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Objective:To investigate the risk factors and their warning value for the occurrence of sepsis in patients with severe multiple trauma.Methods:A retrospective cohort study was conducted to analyze the clinical data of 92 patients with severe multiple trauma admitted to Yuyao People′s Hospital from July 2019 to October 2021. There were 71 males and 21 females, with the age range of 36-55 years [(45.5±13.6)years]. The injury severity score (ISS) was 20-29 points [(25.3±6.4)points]. The patients were divided into sepsis group ( n=32) and non-sepsis group ( n=60) according to whether sepsis occurred during hospitalization. Data were recorded for the two groups, including gender, age, basic diseases, cause of injury, number of injury sites, ISS, post-injury complications, and levels of aryl hydrocarbon receptor (AHR), C-reactive protein (CRP) and procalcitonin (PCT) at 1, 3 and 5 days after injury. The above data were analyzed to identify their correlation with the occurrence of sepsis in patients with severe multiple trauma by univariate analysis. The independent risk factors for sepsis in patients with severe multiple trauma were determined by multivariate Logistic regression analysis. The warning value of the single or combined risk factors for the occurrence of sepsis in patients with severe multiple trauma was evaluated by the receiver operating characteristic (ROC) curve and area under the curve (AUC). Results:By univariate analysis, it was demonstrated that the occurrence of sepsis was correlated with ISS, level of AHR at day 1 after injury, level of CRP at day 3 after injury and level of PCT at day 3 after injury ( P<0.05 or 0.01), but not with age, sex, basic diseases, level of AHR at 3, 5 days after injury, level of PCT at 1, 5 days after injury and level of CRP at 1, 5 days after injury (all P>0.05). By multivariate Logistic regression analysis, higher ISS ( OR=1.12, 95% CI 1.01, 1.24, P<0.05), level of AHR at day 1 after injury ( OR=1.30, 95% CI 1.10, 1.52, P<0.01) and level of PCT at day 3 after injury ( OR=1.81, 95% CI 1.08, 3.03, P<0.05) were found to be strongly correlated with the occurrence of sepsis. ROC curve analysis showed that higher ISS (AUC=0.69, 95% CI 0.57, 0.76) and level of AHR at day 1 after injury (AUC=0.79, 95% CI 0.68, 0.90) had warning value for the occurrence of sepsis, and the warning efficiency of combined panel was much better (AUC=0.86, 95% CI 0.77, 0.95). Conclusions:Higher ISS, level of AHR at day 1 after injury and level of PCT at day 3 after injury are independent risk factors for the occurrence of sepsis in patients with severe multiple trauma. ISS, AHR and combination of both exhibit good warning value for the occurrence of sepsis in patients with severe multiple trauma.
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Since the outbreak of COVID-19, the hospital is faced with such challenges as sustained input in patient screening, referral and rescue, supportive medical supplies including the management of personal protective supplies and the maintenance of medical equipment. In the face of increasing workload, the medical materials support team of the hospital took the following measures in the principles of " discovering new sources of supplies and minimizing consumption" . These measures taken include proactive supply procurement strategy, prioritizing allocations based on risk exposure, uniform distribution of supplies based on inventory and usage, and traceable management for donated supplies; optimal and central deployment of equipments, emergency installation, pre-maintenance and emergency repairs for equipments; efficient and safe sterilization of reusable materials and equipments using sterilizers; enhanced personnel training and management to keep updating the medical supplies capacity of the team. All these efforts have contributed significantly to the orderly work of epidemic control.
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In order to explore the causes and nursing care of gastroesophageal reflux in patients with ceryical vertebra frac-ture and paraplegia,the clinical data of 79 patients were retrospectively analyzed. Among which,31 patients suffered from gas-troesophngeal reflux. The main causes of gastroesephageal reflux were improper body position,gastrointestinal dysfunction,con-sciousness disorders,lnappropriate nasngastric feeding,drng adverse reaction,inappropriate feeding time,lack of knowledge in nurse aids and family members. It is suggested to take proper body position,assess gastrointestinal functions,implement naso-gastric feeding correctly,observe patient carefully to detect gastroesophageal reflux as early as possible,as well as provide health education for the nurse aids and family members to prevent gastroesophageal reflux and complications.
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Object To study the preparation and technology on sinomenine (SM) release from Sinomenine Sustained-release Tablets (SSTs) in which hydroxypropyl methyl cellulose (HPMC) was used as the primary excipients. Methods SSTs were prepared with different HPMC viscosity of K4M, K15M, and K100M, different HPMC content, and preparing technology. Results Little effect was observed on the releasing rate of SM with different HPMC viscosity when the content of HPMC was 30%. SM releasing rate increased with the decreasing of proportion of HPMC while the content of HPMC was less than 30%. But the releasing velocity slowed down while the content of HPMC increased and the effect on the releasing rate was not found as the content of HPMC was over 30%. When the ratio of SM and HPMC was 1∶1.5, the releasing rate decreased with the increasing of tablet weight from 280 mg to 360 mg. The releasing rate was insensitive to the particle size of HPMC and hardness of SSTs in this study. Conclusion It is necessary to control the tablet weight and choose the proper quantity of HPMC in the preparation of SSTs.