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Objective:To explore the application value of humidifying high-flow nasal cannula oxygen therapy (HHFNC) in children with pediatric intensive care unit (PICU) after weaning.Methods:From January 2018 to October 2021, 42 children with endotracheal intubation admitted to PICU of Tai′an city Central Hospital were prospectively selected and randomly divided into HHFNC group and nasal continuous positive airway pressure (NCPAP) group, with 21 patients in each group. The blood gas analysis [arterial partial pressure of oxygen (PaO 2), partial pressure of carbon dioxide in artery (PaCO 2), PaO 2/oxygen concentration (FiO 2)], blood oxygen saturation (SaO 2), comfort, non-invasive ventilation time, and total hospital stay of the two groups of children 1 hour after using HHFNC and NCPAP were compared, and the rate of reintubation of trachea within 48 hours, gastroesophageal reflux, nasal injury, facial skin indentation, abdominal distension, and pulmonary air leakage were recorded. Results:There was no significant difference between the two groups in terms of blood gas analysis (PaO 2, PaCO 2, PaO 2/FiO 2), SaO 2, pulmonary air leakage, non-invasive ventilation time, hospital stay, and reintubation rate within 48 h after weaning (all P>0.05). Compared with NCPAP group, HHFNC group had higher comfort, lower incidence of facial skin indentation, gastroesophageal reflux, nasal injury and abdominal distension, and the difference was statistically significant (all P<0.05). Conclusions:HHFNC and NCPAP can both be used as the transitional respiratory support mode after weaning, and the clinical treatment effect are similar. The HHFNC group has higher comfort, which is more conducive to improving the tolerance of children, reducing adverse reactions, and has higher safety.
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Objective To study the clinical application value of humidified high flow nasal cannula(HHFNC) on bronchitis in children.Methods Total 85 cases of bronchitis that needed oxygen therapy in our department from Oct 2015 to Feb 2016 were randomly divided into three groups,HHFNC group,NCPAP group and nasal cannula oxygen group(control group).According to the blood gas results,FiO2 was adjusted to maintain PaO2 in 50~70mmHg(1mmHg=0.133kPa),TcSO2 90% to 95%.The main symptoms and signs(wheezing,shortness of breath,three depression sign,wheezing rale) disappeared time,length of oxygen inhalation and stay,the change of PaO2,PaCO2,respiratory rate were compared among the three groups.Results Compared with control group,the clinical symptoms and signs disappeared time and length of oxygen inhalation and stay were significantly shorter in HHFNC group(P0.05).Conclusion HHFNC can significantly improve the clinical symptoms,signs and blood gas results in children with bronchitis,reduce the length of oxygen inhalation and stay.HHFNC is an effective and well-tolerated treatment for bronchitis in children.
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Objective To investigate the clinical efficacy of uterine artery embolization (UAE) for the treatment of cesarean scar pregnancy compared with gelatin sponge strip and gelatin sponge particles as an embolic agent.Methods A retrospective study was performed of 94 consecutive patients with a diagnosis of cesarean scar pregnancy, and they were divided into two groups randomly.The embolic agent in experimental group was gelatin sponge strip and gelatin sponge particles were used in control group.All the cases underwent curettage operation after UAE.The mean amount of bleeding loss during curettage operation, abdominal pain degree after UAE procedure, UAE costs and time of recovery to the normal level of blood β-human chorionic gonadotropin (β-HCG) were compared between two groups.Results The mean amount of bleeding loss during curettage operation and time of recovery to the normal level of blood β-HCG were no statistical differences compared with the two groups, but the abdominal pain degree after UAE procedure and UAE costs in experimental group were lower than in control group, there were significant statistical differences compared with the two groups.Conclusion Gelatin sponge strip as an embolic agent in the UAE procedure of cesarean scar pregnancy could reduce post-operative pain and the cost, which is worthy of clinical promotion.
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Objective To evaluate the efficacy and safety of aripiprazole treatment for co-morbid attention defi?ciency hyperactivity disorder (ADHD) in children with Tourette syndrome (TS). Methods Forty four TS children with co-morbid ADHD were randomly divided into aripiprazole group and haloperidol group. The aripiprazole group and halo?peridol group received aripiprazole and haloperidol treatment for 12 weeks, respectively. Yale global tic severity scale (YGTSS) and Conners parent symptom questionnaire (PSQ) were used to assess the tic and ADHD symptoms before, 2, 4, 8 and 12 weeks after treatment. Side effects were recorded weekly. Results Repeated measure ANOVA indicated that the main effects of groups was not significant to the YGTSS scores (P>0.05), but significant to the PSQ scores (P0.05). The PSQ scores of aripiprazole group were significantly lower than that of haloperidol group. The adverse reactions of aripiprazole group were milder compared with the haloperidol group (P<0.05). Conclusions The present study demonstrates that aripipra?zole has the same efficacy in the treatment of tics as haloperidol, improves co-morbid ADHD symptoms, and its adverse reactions are much less compared with haloperidol.
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Objective To investigate clinical effects of Deanxit in non-erosive gastroesophageal re-flux disease ( NERD) with anxiety and depression.Methods A total of 76 patients diagnosed NERD with anxiety and depression by endoscopy and hospital anxiety and depression scale ( HAD) were randomly divid-ed into regular treatment group and Deanxit treatment group.Clinical efficacy, symptom score, and anxiety and depression score were observed after one week, four weeks, and eight weeks.Results Deanxit signifi-cantly increased the clinical efficacy after one week ( P <0.01) and remission rate after one week ( P <0.05), four and eight weeks ( P <0.01).It improved symptoms, depression, and anxiety, which showed significant differences ( P <0.01) compared to control group after one week, four and eight weeks adminis-tration.Conclusions Deanxit can be applied in NERD with anxiety and depression treatment, which has quick effect and high remission rate, and improve patient's reflux symptoms and anxiety depression.
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Objective To assess the effects of hydrocortisone (HC) on brain injury in septic shock rats induced by lipopolysaccharide (LPS).Methods Pathogen-free Wistar male rats were chosen to produce septic shock model by injection of LPS (Escherichia coil,O55:B5),25 mg/kg LPS was given by femoral vein.All rats in accordance with the random number table,were randomly divided into 3 groups:normal control group,LPS group,and low dose of HC group (HC 5 mg/kg).Every group had ten rats.Six hours after the septic shock model was established,the blood sample and brain tissue were collected to perform histopathological examination and measure the serum level of neuron specific enolase (NSE).Results The serum level of NSE,brain water content,inflammation score,neural damage score,vascular reaction score in LPS group were significantly higher than those in control group [(10.078 ± 0.526) μg/L vs.(3.719 ± 0.602) μg/L,(82.328 ±0.011) ％ vs.(78.896 ±0.005) ％,(2.750 ±0.463) scores vs.(0.125 ±0.345) scores,(2.875 ± 0.353) scores vs.(1.125 ± 0.354) scores,(2.875 ± 0.463) scores vs.(0.500 ± 0.534) scores,P ＜ 0.01,respectively].After HC treatment,the serum level of NSE,brain water content,and brain tissue pathological score [(6.297 ± 1.393) μg/L,(80.283 ± 0.005) ％,(0.625 ± 0.744) scores,(1.375 ± 0.744) scores,(1.250 ± 0.463) scores] were significantly lower than those in LPS group (P ＜ 0.05,respectively).Conclusion After giving low dose of HC,the serum level of NSE,brain edema,brain pathological changes all got improvement,which indicated that low dose HC could have protect effect on septic encephalopathy induced by LPS.
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Objective To analyze the relationship between Tourette syndrome and mycoplasma pneumoniae.Methods Seventy Tourette syndrome children were selected as TS group, and seventy healthy children as control group, then throat swabs MP-DNA and plasma MP-IgM, MP-IgG were detected.TS group were divided into MP-DNA positive group (n =21) and MP-DNA negative group (n =21) according to result of throat swabs MP-DNA.TS group were given haloperidol orally, we noted down daily dose of haloperidol at weekend.On the basis of the haloperidol therapy, MP-DNA positive group were treated with azithromycin.Before and 1, 2, 4, 6, 8 weeks after treatnent, we assessed YGTSS of MP-DNA positive group and MP-DNA negative group.Results (1) MP-DNA positive rate of TS group and control group were 30％ and 0％ respectively, and the differences were significant (x2 =24.706, P =0.000);MP-IgM positive rate of TS group and control group were 27％ and 17％ respectively, and there was no significant difference between two groups (x2 =2.030, P =0.154);MP-IgG positive rate of TS group and control group were 80％ and 64％ respectively, and the differences were significant (x2 =4.301, P=0.038).(2) Before and after 1, 2 weeks of treatment, the score of YGTSS was 30.65 ±5.41, 12.14 ±5.93, 28.07 ±8.69, 29.63 ±2.99, 11.68 ±5.99, 25.80 ± 9.42 respectively in MP-DNA positive group and MP-DNA negative group, and there was no significant difference between two groups (P ＞ 0.05);After 4, 6 and 8 weeks of treatment, the score of YGTSS was 60.87 ±23.75, 71.93 ±13.08, 80.19±12.91, 46.94±18.76, 60.53 ±17.42, 71.08 ±14.22 respectively in MP-DNA positive group and MP-DNA negative group, and the differences were significant (P＜0.05);3.After 1, 2, 4 and 6 weeks of treatment, the daily dose of haloperidol was 0.43 ±0.12, 0.86±0.23, 1.71 ±0.46, 2.37 ±0.67, 0.44 ±0.11, 0.88 ±0.22, 1.76 ±0.44, 2.54 ±0.54 mg respectively in MP-DNA positive group and MP-DNA negative group, and there was no significant difference between two groups (P ＞ 0.05);After 8 weeks of treatment, the daily dose of haloperidol was 2.45 ± 0.75, 3.00±0.93mg, and the differences were significant (t=2.104, P=0.042).Conclusion Mycoplasma pneumoniae may play a role in the pathogenesis of Tourette syndrome, the pathogensis of Tourette syndrome been involed in immune reaction.
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Objective To analyze the clicinal feature and therapy of the children with severe pancreatitis.Methods The clinical data of 12 children with severe pancreatitis were collected and analyzed retrospectively.Results All the cases had acute onset,10 cases had abdominal pain and fever,6 cases had abnormal blood glucose,2cases had gastrointestinal bleeding.All these cases had abdominal distention,hypoactive bowel sounds,ascites,intestinal obstruction.All these cases had a higher level of blood and urine amylase than normal,and abnormal liver function.9 cases had elevated WBC,3 cases had descendant blood calcium,edematous and inflammatory thymus were presented in 12 cases,2 of whom were associated with expancreatical damage,such as liver,intestinal,and biliary tract stones.Conclusion The early stage of severe pancreatitis is not obvious in symptoms and signs,and is prone to multiple organ damage or failure to which all pediatric clinicians should have high alert.
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In the recent years,our country have made great developement on the reform about the nation health curative system,consummating the health curative market mechanism and conversion on the conception about health.If legionary hospital want to make a good place in the future competition about curative market,they must do more things.To do this,they must get away from the bad factors in the conducting system for current market and use good factors to achieve more markets in the competition.In order to actualize the business,we must consummate the system about curative service management.
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In order to solve the problems about the lack of investing capital and to evade investing risk,a military hospital can achieve better economic benefit by introducing cooperative medical items.This method can not only make full use of its own good invisible assets and medical resource,but also help to raise its level of medical service and expand its market of medical service.To make a good item of cooperative medical service,special attentions must be payed to the following aspects such as prophase demonstrating,contract signing,partitionning of income and expenditure,financial accouting and daily accouting.
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With the deeper development about the local medical service , the legionary hospital ought to strengthen the search on the economic circulation to ensure the advantageous station in the competition of medical market.By modulating the intersected situation of sanitation economy and finance, legionary hospital will adjust the source of sanitation economy and finance and build the new system to support the scientific decision-making about the economic circulation.
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With the development of paid medical service in military hospitals,finance management is playing a more and more important role in their scientific and capacity development.It is involved in every aspect of hospital management,particularly in the patient-centered medical service.The present study aimed to establish an integral mode of finance management in military hospitals,that is,to combine medical,economic and logistic management into a whole based on finance management,so as to the improve the efficiency of medical resources,raise the hospital's competitive capacity,and promote its social benefits.
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Economization of water,electricity and gas plays an important part in the construction of an economical hospital.The metering and accounting system for water,electricity and gas management in our hospital can rationally and accurately account the consumption of water,electricity and gas.Under this system,we have implemented quota management and cost control in the medical departments,efficiency assessment in the production and supply units,cost inclusion in the internal services unit,cost collection from the logistics support contractor units,and the maintenance of pipeline leakage,which has proved to be a set of effective and scientific solutions to the promotion of the efficiency of water,electricity and gas management in the hospital.