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Objective To evaluate the effect of the clinical nursing path integrated with the holistic nursing on advanced schistosomiasis patients with ascites. Methods A total of 226 advanced schistosomiasis patients with ascites were randomly di?vided into a control group and an experimental group (113 cases each group). The subjects in the experimental group were nursed by the clinical nursing path integrated with the holistic nursing,while those in the control group were nursed only by the holistic nursing. Then the clinical relevant indexes of the two groups were observed,and the quality of life of the patients before and after hospital discharge was assessed. Results The improvement rate,satisfaction degree,and awareness rate of health knowledge of the patients in the experiment group were 93.8%,100%and 97.4%,respectively,which were significantly higher than those of the control group(all P<0.05). The mortality rate and the complication rate of the patients in the experimental group were 0 and 2.7%,respectively,which were significantly lower than those of the control group(both P<0.05). In addi?tion,the average hospitalization days and the hospitalization cost of the experiment group were(12.2 ± 0.7)d and(4 725.0 ± 310.1)Yuan respectively,which were less than those of the control group(both P<0.01). When 6 months after the discharge from hospital,the quality of life of the patients in the experimental group in various fields was significantly better than that of the control group(all P<0.05). Conclusions The clinical nursing pathway integrated with holistic nursing can effectively improve the improvement rate and decrease the mortality of the advanced schistosomiasis patients with ascites;meanwhile,it can short?en the hospitalization time and save the hospitalization cost. Therefore,this nursing model is suitable for popularization and ap?plication in the treatment and nursing work of the advanced schistosomiasis assistance.
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Objective To explore the short‐term effect of chronic periodontitis patients after implant treatment .Methods Selected 60 cases of tooth loss in chronic periodontitis patients as research group ,a total of 75 implants were placed ,and 50 cases of periodontal healthy teeth missing patients as control group ,a total of 67 implants were placed .Compared two groups of modification sulcus bleeding index(mBII) ,papilla index score(PIS) ,modification plaque index(mPLI) and probing depth(PD) 6 months after op‐eration ,and detected implant sulcular fluid IL‐2 ,IL‐8 content in two groups before and after operation .Results Research group 75 implants had 2 off on their own ,implant loosening degrees 0 ,implant survival rate was 97 .3% ;the control group had no implant failure ,implant loosening of implant survival rate was 100% ,two groups of implant survival rate was no significant difference(χ2 =2 .737 ,P= 0 .098) .The mSBI ,PIS ,mPLI ,PD in research group and control group had no statistically significant(P > 0 .05) .Re‐search group sulcular fluid IL‐2 ,IL‐8 content was significantly higher than those in control group before and after the operation (P< 0 .05) .Conclusion The short‐term effect of implant treatment in chronic periodontitis patients is satisfactory ,without increas‐ing the risk of peri‐implantitis ,and worth of clinical promotion .
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PURPOSE: We aimed to verify whether the formal clinical index derived from infants and toddlers have a good association with the disease severity when we confine subjects to only infants, who undergo profound changes physically and immunologically. METHODS: We retrospectively reviewed the medical records of hospitalized infants with acute bronchiolitis caused by respiratory syncytial virus between January 1, 2010 and December 31, 2011 in three hospitals. The age, respiratory rate, presentation of chest retraction, and percutaneous oxygen saturation upon admission; presentation of fever, use of oxygen therapy and inhaled corticosteroid within 24 hours after admission were investigated. We then examined the effect of clinical index on severity of acute bronchiolitis; the mean length of stay, mean duration of fever and oxygen therapy. RESULTS: A total of 172 infants were studied. The mean length of stay was longer in patients younger than 3 months (P=0.015), in those with fever (P=0.028) and chest retraction (P=0.014), and in those who needed oxygen supplement (P=0.000). In the patients with fever, the mean duration of fever was longer in those who needed the oxygen supplement than those who did not (P=0.046). CONCLUSION: Younger than 3 months of age, chest retraction upon admission; fever, need of oxygen supplement within 24 hours after admission may predict the severe course of infants with acute bronchiolitis.
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Humans , Infant , Bronchiolitis , Fever , Length of Stay , Medical Records , Oxygen , Respiratory Rate , Respiratory Syncytial Viruses , Retrospective Studies , ThoraxABSTRACT
PURPOSE: We developed a standardized critical pathway for gastric cancer surgery and then determined the increase of application, which resulted in an improvement in terms of measurable indices, such as hospital stay and cost. MATERIALS AND METHODS: A critical pathway was revised and used widely from the 2nd quarter of 2009. We collected clinical data, such as length of stay and complication rate, as clinical indices of quality prospectively. The total cost paid at the patient's discharge, as well as the daily hospital income, were calculated and compared by each quarter from January 2008 to December 2009. RESULTS: The application rate of critical pathway was 11.8% and 87.8% in 2008 and 2009, respectively. There were no perioperative deaths. There was no difference in the complication rates between 2008 and 2009 (P=0.45). However, the mean length of stay was significantly different between the 2 years (P<0.05). Although the total cost was not different, the daily hospital income was significantly higher in the latter year (P<0.05). CONCLUSIONS: An increase in the application of critical pathway for gastrectomy resulted in significant decreases in length of stay and increases in the daily hospital income without a compromise on the clinical indices.
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Critical Pathways , Gastrectomy , Length of Stay , Prospective Studies , Stomach NeoplasmsABSTRACT
BACKGROUND: Onychomycosis is a common fungal infection accounting for 50% of all nail disorders. Above all the clinical types of onychomycosis, distal and lateral subungual onychomycosis (DLSO) is the most common clinical type seen up to 70~90% in onychomycosis patients. Even though the cure rate and recurrence rate of DLSO are considered to be different according to the clinical type of DLSO. Clinical experience, there is a few clinical study showing the difference. OBJECTIVE: This is to investigate the therapeutic efficacy of lateral type of DLSO comparing with the other types of DLSO. METHODS: We reviewed 81 DLSO cases who visited our clinic from June 1st, 2006 to June 31st, 2010, and classified them into 2 groups; lateral type and non-lateral types including edge, distal and linear type. We treated the patients with oral antifungal agent for 4 months, and followed them up in 2 months. Scoring clinical index for onychomycosis (SCIO) was checked and photography was taken before treatment and after treatment. RESULTS: There are no significant differences in average age and male to female ratio between lateral DLSO and non-lateral DLSO. The comparison of SCIO score distribution before treatment between lateral DLSO and non-lateral DLSO showed no significant statistical difference. However, there was significant change in SCIO score distribution after the treatment. Decreased SCIO score in lateral DLSO was 6.99, while non-lateral DLSO was 11.1 (p=0.018). There was 2cases worsen cases in lateral DLSO, while there was no worsen case in non-lateral DLSO (p=0.019). CONCLUSION: Lateral DLSO is more difficult to treat than non-lateral DLSO.
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Female , Humans , Male , Accounting , Nails , Onychomycosis , Photography , RecurrenceABSTRACT
Objective To detect Porphyromonas gingivalis and clinical index in subgingival specimens after removal of orthodontic appliances and to evaluate clinical index and P.gingivalis factors associated with orthodontic appliances during an episode of gingival inflammation and the impact of appliance removal on periodontal health.Methods Choose 20 patients prepare to removal of orthodontic appliances.Plaque index(PLI),sulcus bleeding index(SBI) and probing depth(PD) of observed teeth were examined and subgingival plaques were collected at prior to appliance removal(baseline) and 1,3 and 6 months after appliance removal.The numbers of P.gingivalis,total bacteria,the proportion of P.gingivalis and the prevalence of P.gingivalis in the samples were detected with the TaqMan real-time PCR.Results The prevalence of P.gingivalis decreased from baseline to the 6th month after fixed appliance removal in two groups,and significant change was found in 6th month(P ＜ 0.05); The numbers of P.gingivalis significantly reduced from baseline to the 6th month(P ＜ 0.05); The proportion of P.gingivalis in subgingival plaque decreased from baseline to the 6th month(P ＜0.05).PLI,SBI and PD significantly decreased from baseline to the 6th month after fixed appliance removal.Conclusion After fixed appliance removal,most of patients can recover periodontal tissue health in good oral hygiene.The percentage of P.gingivalis are closely associated with periodontal status.TaqMan real-time polymerase chain reaction has a high sensitivity and specificity.It was demonstrated the broad potential of application on detection of oral microbes.
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0.05).Conclusions The SCIO system is practical to assess the therapeutic effects of itraconazole and terbinafine for patients with onychomycosis.Treatment of onychomycosis with the two drugs is equally effective and safe.
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OBJECTIVE:To probe into the related problems in the application of the cost-effectiveness analysis in pharmacoeconomics METHODS:To discuss the problems in the cost-effectiveness analysis by means of literature metrology,pharmacoeconomic criteria and mathematical proof RESULTS & CONCLUSION:When the cost-effectiveness analysis is adopted in evaluating the economy of drugs,we should especially pay attention to the selection of the clinical treatment indices,the calculation of costs,the usage of the incremental analysis and the comparison with the cost-minimization analysis
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Seventy-nine children and 433 adults were treated for epidural hematoma at our hospital during the last 10 years. The authors have tried to compare the various clinical characteristics and significant prognostic factors of epidural hematoma in children and adults. The result confirmed that children with traumatic epidural hematoma are less likely to have direct relationship with various causes of head trauma, associated extracranial injuries, skull fractures, temporal region hematomas, and immediate surgeries, but tend to have high preoperative GCS scores, prompt pupil responses, require only conservative treatments, have short durations of coma, and have good outcome. The cause of injury, amount of hematoma and focus of bleeding on surgery are found to be significant prognostic factors in adults, but are not in children. In cases with same scores of preoperative Glasgow Coma Scale(GCS) and durations of coma, very severe neurologic status(below 7 of GCS, both dilated fixed pupil) had a worse outcome in children as well as in adults without significant difference between them. The clinical index on preoperative GCS and pupillary response used when deciding the operation time were different in children compared to adults. Operations performed in delayed fashion in children under close observation for changes in GCS and pupillary response showed good outcome. However, adults require operations as early as possible because of possible rapid progression.