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Objective:To investigate the effects of noninvasive positive pressure ventilation combined with positive expiratory pressure device on pulmonary function, inflammatory factors and short-term prognosis in older adult patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), which provide objective evidence for clinical treatment and prognosis evaluation of this disease.Methods:Eighty-three older adult patients with AECOPD who received treatment in Taizhou Central Hospital, China between January 2016 and December 2018 were included in this study. They were randomly assigned to undergo either noninvasive positive pressure ventilation (control group, n = 38) or noninvasive positive pressure ventilation combined with positive expiratory pressure device (study group, n = 45) for 7 days. Pulmonary function, blood gas indexes, inflammatory factor levels and curative effect were compared between the two groups. Results:After treatment, partial pressure of oxygen (PaO 2) and oxygenation index (PaO 2/FiO 2) in each group were significantly increased, and partial pressure of carbon dioxide (PaCO 2) was significantly decreased, compared with before treatment (all P < 0.05). The degree of improvement in PaO 2, PaCO 2 and PaO 2/FiO 2 in the study group was greater than that in the control group ( t = 2.261, 6.854, 2.040, all P < 0.05). The ratio of forced expiratory volume in the first second (FEV 1) to forced vital capacity (FEV 1/FVC), the ratio of FEV1 to predicted value (FEV 1/Pre), and the maximum voluntary ventilation (MVV) per minute in each group were significantly increased compared with before treatment. After treatment, the degree of increase in FEV 1/FVC, FEV 1/Pre, and MVV in the study group was greater than that in the control group ( t = 2.442, 2.120, 2.944, all P < 0.05). After treatment, serum levels of inerleukin-8, tumor necrosis factor-α, and high-sensitivity C-reactive protein in each group were significantly decreased compared with before treatment (all P < 0.05). After treatment, the degree of decrease in serum levels of inerleukin-8, tumor necrosis factor-α, and high-sensitivity C-reactive protein in the study group was significantly greater than that in the control group ( t =7.978, 10.857, 8.543, all P < 0.05). Length of hospital stay, duration of antibiotic use, chronic obstructive pulmonary disease assessment test score and St. George's Respiratory Questionnaire score in the study group were (7.52 ± 1.38) days, (7.14 ± 1.38) days, (18.95 ± 4.76) points, (1.73 ± 4.21) points, respectively, which were significantly shorter/lower than those in the control group [(8.55 ± 1.47) days, (8.25 ± 1.45) days, (8.07 ± 5.81) points, (55.97 ± 5.28) points, t = -2.510, -2.722, -7.943, -10.351, all P < 0.05]. Conclusion:Noninvasive positive pressure ventilation combined with positive expiratory pressure device can effectively improve the pulmonary function of older adult patients with AECOPD, decrease the level of inflammatory factors, and improve short-term prognosis. This study is highly innovative and scientific and is of significance for clinical promotion.
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Objective To study the clinical curative effect and complication of methylprednisolone in the treatment of patients with acute myelitis.Methods 42 patients with acute myelitis were selected and randomly divid-ed into two groups,21 cases in each group.The control group was treated with dexamethasone,the observation group was treated with methylprednisolone.After treatment,the clinical parameters and effect of the two groups were com-pared.Results The total effective rate of the observation group was 85.7%,which was higher than 42.9% of the control group (χ2 =2.41,P <0.05).The improvement of muscle strength,restore micturition,walk on their own time in the observation group were (10.1 ±4.1)d,(7.1 ±3.4)d,(16.1 ±4.2)d,respectively,which were better than (23.4 ±7.3)d,(10.2 ±3.1)d,(22.6 ±7.3)d in the control group(t =3.15,1.69,1.97,all P <0.05).The total incidence of gastrointestinal reaction and complication rates of the observation group was 4.8%,which was lower than 19.0% of the control group (χ2 =6.37,P <0.05).Conclusion In treatment of patients with acute myelitis,methyl-prednisolone has good effect,which should be used in clinical practice.
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A novel polymer- overoxidized polypyrrole film chemically modified electrode (CME) as the liquid chromatography-electrochemical detector (LC-ECD) was fabricated and applicated, which could be used to determine the monoamine neurotransmitters. The experimental model of parkinsonian animal was established by using medicine. Microdialysis sampling coupled with LC-ECD was used to monitor the monoamine neurotransmitters and their metabolites in experimental animal brain in vivo under different situations. The mechanism of experimental animal's Parkinsonian disease was studied elementarily. An accurate and reliable analysis method was supplied for filting the new and the more effective medicine to cure parkinsonian disease.
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Objectives: To observe the effect of total enteral nutrition (TEN)and total parenteral nutrition (TPN)in aged patients with mechanical ventil ation. Methods: 60 cases of aged patients with mechanical ventilation were randomly divided to TEN group and TPN group.All patients accepted the same amount of calorie and nitrogen. Results: with regard to albumin and hemoglobin levels and nitrogen equilibrium TEN group was superior to parenteral nutrition group ( P 0.05). Conclusions: Enteral nutrition can reduce mechanical ventilation time and lower treatment cost in aged patients.