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Objective:To observe the effect of noninvasive positive pressure ventilation (NIPPV) and high-flow nasal cannula oxygen therapy (HFNC) on the prognosis of patients with coronavirus disease 2019 (COVID-19) accompanied with acute respiratory distress syndrome (ARDS).Methods:A retrospective study was conducted in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology when authors worked as medical team members for treating COVID-19. COVID-19 patients with pulse oxygen saturation/fraction of inspiration oxygen (SpO 2/FiO 2, S/F) ratio < 235, managed by medical teams [using S/F ratio instead of oxygenation index (PaO 2/FiO 2) to diagnose ARDS] from February to April 2020 were included. The patients were divided into NIPPV group and HFNC group according to their oxygen therapy modes. Clinical data of patients were collected, including general characteristics, respiratory rate (RR), fraction of FiO 2, SpO 2, heart rate (HR), mean arterial pressure (MAP), S/F ratio in the first 72 hours, lymphocyte count (LYM), percentage of lymphocyte (LYM%) and white blood cell count (WBC) at admission and discharge or death, the duration of dyspnea before NIPPV and HFNC, and the length from onset to admission. The differences of intubation rate, all-cause mortality, S/F ratio and RR were analyzed, and single factor analysis and generalized estimation equation (GEE) were used to analyze the risk factors affecting S/F ratio. Results:Among the 41 patients, the proportion of males was high (68.3%, 28 cases), the median age was 68 (58-74) years old, 28 cases had complications (68.3%), and 34 cases had multiple organ dysfunction syndrome (MODS, 82.9%). Compared with HFNC group, the proportion of complications in NIPPV group was higher [87.5% (21/24) vs. 41.2% (7/17), P < 0.05], and the value of LYM% was lower [5.3% (3.4%-7.8%) vs. 10.0% (3.9%-19.7%), P < 0.05], the need of blood purification was also significantly lower [0% (0/24) vs. 29.4% (5/17), P < 0.05]. The S/F ratio of NIPPV group gradually increased after 2 hours treatment and RR gradually decreased with over time, S/F ratio decreased and RR increased in HFNC group compared with baseline, but there was no significant difference in S/F ratio between the two groups at each time point. RR in NIPPV group was significantly higher than that in HFNC group after 2 hours treatment [time/min: 30 (27-33) vs. 24 (21-27), P < 0.05]. There was no significant difference in rate need intubation and hospital mortality between NIPPV group and HFNC group [66.7% (16/24) vs. 70.6% (12/17), 58.3% (14/24) vs. 52.9% (9/17), both P > 0.05]. Analysis of the factors affecting the S/Fratio in the course of oxygen therapy showed that the oxygen therapy mode and the course of illness at admission were the factors affecting the S/F ratio of patients [ β values were -15.827, 1.202, 95% confidence interval (95% CI) were -29.102 to -2.552 and 0.247-2.156, P values were 0.019 and 0.014, respectively]. Conclusion:Compared with HFNC, NIPPV doesn't significantly reduce the intubation rate and mortality of patients with COVID-19 accompanied with ARDS, but it significantly increases the S/F ratio of those patients.
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Objective To explore the application value of sensitive index of nursing quality in nursing management of patients with cancer pain.Methods One hundred and eight patients with cancer pain in the First Affiliated Hospital of Xinxiang Medical University from February 2014 to March 2015 were selected as the control group;one hundred and eight patients with cancer pain in the First Affiliated Hospital of Xinxiang Medical University from April 2015 to June 2016 were selected as the study group.The traditional cancer pain nursing quality evaluation criterion was taken in the control group,and the improved cancer pain nursing quality evaluation criterion was taken in the study group to evaluate the nursing quality.The accuracy of pain assessment,awareness rate of cancer pain knowledge,degree of satisfaction to the nursing work were compared between the two groups.Results The accuracy of pain assessment of patients in the study group (90.7％,98/108)was significandy higher than that in the control group (45.4％,49/108) (x2 =51.16,P ＜ 0.05);the awareness rate of cancer pain knowledge of patients (98.1％,106/108) in the study group was significantly higher than that in the control group (72.2％,78/108) (x2 =28.83,P ＜ 0.05);the satisfaction rate of the patients in the study group (100.0％,108/108) was significantly higher than that in the control group (85.2％,92/108) (x2 =17.38,P ＜ 0.05).Conclusion The overall quality of cancer pain care can be improved by strengthening the quality evaluation of the pain assessment accuracy and the awareness rate of cancer pain knowledge in patients with cancer pain.
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Objective To explore the effects of aerobic exercise and resistance training on center arterial blood pressure.Methods Fifteen healthy men who had not practiced aerobic exercise or resistance training within the previous 6 months were enrolled in this study.A self-matched pairs design was adopted.All of the subjects performed moderate intensity aerobic exercise,for 30 min initially,and after 2 weeks,performed resistance training at 60％ of their l-repeat maximum effort (1-RM).Their central aortic systolic blood pressure (CSBP) before and after aerobic exercise and resistance training were measured and compared,respectively.The changes in CSBP and an augmentation index (AI) of radial artery and relative blood pressure were compared between the two interventions.Results CSBP decreased significantly after both sorts of training.The two types of training showed no significant difference in their effects on CSBP.However,after a 20 min recovery,systolic blood pressure and pulse pressure were significantly lower after aerobic exercise than after resistance training.The significant difference persisted after 20 min and 40 min of re-covery.The AI of the radial artery was also significantly lower 5 min after aerobic exercise than after resistance train-ing.Conclusions After moderate aerobic exercise and resistance training,CBSP,AI and systolic pressure all display favorable changes.However,moderate intensity aerobic exercise provides the better effect in improving blood pressure.