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Objective:To explore application effect of early respiratory training schemes based on 4E mode (Engage, Educate, Execute, Evaluate) in children with bronchiolitis obliterans (BO) and provide evidence for the clinical implementation of early respiratory rehabilitation in children with BO.Methods:This was a quasi-experimental study. The children with BO who were admitted to 2 wards of the Department of Respiratory Medicine of Hunan Children's Hospital from January 1 to December 31, 2021 were selected as the research objects. They were randomly divided into the control group and the experimental group, with 23 cases in each group. The control group received routine treatment, nursing and rehabilitation guidance. The experimental group established a multidisciplinary team based on the control group, and used the early respiratory training program based on the 4E model to implement intervention. The clinical symptom severity scale was used to evaluate the improvement of the clinical symptoms of the children within 24 hours of being diagnosed as BO, the day of discharge, and 1 and 3 months after discharge for re-examination, and the hospitalization time of the children and the incidence of adverse events related to respiratory training were counted by using medical records and questionnaires.Results:The clinical symptom severity scores of the experimental group within 24 hours of admission diagnosis and the day of discharge were (20.00 ± 2.51) and (11.30 ± 2.46)points respectively, while those of the control group were (20.57 ± 2.21) and (11.70 ± 2.42) points respectively, with no statistically significant difference ( t=0.81, 0.54, both P>0.05). The clinical symptom severity scores of the experimental group were(10.52 ± 2.31) and (8.55 ± 1.06) points, lower than (12.32 ± 1.39) and (12.45 ± 2.19) points of the control group when they returned to the hospital for re-examination 1 and 3 months after discharge, with a statistically significant difference ( t=3.14, 7.25, both P<0.05). The experimental group was hospitalized for (11.78 ± 1.17) days, which was showter than (13.74 ± 1.63) days in the control group, with a statistically significant difference ( t=4.68, P<0.05). No respiratory training-related adverse events occurred in both groups of children during hospitalization. During home respiratory training after discharge, 1 and 2 respiratory training-related adverse events occurred in the experimental group 1 and 3 months after discharge, respectively, compared with 6 and 9 in the control group. The difference was statistically significant ( χ2=4.64, 5.94, both P<0.05). Conclusions:Early respiratory training solutions based on the 4E mode can improve the clinical symptoms of BO children, shorten the hospitalization time, reduce the number of adverse events related to respiratory training, and promote the recovery of children.
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Objective:To analyze the related literature of pulmonary rehabilitation research at home and abroad, understand its research focus and development trend, and provide a reference and basis for future pulmonary rehabilitation research.Methods:Literature related to pulmonary rehabilitation published in the database of Web of Science and China National Knowledge Infrastructure from January 2015 to February 2022 was retrieved, and the contents such as the number of articles published annually, authors, research institutions, and high-frequency keywords were visually analyzed by bibliometrics and CiteSpace software.Results:The number of articles published each year showed an obvious upward trend from 2015, and the number of Chinese documents was higher than that of English documents from 2019 to 2020. MARTIJN A SPRUIT was the author with the largest number of articles published in English, with a total of 65 articles published, with close cooperation among scholars. Che Guowei was the author with the largest number of articles published in Chinese literature, with 13 articles published in total. The cooperation among the authors was relatively lacking and scattered. The main research institutions abroad were universities, and the institution with the highest number of papers was Maastricht University in the Netherlands, with a total of 85 articles. The research institutions cooperated closely and formed a cooperation network. Hospitals were the main research institutions in China, and the thoracic surgery Department of West China Hospital of Sichuan University had the highest total number of publications, with 14 articles. The cooperation among institutions was not close, and there was a lack of cooperation with universities and scientific research institutions. Through keyword co-occurrence and clustering and timeline view analysis, it was concluded that the research hotspots in this field were pulmonary rehabilitation of patients with different chronic respiratory diseases, the influence of pulmonary rehabilitation on lung function and quality of life of patients with chronic obstructive pulmonary disease, and the intervention methods of pulmonary rehabilitation. The future trend was predicted as the clinical application value of pulmonary rehabilitation in the treatment of lung cancer.Conclusions:At present, pulmonary rehabilitation research is in a stable development period. However, the cooperation between domestic authors and institutions is not close enough compared with foreign countries. In the future, China should strengthen the communication and cooperation between research teams, and learn from foreign research results to further develop the application of pulmonary rehabilitation in lung cancer patients, to promote the development of pulmonary rehabilitation research in China.
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OBJECTIVE：To provide reference for constructing and improving the pharmacovigilance signal management sys - tem in China by comparing signal management system among the European Union （EU），the United States （U. S. ）and Japan. METHODS：Literature analysis method was used to systematically compare the similarities and differences on definitions ，sources， detection methods and management process of pharmacovigilance signals among EU ，U. S. and Japan. Some suggestions were put forward for pharmacovigilance management in China. RESULTS & CONCLUSIONS ：Regulatory authorities of the EU ，U. S. and Japan did not have a uniform definition on signals ；EU drug administration adopted the definition of the eighth working group of Council for International Organizations of Medical Sciences ，FDA adopted its own definition ，while the Japanese regulatory agency had no clear definition. Currently ，post-marketing surveillance still relied mainly on spontaneous reporting systems ；EU，U. S. and Japan had carried out the signal detection based on the spontaneous reporting system ；EU mainly adopted the proportional reporting ratio method ，U. S. mainly adopts the multiple gamma Poisson Shrinker ，and Japan mainly adopted the reporting ratio method. EU had special guidelines for signal management process ，while the U. S. and Japan did not. It is recommended to accelerate the deve- lopment of the legal and regulatory framework on pharmacovigilance in China ，draw up guidelines on pharmacovigilance practices ， strengthen the active ADR surveillance and promote the application of data mining techniques in signal detection field ，for accelerat - ing the standardization and internationalization of China ’s pharmacovigilance work.
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Objective To explore the risk management model of investigator-initiated clinical trials (IITs) from the prospective of clinical research management personnel,to provide further reference for its construction and implementation in China.Methods The risks in IITs and its current situation of risk management were analyzed.Risk management standards including ISO 31000 and related guidelines were adopted to explore the risk management mode for China-based IIT.Results This article proposed the new risk management mode for IITs and also introduced the specified frame and procedures of related risk management.Conclusions The risk management model proposed in this article provided reference for clinical research management.
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Objective@#To explore the clinicopathological features of anti-mitochondrial antibody (AMA) negative and positive patients with primary biliary cholangitis-autoimmune hepatitis overlap syndrome (PBC-AIH OS).@*Methods@#Seventy-four cases diagnosed as PBC-AIH OS from June 2017 to April 2018 were enrolled in this study. Among them, forty cases were AMA negative (negative group) and thirty-four cases were AMA positive (positive group). The clinical manifestations, serum biochemical indexes, immunological indexes and histological data of the negative group were compared with the positive group. Mann-Whitney U test and theχ 2test were used for statistical analysis.@*Results@#There was no significant difference in sex, age, clinical manifestations and major liver function indexes (ALT, AST, ALP, GGT, TB, DB) between the negative group and positive group (P> 0.05). The level of IgM in the negative group (1.68 ± 0.87) was significantly lower than positive group (3.77 ± 2.88)(P< 0.05). The positive rates of antinuclear antibodies (ANA) and gp-210 antibodies was lower than positive group (P< 0.05). There were no significant differences in the stages of inflammation and fibrosis between the two groups (P> 0.05), and the bile duct injury was more significant in the negative than positive group (P< 0.05).@*Conclusion@#The serum IgM level of AMA-negative PBC-AIH OS is low, and immunological antibody is often negative, which makes bile duct injury apparent in liver histology. A liver biopsy should be carried out as soon as possible for early diagnosis and treatment.
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The olfactory disorders are mainly studied in the field of otolaryngology, but less in plastic surgery. In this review, the author summarized the anatomy of olfactory system, the etiology of dysosmia, the test of olfactory function, the relationship between dysosmia and nasal plastic surgery, and the treatment and prevention of dysosmia, in order to explore the relationship between olfactory disorders and plastic surgeries, especially rhinoplasty.
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Objective@#to investigate the risk factors of postoperative local infection in patients with polytetrafluoroethylene implant in rhinoplasty, and to provide evidence for reducing the risk of postoperative infection.@*Methods@#Retrospective analysis of 923 cases of rhinoplasty implanting ePTFE prosthesis were conducted, those related factors included were as follows: gender, age, operation, history of nasal surgery, nasal pore bulky excessive sebum secretion, cartilage cap on the tip-defining points, columella support, nasal septum cartilage harvest, extend the septum cartilage transplantation, interdomal fat pad resection, adjust the alar cartilage, reduce the ala nasi, severe postoperative swelling, prevention of postoperative infection duration, postoperative folliculitis, nasal vestibular mucosa was damaged postoperative, whether the surgical incision has abnormal healing and so on are being investigated and recorded, all of which were established as multivariate logistic regression model analysis of the risk factors for independent prognosis of postoperative infection.@*Results@#The excessive sebum of the nasal pores, adjustment of the alar cartilage and the postoperative nasal collision are the independent risk factors for postoperative infection(P<0.05).@*Conclusions@#Patients with large nasal pores and sebum secretion are more likely to render infection after operation. Partial separation and partial nasal resection of nasal alar cartilage and postoperative nasal impact will increase postoperative risk of infection.
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Objective To study the application value of ultrasound(US) examination for evaluating the knee joint status in the patients with hemophilia.Methods The US examination data of 44 patients (70 knee joints) with hemophilia were collected,among them 11 cases aged below 18 years old,16 knee joints completed the MRI examination,meanwhile the knee joint health status was evaluated by adopting the 2.1 version of hemophilia joint health assessment (HJHS) form.Then the correlation between the US score with the age and bleeding times and the relation between MRI score with HJHS score were analyzed.Results The severity of hemophilia arthropathy had no obvious correlation with hemophilia severity (F=0.013,P =0.987).With the age increase and bleeding frequency increase,the knee joint lesion was aggravated.The detection of early synovial thickening and cartilage change in arthropathy had no obvious difference between US and MRI examinations(P＞0.05);the obvious correlation existed among US score,MRI score and HJHS (P＜0.05).Conclusion US has an important significance for the early diagnosis of hemophilic arthropathy.
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Objective To study the application value of ultrasound(US) examination for evaluating the knee joint status in the patients with hemophilia.Methods The US examination data of 44 patients (70 knee joints) with hemophilia were collected,among them 11 cases aged below 18 years old,16 knee joints completed the MRI examination,meanwhile the knee joint health status was evaluated by adopting the 2.1 version of hemophilia joint health assessment (HJHS) form.Then the correlation between the US score with the age and bleeding times and the relation between MRI score with HJHS score were analyzed.Results The severity of hemophilia arthropathy had no obvious correlation with hemophilia severity (F=0.013,P =0.987).With the age increase and bleeding frequency increase,the knee joint lesion was aggravated.The detection of early synovial thickening and cartilage change in arthropathy had no obvious difference between US and MRI examinations(P＞0.05);the obvious correlation existed among US score,MRI score and HJHS (P＜0.05).Conclusion US has an important significance for the early diagnosis of hemophilic arthropathy.
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Objective To investigate the role of plasma matrix metalloproteinase-9 (MMP-9) and nuclear factor kappa B (NF-κB) in the pathogenesis of obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with hypertension.Methods The patients were selected in the respiratory medicine and neurology of our hospital from January 2014 to June 2014.Polysomnography(PSG) monitoring was employed to assess the patient.All patients were divided into 3 groups,including snoring group(23 cases),OSAHS group(32 cases),OSAHS with hypertension group(31 cases).And then according to the hypertension stage,OSAHS with hypertension group was divided into 3 groups,including OSAHS with stage 1 hypertension group(9 cases),OSAHS with stage 2 hypertension group(9 cases),OSAHS with stage 3 hypertension group(13 cases).The plasma MMP-9 was measured by ELISA.The mRNA expression levels of MMP-9 and NF-κB were detected by real-time quantitative PCR.Results The levels of MMP-9 and MMP-9 mRNA and NF-κB mRNA in OSAHS with hypertension group were significantly higher than those of snoring group and OSAHS group and the differences were statistically significant(P<0.05).The expression of MMP-9,the MMP-9 and NF-κB mRNA expression of monocytes in OSAHS with stage 3 hypertension group was significantly higher than those of OSAHS with stage 1 hypertension group and OSAHS with stage 2 hypertension group and the differences were statistically significant(P<0.05).The plasma MMP-9 was positively correlated with AHI and oxygen desaturation index and negatively correlated with LSaO2(P<0.05).The plasma MMP-9 was positively correlated with the MMP-9 mRNA expression(P<0.05).The MMP-9 mRNA expression was positively correlated with the NF-κB mRNA expression(P<0.05).Conclusion The plasma concentrations of MMP-9,the MMP-9 and NF-κB mRNA expression of monocytes in OSAHS with hypertension patients was significantly high,which is associated with disease severity and degree of hypoxia.The MMP-9 might play an important role in the pathogenesis of OSAHS with hypertension and be regulated by NF-κB pathway.
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Objective To investigate the effects of nasal tip reduction with inner incision combined with external fixation,namely,to evaluate the formation of bilateral alar groove which is en hanced by external fixation with small splints,after removing interdomal fat pad as well as adjusting alar cartilage to reduce nasal tip.Methods Alar cartilage and interdomal fat pad were exposed via the bilateral nasal vestibular incision to remove fat pad and part of enlarged lateral foot of alar cartilage.After suture of incision,based on the tissue removal,plastic splint was used for external fixation of bilateral nasal tip and alar groove for one week,to enhance the formation of alar groove.Results A total of 143 patients were followed up for more than 6 months after operation.Photographs taken before and after operation were compared,suggesting obviously smaller nasal tip and significant alar groove.Left and right alar groove space was decreased from preoperative (28.23±3.31) mm to post operative (23.72±2.65) mm,and nasal tip alar angle was decreased from (104.02±9.57)°to (87.78± 6.98)°,with statistical significance (P＜0.05).Slightly asymmetric nasal alars were found in 6 patients during follow-up examination,while tiny scars caused by splints (at 0.6 cm from the edge of splints) were found in 1 patient.Conclusions On the basis of nasal tip reduction with inner incision,the method of suture with small splints combined with external fixation is simple,effective and available.
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Objective:To study the diagnosis value of Transcranial Doppler ultrasound for intracranial artery stenosis in patients with cerebral infarction.Methods:A total of 140 patients with acute cerebral infarction,transient ischemic attack and posterior circulation ischemic attack in Department of Neurology,Xinjiang cardiovascular and cerebrovascular disease hospital from October 2014 to October 2016 were selected as research object,CT angiography (CTA) and TCD detection were performed in all patients.Used CTA examination results as the gold standard,the detection results of intracranial artery stenosis in two groups were compared,the diagnostic value of TCD and the diagnostic results of TCD to the degree of bilateral middle cerebral artery (MCA) stenosis were analyzed.Results:CTA diagnosis showed that 140 patients had a total of 105 patients with intracranial artery stenosis,in the anterior and posterior circulation vessel of 1155 intracranial segments,CTA detection showed that 249 vessels were narrow,TCD detection showed that 236 vessels were narrow.Com-pared with CTA,TCD was better in the diagnosis of patients (Kappa value＞0.75).The diagnostic sensitivity and positive predictive value of TCD for MCA were the highest,which were 91.26％ and 93.07％,the consistency was the best (Kappa value =0.917).CTA detection showed that 210 MCA vessels had 103 stenoses,mild stenosis 17,moderate stenosis 41,severe stenosis 45,TCD detection showed that the stenosis was 101,mild stenosis 16,moderate stenosis 40,severe stenosis 45.The Kappa test showed that the diagnostic results of TCD to the degree ofMCA stenosis was better consistency compared with CTA (Kappa value=0.884.Conclusion:TCD has a high diagnostic value for cerebral artery stenosis in patients with cerebral infarction,and it is consistent with the diagnosis of CTA.
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Objective To investigate the distribution of human papillomavirus(HPV)in different age groups and its correlation with the degree of cervical lesions.Methods 2 031 patients with HPV screening specimens in our hospital from May 2012 to May 2015 were chosen as study subjects.To acquire patient cervical squamous columnar epithelial cells at the junction to detect HPV DNA types.HPV -positive patients used ultra -thin liquid -based cervical cytology technology (TCT)to detect.Patients with abnormal TCT detection were performed with electronic biopsy,and the diagnosis was made by pathology biopsy,and analyzed the distribution of HPV in different age groups and different degree of cervical lesions.Results In different age groups,≤20 years of age groups of patients with high -risk HPV positive rate was 19.7%,which was significantly higher than that of >20 -30 years,>30 -40 years and >40 -50 years three groups (14.4%,13.9%,15.0%)(χ2 =4.259,5.724,3.988,all P 0.05).There was no significant difference in HPV positive rate among the ≤20 years,>20 -30 years,>30 -40 years,>40 -50 years,>50 years ages patients with high risk HPV infection group and low risk HPV infection group(χ2 =0.679,1.021,0.968,0.736, 0.668,all P >0.05).In the high -risk HPV infected group,the risk of single type infection in >20 -30 years,>30 -40 years,>40 -50 years,>50 years ages patients were significant higher than the mixed types infection(χ2 =4.213,3.894,4.256,5.330,5.666,all P <0.05).Infected patients of all ages with high -risk HPV were HPV16, HPV52,HPV58 type -based,low -risk type HPV43 type places mainly.More than 31 to 40 years age group of patients infected with high -risk HPV types in cervical lesions mainly cervicitis and 40 years and older group of patients with high -risk HPV infection incidence of invasive cervical cancer were significantly higher.Conclusion Different age groups of women for HPV genotyping is important for diagnosis of cervical lesions.
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Objective To investigate the effect of Zhuang medicine acupuncture on brainstem auditory evoked potential (BAEP) in patients with posterior circulation ischemic vertigo (PCIV).Methods Eighty-five PCIV patients were randomly allocated to a treatment group of 45 cases and a control group of 40 cases. The control group received conventional basic therapy and the treatment group, Zhuang medicine acupuncture in addition. The peak latencies (Pg) of BAEP waveⅠ ,Ⅰ andⅠ and the interpeak latencies (IPg) of waveⅠ-Ⅰ,Ⅰ-Ⅰ andⅠ-Ⅰ were compared between the two groups after treatment.Results There were statistically significant post-treatment differences in waveⅠ andⅠ Pg and waveⅠ-Ⅰ andⅠ-Ⅰ IPg between the treatment and control groups (P<0.05).Conclusions Zhuang medicine acupuncture plus medication is an effective way to treat PCIV. It can improve BAEP indicators in the patients.
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Objective To understand the practice of experiential teaching in the core midwifery curriculum. Methods Phenomenology as a qualitative research method was utilized and fifteen students participated in the non-structured interviews. Results Four themes were found: comprehension of knowledge;professional thought; teacher- student relationship;gratitude. Conclusions Experiential teaching can increase the teaching effect of core midwifery curriculum, and develop good ideological and professional qualities.
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Objective To explore the clinical methodology and comparative analysis of both autogenous septum cartilagineum nasi or Medpor surgical implant in secondary unilateral cleft lip rhinoplasty.Methods Thirty-six patients with varied secondary nasal deformities of unilateral cleft lip were treated,autogenous septum cartilagineum nasi or Medpor surgical implant were implanted to supply the powerful supporting strength for nasal constructions.An anthropometry method based on the quantitative analysis of the characteristics of nasal deformity was used to evaluate and compare the preoperative and postoperative measure of the patients.Results After 6 to 24 months follow-up,all 36 cases received satisfactory results.20 of them used autologous septum cartilagineum nasi to supply the powerful supporting strength for nasal construcions,and other used Medpor surgical implant.No rejection and exposure of implants were found.The postoperative quantitative measurement results supported that both of the implants could effectively correct nasal deformities.Conclusions Both of the implants could effectively correct nasal deformities of unilateral cleft lip in secondary rhinoplasties.The quantitative measurement is a scientific approach to evaluate the outcome.
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Objective To evaluate the efficiency and safety of ultrasonic debridement therapy (UDT) and intelligence negative-pressure wound therapy(INPWT) for diabetic foot ulcers with Wagner 2-3degree.Methods Eighty patients with diabetic foot ulcers with Wagner 2-3 degree were divided into two groups according to the treatment method.The UDT and INPWT group (INPWT group) had 53 cases.Routine treatment group(routine group) had 27 cases.Both groups were given blood sugar and blood pressure control,anticoagulation,anti-infection and supportive treatment.The efficiency and complications were compared between two groups.Results In INPWT group,29 cases were healed,14 cases showed obvious effectiveness,7 cases were effective and 3 cases were inefficacy.The total effective rate was 94.34％(50/53).For routine group,they were 7,8,6,6 cases and 77.78％(21/27) respectively.The total effective rate between two groups had significant difference (P ＜0.05).Pain was found in 9 cases and hemoglobin decreased in 1 case in INPWT group.Conclusion INPWT after UDT for diabetic foot ulcers with Wagner 2-3 degree shows a good efficiency and safety.
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Objective To discuss the effect of transplanting autogenous rib cartilage in correction of short and upwardly rotated nose.Methods A piece of autogenous rib cartilage was transplanted into the front of nasal septa to lengthen it,leading to the nasal tip moving forwards and correcting the short and upwardly rotated nose.For low nose cases,simultaneous implants was used into the nasal back.Results The nasal tips were prolonged 0.75 cm on average after operation in 56 patients with short and upturned noses.The nasolabial angle and extent of nostril exposure were normal after operation.The operational consequences were fine in 54 patients,while 2 case were not satisfactory.Efficacy was stable during one year follow-up.Conclusions This method is reliable,and it can be recommended in rhinoplasty of patients with short and upwardly rotated nose.
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Objective To evaluate the role of autologous septal cartilage in the rhinoplasty of the wide and bulbous nasal tip. Methods A big piece of autologous nasal septal cartilage was removed and transplanted to the front of nasal septum, acting as a septal extender to fix the nasal alar cartilage,and then the shape of nasal tip was reconstructed by middle crus suture technique, excessive soft tissue under skin of tip and a part of lateral crura cartilage were removed to stand out the shape of the nasal tip. Results After one year follow-up, 118 of 126 cases achieved satisfied effects, but 8 cases dissatisfied because of their undue thick skin. Conclusions This method is reliable in the correction of the wide and bulbous nasal tip.
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@#ObjectiveTo observe the effect of cognitive therapy and acupuncture on insomnia. Methods72 insomnia sufferers were divided into two groups averagely. 36 sufferers were treated with cognitive therapy and acupuncture (treatment group), and other 36 sufferers were treated with acupuncture (control group) only.ResultsA month after treatment, ,15 sufferers were cured, 18 sufferers were obviously improved, 2 sufferers were improved and one did not show any improvement in the treatment group.Otherwise, 6 sufferers were cured, 12 sufferers were obviously improved, 12 sufferers were improved and 6 did not show any improvement in the control group. (P<0.05)ConclusionCognitive therapy and acupuncture used together shows more efficacy on insomnia compared with acupuncture alone.