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Objective:To analyse the clinical characteristics and antiviral therapy in immunosuppressed hospitalized patients with influenza.Methods:The clinical data of 273 patients with positive influenza A or B virus nucleic acid admitted in Peking University People’s Hospital from November 2015 to March 2022 were retrospectively analyzed. Among them, 123 were immunosuppressed and 150 were non-immunosuppressed. The clinical characteristics and antiviral therapy in immunosuppressed patients with influenza were analyzed. SPSS 22.0 software was used to analyze the data.Results:Chemotherapy for malignancies was the most common cause of immunosuppression (61.8%, 76/123), followed by haemopoietic stem cell transplantation (24.4%, 30/123). The common symptoms were fever (93.5%, 115/123) and cough (41.5%, 51/123). The proportions of co-infections (22.8%, 28/123) and complications (43.9%, 54/123) in immunosuppressed hospitalized patients were higher than those in non-immunosuppressed patients ( χ2=9.365 and 7.496, both P<0.01). Compared with single drug therapy, combination of antiviral drugs did not shorten the fever time, negative conversion time of virus nucleic acid and the length of hospital stay, and reduce the death ( U/ χ2=312.5, 356.0, 749.5 and 0.185, all P>0.05). Compared to patients without corticosteroids use, the use of corticosteroids did not increase mortality in immunosuppressed patients ( χ2=2.508, P=0.113). Conclusions:Classical symptoms may be absent in immunosuppressed patients with influenza, and early detection of influenza virus is still an important means of early diagnosis. Co-infections and complications are more common in immunosuppressed influenza patients. Immunosuppressed influenza patients did not benefit from the combination of antiviral therapy.
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Objective@#To understand the changes of students nutritional status in the National Nutrition Improvement Program for Rural Compulsory Education Students (NNIPRCES) of Henan Province, and to provide scientific basis for designating scientific nutritional intervention measures.@*Methods@#About 20%-30% of primary schools and middle schools in the pilot counties in Henan Province were selected to monitor the nutritional status of students. Surveillance data from 2012 to 2019 were analyzed.@*Results@#From 2012 to 2019(no surveillance data were available in 2018), the detection rates of mild thinness were 4.0%, 3.3%, 3.3%, 3.6%, 3.1%, 2.9%, 4.4%, respectively; the detection rates of moderate and severe thinness were 4.5%, 4.5%, 4.4%, 4.6%, 3.9%, 3.6%, 5.1%, respectively; the detection rates of overweight were 9.6%, 12.4%, 12.3%, 12.2%, 12.7%, 13.4%, 11.1%, respectively; and the detection rates of obesity were 3.9%, 6.8%, 6.7%, 6.2%, 7.6%, 7.2%, 5.8%, respectively. The differences were statistically significant (χ 2=1 032.29, 4 771.39, P<0.05). The detection rates of 2019 mild (5.0%, 3.7%) and moderate to severe thinness (5.9%, 4.3%) were the highest for both male and female students, and the highest for primary school students and junior middle school students were the highest for 2019 mild (4.1%, 6.0%) and moderate to severe thinness (5.1%, 4.9%), with statistical significance (χ 2=653.22, 486.46, 919.07, 306.27, P<0.05). The detection rate of overweight was the highest in both males and females (14.8%, 11.8%) in 2017, and the detection rate of obesity was the highest in 2016 (8.3%, 6.9%). The detection rates of overweight and obesity in primary school students were the highest in 2017 and 2016 (13.7%, 8.4%), and the detection rates in middle school students were the highest in 2017 (11.5%, 3.0%), with statistical significance (χ 2=2 391.65, 2 371.74, 4 827.75, 512.64, P<0.05).@*Conclusion@#In the early stage of the implementation of NNIPRCES in Henan Province, malnutrition among students has improved, however, the contem porary malnutrition shows increasing trend, and the co occurrence of malnutrition and obesity calls for targeted nutritional intervention measures.
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Objective To develop a scale for measuring CHD patients' health belief and to rectify its reliability and validity.Methods The primary items were obtained through reviewing literature and semi-structured interviewing with CHD patients.After team discussion and experts evaluation,the pretesting scale was developed.Two hundred and sixty subjects were recruited in the first study to finish the questionnaire by convenience sampling.The reliability and validity of this scale were tested by exploratory factor analysis,reliability analysis and correlation analysis.Results It was found that eight common factors extracted by exploratory factor analysis.Factor loading of each item ranged between 0.489 and 0.850.The 8 factors explained for 60.698％ of total variance.The correlations between the subscales and the total scale were ranging from 0.811 to 0.876.The correlations between the subscales of the scale were ranging from 0.330 to 0.732.The Cronbach's α coefficients of the total scale was 0.802,and the subscales Cronbach's α coefficients were ranging from 0.684 to 0.834.Test-retest reliability was 0.880,and that of subscales were 0.673～0.841.Conclusions The newly developed coronary artery disease health belief scale has showed acceptable reliability and validity,which can be used as a useful tool for the assessment and intervention of patients' health belief.
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Objective To explore the effect of auricular-plaster therapy combined with aromatherapy on anxiety and quality of life in patients with colorectal surgery.Methods A total of 135 patients with colorectal surgery were randomly divided into group A (auricular-plaster therapy combined with aromatherapy),group B(auricular-plaster therapy),group C (aromatherapy),group D(blank).Anxiety and life quality levels of four groups were determined by using self-rating anxiety scale(SAS),quality of life instruments for cancer patients (QLICP-CR)and were compared between four groups before and after intervention.Results The SAS and QLICP-CR scores of group A were lower than those of group B,group C and group D after intervention.The SAS and QLICP-CR scores of group B and group C were lower than that of group D after intervention.There were no statistical significant differences in SAS and QLICP-CR scores between group B and group C after intervention.Conclusions Auricular-plaster therapy combined with aromatherapy can effectively alleviate anxiety of patients with colorectal surgery and improve their quality of life,and the effect is better than that of auricular-plaster therapy and aromatherapy.
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Objective To observe the ZEEK thrombus aspiration catheter use on the level of vascular and myocardial perfusion in acute ST-segment elevation myocardial infarction (STEMI) patients,as well as the impact of early prognosis in order to clear the relative best use of ZEEK thrombus aspiration catheter.Methods Eighty-eight acute STEMI patients who underwent percutaneous coronary intervention (PCI),according to the direct use of ZEEK thrombus aspiration catheter or after pre-expansion with small balloon,divided into direct aspiration group 45 cases,and inflation pre-aspiration group 43 cases.All patients underwent stenting,observed the perfusion of the vascular and myocardial levels after stenting,after 1 month,determined N end of B type natriuretic peptide (NT-proBNP) level,observed segmental wall motion score index (WMSI) and left ventricular ejection fractions (LVEF).Results Direct aspiration group was significantly better than inflation pre-aspiration group in the TIMI frames count,rate of TIMI coronary myocardial perfusion grade 2-3 grade and after 2 h ST segment resolution ＞ 50％ rate [(31.3 ± 7.9) frames vs.(42.5 ± 8.5) frames,84.4％(38/45) vs.72.1％(31/43),86.7％(39/45) vs.74.4％(32/43),P＜0.01 or ＜ 0.05].After 1 month,direct aspiration group was significantly lower than inflation pre-aspiration group in the peak of creatine kinase isozyme MB,NT-proBNP and WMSI [(2141.3 ± 306.5)U/L vs.(2734.5 ± 366.1)U/L,(443.2 ± 226.4) ng/L vs.(512.9 ± 281.7) nig/L,1.32 ± 0.16 vs.1.59 ± 0.23,P ＜ 0.05],but there was no significant difference in LVEF between two groups (P ＞ 0.05).Conclusions Repeated aspiration to infarction responsibility lesion segments using ZEEK thrombus aspiration catheter,and direct stenting,which is superior to the thrombus aspiration and stenting placement after single or multiple pre-expansion.
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Objective To describe the interpositional omentum and demonstrate its clinical significance.MethodsCT and clinical data of the cases whose suprahepatic gaps widen were reviewed and the contrast of CT was adjusted to observe further.ResultsIn 1 916 cases with upper abdominal CT data,suprahepatic gap was widen in all 152 cases,and 119 cases showed fat density(6.21％ ).There were 3 cases of trauma and 3 cases of acute abdomen in the 119 cases CT in the 119 cases displayed free gas under diaphragma,but displayed fat density after contrast adjusted.There were 11 cases undergoing operations,1 for sigmoid rupture 4 liver cirrhosis and portal hypertension,3 gastric cancer,and 1 acute cholecystitis,1 bile duct carcinoma and Ⅰ case congenital cystic dilatation of common bile duct.The other 108 cases did not undergo surgical operation.ConclusionsInterpositional omentum is a clinical phenomenon that the omentum was shift in suprahepatic gap covering the liver surface.It is not rarely,the incidence rate being 6.21％ ( 119/1 916) in our study.The occurrence mechanism may be similar to that of Chilaiditi syndrome.It is difficult to differentiate interpositional omentum from free gas under diaphragms on CT plain scan picture,but it is easy after contrast adjusted of CT.Free gas under diaphragma should not be identify incorrecdied and patients should not undergo unnecessary surgical procedure.
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Objective Through analyzing the causes of iodine contrast agent extravasation,nursing managers develop effective solutions timely and take appropriate precautionary measures to ensure the safety of patients effectively.Methods 600 patients undergoing CT contrast enhanced scan were selected,300 patients from May 2009 to April 2010 were set as the control group and were given routine nursing care,300 patients from May 2010 to April 2011 were set as the study group and they adopted effective preventive measures.The incidence of adverse events after injection of iodine contrast agent between the two groups was compared.Results The incidence of iodine contrast medium extravasation in the study group was significantly reduced to 2％ after taking a series of preventive measures,which was lower than 10％ of the control group.Conclusions Taking a series of preventive measures can reduce the incidence of adverse events of iodine contrast agent extravasation,ensure the safety of patients,decrease the frequency of nursing complaints and nursing deficiencies,as well as improve the quality of nursing service.
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Objective To study the effects of acute hypervolemic hemodilution (AHH) with hydroxyethly starch 130/0.4 on function of blood clotting in patients undergoing spinal operation. Methods Thirty patients scheduled for spinal operation were randomly divided into AHH group and control group with 15 cases each. Patients in AHH group were performed AHH by transfusing hydroxyethly starch 130/0.4 (15 ml/kg) with 25 ml/min before skin incision, to achieve expansion of 20% to 30%. Patients in control group were transfused routinely. Blood samples were taken from internal jugular vein before anesthesia induction (T0), at 1 h after anesthesia induction (T1) and termination of operation (T2) for determination of hemoglobin (Hb), hematocrit (Hct), platelet (Plt), prothrombin time(PT), partial thromboplastin time ( APTT), thrombin time( TT) and fibrinogen( FIB), at the same time heart rate( HR), mean arterial pressure (MAP) and central venous pressure (CVP) were observed and recorded. Results HR and MAP in both groups had no statistical difference within or between groups (P > 0.05). CVP at T1 and T2 in AHH group [(11.8 ± 1.0,(11.3 ± 1.0) cm H2O (1 cm H2O = 0.098 kPa)]were higher than that at T0 [(6.3 ±0.7) cm H2O]and that in control group ( P < 0.05). Hb and Hct at T1 and T2 in AHH group were lower than that at T0 and that in control group (P< 0.05). Plt and FIB at T1 and T2 in AHH group decreased significantly than that at T0(P<0.05), while there were no statistical difference between two groups(P> 0.05). PT, TT and APTT in both groups had no statistical difference within or between groups (P > 0.05). Conclusion AHH with hydroxyethly starch 130/0.4 has no significant effect on function of blood clotting in patients undergoing spinal operation.