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Objective:To explore the early application effect of the bedside sitting respiratory training in patients with respiratory failure and noninvasive positive pressure ventilation of the acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 102 patients with respiratory failure and noninvasive positive pressure ventilation of the AECOPD treated in Shanghai Public Health Clinical Center from June 2018 to December 2019 were selected and divided into the control group and the research group by random digits table method with 51 cases in each group. The control group was given the conventional treatment and nursing measures; and the research group was given the bedside sitting respiratory training. Pulmonary functional and blood -gas analysis parameters, clinical outcome of patients, etc. before and after the intervention between the two groups were compared. Results:After the intervention, the forced expiratory volume in one second (FEV 1), forced vital capacity(FVC), FEV 1/FVC were (1.79±0.22) L, (3.09±0.28) L, (62.16±5.94)% in the research group, and (1.43±0.18) L, (2.66±0.23) L, (53.48±5.31)% in the control group, the differences were statistically significant(t values were 8.36, 8.00, 7.19, P<0.01). Arterial partial pressure of carbon dioxide (PaCO 2) and arterial partial pressure of oxygen (PaO 2) in blood gas analysis were (51.14±3.79) mmHg(1 mmHg=0.133 kPa), (71.07±5.49) mmHg in the research group, and (57.52±3.86) mmHg, (65.62±5.27) mmHg in the control group, the differences were statistically significant ( t values were -7.78, 4.72, P<0.01). The non-invasive positive pressure ventilation time, hospital stays were (7.41±1.76) d, (11.27±2.41) d in the research group, and (9.79±2.11) d, (15.46±3.12) d in the control group, the differences were statistically significant ( t values were -5.71, -6.70, P<0.01). The incidence of adverse events was 3 cases in the research group, 1 case in the control group, the difference was no statistically significant ( P>0.05). Conclusions:The application of the bedside sitting respiratory training in patients with respiratory failure and noninvasive positive pressure ventilation of the AECOPD can effectively improve the pulmonary physiological function, shorten the noninvasive positive pressure ventilation time and hospitalization time, which has clinical application value.
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Objective:To explore the risk factors related to hospitalization events in out patients on hemodialysis and to evaluate the effect of serum retinol-binding protein (RBP) level on hospitalization events in patients on hemodialysis.Methods:Case-control study. A total of 80 patients on dialysis were recruited, including 47 men (58.8%) and 33 women (41.2%), with an average age of (60.9±11.7) years (range: 32-89 years) and a median dialysis age of 43.6 months. Dialysis-related data were collected, the serum RBP level was detected using the ELISA method. Patients were followed-up until June 30, 2019, to record the events associated with all kinds of hospitalization events. The t-test, Mann-Whitney U test and chi-square test were used to compare the differences between the hospitalized event group and the non-event group. Multivariate logistic regression was used to analyze the related risk factors of hospitalization events. The Kaplan-Meier method, Log-rank test, and Cox proportional hazards regression model were used to analyze survival data. Results:During the 19-month follow-up period, 26/80 patients (32.5%) had 67 events of hospitalization. There was no difference ( P>0.05) in age, sex composition, dialysis age, ratio of diabetes/hypertension, interval dialysis weight gain (IDWG), systolic/diastolic blood pressure before dialysis, kt/v and URR between the groups with or without hospitalization events. The cut-off point of serum RBP was calculated using the patient′s highest Youden index. The patients were divided into the high-RBP group ( n=44) and low-RBP group ( n=36) according to the level of 165.34 mg/L. The incidence of hospitalization events in the high-RBP group was higher than that in the low-RBP group (45.45%>16.67%, P=0.006). Using the multivariate logistic regression model, after adjusting for sex, age, albumin and total cholesterol (CHO), only the serum RBP level was independently correlated with hospitalization events. The high-RBP group had an odds ratio ( OR) of 3.64 (95 %CI, 1.14-11.58; P=0.029) compared with the low-level group in hospitalization events. The Kaplan-Meier survival analysis showed that the incidence of hospitalization events in the high-RBP group was significantly higher than that in the low-RBP group ( P=0.0058). The test results of the multivariable Cox proportional hazards regression model showed that for patients on hemodialysis, an elevated serum RBP level is an independent risk factor for hospitalization events. Conclusion:Elevated serum RBP level is correlated with hospitalization events in patients on hemodialysis. RBP is an independent risk factor for hospitalization events in outpatients on hemodialysis.
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Objective To statistically analyze clinical research literature on acupuncture treatment of gouty arthritis, explore regularities in its point selection and provide a basis for clinical point selection and reasonable point combination.Method Gouty arthritis, acupuncture, warm needling moxibustion, electroacupuncrue and fire needling were used as key words. January 1990 to May 2014 China HowNet (CNKI) full-text database and Wanfang academic periodical full-text database were searched to retrieve, sort out and analyze clinical literature on acupuncture treatment of gouty arthritis at home and abroad. Acupoints included in the literature were sorted out. Statistical analysis was made of the categories, meridians, use frequencies and positions of selected acupoints.Result One hundred and thirty-five articles with a total of 120 acupoints were included. From the analysis of point selection, the acupoints most frequently used to treat gouty arthritis were, arranged in order, Taichong (91), Sanyinjiao (87), Zusanli (80), Yinlingquan (58), Quchi (52), Taixi (51), Yanglingquan (45), Xuehai (44), Taibai (44) and Hegu (44). From the analysis of pertaining meridians, the meridians of more frequently used acupoints were the spleen meridian of foot-taiyin (323), the stomach meridian of foot-yangming (209), the large intestine of hand-yangming (143), the liver meridian of foot-jueyin (140), the gallbladder meridian of foot-shaoyang (134), the kidney meridian of foot-shaoyin (84) and the bladder meridian of foot-taiyang (80). From the analysis of point selection from different places, the part where acupoints were most distributed was the lower limb.Conclusion For acupuncture treatment of gouty arthritis, local and along-meridian point selections are main ones, selected points are relatively scattered and often located in the lower limb, and point selection is partly combined with syndrome differentiation, which provide a clinical reference.
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Thirty-two articles from January 2000 to December 2014,with ankylosing spondylitis treated by acupuncture,moxibustion and medicines(Chinese medicine or western medicine) and statistically significant and effective results,were collected through Chinese National Knowledge Infrastructure(CNKI),WANFANG and VIP databases. It is concluded that there are various methods except medicines treating ankylosing spondylitis,including acupuncture,acupuncture combined with moxibustion,warm acupuncture,electroacupuncture,apitherapy,fire needle therapy,etc. Further studies are needed to be implemented so as to promote the combination therapy of acupuncture and medicine for ankylosing spondylitis,such as the standard cases of the combination therapy and mechanism.
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Objective To study the rule with the treatment based on the pattern differentiation of systemic lupus erythematosus, by analyzing the literature of traditional Chinese medicine for the treatment of systemic lupus erythematosus from January 1999 to July 2014 included in China National Knowledge Infrastructure(CNKI) and summarizing the frequency of TCM pattern and medicine.Methods The frequency statistics and classified analysis were used to describe the patterns and medicines.Results There were 14 patterns, the common patterns are pyretic toxicity with 23(15.13%), deficiency of both qi and yin with 21(13.82%), qi and blood stasis with 20(13.16%). The disease was involved with liver, spleen and kidney. Pattern factors were mainly sthenia factors, accounting for 65.30% of the total, including hot, blood stasis, toxin, damp-heat, qi stagnation, phlegm; asthenia factors were accounted for 34.70% of the total, including deficiency of yin, deficiency of qi, deficiency of yang and deficiency of blood. There were 201 medicines included, the total frequency was 1 669, which could be into 17 categories. The top three were heat-clearing, tonic and stasis-dissolving medicines. Medicine tropisms are mainly lung tropism, stomach tropism, liver tropism, heart tropism, spleen tropism and kidney tropism, accounting for 88.12% of the total.Conclusions Pyretic toxicity is responsible for the sthenia factors of systemic lupus erythematosus, and deficiency of qi and yin is the main responsibility for asthenia factors, treatment should pay attention to both sthenia and asthenia factors.