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Objective:To investigate and analyze the risk factors of pulmonary infection in hemodialysis patients with diabetes nephropathy (DN), and explore the effect of different antibiotic application methods on the efficacy of DN patients with pulmonary infection.Methods:337 inpatients with DN who were admitted to Lishui Central Hospital from August 2021 to April 2022 were selected as the study subjects, and the proportion of pathogenic bacteria in patients with pulmonary infection caused by hemodialysis was analyzed, and the influencing factors of pulmonary infection were analyzed by single factor and multiple factor logistic regression models. DN patients with pulmonary infection were treated with single or multiple antibiotics, and their curative effects were analyzed and compared.Results:Among 337 hospitalized patients with DN in this study, the rate of pulmonary infection caused by hemodialysis was 24.04%(81/337). 87 strains of pathogenic bacteria were cultivated, and the main pathogens of the infected individuals were Klebsiella pneumoniae (36.78%, 32/87), Staphylococcus aureus (17.24%, 15/87), and Acinetobacter baumannii (16.09%, 14/87). The results of univariate analysis showed that patient age, dialysis time, hospital stay, hemoglobin, postprandial blood glucose, malnutrition (blood albumin level<35 g/L), renal function, and volume load were the influencing factors for pulmonary infection in DN patients undergoing hemodialysis (all P<0.05). Multivariate logistic regression model analysis showed that dialysis time, hemoglobin, postprandial, blood glucose malnutrition, renal function, and volume load were risk factors for pulmonary infection caused by hemodialysis (all P<0.05). After treatment, the levels of white blood cells, neutrophils, and hypersensitive reactive protein in patients with pulmonary infection were significantly reduced compared to before treatment (all P<0.05). The effective rate of multi antibiotic therapy (97.44%, 38/39) was higher than that of single antibiotic therapy (80.95%, 34/42) (χ 2=5.563, P=0.018). Conclusions:There are many independent risk factors for pulmonary infection during hemodialysis in DN patients. The infection rate should be reduced through adequate dialysis, blood glucose control, nutrition supplementation, anemia correction and other measures, and the infected can be treated timely with antibiotics according to the situation.
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Objective:To observe any therapeutic effect of stimulating acupoints on the ears of stroke survivors with dysphagia.Methods:Eighty stroke survivors with dysphagia were randomly divided into an observation group and a control group, each of 40. Both groups were given neuromuscular electrical stimulation and routine deglutition training, but the observation group was additionally provided with auricular point pressing for 4 weeks. Surface electromyography (sEMG), water swallowing tests and standardized swallowing assessments (SSAs) were used to assess the subjects′ swallowing function before and after the 4 weeks of treatment. The Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale (HAMA) were used to assess any mood improvement. The swallowing-related quality of life (SWAL-QOL) scale was used to assess the patients′ life quality.Results:After the treatment, the average deglutition time and the maximum amplitude of the masseter, orbicularis oris, submental and hyoid muscle signals of both groups had improved significantly. The average SSA, HAMA, HAMD and SWAL-QOL scores of both groups were also significantly improved as was the average swallowing time. All of the improvements were significantly greater in the observation group than in the control group.Conclusion:Auricular point acupressure has a synergistic effect with routine rehabilitation in the treatment of dysphagia after stroke. It can help to reconstruct the swallowing reflex, promote the recovery of swallowing function, and improve emotions and life quality.
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To investigate the correlation of different types of urinary abnormalities or different proteinuria and hematuria with the pathological injury of kidney in IgA nephropathy with isolated hematuria and/or mild proteinuria. Methods: Patients with primary IgA nephropathy, isolated hematuria and/or mild proteinuria were enrolled in the Department of Nephrology, the Second Xiangya Hospital, Central South University from January 2013 to January 2018. According to the difference of red blood cell count in urinary sediment and quantitative of 24-hour urinary protein (24 h-UP) during renal biopsy, the patients were grouped in 3 ways: a simple hematuria group, a hematuria and proteinuria group, and a simple proteinuria group; a proteinuria I group, a proteinuria II group, and a proteinuria III group; a hematuria I group, a hematuria II group, and a hematuria III group. The clinical parameters such as age, mean arterial pressure, blood urea nitrogen, serum creatinine, blood uric acid, 24 h-UP, and renal pathological damage were compared. Results: A total of 157 patients met the inclusion criteria, including 71 males and 86 females. The most common pathological type was focal and/or segmental glomerulosclerosis. The Lee's classification were dominated by grade III and IV, and the renal pathological injury was heavy. Immunoglobulin deposition was dominated by simple IgA deposition. The most common fluorescence intensity of IgA deposition was +++. 97 (61.78%) patients were accompanied by complement deposition and were mainly composed of simple complement C3 deposition. There were 18 patients (11.47%) in the simple hematuria group, 111 patients (70.70%) in the hematuria and proteinuria group, and 28 patients (17.83%) in the simple proteinuria group. Compared with the simple hematuria group, the proportion of patients with mild injury was lower in the simple proteinuria group, and the proportion of patients with moderate-to-severe injuries was increased (χ2=7.053, P=0.008). Compared with the hematuria and proteinuria group, the proportion of patients with mild injury was lower in the simple proteinuria group, and the proportion of patients with moderate-to-severe injury was increased (χ2=4.294, P=0.038). Compared with the proteinuria I group, the proportion of patients with mild injury was lower in the proteinuria III group, and the proportion of patients with moderate-to-severe injury was increased (χ2=5.433, P=0.020). There was no significant difference in the proportion of patients with renal pathological injury among different hematuria groups (P>0.05). Conclusion: The clinical manifestations of patients with IgA nephropathy with hematuria and/or mild proteinuria are inconsistent with renal pathological damage. Some patients with mild clinical manifestations have severe renal pathological damage and the renal pathological damage is more serious in simple proteinuria. The more proteinuria, the heavier the renal pathological damage.
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Feminino , Humanos , Masculino , Creatinina , Glomerulonefrite por IGA , Hematúria , Rim , ProteinúriaRESUMO
Objective To evaluate the clinical value of 18F-FDG PET/CT in the detection of residual,recurrent and metastatic diseases in post-treatment uterine cervical cancer patients presenting with elevated serum squamous cell carcinoma (SCC) antigen levels.Methods Between March 2009 and October 2012,18F-FDG PET/CT was performed in 48 patients(average age (47.5±11.2) years) with suspected residual,recurrent or metastatic uterine cervical cancer because of increased serum SCC antigen level (＞1.5 tμg/L).The final diagnosis was established by pathology or more than 1 year of clinical follow-up.The diagnostic efficiency of 18F-FDG PET/CT was calculated.Two-sample t test was used for data analysis.Results The serum SCC levels were 1.6-42.5(mean:8.6±9.4) μg/L.Among the 48 patients,45 (93.75％) were confirmed of having malignant lesions.18F-FDG PET/CT along with other imaging detected 174 lesions,of which 169 were proven as residual,recurrent or metastatic diseases.18F-FDG PET/CT correctly identified 159 lesions,yielding a diagnostic sensitivity and accuracy of 94.08％(159/169) and 91.38％(159/174),respectively.The diagnostic sensitivity and accuracy for residual and recurrent diseases were both 9/10;for lymph node metastasis were 94.59％ (105/111) and 92.92％ (105/113),respectively;and for other sites of metastasis were 93.75％ (45/48) and 88.24％ (45/51),respectively.There was no significant difference of SUVmax between the patients with residual/recurrent disease (mean:6.9±3.8,range:2.0-13.7) and those with metastasis (mean:6.3±2.7,range:2.0-14.4,t=0.629,P＞0.05).Conclusion 18F-FDG PET/CT is valuable for the detection of residual,recurrent and metastatic diseases in the uterine cervical cancer patients pr esenting with elevated serum squamous cell carcinoma antigen after conventional treatment.
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Objective To observe the effects of a decoction of buzhong yiqi in conjunction with rehabilitation training in relieving post-stroke fatigue.Methods A group of 115 stroke patients was enrolled and randomly divided into a simple rehabilitation group and a combination therapy group.Both groups received conventional rehabilitation treatment and appropriate treatment of any primary diseases.In addition,those in the combination therapy group were given a decoction of buzhong yiqi twice daily for a total of 4 weeks.EMG signals,subjective evaluations of fatigue severity,active rehabilitation exercise duration,motor function and ability in the activities of daily living (ADL) were assessed before treatment and after 4 weeks of treatment.The slope of the surface electromyogram's mean power frequency (KMPF) and median frequency (KMF) were used to quantify fatigue.Subjective fatigue severity was estimated using a fatigue severity scale (FSS).The active rehabilitation exercise lasted,on average,90 minutes daily.The Fugl-Meyer assessment (FMA) was used to evaluate motor function and the modified Barthel index (MBI) ADL ability.Results There were no statistically significant differences between the groups before treatment.After 4 weeks of treatment all the outcomes in both groups had improved (except the FSS scores of the simple rehabilitation group).The KMPF,KMF,FSS,exercise duration,FMA scores and MBI scores in the combination therapy group were all significantly better than those in the simple rehabilitation group.Conclusion Taking buzhong yiqi can significantly improve the clinical effects of conventional rehabilitation training on post-stroke fatigue.It helps relieve fatigue,improve active participation in rehabilitation exercise,and also improve motor function and ADL ability.
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@#ObjectiveTo observe the effect of Buzhongyiqi decoction on post stroke fatigue.Methods60 stroke patients with fatigue were given Buzhongyiqi decoction for 4 weeks continuously. Chinese New Drug Clinical Guidelines was to evaluate the effect for patients according to improvement of symptoms.ResultsIn 60 cases, markedly effective in 47 cases (78.33%), effective in 10 patients (16.67%), invalid in 3 cases (5%). Symptoms of malaise, anorexia, muscle soreness were significantly improved.ConclusionBuzhongyiqi decoction can improve post stroke fatigue of stroke patients.