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Objective To investigate the effect of radiotherapy combined with interventional therapy on the changes of vascular endothelial growth factor (VEGF) in patients with advanced cervical cancer.Methods 62 cases of cervical cancer collected in the first people’s hospital of jingzhou city during January 2009 to February 2014 were randomly divided into two groups.The patients in group A were treated with radiotherapy, and the patients in group B were treated with radiotherapy combined with interventional therapy.The level of vascular endothelial growth factor in two groups after treatment was measured by enzyme-linked immunoassay.Results The level of vascular endothelial growth factor of group A was ( 241.77 ±85.86 )μg/L, significantly higher than ( 124.66 ±65.86 )μg/L of group B.The level of vascular endothelial growth factor was related with cervical deterioration degree, tumor stage and lymph nodes metastasis (P<0.05),not with the patient’s age, and the size of the tumors.The level of vascular endothelial growth can reflect the clinical efficacy of patients after therapy (P<0.05).Conclusion Vascular endothelial growth factor level has a close relationship with the degree of deterioration of cervical cancer, tumor staging, lymph node metastasis and the curative effect after the interventional therapy.
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Objective To investigate the effect of nursing ward rounds with doctors on cognition disease of primary caretakers of asthmatic children . Methods According to the admission sequence, 82 asthmatic patients and their primary caretakers were set as the control group, 76 asthmatic patients and their primary caretakers were set as the observation group. The control group adopted the traditional method of separating ward rounds between doctors and nurses. The observation group used the method of nursing ward rounds with doctors. Then their differences were compared in terms of cognition of disease and medical compliance of these two groups′primary caretakers. Result The observation group was significantly better than the control group in terms of the cognition of disease and medical compliance (P<0.01). Conclusions The method of nursing ward rounds with doctors can improve the cognition of disease and medical compliance of the asthmatic patients′ primary caretakers. It can effectively monitor and manage the asthmatic patients and control the disease recurrence. As effective ward rounds, it is worth in clinical application.
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Objective:To investigate the effects of the anti-TLR2 antibody blocking TLR2 signaling pathway on inflammatory response in Staphylococcus aureus pneumonia murine models.Methods: Sixty C57BL/6J mice were divided randomly into normal control,SA pneumonia,and anti-TLR2 antibody group,killed 3 and 8 days after inoculation respectively.Normal control mice inoculated sterile PBS intranasally ,SA pneumonia mice inoculated SA ,anti-TLR2 antibody group of mice injected with anti-TLR2 antibody by tail vein and then inoculated SA intranasally.At the predetermined point , the colony-forming units ( CFU ) of bacteria were higher , leukocytes and neutrophil percentage were counted in bronchoalveolar lavage fluid ( BALF ) , the concentrations of KC and IL-10 in BALF and serum were assayed by ELISA ,changes in pulmonary histopathology were observed with HE staining and TLR 2 expression was detected by immunohistochemical.Results:3 days after intranasal inoculation ,the concentrations of KC and IL-10 in BALF and serum was increased in SA pneumonia mice , pulmonary histopathology changes significantly in HE staining.Compared with SA pneumonia mice,the CFU of bacteria were higher,leukocytes count and neutrophil percentage ,the concentrations of KC in BALF and serum,as well as HE pathological scores were reduced significantly in anti-TLR2 antibody group mice ,while no significant difference in IL-10.8 days after intranasal inoculation , HE pathological scores of anti-TLR2 antibody group mice were significantly lower than SA pneumonia group mice ,the CFU of bacteria in BALF were not statistically different between those two groups.Conclusion:Anti-TLR2 antibody attenuates the production of inflammatory mediators and inflammatory cell infiltration in SA pneumonia mice .
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<p><b>OBJECTIVE</b>To analyze the factors that influence the outcome of ventilator weaning and the predictive value of ventilator weaning criteria such as PaO2/FiO2, Vt/kg, Cst, RSBI and the changing trend of RSBI [ΔRSBI = (RSBI2-RSBI1)/RSBI1, RSBI1 and RSBI2 are the start and end of SBT separately] in children.</p><p><b>METHOD</b>One hundred and thirty-two children who were mechanically ventilated over 24 hours were enrolled from April 2012 to October 2013 in Shenzhen Children's Hospital. SIMV+PSV and SBT ventilator mode were used in ventilator weaning according to clinical experience. Age, gender, weight, critical illness score, duration of mechanical ventilation, PICU stays and the causes to mechanical ventilation were taken into account as the effect on the result of ventilator weaning. Using area under ROC curve of the indexes such as PaO2/FiO2, Vt/kg, Cst, RSBI and the ΔRSBI to evaluate the predictability of children ventilator weaning.</p><p><b>RESULT</b>One hundred and thirty-two children were enrolled and 109 succeeded in ventilator weaning, while 23 failed. Seventy-nine children using SIMV+PSV mode and 64 succeeded in ventilator weaning among them, while 23 failed. The success rate was 81.0%. The remaining 53 children using SBT mode, 45 among them succeeded and 8 failed in ventilator weaning, which success rate was 84.9%. There was no statistically significant difference in ventilator weaning mode(χ2=0.334, P=0.563). Age, gender, weight, critical illness score between the succeeded group and the failed group did not show statistically significant difference (t=-0.661; χ2=1.271; t=-0.749, -0.020; P>0.05), but duration of mechanical ventilation, PICU stays and the causes for mechanical ventilation showed significant difference (t=3.751, 3.701; χ2=11.273, P<0.05). The area under ROC curve of PaO2/FiO2, Vt/kg, Cst and RSBI in SIMV+PSV was 0.506, 0.415,0.557 and 0.512, in SBT was 0.503, 0.653, 0.546 and 0.708 separately. There was no statistically significant difference in the predictors mentioned above (P>0.05). But the area under ROC curve of ΔRSBI in SBT was 0.814, which was significantly different compared to RSBI in SIMV+PSV (Z=2.966, P<0.05).</p><p><b>CONCLUSION</b>To children who mechanically ventilated for over 24 hours, duration of mechanical ventilation, PICU stays and the causes for mechanical ventilation are the main influencing factors. ΔRSBI is a better predictor with feasibility and safety, which is also worth generalizing.</p>
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Child , Humans , Critical Illness , Predictive Value of Tests , ROC Curve , Respiration, Artificial , Risk Factors , Treatment Outcome , Ventilator WeaningABSTRACT
Early weaning from mechanical ventilation in children will lead to an extubation failure,however,prolonging mechanical ventilation will increase the risk of ventilator associated complication and the economical burden of disease.Nowadays there is no unified and objective ventilator weaning indexes in pediatrics,so it is significant to searching for appropriate and feasible ventilator weaning indexes.This article detailed the current progress on the condition and predictors of ventilator weaning in children,and comparing the predictability and accuracy of ventilator weaning indexes in children,also looking forward to the possibility of higher accuracy or scheme in ventilator weaning that used for clinical purposes.
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Objective To investigate the preventive effect of clinical nursing pathway of health education on partum urinary retention.Methods Two hundred and forty primiparas hospitalized in our hospital from September 2012 to February 2013 were randomized equally into the observation group and the control group.The former received health education by clinical nursing pathway and the control group conventional health education.The two groups were compared in terms of incidence of postpartum urinary retention.Results The incidences of postpartum urinary retention in the observation group and the control one were 3.33% and 11.67%,respectively.The difference in the incidence between the groups were statistically significant(P<0.05).Conclusion The clinical nursing pathway of health education may effectively prevent the occurrence of postpartum urinary retention.
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Objective To compare the clinical efficacy of three kinds of replacement fluid for continuous hemofiltration in severe sepsis,and to develop a more rational composition.Methods Fifty severe sepsis patients with continuous hemofiltration were divided into four groups randomly.The configuration of the replacement fluid in accordance with the random number table,randomly selected from four different formulations:group A (13 cases):Ports composition provided by Nanjing general hospital;group B (12 cases):Zhongshan hospital composition; group C (11 cases):an improved composition; group D (14 cases):an improved composition by Donghua hospital affiliated to SUN Yat-sen university.Blood electrolytes,blood gas analysis,renal function,blood glucose(highest and lowest serum glucose in treatment period),high sensitive C-reactive protein(hs-CRP) concentration,calcium concentration in filter were tested before and after every treatment period.Results The concentration of blood electrolytes during treatment had no significant change (P ＞ 0.05).Renal function were improved significantly after treatment among four groups (P ＜ 0.05).The level of hs-CRP decreased significantly after treatment (P ＜ 0.05) and there was no significant difference among four groups (P ＞ 0.05).The change of serum glucose during treatment was the smallest in group D than that in group A,B,C [(3.0 + 0.9) mmol/L vs.(11.2 + 2.0),(3.8 + 1.1),(5.5 +1.3) mmol/L](P ＜ 0.05).Calcium concentration in filter was the lowest in group D than that in group A,B,C [(1.5 + 0.5) mmol/L vs.(2.0 + 0.7),(2.3 + 0.5),(2.1 + 0.4) mmol/L] (P ＜ 0.05).The dosage of heparin was the least during treatment in group D than that in group A,B,C[(6.5 ± 2.8) U/(kg·h) vs.(8.9 ± 3.4),(7.9 ± 3.0),(8.7 ± 3.1) U/ (kg· h)] (P ＜ 0.05).Conclusions Improved composition by Donghua hospital affiliated to SUN Yat-sen university hospital compared to other compositions can better maintain a stable blood glucose levels,have a better anticoagulant effect,reducing the application of heparin,maintain a stable homeostasis.It is worthy of using in clinic.
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Objective To observe the change of serum ischemia modified albumin (IMA) in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods Seventy-four end stage renal disease patients undergoing CAPD more than 3 months (CAPD group) were divided into 2 groups according to clinical symptoms of cardiovascular diseases:CAPD symptoms group (29 cases) and CAPD asymptomatic group (45 cases).Seventy healthy subjects were selected as control group.The serum IMA level and abnormal rate of electrocardiogram and heart color ultrasonic were examined and compared.Results The serum IMA level in CAPD group was significantly higher than that in control group [(92.33 ± 17.17) kU/L vs.(69.63 ± 9.24)kU/L,P＜ 0.01].The serum IMA level in CAPD symptoms group was significantly higher than that in CAPD asymptomatic group [(109.37 ± 21.34) kU/L vs.(85.31 ± 8.58) kU/L,P ＜ 0.05].The elevatory rate of serum IMA level and abnormal rate of electrocardiogram and heart color ultrasonic in CAPD symptoms group were significantly higher than those in C APD asymptomatic group [37.9％ (11/29) vs.15.6％(7/45),62.1％ (18/29) vs.22.2％ (10/45),P ＜0.05].Conclusions The serum IMA level in CAPD patients is elevatory.Serum IMA level is significantly higher in CAPD patients with cardiovascular disease clinical symptoms,it can be used for diagnosis of myocardial damage in CAPD patients.
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BACKGROUND: Our study was to investigate the prevalence of carbapenemase genes in strains of Enterobacteriaceae species exhibiting decreased susceptibility to carbapenems in our hospital. METHODS: The carbapenemase producing Enterobacteriaceae species were confirmed by modified Hodge test (MHT) and EDTA-disc synergy test which indicating the production of class B carbapenemases. PCR and sequencing analysis were used to identify the drug-resistant genes. DNA fingerprinting based on enterobacterial repetitive intergenic consensus (ERIC)-PCR was applied to investigate the homology of Enterobacteriaceae species. RESULTS: From a collection of 1,472 Enterobacteriaceae species, 18 isolates with decreased susceptibility to carbapenem treatment were identified and 9 of which were positive by MHT, and 6 of which produced class B carbapenemases. PCR and sequencing analysis of the 18 isolates revealed 4 different carbapenemase genes (blaIMP-8, blaoxa-1, blaIMP-26, and blaoxa-47) in 10 isolates, with the blaIMP-8 and blaoxa-1 genes being the most common (60-70% prevalence). ERIC-PCR showed 5, 2, and 2 unique genotypes for Enterobacter cloacae, Escherichia coli, and Klebsiella pneumoniae, respectively. Three E. coli strains isolated from different patients from the urologic surgery department exhibited the same DNA banding pattern, suggesting a possible clonal dissemination. Majority (17/18) of the carbapenem-unsusceptible Enterobacteriaceae species isolates was obtained from the surgery department of our hospital. CONCLUSIONS: The main carbapenemase genes of Enterobacteriaceae species in our hospital were blaIMP-8 and blaoxa-1. Prevalence of carbapenem resistance may be existed in surgery department and infection control should be taken for preventing further dissemination of drug-resistant strains.
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Humans , Anti-Bacterial Agents/pharmacology , Bacterial Proteins/genetics , Carbapenems/pharmacology , China , DNA Fingerprinting , Drug Resistance, Bacterial/drug effects , Enterobacteriaceae/drug effects , Enterobacteriaceae Infections/microbiology , Genotype , Hospitals, University , Microbial Sensitivity Tests , Sequence Analysis, DNA , beta-Lactamases/geneticsABSTRACT
Objective To discuss the risk factors of the chronic obstructive nephropathy progression.Methods A retrospective analysis of the patients with chronic obstroctive nephropathy was performed.Multivariate logistic regression was used to identify correlate risk factors of the chronic obstructive nephrupathy progression.All calculation were compu- ted with the aid of SPSS 10.0 software package.Results In the analysis of risk factors of the chronic obstructive ne- phropathy progression,gender(OR=1.963,P=0.018),hypertention(OR=2.228,P=0.039),hyperuricemia (OR=4.204,P=0.000),hypocalcemia(OR=2.612,P=0.031),proteinuric(OR=1.639,P=0.049),hy- poabumia(OR=5.505,P=0.000),SIRS(OR=6.113,P=0.000),anemia(OR=5.257,P=0.000),renal atophy(OR=5.964,P=0.009),contrast medium(OR=6.113,P
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OBJECTIVE To investigate and analyze the bacteria on the nurse mask in ICU ward and its air effects disinfection.METHODS Sixty masks were examined for the bacteria numbers,germiculture and drug resistance.The bacteria numbers on the mask were recorded in 2,4,6 and 8 h with or without air disinfection,and the numbers of air bacteria were also estimated before and after air disinfection 2,4,6 and 8 h.The kinds and drug resistance of bacteria in the sputum of patients were recorded during the examining time.RESULTS The meticillin-resistant Staphylococcus(MRS,90.6%) and the Escherichia coli(ECO,9.4%) were the major bacteria on the mask.The numbers of bacteria on the mask at 2,4,6 and 8 h with air disinfection were 1.2?1.5,3.4 ?2.8,4.2?3.4 and 5.3?3.6 CFU/cm2,respectively.The numbers of bacteria on the air before air disinfection were 1264?314 CFU/m3 and after air disinfection 2,4,6 and 8 h were 917?213,790?176,676?179 and 483?167 CFU/m3,respectively.The numbers of bacteria on the mask and on the ward air were decreased obviously after the air disinfection comparing without disinfection.MRS was found in 26.7% patients sputum,and had the same drug-resistance spectrum as the bacteria on the mask.CONCLUSIONS MRS and ECO may be infected through air,and the effective air disinfection could reduce the numbers of bacteria on the air,and decrease the possibility of intercross infection.
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Objective:To observe the effect of supplementing qi,nourishing yin and promoting blood flow Chinese herbs on serum lipoprotein lipase (LPL) in type 2 diabetes mellitus (T2DM) patients.Methods:To determine the serum LPL of 38 cases before and after being treated with supplementing qi,nourishing yin and promoting blood flow Chinese herbal compound Danzhi Jiangtang Capsules.Results:Danzhi Jiangtang Capsules not only can improve T2DM patients in blood sugar,blood lipids and insulin sensitivity index,but also increase the level of serum LPL (P