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Objective To explore the correlation between serum levels of retinol-binding protein(RBP)and β2-microglobulin(β2-MG)levels with the disease and disease outcome in patients with septic shock.Methods A total of 120 patients with sepsis admitted to Qinzhou Hospital of Traditional Chinese Medicine from November 2020 to November 2022 were selected as research objects,and divided into sepsis group(76 cases)and septic shock group(44 cases)according to the severity of the disease.A total of 96 healthy subjects were selected as control group.According to the 28-day disease outcome of sepsis shock group,10 patients died(worsening group)and 34 patients survived(outcome group).Serum RBP and β2-MG levels were detected by immunoturbidimetry within 24 h after admission.Serum RBP and β2-MG levels were compared among all groups.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of serum RBP and β2-MG on the disease outcome of patients with septic shock.Multivariate Logistic regression was used to analyze the related factors affecting the disease outcome of patients with septic shock.Results WBC count,procalcitonin,C reactive protein level,acute physiology and chronic health status score system Ⅱ score,se-quential organ failure assessment(SOFA)score in sepsis shock group were higher than those in sepsis group and control group,and platelet count was lower than those in sepsis group and control group,the difference was statistically significant(P<0.05).Serum RBP and β2-MG levels in sepsis shock group were higher than those in sepsis group and control group,and the difference was statistically significant(P<0.05).The levels of serum RBP and β2-MG in the worsening group were higher than those in the outcome group,and the differ-ence was statistically significant(P<0.05).ROC curve analysis showed that the area under the curve of ser-um RBP and β2-MG combined to evaluate the outcome of septic shock disease was 0.910(95%CI:0.865-0.955).Multivariate Logistic regression analysis showed that serum RBP,β2-MG,C reactive protein and SO-FA score were all risk factors affecting the disease outcome of septic shock patients(P<0.05).Conclusion The serum levels of RBP and β2-MG in patients with septic shock are increased,and the changes of both levels are related to the disease outcome.The combined application has a better predictive value for the disease outcome in patients with septic shock.
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Objective:To explore the effect of motivational interview combined with feedback teaching on active cycle of breathing technique(ACBT) training in lung cancer patients.Methods:A total of 632 patients with lung cancer undergoing radical resection from September 2017 to March 2019 in Sun Yat-sen University Cancer Center were selected and divided into the experimental group and the control group with 316 cases in each group by operation time. The experimental group received motivational interview combined with feedback teaching education, while the control group received routine education. The patients were followed up for 2 months. The compliance and accuracy of ACBT training, self-care ability, sputum discharge and incidence of pulmonary complications were compared between the two groups.Results:The sputum volume in the control group was (6.25±2.44), (9.28±2.63), (10.33±3.15) g in the control group and (8.74±4.17),(13.87±3.19),(14.18±4.16) g in the experimental group at 1, 2, 3 days after operation, and the differences between the two groups were statistically significant ( t values were -1.149, -2.316, -4.124, P<0.01 or 0.05). There were 56 cases(17.72%) of pulmonary complications in the control group and 33 cases (10.44%) in the experimental group. The difference in the incidence of pulmonary complications between the two groups was statistically significant ( χ2 value was 4.743, P<0.01).Two months after operation, the compliance and accuracy of ACBT training in the experimental group were better than those in the control group ( χ2 values were - 4.57, - 2.15, P<0.01).The improvement in the four dimensions after intervention in the experimental group were better than those in the control group, and the differences were statistically significant ( t values were 8.314-19.719, P<0.01). Conclusions:The motivational interview combined with feedback teaching is an effective method of health education, which is conducive to improving lung cancer patients' compliance and accuracy of postoperative ACBT training, improving patients' self-care ability, promoting the discharge of patients' sputum and reducing the incidence of pulmonary complications to promote the recovery of lung function.
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PURPOSE: The efficacy of helmet continuous positive airway pressure (CPAP) in hypoxemic acute respiratory failure (hARF) remains unclear. The aim of this meta-analysis was to critically review studies that investigated the effect of helmet CPAP on gas exchange, mortality, and intubation rate in comparison with standard oxygen therapy. MATERIALS AND METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) by searching the PubMed, Embase, Cochrane library, OVID, and CBM databases, and the bibliographies of the retrieved articles. Studies that enrolled adults with hARF who were treated with helmet CPAP and measured at least one of the following parameters were included: gas exchange, intubation rate, in-hospital mortality rate. RESULTS: Four studies with 377 subjects met the inclusion criteria and were analyzed. Compared to the standard oxygen therapy, helmet CPAP significantly increased the PaO2/FiO2 [weighted mean difference (WMD)=73.40, 95% confidence interval (95% CI): 43.92 to 102.87, p<0.00001], and decreased the arterial carbon dioxide levels (WMD=-1.92, 95% CI: -3.21 to -0.63, p=0.003), intubation rate [relative risk (RR)=0.21, 95% CI: 0.11 to 0.40, p<0.00001], and in-hospital mortality rate (RR=0.22, 95% CI: 0.09 to 0.50, p=0.0004). CONCLUSION: The results of this meta-analysis suggest that helmet CPAP improves oxygenation and reduces mortality and intubation rates in hARF. However, the significant clinical and statistical heterogeneity of the literature implies that large RCTs are needed to determine the role of helmet CPAP in different hypoxemic ARF populations.
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Adult , Humans , Acute Disease , Continuous Positive Airway Pressure , Hospital Mortality , Oxygen Inhalation Therapy , Randomized Controlled Trials as Topic , Respiratory Insufficiency/mortalityABSTRACT
Objective To explore the value of ABCD3-Ⅰ score in predicting prognosis of transient ischemic attack (TIA).Methods A total of 106 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrence of cerebral infarction within 7 d and 90 d was observed.The patients with ABCD3-Ⅰ 0-3 scores were as low risk group (36 cases),the patients with ABCD3-Ⅰ 4-7 scores were as moderate risk group (36 cases),the patients with ABCD3-Ⅰ 8-13 scores were as high risk group (34 cases).Results The occurrence of cerebral infarction within 7 d and 90 d in high risk group was lower than that in low risk group and moderate risk group [within 7 d:23.5%(8/34) vs.2.8%(1/36) and 5.6% (2/36),within 90 d:38.2% (13/34) vs.2.8% (1/36) and 11.1% (4/36)],and there was significant difference (P <0.01).Symptom duration time ≥10 min in ABCD3-Ⅰ score,concomitant diabetes,double TIA,ipsilateral carotid artery stenosis ≥50%,high sign in diffusion weighted imaging were the risk factors for the occurrence of cerebral infarction within 7 d and 90 d in TIA patients (P < 0.05).The area under the receiveroperating characteristic curve for predicting the occurrence of cerebral infarction within 7 d and 90 d in TIA patients by ABCD3-Ⅰ score was higher than that by ABCD2 and ABCD3 score (0.914 vs.0.614 and 0.877,0.869 vs.0.633 and 0.773).Conclusion The ABCD3-Ⅰ score is a simple and effective way to judge the short-term prognosis of TIA and can help to identify the different risk levels,so it is helpful in stratification treatment.
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Objective To explore the application value of aspirin and clopidogrel dual antiplatelet treatment combined with ABCD3-Ⅰ scores in treatment of transient ischemic attack (TIA).Methods Risk factors were evaluated and imaging was performed in 48 h in one hundred and twenty patients with first attack of TIA [magnetic resonance imaging (MRI),magnetic resonance angiography (MRA),diffusion weighted imaging (DWI) scan].According to the ABCD3-Ⅰ evaluation method,the patients were divided into low risk group,moderate risk group and high risk group.Single resistance group was given aspirin 100 mg/d; double resistance group was given aspirin 100 mg/d combined with clopidogrel 75 mg/d.Then the incidence of ischemic stroke in each group within 7 days was observed,and the effects of dual anti-platelet and aspirin monotherapy were compared.Results Within 7 d after TIA,low-risk single resistance group and low-risk double resistance group had no stroke; 9 cases (42.9%,9/21) had stroke in moderate-risk single resistance group,2 cases (2/19) had stroke in moderate-risk double resistance group,and there was significant difference (P < 0.05) ; 9 cases (9/18) had stroke in high-risk single resistance group,3 cases (15.0%,3/20) had stroke in high-risk double resistance group,and there was significant difference (P < 0.05).Three patients in single resistance group and 4 cases in double resistance group showed gastrointestinal adverse reactions such as nausea,acid reflux,and there was no significant difference between 2 groups (P > 0.05).Each group during treatment showed no bleeding tendency,and liver and kidney function in patients was normal.Conclusion In patients of the moderate risk and high risk of ABCD3-Ⅰ scores,dual anti-platelet may have an advantage over single druge in the prevention of ischemic stroke.
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Objective To investigate the effects of distractions on number processing using event-related potentials (ERPs). Methods ERPs were recorded in fourteen undergraduate students while they were asked to compare a heard number with the number "5" and judge whether its numerical value was larger or smaller than five. This task was carried out under a distracted attention (DA) condition and a focused attention (FA) condition. The reaction time and EEG signals were recorded during the experiment. Results There were significant differences between the reaction times in the different conditions (t26 = 3. 70,P
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Objective To explore the effects of Taiji exercise on the psychology and the functions of the autonomic nervous systems of middle aged and elderly people. Methods Two hundred and seven middle aged and elderly Taiji exercisers and 166 age matched non Taiji exercisers were sampled. The Zung Self rating Anxiety Scale(SAS), Zung Self rating Depression Scale (SDS) and autonomic nervous system equilibrium index (ANSEI)were adopted to assess the subjects. Results Compared with those of the control group, the scores of SAS and SDS in Taiji group were significantly higher, and the equilibrium of autonomic nervous systems in Taiji group was also superior. There was no significant difference between the male and the female with regard to SAS, SDS and the equilibrium of autonomic nervous systems within Taiji group. The longer the exercise, the better the equilibrium of autonomic nervous systems. Conclusion Taiji exercise has positive effects on the psychology and the autonomic nervous system of the middle aged and the elderly.
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Objective: To develop the native Chinese Affective Picture System (CAPS) for future research on emotion. Methods: 852 pictures were screened out to make up of CAPS. 46 Chinese university students were collected to rate the valence, arousal and dominance by self-report in a 9-point rating scale for CAPS. Results: The standard deviations of scores on valence and dominance were greater than that on arousal. Scatter plot showed that the score distribution on the dimension of valence and arousal was wide in CAPS. Conclusion: Though IAPS (International Affective Picture System) is highly internationally-accessible, there are still significant differences between the two sources. The native Chinese Affective Picture System is necessary.