The impact of goal directed analgesia on mechanical ventilated patients′s outcomes in intensive care unit:a clinical observational study / 中华内科杂志

To investigate the impact of goal directed analgesia on the outcome of patients with mechanical ventilation in intensive care unit. A total of 126 patients who needed mechanical ventilation were recruited. With a method of before and after paired comparison, they were divided into two group:( 1 ) analgesia with empirical administration or control group; ( 2 ) goal directed analgesia based on critical-care pain observation tool (CPOT). Compared with the control group, after goal directed analgesia was applied, the consumption of midazolam significantly dropped from ( 368. 47 ± 27. 41 ) mg to ( 151. 27 ± 29. 31 ) mg (P<0. 05), whereas the consumption of dexmedetomidine significantly increased from ( 623. 62 ± 20. 91) μg to (812. 34 ± 22. 57) μg(P<0. 05). The median score of Richmond agitation-sedation scale increased from -3 to -1. The incidence of delirium significantly reduced from 23. 81% to 17. 46%( P<0. 05). The mean ventilator duration was significantly shortened from (168. 49 ± 11. 41) h to (142. 38 ± 13. 24) h(P<0. 05). ICU length of stay was significantly shortened from (23. 64 ± 9. 26) d to (19. 63 ± 8. 46) d ( P < 0. 05 ) . Due to the mild sedation, patients receiving goal directed analgesia report less delirium, less ventilation time and shorter ICU length of stay, suggesting that the general outcome is improved.

Change of coagulation function in patients with high altitude polycythemia / 国际检验医学杂志

Objective To investigate changes of coagulation function in patients with high altitude polycythemia (HAPC) .Meth‐ods Activated partial thromboplastin time (APTT) ,prothrombin time (PT) ,thrombin time (TT) and fibrinogen (Fbg) were de‐tected and compared between 69 patients with HAPC and 60 healthy subjects (controls) .Results Fbg ,APTT and TT levels in pa‐tients with HAPC were higher than controls (P0 .05) .Dynamic obser‐vation indicated that comprehensive therapy could these recover coagulation function .Conclusion Hemorrhage and coagulation process in patients with HAPC could be very complicated ,including physiological adaptation and the process of physiology evolving into pathology .

The research and strategy about the current situation about the analysis of cellular morphology in Tibet region / 国际检验医学杂志

Objective To understand the current situation and level of clinical laboratory about the analysis of cellular morphology in Tibet region .Methods Authors investigated the information about the staff of clinical laboratory testing the patient′s blood smear under microscope ,executing the rules and regulations by using standard questionnaires .Results Some of the clinical laboratory didn′t founded the rule and standardization of rechecking about abnormal blood routine (5/15 ,33 .3% ) .Some of the divi-sion leadership didn′t pay enough attention to the staff′s basic operation (2/15 ,13 .3% ) .Most of the staff didn′t being trained about cellular morphology in special purpose workshop (6/43 ,88 .8% ) .Some of the hospital didn′t carried out the chemistry stai-ning about blood cells(10/15 ,66 .7% ) .Conclusion It′s important to promote the quality and level about the analysis of cellular morphology in Tibet region .

The study on the relationship between multiple lacunar infarction and outcomes of mild Cognitive impairment / 中国神经精神疾病杂志

Objective To evaluate the impact of multiple lacunar infarction (MLI) on the outcomes of mild cognitive impairment (MCI). Methods MCI patients were selected in outpatients and hospitalized patients using a common international standard MCI screen. Magnetic resonance imaging (MRI) and computer tomography (CT) were used to determine the presence of MLI. MCI patients were followed up for 6～24 months and their cognitive status and the impact of MLI on MCI were evaluated using Kaplan-Meier survival analysis. Results One hundred twenty patients were diagnosed as having MCI based on clinical evaluation and neuropsychological assessment. Among them, 43 (35.8%) patients had MLI and the rest 77 (64.1%) patients did not have. Twenty-seven MCI patients with MLI (62.8%) developed dementia, while 15 MCI patients without MLI (19.4%) developed dementia during 6～24 months follow-up. Kaplan-Meier analysis indicated that the incidence of dementia was significantly higher in patients with MLI than in patients without MLI did (P＜0.05). Conclusions MCI patients with MLI are more prone to dementia. These results suggest that early interventions aimed at controlling the modifiable risks are warranted for dementia prevention in MCI patients with MLI.