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Objective:To explore and analyze the effect of therapeutic communication system (TCS) intervention mode on Therapeutic effect and quality of life in patients with cardiac valve replacement.Methods:A total of 103 patients with cardiac valve replacement admitted from February 2018 to February 2019 were selected and divided into observation group (51 cases) and control group (52 cases) according to the random number table method. Patients in the control group were treated with staged rehabilitation intervention, while patients in the observation group were treated with staged rehabilitation combined with TCS intervention mode. Patients' prognosis, the score of Short Form 36-item Health Survey (SF-36) before and after intervention, the changes in the score of the Morisky label Scale (MMAS-8) before and after intervention, and perioperative indicators were recorded and compared between the two groups.Results:The quality of life scores of the observation group at 1 month,3 months and 6 months after intervention were (64.42±9.51), (76.23±9.19), (87.24±9.21) points, which were significantly higher than (58.73±9.38), (61.23±9.29), (76.29±9.42) points of the control group ( t values were 3.057, 8.237, 5.964, P<0.05);and also higher than those before intervention (54.29±9.14, 54.45± 9.31), the difference was statistically significant ( F values were 11.358, 7.581, P<0.001); the ICU hospitalization time (43.25±1.72),bed rest time (42.13±8.32) and hospitalization time (16.32±4.20) days in the observation group were significantly lower than (54.34±1.93), (72.33±8.54), (21.24±4.36) days in the control group, and the difference was statistically significant ( t values were 30.766, 18.174, 5.831, P<0.001); the drug compliance (7.21±0.17) was significantly higher than that of the control group (6.01±0.34) ( t value was 22.588, P<0.001). Conclusion:Stage rehabilitation combined with TCS intervention mode can effectively improve the prognosis and perioperative indicators of patients with heart valve, and improve the quality of life of patients, which is worthy of clinical application.
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Objective:To investigate the efficacy of tacrolimus combined with irbesartan in treating female patients with lupus nephritis and its effect on serum levels of high mobility protein B1(HMGB1) and receptor for advanced glycation products(RAGE).Methods:Sixty female patients with lupus nephritis admitted to the First People's Hospital of Wenling from January 2018 to May 2019 were included and divided into control group and observation group according to the random number table method, with 30 cases in each group.The control group received tacrolimus.The observation group was treated with irbesartan on the basis of the control group.After 6 months of continuous treatment, the renal function, scores of lupus nephritis activity index(SLE-DAI) and chronic disease index(SLE-CI), the efficacy, and serum levels of HMGB1 and RAGE were compared between the two groups.Results:Compared with the control group, the serum levels of creatinine(SCr)[(76.46±9.09)μmol/L], urea nitrogen(BUN)[(6.71±0.88)mmol/L], 24h urinary protein quantification[(1.38±0.21)g/24h], scores of SLE-DAI[(9.09±1.41)points] and SLE-CI[(1.17±0.17)points] were significantly reduced in the observation group after treatment, and the plasma albumin(Alb)[(35.08±5.11)g/L] and estimated glomerular filtration rate(eGFR)[(57.79±6.94)mL/min] were significantly increased (all P<0.01). The total effective rates of the observation group and the control group were 90.00% and 63.33%, respectively, and the difference between the two groups was statistically significant(χ 2=4.565, P<0.05). Compared with the control group, the serum levels of HMGB1[(52.31±7.13)μg/L] and RAGE[(1.11±0.18)μg/L] in the observation group were significantly reduced after treatment(all P<0.01). Conclusion:The efficacy of tacrolimus combined with irbesartan in the treatment of female patients with lupus nephritis is significant, and it can inhibit serum levels of HMGB1 and RAGE.
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OBJECTIVE:To evaluate the efficacy and safety of Bacterial lysates(hereinafter referred to as"Broncho-Vaxom") for recurrent respiratory tract infections (RRTIs) of children,and to provide evidence-based reference for clinic. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CNKI,Wanfang database and VIP database,domestic and foreign published randomized controlled trials (RCTs) about Broncho-Vaxom (trail group) vs. placebo (control group) for RRTIs of children were collected during database establishment to Jan. 2018. After literature scanning and data extraction,the risk of bias of included trials were evaluated by using Cochrane 5.1.0 risk bias evaluation tool. Meta-analysis was performed by using Rev Man 5.3 software. RESULTS:A total of 13 RCTs involving 1 228 children were included. The results showed that the trial group was superior to control group in frequency of respiratory infection [MD＝－1.14,95%CI(－1.29,－0.99),P＜0.001],total response rate [RR＝9.47,95%CI(2.33,38.54),P＝0.002],the time of antibiotics use [MD＝－4.36,95%CI(－6.52,－2.21),P＜0.001], infection duration [MD＝－3.89,95%CI(－4.47,－3.04),P＜0.001],febrile time [MD＝－1.81,95%CI(－3.40,－0.22),P＝0.03],serum immunoglobulin (Ig)G level [MD＝1.25,95%CI(0.13,2.37)),P＝0.03],IgA level [MD＝0.77,95%CI(0.07, 1.46),P＝0.03] and the level of T cell subgroup CD4+[MD＝1.33,95%CI(0.90,1.76),P＜0.001] and CD8+[MD＝0.64,95%CI (0.24,1.04),P＝0.002],there was statistical significance. Trail group was similar to control group in respect of cough time [MD＝－6.00,95%CI(－13.86,1.86),P＝0.13] and IgM level [MD＝－0.10,95%CI(－0.32,0.12),P＝0.39] and the incidence of ADR [RR＝0.76,95%CI(0.43,1.35),P＝0.35]. CONCLUSIONS:The current evidence shows that Broncho-Vaxom could effectively prevent the RRTIs of children with good safety.
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Objective To observe the effect of leflunomide and cyclophosphamide combined with prednisone in the treatment of idiopathic membranous nephropathy .Methods 30 patients with idiopathic membranous nephropa-thy were randomly divided into two groups ,15 cases in each group .A group was treated by leflunomide combined with prednisone , B group was treated by cyclophosphamide combined with prednisone , 6 months a course .The clinical effect,24h urine protein quantity,serum albumin levels,blood fat,renal functions and adverse reactions were com-pared.Results 3,6 months after treatment ,the remission rates in A group were 60.00%,73.33%,those in B group were 53.33%,66.67%(χ2 =0.965,0.896,all P>0.05).After treatment,24h urine protein quantity,serum albu-min levels in the two groups [A group:(1.33 ±1.25)g/24h,(38.24 ±4.84)g/L;B group:(1.42 ±1.37)g/24h, (37.12 ±5.43)g/L] were significantly lower than those before treatment [A group:(7.34 ±2.75)g/24h,(20.31 ± 7.33)g/L;B group:(7.22 ±2.84)g/24h,(20.46 ±7.73)g/L] (A group:t=6.232,5.734,all P0.05).There were no significant differences in above indicators between A group and B group after treatment (all P>0.05).The incidence rate of adverse reactions in A group (13.33%) was significantly lower than that in B group(40.00%)(χ2 =4.246,P<0.05).Conclusion The clinical efficacy of leflunomide is similar to cyclophosphamide in treating idiopathic membranous nephropathy with fewer adverse reactions .
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OBJECTIVE:To observe the safety and efficacy of second-generation recombinant factor Ⅷ (Kogenate FS) for treatment of patients with hemophilia A in China. METHODS: 16 patients with hemophilia A were treated with Kogenate FS. The factor Ⅷ antibodies and factorⅧ activities (FⅧ∶ C) were determined before and after the treatment. RESULTS: In the treatment of Kogenate FS for 16 patients with hemophilia A,15 (93.75%) recovered and 1 (6.25%) improved,and irreversible adverse drug reaction was seen in only 1 case. CONCLUSION: The second-generation recombinant factor Ⅷ product (Kogenate FS) was safe,efficacious and well-tolerated for patients with hemophilia A in China.