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Objective@#To investigate the burden of caregivers of elderly patients with chronic diseases and its influencing factors, so as to provide the evidence for reducing the burden of caregivers.@* Methods@#The caregivers of patients with chronic diseases at ages of 65 years and older were selected using convenience sampling method from Jinqiu Hospital during 2020 and 2021. The burden of caregivers was estimated using Chinese version of Caregiver Burden Scale (CBI), the basic information of patients and caregivers was collected, and the influencing factors of caregivers' burden were identified using multivariable linear regression analysis.@*Results@#Totally 276 questionnaires were distributed, and 261 were valid, with an effective rate of 94.57%. There were 48 men (18.39%) and 213 women (81.16%), 166 (63.60%) subjects aged 45 to 59 years and 354 (82.38%) subjects participating in training on COVID-19 prevention. The mean score of caregivers' burden was 26.27±14.93, and the mean scores of social burden and emotional burden were 11.08±5.23 and 7.81±6.24, respectively. The patients with chronic diseases included 183 men (70.11%), had a mean age of (89.97±8.26) years, had a mean score of activities of daily living of 20.00 (interquartile range, 50.00) and had a mean geriatric syndrome number of 4.10±1.57. Multivariable linear regression analysis identified caregivers' participating in training on COVID-19 prevention (β'=0.175), patients' activities of daily living (β'=-0.144), patients' geriatric syndrome number (β'=0.138) and patients' age (β'=0.162) as factors affecting the burden of caregivers.@*Conclusions@#The social and mental burden of the caregivers of elderly patients with chronic diseases is heavy, and patients' activities of daily living, number of geriatric syndromes and age, as well as caregivers' training on COVID-19 prevention may be associated.
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OBJECTIVE:To investigate the effects of intra-articular injection of tranexamic acid on joint swelling,pain and recovery of joint function in patients with simple meniscus injury. METHODS:A total of 62 patients with simple meniscus injury receiving arthroscopic surgery of the knee in orthopedics department of Chongqing people's hospital during Oct. 2016-Apr. 2017 were selected and divided into control group and observation group according to random table,with 31 cases in each group. Both groups received meniscus excision or trimming under knee arthroscopy. Control group was given intra-articular injection of 0.9%Sodium chloride injection 10 mL after wound suture. Observation group was given intra-articular injection of Tranexamic acid for injection 2.0 g added into 0.9% Sodium chloride injection 10 mL after wound suture. The drainage tube was not placed in all the patients,The tourniquet was loosened after the pressurized dressing of wound. Circumferential diameter of the knee and VAS scores of 2 groups were observed before surgery,1,3,5 and 7 d after surgery. Lysholm scores were observed before and one month after surgery. The occurrence of ADR was recorded. RESULTS:There was no statistical significance in circumferential diameter of the knee,VAS score or Lysholm score between 2 groups before surgery(P>0.05). 1,3,5 and 7 d after surgery,circumferential diameter of the knee in 2 groups was significantly bigger than before surgery,but the observation group was significantly smaller than the control group 1,3 d after surgery,with statistical significance(P<0.05). There was no statistical significance in circumferential diameter of the knee between 2 groups 5 and 7 d after surgery(P>0.05). VAS score of observation group 1,3 d after surgery and control group 1,3 and 5 d after surgery were significantly higher than before surgery,but the observation group was significantly lower than the control group 1,3,5 d after surgery,with statistical significance(P<0.05). There was no statistical significance in observation group 5,7 d after surgery and control group 7 d after surgery,compared to before surgery and 7 d after surgery(P>0.05).One month after surgery,Lysholm scores of 2 groups were significantly higher than before surgery,and the observation group was significantly higher than the control group,with statistical significance(P<0.05). No severe ADR was found in 2 groups during medication,and there also was not deep venous thrombosis after surgery. CONCLUSIONS:Intra-articular injection of tranexamic acid can effectively reduce the degree of early knee swelling after knee arthroplasty,relieve postoperative early pain.It promotes the recovery of knee function with good safety.
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Objective To investigate the risk factors of cognitive impairment in post-intensive care syndrome patient (PICS-CI).Methods A retrospective study was conducted. The patient who transferred from post-intensive care unit (ICU) to the general ward for more than 7 days, and with the age ≥ 18 years old in the First Affiliated Hospital of Jinzhou Medical University from October 2015 to November 2016 were enrolled. The gender, age, marital status, education, occupation, salary, economic income, smoking, alcohol drinking, previous of history, mechanical ventilation, the length of ICU stay, sedative and delirium, and initial diagnosis were recorded. According to mini-mental state examination (MMSE), the patients were divided into cognitive impairment (CI) group and non-CI group. Univariate analysis was performed to identify the risk factors of PICS-CI, and variables with statistical difference were selected to do multivariate binary logistic regression analysis for the confirmable independence risk factors.Results 104 of the 290 patients developed CI, and the incidence was 35.86%. Univariate analysis showed that the gender, age, education, financial situation, smoking, alcohol drinking, previous of history, mechanical ventilation, the length of ICU stay, sedative and delirium, and initial diagnosis were recorded of ICU were main predictors of PICS-CI patients. It was shown by multivariate binary logistic regression analysis that the age > 60 years old [odds ratio (OR) = 7.523, 95% confidence interval (95%CI) = 2.572-37.851,P = 0.001], mechanical ventilation (OR = 8.773, 95%CI = 2.588-36.344,P < 0.001), sedation (OR = 9.376, 95%CI = 2.661-42.011,P = 0.002), and delirium (OR = 13.201, 95%CI = 2.502-41.433, P < 0.001) were PICS-CI independence risk factors.Conclusions Nurse staffs should strength care and attention on ICU transferred out patients. In order to minimize PICS impairment, special precaution should be implemented according to different aspects.