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ObjectiveTo study the metabolism of chemical components from Citri Reticulatae Pericarpium（CRP）in different parts of rats by sequential metabolism and ultra performance liquid chromatography-high resolution mass spectrometry（UPLC-HRMS）. MethodSD male rats were employed as experimental subjects， and blood samples of intestinal metabolism and hepatic metabolism were prepared after administration of CRP ethanol extract by in situ intestinal perfusion， and comprehensive metabolic samples were collected after intragastric administration. UPLC-HRMS was used to analyze the samples with acetonitrile（A）-0.1% formic acid aqueous solution（B）as the mobile phase for gradient elution（0-10 min， 10%-30%A； 10-30 min， 30%-95%A； 30-31 min， 95%-10%A； 31-35 min， 10%A）at a flow rate of 0.35 mL·min-1， using a heated electrospray ionization with positive and negative ion mode scanning in the range of m/z 100-1 500. Under these conditions， the differences in the profiles of CRP ethanol extract， blank plasma and drug-containing plasma under different treatment groups were compared， and the chemical components of each sample were analyzed and identified based on the retention time， accurate relative molecular mass， primary and secondary ion fragments， and the information of reference substances. ResultA total of 44 chemical components were identified in the CRP ethanol extract， including flavone-O-glycosides， flavone-C-glycosides and polymethoxyflavonoids， etc. The results of sequential metabolism showed that 22 chemical components in CRP were detected in the intestinal metabolic sample， 18 chemical components were detected in the hepatic metabolic sample， and 9 identical chemical components（narirutin， hesperidin， meranzin， 5，7，8，3ʹ，4ʹ，5ʹ-hexamethoxy-flavone， isosinensetin， sinensetin， 3，5，6，7，8，3ʹ，4ʹ-heptamethoxyflavone， nobiletin and tangeretin）could be detected in all three metabolic samples， with a total of 22 compounds entering the blood in prototype form. ConclusionThe identified 21 components with well-defined structures entering the blood as prototypes may be potential active components of CRP， and differences in the components at different metabolic parts can provide an experimental basis for elucidating the in vivo biotransformation process of the metabolic components of CRP.
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Objective:To summarize the nursing experience of enteral nutritionin a patient with severe pneumonia who received extracorporeal membrane oxygenation combined with prone ventilation.Methods:A patient with severe pneumonia who underwent extracorporeal membrane oxygenation combined with prone ventilation from Xiangya Hospital of Central South University on November 8, 2020 was given individualized nutrition support program. The patient′s condition was evaluated, individual nutrition support plan was formulated, early nutrition was implemented, appropriate feeding route was selected, tolerance was evaluated during the implementation process, and enteral nutrition-related complications were nursing.Results:After careful treatment and nursing, the patient′s condition was improved and was transferred out of ICU for continued treatment.Conclusions:For this kind of patients with severe pneumonia who underwent extracorporeal membrane oxygenation combined with prone ventilation to choose the pyloric feeding to reduce aspiration. Early nourishing nutrition to protect the intestinal mucosa; ultrasonic monitoring of antral motility index was used to guide the implementation of enteral nutrition. Regular evaluation of feeding tolerance during nutrition implementation, the strategy and implementation of enteral nutrition were adjusted according to the intra-abdominal pressure combined with feeding tolerance, and the prevention and nursing of enteral nutrition complications were carried out at the same time.
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Objective:To evaluate the effect of aromatherapy on fatigue in maintenance hemodialysis patients.Methods:Searching related domestic and foreign databases from the establishment of the database to September 1st, 2020, included 6 randomized controlled trials of maintenance hemodialysis patients using aromatherapy to relieve fatigue, a total of 435 patients, including 213 in the experimental group and 222 in the control group example. StataMP 16.0 software was used for Meta-analysis.Results:The result of Meta-analysis was SMD=-0.94, 95% CI -1.71, -0.18, and the combined effect size of the two groups was compared, and the difference was statistically significant ( Z value was 2.42, P<0.05). Subgroup analysis using essential oil varieties as indicators showed that the lavender and citrus essential oil mixed group SMD=-1.89, 95% CI -3.22, -0.57, the combined effect size was statistically significant ( Z value was 2.80, P<0.05); The results of subgroup analysis using essential oil measurement as an indicator showed that the 2-drop group SMD=-1.65, 95% CI -2.65, -0.65, and the combined effect size was statistically significant ( Z value was 3.23, P<0.05); The results of subgroup analysis using intervention time as an indicator showed that the 8-week group SMD=-1.23, 95% CI -1.77, -0.70, and the combined effect size was statistically significant ( Z value was 4.51, P<0.05). Conclusions:Aromatherapy can effectively reduce the fatigue level of maintenance hemodialysis patients, and the positive effect of aromatherapy on fatigue is closely related to the type, dosage and intervention time of essential oils.
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Objective:To explore the quality of life and its influencing factors in patients with hyperthyroidism.Methods:From June 2017 to June 2019, patients with hyperthyroidism who were first diagnosed in the First Affiliated Hospital of Hainan Medical College were selected as the research objects, and the quality of life of the patients was assessed by the Chinese version of World Health Organization Quality of Life Brief Scale (WHOQOL-BREF). Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate the psychological status of the patients. Univariate analysis was used to compare the differences of general information (age, gender, course of disease, marital status, education level, occupation, monthly family income, family relationship, thyroid ophthalmopathy, laboratory examination, thyroid crisis, anxiety level, and depression level) among patients with different quality of life. Multivariate logistic regression analysis was used to analyze the related factors affecting the quality of life of patients with hyperthyroidism.Results:There were 120 patients, aged (45.42 ± 6.38) years old, including 42 males and 78 females. The WHOQOL-BREF score was (76.58 ± 10.42) points, ranging from 25 to 106 points. Among them, 49 cases (40.83%) had high scores (≥80 points) and 71 cases (59.17%) had low scores (<80 points). Univariate analysis showed that there were differences in the quality of life among different marital status, education level, monthly family income, family relationship, thyroid ophthalmopathy, FT 3, FT 4, anxiety level and depression level ( P < 0.05). Multivariate analysis showed that thyroid ophthalmopathy, divorce or widowhood, monthly family income < 2 000 yuan, family disharmony, depression or anxiety, abnormal FT 4 and FT 3 were the risk factors affecting the quality of life of patients with hyperthyroidism ( P < 0.05). Conclusion:The overall quality of life of patients with hyperthyroidism is low, especially those with thyroid ophthalmopathy, divorce or widowhood, monthly family income < 2 000 yuan, family disharmony, depression, anxiety, FT 4 or FT 3 abnormalities.
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Objective To formulate an evidence-based nursing scheme of a pin site nursing method to reduce the incidence of pin site infection among patients with bone pin surgery. Methods Under the principle of PICO, the issue was put forward aiming directly at patient′s clinical manifestations. By some database retrieval and evaluate the retrieval of literature evidence, the optimal evidence will be applied to the patients and the curative effect were observed. Results A total of 1 systematic review, 1 cohort study and 9 randomized controlled trials (RCTs) were included. According to the available evidence mentioned herein and patient′s conditions, they developed a new pin site nursing method and applied to patients. Seven days later, the two pin sites with infection symptoms obviously improved, with decreasing secretion, without skin redness and pain, and the temperature of skin was normal. The other six pin sites without infection did not occur infection. Conclusions The patients with pin sites using based iodine disinfection and sterile gauze strip winding better than the conventional alcohol drop pin site in reducing infection.