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Objective:To evaluate the clinical curative effect of Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction on patients with ischemic stroke (IS) during recovery.Methods:Prospective cohort study. A total of 220 patients with IS during recovery who met inclusion criteria in the First People's Hospital of Dongcheng District in Beijing, were enrolled and divided into control group ( n=110) and observation group ( n=110) by random number table method between January 2015 and July 2020. The control group was given basic treatment, while observation group was given Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction. All were treated for 1 month. Before and after treatment, Traditional Chinese Medicine (TCM) syndromes were scored. The activities of daily living were evaluated by Barthel index. The quality of life was evaluated by stroke specific quality of life scale (SS-QOL). The severity of neurological impairment was evaluated by National Institute of Health Stroke Scale (NIHSS). The functional recovery of stroke was evaluated by modified Rankin scale (mRS). The adverse reactions during treatment were observed and recorded. Results:After treatment, scores of TCM syndromes, mRS and NIHSS in observation group were significantly lower than those in the control group ( t=21.87, 4.66, 12.06, P<0.01), while scores of Barthel index and SS-QOL were significantly higher than those in the control group ( t=14.13, 5.80, P<0.01). During treatment, there were no obvious adverse reactions in either group. Conclusion:Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction can improve clinical symptoms and nerve function in patients with IS during recovery, which is beneficial to improve outcomes and quality of life.
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Objective:To evaluate the safety and efficacy of single incision apocrine gland excision in the treatment of children and adult patients with axillary osmidrosis.Methods:Medical records and follow-up results were reviewed for 164 patients who underwent surgical treatment in our department by the same surgeon from January 2013 to December 2016. There were 54 males and 110 females, aged 8-61 years. with a median age of 22 years. The patients were divided into the children group ( n=31) and the adults group ( n=133), and differences between the two groups were compared. Results:The end point of follow-up was December 2019, the cure and overall satisfaction rates in the third year after surgery were 77.6% (125/161) and 88.2% (142/161) for the total population, including 87.5% (27/31) and 93.5% (29/31) for the children, respectively. There were no significantly differences in the cure rate, scar, pigmentation and the patients' satisfaction between two groups during the follow-up. The cure rate, significantly improved rate and satisfaction rate in patients who became adult during the follow-up were 80.0% (20/25), 92.0% (23/25) and 96.0% (24/25), respectively.Conclusions:Single incision apocrine gland excision could be performed for children patients. Our procedure is safe, reliable and consistant, and worthy of clinical application.
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ABSTRACT BACKGROUND: Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects multiple joints. It is associated with psoriasis and treated with synthetic and biologic drugs. OBJECTIVE: The objective of this study was to assess the outcomes of patients who received biologic therapy with tumor necrosis factor (TNF) inhibitors in terms of effectiveness, safety, functionality, and quality of life. DESIGN AND SETTING: A prospective observational study was performed at a single center in Belo Horizonte, Brazil. METHODS: Patients with PsA who received their first TNF inhibitor treatment were followed up for 12 months. Disease activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Clinical Disease Activity Index (CDAI). Functionality was measured using the Health Questionnaire Assessment (HAQ), and quality of life was evaluated using the European Quality of Life Five Dimensions (EQ-5D). Multiple linear regression was used to identify predictors of the clinical response at 12 months. RESULTS: A total of 143 patients treated with adalimumab or etanercept were evaluated. Most of the clinical measures were significantly improved at 12 months. However, 31%-51% of the patients did not achieve good clinical control. No differences were observed between adalimumab and etanercept, except for poor functionality at 12 months among patients treated with etanercept. The main predictors of a worse clinical response were female sex, etanercept use, poor functionality, or lower quality of life at baseline. The main adverse reactions were alopecia, headache, injection site reaction, sinusitis, flu, dyslipidemia, and infections. CONCLUSION: TNF inhibitor therapy was effective and safe. However, despite improvements in clinical measures, most patients did not achieve satisfactory control of the disease.
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Objective:To investigate the short-term efficacy of sublingual immunotherapy in patients with allergic rhinitis of all ages.Methods:The data of 230 patients with allergic rhinitis of all ages who received sublingual immunotherapy in The Third People's Hospital of Bengbu from November 2020 to September 2021 were included in this study. Patient distribution characteristics were analyzed. Ninety-three patients were randomly selected and divided into child, adolescent, and adult groups according to different ages. Total nasal symptom scores measured before and 4 months after sublingual immunotherapy were compared among patients of different ages to evaluate the short-term efficacy of sublingual immunotherapy. The skin prick test was used to determine the allergic state of patients. Change in total nasal symptom score after treatment relative to that before treatment was used to evaluate the efficacy of sublingual immunotherapy.Results:The age range of patients receiving sublingual immunotherapy was large (3-71 years), but the average age was only 17.70 years. Ninety-three patients were followed up, including 50 children and 43 adolescents or adults. After 4 months of sublingual immunotherapy, total nasal symptom score in children and adolescents or adults were significantly decreased compared with those before treatment [(3.66 ± 1.69) points vs. (6.60 ± 1.96) points, (3.49 ± 1.72) points vs. (6.28 ± 2.28) points, both P < 0.001]. Before and after treatment, there was no significant difference in total nasal symptom score between children and adolescents or adults (both P > 0.05). Conclusion:Patients with allergic rhinitis who receive sublingual immunotherapy tend to be young. Short-term sublingual immunotherapy is effective for allergic rhinitis. There is no remarkable difference in the efficacy of sublingual immunotherapy between patients with allergic rhinitis of all ages.
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Objective:To investigate the clinical efficacy of Bacille Calmette-Guerin polysaccharide nucleic acid combined with montelukast in the treatment of bronchial asthma and its effect on lung function and serum inflammatory factor level.Methods:Eighty patients with bronchial asthma who met inclusion criteria and received treatment in The First People's Hospital of Huzhou from January 2019 to December 2020 were included in this study. They were randomly assigned to undergo either routine systematic treatment and oral montelukast (control group, n = 40) or routine systematic treatment, oral montelukast, and intramuscular injection of Bacille Calmette-Guerin polysaccharide nucleic acid in combination (combined group, n = 40). The changes in serum inflammatory factors and pulmonary function after treatment relative to before treatment, clinical efficacy and adverse reactions were compared between the two groups. Results:Total response rate in the control and combined groups was 80.00% (32/40) and 95.00% (38/40) respectively. Total response rate in the combined group was significantly higher than that in the control group ( χ2 = 4.11, P = 0.043). There were no significant differences in peak expiratory flow rate, forced expiratory volume in 1 second, maximum voluntary ventilation, forced vital capacity, airway resistance and forced expiratory volume in 1 second/forced vital capacity between the two groups before treatment (all P > 0.05). In the combined group, peak expiratory flow rate, forced expiratory volume in 1 second,forced expiratory volume in 1 second/forced vital capacity, maximum voluntary ventilation and forced vital capacity were significantly increased, and airway resistance was significantly decreased after treatment compared with before treatment ( t = -4.81, -5.09, -7.39, -4.12, -7.14, 5.17, all P < 0.001). After treatment, clinical efficacy in the combined group was superior to that in the control group. Before treatment, there were no significant differences in the St George's Respiratory Questionnaire score and Asthma Control Test score between the two groups (both P > 0.05). After treatment, St George's Respiratory Questionnaire score in the combined group was significantly decreased, while Asthma Control Test score was significantly increased compared with before treatment ( t = 9.19, -3.44, both P < 0.001). Before treatment, there were no significant differences in serum interleukin-4, interleukin-5, and interferon-γ levels between the two groups (all P > 0.05). After treatment, serum levels of interleukin-4, interleukin-5, and interferon-γ in the combined group were significantly lower than those in the control group ( t = 6.95, 4.72, -11.24, all P < 0.001). No drugs-related adverse reactions were found in each group during the treatment period. Conclusion:Bacille Calmette-Guerin polysaccharide nucleic acid combined with montelukast is highly effective on bronchial asthma. The combined therapy can improve quality of life and lung function, decrease serum inflammatory factor levels, and is safe.
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Objective:To investigate the efficacy of bifidobacteria combined with Kangfuxin liquid in the treatment of gastrointestinal ulcer in older adult patients and its effects on intestinal flora. Methods:A total of 84 older adult patients with gastrointestinal ulcer who received treatment in The First People's Hospital of Yongkang from January 2020 to December 2021 were included in this study. They were randomly assigned to receive either Kangfuxin liquid treatment (control group, n = 42) or Kangfuxin liquid combined with bifidobacteria treatment (combined group, n = 42) based on conventional symptomatic treatment. Efficacy and intestinal flora were compared between the two groups. Results:Total response rate and Helicobacter pylori eradication rate in the combined group were 97.62% and 88.10%, respectively, which were significantly higher than those in the control group ( χ2 = 8.63, 7.25, both P < 0.05). After treatment, the numbers of Bifidobacteria, Lactobacilli, Digestive cocci and Eubacteria in the combined group were greater than those in the control group, and the numbers of Enterococci, Enterobacter and Clostridium were lower than those in the control group ( t = 11.84, 6.50, 6.33, 7.16, 3.21, 3.24, 6.98, all P < 0.05). After treatment, the levels of interleukin-6 (IL-6) and interleukin-17 (IL-17) in the combined group were (5.09 ± 0.85) ng/L and (6.13 ± 1.27) ng/L, respectively, which were significantly lower than those in the control group, and interferon-γ and prostaglandin E2 (PGE2) levels in the combined group were (25.95 ± 3.67) ng/L and (20.06 ± 0.92) ng/L, respectively, which were significantly lower than those in the control group ( t = 8.28, 7.28, 8.19, 9.10, all P < 0.001). Conclusion:Bifidobacteria combined with Kangfuxin liquid is highly effective on gastrointestinal ulcer in older adult patients. The combined method can adjust intestinal flora and improve inflammatory indicators, and therefore is worthy of clinical promotion.
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Objective:To investigate the clinical efficacy of percutaneous kyphoplasty (PKP) versus percutaneous vertebroplasty (PVP) in the treatment of single-segment osteoporotic vertebral compression fractures (OVCF) in the older adult patients. Methods:A total of 117 older adult patients with single-segment OVCF who received treatment in Binzhou Central Hospital from January 2016 to March 2018 were included in this study. They were randomly assigned to undergo either PVP (observation group, n = 60) or PKP (control group, n = 57). Therapeutic effects, treatment cost and the incidence of complications were compared between the two groups. Results:In the observation group, the amount of bone cement, operative time, treatment cost and the amplitude of increase in vertebral height post-operation relative to preoperative vertebral height were (4.69 ± 1.94) mL, (27.59 ± 5.81) minutes, (6 537.24 ± 898.36) yuan, (2.54 ±1.37) mm, respectively, and they were (5.78 ± 2.04) mL, (38.63 ± 8.17) minutes, (24 371.85 ± 2 365.54) yuan, (8.65 ± 1.48) mm, respectively in the control group. There were significant differences in these indices between the two groups ( t = 6.18, 9.25, 10.26, 7.23, all P < 0.05). Before treatment, there were no significant differences in Cobb angle and vertebral compression rate between the two groups (both P > 0.05). After treatment, Cobb angle of injured vertebrae in the control group was significantly lower than that in the observation group [(9.25 ± 2.36)° vs. (20.38 ± 3.87)%, t = 10.25, P < 0.05]. Vertebral compression rate in the control group was significantly lower than that in the observation group [(20.06 ± 3.53)% vs. (24.76 ± 5.35)%, t = 6.23, P < 0.05]. There was no significant difference in the incidence of complications between the two groups [26.67% (16/60) vs. 17.54% (10/57), χ2 = 8.92, P < 0.05). Conclusion:PVP is more simple and less expensive in the clinical treatment of OVCF than PKP, but PKP is more effective and has lower incidence of complications than PVP. PKP can be preferred if there is no concern about economic and medical conditions.
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Objective:To investigate the effects of deafness capsule combined with vinpocetine injection on hearing function, hemorheology and T lymphocyte subsets in patients with sudden deafness.Methods:Eighty patients with sudden deafness who received treatment in Wenzhou Central Hospital from April 2017 to October 2019 were included in this study. They were randomly assigned to undergo treatment either with vinpocetine injection (control group, n = 40) or with deafness capsule combined with vinpocetine injection (observation group, n = 40) for 1 month. Efficacy, hearing function, hemorheology, T lymphocyte subsets and adverse reactions were compared between the control and observation groups. Results:Total response rate in the observation group was significantly higher than that in the control group [90.00% (36/40) vs. 67.50% (27/40), χ2 = 6.050, P = 0.014). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). After 1 month of treatment, plasma viscosity, high-shear whole blood viscosity, low-shear whole blood viscosity in the observation group were (1.21 ± 0.29) mPa·s, (2.41 ± 0.31) mPa·s, (5.25 ± 1.29) mPa·s respectively, which were significantly lower than those in the control group [(1.65 ± 0.22) mPa·s, (4.94 ± 0.36) mPa·s, (8.64 ± 1.32) mPa·s, t = 7.64, 33.68, 11.61, all P < 0.001). The percentages of CD 8+, CD 4+, and CD 4+/CD 8+ T lymphocyte subsets in the observation group were (24.28 ± 2.16)%, (46.05 ± 6.52)% and (1.90 ± 0.28) respectively, and they were (27.41 ± 2.09)%, (40.54 ± 5.48)%, (1.48 ± 0.24) respectively in the control group ( t = 6.58, 4.09, 7.20, all P < 0.001). Pure tone threshold in the observation group was significantly lower than that in the control group [(38.07 ± 4.82) dB vs. (51.97 ± 5.96) dB, t = 11.46, P < 0.001). Conclusion:Deafness capsule combined with vinpocetine injection is highly effective on sudden deafness. The combined therapy can improve the hearing function, hemorheology, and the immunological function of T lymphocyte subsets in patients with sudden deafness.
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Objective:To investigate the effects of modified radical prostatectomy via an extraperitoneal approach on urinary control and sexual function in patients with prostate cancer.Methods:Fifty-six patients with stable prostate cancer who received treatment in Deqing People's Hospital between March 2015 and March 2018 were included in this study. They were randomly divided into observation and control groups ( n = 28/group). The observation group was subjected to modified radical prostatectomy via an extraperitoneal approach. The control group underwent standard laparoscopic surgery. Clinical efficacy and the effects of modified radical prostatectomy via an extraperitoneal approach on urinary control and sexual function were compared between the two groups. Results:Amount of blood loss and postoperative drainage were (125.39 ± 11.12) mL and (65.39 ± 10.12) mL in the observation group, and (224.79 ± 14.01) mL and (104.79 ± 15.01) mL in the control group. There were no significant differences in amount of blood loss and postoperative drainage between the two groups ( t = 18.83, 15.67, both P < 0.05). At 1, 3 and 6 months after surgery, the percentage of patients who had urinary control recovery in the observation group was 53.57% (15/28), 78.57% (22/28), 98.21% (27/28), respectively, which were significantly higher than those in the control group [21.43% (6/28), 35.71% (10/28), 67.86% (19/28), χ2 = 4.12, 7.21, 5.01, all P < 0.05]. At 1, 3 and 6 months after surgery, the score of erectile function recovery in the observation group was (15.98 ± 0.28) points, (15.99 ± 0.72) points, and (18.91 ± 0.48) points, which were significantly higher than those in the control group [(17.11 ± 0.34) points, (13.11 ± 0.48) points, (13.41 ± 0.39) points, t = 3.01, 12.89, 15.78, all P < 0.05]. Conclusion:Modified radical prostatectomy via an extraperitoneal approach can improve postoperative urinary control and sexual dysfunction.
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ABSTRACT Objective To compare the effectiveness of co-debriefing with debriefing with a facilitator in the development of clinical competences in nursing students in the simulated care of cardiac arrest. Method Randomized pilot study, carried out at a university in Minas Gerais, Brazil, in August 2021, with 17 students, to compare debriefing with a facilitator (control n=8) with co-debriefing (intervention n=9). Pre- and post-test, Objective Structured Clinical Examination and scales were used to assess behavioral skills. Wilcoxon and Mann-Whitney nonparametric comparison tests were used for analysis. Results The intervention group performed better than the control for knowledge about basic life support (control=17.00±2.39 and intervention=19.22 ± 0.66, p=0.021) and psychomotor skills (control=8.12±0.13 and intervention=8.50 ± 0.001, p<0.001). There were no significant differences for behavioral skills. Conclusion Co-debriefing appears to be more effective than debriefing with a facilitator to develop clinical skills in basic life support in nursing.
RESUMEN Objetivo Comparar la efectividad del co-debriefing con el debriefing con facilitador en el desarrollo de competencias clínicas en estudiantes de enfermería en el cuidado simulado de parada cardiaca. Método Estudio piloto aleatorizado, realizado en una universidad de Minas Gerais, Brasil, en agosto de 2021, con 17 estudiantes, para comparar el debriefing con un facilitador (control n=8) con el co-debriefing (intervención n=9). Se utilizaron pruebas previas y posteriores, examen clínico objetivo estructurado y escalas para evaluar las habilidades conductuales. Para el análisis se utilizaron las pruebas de comparación no paramétrica de Wilcoxon y Mann-whitney. Resultados El grupo intervención se desempeñó mejor que el control en conocimientos sobre soporte vital básico (control=17,00±2,39 e intervención=19,22 ± 0,66, p=0,021) y psicomotricidad (control=8, 12±0,13 e intervención=8,50 ± 0,001, p <0,001). No hubo diferencias significativas para las habilidades conductuales. Conclusión El co-debriefing parece ser más efectivo que el debriefing con un facilitador para desarrollar habilidades clínicas en soporte vital básico en enfermería.
RESUMO Objetivo Comparar a efetividade entre co-debriefing com debriefing com facilitador no desenvolvimento de competências clínicas em estudantes de enfermagem no atendimento simulado da parada cardiorrespiratória. Método Estudo-piloto randomizado, realizado em uma universidade de Minas Gerais, Brasil, em agosto de 2021 com 17 estudantes, para comparar o debriefing com um facilitador (controle n=8) e com o co-debriefing (intervenção n=9). Utilizaram-se pré e pós-teste, Exame Clínico Objetivo Estruturado e escalas para avaliar as habilidades comportamentais. Adotaram-se testes de comparação não paramétricos Wilcoxon e Mann-whitney para análise. Resultados O grupo intervenção obteve desempenho superior ao controle para o conhecimento sobre o suporte básico de vida (controle=17,00±2,39 e intervenção=19,22 ± 0,66, p=0,021) e habilidades psicomotoras (controle=8,12±0,13 e intervenção=8,50 ± 0,001, p<0,001). Não houve diferenças significativas para as habilidades comportamentais. Conclusão O co-debriefing parece ser mais efetivo do que o debriefing como um facilitador para desenvolver competências clínicas no suporte básico de vida em enfermagem.
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Objective:To compare the long-term outcomes after focused ultrasound ablation surgery (FUAS) versus myomectomy for uterine fibroids.Methods:A retrospective study was conducted on women who were treated by FUAS or myomectomy for uterine fibroids at First Medical Center of Chinese PLA General Hospital from January 2007 to January 2015. Regular follow-up was conducted to evaluate the symptoms relief, symptoms recurrence, the need for re-interventions and complications of the two groups.Results:The effective rates were 95.7% (730/763) and 95.5% (1 151/1 205) in women who were treated by FUAS and myomectomy, no statistical difference was seen between the two groups ( χ2 =0.027, P=0.869). The cumulative rates of symptoms recurrence at 1 year, 3 years, 5 years, 8 years and 10 years of follow-up in FUAS group were 1.8%, 6.8%, 11.9%, 15.2% and 15.9%, respectively; and the cumulative re-intervention rates were 0.7%, 4.1%, 6.8%, 9.9% and 11.0%, respectively. The cumulative rates of symptoms recurrence at 1 year, 3 years, 5 years, 8 years and 10 years of follow-up in myomectomy group were 1.8%, 5.9%, 10.6%, 14.2% and 14.9%, respectively; and the cumulative re-intervention rates were 0.9%, 4.5%, 7.8%, 10.3% and 11.4%, respectively. No statistical differences were seen between the two groups (all P>0.05). There were no significant differences in the effective rate, symptoms recurrence rate and re-intervention rate between the two groups in patients with intermural fibroids; but the effective rate of FUAS (95.9%, 235/245) was higher than that of myomectomy (89.1%, 115/129), the symptoms recurrence rate (11.9%, 28/235) was lower than that of myomectomy (27.8%, 32/115), and the re-intervention rate (7.7%, 18/235) was lower than that of myomectomy (17.4%, 20/115) in patients with submucosal fibroids, there were significant different (all P<0.05). The effective rate of FUAS (91.0%, 132/145) was lower than that of myomectomy (97.0%, 322/332), the symptoms recurrence rate (32.6%, 43/132) was higher than that of myomectomy (9.9%, 32/322), and the re-intervention rate (22.0%, 29/132) was higher than that of myomectomy group (6.2%, 20/132) in patients with subserosal fibroids, there were significant different (all P<0.01). The incidences of total [1.8% (14/763) vs 21.9% (264/1 205)], minor and moderate adverse events were lower in FUAS group than myomectomy group (all P<0.001). Conclusion:Satisfaction with long-term outcomes after FUAS treatment or myomectomy for uterine fibroids is comparable.
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Objective:To investigate the efficacy and safety of noninvasive high-frequency oscillatory ventilation in the treatment of respiratory failure in premature infants.Methods:Sixty-one premature infants with respiratory failure who received treatment in Neonatal Intensive Care Unit, Wenzhou Central Hospital from June 2019 to June 2020 were included in this study. They were randomly assigned to undergo either noninvasive high-frequency oscillatory ventilation (observation group, n = 31) or transnasal continuous positive airway pressure ventilation (control group, n = 31). Blood gas indicators, including pH value, oxygen partial pressure (PaO 2), partial pressure of carbon dioxide (PaCO 2), oxygenation index (OI), and respiratory index (RI), were determined before ventilation and 2, 8, 12, and 24 hours after ventilation. At the same time, the incidence of complications post-ventilation, including intracranial hemorrhage, bronchopulmonary dysplasia, air leakage, nasal crush injury, retinopathy of prematurity, abdominal distension, and necrotizing enterocolitis, was recorded in each group. Results:There were no significant differences in pH value, PaO 2, PaCO 2, OI, and RI pre-ventilation between observation and control groups ( t = 0.58, 0.64, 0.85, 0.43, 0.70, all P > 0.05). pH value, PaO 2, and OI measured 2, 8, 12 and 24 hours post-ventilation were significantly higher in the observation group than in the control group (pH value: t2 h = 3.20, t8 h = 4.81, t12 h = 6.39, t24 h = 5.22; PaO 2value:t2 h = 5.80, t8 h = 6.31, t12 h = 7.55, t24 h = 6.97; OI value: t2 h = 6.38, t8 h = 8.37, t12 h = 11.30, t24 h = 9.61). PaCO 2 and RI values were significantly lower in the observation group than in the control group (PaCO 2value:t2 h = 4.29, t8 h = 5.09, t12 h = 6.83, t24 h = 8.30; RI value: t2 h = 3.26, t8 h = 5.81, t12 h = 7.36、 t24 h = 6.54) (all P < 0.05). The incidence of complications was significantly lower in the observation group than in the control group [25.81% (8/31) vs. 46.67% (14/30), χ2 = 8.75, P < 0.05]. Conclusion:Compared with transnasal continuous positive airway pressure ventilation, noninvasive high-frequency oscillatory ventilation leads to better ventilation performance and a greater oxygenation ability, exhibits stronger effects on CO 2 clearance and acidosis correction, and has fewer complications in premature infants with respiratory failure. Therefore, noninvasive high-frequency oscillatory ventilation is suitable for clinical application.
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Objective:To investigate the clinical efficacy of ultrasound-guided percutaneous sclerotherapies for a simple renal cyst.Methods:A total of 120 patients with a simple renal cyst who received treatment in the Department of Urology, Changxing People's Hospital from January 2017 to January 2020 were included in this study. All patients underwent ultrasound-guided percutaneous sclerotherapies followed by medical absolute ethanol perfusion (retention treatment group, n = 40), medical absolute ethanol flushing (flushing replacement group, n = 40), and polidocanol perfusion (polidocanol treatment, n = 40). General data, operation, the incidence of complications, and surgical efficacy were compared between the three groups. Results:There were no significant differences in sex, age, course of the disease, cyst size, and cyst distribution among the three groups (all P > 0.05). The Visual Analog Scale score, length of hospital stay, and medical cost in the polidocanol treatment group were (1.98 ± 0.63) points, (3.54 ± 1.25) days, and (6271.34 ± 831.20) yuan respectively, which were significantly lower than those in the retention treatment group [(3.98 ± 1.26) points, (5.87 ± 1.76) days, (8798.45 ± 981.76) yuan and flushing replacement group [(3.05 ± 1.02) points, (4.35 ± 1.42) days, (7 128.19 ± 921.70) yuan]. There were significant differences in The Visual Analog Scale score, length of hospital stay, and medical cost between groups ( t = 8.97, 6.82, 12.42, all P < 0.001). The incidence of complications in the retention treatment, flushing replacement, and polidocanol treatment groups was 25.00% (10/40), 12.50% (5/40), 5.00% (2/40), respectively ( χ2 = 6.71, P = 0.035). The total response rate in the retention treatment, flushing replacement, and polidocanol treatment groups was 75.00% (30/40), 82.50% (33/40) and 97.50% (39/40), respectively ( χ2 = 8.23, P = 0.016). Conclusion:Ultrasound-guided percutaneous sclerotherapy with polidocanol is effective on a simple renal cyst. The sclerotherapy with polidocanol has a low incidence of complications, shortens the postoperative rehabilitation process, and has a good prognosis.
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Objective:To investigate the therapeutic effect of dl-3-n-butylphthalide on dysphagia after cerebral infarction.Methods:Seventy acute cerebral infarction patients with dysphagia who received treatment in The First People's Hospital of Huzhou from December 2019 to December 2020 were included in this study. They were randomly assigned to receive either routine treatment combined with swallowing function training (routine treatment group, n = 35) or intravenous dl-3-n-butylphthalide, routine treatment, and swallowing function training in combination (dl-3-n-butylphthalide treatment group, n = 35). All patients received 2 weeks of treatment. Clinical efficacy and swallowing function training pre- and post-treatment were compared between the two groups. Results:Total response rate was significantly higher in the dl-3-n-butylphthalide treatment group than in the routine treatment group [100.0% (35/35) vs. 91.4% (32/35), χ2 = 1.39, P = 0.238]. Before treatment, there were no significant differences in the scores of the Water-Swallowing Test and the Standardized Swallowing Assessment between the two groups ( P = 0.898, 0.691). The scores of the Water-Swallowing Test and the Standardized Swallowing Assessment measured after treatment in the dl-3-n-butylphthalide treatment group were (0.68 ± 0.76) points and (21.60 ± 2.50) points, which were significantly lower than those in the routine treatment group [(1.15 ± 0.77) points, (27.62 ± 3.80) points, t = 2.57, 7.82, P = 0.012, < 0.001]. Conclusion:Dl-3-n-butylphthalide treatment is highly effective on dysphagia after acute cerebral infarction. It can effectively promote the recovery of a patient's swallowing function. The treatment method is worthy of clinical application.
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Objective:To investigate the efficacy of acupuncture therapy combined with rhubarb applied to the umbilicus in the treatment of constipation in patients with stage IV-V diabetic nephropathy.Methods:Ninety stage IV-V diabetic nephropathy patients with constipation, who received treatment in Wenzhou Hospital of Traditional Chinese Medicine from December 2019 to December 2020, were included in this study. They were randomly assigned to receive either routine treatment (control group, n = 45) or routine treatment plus acupuncture therapy combined with rhubarb applied to the umbilicus (study group, n = 45). Serum motilin, gastrin, and somatostatin levels and orocecal transit time pre- and post-treatment were compared between the two groups. The constipation severity was evaluated using the Constipation Severity Scale (CSS). Quality of life was evaluated using the Patient Assessment of Constipation Quality of Life Questionnaire. Clinical efficacy was compared between the two groups. Results:The somatostatin level and orocecal transit time post-treatment in the study group were (13.66 ± 4.24) ng/L and (80.58 ± 10.11) minutes, respectively, which were significantly lower than those in the control group [(19.31 ± 6.13) ng/L, (87.16 ± 12.04) minutes, t = 5.08, 2.80, both P < 0.05]. Serum motilin and gastrin levels post-treatment in the study group were (281.07 ± 41.16) ng/L and (181.07 ± 35.16) ng/L, respectively, which were significantly higher than those in the control group [(259.64 ± 39.83) ng/L, (162.65 ± 32.83) ng/L, t = 2.51, 2.56, both P < 0.05]. The scores of the Constipation Severity Scale and the Patient Assessment of Constipation Quality of Life Questionnaire post-treatment in the study group were (10.66 ± 3.14) points and (60.14 ± 13.64) points, respectively, which were significantly lower than those in the control group [ (15.31 ± 4.13) points, (71.61 ± 14.72) points, t = 6.01, 3.83, both P < 0.05). Total response rate was significantly higher in the study group than in the control group (97.78% vs. 80.00%, χ2 = 5.51, P < 0.05). Conclusion:Acupuncture therapy combined with rhubarb applied to the umbilicus can be used to treat constipation in patients with stage IV-V diabetic nephropathy. The combined therapy can adjust the secretion of gastrointestinal tract-related hormones, shorten orocecal transit time, improve clinical symptoms, and improve clinical efficacy and quality of life.
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Objective:To investigate the efficacy of quetiapine fumarate combined with lithium carbonate in the treatment of bipolar disorder and its effect on cognitive function.Methods:Sixty patients with bipolar disorder, who received treatment in Zhuji Fifth People's Hospital from January 2017 to December 2019, were included in this study. They were randomly assigned to receive either lithium carbonate (control group, n = 30) or quetiapine fumarate combined with lithium carbonate treatment (combined treatment group, n = 30). All patients received 4 weeks of treatment. Manic and depressive symptoms pre- and post-treatment, clinical efficacy, cognitive function, and adverse reactions were compared between the two groups. Fasting venous blood was taken before and 4 weeks after treatment to measure superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT), and glutathione peroxidase (GSH-Px) levels. Results:The scores of the Bech-Rafaelsdn Mania Rating Scale (BRMS) and the Hamilton Rating Scale for Depression (HAMD) in each group were significantly decreased after treatment compared with before treatment ( t = 10.39, 12.47, both P < 0.001). The score of the Mini-Mental State Examination in each group significantly increased after treatment compared with before treatment ( t = 8.36, 14.52, both P < 0.001). The scores of BRMS and HAMD post-treatment were significantly lower in the combined treatment group than in the control group ( t = 5.86, 5.54, both P < 0.001). The score of MMSE post-treatment was significantly higher in the combined treatment group than in the control group ( t = 2.40, P = 0.020). The response rate was significantly higher in the combined treatment group than in the control group ( Z = 2.16, P = 0.030). After treatment, serum MDA level significantly decreased in each group compared with before treatment ( t = 8.72, 15.47, both P < 0.001). After treatment, SOD, CAT and GSH-Px levels were significantly increased in each group compared with before treatment (SOD: tcontrol group = 2.84, P = 0.006, tcombined treatment group = 4.05, P < 0.001; CAT: tcontrol group = 5.20, P < 0.001, tcombined treatment group = 9.86, P < 0.001; GSH-Px: tcontrol group = 2.67, P = 0.010, tcombined treatment group = 3.71, P = 0.001). Serum MDA level post-treatment was significantly lower in the combined treatment group than in the control group ( t = 12.38, P < 0.001). Serum SOD and CAT levels post-treatment were significantly higher in the combined treatment group than in the control group ( tSOD = 2.24, P = 0.029; tCAT = 2.72, P = 0.009). There was no significant difference in the incidence of adverse reactions between the combined treatment and control groups [20.00% (6/30) vs. 16.67% (5/30), χ2 = 1.02, P = 0.907). Conclusion:Quetiapine fumarate combined with lithium carbonate can greatly improve clinical symptoms and cognitive function and reduce the over-activation of oxidative stress in patients with bipolar disorder. The combined therapy is of certain clinical application value.
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Objective:To explore the clinical effect of transvaginal and laparoscopic myomectomy.Methods:A total of 40 cases treated with hysteromyomectomy in Xinhua Hospital Affiliated to Dalian University and Dalian Women′s and Children′s Medical Center from Decedmber 2018 to March 2020 were selected as the research objects. According to the random number table method, they were assigned into the observation group (20 cases) and the control group (20 cases). In the observation group, hysteromyomectomy was performed via vagina, and in the control group, hysteromyomectomy was performed via laparoscope. Then the time of operation, the amount of bleeding, the recovery time of gastrointestinal function, 24 h postoperative drainage, 12 h postoperative pain and hospitalization expenses were compared between the two groups.Results:The operation of the observation group and the control group were completed as planned. The operation time, the amount of bleeding of the observation groupwere less than those of the control group: (69.75 ± 19.43) min vs. (84.50 ± 22.4) min, (119.25 ± 56.37) ml vs. (159.00 ± 63.73) ml, the differences were statistically significant ( P<0.05). The recovery time of gastrointestinal function, 24 h postoperative drainage, 12 h postoperative pain in two groups had no significant differences ( P>0.05). The hospitalization expenses in observation group was lower than that in control group: (2.27 ± 0.12) ten thousand Yuan vs. (2.66 ± 0.10) ten thousand Yuan, the difference was statistically significant ( P<0.05). Conclusions:Compared with laparoscopic myomectomy, transvaginal myomectomy has the advantages of shorter operation time, less bleeding and less hospitalization expenses.
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Objective:To investigate the effects of Tongxinluo capsule on the improvement of cardiac function and the expression of myocardial enzyme spectrum in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:One hundred patients with coronary heart disease after PCI who received treatment in Hebei Xianghe County People′s Hospitalfrom April 2018 to April 2020 were enrolled and randomly divided into the observation group and the control group. The control group was given conventional treatment, while the observation group was treated with Tongxinluo capsule on the basis of the control group. Patients in both groups were treated for 3 months. The normal clinical remission after treatment was observed in the two groups. The improvement of cardiac function index left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF) and myocardial enzyme index aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase isoenzyme - MB (CK - MB), lactate dehydrogenase (LDH), troponin T (TnT) were compared between the two groups before and after the treatment.Results:After treated for 3 months, the total effective rate in the observation group was higher than that in the control group: 92.0%(46/50) vs. 76.0%(38/50), the difference was statistically significant ( χ2 = 4.76, P<0.05). After treated for 3 months, the levels of LVEDV and LVESV in two groups were decreased, and the level of LVEF in two groups was increased, and the levels of LVEDV and LVESV in the observation group were lower than those in the control group: (153.39 ± 8.35) ml/m 2 vs. (155.57 ± 9.32) ml/m 2, (103.49 ± 9.25) ml/m 2 vs. (109.65 ± 10.46) ml/m 2; the levels of LVEF in the observation group was higher than that in the control group: (58.14 ± 7.41)% vs. (54.59 ± 6.92)%, the differences were statistically significant ( P<0.05). After treated for 3 months, the levels of AST, CK, CK-MB, LDH, TnT in two groups were decreased, and the levels of above index in the observation group were lower than those in the control group: (38.14 ± 7.28) U/L vs. (45.04 ± 8.12) U/L, (637.15 ± 75.25) U/L vs. (756.24 ± 85.24) U/L, (553.28 ± 53.14) U/L vs. (632.17 ± 62.81) U/L, (162.43 ± 15.41) U/L vs. (181.74 ± 19.25) U/L, (0.32 ± 0.15) μg/L vs. (0.39 ± 0.11) μg/L, the differences were statistically significant ( P<0.05). Conclusions:The application of Tongxinluo capsule in patients with coronary heart disease after PCI can effectively alleviate clinical symptoms, improve cardiac function, and regulate the enzyme activity of the body.
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Objective:To explore the effect of hemodialysis and conventional treatment on the heart function of elderly patients with chronic renal heart syndrome(CRCS).Methods:Sixty elderly patients with CRCS who were admitted to Qinhuangdao Port Hospital from July 2017 to July 2018 were selected and divided into the observation group (received hemodialysis and conventional treatment) and the control group (received conventional treatment) according to the random number table method, each group with 30 patients. The levels of left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and left atrium anterior and posterior diameter (LAD) before and after treatment of two weeks were compared between two groups, the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), cystatin C (CysC), creatinine (Cr) and tumor necrosis factor (TNF)-α, high sensitivity C-reactive protein (hs-CPR), interleukin 6 (IL-6) before and after treatment for two week were compared between two groups, and the safety of the two treatment methods was evaluated.Results:After treatment, the levels of LVESD, LVEDD, LAD in the observation group were lower than those in the control group: (26.13 ± 1.28) mm vs. (29.09 ± 1.26) mm, (47.58 ± 1.22) mm vs. (51.34 ± 1.49) mm, (30.02 ± 0.83) mm vs. (33.15 ± 1.02) mm, the level of LVEF in the observation group was higher than that in the control group: (39.63 ± 5.21)% vs. (35.77 ± 4.93)%, the differences were statistically significant ( P<0.05). After treatment, the levels of NT-proBNP, BUN, CysC and Cr in the observation group were lower than those in the control group: (1 089.31 ± 243.29) ng/L vs. (2 990.56 ± 531.22) ng/L, (16.08 ± 3.35) mmol/L vs.(21.93 ± 4.21) mmol/L, (0.35 ± 0.11) mg/L vs. (0.57 ± 0.18 mg/L, (251.62 ± 29.28) μmol/L vs. (290.66 ± 38.12) μmol/L, the differences were statistically significant ( P<0.05). After treatment, the levels of TNF-α, hs-CPR and IL-6 in the observation group were lower than those in the control group: (149.26 ± 19.53) μg/L vs. (182.33 ± 20.25) μg/L, (4.02 ± 1.33) mg/L vs. (5.38 ± 1.57) mg/L, (18.91 ± 3.11) μg/L vs. (22.45 ± 3.82) μg/L, the differences were statistically significant ( P<0.05). The incidence of adverse reactions during the treatment in the two groups had no significant difference ( P>0.05). Conclusions:The use of hemodialysis on the basis of conventional treatment can improve the heart and kidney function of elderly patients with CRCS, and this method is beneficial to alleviate left heart dilation and inflammation. It is a safe and effective treatment method.
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Objective:To investigate the therapeutic effect of rivaroxaban combined with ateplase on patients with acute pulmonary embolism and its influence on inflammatory factors and coagulation function.Methods:One hundred and two patients with acute pulmonary embolism admitted to the First People′s Hospital of Linping District from March 2016 to March 2020 were divided into observation group (51 cases) and control group (51 cases) by random number table.Methods:The control group was treated with ateplase, and the observation group was treated with rivaroxaban on the basis of the control group. The course of treatment in both groups was 10 d. The effective and the changes of arterial partial pressure of oxygen (PaO 2), partial pressure of carbon dioxide in artery (PaCO 2), heart rate(HR), inflammatory factors and coagulation index were compared before and after treatment between the two groups. Results:The total effective rate after treatment in the observation group was higher than that in the control group: 90.20%(46/51) vs. 68.63%(35/51), the difference was statistically significant ( χ2 = 7.256, P<0.05). The level of PaO 2 after treatment in the observation group was higher than that in the control group, the levels of PaCO 2 and HR after treatment in the observation group were lower than those in the control group: (82.91 ± 4.35) mmHg (1 mmHg = 0.133 kPa) vs. (73.35 ± 2.97) mmHg, (34.21 ± 2.89) mmHg vs. (39.98 ± 3.25) mmHg, (76.83 ± 3.76) beats/min vs. (84.20 ± 3.15) beats/min, the differences were statistically significant ( t = 12.96, 9.48, 9.17, P<0.05). The levels of interleukin (IL)- 1β, IL-6 and tumor necrosis factor-α after treatment in the observation group were lower than those in the control group: (0.62 ± 0.20) μg/L vs. (1.08 ± 0.23) μg/L, (15.42 ± 2.53) μg/L vs.(20.93 ± 2.78) μg/L, (0.49 ± 0.16) μg/L vs. (0.78 ± 0.12) μg/L, the differences were statistically significant ( t = 10.78, 10.47, 10.36, P<0.05). The levels of fibrinogen, D-Dimer after treatment in the observation group were lower than those in the control group: (2.78 ± 0.61) g/L vs. (3.53 ± 0.54) g/L, (1.18 ± 0.23) mg/L vs. (1.69 ± 0.28) mg/L; but the levels of prothrombin time, activate part plasma prothrombin time after treatment in the observation group were longer than those in the control group: (15.85 ± 1.48) s vs. (13.04 ± 1.27) s, (40.79 ± 2.34) s vs. (37.46 ± 2.98)s, the differences were statistically significant ( t = 6.58, 10.05, 10.29, 6.28, P<0.05). Conclusions:Rivaroxaban combined with ateplase is effective in the treatment of acute pulmonary embolism, and it can reduce inflammatory reaction and improve coagulation function.