Clinical observation on plum-blossom needle combined with rehabilitation training for hand spasm after stroke / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect difference between plum-blossom needle combined with rehabilitation training and conventional rehabilitation training for hand spasm after stroke.</p><p><b>METHODS</b>A total of 61 patients were randomly divided into a comprehensive treatment group (30 cases) and a rehabilitation training group (31 cases). In the rehabilitation training group, Bobath occupational therapy, OT training, and hand function training were adopted, once every day; on the basis of treatment in the rehabilitation group, plum-blossom needle was applied at the lung meridian of hand-, heart meridian of hand-, pericardium meridian of hand- in the comprehensive treatment group. The treatment was given once every two days, three weeks as one course in the two gnoups. After 3 courses of treatment, clinical efficacy evaluation was performed, and the modified Ashworth scale and Fugl-Meyer (FMA) motor function scores were assessed before and after treatment.</p><p><b>RESULTS</b>After treatment, the grade for Ashworth scale and FMA scores in the comprehensive treatment group and the rehabilitation trainning group were better than those before treatment (all <0.05), and the improvements in hand spasm and hand fuction in the comprehensive treatment group were superior apparently to those in the rehabilitation trainning group (both <0.05) The total effective rate of hand function was 93.3% (28/30) in the comprehensive treatment group, which was better than 74.2% (23/31) in the rehabilitation training group (<0.05).</p><p><b>CONCLUSION</b>Plum-blossom needle combined with rehabilitation training are more effective than simple rehabilitation training for hand spasm after stroke.</p>

Analysis of death risk factors for nosocomial infection patients in an ICU：a retrospective review of 864 patients from 2009 to 2015 / 中华危重病急救医学

Objective To investigate the mortality risk factors of nosocomial infection patients in intensive care unit (ICU), and to guide clinicians to take effective control measures. Methods A retrospectively cohort study was conducted. The relevant information of patients with nosocomial infection treated in ICU of Hengshui Harrison International Peace Hospital Affiliated to Hebei Medical University from June 2009 to December 2015 was analyzed. The patients who admitted to ICU again, with length of ICU stay less than 48 hours, without first etiology of screening within 48 hours of ICU admission, or without complete pathogenic information were excluded. The gender, age, diagnosis, length of ICU stay, invasive operation, nutritional status, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, distribution and drug resistance of the pathogens, and procalcitonin (PCT) levels at 7 days after nosocomial infection were recorded. The risk factors leading to death in patients with nosocomial infection were analyzed by logistic regression, and the receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of all risk factors on the outcome of patients with nosocomial infection. Results In 864 enrolled patients with male of 54.75% and mean age of (63.50±15.80) years, 732 (84.72%) patients survived and 132 (15.28%) died. Compared with survivors, the non-survivors had higher age (years: 65.47±15.32 vs. 58.15±13.27), incidence of urgent trachea intubation (32.58% vs. 22.81%), deep venous catheterization (83.33% vs. 63.25%), and multiple drug-resistant infection (65.91% vs. 33.20%), longer length of ICU stay (days: 13.56±4.29 vs. 10.29±4.32) and duration of coma (days: 7.36±2.46 vs. 5.48±2.14), lower albumin (g/L: 23.64±8.47 vs. 26.36±12.84), higher APACHEⅡ score (19.28±5.16 vs. 17.56±5.62), SOFA score (8.55±1.34 vs. 6.43±2.65), and PCT (μg/L: 3.06±1.36 vs. 2.53±0.87, all P 0.05). The low respiratory tract was the most common site of infection followed by urinary tract and bloodstream in both groups. It was shown by logistic regression analysis that prolonged ICU stay [odds ratio (OR) = 2.039, 95% confidence interval (95%CI) = 1.231-3.473, P = 0.002], APACHEⅡ score (OR = 1.683, 95%CI= 1.002-9.376, P = 0.000), SOFA score (OR = 2.060, 95%CI = 1.208 -14.309, P = 0.041), PCT (OR = 2.090, 95%CI = 1.706-13.098, P = 0.004), and multi-drug resistant pathogens infection (OR = 5.245, 95%CI = 2.213-35.098, P = 0.027) were independent risk factors for ICU mortality in patients with nosocomial infection. The area under ROC curve (AUC) of length of ICU stay, APACHEⅡ score, SOFA score, and PCT level for predicting death of nosocomial infection patients was 0.854, 0.738, 0.786, and 0.849, respectively, the best cut-off value was 16.50 days, 22.45, 6.37 and 3.38 μg/L, respectively, the sensitivity was 83.6%, 90.0%, 81.1%, and 89.6%, and the specificity was 70.3%, 75.6%, 71.3%, and 85.4%, respectively. Conclusions Prol onged ICU stay, nosocomial infection with secondary sepsis and multiple organ dysfunction syndrome were the leading causes of death for nosocomial infection patients in ICU. Prolonged ICU stay, APACHE Ⅱ score, SOFA score, and PCT level could effectively predict death risks for nosocomial infection patients.

Monitoring of antimicrobial resistance of Acinetobacter baumannii in the intensive care unit of a hospital from 2010 to 2013 / 中国感染控制杂志

Objective To analyze the isolation rates and antimicrobial resistance of Acinetobacter baumannii (AB) from intensive care unit (ICU)between 2010 and 2013,and provide evidence for clinical anti-infective therapy. Methods The isolation and antimicrobial resistance of AB from ICU between 2010 and 2013 were analyzed retro-spectively.Results A total of 1 413 pathogenic strains were isolated,556(39.35%)of which were AB,isolation rates in each year were 39.45%,41 .35%,29.44%,and 40.53% respectively.AB were mainly isolated from lower respiratory tract (75.72%).Antimicrobial susceptibility testing results showed that AB had low resistance rates to cefoperazone/sulbactam(5.85%)and amikacin (17.45%);detection rates of multidrug-resistant and extensively drug-resistant AB increased from 9.63% and 3.70% to 42.50% and 31 .88%,respectively (both P < 0.001 ). Conclusion AB is the common pathogen in ICU,antimicrobial resistance is serious,isolation of multidrug-resistant and extensively drug-resistant AB increased year by year;intensifying the monitoring of drug resistance is helpful for the treat-ment and prevention of AB infection.

Prevention of venous thromboembolism after primary intracerebral hemorrhage / 国际脑血管病杂志

Venous thromboembolism includes deep venous thrombosis and pulmonary embolism. It is a more common and preventable complication in neurology. The prevention of venous thromboembolism is an important component in the treatment of the patients with cerebral hemorrhage. The measures include mechanical prevention and drug prevention. The mechanical prevention measures include intermittent pneumatic compression devices and pressure gradient elastic stockings. Studies have suggested that anticoagulants also plays an important role in the prevention of venous thromboembolism. The comprehensive and systematic understanding of the prevention of venous thromboembolism wil help to guide the clinical therapy and improve the outcomes of patients after primary intracerebral hemorrhage.

Budesonide/Formoterol in the Management of Patients with Mild or Moderate Asthma: Clinical Research / 中国药房

OBJECTIVE: To evaluate the efficacy and the safety of low dose budesonide/formoterol combination therapy vs.medium dose of budesonide(BUD) dry powder in the management of mild or moderate adult asthma.METHODS: A total of 62 patients with asthma were randomized to Group A(budesonide plus formcterol) or Group B(budesonide).Main outcome measures: daytime symptom and nocturnal symptom,peak expiratory flow(PEF),number of times of using rapid-acting ? 2 agonist and its ADR.RESULTS: After treatment,both groups had significant improvement in daytime symptom and nocturnal symptom(number of times of wakeup),PEF value and lung function,and the dosage of rapid-acting ? 2 agonist was decreased,showing significant differences between the two groups.The ADR was light in degree.CONCLUSION: Inhalation therapy of low dose of glucocorticoid plus long-acting ? 2 agonist is an optimal choice in the management of asthma.The efficacy of glucocorticoid could be enhanced more by combination with low dose and long-acting ? 2 agonist than by simply increasing its own dose.

Intervention effect of tongfei mixture on nocturnal hypoxia in patients with chronic obstructive pulmonary disease / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the effect of tongfei mixture (TFM, a Chinese recipe mainly consisted of angelica and rehmannia root) on nocturnal hypoxia in patients with chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>Sixty patients with COPD of remission phase were randomly divided into 3 groups, 20 in each group. Group A was the control group; Group B, the group simply treated with oxygen; Group C, treated with oxygen and TFM. Changes of pulmonary function, diaphragm muscle mobility (DMM), 6 min walk distance (6MWD), morning arterial blood gas, nocturnal lowest oxygen saturation (LSaO2), mean blood oxygen saturation (MSaO2), the percentage of saturation lower than 90% time account for total sleeping time (SLT90%) and ultrasonocardiogram before and after treatment were observed.</p><p><b>RESULTS</b>Levels of LSaO2, MSaO2 and SLT90% in Groups B and C were significantly higher than those in Group A (P<0.05, P<0.01). The lowering of PaCO2 in Group C was more significant than that in Group B (P<0.05). The mPAP level in Group C was lower, FEV1, 6MWD and DMM were improved than those in Group A and B, showing significant difference (P<0.05).</p><p><b>CONCLUSION</b>Combined use of oxygen therapy and TFM could not only improve the nocturnal hypoxia, but also lower PaCO2. TFM is an important supplement of oxygen therapy.</p>