ABSTRACT
Objective To Analyze the examination meaning of b-type brain natriuretic peptide precursor (NT-proBNP),homocysteine and coagulation-fibrinolysis indexes for patients with acute cerebral infarction.Methods Selected 40 patients with acute cerebral infarction (experimental group) to hospital from March 2014 to May 2015 and 40 healthy check-up cases (control group).Then,compared the indicators in blood between the two groups of patients,namely homocysteine (Hcy),NT-proBNP,activated clotting time live enzymes enzyme (APTT),original activator inhibitory factor (PAI-1) and tissuetype fibrinolytic enzyme original activator (tPA).Meanwhile,also compared these indicators for the experimental group before and after treatment.Results Before treatment,the levels of Hcy,t-PA,NT-proBNP,PAI-1 and ATPP for experiment group were 17.7±3.6 μmol/L,29.4±7.9 μmol/L,3 212.8±2 511.4 ng/L,130.1±17.8 μmol/L and 37.8±4.5 s,respectively.The levels of Hey,t-PA,NT-proBNP,PAI-1 and ATPP for control group were 7.2± 2.1 μmol/L,15.1 ± 3.7 μmol/ L,198.7 ± 1 14.8 ng/L,67.8 ± 7.9 μmol/L and 37.8 ± 4.5 s,respectively.After treatment,the levels of Hcy,t-PA,NT-proBNP,PAI-1 and ATPP for experiment group were 12.2±1.5 μmol/L,18.2±2.3 μmol/L,348.7±194.8 ng/L,78.6±9.8 μmol/L and 32.2±4.5 s,respectively.Before treatment,the indicator of APTT for experiment patients was significantly shorter than it after treatment and that of the control group.The other four indicators were significantly higher than them after treatment and those of the control group.The differences were statistically significant (P ＜0.05).Conclusion Hcy,NT-proBNP,APTT,PAI-1,and t-PA had closely relation with the occurrence of acute cerebral infarction development,and they can be helpful to evaluate disease progression and predict prognosis for patients with acute cerebral infarction.
ABSTRACT
Objective To understand the stomatological development and structure of stomatological nursing condition,to provide references for the stomatological nursing development.Methods A status survey on stomatological nursing human resources and professional development was carried out.834 stomatological nurses in 120 counties were involved,2700 questionnaires were sent out,2512 copies were recovered.Results 465 nurses were employed by the stomatological institutions.Staff with professional titles as nurse accounted for 58.5％,with college degrees accounted for 82.4％.60.0％ of the nurses did not get any professional training in dentistry,72.0％ of the medical agencies did not have any nurses.The stomatological development was directly affected by local economy condition.Conclusions The stomatological nursing development lagged far behind in Yunnan province.Medical institutions and administrative departments need pay more attention to stomatological nursing development.And medical workers should also transform their ideas.
ABSTRACT
Objective To understand the incidence and the severity of hypertension in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to analyze the impact of OSAHS on the circadian rhythm of blood pressure in patients with hypertension and to investigate the risk factors for the occurrence of hypertension from the aspects of nocturnal hypoxemia and sleep structure. Methods Polysomnography monitor was used for 7-hour sleep monitoring at night and 24-hour ambulatory blood pressure monitoring in 77 patients with OSAHS (severe, n = 33; moderate, n = 23; mild, n = 23). The sleep-related indicators and blood pressure at different times were analyzed, and they were compared to the patients with hypertension without OSAHS (n = 15) and normal controls (n = 15). Results (1) The body mass index (BMI) in the severe, moderate, and mild OSAHS groups was 29.1±2.8, 25.0±2.5, and 23.2±3.0 kg/m~2 respectively, and they were all significantly higher than 20.3±4.1 kg/m~2 in the control group (all P <0.05); sleep apnea-hypopnea index (AHI) was 56.2±14.7, 19.1± 4.4, and 11.2±4.3/h respectively, and they were significantly higher than 2.9±1.0/h in the control group (all P <0. 05); oxygen saturation index (ODI) was 62.5±20.4, 19.6±8.8, and 24.8±22.7/h respectively, and they were significantly higher than 2.7±2.0/h in the control group (all P <0.05); microarousal index (MI) was 47.5±20.9, 12.8±4.6, and 9.8±4.6/h respectively, arid they were significantly higher than 1.3±1.1/h in the control group (all P < 0.05); 24-hour mean systolic blood pressure was 133±14.5, 126±6.5, and 118± 9.9 mm Hg respectively, and the severe and moderate OSAHS groups were significantly higher than 117±9. 6 mm Hg (all P <0.05); 24-hour mean diastolic blood pressure was 92.8±9.6, 86.3±7.5, and 81.9±3.9 mm Hg respectively, and the severe and moderate OSAHS groups were significantly higher than 78.5±5.6 mm Hg in the control group (all P <0.05); and the lowest oxygen saturation was 65.5%±10.4%, 78.5%±5.1%, and 79.7%±9.6% respectively, and the severe and moderate OSAHS groups were significantly lower than 84.7% ±8.2% (P <0.05). (2) There was no significant difference in blood pressure before going to bed and waking up between the hypertension group and the control group. The blood pressure after waking up in the OSAHS combined with hypertension group was significantly higher than before going to bed (142.0±12.4/110.0±10.2 mm Hg vs. 127.4±9.8/84.2± 6.0 mm Hg, P <0.05). (3) ODI and MI in the OSAHS combined with hypertension group were 43.5±26.2/h and 31.6±21.2/h respectively, and they were significantly higher than 26.7± 13.2/h and 27.5±20.6/h in the non-hypertension OSAHS group (all P <0.05), and the non-rapid eye movement sleep period S3 +4 and the sleep efficiency of the former were 5.1%± 3.5% and 62.2±15.4% respectively, and they were all significantly lower than 8.8%± 5.2% and 69.92%±14.8% of the latter (P <0.05 and 0.01, respectively). (4) component ratio of non-dipper blood pressure curve was 56.1% in the OSAHS combined with hypertension group, and it was significantly higher than 13.1% in the control group and 16.7% in the simple hypertension group (all P <0.01 ). (5) Multivariate logistic regression analysis showed that ODI (OR = 1.29, 95% CI 1.57-1.07; P = 0.01 ), MI (OR = 0.925, 95% CI 0.874-0.980; P =0.008) and the time of period S3 +4 (OR = 1.087, 95% CI 1.034-1.142; P =0.001 ) were significantly correlated with hypertension alter adjusting for BMI, sex and age. Conclusions Systolic and diastolic blood pressures in the OSAHS group were significantly high-er than those in the normal control group, and the blood pressure increased with the aggravation of OSAHS. 1he circadian rhythm of blood pressure disappeared, and the blood pressure variabili-ty showed a non-dipper-shaped curve. The major risk factor for causing patients with OSAHS combined with hypertension was nocturnal hypoxemia and then severe sleep disorders and in-creased MI.
ABSTRACT
Objective To evaluate the clinical effects of voice training on the speech ability in patients with oral cancer af. ter free flap reconstruction. Methods Fifty-five patients with oral cancer after free flap reconstruction were assigned to the voice training group(28 cases)and control group(27 cases)from the third week after operation. Their speech function was eval-uated by Chinese Speech Definition Word Table before operation and 2 weeks,3 months and 6 months after the operation. Results The score of speech definition was significantly higher in the voice training group than that of the control group (P< 0.01). Conclusion Postoperative voice training can effectively improve the speech definition for the patients with oral cancer after free flap reconstruction.
ABSTRACT
Objective:To summarize the complications' prevention and nursing experience for patients after autologous transplantation of the microvascular submandibular gland for severe keratoconjunctivis sicca.Methods:Retrospective analysis of 141 patients(151 sides) after autologous microvascular submandibular gland transfer operation was undertaken to record the timing and incidence of major complications and to summarize the nursing experience.Results: The main complications after the transplantation were: vascular crisis,catheter obstruction,salivary fistula and temporary paralysis of hypoglossal nerve.Related nursing measures in response to these complications were discussed.Conclusion:Targeted nur-sing interventions for patients with autologous transplantation the submandibular gland have a positive effect on the prevention of the surgical complications.