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Objective:To explore the efficacy of doctor-nurse co-led care involving education and engagement of patients on improving compliance of patients, and a treat-to-target urate-lowering rate for gout.Methods:Nurses were trained in practice management of gout. Patients diagnosed with gout in the departments of rheumatology and immunology of Anqing Municipal Hospital in Anhui Province were prospectively enrolled from January 1 to June 30, 2019. The patients were divided into the continuous-care group and the conventional management group by random number table method. The patients of continuous-care group received telephone follow-up, WeChat tracking and regular face-to-face communication. The patients of conventional management group were told to follow up regularly in the outpatient department, and the nurses did not follow up. Patients were evaluated before intervention and 12 months after intervention. The treat-to-target rate of blood uric acid and the frequency of gout flares were observed.Results:After 12 months of intervention, the patients of serum uric acid concentrations below 360 μmol/L were 92.39% (85/92) in the continuous-care group, and 26.74% (23/86) in the conventional management group. There was significant difference ( χ2 value was 80.282, P<0.001). After 12 months of intervention, the average serum uric acid concentration of patients in the continuous-care group was (301.6±61.4) μmol/L, and that in the conventional management group was (419.0±98.0) μmol/L, both of which were significantly lower than before intervention, continuous-care group (466.1±119.7) μmol/L, conventional management group (477.8±113.1) μmol/L. But the average serum uric acid concentration of patients in the continuous-care group was significantly lower than that in the conventional management group. There was significant difference between them ( t value was 96.678, P<0.001). At the end of 12 months, the patients of uric-acid-lowering therapy increased in both groups. The proportion of patients was 94.56% (87/92) in the continuous-care group, which was significantly higher than that in the conventional management group (58.14%, 50/86), there was significant difference ( χ2 value was 33.260, P<0.001). Conclusions:The mode of continuing nursing combined with specialized physician-led treatment can significantly improve the compliance and the control rate of treat-to-target for gout, and this management method is simple and feasible which provides a new management concept for clinical treatment of gout.
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Objective To investigate the effect of early using periplaneta americana extract on gastrointesti-nal function in critically patients with infection,and to evaluate its possible mechanism.Methods 66 patients with infection in Intensive Care Unit(ICU)were divided into control group and treatment group(33 cases in each group) according to the random number table.All patients in the two groups were given conventional cluster treatment,the patients in the treatment group additionally received periplaneta americana extract.At the beginning of treatment and 3,7 and 10 days after treatment,the indicators of bowel sounds,gastrointestinal function,APACHEⅡ and blood lactic acid level were respectively tested or recorded.Results At the beginning of treatment,there were no statistically sig-nificant differences between the two groups in terms of gastrointestinal function,bowel sounds,APACHE II score and blood lactic acid level(t =0.132,0.201,0.329,0.190,all P >0.05).3,7 days after treatment,the gastrointestinal function[(1.56 ±0.49)points vs.(1.32 ±0.45)points,(1.27 ±0.44)points vs.(1.02 ±0.42)points],bowel sounds[(1.58 ±0.76)times/min vs.(2.27 ±0.75)times/min,(2.15 ±0.91)times/min vs.(3.11 ±0.97)times/min],APACHE II score[(19.61 ±4.02)points vs.(17.50 ±4.37)points,(17.69 ±3.94)points vs.(15.24 ± 3.82)points]and blood lactic acid level[(2.94 ±0.88)mmol/L vs.(2.45 ±0.75)mmol/L,(2.51 ±0.59)mmol/L vs.(2.20 ±0.55)mmol/L],the terms in the treatment were better than those in the control group,the differences were statistically significant(t3 =2.072,t7 =2.361;t3 =3.712,t7 =4.146;t3 =2.041,t7 =2.565;t3 =2.434,t7 =2.208,all P <0.05).Conclusion Early using periplaneta americana extract has protective effect on gastrointestinal function in critically patients with infection,and improve the condition in a certain degree.
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Objective To observe the effects of Kinesio taping on upper limb spasticity after stroke. Methods From March to Novem-ber, 2015, 39 stroke patients were divided into Kinesio taping group (Kinesio taping and rehabilitation, n=13), white taping group (white tap-ing and rehabilitation, n=13) and blank group (rehabilitation, n=13) randomly. They were evaluated with modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA) of upper limbs and the modified Barthel Index (MBI) before treatment, four and eight weeks after treat-ment. Results There was no significant difference among the three groups in the scores of FMA and MBI (P>0.05) four weeks after treat-ment, but the score of MAS improved more in the Kinesio taping group than in the other two groups (P<0.05). The scores of MAS, FMA and MBI all improved more in the Kinesio taping group than in the other two groups (P<0.05) eight weeks after treatment. Conclusion The application of Kinesio taping can relieve upper limb spasticity, and improve motor function and activities of daily living for patients with stroke.
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Objective To study the role of maintaining ventilator tubing at low position in prevention of ventilator-associated pneumonia (VAP).Methods From January 2010 through December 2011,110 cases with invasive mechanical ventilation in Intensive Care Unit (ICU) were randomly divided into observation group (n =55) and control group (n =55).The patients of control group were given conventional prevention method including the head elevated 30°-45°.The patients of observation group were given prevention method of keeping ventilator tubing at low position in addition to conventional prevention method so as to avoid the condensate in ventilator tubing into the airway.After mechanical ventilation support for 28 days,the incidence of VAP,duration of mechanical ventilation,length of ICU stay,incidence of condensate flowing back,clinical pulmonary infection score (CPIS) and mortality were respectively recorded.At the same time,risk of mistakenly extubation by nurses was recorded.Results The comparison between two groups showed the incidence of VAP (16.36％ vs.34.55％),duration of mechanical ventilation (5.86 ± 2.66) d vs.(11.24 ± 3.80) d,length of stay in the ICU (13.60 ± 4.83) d vs.(19.58 ±5.27) d,incidence of condensate backflow (3.64％ vs.49.09％),presenting significant differences between two groups (P ＜ 0.05).The CPIS of observation group was lower than that of the control group (P ＜0.05),and the mortality in observation group (21.82％) was lower than that in the control group (27.27％),but the difference was not significant (P ＞0.05).There was no statistically significant difference in risk of mistakenly extubation between two groups (P ＞ 0.05).Conclusion Maintaining the ventilator tubing at low position can reduce the incidence of VAP,improve the prognosis,and the risk of mistakenly extubation did not increase compared with the conventional methods
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Objective:To change the disorderly competition of home medical equipment market, explore market management approach, and improve the level of public health protection.Methods: Based on the perspective of asymmetric information theory, the analysis of the market problems is made to study the information gaps between government, businesses and consumers.Results:According to the asymmetric information among market participants lead many problems of home medical instrument market, puts forward some measures to promote the domestic medical equipment market develop healthily and rapidly. Conclusion: Government, businesses and consumers should work together to give play to the role of market signals, promote of the healthy and rapid development of the home medical equipment market.
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Objective To explore the relationship of serum level of Cystatin C and suPAR with tumor infiltration, metastasis, and treatment of patients with malignant tumor. Methods: The serum levels of Cystatin C was detected by particle enhanced nephelometic immunoassay (PENIA) by 7600-010 full-automatic biochemical analyzer made in Japan. The level of suPAR was detected by ELISA. The serum levels of Cystatin C and suPARof 82 normal adults and 172 patients with malignant tumor were measured and compared. Results: The serum level of Cystatin C and suPAR in patients with malignant tumor was significantly increased compared with that of normal adults (P＜0.01 and P＜0.01). The level of Cystatin C and suPAR in terminally ill patients or patients with metastasis was significantly higher than that in the control group. The levels of the two indices in postoperative patients were lower than those in preoperative patients. No significant difference was found in the levels of the two indicies before chemotherapy or radiotherapy and after therapy. Conclusion: The serum levels of Cystatin C and suPARin patients with malignant tumor are correlated with tumor invasion, metastasis and surgical intervention. Detection of Cystatin C and suPAR levels in patients with malignant tumor is valuable for disease monitoring and treatment evaluation.
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Twenty five children with recurrent wheezing,intractable cough and recurrent respiratory infection were examined and treated by electron-bronchoscopy.Among them 9 cases were diagnosed as tracheobronchomalacia.simple endobronchial inflammation was found in 7 cases,foreign body in bronchus were found in 6 cases,bronchostenosis in 2 cases and pulmonary hemorrhage in 1 case.Tracheobronehomalacia is one of the leading causes of recurrent wheezing and intractable cough in children.Electron-bronchoscopie examination is important in diagnosis of tracheobronchomalacia in children.
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Objective To study the X-ray characteristic of non-bacterial infectious pneumonia in children.Methods In 218 cases of non-bacteria infectious pneumonia, the pathogenic agents included influenza virus,parainfluenza virus,respiratory syncytial virus(RSV),adenovirus,mycoplasma(MYCO) and chlamydia.Of them,mono-pathogenic infection were 152,mixed infection were 66.All the cases had chest conventional radiograph,129 cases were followed up for 2 times or more.The average period of the follow up were 7 days.The findings of chest conventional radiograph were analysed.Results The radiographic features included lung marking heavy 197,disorder 187,straight 105 and obscure 194;pulmonary hilum enlarged 91,hilum obscure 93,emphysema 82,point opacities 81,pulmonary radio-translucent diminution 34,patch opacities 33.In 129 cases followed up the lesions were perfectly absorbed 9(6.97%),partly absorbed 56(43.41%),non-absorbed 53(41.08%),progress 7(5.42%).Conclusion The absorbed period of non-bacteria infectious pneumonia is more 7 days.There are some radiographic characteristcs in RSV and MYCO pneumonia.