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Objective:To analyze the clinical efficacy of the Yuying powder combined with the Huanglian Shangqing pill for the treatment of subacute thyroiditis (SAT) with cervical anterior pain as the main complaint, as well as its impact on serum pain factors and oxidative stress levels in patients.Methods:A prospective selection of 100 SAT patients with anterior cervical pain as the main complaint admitted to the Hebei Provincial Hospital of Traditional Chinese Medicine from January 2020 to May 2022 was conducted. They were randomly divided into two groups, with 50 patients in each group. The control group was treated with sustained-release diclofenac sodium tablets, while the observation group was treated with external application of the Yuying powder and internal administration of the Huanglian Shangqing pill. After 2 weeks of continuous treatment, the analgesic efficacy and adverse drug reactions of both groups were observed. The analgesic onset time of two groups of anterior cervical pain was compared. Two simplified McGill pain questionnaires before and after treatment [the SF-MPQ scores, including Pain Rating Index (PRI), Visual Analog Scale (VAS), and Current Pain Intensity (PPI) ], were compared; the traditional Chinese Medicine Syndrome Score, Serum Pain Factors levels [ tumor necrosis factor (TNF)- α, interleukin-1 β(IL-1β), prostaglandin E 2 (PGE 2), and nitric oxide (NO) ] and oxidative stress indicators [the levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) ] were also compared. Results:The total effective rate of analgesia in the observation group [98.00%(49/50)] was significantly higher than that in the control group [82.00%(41/50)] ( P<0.05). The analgesic onset time in the observation group was significantly shorter than that in the control group ( P<0.05). After treatment, the scores of various components (PRI, VAS, PPI) and traditional Chinese medicine syndrome scores in the two groups of SF-MPQ were significantly reduced compared to before treatment (all P<0.05); and the decrease was more significant in the observation group (all P<0.05). After treatment, the serum levels of TNF -α, IL-1β, PGE 2, and NO in both groups significantly decreased compared to before treatment (all P<0.05), and the levels of serum pain inducing factors in the observation group were significantly lower than those in the control group (all P<0.05). After treatment, both groups showed a significant decrease in serum MDA content (all P<0.05), and a significant increase in serum SOD and GSH-Px levels (all P<0.05); And the improvement was more significant in the observation group (all P<0.05). The incidence of adverse reactions in the observation group [4.00%(2/50)] was lower than that in the control group [16.00%(8/50)] ( P<0.05). Conclusions:The overall efficacy of external application of Yuying powder combined with oral administration of Huanglian Shangqing pill in the treatment of SAT with cervical anterior pain as the main complaint is definite, and its effect may be related to significantly downregulating the expression level of serum related pain inducing factors in patients and reducing the level of oxidative stress in the body.
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Objective: To measure setup error of head and neck neoplasm in radiotherapy and discuss over effects of error on physical dose acting on target region and organs at risk of nasopharynx cancer [NPC] patients treated with intensity modulated radiation therapy [IMRT]
Methods: A total of 152 patients who developed head and neck neoplasm and received IMRT were randomly selected. Through comparing digital portal image and digital reconstruction image, we measured setup error, calculated expanding margin from clinical target volume [CTV] to planning target volume [PTV] and analyzed whether there was rules between setup error and treatment time. Additionally, 20 cases of NPC were selected. Three-dimensional error was simulated in planning system. Dose distribution was recalculated and a series of dose parameters of target volume and OAR were analyzed
Results: Setup error in left-right, head-feet and ventral-dorsal direction was [-0.62 +/- 1.46] mm, [-0.41 +/- 1.54] mm and [-0.31 +/- 1.67] mm respectively. Regarding limit value, the maximum and minimum value in left right direction, head-feet direction and ventral-dorsal direction was 2.70 mm and -6.00 mm; 3.00 mm and -5.00 mm, 5.00 mm and -7.50 mm. Expanding margin from CTV to PTV was 2.26 mm, 1.88 mm and 1.97 mm in left-right direction, head-feet direction and ventral-dorsal direction
Conclusion: During IMRT, only when setup error is controlled below 3 mm can sharply reduce the damage caused by radiation to normal tissue; therefore, quality security and control of electronic portal imaging device need [EPID] to be improved
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Objective To analyze characters and causes of medical safety (adverse) events and to propose corresponding countermeasures.Methods 322 medical safety events in some tertiary hospitals were analyzed by using the root causes analysis method.Results Identifying errors,medical defects,medicine mistakes were the top 3 events possessed 16.77％ (54/322),16.15％ (52/322),13.98％ (45/322);The top 3 departments were Neurology,General surgery,Oncology which possessed 9.63％ (31/322),7.45％ (24/322),7.14％ (23/322).Medical staff with a title of middle and highly were involved in possessed 33.23％ (107/322),25.78％ (83/322),and nursing staff was the top one possessed 56.83％ (183/322).Night working shift was the maximum occurrence time possessed 39.75％ (128/322).The top 3 medical acts which more easier to trigger medical adverse events were incomprehensive nursing care,irregular operation of diagnosis and treatment,clinical supervision defect which possessed 17.39％ (56/322),15.84％ (51/322),15.22％ (49/322).The slight consequence case was the top one possessed 47.20％ (152/322).Resolving the dispute by consultation between hospital and patient was the main way possessed 82.26％ (51/62).Conclusions More attentions should be paied to supervision of some certain department management and key sections,and improve the professional technical level,do preventive construction systems about medical safety (adverse) as well as emergency event handling construction mechanism by consummate supporting system and effective staff arrangement.
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Objective To discuss the clinical efficacy of Mepilex surgical dressing in prevention of pressure sore. Methods 46 patients with high risk factors and Norton grading lower than 10 point were divided into the experimental group and the control group with 23 patients in each group. The control group was given reduction of local pressure, protection of the skin, nutritional support and other conventional measures to prevent pressure sore. Besides conventional nursing measures, the experimental group was given Mepilex to cover the bone eminence place, replaced every 7～10 days. The occurrence and development of the pressure sore was observed on the second, fourth, sixth and eighth week after admission. Results The occurrence rate of the experimental group on the sixth week was 4.55%, and the control group was 26.09%,the difference had statistical significance. The cure rate of the two groups showed no difference on the eighth week. Conclusions Application of Mepilex to treat patients with high risk of pressure sore has good effect.
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Objective To explore the method of comfort nursing in patients with nasogastric feeding and observe the influence on enhancement of patients satisfaction degree. Methods Case control study Was used in 162 conscious patients with nasogastric feeding.80 patients from January 2005 to January 2006 were selected as control group and given routine nursing.82 patients from February 2006 to May 2007 were named as the test group and received confort nursing.The satisfaction degree of patients, injury of nasal mucosa, shedding rate of the gastric tube and aspiration rate were investigated with self-designed discomfort questionnaires. Results The satisfaction degree in the test group Was 63.41％,which was higher than that of the control(40.00％,P＜0.01).The rate of nasal mucosa injury, shedding of the gastric tube and aspiration rate were lower in the test group(1.22％,2.44％,1.22％)than those in the control group(8.75％,10.00％,7.50％,P＜0.05).Conclusion The application of comfort nursing in patients with nasogastric feeding contributed to the enhancement of satisfaction degree of patients and nursing quality.
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Objective To study the effect of serum contained Erzhi Tiangui Granule on the secretion function of ovarian granulosa cells from primary senile mice. Methods The serum with decoction from primary senile mice was added to cultured granulosa cells and incubated for 48 h. Then the concentration of estradiol (E2), progesterone (P) and inhibin B (INHB) in cultured medium were measured by chemiluminescence immunoassay (CLIA) and Sandwich ELISA respectively. Results The serum contained Erzhi Tiangui Granule could increase the secretion of E2, P and INHB. Conclusion Erzhi Tiangui Granule can improve the ovarian function of primary senile mice by regulating the secretion function of granulosa cells.