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This article introduces the development history of palliative medicine at home and abroad, investigates the existing problems of palliative medicine teaching in geriatrics, explores the improvement of geriatric palliative medicine education, and elaborates adopting theoretical teaching and clinical practice, including PBL teaching, case teaching and narrative medicine teaching, to carry out palliative medical education for geriatrics graduate students. The results showed that 67.9% of the students have increased the learning sense of palliative medicine, 92.5% of them think that palliative medicine is very important, and 75% of them think that they have enhanced their ability of language expression and communication with patients with advanced diseases, namely, the ability of end-of-life care.
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OBJECTIVE: To observe the effect of integrated Chinese and Western medicine for the treatment of occupational noise-induced deafness( ONID). METHODS: A total of 80 ONID patients were selected and randomly divided into control group and treatment group by judgment sampling method,with 40 cases in each group. The control group received routine western medicine treatment using mecobalamin tablets,vitamin B complex,nerve growth factor and hyperbaric oxygen. The treatment group received routine western medicine as the control group,plus acupuncture,moxibustion and auricular point pressing. The patients in both groups were treated continuously for 30 days. The questionnaire of conscious,the selfconscious symptoms such as tinnitus,headache,dizziness and insomnia were recorded in these two groups before and after treatment. Pure tone audiometry was performed on the patients at the same time. RESULTS: After treatment,the binaural high frequency threshold average( BHFTA) and threshold of weighted value of the left and right ears in the treatment group were better than that in the same group before treatment( P < 0. 05). The difference of the BHFTA and threshold of weighted value of the right ear in the treatment group before and after treatment was higher than that in the control group( P < 0. 05). After treatment,the symptoms of tinnitus,headache,dizziness and insomnia in the two groups were better than those in the same group before treatment. The total improvement rate of tinnitus and dizziness symptoms in the treatment group was higher than that in the control group( P < 0. 05). CONCLUSION: The treatment with integrated traditional Chinese and Western medicine for ONID can improve the hearing level of patients,effectively alleviate the accompanying self-conscious symptoms,and is suitable for promotion in clinical use.
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OBJECTIVE: To explore the effect of delayed pre-job occupational health examination on occupational health surveillance by analyzing the results of pre-job occupational health examinations in radiation exposed workers. METHODS: A convenience sampling method was used to select 1 385 radiation workers as the research subjects in Guangdong Province in 2016 at a pre-job occupational health examination. Workers who did not engage in radiation work were selected as control group. Workers who engaged in radiation work but did not take pre-job occupational health examinations were selected as observation group. The difference of the results of occupational health examination between the two groups was analyzed. RESULTS: The proportion of the observation group was 55. 8%(773/1 385). The abnormal rates of the white blood cell( WBC) count,“double + ring”rate and lens in the observation group were higher than those in the control group(9. 3% vs 5. 7%,6. 0% vs 3. 6%,6. 2% vs 3. 6%,P < 0. 05),respectively. The WBC count in the observation group was lower than that in the control group [(6. 1 ± 1. 5) × 10~9/L vs(6. 7 ± 1. 5) × 10~9/L,P < 0. 01]. The contents of the thyroid stimulating hormone and triiodothyronine in the observation group were higher than those in the control group[(1. 3 ± 0. 4) m U/L vs(1. 2 ± 0. 3) m U/L,(1. 8 ± 0. 4) nmol/L vs(1. 7 ± 0. 5) nmol/L,P < 0. 01]. The tetraiodothyronine level in the observation group was lower than that in the control group [( 110. 8 ± 22. 4) nmol/L vs(113. 8 ± 23. 2) nmol/L,P < 0. 05]. CONCLUSION: The delay of pre-job occupational health examination of radiation exposed workers affects the examination results and the accuracy of basic health records.
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Objective@#Study of the results and the degree on occupational noise-induced deafness in-to the different high frequency hearing threshold weighted value, in order to provide theoretical basis for the re-vision of diagnostic criteria on occupational noise-induced deafness.@*Methods@#A retrospective study was con-ducted to investigate the cases on the diagnosis of occupational noise-induced deafness in Guangdong province hospital for occupational disease prevention and treatment from January 2016 to January 2017. Based on the re-sults of the 3 hearing test for each test interval greater than 3 days in the hospital, the best threshold of each frequency was obtained, and based on the diagnostic criteria of occupational noise deafness in 2007 edition, Chi square test, t test and variance analysis were used to measure SPSS21.0 data, their differences are tested among the means of speech frequency and the high frequency weighted value into different age group, noise ex-posure group, and diagnostic classification between different dimensions.@*Results@#1. There were totally 168 cases in accordance with the study plan, male 154 cases, female 14 cases, the average age was 41.18 ±6.07 years old. 2. The diagnosis rate was increased into the weighted value of different high frequency than the mean value of pure speech frequency, the weighted 4 kHz frequency increased by 13.69% (χ2=9.880, P=0.002) , 6 kHz increased by 15.47% (χ2=9.985, P=0.002) and 4 kHz+6 kHz increased by15.47% (χ2=9.985, P=0.002) , the difference was statistically significant. The diagnostic rate of different high threshold had no obvious differ-ence between the genders. 3. The age groups were divided into less than or equal to 40years old group (A group) and 40-50 years old group (group B) , there were higher the diagnostic rate between high frequency weighted 4 kHz (A group χ2=3.380, P=0.050; B group χ2=4.054, P=0.032) , weighted 6 kHz (A group χ2=6.362, P=0.012; B group χ2=4.054, P=0.032) , high frequency weighted 4 kHz+6 kHz (A group χ2=6.362, P=0.012; B group χ2=4.054, P=0.032) than those of speech frequency average value in the same group on oc-cupational noise-induced deafness diagnosis rate, the difference was statistically significant. There was no sig-nificant difference between age groups (χ2=2.265, P=0.944) . 4. The better ear's mean value of pure speech fre-quency and the weighted values into different high frequency of working years on each group were compared, working years more than 10 years group was significantly higher than that of average thresholds of each frequen-cy band in 3-5 group (F=2.271, P=0.001) , 6-10 group (F=1.563, P=0.046) , the difference was statistically significant. The different high frequency weighted values were higher than those of the mean value of pure speech frequency, and the high frequency weighted 4 kHz+6 kHz had the highest frequency difference, with an average increase of 2.83 dB. 5. The diagnostic rate into weighted different high frequency was higher in the mild, moderate and severe grades than in the pure speech frequency. In the comparison of diagnosis for mild occupational noise-induced deafness, in addition to the weighted 3 kHz high frequency (χ2=3.117, P=0.077) had no significant difference, the weighted 4 kHz (χ2=10.835, P=0.001) , 6 kHz (χ2=9.985, P=0.002) , 3 kHz+4 kHz (χ2=6.315, P=0.012) , 3 kHz+6 kHz (χ2=6.315, P=0.012) , 4 kHz+6 kHz (χ2=9.985, P=0.002) , 3 kHz+4 kHz+6 kHz (χ2=7.667, P=0.002) were significantly higher than the diagnosis rate of the mean value of pure speech frequency. There was no significant difference between the two groups in the moderate and se-vere grades (P>0.05) .@*Conclusion@#Bring into different high frequency hearing threshold weighted value in-creases the diagnostic rate of occupational noise-induced deafness, the weighted 4 kHz, 6 kHz and 4 kHz+ 6 kHz high frequency value affects the result greatly, and the weighted 4 kHz+6 kHz high frequency hearing threshold value is maximum the effect on occupational noise-induced deafness diagnosis.
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Objective To explore the relationship between the objective indexes and TCM syndromes of occupational hand arm vibration disease ,and to provide clinical data for the objectification of TCM syndrome differentiation. Methods 101 patients with occupational hand arm vibration disease were collected ,including 24 patients with Xingbi,39 with Tongbi and 38 with Zhuobi,according to the theory of traditional Chinese medicine syndrome differentiation ,the relationship was observed between different TCM Syndrome types and various of parameters,such as 5-and 10-minute rewarming rates in cold water rewarming test,terminal latency,amplitude, conduction velocity ,average time ,average amplitude of abductor pollicis brevis and abductor digiti minimi in electromyography. Results 5-and 10-minute rewarming rate in cold water rewarming test did not differ significantly among the three groups(P > 0.05). Amplitude of median nerve motor conduction differed significantly among the three groups of Xingbi,Tongbi and Zhuobi(χ2 = 6.14,P < 0.05),Further comparison between the groups was made in Xingbi and Tongbi(χ2=0.132,P=0.895),Xingbi and Zhuobi(χ2=2.277,P=0.023),Tongbi and Xingbi (χ2 = 2.172 ,P = 0.030). There were no significant differences among the three groups in latency and conduction velocity of the median nerve motor conduction and latency ,amplitude and conduction velocity of ulnar nerve motor conduction(P>0.05). The differences of conduction velocity and amplitude of median nerve and ulnar nerve sensory conduction,average time and average amplitude of abductor pollicis brevis and abductor muscle among the three groups had no statistical differences(P>0.05). Conclusions The distribution is different in the amplitude of median nerve motor conduction among the three groups of Xingbi,Tongbi and Zhuobi,further analysis shows that the difference is mainly reflected in the Xingbi group. We conclude that the median nerve axonal injury is lighter in Xingbi group than in the other two groups.
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Objective To explore the relationship between the objective indexes and TCM syndromes of occupational hand arm vibration disease ,and to provide clinical data for the objectification of TCM syndrome differentiation. Methods 101 patients with occupational hand arm vibration disease were collected ,including 24 patients with Xingbi,39 with Tongbi and 38 with Zhuobi,according to the theory of traditional Chinese medicine syndrome differentiation ,the relationship was observed between different TCM Syndrome types and various of parameters,such as 5-and 10-minute rewarming rates in cold water rewarming test,terminal latency,amplitude, conduction velocity ,average time ,average amplitude of abductor pollicis brevis and abductor digiti minimi in electromyography. Results 5-and 10-minute rewarming rate in cold water rewarming test did not differ significantly among the three groups(P > 0.05). Amplitude of median nerve motor conduction differed significantly among the three groups of Xingbi,Tongbi and Zhuobi(χ2 = 6.14,P < 0.05),Further comparison between the groups was made in Xingbi and Tongbi(χ2=0.132,P=0.895),Xingbi and Zhuobi(χ2=2.277,P=0.023),Tongbi and Xingbi (χ2 = 2.172 ,P = 0.030). There were no significant differences among the three groups in latency and conduction velocity of the median nerve motor conduction and latency ,amplitude and conduction velocity of ulnar nerve motor conduction(P>0.05). The differences of conduction velocity and amplitude of median nerve and ulnar nerve sensory conduction,average time and average amplitude of abductor pollicis brevis and abductor muscle among the three groups had no statistical differences(P>0.05). Conclusions The distribution is different in the amplitude of median nerve motor conduction among the three groups of Xingbi,Tongbi and Zhuobi,further analysis shows that the difference is mainly reflected in the Xingbi group. We conclude that the median nerve axonal injury is lighter in Xingbi group than in the other two groups.
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OBJECTIVE: To analyze the impact of GBZ 49-2014 Diagnosis of Occupational Noise-induced Deafness and GBZ49-2007 Diagnostic Criteria of Occupational Noise-induced Deafness on the diagnosis of occupational noise-induced deafness( ONID). METHODS: A total of 84 individuals,who were workers exposed to noise and diagnosed as observation subjects by GBZ 49-2007 were selected as the subjects of study by judgment sampling. They were diagnosed based on the criteria of GBZ 49-2014 and GBZ 49-2007. The impact of different diagnostic audiometry,different age and gender correction methods and the inclusion of a weighting of 0. 1 high-frequency 4. 0 k Hz hearing threshold of GBZ 49-2014 on the diagnosis of ONID was analyzed. RESULTS: The binaural high frequency threshold average( BHFTA) calculated by GBZ 49-2014 were lower than that of GBZ 49-2007 [( 52. 1 ± 10. 3) vs( 52. 8 ± 10. 1) d B,P < 0. 05 ],but monaural threshold of weighted value( MTWV) of the good ear calculated by GBZ 49-2014 were higher than speech frequency threshold average( SPTA) of the good ear of GBZ 49-2007 [( 23. 2 ± 4. 1) vs( 19. 3 ± 4. 8) d B,P < 0. 01]. All of the 84 patients had BHFTA ≥40 d B and SPTA < 26 d B when diagnosed by GBZ 49-2007,and could not be diagnosed as ONID. A total of33. 3% patients had BHFTA ≥40 d B and MTWV ≥26 d B when diagnosed by GBZ 49-2014 which could be diagnosed as mild ONID. The detection rate of ONID was 21. 4% to 34. 5%( P < 0. 01) when the threshold of 4. 0 k Hz was used as the weighting diagnostic threshold of hearing in the case of using different diagnostic audiograms and different age and sex correction methods. CONCLUSION: A high-frequency hearing threshold of 4. 0 k Hz with a weighting of 0. 1 was included in GBZ 49-2014 as a diagnostic threshold,which reduced the diagnostic threshold of ONID.
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<p><b>OBJECTIVE</b>To investigate the efficacy and safety of precise laparoscopic Roux-en-Y gastric bypass(LRYGB) in the treatment of obesity and metabolic diseases.</p><p><b>METHODS</b>Clinical and follow-up data of obese patients underwent precise LRYGB in our department between June 2011 and April 2013 were analyzed retrospectively.</p><p><b>RESULTS</b>A total of 140 obese patients were included in this study. All the precise LRYGB procedures were successfully performed with no conversion to open surgery or perioperative death. Average operation time was (138.0±21.3) min, postoperative hospital stay was (5.2±1.2) d. No severe complications was observed. The percentages of excess weight loss in 1, 3, 6, and 12 month after operation were (26.4±8.6)%, (53.3±6.7)%, (75.3±7.9)%, (78.5±8.5)%, respectively. The improvement rates of fatty liver, hyperlipidemia, hypertension and type 2 diabetes mellitus were 84.6%(33/39), 92.3%(12/13), 77.3%(17/22) and 82.4%(14/17).</p><p><b>CONCLUSIONS</b>Precise LRYGB is a modified and optimized traditional surgical technique which does not significantly increase the operative time. It is safe and feasible. The postoperative weight loss effect is significant and it can effectively improve the related co-morbidities.</p>
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Humans , Diabetes Mellitus, Type 2 , Gastric Bypass , Hypertension , Laparoscopy , Length of Stay , Metabolic Syndrome , Obesity , General Surgery , Retrospective Studies , Weight LossABSTRACT
OBJECTIVE@#To discuss a effective method of nasal septum deviation.@*METHOD@#One hundred and sixteen subjects with nasal septum deviation were divided into treatment group (69 subjects) and control group (47 subjects) randomly. The combination therapy of correction of deviated nasal septum and plasma radiofrequency ablation were used in the treatment group. The combination therapy of deviated nasal septum and partial inferior turbinectomy were used in the control group. The data were analyzed by statistical method.@*RESULT@#The effective rate of physical signs and symptoms of the treatment group was 100.0%, while the control group was 85.1%. There was significant difference of two effective rates (P < 0.05). Furthermore, hyperventilation and nasal adhesion were not happened in treatment group 6 months after treatments.@*CONCLUSION@#The correction of deviated nasal septum and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was easy for observation as well as the minimal tissue damage. The combination therapy method was according with the principle of functional minimally invasive surgery.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Catheter Ablation , Combined Modality Therapy , Nasal Septum , Congenital Abnormalities , General Surgery , Plastic Surgery ProceduresABSTRACT
Objective To determine circulating specific IgG immune complexes activating complement(IgG/C3-CIC)concentrations in maternal serum of normal term pregnant women and women with pregnancy induced hypertension(PIH).Methods We detect the serum level of IgG/ C3-CIC and IgG in 115 subjects,including 34 cases of normal pregnant women and 81 cases of PIH women.Results The serums concentrations of IgG/C3-CIC in normal term pregnant women, women with mild PHI,moderate PIH and serve PIH were 0.284?0.18,0.303?0.16,0.483?0.286 and 0.462?0.206,respectively.The serum concentration of IgG in the women were 191.07?112. 92g/L,147.56?47.91 g/L,140.18?32.89 g/L and 125.40?53.24 g/L,respectively.The serum concentration of IgG/C3-CIC in patients with moderate PIH and severe PIH was higher than that in patients with mild PIH and normal term pregnant women(P