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Objective:To analyze the application value of tibial transverse transport (TTT) microvascular reconstruction combined with antibiotic bone cement in the limb salvage of diabetic foot.Methods:Seventy-seven patients with diabetic foot admitted to the Traditional Chinese Medicine Hospital of Zhongshan from January 2018 to January 2021 were enrolled retrospectively, and they were divided into the control group (performed TTT microvascular reconstruction, 47 cases) and the combined group (performed TTT microvascular reconstruction combined with antibiotic bone cement, 30 cases) according to the surgical method. Wound healing rate, limb salvage rate, the ulcer healing time, bone window healing time, wound infection control status, affected side lower limb vascular blood supply situation, and peripheral nerve function recovery were compared between the two groups.Results:The amputation rate between the two groups had no significant difference ( P>0.05), but the healing rate in the combined group was higher than that in the control group: 90.00%(27/30) vs. 68.08%(32/47); and the ulcer healing time, bone window healing time in the combined group were shorter than those in the control group: (12.55 ± 2.14) weeks vs. (15.01 ± 3.17) weeks, (17.47 ± 2.09) weeks vs. (19.00 ± 2.58) weeks, there were statistical differences ( P<0.05). The positive percentage of bacteria culture in wound secretions in the combined group after the surgery for 6 d was lower than that in the control group: 20.00%(6/30) vs. 44.68%(21/47), there was statistical difference ( P<0.05). After the surgery for 3 months, the dorsal skin temperature and ankle brachial index in the combined group were higher than those in the control group: (31.05 ± 1.74) ℃ vs. (29.27 ± 1.66) ℃, 0.93 ± 0.29 vs. 0.80 ± 0.19, there were statistical differences ( P<0.05), but the scores of visual analog scale (VAS) and 10 g nylon line test values between the two groups had no significant differences ( P>0.05). Conclusions:TTT combined with antibiotic bone cement can achieve better wound healing and infection control effect in the limb salvage of diabetic foot, and the blood supply improvement of the affected limb is more significant.
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Objective:To analyze the health literacy level among medical staff and its influencing factors.Methods:Using the convenient sampling method, the in-service medical staff from four medical institutions (Shanghai Pudong New Area People′s Hospital, Shanghai Pudong New Area Zhoupu Hospital, Shanghai Tenth People′s Hospital Chongming Branch, and Shanghai Jing′an District Zhabei Central Hospital) were administered with a national residents′ health literacy questionnaire uniformly compiled by the China Health Education Center, and an electronic questionnaire independently compiled in combination with professional characteristics of the medical staff. The survey period was January 5-17, 2021. The contents of the questionnaire included basic information regarding gender, age, education, and professional title. Respondents were also asked whether they had chronic diseases, and three aspects of health literacy for basic knowledge and concepts, healthy lifestyle and behavior and health skills covering six other types of health problems including scientific outlook on health, infectious disease prevention and control literacy, chronic disease prevention and control. Safety and first aid literacy, basic medical literacy, health information literacy were also assessed. The total score for the questionnaire was 100 points. Respondents with a score of 80 or more were considered to have a competent health literacy. A total of 870 questionnaires were distributed, excluding incomplete ones, 826 valid questionnaires were used for analysis. Logistic regression was used to analyze factors influencing the health literacy among medical staff.Results:The overall health literacy level of medical staff was 64.0%, with 79.7% of respondents indicating that they had basic knowledge and concepts, 70.8% indicating that they practiced healthy lifestyles and behaviors, and 33.5% showed proficiencies in terms of health skills. From high to low, the health literacy levels for the six types of health problems were safety and first aid literacy (80.5%), scientific outlook on health (76.4%), infectious disease prevention and control literacy (60.2%), chronic disease prevention and control literacy (70.9%), basic medical literacy (52.7%), and health information literacy (50.2%). The results of a multivariate logistic regression analysis showed that physical condition, a lifestyle harmful to one′s health, highest educational background, and a professional title in the previous year were the independent influencing factors related to health literacy ( P<0.05). Conclusion:Levels of health skills, basic medical literacy, and health information literacy among medical staff are low, and physical condition in the previous year, lifestyle, professional title, and education are important factors influencing the level of health literacy among medical staff.
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Objective:To compare the value of Caprini, Padua and Autar risk assessment models in the risk assessment of venous thromboembolism in hospitalized stroke patients.Methods:A retrospective case-control study were used to collect hospitalized stroke patients in the neurology department of Xiangya Hospital from January 1, 2018 to June 30, 2020. 75 patients with venous thromboembolism (VTE) were VTE group and 75 patients without VTE were control group. The risk of thrombosis was assessed by Caprini risk assessment model, Padua risk assessment model and Autar risk assessment model respectively. The predictive value of each model on the risk of VTE formation in stroke patients was analyzed by receiver operating characteristic (ROC) curve and area under the curve (AUC).Results:The areas under the curve of Caprini, Padua and Autar risk assessment models for predicting the risk of VTE formation in stroke patients were 0.768±0.039, 0.746±0.040 and 0.710±0.042 respectively. The sensitivity, specificity and accuracy were 81.3%, 61.3%, 71.3%(Caprini), 72.0%, 72.0%, 72.0%(Padua), 66.7%, 68.0% and 67.3%(Autar) respectively. There was no significant difference in the prediction value of the three models on the formation risk of stroke VTE (all P>0.05). The technique for order preference by similarity to ideal solution (TOPSIS) method was used to comprehensively evaluate the AUC, sensitivity, specificity and accuracy of the three risk assessment models. Padua risk assessment model was the best, followed by Caprini risk assessment model and Autar risk assessment model. Conclusions:The Caprini, Padua, and Autar risk assessment scales can well predict the risk of VTE in stroke patients. The Caprini scale has the highest sensitivity and the Padua scale has the highest specificity. There is no significant difference in the predictive value of the three scales. Comprehensive evaluation of predictive value: Padua risk assessment scale is the best.
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Objective:To investigate the causes and treatment of thrombosis after PICC insertion in patients with skull base malignant tumors.Methods:To analyze the clinical situation of thrombosis after PICC insertion in a patient with skull base malignant tumor in September 2018, then identify the causes of venous thrombosis in the patient, and summarize the nursing after thrombosis.Results:By analyzing the causes of thrombosis in the patient, specific nursing care including strict observation of the disease condition, functional exercise, local care and catheter care, psychological care, and intake and output volume care were taken to ensure the normal function of PICC catheter. Finally, the patient successfully completed the planned radiotherapy and chemotherapy, and was discharged after extubation.Conclusions:One to three weeks after PICC insertion is the high risk period for thrombosis. Nurses should improve their ability to identify high-risk thrombotic risks, identify individual high-risk factors of patients, and arrange the thrombotic risk management and make disease assessment. Through guiding the patients with thrombosis after PICC catheter to take functional exercise and cooperating with drug therapy, the symptoms of thrombophlebitis can be relieved, and the function of PICC catheter was preserved, which is worthy of clinical reference.
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Objective To explore the distribution of common gene types of thalassemia in Yangjiang, Guangdong, so as to provide a theoretical basis for clinical diagnosis, prevention and treatment. Methods A total of 9, 277 cases were collected from the Department of gynaecologic outpatient, antenatal clinic, outpatient department of Pediatrics and children's health care department from April 2015 to April 2017. PCR + conduction hybridization was used to detect alpha thalassemia and beta thalassemia. Results In 9 277 cases, the detection of α thalassemia in 1 711 cases, accounting for 18. 44％(1 711/9 277); detection of thalassemia in 671 cases, accounting for 7. 24％ (671/9 277), there are 3 kinds of β thalassemia homozygote, α thalassemia and β thalassemia with 100 cases, accounting for 1. 08％ (100/9 277), which detected 16 α thalassemia gene type 14 β thalassemia gene type. Conclusion Guangdong Yangjiang area of αthalassemia by ～(--SEA)/αα and β thalassemia major in β～(CD41-42)/βN and β～(654)/β～N, β～(-28)/β～N, α and β thalassemia gene type compound less investigation for diagnosis, treatment and prevention of thalassemia has important significance, is worth promoting in clinical.
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OBJECTIVE@#To determine the clinical effect of standardized training and management of peripherally inserted central catheter (PICC) and catheter-related complications.@*METHODS@#A total of 610 patients were divided into a control group and an observation group, the control group (n=300) were catheterized by trainees who received "short-term intensive training", the observation group (n=310) by "system standardized training and management". The clinical efficacy of catheterization and the rate of catheter-related complications were compared.@*RESULTS@#There was significant difference in the one-time puncture success rate, one-time cannulation success rate, the time for operation and the pain score between the 2 groups (all P<0.01), and there was also significant difference in the occurrence of catheter extrusion, plug, arrhythmia, catheter-related thrombosis, phlebitis, puncture point effusion and catheter-related infection between the 2 groups (all P<0.05).@*CONCLUSION@#Standardized PICC training and management can improve the effect of catheterization and reduce the incidence of PICC-related complication.
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Humans , Catheter-Related Infections , Catheterization, Peripheral , Methods , Incidence , Inservice Training , ThrombosisABSTRACT
The peripherally inserted central catheter occlusion is not rare in adults.Its occurence is related with the catheter's tip position,catheter type and the skills of medical staff.Personnel training is particularly important in the prevention of occlusion.Urokinase and heparin can be used for thrombolysis.
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Objective To determine the in vitro antifungal effects of closantel against Candida albicans.Methods A microdilution method was used to determine the minimum inhibitory concentration (MIC)of fluconazole alone and in combination with closantel against Candida albicans standard strain CAF-2.Ten strains of Candida albicans were cultured in RPMI-1640 liquid culture containing 10％ calf serum with or without the presence of closantel at 16 mg/L,followed by the observation of hypha formation.Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) were performed to observe the ultrastructure of Candida albicans CAF-2 strain after exposure to closantel at 16 mg/L for 24 hours.Results Closantel could inhibit the growth of Candida albicans,and enhance the antifungal effect of fluconazole against Candida albicans in vitro.The percentage of Candida albicans forming hypha was 91.2％ ± 3.9％ in untreated Candida albicans,significantly higher than that in closantel-treated Candida albicans (29.8％ ± 5.1％,t =30.24,P ＜ 0.05).As TEM showed,closantel-treated Candida albicans gave a round,oval or pleomorphic appearance,with an irregular budding from the cell surface.Further more,the electron dense layer in the outer layer of cell wall was absent or unevenly distributed,the transparent layer was irregularly thickened,some cell membrane was locally disrupted or collapsed,and intracellular vacuoles increased after closantel treatment.Scanning microscopy revealed a rough surface,sparse and irregular budding of Candida albicans after treatment with closantel.Conclusion Closantel exhibits a promising anti-Candida albicans property in vitro.
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Objective To investigate the nasal endoscope Television Co-line self-retaining laryngoscope vo-cal polyps surgery treatment. Methods 121 cases diagnosed of vocal cord polyp (of which 54 cases of bilateral, u-nilateral 67 cases), in the serf-retaining laryngoscope and surveillance camera system of vocal cord polyp removed and opened Lacunar Reinke and will preoperative laryngoscopy and laryngoscopy after surgery and review the results of the video and retain. Results 4 weeks to review 70° nasal endoscope, and 116 cases of vocal sounds close to nor-mal, the cure rate reached 95.9 percent, and the remaining five cases because of vocal hypertrophy or incomplete closure of the vocal cords, sounds worse than normal shoots. Follow-up 3～18 months without recurrence, no serious complications. Conclusion The nasal endoscope and television surveillance camera system of amplification, in par-ticular, Reinke Lacunar throat image more clearly, so that lesions can be completely removed, and the vocal cords can be a very good organization had to protect, and by retaining the video can be pre-operative, during and after vo-cal dynamic comparative situation.
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Rapidly and accurately quantitative analysis of whole-cell sugars in some strains of actinomycetes by GC-MS was performed in this paper. After the polysaccharides were hydrolyzed, deoxidized and esterified , the alditol acetate derivates was analyzed by GC-MS. The derivates of rhamnose, ribose, arabinose , xylose, madurose, mannose, glucose, galactose were separated commendably under this condition. The ratio of the peak area was calculated to get the relative percentage of the various sugars.