Effect of opioid-sparing analgesia on incidence of sepsis in severely burned patients: a retrospective cohort study / 中华麻醉学杂志

Objective:To evaluate the effects of opioid-sparing analgesia on the incidence of sepsis in severely burned patients in the retrospective cohort study.Methods:The clinical data from patients with severe burns admitted to three teaching hospitals in Guangdong from 2011 to 2020 were retrospectively extracted and analyzed. The patients were divided into 2 groups based on the analgesic regimen within 30 days after injury: continuous opioids analgesia group (continuous opioid infusion at a relative constant rate for more than 72 h) and opioid-sparing analgesia group (patient-controlled intravenous analgesia/intermittent administration/opioid-free analgesia). Patient′s age, severity of burn, inhalation injury and basal pain score at rest were matched by the propensity score at a 1∶1 ratio. The primary outcome measure was the occurrence of sepsis within 90 days of admission. Secondary outcome measures included 30-day and 90-day all-cause mortality, clinical diagnosis of multiple organ dysfunction syndrome, and prevalence of burn wound infection. The amount of opioid used was also recorded.Results:A total of 328 severely burned patients were finally enrolled, with 145 patients in continuous opioid analgesia group and 183 patients in opioid-sparing analgesia group, and 110 pairs of patients (220 cases) were finally matched by the propensity score.Compared with continuous opioid analgesia group, the total consumption of opioid, daily consumption per analgesia, and consumption per burn area were significantly decreased, and the incidence of sepsis and wound infection was decreased( P<0.05), and no significant change was found in the incidence of multiple organ dysfunction syndrome, 30-day and 90-day all-cause mortality in opioid-sparing analgesia group( P>0.05). Conclusions:Compared with the continuous opioid analgesia regimen, opioid-sparing analgesia can reduce the risk of sepsis in severely burned patients.

Application research of teach-back in mouth-opening training of patients with nasopharyngeal carcinoma / 中国实用护理杂志

Objective:To investigate the effect of teach-back on the compliance of mouth-opening training in patients with nasopharyngeal carcinoma after radiotherapy.Methods:Eighty patients with nasopharyngeal carcinoma in the First Affiliated Hospital of Gannan Medical University were selected. They were divided into intervention group and control group according to the random number table method. The intervention group used the teach-back method for health education, and the control group used conventional methods for health education. The knowledge mastery of mouth-opening training, the degree of compliance with mouth-opening training and the difficulty of mouth opening were compared between the two groups.Results:Within 1 week of the intervention group, the complete mastery rate, partial mastery rate, and unmastered rate was 77.5% (31/40), 17.5% (7/40), and 5.0% (2/40), respectively, within 2 weeks, that was 97.5% (39/40), 2.5% (1/40), 0. Within 1 week of the control group was 65.0% (26/40), 10.0% (4/40), 25.0% (10/40), respectively, within 2 weeks, that was 75.0% (30/40), 20.0% (8/40), and 5.0% (2/40). The knowledge mastery of mouth-opening training in the intervention group was higher than that in the control group within 1 week and 2 weeks, and the difference between the two groups was statistically significant ( χ2=6.590, 8.618, P<0.05). At the end of radiotherapy, the complete compliance rate, partial compliance rate, and non-compliance rate of the intervention group was 90.0% (36/40), 10.0% (4/40), 0, respectively. After 3 months of radiotherapy, the rate was 75.0% (30/40), 22.5% (9/40), 2.5% (1/40). At the end of 6 months of radiotherapy, the rate was 60.0% (24/40),30.0% (12/40) and 10.0% (4/40). At the end of the radiotherapy, the control group was 70.0% (28/40), 20.0% (8/40), and 10.0% (4/40), respectively. After 3 months of radiotherapy, the rate was 40.0% (16/40), 45.0% (18/40) and 15.0% (6/40). After 6 months of radiotherapy, the rate was 20.0% (4/40), 40.0% (16/40), and 40.0% (16/40). The compliance of the intervention group at the end of radiotherapy, 3 months after radiotherapy, and 6 months after radiotherapy was higher than that of the control group, and the difference between the two groups was statistically significant ( χ2=5.986, 10.615, 15.771, P<0.05 or 0.01). In the intervention group, the incidence of Ⅰ degree, Ⅱ degree, Ⅲ degree and Ⅳ degree difficulty of mouth opening after 6 months of radiotherapy was 10.0% (4/40), 5.0% (2/40), 0, 0, respectively, and the control group was 15.0% (6/40), 15.0% (6/40), 2.5% (1/40), 2.5% (1/40), the incidence of difficulty of mouth opening of the intervention group was lower than that of the control group, and the difference between the two groups was statistically significant ( Z=15.737, P<0.01). Conclusions:Teach-back can effectively improve the mastery of patients′ mouth-opening training knowledge and the compliance of mouth-opening training, which is beneficial to reduce the incidence of mouth-opening difficulties in patients with nasopharyngeal carcinoma. It is worthy of clinical promotion.

Application research of teach-back in mouth-opening training of patients with nasopharyngeal carcinoma / 中国实用护理杂志

Objective@#To investigate the effect of teach-back on the compliance of mouth-opening training in patients with nasopharyngeal carcinoma after radiotherapy.@*Methods@#Eighty patients with nasopharyngeal carcinoma in the First Affiliated Hospital of Gannan Medical University were selected. They were divided into intervention group and control group according to the random number table method. The intervention group used the teach-back method for health education, and the control group used conventional methods for health education. The knowledge mastery of mouth-opening training, the degree of compliance with mouth-opening training and the difficulty of mouth opening were compared between the two groups.@*Results@#Within 1 week of the intervention group, the complete mastery rate, partial mastery rate, and unmastered rate was 77.5% (31/40), 17.5% (7/40), and 5.0% (2/40), respectively, within 2 weeks, that was 97.5% (39/40), 2.5% (1/40), 0. Within 1 week of the control group was 65.0% (26/40), 10.0% (4/40), 25.0% (10/40), respectively, within 2 weeks, that was 75.0% (30/40), 20.0% (8/40), and 5.0% (2/40). The knowledge mastery of mouth-opening training in the intervention group was higher than that in the control group within 1 week and 2 weeks, and the difference between the two groups was statistically significant (χ2=6.590, 8.618, P<0.05). At the end of radiotherapy, the complete compliance rate, partial compliance rate, and non-compliance rate of the intervention group was 90.0% (36/40), 10.0% (4/40), 0, respectively. After 3 months of radiotherapy, the rate was 75.0% (30/40), 22.5% (9/40), 2.5% (1/40). At the end of 6 months of radiotherapy, the rate was 60.0% (24/40),30.0% (12/40) and 10.0% (4/40). At the end of the radiotherapy, the control group was 70.0% (28/40), 20.0% (8/40), and 10.0% (4/40), respectively. After 3 months of radiotherapy, the rate was 40.0% (16/40), 45.0% (18/40) and 15.0% (6/40). After 6 months of radiotherapy, the rate was 20.0% (4/40), 40.0% (16/40), and 40.0% (16/40). The compliance of the intervention group at the end of radiotherapy, 3 months after radiotherapy, and 6 months after radiotherapy was higher than that of the control group, and the difference between the two groups was statistically significant (χ2=5.986, 10.615, 15.771, P<0.05 or 0.01). In the intervention group, the incidence of Ⅰ degree, Ⅱ degree, Ⅲ degree and Ⅳ degree difficulty of mouth opening after 6 months of radiotherapy was 10.0% (4/40), 5.0% (2/40), 0, 0, respectively, and the control group was 15.0% (6/40), 15.0% (6/40), 2.5% (1/40), 2.5% (1/40), the incidence of difficulty of mouth opening of the intervention group was lower than that of the control group, and the difference between the two groups was statistically significant (Z=15.737, P<0.01).@*Conclusions@#Teach-back can effectively improve the mastery of patients′ mouth-opening training knowledge and the compliance of mouth-opening training, which is beneficial to reduce the incidence of mouth-opening difficulties in patients with nasopharyngeal carcinoma. It is worthy of clinical promotion.

Analysis of risk factors of cerebral infarction in young adults and its correlation with TOAST types / 中国基层医药

Objective To explore the risk factors of youth cerebral infarction and its correlation with clinical TOAST types.Methods 82 young patients with acute cerebral infarction(aged from 18 to 45 years old)were select-ed.The risk factors for youth cerebral infarction patients,and the proportion of TOAST subtype and related risk factors were analyzed.Results Risk factors for youth cerebral infarction were as follows:hyperlipidemia (χ2 =48.703,P <0.05),hypertension (χ2 =40.829,P <0.05),carotid sclerosis (χ2 =46.217,P <0.05),hyperhomocysteinemia (χ2 =40.255,P <0.05),smoking history (χ2 =7.853,P <0.05),diabetes (χ2 =18.256,P <0.05)and family history (χ2 =5.944,P <0.05),heart disease (χ2 =5.754,P <0.05).The proportion of their TOAST subtypes were as following:small artery occlusion lacunar(SAD)(39.0%),large artery atherosclerosis(LAA)(24.4%),stroke of other undetemined etiology(SUE)(17.0%),and acute stroke of other detemined etiology(SOE)(12.2%),cardio-embolism(CE)type(7.3%).Major risk factors for LAA subtype included hyperlipidemia,hypertension and carotid atherosclerosis;Major risk factor for SUE subtype was hyperhomocysteinemia;Major risk factors for SOE included hypertension,diabetes.Major risk factor for CE subtype was heart disease.Conclusion The highest proportion of TOAST types in youth cerebral infarction group is small artery occlusion lacunar.Major risk factors for this group of youth cerebral infarction are as follows:hypertension,carotid atherosclerosis,heart disease,diabetes,hyperhomocys-teinemia,obesity,smoking and family history,and these risk factors should be actively intervened.

Application of Ultrasound Guided Drainage Combined with Different Hardeners for Treatment of Simple Breast Cysts / 中国医学影像学杂志

Purpose To investigate the clinical effect of ultrasound guided drainage combined with different hardeners for simple breast cysts,and to further provide reference for individual treatment.Materials and Methods Clinical data of 117 cases breast simple cysts were analyzed retrospectively,of which 42 cases were routine ultrasound-guided puncture combined with fluid injection of hypertonic sugar (group A),40 cases were routine ultrasound guided drainage combined with ethanol injection therapy (group B),and 35 cases were routine ultrasound guided therapy alone (control group).The clinical efficacy and adverse reactions were compared among the three groups after treatment.Results The total effective rate of group A was 95.24％,group B was 97.50％,and control group was 82.86％.Total effective rate of group A and B had no significant difference (P＞0.05),which were both higher than control group (P＜0.05).The adverse reactions rate of group B was higher than group A and control group,which had statistical significance (P＜0.05).Conclusion Ultrasound guided injection of hypertonic sugar or ethanol after drainage treatment for simple breast cysts can both obtain satisfactory clinical results,but adverse reactions of the former one are mild,it should be widely applied.

Utilization Analysis of Hypoglycemics in 36 Hospitals of Guangzhou in 2003～2005 / 中国药房

1.CONCLUS-ION:The use of hypoglycemics in Guangzhou is basically in line with the rational level,except for few cases in improper use of combination therapies.

Analysis of the Costs of Various Drugs Consumed in 36 Hospitals of Guangzhou in the Years 1997～ 2000 / 中国药房

OBJECTIVE： To analyze the trend of costs of various drugs consumed in hospitals of Guangzhou METHODS： The data were derived from the Hospital Purchasing of Drug Information System in Guangzhou from 1997 to 2000 The expense of each drug was calculated at the price of that year RESULTS： The annual increasing rates of drug expenses in 1998， 1999 and 2000 were 17 01％ ， 24 49％ ， 23 11％ respectively CONCLUSION： It is a matter of great urgency to rationally use drugs， to eliminate the waste of resources and to lighten the patients'burden

Analysis of the Costs of Various Drugs Consumed in 36 Hospitals of Guangzhou in the Years 1997～2000 / 中国药房

OBJECTIVE:To analyze the trend of costs of various drugs consumed in hospitals of Guangzhou METHODS:The data were derived from the Hospital Purchasing of Drug Information System in Guangzhou from 1997 to 2000 The expense of each drug was calculated at the price of that year RESULTS:The annual increasing rates of drug expenses in 1998,1999 and 2000 were 17 01%,24 49%,23 11% respectively CONCLUSION:It is a matter of great urgency to rationally use drugs,to eliminate the waste of resources and to lighten the patients'burden

Protective effects of quateranary ammonium salt derivative (F_2) of haloperidol on ischemia and reperfusion injury in rat hearts / 中国药理学通报

AIM To study the effects of quateranary ammonium salt derivative (F 2) of haloperidol on ischemia and reperfusion injury in rat hearts. METHODS Ischemia and reperfusion injury in rat hearts was induced by occluding the left anterior descending coronary artery for 30 min and restoring blood reperfusion for 30 min. F 2 (1, 2, 4 mg?kg -1 , respectively) was intravenously injected before heart ischemia. Plasma creatine kinase (CK), creatine kinase isoenzyme MB(CK MB), lactate dehydrogenase(LDH),? Hydroxybutyrate dehydrogenase (HBDH), grutamic oxalacetic transaminase(GOT), superoxide dismutase (SOD) activity and malondiadehyde (MDA) contents were measured. The pathologic changes of ischemia and reperfusion myocardium were observed on the transmission electron microscopy. RESULTS F 2 reduced the release of CK,CK MB LDH,HBDH,GOT from I/R rat hearts, increased the activity of SOD and decreased the MDA contents. In F 2 (1mg?kg -1 ) group, the serum CK MB LDH HBDH concentration was lowered significantly (vs I/R group P