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Objective To compare the effects of caffeine citrate and aminophylline combined with naloxone in the treatment of premature infants with apnea.Methods From March 2015 to March 2017,140 premature infants with apnea who were treated in neonatal intensive care unit in Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were selected in the research.The children were randomly divided into the study group and the control group according to the digital table,with 70 cases in each group.The control group was treated with aminophyl-line combined with naloxone,and the observation group was treated with caffeine citrate.The adverse reaction of children during the treatment was recorded,and the level of apnea was evaluated after treatment.The blood gas index of children before and after 48h treatment was compared,the mortality rate of the children was counted,and the incidence of brain injury during the 1 year follow -up was analyzed.Results After treatment for 48h,the level of PaO2in the two groups was significantly higher [study group: (10.54 ±0.41) kPa,control group: (9.66 ± 0.39) kPa] than those before treatment[study group: (7.18 ±0.26) kPa,control group: (7.21 ±0.24) kPa],and the level of PaCO2[study group: (5.31 ±0.24) kPa,control group: (5.82 ±0.25) kPa]was significantly lower than those before treatment[study group: (6.83 ±0.28) kPa,control group: (6.77 ±0.30) kPa](t＝19.153,13.624,11.271,7.304;P＝0.000,0.000,0.000,0.000),and the level of PaO2in the study group was significantly higher than that in the control group,and the level of PaCO 2in the study group was significantly lower than that in the control group(t＝6.029,4.327;P＝0.000,0.000).The overall effective rate of apnea therapy in the study group (92.86%) was significantly higher than 77.14%in the control group (χ2＝4.509,P＝0.034).The mortality rate(1.43%) and the incidence rate of brain injury (0.00%) of the study group were significantly lower than those of the control group (10.00%and 7.14%)(χ2＝4.773,5.185;P＝0.029,0.023).The incidence rate of adverse reactions (30.00%) of the study group was significantly lower than 50.00%of the control group (χ2＝5.833,P＝0.016).The endometri-al thickness of the study group was significantly lower than that of the control group (P＜0.05).The rate of ovulation success(87.84%) and pregnancy success rate (45.94%) of the study group were significantly higher than those of the control group(72.97%and 28.39%)(χ2＝5.189,4.890;P＝0.023,0.027).The rate of abortion(8.82%) of the study group was significantly lower than 33.33%of the control group (χ2＝5.242,P＝0.022).During the period of treatment,the incidence rate of adverse drug reactions (6.77%) of the study group was not significantly different from 8.11%of the control group (χ2＝0.098,P＝0.754).Conclusion Compared with aminophylline combined with naloxone treatment,caffeine citrate can significantly improve the blood gas status of apnea preterm infants,improve the overall curative effect of apnea,prevent the occurrence of neonatal death and brain injury,and reduce the adverse reactions of the children during the treatment.It is worthy of clinical application.
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Objective:Study the effect about cone beam CT(CBCT) image guidance sytem to improve the positioning accuracy and reducing the set-up uncertainty in precise radiotherapy. Methods:Use CBCT system to scan head and neck tumors patients (30 cases) and chest tumor patients (40 cases), including head and neck tumor patients were scaned 90 times, chest tumor patients were scaned 113 times. Setup deviation statistics about anterior and posterior, head and feet, left and right direction. Results:The patients with head and neck cancer, the maximum error of anterior-posterior is 6mm, Three directions errors which greater than 3mm all less than 10%. Patients with chest tumor position error are in the head and foot direction, greater than 5 mm up to 21.51%. Before and after the direction of the error did not exceed 5mm. The left and right direction greater than 5 mm up to 4.53%. Conclusion:It greatly enhances the precision of radiotherapy, improved the curative effect of radiotherapy by using CBCT online image guidance system for the patient position correction. Compared with EPID, patients scaned with CBCT absorb smaller cumulative dose, the image resolution is higher, image matching is more accurate. But compared with the ordinary helical CT,the resolution and scanning range also need to improve.
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Objective To evaluate the effects of noninvasive positive pressure ventilation on the severe cases of hand foot and mouth disease (HFMD).Methods Eighty-six cases of severe HFMD admitted to our hospital between Apr 2009 and Aug 2010 were divided into two groups based on the time when admitted to our hospital.Thirty-eight cases (group A,Apr to Jul,2009) received routine treatment and 48 cases (group B,Apr to Aug,2010) were ventilated with nasal continuous positive airway pressure based on routine treatment.The difference of the total efficiency was compared between two groups.Results Twenty-five out of 38 patients were cured,six showed improved signs,and seven showed no improvement in group A,of which the total efficiency was 81.5％.Forty out of 48 patients were cured,seven showed improved signs,and one showed no improvement in group B,of which the total efficiency was 97.9％.The clinical effect of group B was much better than group A and the difference was statistically significant ( x2 =6.71,P ＜0.05).Conclusion Early nasal continuous positive airway pressure has most valuable effect on HFMD and is helpful in preventing -HFMD from getting worse.
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-140dapa for 25 ears with positive figure 48.0%,when tympanum pressure ≤-140dapa for 43 ears with positive puncture 93.0%,there's marked difference between the 2 groups.[Conclusion] The negative pressure in the "C" tympanum figure was closely related with auris media fluid,esp.the tympanum pressure≤-140dapa.
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OBJECTIVE To improve the managerial level of hospital infection by the hospital infection control system through network information.METHODS The control system was installed software in the doctor workstation to realize the real-time monitoring and early warning on hospital infection.RESULTS The passive situation of previous retrospective investigation was changed and the prospective and dynamic monitoring on hospital infection,was realized to move forward the gateway of hospital infection control,facilitate the timely detection on epidemic trend of hospital infection and the clue of outbreak and substitute the previous operations by hands on data processing,statistical analysis and submitting.CONCLUSIONS Full use of hospital information system can promote the hospital infection management.
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Objective To assess accuracy and safety of ultrasonography guided or sonography X-ray guided percutaneous neddle biopsy(US-PCNB or CT-PCNB) for diagnosis of pulmonary masses.Methods Seventy one patients with radiographic evidences of pulmonary mass underwent US-PCNB or CT-PCNB.The diagnostic results of US-PCNB or CT-PCNB were confirmed by surgery or by follow-up examinations.Results The accuracy rate for diagnosis of pulmonary malignancy US-PCNB and CT-PCNB was 96 2% vs 94 7%.Complications occurred 3 87% vs 5 26%.Conclusions There was no statistically differences between US-PCNB and CT-PCNB.US-PCNB suitable for pulmonary tumors of around type.CT-PCNB suitable for pulmonary tumors of central type.