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ObjectiveTo explore the role of supportive psychotherapy in mental health improvement of COVID-19 positive patients， and to provide references for the implementation of early psychological intervention measures in response to the sudden epidemic outburst， such as COVID-19. MethodsA total of 35 patients with severe COVID-19 admitted to ICU ward of Wuhan People’s Hospital from February 1 to March 1， 2020 were enrolled in this study. All the selected individuals received a 2-week supportive psychotherapy. Then Pittsburgh Sleep Quality Index （PSQI）， Patients’ Health Questionnaire Depression Scale-9 item （PHQ-9）， Generalized Anxiety Disorder Scale （GAD-7） and Social Support Rating Scale （SSRS） were used to evaluate the sleep quality， depression， anxiety and social support of participants at the baseline and the 2nd week of the intervention. ResultsInsomnia was detected in 32 patients （91.43%）， anxiety symptoms in 31 （88.57%）， depressive symptoms in 32 （91.43%）， and 29 patients （82.86%） reported feeling a lack of social support. After 2 weeks of intervention， the PSQI， GAD-7 and PHQ-9 scores decreased （t=5.272， 5.475， 4.621， P<0.01）， and SSRS score increased （t=-4.639， P<0.01）. After the intervention， the proportion of patients with insomnia， anxiety， depression and lack of social support was also decreased （χ2=18.714， 16.232， 16.970， 4.480， P<0.01）. ConclusionSupportive psychotherapy may ameliorate anxiety， depression and sleep quality in COVID-19 patients.
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Objective To analyze the influential factors of the prognosis of neonatal cholestasis. Methods The data on 106 newborns with neonatal cholestasis collected from January 1, 2009 to June 30, 2016 was collected and analyzed retrospectively. All cases were divided into cure group (99 patients) and improvement group (7 patients) according to the effect of oral ursodeoxycholic acid therapy and comprehensive medical treatment. There was no cure for invalid case. The clinical features, course of disease and curative effect were observed. The levels of total bilirubin (TB), direct bilirubin (DB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (γ-GT), total bile acid (TBA) were compared between two groups. The ratio of neonatal bacterial infection, cytomegalovirus (CMV) infection, sex, total intravenous nutrition (more than 7 d), perinatal hypoxia, premature birth, maternal complicated intrahepatic cholestasis of pregnancy (ICP) were compared between two groups. Multiple Logistic regression analysis was used to analyze the prognosis factors of neonatal cholestasis. Results The levels of serum ALT, AST, γ-GT, TB, DB and TBA in improvement group were significantly higher than those in cure group, the course of disease in improvement group was significantly longer than that in cure group, there were significant differences (P<0.05). A strong linear correlation was showed between course of disease and the levels of serum ALT, AST, TB, DB and TBA (tALT=13.050, tAST=14.696, tTB=12.771, tDB=13.776, tTBA=12.019, P < 0.05). Multiple Logistic regression analysis showed that the prognosis of neonatal cholestasis was associated with bacterial infection, CMV infection, total intravenous nutrition (more than 7 d) and premature ( OR=9.375, 7.909, 11.333, 11.333, P < 0.05). Conclusions The higher the level of serum TB, DB, TBA, ALT and AST, the longer the course of the disease. Bacterial infection, CMV infection, total venous nutrition( ≥ 7 d) and premature are the risk factors of the prognosis of neonatal cholestasis. Therefore, prevention of neonatal bacterial and CMV infection, reduction of the occurrence of preterm delivery and reduction of the total parenteral nutrition time are very important to improve the prognosis of neonatal cholestasis.
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Objective To investigate the clinical application and value of retrograde catheterization via superficial femoral artery for the treatment of limb chronic total occlusive disease (CTO). Methods Fifty-nine patients with proximal and middle occlusive lesions of superficial femoral artery from Jan. 2013 to Jan. 2015 in department of emergency surgery were retrospectively analyzed. Percutaneous transluminal angioplasty (PTA) together with stent implantation was performed to reopen the all narrowed or obstructed superficial femoral artery.Seventeen patients received ipsilateral retrograde catheterization via superficial femoral artery together. The length of the diseased artery ranged from 6.5 to 13.4 cm, with a mean of (8.3 ± 2.9) cm, including right (11 cases)and left (8 cases) femoral arteries. After the interventional therapy patients were followed up for 1- 24 months. Results All patients were treated successfully. The proximal and middle occlusive lesions of superficial femoral artery were reopened.No serious complications were found including nerve and vessel damage+After the treatment, the ischemic symptoms were markedly improved or even disappeared. In 14/19 of patients the superficial femoral arteries remained patent during the follow-up period. The ankle preoperative brachial index (ABI) was 0.20 to 0.51 (0.39 ± 0.06), while the postoperative ABI was 0.65 to 1.15 (0.74 ± 0.13). The difference in ABI between pre-operation and post-operation was statistically significant (P<0.05). Conclusions Retrograde catheterization via superficial femoral artery is an effective alternative to treat proximal and middle occlusion of ipsilateral superficial femoral artery. It has high successful rate and safety.
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Objective To explore the value of improved family management model to reduce the occurrence of death and rehospitalization rate of children with bronchopulmonary dysplasia (BPD) after discharge.Methods The children with BPD who were admitted in Neonatal Intensive Care Unit of Zhongshan Hospital Affiliated to Sun Yat-Sen University from January 2006 to December 2013 were enrolled.Thirty-one cases with BPD used with improved family management mode after discharge from January 2010 to December 2013 were as experimental group.Twenty-seven cases with BPD used with traditional family management mode after discharge from January 2006 to December 2009 were as control group.The occurrence of death and rehospitalization were observed because of apnea,choking,respiratory failure,pneumonia and asthma within 3 months after discharge and compared the difference between two groups with chi-square test.The lung functions of all cases were checked in 40 week of the corrected gestational age and 3 month of the corrected age and compare the difference between the experimental group and control group with t test.Results The occurrence of death in the experimental group was 3.22％ (1/31 cases),and that of the control group was 22.22％ (6/27 cases),there was significantly statistical difference in the occurrence of death between two groups (x2 =4.907,P ＜0.05).The occurrence of rehospitalization in the experimental group was 25.80％ (8/31 cases),and that of the control group was 77.78％ (21/27 eases),there was significantly statistical difference in the occurrence of rehospitalization because of apnea,choking,respiratory failure,pneumonia and asthma between two groups (x2 =15.591,P ＜ 0.05).The difference of the lung functions between two groups in 40 week of the corrected gestational age was not statistically significant.The respiratory rate in the experimental group (30 survivors) were lower than those in the control group (21 survivors) in 3 month of the corrected gestational age (t =9.225,P ＜ 0.05),and time to peak tidal expiratory flow,volume to peak tidal expiratory flow,25 ％ tidal expiratory flow,50％ tidal expiratory flow,75 ％ tidal expiratory flow levels in the experimental group were higher than those in the control group in 3 month of the corrected gestational age,the difference of lung functions between 2 groups were statistically significant (t =3.992,3.301,4.645,3.152,2.916,all P ＜ 0.05),the lung functions in experimental group were significantly better than that in control group in 3 month of the corrected age.Conclusions The improved family management mode can reduce the occurrence of death and rehospitalization for the children with BPD after discharge and is conducive to the improvenent of pulmonary function.
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Objective To explore the effect of chemotherapy on serum IL-6 expression in cancer patients with T2DM. Methods Eighty patients were divided into the malignant tumor group with T 2DM (n=40) and the malignant tumor group without T2DM (n=40).All the patients were given two cycles of chemotherapy .2 ml of fasting venous blood in the morn-ing before and after the day of chemotherapy was collected .Then the serum was separated .Enzyme-linked immunosorbent assay (ELISA)was used to measure the level changes of serum IL-6.20 cases of healthy people were selected for compari-son.Results The expression of serum IL-6 in groups with or without T2DM was significantly higher than in the normal control group before the first cycle of chemotherapy (P0.05).Conclusion The expression level of serum IL-6 declines after the first cycle chemotherapy in the malignant tumor groups with T2DM or without T2DM but rises in the malignant tumor group with T2DM after the second cycle chemotherapy .
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ObjectiveTo study the curative effect of early intervention on selective head sub-hypothermia in full term infant with severe asphyxia.MethodsForty two full term infant with severe asphyxia were randomly divided into treatment(n =22) and control ( n =20) group,all patients were treated according to three supportive therapy and three heteropathy after resuscitation,and meanwhile the treament group combined with selective head sub-hypothermia.In the 2 groups,heart and breath oxygen saturation,blood sugar were measurded within 72 hours after treatment,and the Chinese 20-item neonate nerve behaviors were evaluated 28 days after birth.Test were conducted with the Bayley infant development scale in 2 months after birth.ResultsAfter 72 hours of treatment,the heart rate of treatment group reduced and showed significant difference from that of contol group and restored to normal.There were no significant differences in breath,blood pressure(BP),degree of blood ozygen saturation,blood sugar between the 2 groups.After 28 days of birth,scores of neonate nerve behaviors were ( 37 ± 3) in treatment group and (31 ± 3) in control group,respectively ;which showed significant difference ( P ＜ 0.01 ).In the 2nd months of birth,scores of Bayley infant development scale were (91 ± 3 ) in treatment group and ( 86 ± 4 ) in control group,respectively,which showed significant difference(P ＜ 0.05 ).ConclusionSelective head sub-hypothermia was convenient and safe,and had reliable curative effect by relieving or prenventing sequel and raising quality of life.
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This paper summarizes the experiences of nursing care of five patients with stoma after small bowel allotransplantation. The nursing care focused on observation of the survival,motility,secretion and other functions of early transplanted bowel,preparation and cooperation for colonoscopy,stoma care during enteral nutritional support,observation of the digestion,absorption and rejection of transplanted bowels. The five patients survived after operations. The stoma of transplanted bowels was ruddy and had a good circulation without complications such as rupture of skin around stoma. The patients gradually restored the normal diet by mouth.
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Objective To explore the protective ventilation strategies in hyaline membmne disease(HMD) of neonates,in order to decrease the incidence of ventilator-associated lung injury(VAU).Methods 68 newborn infants,diagnosed as of neonatal hyaline membrane disease and needed ventilator support,were recruited from the neonatal intensive care unit from 2003 to 2005.Infant with HMD were divided into the conventional ventilation practice group (the control group) and protective ventilation strategies group (the experimental group).The ventilator settinns,artery blood gas analysis,ventilator-associated lung injury and other clinical data were analyzed and compared.Results The incidence of ventilator-associated lung injury in the experimental group wag significantly lower than that in the cntrol group(2.94% VS 17.6%,P＜0.05).PaCO2 in experimental group was significantly higher than that in control group.The mortality in the experimental group was significantly lower than that in control group.Condusion The protective ventilation strategies can decrease the incidence of ventilator-associated lung injury in neonatal HMD.the protective ventilation strategies can decrease the mortality in neonatal HMD.
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Objective To observe the changes in inflammatory mediators in plasma in respiratory distress syndrome(RDS) of neonates received lung protective ventilation treatment. Methods Sixty newborn infants,diagnosed as RDS of neonatal and needed ventilator support, were recruited from the intensive care unit from May 2003 to May 2006. Infant with RDS were randomly divided into two groups. Both had 30 newborn infants. The infants in the experimental groups received lung protective ventilation treatment tidal volume:5-8 ml/kg,positive end-expiratory pressure (PEEP):0.51~0.98 kPa, and the control groups received large tidal volume ventilation (tidal volume:10-15 ml/kg,PEEP:0-0.29 kPa). The contents of TNF-?, interleukin-6 in plasma were measured. Results After those two therapies, the contents of tumor necrosis factor-?(TNF-?), interleukin-6 in plasma decreased obviously, especially after receiving lung protective ventilation treatment. Conclusions There are statistical differences in the amount of inflammatory mediators released between the experimental group under lung protective ventilation treatment and the control group received large tidal volume ventilation,and better effects are seen in RDS infants under lung protective ventilation treatment .
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OBJECTIVE:To observe the curative effect of tazobactam sodium/piperacillin sodium for injection on the Neonatal infections.METHODS:140neonatal infections cases were randomly divided into treatment group and control group:the treated group were treated with tazobactam sodium/piperacillin sodium for injection100～200mg/(kg?d);while the con?trol group were treated with penicillin-G100000～200000IU/(kg?d).The course of therapy for both groups were5d～10d.RESULTS:The effective rates of the treatment group and the control group were91.43%,52.86%(P
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Objective To explore the pathogenesis of syringoma in order to cure this disease. Methods The clinical manifestation was observed in 39 cases of syringoma. The serum level of estradiol (E 2), progesterone (Pro), luteinizing hormone(LH) and follicle stimulating hormone (FSH) were detected with radioimmunoassay in all the 30 female cases and 25 normal controls. The expression of estrogen and progesterone receptor (ER and PR) was determined in syringoma tissues using ABC method and anti ER and anti PR monoclonal antibodies. Results Syringoma mainly involved middle aged women. The average level of serum E 2 in female patients was (73?28) ng/ml and its control group, (42?19) ng/ml ( P
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PurposeTo investigate the effect of gasoline on the skin barrier function.MethodsA rat skin model in vitro was used in this study. The amount of 3H-water penetrated throught the skin was applied as the index of evaluating the barrier function.ResultsThe results showed that the amount of 3H-water was not obviously increased in those exposed to gasoline for 0.5,1 and 2 h(P > 0.05), but the 3H-water penetration amount through the skin increased linearly with the time. In the group exposed to gasoline 4 h, the 3H-water penetration amount through the skin was significantly higher than that in the control group (P 0.05). The skin barrier function of the group (expopsed to gasoline 4 h) was disrupted.Conclusions Gasoline may disrupt the skin barrier function. Gasoline would remove the lipids within the intercellular domains of the stratum corneum and then lead to damage the skin.
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Objective To observe the renoprotective effects of angiotensin Ⅱ (ATⅡ) receptor antagonist, L-158809 and to explore its potential mechanisms. Methods The experimental rats consisted of normal control and type 2 diabetic model groups with or without treatment of L-158809 (2 mg?kg -1 ?d -1 ) for 16 weeks. Blood glucose, HbA 1c , serum immunoreactive insulin, serum creatinine, mean arterial blood pressure, creatinine clearance (Ccr) and urinary albumin excretion index (UAEI) as well as plasma and renal ATⅡ content were measured. The kidney morphological changes were examined by renal histopathology. Marix metalloproteinase-2 (MMP-2) and the tissue inhibitor of metalloproteinase-2 (TIMP-2) expression in renal tissues were studied by immunohistochemistry, zymography and Western blot. Results In type 2 diabetic rats, L-158809 restored the blood pressure (P
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Serum Ca, P, AKP, plasma iPTH, cAMP, urinary Hyp and BMC were measured in 31 cases of Graves' disease. The results showed that about 66.67% of the patients (including 21 controlled and 10 uncontrolled cases) had a decreased BMC, while serum Ca, P, plasma iPTH, cAMP were within the normal range. The data also showed that about 54.6% of the patients had increased serum AKP, but it would not exceed 25 U if no hepatic disease existed. There were positive correlations between serum T, and urinary Hyp, and between urinary Hyp and serum AKP, but a negative correlation between urinary Hyp and BMC. It was suggested that serum AKP and urinary Hyp could be considered as the indices of negative balance of bone metabolism in Graves' disease, and probably it was induced by excessive thyroid hormone directly.
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Objective To investigate the relationship between serum nitric oxide (NO) and bone metabolism in streptozotocin induced early diabetic (STZ DM) rats. Methods Twenty SD rats were divided into 2 groups, 12 STZ DM rats and 8 controls. Fasting blood glucose, HbA 1c , serum insulin, bone mineral density (BMD) (whole body, lumbar and femoral bone), bone metabolic parameters 〔such as serum calcium, vitamin D 3, parathyroid hormone (PTH), calcitonin, osteocalcin, and urinary pyridinoline/creatinine〕, as well as serum NO were measured. Results Compared with the controls, serum NO in STZ DM group significantly elevated 〔(51.3?11.9 vs 38.1?12.0)?mol/L, P
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Blood glucose level responses to different diets were examined in 12 healthy man. The test breakfasts consist of different proportion of protein and carbohydrate. Three kinds of test breakfast were fed respectively for each person. Blood glucose were measured before and 1, 2 and 4 hr after breakfast. The results indicated that high-CHO diet maintained higher level of blood glucose than other diets in 1-2 hr after breakfast. However the blood glucose level began dropping from 2 hr and dropped below fasting level at 4 hr after breakfast. The high-protein diet resulted in decreasing of blood glucose level in 1-2 hr after breakfast. The blood glucose level then increased continuously until 4 hr after breakfast.The results in this experiment showed that adjustment of the proportion of carbohydrate and protein in diets could maintain the blood glucose to a higher and stable level.