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Objective:To investigate the status quo of disaster preparedness of nursing organization among newly recruited nurses in tertiary grade A hospitals of Zhengzhou city and analyze the influencing factors in order to provide theoretical basis for further improving the standardized training program for newly recruited nurses.Methods:This study was a cross-sectional survey. From December 2021 to March 2022, 964 newly recruited nurses from 4 tertiary grade A hospitals of Zhengzhou city were selected as the survey objects by convenient sampling method. The general information questionnaire and Hospital Nursing Department Disaster Preparedness Scale were used to conduct the questionnaire survey. Disordered multiple classification Logistic regression was used to analyze the influencing factors of disaster preparedness of hospital nursing organization.Results:The disaster preparedness score of nursing organization of newly recruited nurses was (37.62 ± 7.57) points. The results of disordered multiple classification Logistic regression showed that the factors influencing the disaster preparedness level of nursing organization of newly recruited nurses were whether they had participated in disaster rescue work and the degree of attention paid by nursing organizations to disaster rescue training (both P<0.05). Conclusions:The disaster preparedness of the nursing organization of newly recruited nurses in tertiary grade A hospitals of Zhengzhou city was at a medium level. Nursing managers should pay attention to the disaster preparedness of newly recruited nurses, develop their core abilities for disaster rescue according to their influencing factors, and incorporate disaster preparedness related contents on the basis of standardized training programs.
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Objective:To evaluate the efficacy of Qinggan Bupi Jiangtang Decoction combined with western medicine in the treatment of adult type 2 diabetes mellitus (T2DM) with with liver hyperactivity and spleen deficiency syndrome.Methods:Prospective cohort study. A total of 103 T2DM patients with liver hyperactivity and spleen deficiency syndrome in the Department of endocrinology of Shanghai Municipal Hospital of Traditional Chinese Medicine from February 2020 to February 2021 were randomly divided into the observation group (52 cases) and the control group (51 cases) according to random number table method. Both groups were treated with conventional western medicine, the control group was treated with sitagliptin phosphate on the basis of routine treatment, and the observation group was treated with Qinggan Bupi Jiangtang Decoction on the basis of routine treatment. Both groups were treated for 12 weeks. TCM symptom scores were performed before and after treatment. The FPG, 2hPBG, HbA1c and fasting insulin (FINS) were detected by dry chemistry method and Roche electroluminescence method, and insulin resistance index (HOMA-IR) was calculated. The clinical efficacy was evaluated by dynamic blood glucose monitoring indexes TIR (percentage of time when glucose was in the range of 3.9-10.0 mmol/L), TAR (percentage of time when glucose was higher than the target range ≥ 11.1 mmol/L) and TBR (percentage of time when glucose was lower than the target range <3.9 mmol/L).Results:The total effective rate was 92.3% (48/52) in the observation group and 56.9% (29/51) in the control group ( χ2=15.32, P<0.01). The score of TCM syndrome in the observation group was significantly lower than that of the control group ( t=6.30, P<0.01). The compliance rate of HbA1c in the observation group was 46.2% (24/52) and that of the control group was 23.5% (12/51). There was significant difference between the two groups ( χ2=5.80, P=0.016). Compared with the groups before treatment, MAGE, TAR, TBR significantly decreased and TIR significantly increased in both groups after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 0.78, 1.06, 0.22 and 1.45, respectively, P>0.05). Compared with the groups before treatment, the levels of FPG, 2 hPBG and HbA1c in the two groups significantly decreased after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 1.32, 0.18,1.50, respectively, P>0.05). Compared with the groups before treatment, the levels of FINS and HOMA-IR in the two groups significantly decreased after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 1.25, 0.51, respectively, P>0.05). There were no adverse reactions in the observation group, 2 cases of mild nausea and 1 case of transient diarrhea in the control group. There was no significant difference between the two groups ( χ2=3.15, P=0.118). Conclusion:Qinggan Bupi Jiangtang Decoction combined with routine treatment can improve the blood glucose level, TIR and blood glucose standard rates of adult T2DM with liver hyperactivity and spleen deficiency syndrome, and the curative effect is equivalent to sitagliptin phosphate tablets.
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Thanks to the support of relevant national policies since 2018, Internet hospitals in China had developed rapidly. The authors sorted out the current situation of Internet hospital management and construction in China through policy document search and literature search, and found such loopholes as lack of unified supervision and process supervision, barriers between online and offline one-stop services, obsolete information interoperability and network security technology, and poor doctor-patient satisfaction and treatment efficiency. It is recommended to establish a provincial-level standardized supervision and evaluation system, explore an integrated online and offline medical service system, improve the hospital informationized operation guarantee system, promote the improvement of doctor-patient communication satisfaction system, and further promote the development of Internet hospitals in China.
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@#Based on the structure of combretastatin A-4 (CA-4), a microtubulin inhibitor, eight novel compounds were designed and synthesized by introducing different substituents into the benzimidazole backbone which substituted B ring of CA-4, and the structures were characterized by NMR and HRMS. Proliferation inhibition of six tumor cells including A549, HepG2, HCT-116, MCF-7, PC-3 and Siha was measured by MTT method.The effect of active compound on cell migration was evaluated by scratch test.Molecular docking technique was applied to investigate the interaction between the most active compound with the tubulin and PI3K kinases respectively.Compound 4e showed prominent inhibition against six strains of tumor cells, especially with the strongest inhibitory effect on Siha cells (IC50 = 12.18 ± 1.17 μmol/L).Moreover, compound 4e could effectively inhibit cell migration, which deserves further study.Molecular docking study showed that the binding energy to the tubulin of compound 4e was stronger than that of CA-4, and the affinity with PI3Ks displayed that the PI3Kδ subtype kinase was the strongest; its binding energy was -37.2 kJ/mol.This study lays a foundation for the development of anti-tumor drug based on PI3K and microtubulin.
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Objective:To observe the clinical effect of the Jinshui-Xiangsheng Decoction in treating metabolic syndrome (MS) with yin deficiency and heat. Methods:From October 2018 to May 2020, a total of 60 patients with MS and Yin deficiency and heat syndrome in the Department of Endocrinology, Shanghai Hospital of Traditional Chinese Medicine who met the selection criteria were divided into 2 groups according to a random number table, with 30 in each group. The control group took Western medicine standard treatment and lifestyle intervention, and the observation group took Jinshui-Xiangsheng Decoction on the basis of the control group. Both groups were treated for 12 weeks. TCM syndrome scores were performed before and after treatment, and fasting blood glucose, TG, TC, HDL-C, LDL-C, and fasting insulin (FINS) were detected by automatic biochemical analyzer and enhanced chemiluminescence immunoassay. We aimed to observe and record the patient's waist circumference, BMI, blood pressure level, and evaluate the clinical efficacy. Results:The total effective rate was 93.3% (28/30) in the observation group and 60.0% (18/30) in the control group. There was significant difference between the two groups ( χ2=4.135, P=0.016). After treatment, waist circumference, BMI, systolic blood pressure and diastolic blood pressure in the observation group were significantly lower than those in the control group ( t values were 4.650, 2.687, 2.134 and 2.333, respectively, P<0.01 or P<0.05), and fasting blood glucose, FINS, TG, TC, LDL-C and HDL-C were significantly lower than those in the control group ( t values were 2.812, 2.899, 2.678, 2.485, 2.527 and 2.905, respectively, all Ps<0.05). The score of TCM syndrome [(3.87 ± 2.21) vs. (6.50 ± 2.01), t=-4.827] in the observation group was significantly lower than that of the control group ( P<0.01). Conclusion:Combination of conventional western medicine treatment and Jinshui-Xiangsheng Decoction can improve clinical objective indicators and clinical symptom scores, and improve metabolic disorder state for the patients with metabolic syndrome and Yin deficiency and heat.
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Objective:To explore the relationship between the preoperative fear of pain(FOP) and postoperative pain in patients with lung cancer undergoing video-assisted thoracoscopic surgery, with a view to provide a basis for psychological and behavioral intervention in perioperative pain.Methods:One hundred lung cancer patients underwent thoracoscopic surgery from August 2018 to December 2019 were recruited. The FOP was collected by the Chinese version of the fear of pain questionnaire-Ⅲ before operation. And postoperative pain including rest pain and cough pain was collected after surgery. The correlation analysis and relative risk coefficient was used to evaluate the relationship between preoperative FOP and postoperative pain.Results:Both rest pain and cough pain were positively correlated with FOP with the correlation coefficients of 0.404 and 0.489 (both P <0.05). Patients with a high level of FOP before surgery were more likely to report severe pain when coughing after surgery, which was 3.643 times (95% CI value was 1.585-8.372) higher than the patients with non-high level preoperative FOP. Conclusions:Patients with a high level preoperative FOP may report higher pain after surgery. Screening and identification of such patients are needed for further cognitive behavioral intervention.
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The diagnosis and treatment of spontaneous rupture and massive hemorrhage of tuberous sclerosis-related renal hamartoma in a woman in the third trimester are reported. The patient was admitted at 39 weeks of gestation, with threatened labor and a history of bilateral renal hamartoma, which had been hidden. Placental abruption was considered due to persistent lumbago, abdominal pain, abdominal muscle tension, uterine tension and fetal heart rate dropping to 90 bpm, and an emergency cesarean section was performed at 39 +1 weeks. About 200 ml of bloody ascites was found in the peritoneal cavity. A live boy was delivered and no blood clot was seen in the maternal face of the placenta. After the uterine incision was closed, a huge bluish purple mass was detected on the right-side retroperitoneum and the renal angiography showed rupture and hemorrhage of a right renal hamartoma. A selective right renal artery embolization was performed. The patient recovered after the operation and was discharged seven days later required by the family. The patient was in good condition except for hematuria during a 30-day postpartum follow-up, and oral everolimus treatment and regular follow-up were continued. The newborn with a birth weight of 2 355 g was transferred to the neonatology department after birth due to severe asphyxia, and postnatal echocardiography suspected heart rhabdomyoma. The baby had one seizure but was otherwise well, and was discharged after eight days. The seizure did not recur to the neonate after discharge. Clinicians should pay attention to pregnant women with renal hamartoma. If abnormal abdominal distension, hematuria or lumbago occur during pregnancy, rupture of renal hamartoma and possible massive hemorrhage should be considered.
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Objective@#To investigate the learning cognition and demand of medical college undergraduates for statistics course and its teaching effect, so as to better carry out the teaching work of statistics course and provide better teaching experience.@*Methods@#A total of 319 undergraduates from 11 medical universities and colleges who had finished statistics course were involved to conduct a questionnaire survey by using the online questionnaire survey method.@*Results@#The senior undergraduates (grade 3, grade 4, grade 5) participated in statistic course accounted for a large proportion of 94.60%; 61.90% subjects thought the course was difficult. For undergraduate public health majors and non-public health majors, more than 90% considered that it was necessary to set up the corresponding statistics courses; about 4.00% did not like the corresponding statistics courses; 75.87%, 69.52% and 50.16% thought that "teaching method", "teaching content" and "class schedule" were the main reason influencing the statistics course, respectively; and 61.9% thought that case teaching was the best way to master the course. The results also showed that all subjects had a common comprehending of statistical theory and a poor comprehending of software operation skills. About 90% of the research subjects had requirement for theoretical knowledge or software operation.@*Conclusion@#Colleges and universities should make theoretical courses more targeted, increase the proportion of case teaching, strengthen the teaching of software operation skills and appropriately set up corresponding training courses, to solve the problem that it is difficult to achieve satisfactory teaching effect.
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Objective To investigate the learning cognition and demand of medical college undergraduates for statistics course and its teaching effect,so as to better carry out the teaching work of statistics course and provide better teaching experience.Methods A total of 319 undergraduates from 11 medical universities and colleges who had finished statistics course were involved to conduct a questionnaire survey by using the online questionnaire survey method.Results The senior undergraduates (grade 3,grade 4,grade 5) participated in statistic course accounted for a large proportion of 94.60％;61.90％ subjects thought the course was difficult.For undergraduate public health majors and non-public health majors,more than 90％ considered that it was necessary to set up the corresponding statistics courses;about 4.00％ did not like the corresponding statistics courses;75.87％,69.52％ and 50.16％ thought that "teaching method","teaching content" and "class schedule" were the main reason influencing the statistics course,respectively;and 61.9％ thought that case teaching was the best way to master the course.The results also showed that all subjects had a common comprehending of statistical theory and a poor comprehending of software operation skills.About 90％ of the research subjects had requirement for theoretical knowledge or software operation.Conclusion Colleges and universities should make theoretical courses more targeted,increase the proportion of case teaching,strengthen the teaching of software operation skills and appropriately set up corresponding training courses,to solve the problem that it is difficult to achieve satisfactory teaching effect.
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OBJECTIVE@#To investigate the anti-inflammatory effect and mechanisms of interleukin-35 (IL-35) in inflammatory bowel disease.@*METHODS@#BALB/c mice were divided into three groups with 10 mice in each group:control group, model group (oral administration of 4% glucan sodium sulfate for 7 d) and IL-35-treated group (oral administration of 4% glucan sodium sulfate for 7 d, intraperitoneal injection of 2 μg IL-35 at d2-5). Disease activity index (DAI) was scored every day. After 7 d, the mice were sacrificed, and the serum and intestinal tissue samples were collected. The gross morphology of the colon was observed; HE staining was used to observe the pathological changes of colon tissue; flow cytometry was employed to detect the change of macrophage polarization ratio in colon tissue; the mRNA expression levels of cytokines IL-6, TNF-α, IFN-γ, IL-10 and SHIP1 in colon tissue were determined by real-time quantitative RT-PCR; the expression and distribution of SHIP1 in colon tissue was measured by immunohistochemistry; Western blotting was adopted to detect the expression level of SHIP1 protein in colonic intestinal tissues of each group.@*RESULTS@#The DAI scores of the mice in the model group were higher than those in the control group, while the DAI scores in the IL-35-treated group were lower than those in the model group (all 0.05). Compared with the model group, microscopic inflammatory infiltration score was decreased and microscopic crypt destruction and score was significantly lower in IL-35-treated group (all <0.05). The relative expression of proinflammatory cytokines IL-6, TNF-α and IFN-γ in the colon tissue of IL-35-treated group was decreased compared with the model group, while the relative expression of IL-10 mRNA was higher than that of the model group (all <0.05). Compared with the control group, the proportion of M1 macrophages in the model group increased (<0.05), while the proportion of M1 macrophages in the IL-35-treated group was lower than that in the model group (<0.05). The relative expression of SHIP1 mRNA and protein in the colon tissue of IL-35-treated group was higher than that in the model group (all <0.05).@*CONCLUSIONS@#IL-35 can inhibit the polarization of M1 macrophages and regulate inflammatory cytokines to promote anti-inflammatory effect on mice with colitis.
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Animals , Mice , Anti-Inflammatory Agents , Pharmacology , Colitis , Drug Therapy , Colon , Cytokines , Genetics , Disease Models, Animal , Gene Expression Regulation , Glucans , Pharmacology , Interleukin-6 , Genetics , Interleukins , Pharmacology , Macrophages , Mice, Inbred BALB C , Phosphatidylinositol-3,4,5-Trisphosphate 5-Phosphatases , GeneticsABSTRACT
Learning objective clarity is very important for college students' classroom learning . Health assessment course as one of the compulsory course of nursing teaching, is the basis of nursing students' learn nursing profession, therefore to explore the related factors of health assessment course learning objec-tives has its practical significance. Under the guidance of the concept of the reform of the teaching system, the SIMPP analysis of the students learning objective in the college nursing students in health assessment course has been carried out. Results show that among college nursing students, three kinds of students' learning goals are very clear, four kinds of students' learning goals are clear, and two kinds of students' learning goals are unclear. The related factors influencing the nursing students' learning goal mainly are the student personal subjective factors. Teachers should pay attention to the observation of the students' study status in health assessment course, understand the student individual situation, control the clear degree of learning goals among students and do the ideological work of students at the beginning of the course to im-prove the students' clear degree of learning goals.
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@#Objective To investigate the effect of hyperbaric oxygen (HBO) on the behaviors, organizational morphology and the expression of protein kinase R-like ER kinase (PERK) in rats with spinal cord injury. Methods Thirty-six male Sprague-Dawley rats were randomly divided into normal group, sham group, model group and HBO group, with nine cases in each group. The normal group did not receive any treatment, the sham group received only laminectomy, and the other two groups were established spinal cord injury model with modified Allen's method. Six hours after operation, the model group was treated with regular air, and HBO group received HBO treatment for seven days. The recovery of locomotor function was evaluated by BBB (Basso Beattie and Bresnahan) on the day before operation and six hours, three days, seven days after operation. HE staining was used to observe the change of tissue morphology in injured spinal cord, and the expression of PERK in spinal cord was detected by Western blotting. Results There was no neurological deficit in the normal group and the sham group. The neurological score was lower in the model group than in the sham group three days and seven days after operation (P < 0.05), and was higher in HBO group than in the model group seven days after operation (P < 0.05). There was no obvious structural change in the normal group and the sham group, however, the model group showed swelling cells, condensed cytoplasm, and nucleus pycnosis hyperchromatic, and the HBO group showed slighter swelling cell compared with the model group. The expression of PERK was higher in the model group than in the sham group, and was lower in HBO group than in the model group seven days after operation (P < 0.05). Conclusion HBO could reduce the expression of PERK in the injured spinal cord, and improve the recovery of hind limb locomotor function in spinal cord injury rats.
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Objective To establish a comprehensive,simple,and effective scoring model for predicting the recurrence risk after endovascular embolization of intracranial aneurysms in order to assess the possibility of recurrence and to provide guidance for the selection of surgical protocols and postoperative management.Methods From May 2012 to May 2014,434 patients (441 aneurysms) with intracranial aneurysm treated with endovascular embolization at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively,and they were used as a modeling group.After modeling,109 patients (109 aneurysms) were used as a validation group.In the modeling cohort,a predictive scoring model of recurrence risk was established according to the results of multivariate logistic regression analysis;the model was validated in the validation cohort.According to the scoring model of the modeling group,the scoring table of best cut-off value of the receiver operating characteristic (ROC) curves was divided into a low-risk and a high-risk of recurrence.The recurrence risk score model was compared with the North America aneurysm recanalization stratification scale (ARSS) model,and Raymond grade.Results Multivariate logistic regression analysis showed that the 3 factors included in the scores and finally,a established scoring model of recurrence risk prediction were non-stent assisted embolization (1 point),Raymond grade ≥Ⅱ (1 point),and the size of aneurysm (aneurysm >25 mm[3 points)],aneurysm 10-25 mm[1 point],and aneurysm <10 mm[0 point]).The validation indicated that the scoring system had higher predictive value (AUC=0.738,95%CI 0.641-0.834,P<0.05) and goodness of fit (Hosmer-Lemeshow χ2=2.109,P=0.146).The scoring table was further divided into the low-risk recurrence (0-1 point) and high-risk recurrence (2-5 points),its sensitivity was 72.73% (48/66) and specificity was 68.80% (258/375).The predictive ability of the aneurysm recurrence risk score model was similar to that of the ARSS score (χ2=0.54,P=0.462),and it was better than the Raymond grade (χ2=15.10,P<0.01).Conclusion The established simple aneurysm recurrence risk predicting score model in this study may accurately predict the recurrence of aneurysms,however,a multicenter,large sample prospective study is needed for further validation.
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Objective To investigate the safety and effectiveness of using low-profile visualized intraluminal support (LVIS) stents for the treatment of aneurysms in the small intracranial vessels (diameter <2.5 mm).Methods Between October 2014 and April 2016,the clinical data of all 30 patients with intracranial saccular aneurysm treated with LVIS stents with the small parent arteries <2.5 mm in diameter in Changhai Hospital,the Second Military Medical University were analyzed retrospectively,including 7 ruptured aneurysms and 23 unruptured aneurysms.The anterior circulation aneurysm accounted for 93.3% (n=28),and the diameters of the parent arteries were 1.6-2.4 mm.The complications associated with surgery,angiography,clinical outcomes,and mid-term follow-up data were analyzed.Results The success rate of stent implantation was 100%.Immediate embolization results:Raymond grade Ⅰ in 12 cases (40.0%),Raymond grade Ⅱ in 11 cases (36.7%),and Raymond grade Ⅲ in 7 cases (23.3%).Complications occurred in 2 cases,including one perforating artery occlusion and one intraoperative rupture.Twenty-five patients accepted the angiographic follow-up (Raymond grade Ⅰ in 21 cases,grade Ⅱ in 3 cases,and grade Ⅲ in 1 case).The follow-up time ranged from 4 to 14 months,with an average of 8.1± 2.6 months.One patient had asymptomatic intracranial artery stenosis in the distal end of the stent.No new neurological dysfunction or death occurred.Conclusion The deployment of LVIS stents in small vessels is safe and feasible,the effect of mid-term follow-up is better.However,a larger sample study and long-term follow-up results are needed.
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<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture (EA) on the activation of microglia cells in the Lto Lspinal cord in rats with neuropathic pain, so as to investigate whether EA could inhibit the activation of spinal microglial cells and regulate the expression of brain-derived neurotrophic factor (BDNF) to achieve the analgesic effect.</p><p><b>METHODS</b>Forty male Sprague Dawley rats were randomly divided into a normal group, a sham-model group, a model group and an EA group, 10 rats in each one. The rats in the normal group received no treatment; the rats in sham-model group were treated with operation to exposure sciatic nerve for 2 to 3 min (no knot); the rats in the remaining groups were treated with model establishment of chronic constrictive injury (CCI). 7 days after model establishment, the rats in the EA group were treated with EA at "Zusanli" (ST 36) and "Yanglingquan" (GB 34), 30 min per time, once a day for consecutive 7 days. Only immobilization was used in the remaining groups the mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) of affected side feet were respectively measured before model establishment and 3 days, 5 days, 7 days, 10 days, 12 days and 14 days after model establishment; 14 days after model establishment, rats were sacrificed; the immunohistochemical method was used to measure the expression of Iba1 and BDNF in the sample of Lto Lspinal cord; real-time fluorescent quantitative PCR was used to measure the expression BDNF mRNA.</p><p><b>RESULTS</b>Compared with the sham-model group, the pain threshold was decreased significantly in the model group (<0.05), leading to hyperpathia. After EA treatment, compared with the model group, the pain threshold was increased significantly in the EA group (<0.05). 14 days after operation, the microglia cells in the Lto Lspinal cord, expression of BDNF and level of mRNA in the model group were significantly higher than those in the normal group and sham-model group (all<0.01); those in the EA group were significantly lower than those in the model group (all<0.01).</p><p><b>CONCLUSIONS</b>The analgesic effect on neuropathic pain is likely to be achieved by EA through inhibiting the activation of spinal microglia cells and down-regulating the expression of BDNF.</p>
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Objective To investigate the effect of sepsis on vecuronium-induced inhibition of acetylcholine release in neuromuscular junction in rats.Methods Thirty-six adult male SPF SpragueDawley rats,aged 2-3 months,weighing 200-220 g,were randomly divided into 3 groups (n=12 each) using a random number table:control group (group C),sham operation group (group S) and sepsis group (group Sep).Sepsis was induced by cecum ligation and puncture (CLP) in rats anesthetized with intraperitoneal chloral hydrate 350 mg/kg.At 12 h after CLP,the sciatic nerve-pretibial muscle was prepared.Vecuronium was added to the culture medium with the final concentration of 0.08 μg/ml,and the sciatic nerve-pretibial muscle was incubated for 15 min.Before and after administration,evoked endplate potentials (EPPs) and miniature endplate potentiais (MEPPs) were recorded by using intracellular microelectrode.EPP/MEPP ratio was calculated.Results Compared to C and S groups,EPPs,MEPPs and EPP/MEPP ratio were significantly increased before and after administration in group Sep.EPPs,MEPPs and EPP/MEPP ratio were significantly lower after administration than before administration in the three groups.Conclusion Sepsis can promote acetylcholine release in neuromuscular junction,thus weakening vecuronium-induced inhibition of acetylcholine release in neuromuscular junction in rats.
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Objective To analyze the effect of hand hygiene compliance on the incidence of ventilator-associated pneumo-nia(VAP )in children,and explore the role of hand hygiene in the prevention and control of VAP .Methods Hand hygiene compliance among HCWs in a pediatric intensive care unit (PICU)was intervened,hand hygiene compliance rate of HCWs and incidence of VAP in children with mechanical ventilation from March 1,to October 31,2012 (before intervention)and from January 1,to August 31,2013 (after intervention)were compared.Results Hand hygiene compliance rate after in-tervention was higher than before intervention(37.31%[97/260]vs 24.17% [58/240])(χ2 =10.08,P <0.01);the con-sumption of hand washing liquid and alcohol-based handrub enhanced from 3.48mL /bed day before intervention to 4.49 mL/bed day after intervention,which increasing by 29.02%.The incidence of VAP after intervention was lower than be-fore intervention (2.21‰[5/2 261]vs 6.50‰[13/2 001])(χ2 =4.67,P <0.05).Conclusion Implementation of com-prehensive measures and improvement of HCWs’hand hygiene compliance can reduce the incidence of VAP in chil-dren.
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Objective To evaluate the safety and efficacy of intranasal dexmedetomidine and nitrous oxide/oxygen inhalation sedation assisted in tooth extraction in elderly outpatients.Methods Sixty elderly patients who need tooth extraction were divided into two groups,with 30 patients in each group.The groupⅠwas treated with nitrous oxide/oxygen inhalation sedation,and the groupⅡwas treated with intranasal dexmedetomidine and nitrous oxide/oxygen inhalation sedation.Recording those signs basis val-ue(T0 ),during the injection(T1 ),during the extraction(T2 ),10 min after extraction(T3 ):vital signs,Ramsay sedation score,anxie-ty score,VAS pain score and patients′degree of satisfaction.Results In groupⅡ,patients′degree of satisfaction were significantly higher than groupⅠ(P<0.05)after operation.The VAS pain scores and anxiety scores of groupⅡwere significantly lower than groupⅠ in T1 and T2 (P<0.05).In T2 ,group Ⅱ had lower heart rates (P<0.05).In T2 ,Ramsay score of group Ⅱ was higher than group Ⅰ(P<0.01).Conclusion Intranasal dexmedetomidine and nitrous oxide/oxygen inhalation sedation can be a safe and effective anesthetic method in tooth extraction of elderly patients.
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OBJECTIVE@#To evaluate the efficacy of standardized medication for patients with chronic rhinosinusitis.@*METHOD@#According to the diagnosis and treatment guidelines on chronic rhinosinusitis formulated in 2008, by means of prospective study, we studied 54 patients suffering from chronic rhinosinusitis treated with standardized medication including, a combination of local intranasaI corticosteroids, macrolides, mucus discharging agent and nasal irrigation treatment and followed up for 3 months. Visual analogue scale (VAS), sino nasal outcome test-20 Chinese version scales (SNOT-20 CV), Lund-Mackay CT and Lund-Kennedy endoscopy methods were employed to conduct the subjective and objective assessment and comprehensively evaluate the clinical efficacy before and after treatment.@*RESULT@#(1) After three months of standardized medication, the patients' total scores of VAS, SNOT-20 CV, CT and endoscopy were improved significantly compared with those before-treatment (P < 0.01 for all these scoring systems). (2) There was statistically significant difference between the clinical efficacies of chronic rhinosinusitis patients with and without nasal polyps groups (P < 0.01). After 3 months of standardized medication, the effective rates of the CRSwNP group evaluated by subjective assessment and CT evaluation were 66.7% and 94.4% respectively, while those of the CRSsNP groups were 91.7% and 97.2% respectively. (3) Betwecn CRSwNP and CRSsNP groups, there was no significant difference in the improvement rate or inefficiency rate in subjective assessment except for the cure rate, while there were significant differences in both cure rate and improvement rate in CT evaluation. (4) The CRS patients' self-testing-based questionnaires results showed positive correlation with objective assessments.@*CONCLUSION@#The standardized medication with combination of intranasal local glucocorticoid, macrolides (14-membered ring), the mucus discharging agent and nasal irrigation on CRS was effective.
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Administration, Intranasal , Chronic Disease , Glucocorticoids , Therapeutic Uses , Macrolides , Therapeutic Uses , Prospective Studies , Quality of Life , Rhinitis , Drug Therapy , Sinusitis , Drug Therapy , Treatment OutcomeABSTRACT
OBJECTIVE@#To investigate which aeroallergens were prevalent in patients with allergic rhinitis in Yunnan.@*METHOD@#Retrospective analysis of the medical records of intradermal test performed in 1893 AR patients. The samples were divided into four age groups: 4-17-year-olds, > 17-35-year-olds, > 35-50-year-olds and > 50-70-year-olds. According to gender,the samples were decided into two groups: the males and the females. The positive rate of aeroallergens were compared among the groups.@*RESULT@#(1)The total positive rate of intradermal test was 70.1%. The top ten allergens were as follow: dermatophagoides pteronyssinus, dermatophagoides farina, house dust, pollen of the summer and autumn, alnus nepalensis, chenopodiaceae, mugwort, poaceae, brassica and cockroach. (2) In all groups,patients with triple positive allergens were the most common,followed by dual positive allergens and single positive allergen. (3) Among the top ten allergens, the top three positive ones in all groups were dermatophagoides pteronyssinus, dermatophagoides farina and house dust. And there were significant differences between 4-17-year-olds group and the other age groups (P < 0.01). (4) There was no significant difference between male and female patients in distribution of aeroallergens except House dust and mite.@*CONCLUSION@#The most common allergen in patients with allergic rhinitis in Yunnan is mite,the follow are pollen of the summer and autumn, alnus nepalensis, chenopodiaceae, mugwort, poaceae, and brassica. The distribution of aeroallergens are different among the age groups, but has no evident correlation with gender.