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Objective:To explore the effect of continuous pumping normal saline at same infusion speed before flushing or sealing the tube on the hemodynamics of patients with hypovolemic shock receiving norepinephrine.Methods:A total of 56 cases of hypovolemic shock patients receiving norepinephrine via micro-pump were randomly assigned to the observation group and the control group (28 cases in each group). Patients in the control group received conventional operation method to flush or seal the tube, while patients in the observation group continued pumping normal saline at the same infusion speed, followed by flushing or sealing the tube based on the control group. The changes of hemodynamics after flushing or sealing the tube was compared between two groups.Results:After 30 s, 1 min, 2 min, 3 min, 5 min of flush or seal the tube, the systolic blood pressure were (105.4±17.4) mmHg, (106.3±21.3) mmHg, (102.1±14.5) mmHg, (100.6±16.9) mmHg, (101.0±14.3) mmHg (1 mmHg=0.133 kPa), mean arterial blood pressure were (81.1±8.6) mmHg, (82.4±9.9) mmHg, (78.6±7.3) mmHg, (76.9±6.7) mmHg, (75.7±6.5) mmHg in the observation group, lower than those in the control group [(150.6±26.7) mmHg, (151.8±30.1) mmHg, (139.7±29.8) mmHg, (125.3±25.3) mmHg, (114.4±21.6) mmHg and (107.4±11.6) mmHg, (106.1±11.5) mmHg, (98.1±11.1) mmHg, (88.9±9.6) mmHg, (79.5±8.0) mmHg], the differences were statically significant ( P<0.05). After 30 s, 1 min, 2 min, 3 min of flush or seal the tube, the diastolic blood pressure were (69.0±10.50)mmHg, (70.5±10.7)mmHg, (66.9±8.3)mmHg, (65.1±6.2)mmHg in the observation group, lower than those in the control group [(85.9±11.6) mmHg, (83.3±8.7) mmHg, (77.3±7.4)mmHg, (70.7±7.2) mmHg], the differences were statically significant ( t value was 10.199-18.464, P<0.05). Conclusions:Before flushing or sealing the tube, continue pumping normal saline at same infusion speed can reduce the risk of abnormal hemodynamics for the hypovolemic shock patients receiving norepinephrine via micro-pump.
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Acute myeloid leukemia (AML) is a group of heterogeneous malignant diseases inhematological system, with significant differences in morphology, immunology, genetics, molecular biology and clinical manifestations. Cytogenetics detection has become one of the main bases for the accurate diagnosis, treatment options and prognosis judgement of AML. However, the high heterogeneity at the molecular level leads to low detection rate by conventional cytogenetics detection technology. Clonal chromosome aberrations in 40 %ˉ50 % of patients with AML could not be detected by using standard chromosomal banding, which might be called normal karyotype AML (NK-AML). The common molecular genetic changes in non-M3 AML includes FLT3, NPM1, DNMT3A and IDH mutations. This paper mainly reviews the characteristics of the above four genes, pathogenesis and prognosis of non-M3 AML.
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Objectives To investigate the clinical features of clomiphene citrate (CC) resisitant in patients with the polycystic ovary syndrome(PCOS). Methods A total of 145 women with PCOS were analyzed in the center for reproductive medicine of our hospital. According to the responses to CC ,patients were divided into two groups:(1)the CC resistant group(n = 32),(2)the CC response group(n = 113). The clinical features were compared between these two groups. Results (1)Body weight,body mass index(BMI),blood pressure and F?G scores were significantly higher in the CC resistant group than those in the CC response group (P < 0.05, respectively).(2)Basic antral follicle counts(AFC),C reaction protein(CRP),fasting insulin(FI)and HOMA?IR in the CC resistant group were significantly higher than those in the CC response group (P < 0.05, respectively),however,no significant difference was observed in sex hormones between these two groups. Conclusion PCOS patients with CC resistant are more likely to have higher body weight,BMI,blood pressure, insulin resistant?indexes and basic AFC ,the clinical doctors should consider these features before the treatment of ovulation induction.
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Objective To describe the adequate feeding of early enteral nutrition in critical patients with cancer, and explore its influencing factors. Methods A retrospective analysis study was performed and 161 patients were involved. Results Nearly 57.14%patients got adequate feeding. The independent risk factors included complications (P < 0.05,OR=2.312,OR 95%CI 1.078-4.958), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) scores (P < 0.05,OR=1.111,OR 95%CI 1.017-1.214) and hypoalbuminemia (P<0.05,OR=2.252,OR 95%CI 1.036-4.892) , and the protective factor was previous enteral nutrition experience (P<0.01,OR=0.123,OR 95%CI 0.021-0.494). Patients who got adequate feeding showed more increase in albumin levels, more decrease in APACHEⅡscores and shorter ICU stays. Conclusions Part of patients got inadequate feeding, due to comprehensive effects of many factors. And adequate feeding may be beneficial to the increase of albumin levels, also helps patients rehabilitate early and shorten the ICU stays.
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Objective To identify the risk factors associated with incontinence-associated dermatitis (IAD) in ICU patients with enteral nutrition associated diarrhea (ENAD), and to provide information for taking evidence-based preventive measures. Methods We used a case-control study to collect data. Information of the patients (n=55) and controls (n=55) were retrieved from the medical records of 2 intensive care units (ICUs). The patients with IAD and the controls without IAD were matched with age, gender and ward. Information on disease-related information, perineal environment, drug use and nutritional status were collected. Results The simple factor analysis showed that the risks of IAD were related to coronary heart disease (CHD )(χ2=3.96), composite variable for perfusion (χ2=7.33), APACHE II score (χ2=9.87), FiO2 (Z=-2.96), artificial airway (χ2=93.91), ENAD days (Z=-5.45), stool property (χ2=8.46), antibacterial drug use (χ2=5.55), steroid medicine (χ2=11.34) and enteral nutrition days(Z=-3.33), P<0.05. Logistic regression analysis showed that FiO2(P<0.05,OR=1.03, OR95%CI=1.01-1.06), APACHE Ⅱscore(P<0.05,OR=3.12, OR95%CI=1.01-9.64)and ENAD days(P<0.01,OR=1.64, OR95%CI=1.29-2.10)was independent risk factors for IAD. Conclusions The higher of FiO2, APACHE II score over 15 points and the longer of ENAD days, patients are more likely to occur IAD. Early monitoring and prevention of IAD are recommended to promote skin health.
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Objective:To interpret the main revision of the microbiological examination for nonsterile products:tests for specified microorganisms in Chinese Pharmacopoeia (2015 edition). Methods:The microbiological examination for nonsterile products:tests for specified microorganisms in Chinese Pharmacopoeia (2015 edition) was compared with the relevant content in the 2010 edition, and then the differences were investigated. Results:Microbiological examination for nonsterile products:tests for specified microorganisms in Chinese Pharmacopoeia (2015 edition) had been revised at a comparatively large scale in the inspection items, test method, micro-bial culture system, the quality control concept and so on. Conclusion:Microbial inspection system in Chinese Pharmacopoeia (2015 edition) is gradually improved to become a high standard check system in line with the international standards.
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Objective To make contrast analysis of sleeve lobectomy and wedge resection in lung cancer treatment by observing the clinical curative effect.Methods 100 patients with lung cancer using random table method, all the patients were divided into the observation group ( 50 cases, treated with sleeve resection ) , control group (50 cases,treated with wedge resection),follow-up after treatment lasted respectively for 3 years.Results In the two groups,anastomotic fistula incidence and mortality rates of the observation group were 4%,6%;6% and 8% in the control group,there were no statistical difference (χ2 =0.00,0.00,all P>0.05);the positive rate of stump cancer cell bronchial in the observation group was 4%,it was obviously less than 16% in the control group,and the differ-ence was obvious (χ2 =4.00,P<0.05) .The anastomotic scar tissue hyperplasia and recurrence rate of the observa-tion group during the follow-up period were 2%,2%;which were lower than 16%,18% of the control group (χ2 =4.40,7.11,all P<0.05).The 1,3 year survival rates of the observation group were 92%,64%,which were higher than 62%and 42%of the control group (χ2 =12.70,4.86,all P<0.05).Conclusion Taking sleeve resection for bronchogenic carcinoma can effectively control the positive rate of bronchial stump with cancer cells,inhibit anasto-motic scar tissue hyperplasia,reduce the recurrence rate,and the curative effect is very good,which is worth of clinical application.
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Objective To determine the population structure of Streptococcus pncumoniae isolates collected from infants with eye infections,including drug resistance,resistance genes, serotypes and molecular types.Methods The susceptibility of 39 isolates to 10 antibacterial agents was tested by K-B disk diffusion and Etest.Latex agglutination test was performed to determine the serotype of the strains,and PCR was carried out to detect macrolides resistance genes mefE and ermB.Molecular types of the 20 strains were determined by multilocus sequence typing (MLST).Results A total of 39 Streptococcus pneumoniae isolates were obtained,in which 30 (76.9％) were resistant to 3 or more antibacterial agents,and no vancomycin,penicillin or cefotaxime resistant strain was found.ermB gene was found in 33 strains and mefE gene was found in 4 strains.Twelve serotypes were found,and the most frequent serotypes were 19 (8/39) and 14 (4/39). Seventeen strains (43.6％) were covered in PCV7 vaccine. The international clone Taiwan19F-14 and Spain23F-1 were found by MLST. Conclusions Streptococcus pneumoniae isolates from infants with eye infections include international resistance clones.The distribution of serotype and molecular type are dispersed, and the clones are sporadic. The isolates are highly resistant to commonly used antibacterial agents.
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To explore the anti-angiogenic effects of genistein on synovium in a rat model of type II collagen-induced arthritis (CIA).
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ObjectiveTo evaluate the inhibitive effect of Photodynamic therapy (PDT) with different parameters on dental caries formation in rats.MethodsWistar rats were infected with S.mutans to establish the rat caries mode 1.The rat's teeth were treated with 0.9% NS and 0.2% NaF as controls;laser,photosensitizer and laser plus photosensitizer,respectively as treated groups.Hematoporyrin monomethyl ether(HM ME) was used as photosensitizer and laser as the light source.The rats were sacrificed after five weeks.Keyes count was used to measure the inhibitory effect of PDT on dental caries.The surface morphology of the teeth was evaluated by scan electronic microscopy(SEM).Results The PDT-treated group and NaF-treated group showed significantly reduced Keyes scores compared with the negative controls (P＜0.05).The laser-treated group,photosensitizer-treated group and NS-treated group showed no significantly reduced Keyes scores compared with the negative controls (P＜0.05).The differences of Keyes scores between various parameter PDT treated groups were significant (P＜0.05).Additionally,Keyes scores reduced gradually with the increasing of laser power.The outcome of SEM showed that the teeth treated with different laser powers exhibited different changes in morphology.Conclusion HMMEPDT had significant inhibitive efficacy on caries development in rats and its inhibitory effect presented close correlation with the power of laser,which indicates that it is important to apply appropriate power in clinical treatment.
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Objective To study the causes and nursing points of re-operation after orthotopic liver transplantation (OLT). Methods The clinical data of 241 patients who underwent OLT in the past three years were analyzed, and the causes and nursing of re-operation were summarized. Results In the 241 patients,30 cases underwent re-operation. The incidence of re-operation was 12.4%. The causes included: intra-abdominal bleeding in 14 cases with the incidence of 46.7%, biliary complications in 8 cases with the incidence of 26.6%, 4 cases infection in different organs with the incidence of 13.3%, wound dehiscence in 2 cases with the incidence of 6.7% and recurrence of carcinoma in 2 cases with the incidence of 6.7%. 7 patients died after re-operation with the mortality rate of 13.3%. Conclusions The causes of re-operation after OLT were various, intra-abdominal bleeding and biliary complications were the main factors. Knowing the causes and taking rational nursing helped to raise the survival rate and quality of life after OLT.