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OBJECTIVE:To study the effects of etanercept combined with cyclophosphamide on related indexes of patients with rheumatoid arthritis complicated with interstitial pneumonia (RA-IP).METHODS:A total of 84 RA-IP patients were randomly divided into control group (42 cases) and observation group (42 cases).Control group was given Etanercept for injection 25 mg subcutaneously twice a day.Observation group was additionally given Cyclophosphamide tablets 50 mg orally,once a day,increasing by 50 mg every 7 d later,with maximum dose lower than 100 mg,for consecutive 2 weeks,2 weeks later repeated,on the basis of control group.Both groups were treated for 3 months.The number of joint tenderness and joint swelling,morning stiffness time,VAS score,DAS28 score,CRP,ESR,serum rheumatoid factor (RF),TNF-α,p (O2),VC,clinical score,imaging score,physiological score and the occurrence of ADR were observed in 2 groups before and after treatment.RESULTS:After treatment,the number of joint tenderness and joint swelling,morning stitffness time,VAS score,DAS28 score,the levels of CRP,ESR,RF and TNF-α,clinical score,imaging score,physiological score in 2 groups were significantly lower than before treatment;the observation group was significantly lower than control group.p(O2) and VC of 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Etanercept combined with cyclophophamide in the treatment of RA-IP can improve clinical symptom,signs,life quality and lung function without increasing the occurrence of ADR.
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Objective Application of PDCA method to improve the coincidence rate of emergency inspection report time.Methods 472 cases of emergency inspection report returns the fraction defective of the time from September to December 2014 (blood routine,blood biochemistry,blood coagulation,cerebrospinal fluid,urine analysis).Analyzing the reason and take measures to improve the emergency inspection report time coincidence rate.At the same time,counted 654 cases of emergency inspection report returns the fraction defective of the time after the improvement from July to November 2015,and compared and analyzed the coincidence rate before and after the improvement measures.Results Emergency inspection report of the total fraction defective return time decreased from 13.9 ％ to 4.9 ％ by taking measures.Blood coagulation,blood biochemistry,urine analysis,routine blood,cerebrospinal fluid and urine analysis of emergency return time unqualified rate decreased from 18.2 ％,16.2 ％,10.3 ％,6.75 ％ and 9.1％ to 5.2 ％,5.0 ％,6.4％,5.0 ％ and 3.9 ％ respectively.Conclusion The application of PDCA could improve the time coincidence rate of emergency department,and to finish the emergency detection and report detection results in the shortest possible time.
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Objective:To explore the efficacy of etanercept combined leflunomide to treat ankylosing spondylitis (AS) and its safety.Methods:90 cases with AS patients admitted in our hospital from June 2016 to January 2015 were selected.The patients were divided into observation group and control group by random number table method,45 cases in each group.Observation group was treated with etanercept combined with leflunomide,the control group were treated by leflunomide only.Morning stiffness time,AS activity index (BASDAI),AS measurement index (BASMI) were recorded before and after treatment in two groups,the total effective rate and adverse reaction were compared between the two groups.Results:After treatment,the BASDAI and morning stiffness time,BASMI of two groups of patients compared with before treatment were decreased,and the indexes above of the observation group were significantly lower than the control group,the difference was statistically significant (P＜0.05);The effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant (P＜0.05);During the course of treatment,the main adverse reactions occurred in patients with liver function damage,diarrhea and allergic skin rash,but there was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Etanercept combined with leflunomide can obtain ideal effect,and low incidence rate of adverse reaction,it is worth popularizing in clinical use.
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OBJECTIVE@#To evaluate the effect of patient education on patients with allergic rhinitis (AR).@*METHOD@#From January 2009 to December 2013, 100 cases of allergic rhinitis were treated. The patients were randomly divided into experimental group or control group by Stochastic tables law,50 patients in control group accepted only drug treatment, 50 patients in experimental group accepted both drug treatment and patient education. The difference in compliance with treatment, treatment effect, incidence of adverse drug reactions and complications, average costs and times of treatment between two groups were evaluated by the rhinoconjunctivitis quality of life questionnaire (RQLQ) score. The independent sample t-test and χ2 test were used for statistical analysis.@*RESULT@#The patients of experimental group showed more positive attitude to treatment compared to the patients of control group (P < 0.01). The average scores of each classification and overall symptoms after treatment in experimental group were lower than those in control group (P < 0.05). The incidence of adverse drug reactions (nose-bleed, dry nose,nasal mucosa ulcer)and complications in patients with AR (asthma, chronic cough, secretory otitis media) in experimental group was lower than that in control group, with statistically differences (P < 0.05). The average times of treatment and costs of diagnosis and treatment(calculation of budesonide nasal spray)in experimental group were significantly lower than those in control group (P < 0.01). The total score for RQLQ and the scores of seven dimensions in experimental group were lower than those in control group (P < 0.05).@*CONCLUSIONS@#Patient education can help the patients with AR to cooperate actively with treatment, to reduce the incidence of adverse drug reactions and AR complications, and to save medical costs and improve the quality of life.