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Objective:To explore the application effect of early intervention of pulmonary rehabilitation management in emergency department-ward linkage under multi-disciplinary team (MDT) mode in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:Using convenient sampling method, 124 AECOPD patients admitted to Department of Emergency of Qilu Hospital of Shandong University (Qingdao) were selected as the study objects. According to the admission order, 62 patients admitted from March to October 2020 were taken as the control group, and 62 patients admitted from March to October 2021 were taken as the observation group. The control group was given routine treatment and rehabilitation guidance. On the basis of this, the observation group received the early lung rehabilitation management of emergency-ward linkage under MDT mode. The arterial oxygen saturation, lung function index (FEV 1, FEV 1%Pred, FEV 1/FVC), 6-minute walk test (evaluation only after intervention) and quality of life of patients were evaluated before and after intervention. Results:Finally, 60 patients in each group completed the study. After the intervention, the arterial oxygen saturation, the score of quality of life, 6-minute walk test and FEV 1, FEV 1%Pred, FEV 1/FVC of patients in observation group were 0.93 ± 0.04, (29.68 ± 4.87) points, (341.93 ± 46.55) m, and (1.86 ± 0.68) L, (66.13 ± 8.96)%, (68.2 ± 58.53)%, respectively. And in the control group, they were 0.91 ± 0.04, (35.83 ± 2.94) points, (268.75 ± 50.78) m, and (1.50 ± 0.66) L, (61.70 ± 7.16)%, (64.10 ± 8.42) %, respectively. The observation group was significantly better than the control group ( t values were -8.23 to 8.37, all P<0.01). Conclusions:Early intervention of pulmonary rehabilitation by emergency-ward linkage under MDT mod can effectively improve arterial oxygen saturation, pulmonary function, exercise ability and quality of life of patients with AECOPD.
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OBJECTIVE：To provide reference for the selection of drug treatment plan in patients with Brucellosis combined with liver dysfunction. METHODS ：Clinical pharmacists analyzed drug treatment plan in a patient with Brucellosis combined with liver dysfunction in the First Affiliated Hospital of Medical College of Shihezi University. Referring to Brucella treatment guideline . Consensus statement by the American association of clini - HbA1c cal endocrinologists and American college of endocrinology on the comprehensive type 2 diabetes management al - and domestic and foreign clinical information ，the suggesti ons were put forward according to the change of liver dysfunction. RESULTS：The patient had chronic infection and moderate liver injury. The liver dysfunction in this patient was a common complication of Brucellosis. After consultation of doctors and pharmacists ，in consideration of the abnormal liver function ， intravenous drip of levofloxacin （0.5 g，qd）was given in the patient for anti-infection treatment. After the liver function was improved，levofloxacin was stopped ，and intravenous drip of rifampin （0.6 g，qd）and oral administration of doxycycline （100 mg，bid）were given for anti-infection treatment instead ；during the treatment period ，intravenous drip of reduced glutathione （1.8 g，qd）and diammonium glycyrrhizinate （150 mg，qd）were given for anti-inflammatory and liver protecting treatment. During the treatment，the clinical pharmacists closely monitored ADR of patients ，and carried out medication education for patients to improve the compliance. 10 d after medication ，although some of the liver function indexes of the patient did not return to normal ，but Brucellosis and liver dysfunction symptoms were improved. The patient could continue to take the same dose of rifampin and doxycycline after discharge. CONCLUSIONS ：When the patients with Brucellosis have abnormal liver function ，anti-infection treatment should be the main treatment target. The clinical pharmacists should refer to the relevant guidelines and combine with the clinical practice to help doctors adjust the treatment plan ，so as to ensure the safety and effectiveness of the patients ’medication.
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Objective@#To investigate the effects of "Q" nose paste on fixing nasogastric tube.@*Methods@#Totally 167 patients with nasogastric tube were divided into the observation group(80 cases) and the control group(87 cases) by random digits table method.The observation group fixed nasogastric tube using "Q" nose paste,while the control group using "π" nose paste. The occurrence rate of pressure injury of nasal mucosa and nasogastric tube dislocation, nurses′ operation time of pasting, removing nose paste, the time intervals of exchanging nose paste were observed and compared between the two groups.@*Results@#The occurrence rate of pressure injury of nasal mucosa in the observation group was 0,and it was significantly lower than the control group 6.897% (6/87), the difference was statistic between the two groups (χ2=5.523, P<0.05). The nurses′ operation time of pasting and removing nose paste in the observation group was (18.99 ± 1.13), (10.20 ± 0.96) s, and they were significantly shorter than the control group (38.97 ± 1.28), (20.38 ± 1.30) s, the difference was statistic between the two groups (t=-106.521, -57.266, P<0.01). The time intervals of exchanging nose paste in the observation group was (3.78 ± 0.98) d, and it was significantly lower than the control group (2.07 ± 0.91) d, the difference was statistic between the two groups(t=11.628, P<0.05). There was no statistical difference in the rate of nasogastric tube dislocation between the two groups (P>0.05).@*Conclusions@#Application of "Q" nose paste in fixation of nasogastric tube can decrease the incidence of nasal mucosa pressure ulcers, it is conducive to extend the interval of nasal sticker replacement and improve work efficiency, thus is worthy of clinical application.
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BACKGROUND:Repair of extrahepatic biliary tract injury is a difficult problem in the abdominal surgery. Tissue-engineered extrahepatic biliary tract is an ideal selection for this problem. Construction of tissue-engineered extrahepatic biliary tract with excelent performance is a key to related studies. OBJECTIVE:To investigate the biocompatibility of bile duct endothelial cels differentiated by porcine bone marrow mesenchymal stem cels with electrospun nanofibers. METHODS:Porcine bone marrow mesenchymal stem cels were induced toward biliary tract endothelial cels, which were then identified by morphology and RT-PCR. Polylactic-co-glycolic acid (PLGA) nanofiber membranes were prepared by electrospinning. The morphology was determined by scanning electron microscopy and the short-term (2-week)in vitro degradation rate was determined. Adhesion and proliferation of biliary tract endothelial cels on the nanofiber surface was analyzed by calculating the cel adhesion rate and MTT assay, respectively. Cel growth, morphology and distribution on the material surface were observed by fluorescence staining and scanning electron microscopy, respectively. RESULTS AND CONCLUSION: After 4 weeks of directed differentiation of bone marrow mesenchymal stem celsin vitro, cels showed typical morphology of dendritic bile duct endothelial cels and had the expression of CK19. Scanning electron micrographs showed that electrospun materials were continuous nanofibers with diameters between 200 and 500 nm. No significant degradation of the PLGA nanofibers was observed within 2 weeks. Based on the measured cel adhesion rate, MTT assay, fluorescence staining, and scanning electron microscopy, the differentiated cels possessed a good proliferative capacity on PLGA nanofibers. Bone marrow mesenchymal stem cels differentiated into bile duct endothelial cels in vitro. Materials prepared by the electrospinning method had a nanofiber structure, which did not significantly degrade within 2 weeks. Differentiated cels exhibit good biocompatibility with the nanofibers.
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[Summary] To investigate the association of rs2282679 A/C polymorphism in vitamin D binding protein gene with vitamin D deficiency in 1 216 participants.A standardized questionnaire was applied to collect information on alcohol consumption,smoking habits,and use of medications.Serum 25-hydroxyvitamin D [25 (OH) D] was determined by radioimmunoassay.Vitamin D binding protein genotypes were determined by SNaPshot method.1216participants included 457 women(37.6％),478 (39.3％)with vitamin D deficiency [25 (OH) D＜50 nmol/L],and 386 (31.7％) overweight/obese participants.The frequencies of rs2282679 CC,AC,and AA genotypes were 8.7％,41.0％,and 50.3％,respectively.The distributions of genotypes and alleles differed significantly between participants with sufficient vitamin D and those with vitamin D deficiency (P ＜ 0.05).There were significant differences in the serum levels of 25 (OH) D between three genotypes before and after being adjusted for covariates (P＜0.01).AA had a 22％ (OR =0.78,95％ CI 0.65-0.93,P =0.006) lowered risk of vitamin D deficiency compared with the whole studied population.Compared with CC genotype,AA had a 36％ lowered risk of vitamin D deficiency(OR =0.64,95 ％ CI 0.42-0.98,P =0.006),while there was no significant difference between AC and CC genotypes(OR=0.87,95％ CI0.57-1.34,P=0.53).In conclusion,the vitamin D binding protein rs2282679A/C polymorphism was significantly associated with serum level of 25 (OH) D and risk of vitamin D deficiency.
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Objectives To investigate the associations of serum superoxide dismutase ( SOD) , malondialdehyde (MDA), and uric acid (UA) with blood pressure and the prevalence of hypertension in a Chinese population. Methods We measured serum superoxide dismutase (SOD), malondialdehyde (MDA) and uric acid (UA) in 506 randomly selected participants. For database management and statistical analysis, we used the SAS 9.13 Software. Results Compared with normotensive participants, hypertensive patients had significantly lower serum levels of superoxide dismutase activity ( =0.0002), and higher serum levels of malondialdehyde and uric acid ( <0.05) .Univariate analysis indicated that serum superoxide dismutase activity was negatively associated with blood pressure, and serum levels of uric acid (P 0.0001);while serum levels of malondialdehyde was positively associated with blood pressure, and serum levels of uric acid (P 0.05) . There was significant difference in systolic (Ptrend=0.02) and diastolic blood pressure (Ptrend=0.04) between three groups defined by tertiles of serum levels of superoxide dismutase, with a lower blood pressure in the highest tertile than in the lowest tertile. Furthermore, the systolic (Ptrend=0.01) and diastolic blood pressure (Ptrend=0.003) in the highest tertile, which defied by the serum levels of malondialdehyde, were significantly higher than those in the lowest tertile. Conclusions Hypertensive patients have a disturbed oxidative and anti-oxidative balance. Oxidative stress may play a role in the pathogenesis of hypertension in Chinese.