ABSTRACT
Objective:To investigate the current situation of medication belief, compliance and asthma control level of elderly patients with asthma, and to analyze the influencing factors of asthma control level, so as to provide theoretical reference for improving asthma control level of elderly patients with asthma.Methods:Using the convenient sampling method, 325 elderly patients with asthma were selected from the respiratory clinic of Jilin Central Hospital and the Affiliated Hospital of Beihua University from June to December 2019. The general information, medication belief, compliance and the level of asthma control in elderly patients with asthma were evaluated by general information questionnaire, the specific medication beliefs scale (BMQ-S), Chinese bronchus Asthma medication adherence scale (MARS-A) and Asthma Control Test scale (ACT).Results:The scores of BMQ-S, MARS-A and ACT were (2.82±8.36), (3.67±0.85) and (17.96±5.10) respectively. Regression results showed that age, education level, medication belief and compliance were important influencing factors of asthma control level in elderly patients with asthma ( P<0.05 or 0.01), which could explain 77.9% of variation. The total score of asthma control level was positively correlated with the total score of belief in taking medicine and the total score of compliance ( r values were 0.704, 0.775, P<0.05). The structural equation model fit index between the necessity of medication belief, the concern of medication belief, the compliance and the level of asthma control was high, the path coefficient significantly ( P<0.05), compliance had a mediating effect between the necessity of medication belief and the level of asthma control. The direct and indirect effects of the necessity of medication belief on the level of asthma control in elderly asthmatics were 0.320 and 0.389 respectively, and the direct effect of medication belief concern on the level of asthma control was-0.089. Conclusions:The medication belief necessity and medication belief concern have a direct predictive effect on asthma control level in elderly patients with asthma, and compliance has a mediating effect between medication belief necessity and asthma control level.
ABSTRACT
Objective To survey the current situation and explore the association between empathic ability and job adjustment disorder of pediatric nurses. Methods The Jefferson scale of empathy health professionals and job adjustment disorder scale were used for the survey among 189 pediatric nurses. Pearson correlation analysis was used to explore the association between empathic ability and job adjustment disorder of pediatric nurses. Results The total score of empathic ability of pediatric nurses was (76.32 ±5.03), the score of their job adjustment disorder was (23.69 ±6.03). Their empathic ability and its dimensions were significantly negatively related with job adjustment disorder (P ＜0.01). Conclusions The empathic ability of pediatric nurses was at a medium to low level, job adjustment disorder was at a medium to high level. The higher level of pediatric nurses' empathic ability, the lower level of job adjustment disorder is. Hospital staff should take measures to improve pediatric nurses' empathic ability, and the pediatric nurses themselves should also actively cultivate their own perception, and improve the empathic ability so as to better acclimatize themselves to pediatric nursing job and reduce the degree of job adjustment disorder.
ABSTRACT
Objective To investigate the current status of perceived social support and challenge-hindrance working pressure source and explore the association between the perceived social support and challenge-hindrance working pressure source in clinical nurses. Methods The perceived social support scale and challenge-hindrance working pressure source scale were investgated in the study among 295 clinical nurses. Pearson correlation analysis was used to explore the association between the clinical nurses' perceived social support and challenge-hindrance working pressure source. Results The total score of clinical nurses' perceived social support was (62.12 ±10.48), the score of clinical nurses' challenging working pressure source was (22.63 ±3.67), and the score of hindrance working pressure source was (15.17±3.41). The clinical nurses' perceived social support and its dimensions were significantly positively related with the challenging working pressure source (P ＜0.01). Other support dimension of perceived social support was significantly negatively related with the hindrance working pressure source (P ＜0.01). Conclusions The perceived social support and challenge-hindrance working pressure source of clinical nurses are at a medium to high level. The higher level of clinical nurses' perceived social support is, the higher level of challenge working pressure sources. The family members, friends, leaders and colleagues should give more support for the clinical nurses, so as to enhance their subjective support, increase positive effect of working pressure source, promote their progress and improve their quality of nursing.
ABSTRACT
Objective To evaluate the curative effect and feasibility of catheter-directed thrombolysis with urokinase for acute limb ischemia. Methods The clinical data of a total of 21 patients with acute limb ischemia, who were treated with infusion of urokinase through UniFuse thrombolytic catheter, were retrospectively analyzed. The clinical curative efficacy, prognosis and complications of catheter - directed thrombolysis (CDT) were summarized. Results In all patients, thrombolysis therapy was effective, the clinical symptoms were alleviated, and successful limb salvage was achieved. One patient died of cerebral hemorrhage due to renal decompensation. No other serious complications such as hemorrhage, hematoma or disability occurred. Conclusion Preliminary clinical study shows that CDT with urokinase is effective and safe for the treatment of acute limb ischemia. This therapy can help reduce unnecessary surgical procedures or stent implantation, and the risk of thrombolysis is controllable. (J Intervent Radiol, 2018, 27: 262-265)
ABSTRACT
Clinically, chronic obstructive pulmonary disease (COPD) and coronary heart disease (CAD) often interact to promote disease progression. This article discussed that zongqi is the heart-lung correlation functional basis and yingwei relevant is heart-lung correlation core. Zongqi deficiency is the incidence basis of COPD and CAD from the pathology. Communication and transformation of nutrient and defensive qi is the core mechanism of COPD combined with CAD. Phlegm and blood stasis are toxic intricate. Further damage to jingqi is the key to combination of COPD and CAD. It lays the foundation for next clinical syndrome differentiation, development of comprehensive treatment programs and clinical research.
ABSTRACT
Aim To study the effect of Tongxinluo on the polarization of macrophages to type M2 and M1, and on Notch signaling pathway.Methods THP-1 was respectively induced by PMA and IL-4 or LPS to M2 and M1 type polarized macrophages, and treated by Tongxinluo.The expressions of marker molecules IL-10, TNF-α, IL-6 and protein of Notch signaling pathway were detected.Results The level of IL-10 increased in M2 group and there was no statistical difference on the level of IL-6 and TNF-α;the level of IL-10 decreased and IL-6, TNF-α increased in M1 group;the level of IL-10 increased and IL-6,TNF-α decreased in TXL group.There was no statistical difference in the expression of active Notch-1, DLL4 and Hes-1 between control group and M2 group;the expression of active Notch-1, DLL4 and HES-1 increased significantly in M1 group;the expression of active Notch-1, DLL4 and HES-1 decreased significantly in TXL group;there was no significant difference in the expression of Notch-1 protein in each group.Conclusion The polarization of macrophages to M1 type can be inhibited by Tongxinluo, and its mechanism may be related to the inhibition of activation of Notch-1 signaling pathway.
ABSTRACT
Objective To examine the clinical effect of simultaneous intervention for heart and lung on chronic obstructive pulmonary disease (COPD) of stationary phase combined with stable angina pectoris with Qi deficiencyblood stasis-phlegm blockade syndrome.Methods Ninety-six COPD stationary phase combined with stable angina pectoris patients with Qi deficiency-blood stasis-phlegm blockade syndrome were randomized into control group,Juhong [Exocarpium Citri Rubrum] tablet group,the Tongxinluo (通心络) group and the Ju&Tong group,24 cases in each group.The control group was given western medicine routine therapy.In addition to the treatment of the control group,Juhong tablet 3.6 g was given to the Juhong tablet group orally,twice each day;Tongxinluo capsule 1.04 g was given to the Tongxinluo group orally,three times each day;Juhong tablet and Tongxinluo capsule were given to the Ju&Tong group.Each group was treated for 8 weeks.The following intems were compared before and after treatment including the scores of cough,cough up phlegm,dyspnea and St.George's Respiratory Questionnaire (SGRQ),anginal attacks,durante dolors,nitroglycerin consumption,pulmonary function [including forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)],as well as the levels of serum C reactive protein (CRP),interleukin 1β (IL-1β) and interleukin 10 (IL-10).Results After treatment,the scores of cough,cough up phlegm,dyspnea and SGRQ decreased in the Juhong tablet group,the Tongxinluo group and the Ju&Tong group.FEV1 and FVC increased.Anginal attacks,durante dolors,nitroglycerin consumption,as well as the levels of serum CRP,IL-1 βand IL-10 decreased.Moreover,the effect of certain indexes in the Ju&Tong group was superior to those in the Juhong tablet group and the Tongxinluo group (P ＜ 0.05 or P ＜ 0.01).Conclusion Simultaneous intervention for heart and lung might improve clinical symptoms and pulmonary function of COPD stationary phase combined with stable angina pectoris with Qi deficiency-blood stasis-phlegm blockade syndrome patients.Inhibiting chronic persistent inflammation might be one of the important mechanisms.
ABSTRACT
Objective To investigate the application of lower limb electromyography in guiding preoperative localization for multiple segment intervertebral disc herniation treated with ozone injection and in predicting the curative efficacy.Methods A total of 51 patients with MRI-proved multiple segment lumbar intervertebral disc herniation,who were admitted to authors' hospital during the period from January 2012 to December 2013 and who had complete clinical materials,were included in this study.Guided by DSA,intradiscal injection of ozone together with the injection of ozone plus compound betamethasone and bupivacaine into the space around the spinal nerve was carried out in all patients.The degree of lower lumbago was evaluated with M-JOA score,and Oswestry disability index (ODI) was adopted to assess the curative effect.Results Preoperative electromyography showed that 43 patients had nerve root injury,the positive rate was 84.3％.The positive HIZ sign was detected in 30 patients,with the positive rate being 58.8％.The positive Modic sign was observed in 24 patients,the positive rate was 47.1％.Postoperative MJOA scores indicated that one-,3-and 6-month effective rates were 90.1％,86.2％ and 78.5％ respectively;and postoperative ODI values showed that one-,3-and 6-month effective rates were 87.3％,79.5％ and 74.6％ respectively.Conclusion In treating multiple segment intervertebral disc hemiation with ozone injection,lower limb electromyography is very valuable in accurately making preoperative localization as well as in precisely predicting the curative efficacy,thus this technique is worth popularizing in clinical practice.
ABSTRACT
Objective To evaluate the role of transarterial chemoembolization (TACE) as an adjuvant therapy in patients with hepatocellular carcinoma (HCC) treated with hepatectomy. Methods Clinical data of 386 consecutive patients who underwent hepatectomy for HCC were analyzed retrospectively.Of the 386 patients, 156 patients did not undergo TACE served as controls (non-TACE group), the remaining 230 patients underwent TACE (TACE group) preoperatively (n=71), postoperatively (n=86), or both (n =73). For the purpose of comparison, patients who did not undergo preoperative TACE were assigned to group A (n=242), and those patients who underwent preoperative TACE were assigned to group B (n =144). Patients cumulative survival rates were calculated by survival table and analyzed using Kaplan-Meier survival curves. Results There were significantly higher complete necrosis rates in group B (18/144) than those in group A (0/242) ( P ＜ 0.01). The difference between the survival rate of patients with complete necrosis and those with incomplete necrosis was statistically significant (P＜0.01).The 1-,3-,5-and 10-year survival rates were 90.4%(66/73),72.9%(42/73),51.9%(22/73) and 25.4%(2/73) in combined TACE group, 74.0% (50/71) ,46.2%(28/71) ,27.3%(5/71) and 0(0/71) in preoperative TACE group, 88. 0% (73/86) ,59. 6% (39/86) ,36. 7% (11/86) and 0(0/86) in postoperative TACE group, and 75. 8% (110/156), 63.4% (48/156), 31.0% (13/156) and 23.9% (10/156) in non-TACE group,respectively. Combined TACE group got a significantly higher survival rate compared with non-TACE group or preoperative TACE group or postoperative TACE group (P＜0.05). The survival rates in either preoperative or postoperative TACE group were not significantly better than those in non-TACE group (P＞0.05).Conclusions As an adjuvant treatment, combined pre-and post-operative TACE can increase survival rate in patients with surgically resectable HCC. No significant benefit for patient's long term survival when either preoperative or postoperative TACE was performed in addition to surgery.