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Objective:To analyze the application effect of integrated medical and nursing management model based on intelligent medical system in preventing postoperative breast cancer lymphedema.Methods:A total of 180 patients undergoing axillary lymph node dissection for breast cancer were selected in the Affiliated Hospital of Nantong University from July 2018 to August 2019. According to the random number table method, they were divided into treatment group and control group for 90 cases in each group, and finally completed the study: 86 cases in treatment group and 82 cases in control group. The control group was given routine health management, and the treatment group was given an integrated management model based on intelligent medical systems. After 6 months of follow-up, the two groups of patients were compared for their cognition of lymphedema, prevention behavior, incidence of lymphedema, and patient satisfaction.Results:The incidence, clinical manifestations, risk factors, prevention methods, and overall awareness rates of lymphedema in the treatment group were 82.56%(71/ 86), 84.88%(73/86), 83.72%(72/86), 83.72%(72/86), 83.72%(72/86), and the control group were 67.07%(55/82), 70.73%(58/82), 68.29%(56/82), 69.51%(57/82), 70.73%(58/82), the differences were statistically significant ( χ2 values were 4.046-5.508, P<0.05). The total scores of skin care, lifestyle, avoidance of upper limb compression, and prevention of lymphedema in the treatment group were (9.54±1.04), (30.45±2.45), (9.35±1.08), (58.92±8.20) points, and the control group were (8.12±1.32), (8.12±1.32), (8.74±1.14), (53.45±7.64) points, the differences were statistically significant ( t values were 3.561-7.764, P<0.01). The incidence of lymphedema in the treatment group was 9.30%(8/86), and that in the control group was 23.17%(19/82), the difference was statistically significant ( χ2 value was 5.985, P<0.05). Satisfaction was 95.35%(82/86) in the treatment group and 82.93%(68/82) in the control group, the difference was statistically significant ( χ2 value was 6.771, P<0.01). Conclusions:The integrated management of medical care and patients based on intelligent medical system can help improve the level of lymphedema cognition in patients with breast cancer surgery, promote the development of lymphedema prevention behavior, reduce the incidence of postoperative lymphedema, and improve patient satisfaction.
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Objective To evaluate prenatal diagnosis value of echocardiography in pathological types,differential diagnosis and accompanied malformations of fetal persistent truncus arteriosus(PTA).MethodsTwenty-four cases of PTA selected from 1 392 cases were analysed,who were definitely diagnosed to be suffered from cardiovascular malformation by fetal echocardiography.The ultrasound findings,pathological results and followed up were analysed.According to Van Praagh classification,the type IV PTA was excluded in this study which was classified into pulmonary artery atresia.Results The total PTA were 24 cases,in which 10 cases of A1 type,3 cases of A2 type,9 cases of A3 type,and 2 cases of A4 type.Nine cases of PTA accompanied other cardiac anomalies,and 1 case of PTA accompanied both cardiac anomalies and extracardial malformations.Two PTA cases were born,one was A1 type underwent surgical intervention,and the other was died due to multiple organ-failure.Fourteen PTA cases were termination and 7 cases were confirmed by pathology.Seven women pregnant again,of which 5 cases were born while only one was diagnosed atrial septal defect after birth,2 pregnant women were still during follow-up.Eight PTA cases follow-up were lost.Conclusions A1 type and A3 type of PTA have high incidence in fetus.Accompanied cardiac anomalies is certainly related to different types.Combination of multiple ultrosund techniques can diagnose PTA prenatally,make accurate classification and detect accompanying malformations,which is of great significance to offer proper pregnancy counselling and postpartum treatment.
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Objective To compare the reliability and validity of 2 incontinence- associated dermatitis (IAD) risk assessment tools (IAD risk assessment scale and PAT) in patients with incontinence, and to search for the best risk assessment tool. Methods A total of 101 IAD cases were chosen from the Affiliated Hospital of Nantong University.Reliability was evaluated by the inter- rater reliability,internal consistency,item sensitivity analysis and retest reliability; validity was evaluated by the structure validity and predictive validity. Results Cronbach α was 0.313 (IAD risk assessment scale) and 0.421(PAT);Cronbach α coefficient was the highest after the items that Change sheets and mats and relevant factors were removed respectively in two tools,which were 0.431, 0.428; The correlation between the total scores were 0.711 (P<0.01)(IAD risk assessment scale)and 0.498 (PAT)(P<0.01);Area under curve were 0.661 (IAD risk assessment scale),0.864 (PAT); the best cut-off value to forecast a poor prognosis was 53.5 (IAD risk assessment scale),6.5 (PAT). Conclusions The reliability and validity of IAD risk assessment scale and PAT are low. The change of sheets and mats and Related influencing factors are needed to be adjusted and revised.
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Objective:To study clinical characteristics and risk factors of young patients with coronary heart disease (CHD) complicated metabolic syndrome (MS).Methods: A total of 200 CHD young patients were selected from our hospital, including 100 patients with MS (CHD+MS group) and 100 patients without MS (CHD control group).Lesion severity was evaluated according to coronary lesion score.General data were compared between two groups,and risk factors were assessed CHD+MS group.Results: Compared with CHD control group, there were significant rise in body mass index (BMI), levels of total cholesterol (TC), 2h postprandial blood glucose (2hPG), fasting blood glucose (FBG), triglyceride (TG), blood pressure, serum uric acid (UA) and creatinine (Cr) and homeostasis model-insulin resistance index (HOMA-IR), and significant reduction in level of high density lipoprotein cholesterol (HDL-C) in CHD+MS group, P<0.01 all.Compared with CHD control group, there were significant rise in incidence rate of multi-vessel coronary disease (6% vs.32%) and Gensini score of coronary angiography [(5.1±2.0) scores vs.(8.4±5.3) scores] in CHD+MS group, P<0.01 both.Logistic regression analysis indicated that low HDL-C, HOMA-IR, hypertension and diabetes mellitus history were risk factors for CHD complicated MS in young patients(OR=1.097~2.246,P<0.01 all).Conclusion:There are much risk factors and abnormal metabolism,and coronary disease are more serious in young patients with CHD complicated MS.
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Objective To explore the diagnostic value of combined bedside detection of aminoterminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) in the diagnosis of cardiac dyspnea. Methods A total of 120 patients with dyspnea admitted in our department from June 2014 to February 2016 were included in this study. At the time of admission, NT-proBNP and cTnI levels were measured by bedside test. Values of NT-proBNP>300 ng/L or cTnI>0.16 mg/L were defined as positive for cardiac dyspnea. According to the final diagnosis, patients were divided into two groups:cardiac dyspnea group (n=68) and pulmonary dyspnea group (n=52). At the same time, 30 healthy people were selected as control group. Values of NT-proBNP and cTnI were used for statistical analysis between the three groups. The sensitivity and specificity of NT-proBNP, cTnI and cTnI+NT-proBNP were compared between three groups. Results The levels of NT-proBNP and cTnI were significantly higher in pulmonary dyspnea group and cardiac dyspnea group than those in the control group, and the levels were significantly higher in cardiac dyspnea group than those of pulmonary dyspnea group (P<0.01). The detection sensitivity of NT-proBNP and cTnI alone was 67.65% and 52.94%, combined detection of both was up to 94.12%. The specificity of NT-proBNP and cTnI detection alone was 70.00% and 53.33%, respectively, and combined detection of both was up to 86.67%. The sensitivity of NT-proBNP+cTnI was significantly higher than that of NT-proBNP and cTnI alone (P<0.05), but there was no significant difference in the specificity between combined detection andindividual detection of NT-proBNP. The positive predictive value of the combined detection in the diagnosis of cardiac dyspnea was 94.12%(64/68), and the negative predictive value was 86.67%(26/30). Conclusion Bedside detection with combination of cTnI and NT-proBNP has important clinical application value in the rapid diagnosis of cardiac dyspnea, which is a rapid clinical testing method.
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Objective To analyze the risk factors of acute organophosphate pesticide poisoning intermediate syndrome(IMS ),and discuss the corresponding nursing countermeasures. Methods From January 2007 to January 2011,50 cases of patients with acute organophosphate pesticide poisoning were collected as the research object.And we analyzed the risk factors of related intermediate syndrome. Results The incidence rate of acute organophosphate poisoning intermediate syndrome was 10.0％.IMS mainly occurred at age of 20～50 years old,rarely occurred at age of ＜20 and ＞50 years old.The incidence of IMS with oral intake was higher than respiratory poisoning and skin poisoning.The incidence of IMS caused by drugs of moderate toxicity was higher than drugs with high or low toxicity.The incidence of IMS patients who got atropinization within 2 hours was less than those without it.The incidence of IMS patients using aminoglycoside drugs was higher than those not using them. Conclusions Poisoning way,toxicity of toxicant,timely treatment,basic diseases,atropinization within 2 hours,and using aminoglycoside drugs can influence the condition and prognosis of intermediate syndrome caused by organophosphate pesticide poisoning.
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AIM: To determine the antioxidant and the immunoregulatory effects of Centella asiatica extracts. METHODS: Centella asiatica was extracted with alcohol and different organic solvent. The content of polyphenol was determined by Folin-ciocalteau method. The efficacy of the extracts to scavenge the hydroxy radical (OH·), 1,1-diphenyl-2-picryl-hydrazyl radical (DPPH·) and intra-cellular reactive oxygen species (ROS) was measured. Lymphocyte proliferation was assessed to observe the influence of Centella asiatica extracts. RESULTS: (1) Centella asiatica was found to have abundant polyphenol extrated from different phases and in a descending order as follows: ethyl acetate extracts>n-butanol extracts>water extracts>ligarine extracts. (2) Extracts of Centella asiatica exhibited the scavenging efficacy of OH· and DPPH· free radicals, in which the acetic ether extracts showed the significant effect. (3) The acetic ether extracts had significant ability to inhibit the generation of ROS in stimulated lymphocytes. (4) The acetic ether extracts suppressed the lymphocyte proliferation. (5) The active ingredient was identified as flavone. CONCLUSION: Flavones in the Centella asiatica posseses antioxidant activity and effectively inhibits lymphocyte proliferation, showing ability of immunosuppre-ssion.
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Objective To explore the application of PBL (Problem - Based learning) mode in fami-ly peritoneal dialysis training to improve the teaching effects of peritoneal dialysis training. Methods The PBL mode was applied in every peritoneal dialysis training lesson, the teaching effects were evalued af-ter a lesson immediately. Results The PBL mode would be helpful to inspire patients' and their family members' interest to learn the knowledge of peritoneal dialysis training.It was also helpful in knowledge un-derstanding, knowledge mastering and establishment of treatment confidence. Conclusions The PBL mode was an important way to improve the teaching effects of peritoneal dialysis training and realize the teaching objective. It is worth applying in practice of peritoneal dialysis training.
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Objective To observe efficacy of Pulmicort in treatment of capillary bronchitis.Methods Children with capillary bronchitis were randomly divided into two groups,ninty-eight cases of study group were treated with Pulmicort,fifty-eight cases of control group were treated with common therapy,observe clinical symptom:cough,breathes heavily. Results Two groups efficiency were 93.8% and 72.4% respectively.The study group was significantly better than that in control group. Conclusion Pulmicort inhalation in treatment of children with capillary bronchitis are effective.
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Objective To assess the methods and points of transvaginal ultrasound - guided partly microwave ablation (MWA) on polycystic ovary syndrome(PCOS). Methods 22 patients with PCOS underwent transvaginal ultrasound - guided MWA with 18G PTC needle on part of ovarian interstitium. Results The one - shot achievement of earlier period ratio was 20% with 5 cases. The other 17 cases underwent injecting 400ml normal saline or pressure on inferior belly. Then the one - shot achievement ratio was 81.2% . The average puncture time was respectively 3.8 and 1.7. Conclusion Transvaginal ultrasound -guided puncture on polycystic ovary appears realtime and safe with little complications. Also it can improve the puncture achievement ratio by better means.
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The effects of the pulsed electromagnetic fields (PEMFs) of different intensity on bone mineral density (BMD) and biomechanical properties of rabbits' femur had been studied. Twenty-seven female white big ear rabbits were randomly divided into three groups. The magnetic groups were fed in 15 Hz PEMFs, which pulse duration was set to be 5 ms (6 h x d(-1)), the magnetic intensity was 10 x 10(-4) T and the other was 20 x 10(-4) T. Control group were just fed in coils, and the instrument of PEMFs was powered off. After six weeks, by examine BMD and biomechanical properties of the rabbits' femur, the effects of these PEMFs were studied. Compared with control group, the values of BMD, maximum load and structural rigidity of magnetic group were significantly increased (P < 0.05). In addition, there was significant increase in values of BMD and structural rigidity in group 10 x 10(-4) T in comparison with group 20 x 10(-4) T (P < 0.05). PEMFs is effective in improving BMD and biomechanical properties. The experiment indicated that there was evident "window-effect" during the treatment by PEMFs. It is favorable to the treatment and prevention of osteoporosis.
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Animales , Femenino , Conejos , Fenómenos Biomecánicos , Densidad Ósea , Fisiología , Efectos de la Radiación , Relación Dosis-Respuesta en la Radiación , Campos Electromagnéticos , Fémur , Metabolismo , Fisiología , Osteoporosis , Distribución AleatoriaRESUMEN
To explore the association between alkaline phosphatase (ALP) and degenerative cardiac valvular calcification, the activity of ALP and the grades 0～Ⅳ degenerative calcified valves were determined by biochemical and immunocytochemical methods. ALP positive substance was present in the matrix around the foci of calcification and in the cytoplasm of fibroblasts. The bioactivity of ALP was much higher in grades Ⅰ and Ⅱ calcified valves than that in grades 0 and Ⅲ～Ⅳ calcified valves. The results indicate that the level of ALP bioactivity is predominantly dependent on the process of extruding matrix vesicles from senescent cells in the valves.
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AIM: To observe the effect of nimodipine on the severe brain injury. METHODS: Nimodipine was ccsed for acute severe brain injury patients early in 6 hours after wounded. The effect and safety were observed in an open trial. RESULTS: The mortality and morbidity of 20 patients decreased significantly by the use of nimodipine in comparisom with another 20 patients treated normally. CONCLUSION: Nimodipine is benefit to severe brain injury patients.