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Objective:To explore the effect of self-management capability cluster intervention on clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.Methods:A total of 88 patients undergoing hemodialysis in dialysis center from June to December 2019 were randomly divided into intervention group (44 cases) and control group (40 cases) according to odd-even number method. Patients in both groups were treated with hemodialysis and basic treatment, and patients in intervention group were treated with self-management capability cluster intervention. The self-management ability, dialysis compliance and related complications were compared between the two groups before and after intervention. The data were statistically analyzed by SPSS 26.0 software. Independent sample t-test was used for intergroup comparison, and paired t-test was used for intragroup comparison. Results:There was no significant difference in self-management ability at baseline between intervention group and control group ( P>0.05). After 6 months, the total score of self-management ability ((68.61±10.16), (55.12±9.29)) and emotional processing ((13.42±2.89), (11.04±2.46)), executive self-care ((21.67±4.87), (16.71±3.59)), problem solving ((16.61±3.22), (12.03±4.61)), partnership ((14.26±3.64), (10.88±3.29)) were higher than those in the control group, and the differences were statistically significant ( t=7.112, 3.764, 4.739, 5.515, 5.834, all P<0.05). The total score of self-management behavior and the scores of four dimensions in the intervention group were significantly higher than those in the control group ( t=13.413, 5.432, 8.114, 1.910, 4.127, all P<0.05). There were significant differences between the intervention group and the control group in jumping behavior (9.09%, 22.50%) , shortening behavior (11.36%, 30.00%) , hyperkalemia (15.91%, 55.00%), heart failure (11.36%, 37.50%) and arteriovenous fistula occlusion (4.55%, 10.00%) ( χ2=4.095, 5.206, 17.571, 8.843, 5.127, all P<0.05). There were significant differences between the intervention group and the control group in urea clearance index, anemia improvement, blood phosphorus, parathyroid hormone level ( t=3.830, 4.558, -3.720, 6.481, all P<0.05). Conclusion:Self-management capability cluster intervention can improve the clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.
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Objective To discuss the treatment method and effect of the application of the dorsal branches island flaps of the digital arteries in clinic.Methods During January,2010 to February,2015,a total of 20 cases of palmar soft tissue defect of the 2nd-5th distal segments of single fingers were incorporated and repaired by the dorsal branches island flaps of the digital arteries in the base of the distal phalanx.The size of the selected flaps was 3.5 cm × 2.5 cm-2.0 cm × 2.0 cm.In addition,palmar soft tissue defect (n =15) of the 2nd-5th middle and distal segments of single fingers were repaired by the dorsal branches island flaps of the digital arteries at the 1/3 site of the proximal digital arteries,and the selected flaps size was 4.5 cm × 2.5 cm-3.0 cm × 2.0 cm.Full-thickness skin graft urethroplasty was used in the donor sites.Flap shape,texture,sensory recovery and texture of the skin region,function recovery of the wounded fingers were followed up at 1,3,and 6 months after operation.Results Thirty-five patients were followed up from 6 to 13 months (average of 7 months).All flaps survived completely in the incorporated 35 cases postoperatively.Flaps had satisfactory appearance,fine texture,and soft texture in the skin transplantation area.The postoperative improvement of sensory function was between S2 and S3,and the two-point discrimination was 10-15 mm.Assessment of the upper limb function using the standard issued by the Hand Surgery Society of Chinese Medical Association graded 23 cases as excellent,10 cases as good,and 2 cases as fair.Conclusion The dorsal branches island flaps of the digital arteries are characterized by easy dissection,reliable blood supply,and no major blood vessels needed to be sacrificed,which is an effective procedure for finger soft issue defect repairing.
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Objective To analyze the correlation between clinical compliance and peritoneal dialysis treatment outcome and quality of life on end-stage renal disease patients with high and low clinical compliance.Methods Total of 137 continuous ambulatory peritoneal dialysis (CAPD) patients of end-stage renal disease were collected in second-class hospital in Weifang by convenience sampling,and divided into high and low clinical compliance group (68 patients in each)according to ESA score.SF-36,dropout rate,fatality rate,infection rate and rehospitalization rate were used to estimated,and Cox multi-factor regression model was used to analyze correlation between therapy outcome and risk factors.Results 61 CAPD patients (44.52％) were dropout,with 23 cases (37.70％) by death.The dropout rate without death(11.8％,44.12％),fatality rate (7.4％,26.5％) and infection rate(8.8％,38.2％)had significant difference between high and low clinical compliance group (P＜0.05).The SF-36 scores of 8 dimension also had significant difference between the two groups.Cox multi-factor regression model showed that clinical compliance was an important risk factor of therapy outcome and death(HR =1.68,P＜0.05).Conclusion Clinical compliance is an important risk factor of therapy outcome,and should be listed as efficacy monitoring index of peritoneal dialysis and the target of improving the curative effect of the intervention.
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ObjectiveTo disclose the life quality of uremic patients undergoing hemodialysis in several bemodialysis institutions and its risk factors.MethodsLogistic model was applied to analysis between the risk factors and uremic patients by using the universal kidney disease quality of life short form (KDQOL-SFTM).Resuits①The scores of the patients kidney disease target area and short fort health survey questionnaire were worse than those of the common crowd ( RP:39.69 ± 19.56 vs 86.02 ± 18.75 ; BP:66.33 ± 21.65 vs 81.55 ±20.83 ; MH:58.92 ± 15.87 vs 73.23 ± 16.54 et al) ② The main affecting factors of the life quality for uremic patients undergoing hemodialysis was sex ( male group:female group 46.58 ± 21.67:50.37 ± 22.56,P ＜ 0.05 ),age ( ≥55y group:＜ 55y group 38.78 ± 16.78:57.78 ± 20.45,P ＜ 0.05 ),culture (above senior high school degree group:completed and below senior high school degree group 55.64 ± 21.85:42.59 ± 21.65 P ＜ 0.05 ),diabetes ( nondiabetes group:diabetes group 59.47 ± 18.69:47.67 ± 11.33,P ＜ 0.05 ),medical treatment guarantee ( unversichert group:versichert group 43.54 ± 16.85:56.56 ± 19.67,P ＜ 0.05 ),the state of earning and work ( employed group:nonemployed group,72.90 ± 12.56:60.87 ± 11.45,P ＜ 0.05 ) and so on.③The main affecting factors of the life quality for uremic patients undergoing hemodialysis were diabetes,medical treatment guarantee,age.ConclusionThe main affecting factors of the life quality for uremic patients undergoing hemodialysis are diabetes,medical treatment guarantee,age.
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AIM: To establish the determination method of chlorogenic acid and baicalin in Ganmaozhike Granules (Flos Lonicerae,Radix Scutellariae,etc.). METHODS : The contents of chlorogenic acid and baicalin in Ganmaozhike Granules were determined by HPLC. RESULTS : The linear velation was good. The average recovery of chlorogenic acid was 101.9%,RSD was 1.12%;The average recovery of baicalin was 99.2%,RSD was 1.31%. CONCLUSION : The method is simple,accurate and with a good reproducibility and can be used for the quality control of the granules.
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Objective:To study the optimum ethanol extraction process. Methods: The extraction rate of extractum and total flavonoids as well scutellarin was choosen as the assessment index. The optimum ethanol extraction process was selected with the orthogonal design. Results: The optimum ethanol extraction process conditions follow as: adding 10 fold of 75% ethanol, extracting for 2.0h and twice in all. Conclusion: The average extraction rate of extractum and total flavonoids as well scutellarin was 13.6%, 91.7%, 78.4%(n=3), respectively.