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Objective:To evaluate the standardized usage of oral antidiabetic agents in inpatients to provide reference for the pre -scription standardization .Methods:A retrospective study was used to evaluate the prescriptions of oral antidiabetic agents in inpatients during January and March in 2017 , and statistical analysis was conducted on drug usage and standardization evaluation .Results:There were 886 medication plans including 4,397 prescriptions, which involved in 13 kinds of antidiabetic agents .Metformin and acarbose a-gents were used most frequently .The non-standardization rate was 70.54％with 66.03％unlabeled accurate time for oral administra-tion and 4.51％ labeled wrong time for oral administration .Twelve antidiabetic agents existed non-standardized applications ( >50％) .Conclusion:The main problem in the non-standardized usage of antidiabetic agents is leaving the special time for oral adminis -tration of antidiabetic agents out of account , which not only affect the best efficacy , but also reduce patients ' compliance .It' s neces-sary to standardize the prescriptions of antidiabetic agents to improve the standardization of medication therapy .
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Objective To compare the curative effect of treating postherpetic neuralgia (PHN) by dorsal root ganglia pulsed radiofrequency combined ozone and simple dorsal root ganglia pulsed radiofrequency.Methods 68 cases of chest and back PHN patients in accordance with incorporation standard were randomly divided into two groups:control group (n =34) received dorsal root ganglia pulsed radiofrequency while experimental group (n =34) received dorsal root ganglia pulsed radiofrequency combined ozone.The visnal analogue scale (VAS) of two groups before treatment,and 1,3,7 days,1,3 and 6 months after treatment was observed and compared;the clinical treatment effect was evaluated.Results VAS of two groups after treatment all declined obviously compared with that before treatment (P =0.000).Compared with control group,the VAS of experimental group 1 and 3 days after treatment was not significantly different (P＞ 0.05).However,the VAS 7 days,1 and 3 months after treatment declined obviously (P ＜ 0.05).The obvious effect rate of experimental group was higher than control group,so the difference was statistically different (P ＜ 0.05).Patients in both of the groups obtained satisfying curative effect,among which the effective rates of control group and experimental group were 85.29％ and 91.18％ separately.The difference was not statistically different (P ＜ 0.05).But the obvious effect rate of experimental group (70.59％) was higher than control group (38.24％),and the difference was statistically different (P ＜ 0.05).Conclusion Both dorsal root ganglia pulsed radiofrequency combined ozone and simple dorsal root ganglia pulsed radiofrequency generate effect in treating postherpetic neuralgia.But the curative effect of dorsal root ganglia pulsed radiofrequency combined ozone is superior to simple dorsal root ganglia pulsed radiofrequency within medium and long term;therefore,it is a safe and effective treatment.
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Objective To compare the curative effect of treating postherpetic neuralgia (PHN) by dorsal root ganglia pulsed radiofrequency combined ozone and simple dorsal root ganglia pulsed radiofrequency.Methods 68 cases of chest and back PHN patients in accordance with incorporation standard were randomly divided into two groups:control group (n =34) received dorsal root ganglia pulsed radiofrequency while experimental group (n =34) received dorsal root ganglia pulsed radiofrequency combined ozone.The visnal analogue scale (VAS) of two groups before treatment,and 1,3,7 days,1,3 and 6 months after treatment was observed and compared;the clinical treatment effect was evaluated.Results VAS of two groups after treatment all declined obviously compared with that before treatment (P =0.000).Compared with control group,the VAS of experimental group 1 and 3 days after treatment was not significantly different (P＞ 0.05).However,the VAS 7 days,1 and 3 months after treatment declined obviously (P ＜ 0.05).The obvious effect rate of experimental group was higher than control group,so the difference was statistically different (P ＜ 0.05).Patients in both of the groups obtained satisfying curative effect,among which the effective rates of control group and experimental group were 85.29％ and 91.18％ separately.The difference was not statistically different (P ＜ 0.05).But the obvious effect rate of experimental group (70.59％) was higher than control group (38.24％),and the difference was statistically different (P ＜ 0.05).Conclusion Both dorsal root ganglia pulsed radiofrequency combined ozone and simple dorsal root ganglia pulsed radiofrequency generate effect in treating postherpetic neuralgia.But the curative effect of dorsal root ganglia pulsed radiofrequency combined ozone is superior to simple dorsal root ganglia pulsed radiofrequency within medium and long term;therefore,it is a safe and effective treatment.
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[ABSTRACT]OBJECTIVE To obser ve t he pathological changes of nasal mucosa in rats after instillation of 37℃ normal saline. METHODS Forty-eight qualified rats were given instillation of 37℃ nomal saline 30 times, once per minute. Another 2 qualified rats served as control. After instillation, in the 15, 30 minutes and 1st, 3rd, 7th, 14th, 42th, 28th day respectively, the nasal septum mucosa of 6 rats was observed by light and electron microscopy. The corresponding area of the mucosa of control group was also observed by light and electron microscope. RESULTS Under light microscope, the arrangement of cell was disordered in the 1st, 3rd, 7th days. But there is no damage of vascular gland structure. After 14 days, the disorder recovered. With electron microscope, edema of cells, expansion of perinuclear gap, disorder of cilia and microwilli was found in the 30 minutes, 1st, 3rd day. All these began recover in the 7th days, and completely restored in the 28th day. CONCLUSION 37℃ nomal saline drip can damage nasal mucosa, but the damage is light, which is characterized by disorder and shortage of cilia and microvilli, edema of the epithelial cells. And the damage can recover quickly. It began in the 30 minutes after instillation, reached its peak in the 3rd day. And the recovery began in the 7th day, and completed in the 28 day.
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Objective To explore the related risk factors for neuropathic pain in diabetic rats.Methods Female Wistar rats of clean grade were divided into three groups :Non diabetic standard diet (NdStd) group (n=10) ,diabetic high fat diet and pain (DbHFP) group (n=10) ,and diabetic high fat diet and no pain (DbHFNP) group (n=10).Body weight ,blood glucose ,TG ,TC ,HDL‐C ,LDL‐C and 50%pain threshold were measured regularly to assess the relationship between blood lipids and pain. Results Non‐conditional logistic regression analysis showed that pain threshold was negatively correlated with TG , LDL‐C and blood glucose(P 0.05). Conclusion Pain threshold of diabetic rats was negatively correlated with TG ,LDL‐C and blood glucose ,and positively correlated with HDL‐C.
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Objective To systematically evaluate the efficacy and safety of amlodipine (A)/hydrochlorothiazide(H) versus val‐sartan(V)/hydrochlorothiazide(H) in treatment of essential hypertension .Methods Literature was retrieved online in Cochrane Li‐brary ,PubMed ,OVID ,MEDLINE ,EMBASE ,CBM ,CNKI ,VIP and Wan fang database up to November 2013 .Relevant magazines were retrieved manually .Quality of the included studies was assessed and Meta‐analysis was performed with RevMan 5 .2 software . Results Seven randomized controlled trials(RCTs) were finally included .Meta‐analyses showed that :in terms of lowering ABP ,V/H group was more effective than A/H group ,the difference was statistically significant (P0 .05) .Ad‐verse events occurred less frequently with V/H group compared with A/H group ,the difference was statistically significant (P<0 .05) .Conclusion A/H treatment of essential hypertension is inferior to V/H ,and has more adverse events .
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Objective To introduce small group learning in the course of introduction to gen-eral practice to cultivate students' ability of active learning and innovation. Methods Totally 221 students of 2008 grade A and B classes were enrolled as teaching objects and were divided into 20 groups. Introduction to general practice was used as learning materials. One week before the class, teacher gave students learning task and A and B classes carried on class discussion respectively. Re-view speaking was conducted by the representatives of groups. Effectiveness was evaluated through the observation,interview,questionnaire survey and answer scoring points. Results Overall support per-centage to small group learning was 91%. Percentages of students who believed that small group learn-ing was beneficial to cultivating the ability of active learning and innovation were 88% and 73% re-spectively. Conclusions Introducing small group learning in the course of introduction to general practice is effective and conductive to training students' ability to study and innovate.
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BACKGROUND:Positive treatment of perioperative analgesia after total knee arthroplasty can accelerate recovery of joint function, reduce complications after replacement, and improve overal technical evaluation of total knee arthroplasty. ＜br> OBJECTIVE:To summarize commonly used analgesic drugs and analgesia method of total knee arthroplasty. ＜br> METHODS:A computer-based online research of Wanfang database and PubMed database was performed to col ect articles published between 1994 and 2014 with the keywords of“total knee replacement, epidural analgesia, peripheral nerve block, joint local analgesia, patient control ed analgesia, cold treatment”in Chinese and English. ＜br> RESULTS AND CONCLUSION:There were 986 articles after the initial survey. Final y, 55 articles were included according to the inclusion and exclusion criteria. As the technology for total knee arthroplasty, early functional rehabilitation and replacement of pain control has been widely concerned, a large number of literatures about analgesic drugs and analgesic programs emerge. Analgesic drugs include opioids, non-steroidal anti-inflammatory drugs, local anesthetics and N-methyl-aspartate receptor blockers. Analgesic program includes epidural analgesia, peripheral nerve blockage, joint local analgesia, patient-control ed analgesia and cold therapy. These analgesic drugs and methods have their advantages and disadvantages. At present, multimodal analgesia schemes have been recognized, but the optimal pain management scheme remains controversial. Increasing considerations should be paid on the choice of analgesic methods, depending on individual characteristics and existing technology.
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A retrospective analysis of 3 patients with nasal sinus foreign body caused by debris flow admitted to our department. All of the three patients showed foreign odor and mucopurulent discharge in nasal cavity after the debris flow blast injury. CT examination found high density soft tissue shadow or calcification in the nasal sinus. All the diagnoses were nasal sinus foreign body in three patients. The nasal sinus foreign bodies was dislodged through endoscopic sinus surgery. Three patients are all well-healed.
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Adult , Female , Humans , Male , Foreign Bodies , Paranasal SinusesABSTRACT
<p><b>OBJECTIVE</b>Protein induced by vitamin K absence or antagonist II (PIVKA II), also called des-gamma carboxy prothrombin (DCP), is a sensitive marker for the diagnosis of hepatocellular carcinoma (HCC), in Japan and the United States since the sensitive kits were available (1998). PIVKA II is not used in clinical diagnosis in China so far. The aim of this study was to assess the diagnostic value of PIVKA II in Chinese patients with HCC.</p><p><b>METHODS</b>Serum PIVKA II and alpha-fetoprotein (AFP) levels were determined in 60 patients with HCC and 30 patients with cirrhosis not carrying HCC.</p><p><b>RESULTS</b>The mean serum concentration of PIVKA II in HCC patients (784.3 +/- 1364.1 mean +/- s) was higher than that in cirrhosis patients (16.1 +/- 31.7); this difference was highly significant (P < 0.0001). When the cutoff level of 40 mAU/ml was used as the level of discriminating HCC from cirrhosis, 51.7% of patients (31/60) with HCC had PIVKA II values above this level (sensitivity). Only 4 patients with cirrhosis had such high PIVKA II levels. Thus, the specificity of this test was 86.7% (26/30). Total accuracy was 62.2% [(31 + 26)/(60 + 30)]. Seven of 19 small HCCs (36.84%) had PIVKA II values above the cutoff level. Concentrations of AFP above 20 ng/ml were observed in 34 of 60 patients with HCC (56.7%) and in 11 patients with cirrhosis (36.7%). Eleven of 26 patients with HCC (46.2%) without increased AFP had concentrations of PIVKA II greater than 40 mAU/ml. No significant correlation was found between serum levels of AFP and PIVKA II that were measured in 60 HCC patients (rs = 0.101, P = 0.247). Combining the information from PIVKA II and AFP showed an increase of approximately 21.6% over AFP and 26.7% over PIVKA II alone. For small HCC patients, combining the information from PIVKA II and AFP showed an increase of approximately 15.8% over AFP alone and 21.1% over PIVKA II alone.</p><p><b>CONCLUSION</b>PIVKA II is a useful early diagnostic marker for HCC and may be more sensitive when combined with AFP in Chinese patients.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Biomarkers , Biomarkers, Tumor , Blood , Carcinoma, Hepatocellular , Blood , Diagnosis , Pathology , Liver Cirrhosis , Blood , Liver Neoplasms , Blood , Diagnosis , Pathology , Protein Precursors , Blood , Prothrombin , alpha-FetoproteinsABSTRACT
time of infusion. Data analysis indicated that A1B3C2 was the best combination of the 3 factors according to the degree of lung injury. Conclusion Adequate amount of HES 200/0.5 infused during compensated stage of hypovolemic shock produces best result.
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Objective To access the changes in blood gases and electrolytes during anaphylactic shock induced by Echinococcus granulosus (EG) in sheep.Methods Fifteen healthy sheep of either sex weighing 31.2 ? 3.5 kg were repeatedly infected with EG for six months. The infected sheep were anesthetized with intramuscular thiopental 20mg?kg-1 and ketamine 15 mg?kg-1. The animals were breathing spontaneously and placed on the left side. ECG (lead Ⅱ) was monitored. Swan-Ganz catheter was placed via right internal jugular vein for hemodynamic monitoring. Anaphylactic shock was induced with antigen prepared from fluid in EG capsules. Blood samples were taken from right internal carotid artery before shock (T0) and 3.5 min (T1 ), 8 min (T2), 15 min (T3), 30 min (T4) and 60 min (T5 ) after shock was induced for determination of blood Na+ , K+ , Hct, Hb, pH, PaO2 , PaGO2 and HCO3-. Shock was confirmed by hypotension (MAP decreased by 30%), tachypnea, dyspnea, agitation and pupil dilation. Results Three sheep did not develop shock and two sheep died of severe shock within 10 min after iv antigen challenge. Blood K+ significantly increased at T1 and T2 after antigen challenge and then gradually returned to baseline value at T5 . PaO2 decreased, PaGO2 increased and pH deceased after challenge. Hct and Hb also increased significantly after challenge. Conclusion There are significant changes in blood gas and electrolytes indicated by hyperkalemia, acidosis and hypoxemia during anaphylactic shock induced by EG.