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Objective@#To observe the effect of BiPAP non-invasive assisted ventilation on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with acute left heart failure.@*Methods@#From January 2017 to December 2018, 100 AECOPD patients with acute left heart failure admitted to the Central Hospital of Yiwu were randomly divided into observation group and control group according to random number table method, with 50 cases in each group.The control group received routine treatment such as oxygen inhalation, anti-infection, spasmolysis and asthma relief, phlegm resolving, diuresis and cardiotonic therapy.The observation group used BiPAP non-invasive auxiliary ventilation therapy on the basis of routine treatment.The basic vital signs[heart rate(HR), systolic blood pressure(SBP), respiratory rate(RR)] and blood gas analysis[partial pressure of arterial oxygen(PaO2), partial pressure of carbon dioxide(PaCO2), oxygen saturation(SaO2), pH value] before treatment and 48h after treatment were compared between the two groups.The levels of N-terminal pro-brain natriuretic peptide were observed and compared before treatment and 24h, 48h after treatment.The therapeutic effect of the two groups was compared.@*Results@#The basic vital signs(HR, SBP, RR) and blood gas analysis (PaO2, PaCO2, SaO2, pH value) of the two groups were improved after treatment, and the improvement degrees of the observation group were better than those of the control group(control group: HR t=12.352, P=0.000; RR t=7.872, P=0.000; SBP t=10.469, P=0.000; observation group: HR t=20.032, P=0.000; RR t=12.319, P=0.000; SBP t=13.911, P=0.000; intergroup comparison after treatment: HR t=6.711, P=0.000; RR t=3.742, P=0.000; SBP t=4.172, P=0.000; the control group: pH t=13.115, P=0.000, SaO2 t=3.134, P=0.001; PaO2 t=3.812, P=0.000; PaCO2 t=5.335, P=0.000; the observation group: pH t=24.980, P=0.000; SaO2 t=5.305, P=0.000; PaO2 t=7.357, P=0.000; PaCO2 t=10.172, P=0.000; intergroup comparison after treatment: pH t=7.394, P=0.000; SaO2 t=2.851, P=0.002; PaO2 t=3.467, P=0.000; PaCO2 t=4.063, P=0.000). The N-terminal pro-brain natriuretic peptide in the observation group decreased significantly after 24 hours of treatment compared with the control group, but the difference was no statistically significant(t=0.996, P=0.161). The N-terminal pro-brain natriuretic peptide levels in the observation group were significantly lower than those in the control group at 48 and 72 hours after treatment(t=6.043, P=0.000; t=12.897, P=0.000). The effective rate in the observation group was 88.00%(44/50), which was higher than 72.00%(36/50) in the control group(χ2=4.000, P=0.046).@*Conclusion@#BiPAP noninvasive assisted ventilation can effectively relieve symptoms, lessen the work of respiratory muscles, reduce cardiac load, improve myocardial oxygen supply, improve cardiac function, improve patients' oxygenation, improve hypoxemia and hypercapnia, reduce mortality and improve prognosis of AECOPD patients complicated with acute left heart failure.
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At present, non-alcoholic fatty liver disease (NAFLD) has become the major cause of chronic liver disease in the world and is considered a common pathogenic factor of cryptogenic cirrhosis. In clinical practice, NAFLD is commonly seen in obese patients; however, it is not rare among non-obese individuals, especially in the Asian population. Non-obese NAFLD patients have similar metabolic profiles to obese NAFLD patients, but many studies have revealed that compared with obese NAFLD, non-obese liver fibrosis and liver cirrhosis have unique features. This article reviews the research advances in the pathogenesis and risk factors of non-obese non-alcoholic fatty liver fibrosis and liver cirrhosis in recent years, in order to gain a better understanding of the prevention, diagnosis, and treatment of this disease.
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Traditional Chinese medicine culture contains the essence of Chinese traditional culture and provides inspiration and inexhaustible power for the construction of the socialist core value system.Great medical sincerity,harmony between man and nature,reconcile to harmony,people-oriented idea and other philosophical thoughts and ethical moralities are the common value orientation and inner requirement between traditional Chinese medicine culture and socialist core value system and also the foundation and direction for the peripheral extension of their connotation.In a particular sense,traditional Chinese medicine culture and socialist core value have the intersection of internal attributes.Promoting the interaction and internal harmony between the two will have important reference significance for contemporary culture,social construction and the development of Chinese medicine itself.
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Objective To study the correlation of PAZ with anti-tuberculosis treatment regimen and drug-induced liver injury in tuberculosis patients with HBV-DNA positive in order to provide an optimized treatment regimen. Methods from Jan 2013 to Dec 2014, 199 pulmonary tuberculosis with HBV-DNA positive patients and 103 pulmonary tuberculosis patients without HBV in our hospital were collected. They were assigned as follows:122 cases were anti tuberculosis treatment with antiviral therapy,64 cases were A(HRZE),58 cases were B (HRE). 77 cases were anti tuberculosis treatment but not antiviral therapy , 41 cases were C (HRZE), 36 cases were D(HRE) and 103 patients without HBV were E (HRZE, the contrast group). We had observed the liver injury for 2 months after the treatment. Results 1.Incidence of liver injury was 34.38% in group A , higher than the cases in group B(20.69%,P > 0.05). 2.Incidence of liver injury in group C was apparently higher than in group D (73.17% vs. 30.56%,P 0.05)4.Incidence of liver injury in group A was lower than group C (34.38% vs. 73.17%,P 0.05). Conclusion Although anti tuberculosis treatment combined with antiviral therapy can be partially reduce the incidence of liver injury and relieve the severity of liver injury in tuberculosis patients infected with HBV , but PZA toxicity to hepatocytes is a major risk factor for liver injury , and we need to change the treatment plan to reduce the occurrence of liver injury.
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Objective To explore the behavioral patterns of middle school students and provide basis for unintentional injury prevention in these students.Methods 171 injury students and 171 normal students as controls were evaluated by Youth Self-Report(YSR),and mean scores were compared between the two groups by t Test.Logistic regressions were performed to analyze the relationship between injury students and behavioral problems.Results The rate was higher in injury group(15.79%) than in control group(8.19%).The score of injury group of boys was higher than thar of control group(t=2.942,P=0.004);the score of injury group of girls was higher than thar in control group(t=3.766,P=0.000).Multi-factor Logistic regression analysis showed that attention-deficit(OR=5.376),the problem of thinking(OR=3.672),social problems(OR=2.204) and friendly fellows' action was a risk factor.Conclusions There is a significant effect of the behavior of students and fellow students on the injury to students.