ABSTRACT
Objective:To analyze the effect of implementing information-motivation-behavior skill model (IMB) home care in elderly patients with chronic obstructive pulmonary disease (COPD).Methods:From October 2017 to October 2018, patients with COPD who were discharged after treatment in Wuxi Fifth People′s Hospital were included and divided into control group and observation group by block randomization method. The control group was given routine health education, discharge guidance and follow-up guidance after discharge. The observation group received the information-motivation-behavior home care based on IMB. The general information before intervention, the level of disease cognition, quality of life before and after the intervention and the health behavior after the intervention were compared between the two groups.Results:The Bristol COPD Knowledge Questionnaire (BCKQ) score in the observation group was higher than that in the control group [(58.36±6.68) vs. (52.14±5.80) points] ( P<0.05). The scores of physical activity, health responsibility, stress management, nutrition, and spiritual growth in the Health Promoting Lifestyle Profile-Ⅱ (HPLR-Ⅱ) after the intervention in the observation group were higher than those in the control group [(26.01±3.95) vs. (23.25±3.48) points, (38.65±4.33) vs. (34.64±4.05) points, (16.98±2.51) vs. (14.20±1.80) points, (19.87±2.20) vs. (15.65±3.51) points, (20.32±2.85) vs. (17.35±2.89) points] ( P<0.05). The symptoms, mobility, and disease impact scores of the St George′s Respiratory Questionnaire (SGRQ) in the observation group were lower than those in the control group [(40.32±4.30) vs. (45.36±4.50) points, (43.21±4.87) vs.(45.33±4.25) points, (38.41±4.37) vs. (42.35±4.01) points] (all P<0.05). Conclusion:Implementing the home care model based on IMB in elderly patients with COPD can improve patients′ disease awareness and improve their health behaviors and quality of life.
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Objective To explore the application value of neoadjuvant chemotherapy (NACT) in treating cervical carcinoma. Methods Seventy-one cervical carcinoma patients who were divided into three groups:PF group (cisplatin and fluorouracil,23 cases) or CBP group (carboplatin,bleomycetin and cyclophosphamide, 24 cases) or TP group (paclitaxel and cisplatin, 24 cases); operation was made 14 - 21 days afterwards. The therapeutic effect, chemotherapy side-effect and the effect on operation and pathology for these three groups were analyzed and compared. Results The effective rate was 93.8%(30/32),88.6% (31/35),82.4%(28/34) in TP group,CBP group,PF group,respectively. However, the therapeutic effect had no statistics significance with age, preoperative tumor grade, pathologic type for all the three groups, the therapeutic effect had statistical significance with clinical stage. The rate which pathological examination showed no residual cancer was biggest in CBP group [CBP group was 28.6%(6/21), TP group was 4.3% (1/23), PF group was 11.8%(2/17), P < 0.05 ]. Conclusions Three NACT projects are safe and effective treatment for cervical cancer. However,each project has advantages. The NACT projects can be elected for different patient according to his illness and economy.
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Objective To explore the effectiveness and safety of vaginal paravaginal repair(VPVR) plus vaginal bridge repair in the treatment of female pelvic organ prolapse (POP). Methods Sixty-five patients with different defects of pelvic floor underwent VPVR or plus vaginal bridge repair for posterior vaginal wall. Patients were followed up after operation. The cure rate was estimated subjectively and objectively. The patients' quality of life was evaluated by the pelvic floor distress inventory short form 20 (PFDI-20). Results All 65 cases were treated by vaginal hysterectomy and anterior vaginal repair, in which there were 33 cases underwent VPVR while 32 cases underwent VPVR plus middle area repair. Forty concomitant procedures for vaginal bridge repair were also performed. The average operative time was (110.00±20.12) min and blood loss was (119.52±45.33) ml. The symptom of stress urinary incontinence of 25 cases significantly released after operation. Four incision recovery delayed and there were no other complicatious occurred. Patients were followed up for 6-29 months,the objective cure rate was 100.00% (65/65) and subjective cure rate was 92.31%(60/65), and 58 cases (89.23%)improved significantly with the quality of life comparing with that of pre-operation by completing PFDI-20 (P<0.01). Conclusions It is an effective and safe procedure for VPVR plus vaginal bridge repair to correct median to severe anterior vaginal prolapse and posterior vaginal wall prolapse. More clinical trials are needed to evaluate their long-term outcome.
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Objective To study the value of 5% glucose irrigation for dissection surface hemostasis in laparoscopic conservative treatment of tubal pregnancy. Methods Clinical parameters including numbers of failure in oviduct sparing, the postoperative intraperitoneal bleeding, persistent pregnancy, recurrent tubal pregnancy on the same side and normal uterine pregnancy were compared between the Experimental Group (glucose irrigation for dissection surface hemostasis; 43 cases) and the Control Group (unipolar electrocogulation hemostasis; 43 cases). Results We failed to reserve the oviduct in 10 patients in the Control Group (10/43, 23%) and in no patients in the Experimental Group (0/43) ( ? 2 =11 316, P =0 001). Recurrent tubal pregnancy on the same side was observed in 2 cases in the Control Group (2/34, 6%) and in no cases in the Experimental Group (0/34), without significant differences ( P =0 175). No postoperative intraperitoneal bleeding or persistent pregnancy was seen in both of the groups. Normal uterine pregnancy rates were 44 1% (15/34) in the Experimental Group and 40.0% (10/25) in the Control Group, without significant differences between the two groups ( ? 2 =0 100, P =0 752). Conclusions Use of 5% glucose irrigation is superior to electrocogulation for dissection surface hemostasis in the treatment of tubal pregnancy.