and Chinese Biomedical Literature Database (CBM) combined with a manual search of Jinan University library journal database. Literature inclusion and exclusion criteria were established to extract data and the qualities of the included studies were assessed using a Jadad rating scale. A meta-analysis was made using the software ReviewManager 5.2.ResultA total of 17 articles were included with 1158 patients. The results of meta-analysis showed that there were statistically significant differences in the total efficacy rate [OR=3.99, 95%CI(2.83, 5.63),P<0.00001] and the cure rate[OR=2.67, 95%CI(2.03, 3.53),P<0.00001] between the nape acupuncture and control groups.ConclusionNape acupuncture has clinically a good therapeutic effect on post-stroke dysphagia. Multi-center, large-sample and high-quality studies are still needed for validation because the qualities of the included articles are lower, which is one of the factors influencing the assessment.
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Guidelines of Prevention and treatment of Children's Influenza A (H1N1) with TCM includes four parts of prevention, diagnosis, clinic treatment and nursing. The drug prophylaxis stresses on administration by identified body without diseases, which includes normal constitution, qi-deficiency constitution, inner-heat constitution and phlegm-damp constitution, children of different constitution are given different appropriate drugs. The treatment bases on syndrome differentiation, such as mild syndrome, severe syndrome, crises and convalescence. The syndrome-classification includes wind-heat invading the exterior, dampness obstructing defensive qi, the heat-toxin blocking the lung, exuberant toxin in both qi and ying, deficiency of heart-yang, the evil sinking into jueyin, residual evil remaining in the body and the deficiency of both qi and yin. The nursing emphasizes the isolation, keeping body warm, bland diet and nursing during convalescence.
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AIM: To investigate the effect of huayu xiaoliu fang, a Chinese medicine, on the cell cycle of human lung carcinoma cell line by serologic pharmacological method. METHODS: PGLH7 cells were incubated with rabbit serum containing huayu xiaoliu fang at different doses obtained by serologic pharmacological method. MTT assay was used to calculate the proliferation inhibition rate. The target cells were harvested to analyze the cell cycles by flow cytometry. RESULTS: The Chinese medicine-containing serum inhibited the growth of PGLH7 cells significantly. There was remarkable difference in the proliferation inhibition rate between 10% (high dose) Chinese medicine-containing serum and the control serum (P