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Objective:To investigate the effect of botulinum toxin type A on children with odorihidrosis.Methods:From March 2017 to February 2021, 121 children with odorihidrosis, including 48 males and 73 females, aged 13 to 17 (15.9±1.2) years, were admitted to the Burn and Plastic Surgery Department of the 980 Hospital of PLA. There were 24 cases in mild group, 50 cases in moderate group and 47 cases in severe group. Botulinum toxin A was injected into 20-50 points on each side, and 1 U was injected into each point. The total amount of botulinum toxin A was 50-100 U on both sides.Results:Three groups of children were evaluated for efficacy, 24 cases of mild group was significantly effective in 23 cases, accounting for 95.8%. In the moderate group, 46 (92.0%) of 50 cases showed obvious effect. 49 cases (98.0%) were effective; In the severe group, 40 cases (85.1%) showed obvious effect and 45 cases (95.7%) were effective. Three groups of children with different efficacy had no statistical significance ( P>0.05). The significant efficiency in mild and moderate groups was higher than that in severe group, and the difference was statistically significant ( P<0.05). Conclusions:Botulinum toxin type A is effective in the treatment of children with mild and moderate bromhidrosis, and is worthy of clinical application.
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Anemia often occurs in patients undergoing cardiac surgery, which increases the incidence and related risks of blood transfusion together with surgical bleeding.Both anemia and transfusion were associated with poor prognosis and increased mortality.Current practice guidelines generally recommend the implementation of patient blood management (PBM), which relies on anemia management and restrictive transfusion to reduce perioperative blood loss and transfusion rate, and improve the prognosis of patients.This article reviews recent research progress of anemia management and blood transfusion in adult patients undergoing cardiac surgery, in order to provide basis for the practice of PBM in cardiac surgery patients in the future.
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Intraoperative blood salvage (IBS) is a life support technology that uses a series of artificial devices to treat the recycled blood during surgery, which then is transfused back into the patients. Currently, it′s the key method for perioperative blood protection. With the continuous development of science and technology as well as the deepening of researches, it has been realized that the damage of autologous blood recycling to red blood cells can not be ignored. This paper reviews the current progress of IBS researches and their effects on RBC.
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Objective:To understand the current status of nurses' awareness and needs for the Employee Assistance Program (EAP), as to provide basis for the hospital to formulate EAP.Methods:Using the purpose sampling method, 352 ICU nurses from the Nanjing Drum Tower Hospital Affiliated of Nanjing University Medical School were selected as the research subjects from December 2019 to January 2020. Finally, 350 valid questionnaires were obtained. Use the EAP demand questionnaire to investigate the ICU nurses' awareness and demand for EAP.Results:Among the 350 nurses in the intensive unit, 214 cases (61.14%) had never understood EAP, only 8 (2.29%) had understood and experienced the EAP, and 332 cases (94.86%) believed that the hospital′s implementation of EAP was a benefit provided to nurses. The top two service requirements were: "Relief of work pressure" and "mental health consultation", and hope to receive mixed-mode EAP services; in ICU and CCU, nurses hope EAP can help resolve work-family conflicts; in EICU, they need to provide Specific job skills training services.Conclusions:ICU nurses have insufficient cognition of EAP and urgently need to obtain EAP implementation knowledge; at the same time, it is necessary to formulate an implementation plan that meets ICU nurses′ needs for EAP, that is, to relieve work pressure and carry out psychological counseling to ensure that EAP is launch successfully in ICU nurses.
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Objective:To investigate the awareness of diabetic retinopathy (DR) prevention and treatment knowledge of diabetic patients in the community of Shenzhen, and analyze its influencing factors.Methods:A cluster random sampling method was used to select 904 patients with diabetes diagnosed in 6 community health service centers in 2 administrative districts of Shenzhen and included in this study. Questionnaire survey of patients were performed to understand their knowledge of DR prevention and treatment. The multi-factor logistic regression analysis method was used to analyze the related influencing factors of DR prevention knowledge awareness.Results:Among 904 patients, 144 patients (15.93%, 144/904) knew about DR prevention and treatment knowledge. The highest awareness rate were about "Diabetes can affect vision and even cause blindness" (88.60%, 801/904). The lowest awareness rate (6.20%, 56/904) were about "DR treatment methods". About "diabetes requires regular fundus examinations" and "diabetics", the awareness rate of fundus examination interval were less than 50.00%. The results of multivariate logistic regression analysis showed that gender [odds ratio ( OR)=1.595], education level ( OR=2.963, 3.937), monthly income level ( OR=3.871, 4.675), diabetes course ≥15 years ( OR=1.829), treatment measures ( OR=3.318, 4.512). Whether people had DR ( OR=1.605) were important factors that affected the awareness of DR prevention and treatment knowledge ( P<0.05). Conclusions:The overall awareness of DR prevention and treatment knowledge among diabetic patients in the community of Shenzhen is relatively low. Males, low education and income levels are the main influencing factors.
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Objective@#To study the effect of using modified prone position to reduce the occurrence of pressure injury in patients with prone position ventilation.@*Method@#Totally 64 patients with prone position ventilation from February 2014 to February 2018 were selected in the Department of Intensive Care of the Drum Tower Hospital, Medical College of Nanjing University. Twenty-six patients with prone position ventilation From February 2014 to February 2016 were selected as the control group. The patients in the control group were in a horizontal prone position, with soft pillows under both sides of the shoulders and hips along the longitudinal axis of the patient (vertical axis), and gel pads under chests; Thirty-eight patients with prone position ventilation from March 2016 to February 2018 were selected as the experimental group. The patients in the experimental group were positioned on turnover sliding cloth, soft pillows were placed under the sliding cloth, on one side along the vertical axis (vertical axis) of the patients, and the soft pillows were repositioned to other side of the patients every 4 hours, i.e. the patients were turned over in the prone position. The incidence of pressure injury, the number of occurrences (each site marked as 1) and the incidence of other related complications were compared between the two groups.@*Results@#The incidence of pressure injury in the experimental group was 10.53% (4/38) and 46.15% (12/26), in the control group. The median and quartile of the number of pressure injuries in the experimental group were 0 (0,0), and 0 (0,2) in the control group. Statistical analysis was performed using the rank sum test. The difference was statistically significant (F=10.287,11.469, P<0.05). Among other related complications, the unplanned extubation rate was 0.38%(1/26) in the control group and 0 in the experimental group. No aspiration occurred in both groups.@*Conclusions@#The use of a modified prone position can reduce the incidence of pressure injuries and reduce the incidence of other related complications, by reducing the duration of skin pressure and decreasing the friction and shear force. It is worthy of popularization and application in clinical practice.
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Objective To study the effect of using modified prone position to reduce the occurrence of pressure injury in patients with prone position ventilation. Method Totally 64 patients with prone position ventilation from February 2014 to February 2018 were selected in the Department of Intensive Care of the Drum Tower Hospital, Medical College of Nanjing University. Twenty-six patients with prone position ventilation From February 2014 to February 2016 were selected as the control group. The patients in the control group were in a horizontal prone position, with soft pillows under both sides of the shoulders and hips along the longitudinal axis of the patient (vertical axis), and gel pads under chests;Thirty-eight patients with prone position ventilation from March 2016 to February 2018 were selected as the experimental group. The patients in the experimental group were positioned on turnover sliding cloth, soft pillows were placed under the sliding cloth, on one side along the vertical axis (vertical axis) of the patients, and the soft pillows were repositioned to other side of the patients every 4 hours, i.e. the patients were turned over in the prone position. The incidence of pressure injury, the number of occurrences (each site marked as 1) and the incidence of other related complications were compared between the two groups. Results The incidence of pressure injury in the experimental group was 10.53% (4/38) and 46.15% (12/26), in the control group. The median and quartile of the number of pressure injuries in the experimental group were 0 (0,0), and 0 (0,2) in the control group. Statistical analysis was performed using the rank sum test. The difference was statistically significant (F=10.287,11.469, P<0.05). Among other related complications, the unplanned extubation rate was 0.38% (1/26) in the control group and 0 in the experimental group. No aspiration occurred in both groups. Conclusions The use of a modified prone position can reduce the incidence of pressure injuries and reduce the incidence of other related complications, by reducing the duration of skin pressure and decreasing the friction and shear force. It is worthy of popularization and application in clinical practice.
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Objective To investigate the prevention effect of chlorhexidine gluconate (CHG) gel dressings combined with chlorhexidine wipe bath on femoral venous central line-associated bloodstream infections (CLABSI) in continue renal replacement therapy (CRRT). Methods A total of 593 cases of patients with femoral venous catheter who receipted CRRT were divided into the experimental group and the control group. 282 cases of patients who hospitalized in ICU from January 2016 to December 2016 were assigned into the control group and received 3M transparent dressings and whole-body warm water bathing.Those hospitalized in ICU from January 2017 to November 2017 were assigned into the experimental group including 311cases and received 3M CHG gel dressingscombined with 2％chlorhexidine wipe bathing. Incidence of CLABSI were compared between the two groups. Results 4 cases of patients occurred CLABSI in the experimental group and 12 cases occurred CLABSI in the control group, the difference between groups was statistically significant(χ2=3.900,P<0.05). In the experimental group, 311 cases were retained for 3219 catheter-days, and 282 cases in the control group were retained for 2249 catheter-days. Compared with transparent dressings and whole-body warm water bathing, chlorhexidine gluconate gel decreasescombined with 2％ chlorhexidine wipe bath could reduce the morbidity of CLABSIs from 5.3‰(12/2249) to 1.2‰(4/3219). The on onsite time of CLABSI in the experimental group was (12.5 ± 8.23) days, which in the control group was (10.50 ± 6.46) days, the differenceare not statistically significant (t=0.504,P>0.05). Conclusions CHG gel dressings combined with chlorhexidine wipe bathing would be more effective to prevent CLABSI in CRRT.
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OBJECTIVE:To establish the HPLC fingerprints for Huobahuagen tablets intermediate. METHODS:HPLC was per-formed on Inertsil ODS-4 column with mobile phase consisted of acetonitrile-0.1% phosphoric acid (gradient elution) at the flow rate of 0.75 mL/min. The detection wavelength was set at 220 nm,and column temperature was 30 ℃. The sample size was 10 μL. Using wilforgine as reference,HPLC chromatograms of 10 batches of samples were determined. Common peak identification and similarity evaluation were performed by using Similarity Evaluation System for TCM Chromatographic Fingerprint (2004 A edi-tion). RESULTS:There were 25 common peaks in HPLC chromatograms of 10 batches of samples,and similarity degrees were higher than 0.9. After validated,HPLC chromatograms of 10 batches of samples were in good agreement with control fingerprints. CONCLUSIONS:The established fingerprint can provide reference for identification and quality evaluation of Huobahuagen tab-lets intermediate.
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Aim To investigate the reversal effect of PARP-1 inhibitor PJ34 on cisplatin-resistance in hu-man lung adenocarcinoma A549/DDP cells and the mechanism. Methods A549/DDP cells were treated with PJ34 alone or combined with cisplatin. The effects of proliferation inhibition were assayed by MTT meth- od. The apoptosis ratios of cells were analyzed by flow cytometry. The protein expression of PARP-1 and LRP, GST-π were measured by Western blot assay. Results PJ34 could inhibit the proliferation of A549/DDP cells alone. The non-toxic dose of PJ34 could signifi-cantly resensitize A 5 4 9/ DDP cells to cisplatin , induce apoptotic,lower the expression of PARP-1 and resist-ance-associated protein LRP and GST-π. Conclusion PJ34 could inhibit the proliferation of A549/DDP cells and resensitize A549/DDP cells,partially reverse cisplatin-resistance in A549/DDP cells, with a proba- ble mechanism relating to increased apoptotic rate,and lowered expression of PARP-1 and resistance-associat-ed protein LRP and GST-π.
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ObjectiveTo investigate the effects of two health education models on the psychology and nutrition of patients waiting for cadaveric renal transplantation.Methods A total of 125 patients waiting for cadaveric renal transplantations were involved in our study.They were diagnosed with chronic renal failure in our hospital during September 1, 2009 to August 30, 2010.The patients were randomly divided into control group (n = 62) and observational group(n = 63).Patients in the control group received traditional health education with routine preoperative education during hospitalization.In the observational group, full-time nurses assessed the nutrition status of each patient and monitored the data. The observational patients were followed up and were given dietary guidance and knowledge of transplantation.Various kinds of education formats were adopted in observational group to provide communication opportunities between patients and surgeons in charge as well as patients who underwent transplantation.Psychological testings of patients in both groups were tested by self-rating anxiety scale (SAS) and self-rating depression scale (SDS) before and after the health education.Triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC) and biochemistry index were also tested.Psychological and nutritional status of patients in the two groups was compared.ResultsThere were no significant differences in scores of the SAS, SDS, TSF, Hb, and albumin (Alb) between the two groups (all P＞0.05) before health education.After health education, SAS and SDS in observational group were lower than those in the control group (40.02 ±9.05 vs 47.05 ± 10.32,42.70 ± 10.01 vs 50.83 ± 10.12; both P＜0.01).Both TSF and Hb were elevated after education (P ＜ 0.001 or 0.05).Alb was significantly elevated in the observational group [(35.67 ±6.19)g/L vs (37.48 ±5.09)g/L, P ＜0.01].ConclusionComprehensive and various health education methods can significantly alleviate mental stress and improve nutrition of the patients waiting for kidney transplantation, which is helpful for patients facing disease positively and having a better quality of
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Objective To evaluation the efficacy of ketamine on the expression of adhension molecular CR3and intracellular cAMP, cGMP in neutrephils in patients associated with cardiopulmonary bypass (CPB), as well as the cardiovascular function of the CPB patients. Method Sixty patients operated on with prosthetic valve replace-rnent under CPB were randomly divided into 4 groups: placebo, ketamine 0.1 mg/kg ( ketamine Ⅰ) ,ketamine 0.5 mg/kg ( ketamine Ⅱ) ,ketamine 1 mg/kg( ketamine Ⅲ). Each group included 15 eases. Venous blood sam-pies were obtained during anesthesia induction (T1), 10 min before CPB (T2), end of CPB (T3) and 24 hoursafter operation (T4). The expression of CR3 was measured by Flow cytometry and the concentration of cAMP/cGMP by HPLC. Results Ketamine with various dosages decreased the expression of CR3 at the T3 and T4 inpatients of ketamine groups compared with patients of placebo group (P<0.05). The dosages of ketamine Ⅱgroup and ketamine Ⅲ group had more significant effect than that of ketamine Ⅰ group. The dosages of ketamineⅡ and ketamine Ⅲ group increased the intracellular cAMP at the T3 and T4 compared with ketamine Ⅰ groupand placebo (p<0.05), respectively. However,cGMP was lower in ketamine Ⅱ and ketamine Ⅲ group thanthat in ketamine Ⅰ group and placebo (P<0.05) at the T3.Morever,the mean arterial blood pressure was higherin ketamine Ⅱ and ketamine Ⅲ group at T4. Only the patients of ketamine Ⅲ group required less inotropic drugsafter operation. Conclusions Ketamine can reduce the expression of adhhension molecular CB3 and intracellularcAMP, cGMP in neutrophils from patients associated with CPB.
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Objective To investigate the protective effects of different concentrations of propofol on thelungs apainst acute injury induced by lipopolysaccharide (us) in rats.Methods Twenty-four male Wistar ratsweighing 150-250g were randomly divided into 4 groups with 6 animals in each group : (1) control group receivedonly normal saline; (2) LPS group received LPS 5 mg?kg~(-1)i. v.; (3) propofol group 1 received a bolus 5 mg?kg~(-1) after LPS followed by propofol infusion at 5 mg?kg~(-1) ; (4) propofol group Ⅱ received a bolus of propofol 10mg.kg~(-1) after LPS followed by propofol infusion 10 mg?kg~(-1). Blood samples were obtained from femoralartery for determintiion of serum concentrations of TNF-?, IL-? and IL-10 at 1, 2, 3, 4 h after LPS injection. Theanimals were then killed by exsanguination. The lungs were removed. Left lung was lavaged and the broncho-alveolar lavage fluid (BALF) was collected for determination of its neutrophil count, and protein, TNF-?, IL-I?and IL-10 levels. Right lung was used for measurement of wet / dry lung weight ratio. Results In LPS group thewet/dry lung weight ratio, BALF neutrophil counts and protein contents and BALF and serum TNF-?, Ib-I? andIL-10 levels were significantly increased compared with control group (P
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Objective To investigate the effects of thiopental on expression of nuclear factor kappa B (NF-?B) and content of TNF-? and IL-1? in the lungs induced by lipopolysaccharide (LPS) .Methods Twenty-four male Kunming mice weighing 15-25 g were randomly divided into 4 groups (n = 6 each) : I control group received intraperitoneal (i.p.) normal saline (NS) 1 ml?kg-1 ; Ⅱ LPS group received i.p. LPS 5 mg?kg-1 ; Ⅲ LPS + thiopental (TH) received intrapentoneal TH 60 mg?kg-1 20 min after i.p. LPS 5 mg?kg-1 and Ⅳ TH group received i.p. TH 60 mg?kg-1 alone. The animals were bled to death at 3 h after LPS administration. The lungs were immediately removed for determination of expression of NF-?B p65 (Western blot) and TNF-? and IL-1? content (ELISA) in the lung. Results The expression of NF-?B p65 was significantly increased and the level of TNF-? and IL-1? in the lungs were significantly increased after LPS stimulation as compared with control group ( P