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Objective:To analyze the application of video nystagmography in the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) so as to provide evidence for clinical diagnosis.Methods:A total of 120 patients with suspected BPPV who received treatment in Yueqing People's Hospital from January to July 2020 were included in this study. There were anterior ( n = 24), posterior ( n = 80) and horizontal semicircular canal ( n = 16) BPPV according to the disease type. The detection rates of anterior, posterior and horizontal semicircular canal BPPV by video nystagmography and naked eyes were determined. Therapeutic effects of video nystagmography on three types of BPPV were compared. Results:The diagnostic rates of anterior, posterior and horizontal semicircular canal BPPV were 91.68%, 92.50% and 93.75%, respectively, and the difference was not statistically significant ( χ2 = 0.06, P > 0.05). The detection rates of anterior, posterior and horizontal semicircular canal BPPV by video nystagmography were 91.68%, 92.50% and 93.75% respectively, which were significantly higher than those by naked eyes (58.34%, 78.75%, 56.25%, χ2 = 7.11, 6.14, 3.86, all P < 0.05). After 1 week of treatment, total response rates of anterior, posterior and horizontal semicircular canal BPPV were 62.50%, 66.25%, 68.75%, respectively. After 3 months of treatment, total response rates of anterior, posterior and horizontal semicircular canal BPPV were 95.83%, 96.25% and 100.00%, respectively. There were no significant differences between anterior, posterior and horizontal semicircular canal BPPV after 1 week and 3 months of treatment ( χ2 = 0.18, 0.64, P > 0.05). At 3 months after surgery, the recurrence rates of anterior, posterior and horizontal semicircular canal BPPV were 4.16%, 5.00% and 6.25%, respectively, and the difference was not statistically significant ( χ2 = 0.08, P > 0.05). Conclusion:Video nystagmography is highly effective in the diagnosis and treatment of BPPV. It can accurately judge the occurrence of nystagmus in BPPV and increase the detection rate, which is worthy of clinical application.
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Objective To observe the effect of propafenone for patients with paroxysmal supra-ventricular tachycardia (PSVT) during pre-hospital emergency rescue treatment. Methods A retrospective study was conducted. Seventy-six patients with occurrence of PSVT in the process of pre-hospital emergency treatment in Tianjin Hongqiao Hospital from March 2018 to March 2019 were selected. The patients were divided into amiodarone group and propafenone group according to the difference in medications, 38 cases in each group. The effective rate of rescue, the time of recovery of normal heart rate, the total time of treatment, the levels of heart rate before and after treatment and the incidence of adverse reactions were observed in both groups. Results The total effective rate of propafenone group was significantly higher than that of amiodarone group [94.74% (36/38) vs. 73.68% (28/38), P<0.05]. The times of recovery of normal heart rate and total treatment of propafenone group were significantly lower than those of amiodarone group [times of recovery of normal heart rate (hours): 7.14±1.84 vs. 12.56 ± 2.56, times of total treatment (days): 6.14 ± 2.20 vs. 8.87±2.48, both P<0.05].Before treatment, there was no statistical significant difference in heart rate between propafenone group and amiodarone group (hpm: 171.8 ± 24.4 vs. 173.7 ± 25.5, P>0.05), but after treatment, the heart rate of propafenone group was significantly lower than that in amiodarone group (hpm: 112.9±7.5 vs. 138.4 ± 9.0, P<0.05). The incidence of adverse reactions in propafenone group was significantly lower than that of amiodarone group [2.63% (1/38) vs. 15.79% (6/38), P<0.05]. Conclusion Application of propafenone in the pre-hospital emergency treatment of patients with PSVT can effectively improve their clinical efficacy, and its therapeutic safety is high.
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Objective To understand the characteristics of patients with hematological illness and chronic subdural hematoma.,and the effect of blood disease on the treatment of chronic subdural hematoma. To guide the treatment of patients who both with hematological illness and chronic subdural hematoma. Methods Through a retrospective study of the cases of chronic subdural hematoma from January 1, 2000 to June 1, 2017 in Peking Union Medical College Hospital, the following items were investigated. 1).According to whether or not they were associated with blood disorders, the collected cases were divided into the blood disorders group and the non-blood disorders group. And the clinic data of the sex composition, average ages, treatment effect and mortality were compared. 2). Ac-cording to the treatment, the cases with blood disease were divided into the surgical group and the conservative group. And the treatment effect and mortality were compared. Results A total of 433 patients with chronic subdural hematoma were included in this study, including 35 patients associated with hematological illness. 1) Compared to the controls group, the patients group was younger( P＜0.01) ;the male ratio was lower ( P＜0.01) ; the treatment effect was lower( P＜0.001) and the mortality was higher( P＜0.001) . 2) Within the patients with hematological illness, the surgical group had the better treatment effect(78.9% vs 31.3%,P＜0.01) and the lower mortality (15.8% vs 50.0%,P＜0.05). Conclusions 1)The hematological illness group is younger and the male ratio is lower than the non-hematological illness group; 2) The hematological illness is a risk factor for the treatment of chronic subdural hematoma; 3) The patients who both with the hematological illness and the chronic subdural he-matoma should be treated by surgery.
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Objective To comprehensively analyze the nursing measures of early thrombolytic therapy for acute myocardial infarction. Methods 140 patients with acute myocardial infarction admitted in our hospital from October 2013 to October 2016 were randomly divided into control group (70 cases) and experimental group (apply early thrombolytic care on the basis of routine nursing method, 70 cases) according to different nursing methods. SPSS20.0 statistical software was used to analyze the incidence of complications, mean hospitalization time, average bedridden time and total satisfaction. Results The average hospital stay and the average length of stay in the experimental group were much shorter than those in the control group (P<0.05). The total score of the experimental group was much higher than that of the control group (P<0.05). The complication rate of the experimental group was much lower than that of the control group (P<0.05). Conclusion Nursing measures for early thrombolytic therapy in patients with acute myocardial infarction can significantly reduce the incidence of complications in patients.
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Objective To evaluate the therapeutic effects of early intratympanic steroid of different concentrations and types combined with systemic steroid on severe idiopathic sudden sensorineurl hearing loss(ISSNHL).Methods We reviewed 95 patients with unilateral ISSNHL from January 2012 to June 2016 in the Department of Otolaryngology of the People's Hospital of Changshou and according to the steroid treatment methods,Patients were divided into systemic steroid therapy alone group(group A,30 cases),early intratympanic steroid of low concentration combined with systemic steroid group (group B,32 cases) and early intratympanic steroid of high concentration combined with systemic steroid group (group C,33 cases).Results Total effective rates of the group A,group B and group C were 46.67 ％,56.25 ％,78.79％.Group C was significantly higher than that of group A and group B(P＜0.05);the average pure tone threshold improvement was (46.67±9.32) in group C which was better than group A (20.53±8.83) and group B(25.19± 7.46),the differences were stastically significant (P＜0.01).Conclusion Severe ISSNHL should be treated by intratympanic steroid of high concentration combined with systemic steroid as early as possible in order to rescue the hearing,the efficacy of which is much better than other steroid treatments so far.
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AIM The proofs of evidence-based medicine of Qingkailing Injection's effect on viral hepatitis are lack in spite of the wide use of Qingkailing Injection in medical practice.This study aims to use Meta-analysis to evaluate its clinical effect and safety.METHODS Such databases as CNKI,VIP and Wanfang were searched for randomized controlled trials related to Qingkailing Injection in treatment of viral hepatitis,which were published officially between 1996--2016.Revman 5.3 software was used to conduct Meta-analysis for the effective rate,rate of adverse reaction,the decrease rate of ALT,AST and TBIL of Qingkailing Injection.Meanwhile,subgroup analysis was conducted to the clinical effect of doses [＜ 0.5 mL/(kg · d),0.5-0.67 mL/(kg · d),＞0.67 mL/(kg · d)],treatment courses (≤ 14 d,＞ 14 d),manufacturers (Beijing University of Chinese Medicine Pharmaceutical Factory,Shenwei Pharmaceutical Company,Shanxi Taihang Pharmaceutical Company),year (1996 to 2002,2003 to 2009,2010 to 2016).RESULTS Fourteen studies were included according to the criterion.The results of Meta-analysis showed that the total effective rate,the decrease rate of ALT,AST and TBIL in Qingkailing Injection group were significantly higher than those in the control group (P ＜ 0.05).Whereas,no significiant differences were found between Qingkailing Injection group and the control group of its rate of adverse reaction (P ＞ 0.05).Subgroup-analysis showed that the effective rate of Qingkailing in doses subgroup,treatment courses subgroup,manufacturers subgroup and year subgroup were significantly higher than those of the control group.CONCLUSION Qingkailing Injection has obvious benefit in the treatment of viral hepatitis,which can reduce the activity of ALT and AST,also can reduce the content of TBIL.But we should pay attention to the prevention of allergic reaction in the clinical use.
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Objective To explore a new method for lacrimal passage irrigation after laser dacryocystoplasty surgery. Method One-hundred patients (104 eyes), which underwent laser dacryocystoplasty surgery combined with lacrimal drainage tube indwelling, were divided into two groups. In Group A (50 patients, 52 eyes), lacrimal passage irrigation was performed by traditional No.5 needle. While in Group B (50 patients, 52 eyes), it was done by No.7 blunt round needle designed by the researchers. Lacrimal passage irrigation was performed three times, each at the 3rd day, 1 week and 1 month after surgery. The silicone tube was removed 3 months after surgery and the treatment was evaluated. Results The total effective rate was 64% (32/50) in Group A and 92%(46/50) in Group B. The difference was statistically significant (χ2=18.537, P < 0.01). Conclusions The No.7 blunt round needle showed better effect when used for lacrimal passage irrigation after laser dacryocystoplasty surgery. It could improve the efficiency of lacrimal passage irrigation, thus decreasing irrigation times and reducing psychological pressure for the patients, which is worthy of clinical application.
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Objective To compare the therapeutic effect of combined fascia sheath suspension and frontal muscle flap suspension in the treatment of congenital severe congenital ptosis.Methods 46 cases (58 eyes) with congenital severe upper eyelid prolapse who were treated from March 2015 to March 2016 in Eye Hospital of Hebei Province were selected.The patients were divided into two groups:combined fascial sheath suspension group and frontalis muscle flap suspension.Comparisons of postoperative patients with eyelid height,eyelid radian,corneal exposure with eyes closed,eyelid activity,complication of the situation were carried out.And patient satisfaction survey was conducted.Results The effective rate of combined fascial sheath suspension group was 93.10％,the complication rate was 6.9％,and the patient satisfaction rate was 91.22±0.37,significantly better than the frontal muscle flap suspension group of patients (75.86 ％,24.14 ％ and 75.05 ± 0.28,respectively).The time of closure of the eyelid was shortened,the complications were less,and the eyelid had better activity.The difference between the two groups was statistically significant (P＜0.05).Conclusions Combined fascia sheath for congenital severe upper eyelid droop is significant,with fewer complications and a higher rate of satisfaction,which is worth clinical promotion.
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Objective To investigate the clinical efficacy of SOX and XELOX in neoadjuvant chemo-therapy for advanced gastric carcinoma .Methods Seventy-five cases with advanced gastric carcinoma were se-lected from our hospital from Feb 1,2011 to Oct 1,2015.SOX and XELOX were used to these patients treatment . The relationship between SOX and XELOX with tumor stage ,clinical curative effect evaluation ,operation ,postop-erative pathology ,adverse reaction ,survival analysis with advanced gastric carcinoma had been analyzed retrospec -tively.Results The efficacy of SOX and XELOX were 47.22%,41.03%.Compared with the two groups ,the CT curative effect evaluation,effective rate,disease control rate had no significant differences (P>0.05).The median survival time of DFS and OS were significant between the two groups (P<0.05).Conclusion The SOX and XELOX for neoadjuvant chemotherapy of advanced gastric carcinoma treatment is safety and effective , and the XELOX is better than SOX in terms of long -term effect,prognosis and clinical benefits .
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Objective To comprehensively analyze the nursing measures of early thrombolytic therapy for acute myocardial infarction. Methods 140 patients with acute myocardial infarction admitted in our hospital from October 2013 to October 2016 were randomly divided into control group (70 cases) and experimental group (apply early thrombolytic care on the basis of routine nursing method, 70 cases) according to different nursing methods. SPSS20.0 statistical software was used to analyze the incidence of complications, mean hospitalization time, average bedridden time and total satisfaction. Results The average hospital stay and the average length of stay in the experimental group were much shorter than those in the control group (P<0.05). The total score of the experimental group was much higher than that of the control group (P<0.05). The complication rate of the experimental group was much lower than that of the control group (P<0.05). Conclusion Nursing measures for early thrombolytic therapy in patients with acute myocardial infarction can significantly reduce the incidence of complications in patients.
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OBJECTIVE:To systematically review the efficacy and safety of Deproteinised calf blood serum injection in the treatment of cerebral infarction,and to provide evidence-based reference for clinical treatment.METHODS:Retrieved from Co-chrane Library,EMBase,Medline,CBM,CJFD,VIP and Wanfan database,randomized controlled trials(RCT)about theeffica-cy and safety ofDeproteinised calf blood serum injection(test group)based on basic treatment(control group)in the treatment of cerebral infarction were collected.Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality eval-uation with Cochrane system evaluation manual 5.1.0.RESULTS:A total of 18 RCTs were included,involving 2 111 patients.Re-sults of Meta-analysis showed the total effective rate [OR=3.30,95%CI(2.48,4.39),P<0.001],National Institutes of Health Stroke Scale (NIHSS) score[MD=-1.47,95%CI(-2.06,-0.88),P<0.001] and activities of daily living(ADL) score[MD=9.09,95%CI(6.46,11.72),P<0.001] in test group were significantly better than control group,there were significant differences be-tween the 2 groups;and there was no obvious adverse reactions during treatment. CONCLUSIONS:Both efficacy and safety of De-proteinised calf blood serum injectionin the treatment of cerebral infarction are good.
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Objective To evaluate the long-term effective rate,retention rate and tolerability of the ketogenic diet (KD) in pediatric drug-resistant epilepsies.Methods Data of 36 children who were treated in Department of Pediatrics,the Second Affiliated Hospital of Xi'an Jiaotong University from Nov.2011 to Dec.2013 and had continuous follow-up of at least 12 months after initiation of the KD were analyzed prospectively.Response was defined as 50％ seizure reduction.The effective rate,retention rate, outcome-predictive value of various clinical factors were also assessed.The causes of the patients withdrew from KD and side effects were recorded and analyzed.Results Thirty-six children(29 boys,7 girls; mean age of 2.84 years)were included.The effective rate was 50.0％,52.8％,47.2％ and 41.7％ at the 1,3,6,12 months;the retention rate respectively was 94.4％,91.2％,69.4％ and 52.8％.Seventeen cases withdrew from KD.Seven cases (41.2％)ceased KD becau~ of a lack of compliance,5 patients because of poor outcome,and 2 cases because of repeated infection.None of the age,disease duration,etiology and seizure type could be used as the predictor for the favourable treatment for outcome.The antiepileptic drugs before KD might be predicted the efficacy of the KD.The less amount of the antiepileptic drugs,the more opportunity of the KD might have to succeed.The side effects on the start-up period were drowsiness,week and digestive discomfort,hyperlipoidemia,hypoglycemia and hepatic dysfunction.The side effects on the maintenance period were digestive discomfort,susceptibility to infection,hyperlipoidemia,the deficiency of trace elements.Conclusions The KD is a safe and potentially effective method in treatment of refractory epilepsy patients who do not respond to customary medication therapies.
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Objective To observe the effect of Aquacel AG dressing in treating diabetic foot and nursing measures.Methods Seventy-nine hospitalized patients diagnosed as diabetic foot were enrolled,and 45 of them were chosen randomly as the experimental group,who was treated with Aquacel AG dressing,and changed the dressing per 3 to 5 days.The other 34 patients were named as the control group,who was treated with normal cotton dressing by wet compress,and changed the dressing one time per day.The total effective rate and healing condition were compared between the two groups.Results The total effective rate of the experimental group was 93.3％,higher than that of the control group (79.4％) significantly.The healing time of the experimental group was (64±10)days,shorter than that of the control group,(88±12)days.Conclusions Aquacel AG dressing was suggested to use in treating diabetic foot.
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Objective To evaluate the efficacy and safety of entecavir(ETV)treatment on patients with chronic severe hepatitis B.Methods 82 native patients of chronic severe hepatitis B with positive HBV-DNA were divided into two groups,treatment group(37 cases) were prescribed with normal treatment plus ETV(0.5mg qd),while control group(45 cases) were treated with normal treatment alone.Symptoms,the levels of TB,ALT,PTA,HBV-DNA loads were determined before and at the end of the study.Results The effective rate of the treatment group(75.7%) were significant higher than that in the control group(53.4%)(P