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Objective:To investigate the correlation between neutrophil/lymphocyte ratio (NLR) combined with low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and severity of coronary lesions in patients with acute coronary syndrome (ACS).Methods:Patients who were diagnosed with ACS due to chest pain and received emergency coronary angiography in the First Affiliated Hospital of University of Science and Technology of China and the Affiliated Hospital of Anhui Medical University from January 2017 to June 2020 were enrolled in the final analysis. The data of gender, age, body mass index (BMI), past history, emergency blood routine indicators [neutrophil (NEU), lymphocyte (LYM), monocyte (MON), eosinophil (EOS), basophil (BAS), red blood cell (RBC), mean corpuscular volume (MCV), blood red cell distribution width (RDW), mean platelet volume (MPV), platelet volume distribution width (PDW)], blood lipid index [triglyceride (TG), total cholesterol (TC), HDL-C, LDL-C, very low-density lipoprotein cholesterol (VLDL-C)], and coronary angiography were collected. The results of coronary angiography were evaluated by the Gensini score. According to the Gensini score, the patients were divided into the control group (Gensini score = 0, 55 cases) and the study group (Gensini score > 0, 889 cases), and then the patients in the study group were divided into the low-Gensini-score group (Gensini score < 66, 419 cases) and the high-Gensini-score group (Gensini score ≥ 66, 470 cases). The differences in the general baseline data of the four groups were compared, and the correlation between the statistically significant data and the Gensini score was linearly analyzed, and then the combined diagnostic factors (NLR combined with LDL-C/HDL-C ratio) were obtained by Logistic regression analysis. The receiver operator characteristic curve (ROC curve) was used to evaluate the predictive value of NLR combined with LDL-C/HDL-C ratio in predicting the severity of coronary artery lesions in patients with ACS. Finally, multivariate linear regression analysis was used to establish the predictive model between NLR combined with LDL-C/HDL-C ratio and Gensini score.Results:A total of 944 patients were finally included. The differences in gender, age, BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, EOS, RDW, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C ratio between the control group and the study group were statistically significant. The differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, EOS, TG, TC, HDL-C, LDL-C, NLR and LDL-C/HDL-C ratio between the low-Gensini-score group and the high-Gensini-score group were statistically significant. Linear regression analysis showed that compared with other indicators, the correlation between NLR, LDL-C/HDL-C ratio and Gensini score was stronger in the study group ( r values were 0.634 and 0.663, respectively, both P < 0.05). Binary Logistic regression analysis of the indicators related to Gensini score showed that NEU, LYM, HDL-C and LDL-C were independent risk factors for coronary stenosis in patients with ACS [odds ratio ( OR) were 0.189, 10.309, 13.993, 0.251, 95% confidence intervals (95% CI) were 0.114-0.313, 4.679-22.714, 3.402-57.559, 0.121-0.519, respectively, all P < 0.05]. ROC curve analysis showed that NLR combined with LDL-C/HDL-C ratio had higher predictive value in predicting the severity of coronary lesions in ACS patients [area under the ROC curve (AUC) was 0.952, 95% CI was 0.93-0.969], when the cutoff value was -3.152, the sensitivity was 98.20%, and the specificity was 81.60%. According to the results of multivariate linear regression analysis, the prediction model between NLR, LDL-C/HDL-C ratio and Gensini score was established, and the formula was Gensini score = -7.772+15.675×LDL-C/HDL-C ratio+8.288×NLR ( R2 = 0.862). Conclusion:There is a significant correlation between emergency NLR combined with LDL-C/HDL-C ratio and Gensini score in patients with ACS at admission, which has a certain predictive value for the severity of coronary artery stenosis in patients with ACS, and can be used as a predictor for evaluating the severity of coronary artery disease.
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Objective:To investigate the effects of nedaplatin combined with docetaxel on serum tumor markers and T lymphocyte subsets in patients with epithelial ovarian cancer.Methods:Ninety-two patients with epithelial ovarian cancer who received treatment from March 2016 to December 2017 were included in this study. They were randomly assigned to undergo nedaplatin combined with docetaxel (observation group, n = 46) or cisplatin combined with paclitaxel (control group, n = 46). Both groups received two 21-day courses of treatment. Serum tumor marker level, T lymphocyte subset level, clinical efficacy, incidence of adverse reactions, and 2-year survival rate were compared between the two groups. Results:After treatment, serum cancer antigen 125 (CA125), cancer antigen 199 (CA199), and carcinoembryonic antigen (CEA) levels were (45.84 ± 22.46) U/mL, (35.13 ± 15.03) U/mL, (16.21 ± 3.20) U/mL, respectively in the control group and they were (28.33 ± 20.11) U/mL, (14.82 ± 10.11) U/mL, (5.16 ± 1.33) U/mL, respectively in the observation group. After treatment, CA125, CA199, and CEA levels in each group were significantly decreased compared with before treatment. After treatment, CA125, CA199, and CEA levels were significantly lower in the observation group than in the control group ( t = 3.94, 7.61, 21.63, all P < 0.05). After treatment, the numbers of CD3 +, CD4 +, CD8 + cells in the control group were (16.22 ± 3.12)%, (15.20 ± 1.46)%, (29.21 ± 5.17)%, respectively, and they were (31.22 ± 4.11)%, (24.99 ± 1.71)%, (24.25 ± 4.45)% respectively in the observation group. After treatment, the numbers of CD3 + and CD4 + cells in the observation group were significantly higher than those in the control group ( t = 19.72, 29.53, both P < 0.05). After treatment, the number of CD8 + cells in the observation group was significantly lower than that in the control group ( t = 4.93, P < 0.05). Total response rate was significantly higher in the observation group than in the control group [78.26% (36/46) vs. 58.70% (27/46), χ2 = 4.08, P < 0.05]. The incidence of adverse reactions was significantly lower in the observation group than in the control group [23.91% (11/46) vs. 45.65% (21/46), χ2 = 4.79, P < 0.05]. The 2-year survival rate was significantly higher in the observation group than in the control group [43.48% (20/46) vs. 23.91% (11/46), χ2 = 3.94, P < 0.05]. Conclusion:Nedaplatin combined with docetaxel is highly effective on epithelial ovarian cancer. The combined therapy can greatly reduce serum CA125, CA199, and CEA levels but has no great effects on T lymphocyte subsets. It can increase the survival rate but has no serious adverse reactions.
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Resumo O objetivo deste estudo é explorar a teoria da atividade como um referencial teórico interdisciplinar adequado, situando os elementos sociais, pedagógicos e tecnológicos do blended learning no ensino superior, considerando a adoção e a efetividade do blended learning, que constitui a nova normalidade no atual contexto de presença e uso intensivo de tecnologias digitais na educação. Conclui-se a validade internacional da teoria da atividade e sua permanente transformação e evolução histórica, desde suas origens até os dias atuais, oferecendo transcender o caráter individual em direção a um caráter coletivo, representando adequadamente os elementos sociais, tecnológicos e histórico-culturais presentes em toda atividade formativa.
Résumé L'objectif de cette étude est d'explorer la théorie de l'activité comme cadre théorique interdisciplinaire approprié, tout en situant les éléments sociaux, pédagogiques et technologiques du blended learning dans l'enseignement supérieur et tenant compte que l'adoption du blended learning et son efficacité constituent la nouvelle normalité dans le contexte actuel d'usage intensif des technologies numériques dans l'éducation. La conclusion est que la validité internationale de la théorie de l'activité, avec sa transformation permanente et son évolution historique, depuis ses origines jusqu'à nos jours, nous permet de transcender son caractère individuel vers un caractère collectif et représenter adéquatement les éléments sociaux, technologiques et historico-culturels présents dans toute activité de formation.
Resumen El propósito es explorar la teoría de la actividad como referente teórico interdisciplinar adecuado, donde se sitúan los elementos sociales, pedagógicos y tecnológicos del blended learning en la educación superior, considerando que la adopción y efectividad del blended learning lo han constituido en el nuevo normal, en el actual contexto de presencia y uso intensivos de tecnologías digitales en educación. Se concluye en la validez internacional de la teoría de la actividad y su permanente transformación y evolución histórica desde sus orígenes hasta la época actual, ofrece transcender el carácter individual hacia un carácter colectivo, representando adecuadamente los elementos sociales, tecnológicos e histórico-culturales presentes en toda actividad formativa.
Abstract The objective is to explore activity theory as a suitable interdisciplinary theoretical framework, where to place the social, pedagogical and technological elements of blended learning in higher education and considering the adoption and effectiveness of blended learning, constituting the new normality, in the current context of presence and intensive use of digital technologies in education. It concludes on the international validity of the theory of activity and its permanent transformation and historical evolution from its origins to the present day, it allows to transcend the individual character towards a collective character, adequately representing the social, technological and historical-cultural elements present throughout the formative activity.
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Objective To improve the efficiency and accuracy of formality examination of the National Natural Science Fund Project (hereinafter referred to as formality examination).Methods According to the practice,we find that Combine Files of Adobe Acrobat Pro software,which relies on the large data of internet-based Science information system (hereinafter referred to as the system) can quickly search and examine the various problems in the application.Results In previous years,we examined the PDF version or hard copy of the application form of NSFC according to the list of questions about formality examination.It is easy for the examiner to miss the examination due to fatigue after long time working which resulted in many amendments by the applicant.Relying on the above two technologies,we redesigned and constructed a three-level formality examination process,reduced the burdens of examiner,and also greatly improved the efficiency and accuracy of formality examination.Conclusions Finding and using the right tools can lead to amazing productivity gains in boring management.
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Objective To evaluate the effect of acupuncture and massage combined with anterior cervical decompression and bone grafting for the treatment of cervical spondylotic myelopathy, and to analyze the mechanism of action and provide guidance for clinical prevention and treatment.Methods A total of 62 patients with cervical spondylotic myelopathy were enrolled in our hospital from October 2013 to October 2014.The patients were divided into treatment group and control group according to random number table.The control group was treated with anterior decompression and bone grafting, and the treatment group received acupuncture and massage combined with anterior cervical decompression and bone grafting and internal fixation.The changes of JOA score, TCM syndrome score, VAS score and quality of life score before and after treatment were observed and the prognosis was evaluated.Results After treatment,the JOA score, quality of life score of the two groups were significantly increased than those before treatment, while the TCM symptom scores, VAS scores were significantly decreased.The improvement effect of the treatment group was better than that of the control group(P<0.05);The prognosis of the treatment group is better than that of the control group(P<0.05).Conclusion The treatment of cervical spondylotic myelopathy with acupuncture and massage combined with anterior decompression and bone grafting and internal fixation can significantly improve the clinical efficacy and prognosis, and the safety is higher.
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Objective To evaluate the efficacy of lamivudine and adefovir in the treatment of patients with decompensated hepatitis B cirrhosis . Methods 90 cases of patients with hepatitis B cirrhosis of the liver decompensation period from August 2013 to June 2015 in our hospital were researched.According to the random number table method divided into observation group and control group , each of 45 cases, the total course of treatment was one year.The observation group was treated with lamivudine combined with adefovir dipivoxil , control group was treated with lamivudine.The clinical effect, the indexes of liver function, the changes of HBV-DNA and Child-pugh score were compared between the two groups after treatment.Results After treatment, the total effective rate of the observation group ( 93.33%) was obviously higher than that of control group (48.89%), the difference was statistically significant (P<0.05), the observation group alanine amino acid, total bilirubin, aspartate aminotransferase were (71.23 ±21.32)U/L, (28.32 ±4.65)Umol/lL, (4.65 ±9.25)U/L, they were significantly lower than control group (111.54 ±16.25)U/L, (46.53 ±4.89 ) Umol/L, ( 4.89 ±12.11 ) U/L, the observation group albumin ( 39.82 ±2.62 ) g/L was significantly higher than control group (35.55 ±2.22)g/L, the difference was statistically significant (P<0.05), after treatment, the observation group hepatitis b HBV DNA levels, Dhild pugh score (2.78 ±0.45)log10 copies/mL, (6.12 ±1.23) were significantly lower than the control group (3.89 ±0.65)log10 copies/mL, (7.89 ± 1.21)scores, the difference was statistically significant (P <0.05).Conclusion The combination of lamivudine and adefovir dipivoxil significantly decompensated hepatitis B cirrhosis has a curative effect, it could effectively improve the patient's liver function, Dhild-pugh score, HBV-DNA level.
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Objective To observe the clinical effect of pioglitazone combined with gliclazide sustained-release tablets in the treatment of patients with early type 2 diabetes mellitus.Methods 80 patients with early type 2 diabetes mellitus in our hospital from June 2013 to July 2016 were selected as the study object,and the patients were randomly divided into two groups, 40 cases in each group.The control group were treated with gliclazide sustained-release tablets, the observation group were treated with pioglitazone combined with gliclazide sustained-release tablets.Then the blood glucose level, glycosylated hemoglobin level, lipid metabolism indexes and islet function indexes of two groups before and after the treatment were detected and compared.Results The blood glucose level, glycosylated hemoglobin level, lipid metabolism indexes and islet function indexes of two groups before the treatment were compared, the difference was statistically significant (P<0.05), while the blood glucose level, glycosylated hemoglobin level, lipid metabolism indexes and islet function indexes of two groups after the treatment were continuously improved , and the blood glucose level and glycosylated hemoglobin level of observation group were lower than those of control group, the ipid metabolism indexes and islet function indexes were all better than those of control group, the difference was statistically significant (P <0.05).Conclusion The clinical effect of pioglitazone combined with gliclazide sustained-release tablets in the treatment of patients with early type 2 diabetes mellitus is better, and it also has active adjustion role for the blood glucose, blood lipid and islet function state.
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Objective To investigate the clinical effect of fluticasone propionate combined with noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease (COPD).Methods 88 cases of COPD patients from October 2014 to October 2016 in our hospital were selected and randomly divided into two groups of the control group observation group with 44 cases in each group.The control group was treated with conventional treatment, the observation group was treated with fluticasone propionate plus noninvasive positive pressure ventilation, and then the curative effect of the two groups was compared.Results The total effective rate of observation group was 100% higher than that of the control group 70.5%, the difference was statistically significant (P<0.05), after treatment, the observation group of FVC (2.50 +0.32) L, FEV1 (1.36 +0.20) L, FEV1%(51.23+4.32), PaO2(10.51+2.10) kPa, PaCO2(5.15 +1.19) kPa, compared with the control group, the difference was statistically significant (P<0.05), the observation group recurrence rate 4.5% was lower than the control group 13.6%, the difference was statistically significant (P <0.05).Conclusion COPD patients with fluticasone propionate combined noninvasive positive pressure ventilation, can effectively improve lung function, reduce disease recurrence rate, a significant effect.
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Objective To investigate the effect of pidotimod granules and Carboxymethyl starch sodium solution in treating children with recurrent respiratory tract infection curative effect and effect on immune function of children.Methods 128 cases of children with recurrent respiratory tract infection in our hospital from June 2013 to June 2016 were selected and divided into treatment group and control group with 64 cases in each group. Children in the control group were treated with Carboxymethyl starch sodium solution, the treatment group was given pidotimod granules on the basis of the control group.Two groups of children were treated for 12 weeks.The therapeutic effects of the two groups were compared, the changes of immune function before and after treatment, cough, fever, lung rales disappear time, and the incidence of adverse reactions.Results The total effective rate of the treatment group (90.62%) was higher than the control group (75.00%), the difference was statistically significant (P<0.05), the levels of IgA, IgM and IgG increased after treatment in both groups, the levels of IgA, IgM and IgG in the treatment group were higher than those in the control group, the difference was statistically significant (P<0.05), the levels of CD3 +, CD4 +and CD4 +/CD8 +increased after treatment in both groups, and the levels of CD3 +, CD4 +and CD4 +/CD8 +in the treatment group were higher than those in the control group, the difference was statistically significant (P<0.05), the treatment group in children with cough, fever, pulmonary rales disappeared faster than the control group, the difference was statistically significant (P <0.05), two groups were no obvious adverse reactions.Conclusion Pidotimod granules combined with carboxymethyl starch sodium solution in treating children with recurrent respiratory tract infections is effective, and could significantly improve the immune function of children.
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Objective To observe the efficacy of laparoscopic surgery combined with sodium hyaluronate in the treatment of adhesive intestinal obstruction and its influence on disease-related indexes.Methods 180 cases of patients with adhesive ileus from September 2010 to April 2014 were selected and randomly divided into control group and observation group two groups, 90 cases in each group.The control group was treated with laparotomy and the observation group was treated by laparoscopic surgery combined with sodium hyaluronate.Then the operation related indexes such as operation time, intraoperative bleeding volume, postoperative gastrointestinal function recovery time, hospitalization time and complications of two groups were compared.And the serum levels of gastrointestinal hormone such as GAS, MTL, CCK and SS and inflammatory cytokines such as hs-CRP, IL-2, IL-6, IL-10 and TNF-αof two groups before and after treatment were detected and compared.Results The intraoperative bleeding volume of observation group was less than control group, postoperative gastrointestinal function recovery time and hospitalization time were shorter than control group, the incidence of complications was lower than control group, the difference was statistically significant (P <0.05).1, 4 weeks postoperative, the serum levels of gastrointestinal hormone such as GAS, MTL and SS of observation group were higher than control group, while the CCK was lower than control group, the difference was statistically significant (P<0.05).1, 4 weeks postoperative, the serum levels of inflammatory cytokines such as hs-CRP, IL-2, IL-6 and TNF-αof observation group were lower than control group, the difference was statistically significant (P<0.05).Conclusion Compared with the traditional laparotomy, laparoscopy combined with sodium hyaluronate has the advantages of small effect on patients with digestive function and postoperative inflammatory reaction, thus helps to shorten the recovery time of patients after surgery and inhibition the occurrence of complications such as recurrent intestinal obstruction.
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Objective To explore clinical effect of metacentric particles with bisoprolol fumarate pesos on the elderly patients with heart failure with ventricular arrhythmia treatment.Methods In August 2013 to April 2016, 102 cases of elderly patients in our hospital heart failure with ventricular arrhythmia were selected as research object, according to touch the ball method, they were divided into control group and experimental group, each group of 51 cases, control group was given bisoprolol fumarate pesos, on this basis, the experimental group was combined use of metacentric particles.Two groups of clinical curative effect were compared .Results The experimental group and control group rate of sinus heart rate to maintain statistical comparison of the experimental group was higher than control group ,the difference was statistically significant(P<0.05),group total effective rate was significantly higher than the control group ( P <0.05 ) , the incidence of adverse reactions were significantly lower than the control group (P<0.05),the control group and experimental group heart rate compared before treatment, there was no statistically significant difference, but after treatment, the experimental group was lower than the control group, the differe nce was statistically significant (P <0.05). Conclusion Metacentric particles with bisoprolol fumarate pesos for elderly patients with heart failure with ventricular arrhythmia in clinical curative effect is distinct, high safety.
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Objective To investigate the effect of the high mobility group protein 1 (HMGB1), cancer embryonic antigen (CEA) and squamous cell carcinoma antigen ( SCC-Ag) by paclitaxel combined with cisplatin chemotherapy in the treatment of advanced esophageal cancer patients .Methods 43 cases advanced esophageal cancer patients from our hospital were selected and randomly divided into the control group and the experiment group.19 cases in the control group were treated by surgery combined with postoperative chemotherapy , 24 cases in the experimental group were treated with surgery and chemotherapy.The clinical efficacy and high mobility group protein 1 ( HMGB1 ) , cancer embryonic antigen ( CEA ) and squamous cell carcinoma antigen ( SCC-Ag ) levels were compared between the two groups before and after treatment.Results The total effective rate of the experimental group was (91.7%) higher than that of the control group (57.9%), the difference was statistically significant (P <0.05).After treatment, the serum levels of SCC-Ag, CEA and HMGB1 were decreased in the two groups, compared with the control group, the experimental group SCC-Ag, CEA and HMGB1 levels were lower, the difference was statistically significant ( P <0.05 ) .There was no significant difference in adverse reactions between the two groups.Conclusion Paclitaxel combined with cisplatin in the treatment of advanced esophageal cancer patients with good results, presumably with the decrease of serum SCC-Ag, CEA and HMGB1 levels in patients with.
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Objective To investigate the clinical effects of enalapril combined with atorvastatin in the treatment of diabetic nephropathy .Methods 108 patients with diabetic nephropathy from August 2014 to August 2016 were selected and randomly divided into the observation group and the control group, 54 cases in each group.The control group were treated with enalapril based on the conventional diabetes treatment, and the observation group were treated with atorvastatin based on the control group, the changes of FPG, 2 hPG, HbAlc, SBP, DBP, UAER, SCr and Ccr were observed and compared between the two groups.Results After treatment, the control group and the observation group patients with diabetes indicators FPG, 2 hPG and HbAlc in the control group, were significantly lower than before treatment, the difference was statistically significant (P <0.05), but there was no statistically significant difference between the two groups after treatment.The control group and the observation group patients with diabetic nephropathy , SBP, DBP, UAER, Scr, Ccr were significantly lower than before treatment, the difference was statistically significant (P<0.05), and after treatment, UAER, Scr and Ccr in the observation group were significantly lower than those in the control group, the difference was statistically significant ( P<0.05).Conclusion Enalapril combined with atorvastatin can effectively delay the progression of the disease, protect renal function based on good control of blood glucose in the treatment of diabetic nephropathy.
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Objective To explore the clinical efficacy of rosuvastatin combined with oxycodone sustained release tablets in patients with advanced non-small cell lung cancer and its effects on serum IL-6 and TNF-αlevels.Methods 62 cases with advanced non-small cell lung cancer from May 2014 to May 2016were divided into observation group and control group according to random number table, each group with 31 cases.Control group were treated with oxycodone sustained-release tablets, and observation group were treated with rosuvastatin and oxycodone sustained-release tablets.The levels of serum IL-6 and TNF-αwere compared pre-and post-treatment betweene two groups.The effective dose, the number of painful pain, the NRS score, the improvement of quality of life of oxycodone hydrochloride sustained-release tablets after treatment and adverse reaction rate were observed. Results After treatment, serum IL-6, TNF-αlevels in two groups were significantly lower than pre-treatment (P <0.05), and which in observation group were significantly lower than control group (P<0.05).Compared with control group, the effective dose of Oxycodone Hydrochloride Prolonged-release Tablets, broke out pain, NRS score in observation group were significantly higher ( P <0.05 ) .The effective rate of cancer pain treatment in observation group was 96.77% (30/31), significantly higher than 74.19% (23/31) of control group (χ2 =12.269, P<0.0001).The improvement of quality of life incontrol group was 32.25%, significantly lower than 80.64% in observation group (P<0.05).There was no significant difference in adverse reactions between two groups.Conclusion Rosuvastatin combined with oxycodone sustained release tablets in treatment with advanced non-small cell lung cancer were effective, and can reduce the patient's serum IL-6, TNF-αlevels effectively.
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Objective To investigate the clinical efficacy and value of low molecular weight heparin calcium combined with vertebroplasty in the treatment of osteoporotic vertebral compression fractures in elderly patients .Methods 67 elderly patients with osteoporotic vertebral compression fractures in our hospital from January 2013 to January 2016 were selected and randomly divided into control group 30 cases and treatment group 37 cases. All patients were treated with percutaneous vertebroplasty, the control group was given calcium carbonate D3 conventional treatment, the treatment group was treated with low molecular weight heparin calcium anti osteoporosis treatment, the course of treatment was one month.Measurement of bone mineral density before and after the operation of different follow-up time points ( BMD ) and the changes of the oswestry disability index ( ODI ) evaluation activities and the visual analogue scale (VAS) to assess the degree of pain, and the changes of vertebral height before and after operation were analyzed. Results All patients were followed up for an average of 16.4 months (12 to 21 months).Compared with before vertebroplasty, the BMD of the patients in the treatment group was higher than that in the control group at one month, three months and six months, the difference was statistically significant (P<0.05), the low molecular weight heparin treatment after January, treatment group VAS and ODI scores were significantly lower than the control group, and the subsequent different follow-up time points ODI and VAS score can effectively maintain, the difference was statistically significant ( P<0.05) .Compared with before vertebroplasty, postoperative anterior vertebral height, middle height better than preoperative vertebral height, the difference was statistically significant (P<0.05), and after one months of treatment, the treatment group of anterior vertebral height, middle height were better than the control group, the difference was statistically significant (P <0.05).Conclusion After treatment with low molecular weight heparin calcium, the healing process of vertebral body after vertebroplasty, to a certain extent, it can increase the bone mass and prevent bone destruction, increase bone strength, and further achieve the treatment of osteoporosis and prevention of osteoporotic fracture in elderly patients with osteoporotic vertebral compression fractures.
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Objective To observe the effects of dexmedetomidine combined with propofol on the hemodynamics level in elderly patients undergoing gastroscopy.Methods 68 patients undergoing endoscopy from January 2014 to January 2015 in our hospital were selected and randomly divided into observation group and control group, 34 cases in each group.Propofol anesthesia combined with dexmedetomidine was used in the observation group and propofol anesthesia was used in the control group.The RR ( respiratory rate) and HR ( heart rate) of the two groups were observed before the administration (T0), after the administration (T1), when the gastroscope was inserted (T2), after the examination (T3), 5 min after the examination (T4), MAP (mean arterial pressure) and SpO2(pulse oxygen saturation) were measured.The postoperative consciousness, orientation recovery time and surgical tolerance were compared between the two groups.The anesthetic adverse reactions were recorded during the operation.Results The observation group in T1, T2, T3, T4 time point HR were lower than the control group, and the data remained relatively stable level, the difference was statistically significant (P<0.05).There was no significant difference in consciousness recovery time and recovery time of orientation force between observation group and control group.The tolerance of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05).The total adverse reaction rate of the observation group was 32.35% lower than that of the control group 88.24%, the difference was statistically significant ( P <0.05 ) .Conclusion Dexmedetomidine combined with propofol for the elderly patients with painless gastroscopy , analgesic effect is good, and can better maintain hemodynamic fluctuations, reduce propofol anesthesia adverse reactions, does not Affect the patient's awareness and ability to restore the direction.
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Objective To study the effect improvation of lung function and prognosis of singulair and seretide for moderate to severe AECOPD . Methods 78 patients associated with moderate to severe AECOPD from January 2014 to June 2016 in our hospital were researched.They were divided randomly into observation and control groups according to the order of admission, 39 cases in each group.In the control group, they were treated by conventional anti-infective, expectorant, oxygen, suction seretide.In the observation group, using singulair on the basis of the control group.Clinical data, clinical efficacy, clinical symptoms begin to improve time, hospitalization time, blood gas analysis (PaO2, PaCO2) after five days and pulmonary function after treatment forced expiratory volume in one second ( FEV1 ) , call gas peak velocity ( PEF) , forced expiratory volume in one second than the forced vital capacity (FEV1/FVC), maximum mid-expiratory flow rate (MMEF) were compared with each other.Results Their clinical data of patients and other general information and basic condition had no significant difference between each other.The effective rate of observation group and control group were 97.44%and 87.18%, clinical effecicy of observation group was better than the control group, the difference was statistically significant (u=2.2805, P<0.05).Postoperative hospital stay, time of symptoms began to improve of the observation group were shorter than the control group, the difference was statistically significant (P<0.05), PaO2 of 5-day post-treatment of observation group was higher, and PaCO2 was lower, the difference was statistically significant (P<0.05).Lung function of two groups of patients had no significant difference before treatment, after treatment, pulmonary function in the observation group (including FEV1, PEF, FEV1/FVC, MMEF) was better than the control group, the difference was statistically significant (P<0.05).Conclusion Seretide combined with singulair to treat severe AECOPD has a good effect, it can significantly improve the therapeutic effect and improve the patient's lung function.
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Objective To analyze Clopidogrel Resistance (CR) and influencing factors of coronary heart disease (CHD) with diabetes (DM) patients and evaluatc the relationship of CR and major adverse cardiovascular events (MACE) and readmission of CHD with DM patients.Methods 270 CHD patients were enrolled.Clinical conditions of CR were measured by adenosine diphosphate (ADP) induced maximum platelet aggregation rate (MPAR).After 1-year follow-up,MACE events and rehospitalization were recorded.Results CR of NDM and DM patients were 45 (33.1％) and 78 cases (58.2％) respectively,and the difference was significant (P ＜ 0.001).Factors of CR of CHD DM patients included heart rate,TG level,the number of severe coronary artery disease.MACE events of CS and CR patients were 35 (23.8％) and 47 patients (38.2％) respectively,and the difference was significant (P =0.010).The readmitted patients of CS and CR groups were 15 cases (10.2％) and 27 patients (22.0％) respectively,and the differcnce was significant (P =0.008).The MACE of CR and CS patients in DM group were 32 (41.0％) and 12 cases (21.4％) respectively,and thc difference was significant (P ＜ 0.05).The Readmitted cases of CR and CS patients in DM group were 19 (24.4％) and 5 (8.9％) respectively,and the diffcrcnce was significant (P ＜ 0.05).Conclusions CR of CHD DM patients increased significantly.The influencing factors of CR of CHDDM are including heart rate,TG level,the number of severe coronary artery disease.MACE events and rehospitalization rate were significantly increased in CHD patients with DM AR.Therefore,it should be further strengthened the anti-platelet therapy for CHD patients with DM.
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Objective To investigate the effect of simvastatin and aspirin on atherosclerosis and its effect on non endothelium dependent diastolic function(NMD)and blood lipid in patients.Methods Retrospective analyzed a total of 95 the clinical data of patients with atherosclerosis treated in Tianjin Baodi Hospital from August 2014 to May 2016.The patients were divided into simvastatin group and combined treatment group according to their treatment methods,simvastatin group was given simvastatin,combined treatment group was given aspirin on the basis of simvastatin.After four weeks treatment,the difference of plaque quantity,NMD and blood lipid between the two groups were observed.Results After treatment,the size and number of plaques in the combined treatment group were smaller than those in the simvastatin group,the difference was statistically significant(P<0.05),the NMD level in the combined treatment group was significantly higher than that in the simvastatin group,the difference was statistically significant(P<0.05),the levels of IL-18,IL-6 and hs-CRP in the combined treatment group were lower than those in the simvastatin group,the difference was statistically significant(P<0.05),the levels of LDL-C,TG and TC in the combined treatment group were lower than those in the simvastatin group,HDL-C levels were higher than simvastatin group,the difference was statistically significant(P<0.05).Conclusion Simvastatin combined with aspirin can significantly improve the endothelium dependent diastolic function and lipid level in patients with atherosclerosis,and has good therapeutic effect.
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Objective To investigate the effect of dexamethasone combined with clomiphene on serum sex hormone levels in patients with polycystic ovary syndrome. Methods 80 pregnancies with polycystic ovary syndrome treated in our hospital from January 2013 to December 2015 were selected and they were randomly divided into observation group and control group with 40 cases in each group. The observation group was given dexamethasone combined with clomiphene, while the control group was given simple clomiphene. Compared the curative effect and the change of the levels of progesterone and estradiol before and after treatment for three months. Results After treatment, the total effective rate of the observation group was 95.00%, higher than the total effective rate of the control group was 72.50%, the difference was statistically significant (P<0.05), compared the levels of progesterone(P), estradiol(E2), luteinizing hormone(LH) and LH/FSH in the observation group and the control group, the difference was statistically significant (P<0.05), after treatment, both levels were higher than before treatment. The total ovulation rate of the observation group was 90.00%, higher than the total ovulation rate of the control group was 72.50%, the difference was statistically significant (P<0.05). The level of progesterone and estradiol in serum of polycystic ovary syndrome treated by dexamethasone combined with clomiphene had a obvious positive correlation (r=0.746, 0.812, 0.731 and 0.796, P<0.05). Conclusion Dexamethasone combined with clomiphene treatment of polycystic ovary syndrome than using only clomiphene treatment is good, which can also improve serum hormone levels in patients, effectively improve the patient's endocrine abnormalities.