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Objective:To explore the application value of humidifying high-flow nasal cannula oxygen therapy (HHFNC) in children with pediatric intensive care unit (PICU) after weaning.Methods:From January 2018 to October 2021, 42 children with endotracheal intubation admitted to PICU of Tai′an city Central Hospital were prospectively selected and randomly divided into HHFNC group and nasal continuous positive airway pressure (NCPAP) group, with 21 patients in each group. The blood gas analysis [arterial partial pressure of oxygen (PaO 2), partial pressure of carbon dioxide in artery (PaCO 2), PaO 2/oxygen concentration (FiO 2)], blood oxygen saturation (SaO 2), comfort, non-invasive ventilation time, and total hospital stay of the two groups of children 1 hour after using HHFNC and NCPAP were compared, and the rate of reintubation of trachea within 48 hours, gastroesophageal reflux, nasal injury, facial skin indentation, abdominal distension, and pulmonary air leakage were recorded. Results:There was no significant difference between the two groups in terms of blood gas analysis (PaO 2, PaCO 2, PaO 2/FiO 2), SaO 2, pulmonary air leakage, non-invasive ventilation time, hospital stay, and reintubation rate within 48 h after weaning (all P>0.05). Compared with NCPAP group, HHFNC group had higher comfort, lower incidence of facial skin indentation, gastroesophageal reflux, nasal injury and abdominal distension, and the difference was statistically significant (all P<0.05). Conclusions:HHFNC and NCPAP can both be used as the transitional respiratory support mode after weaning, and the clinical treatment effect are similar. The HHFNC group has higher comfort, which is more conducive to improving the tolerance of children, reducing adverse reactions, and has higher safety.
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Objective To intervene and appraise the health literacy of diabetic patients entering contracts with family doctors in pilot communities,and learn the effect and feasibility of health literacy management by family doctors for diabetic patients.Methods By means of community intervention study and questionnaire survey,560 diabetic patients as mentioned above in Shanghai were subject to a baseline assessment on their health literacy,followed by management and routine follow-up on their diabetic health literacy.At the end of six months of comprehensive intervention,their health literacy was appraised again to observe the effects of such management.Results Six months of guidance and management found the average scoring of the health literacy of these patients 23.46 over the baseline,an increase of 36.8% of the patients in their compliance of the four basic diabetic diet behaviors,and an increase of 27.8% of them in regular and quantitative exercises.Conclusions It is feasible for community family doctors to carry out the health literacy management for diabetic patients contracted,and health literacy management can change the awareness and behaviors of such patients to some extent.
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Vegetable oil is one of the most potential alternatives of petroleum and has become a hot issue in recent years. This review focuses on the influence of vegetable oil structure on platform compounds and polymers properties, and further systematically introduces their developments and the latest progress. Meanwhile, we also summarized the main confronting problems and the future development directions in the research of oil-based platform compounds and polymers. The review provides useful information for readers to fully understand biochemical engineering of vegetable oils and their prospects.
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Objective To examine the effects of Shenqi Bufei Tang decoction on the expression of histone deacetylase-2 ( HDAC2) and nuclear factor-κB p65 ( NF-κB p65) in the airway smooth muscle tissues of COPD rats with lung-qi deficiency syndrome. Methods A total of 40 male rats were randomly divided into normal control group,model control group,Shenqi Bufei Tang decoction group,and aminophylline group.The COPD rat model with lung-qi deficiency syndrome was established by intra-tracheal instillation of lipopolysaccharide (LPS) and passive smoking for 28 days.Pathological changes of lung tissues were ob-served under the light microscope and the thickness of the small airway wall and airway smooth muscle ( ASM) layer analyzed by the image analysis.Immunohistochemistry,real-time PCR and Western blotting were used to detect the expressions of NF-κB p65 and HDAC2 in ASM. Results The thickness of the airway wall and ASM,and the expression levels of NF-κB p65 mRNA and protein were significantly increased in the model control group when compared with those in the normal control group ( P0.05). Conclu-sion Shenqi Bufei Tang decoction can inhibit the proliferation of ASM in COPD rats with lung-qi deficiency syndrome,which may be associated with the increased expression of HDAC2 and decreased expression of NF-κB p65.
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An electronic medical record(EMR)system is built at urban community health centers to optimize services,achieving information integration of outpatient medical services based on the doctors' workstation.This system has optimized service at the outpatient clinics in the following:1.Digitizing service processes for higher efficiency and service quality; 2.Using EMR templates to save doctors' time in writing medical records for more of their time in patient inquiries and checks; 3.Using LIS,PACs and ECG/EKC systems to check lab results and imaging diagnostics of patients; 4.Using the diagnostic and therapy record sub-system to check electronic records of the patients for consulting their health history;5.Using the Shanghai Medical Alliance's(SMA)shared sub-system to acquire patients' medical records at SMA medical institutions,learning their conditions for their therapies.EMR,when it is built and put into use,can help improve GP's diagnostics and therapeutics,and provide better care to the outpatients as well.
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The paper covered the development, structure, functionality, effectiveness and goals of the community health information system in the district. It is found that Zhabei district has developed the standard electronic health archives which can be collected by various sources and renewed instantly;regional health information sharing and collaboration platform has been established as well; a sharing and joint service platform has been built for regional health information sharing between communities and secondary hospitals shared; "Health key" has been developed as a model for self-service health management for residents.
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Objective To study the cost effectiveness, cost utility and cost benefit of three programs for TB control, viz. the World Bank TB project, the Ministry of Public Health TB project and measures taken by non project areas. Method A survey was conducted in TB prevention and treatment institutions in 17 counties of 6 provinces with regard to the course of disease, expenditure for treatment and financial burden of 1 700 new and retreated TB patients. Result The World Bank project, wherein the strategies of directly observed treatment and short course chemotherapy were adopted, proved to be a low input and high output program with low capitalized cost and significant effectiveness, utility and benefit. Suggestion A new round of TB control projects ought to be started so as to achieve the sustainable development of TB prevention and treatment programs and to achieve the goals of the nation in this aspect.
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Objective To study the effect of different intervenient measures for TB control on disease financial burden. Method A survey was conducted of the expenses incurred on 1 700 new and retreated TB patients from areas covered by the World Bank project, the Ministry of Public Health project, and non project areas where intervenient measures were also taken. The method of economic estimation was used to explore the disease financial burden carried by the patients families and society. Result The average family disease financial burden is as follows: 1 735 yuan for a new case and 2 755.99 yuan for a retreated case in the international TB program(ITP); 2 669.27 yuan for a new case and 3 530.17 yuan for a retreated case in the national TB program(NTP); and 6 787.02 yuan for a new case and 7 276.10 yuan for a retreated case in the non project areas using conventional TB therapy(CTT). The average social disease financial burden is as follows: 4 735.55 yuan in ITP; 6 471.91 yuan in NTP; and 10 919.96 yuan in CTT. Conclusion The disease financial burden was the lowest in ITP, highest in CTT, and intermediate in NTP.
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Objective To study the effect of three different kinds of intervenient measures for TB control on the disease burden of TB patients. Method The estimating method of disability adjusted life years(DALY) as recommended by the WHO was used to assess the disease burden of TB patients. Result The average disease burden of new and retreated TB patients covered by the international TB program(ITP) was the lightest, with the loss of 0.31 DALY and 0.62 DALY respectively; the average disease burden of new and retreated TB patients covered by the national TB program(NTP) was intermediate, with the loss of 0.42 DALY and 0.59 DALY respectively; and the average disease burden of new and retreated TB patients from areas using conventional TB therapy(CTT) was the heaviest, with the loss of 0.61 DALY and 0.91 DALY respectively. From a social perspective, the average yearly loss of DALY per thousand TB patients in the ITP, NTP and CTT areas was respectively 16.42, 33.6 and 37.36, with the loss in the NTP areas being 2.05 times as much as that in the ITP areas and the loss in the CTT areas being 2.28 times as much as that in the NTP areas. Conclusion ITP was far superior to NTP and CTT in reducing the disease burden of TB patients, achieving better results both from the perspective of TB patients and the society.