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To solve the problems of insufficient airway opening, insufficient or excessive ventilation, ventilation interruption, and the rescuer's physical strength during the process of cardiopulmonary resuscitation (CPR) outside the hospital and in the hospital, and to ensure the accuracy of ventilation frequency rate and tidal volume. Zhongnan Hospital and School of Nursing, Wuhan University, jointly designed and developed a smart emergency respirator with open airway function, that has been granted National Utility Model Patent of China (ZL 2021 2 1557989.8). The device is structured of pillow, pneumatic booster pump and mask. It can be used simply by plugging the pillow under the patient's head and shoulder, turning on the power supply and wearing the mask. The smart emergency respirator can quickly and effectively open the patient's airway and give accurate ventilation with adjustable ventilation parameters. The default settings are 10 times/min in respiratory rate and 500 mL in tidal volume. The whole operation does not require the operator have professional operation ability, which can be independently applied used in any cases without oxygen source or power supply, therefore, the application scenario has no limit. The device has the advantages of small size, simple operation and low production cost, which can reduce human source, save physical strength and significantly improve the quality of CPR. The device is suitable for respiratory support in multiple scenes outside and inside the hospital, and can significantly improve the success rate of treatment.
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Objective:To understand the clinical diagnosis and treatment ability of Chinese and French medical students, so as to improve the education of clinical medicine in China, improve the diagnosis and treatment ability of medical students, and provide reference for improving training quality of medical personnel.Methods:Retrospective analysis was made on the clinical skills competition of Chinese and French medical students, and the percentages of three categories of students' scores were compared (1 team of general practice residents, 3 teams of Chinese undergraduates, and 3 teams of French undergraduates).Results:In clinical basic skills such as electrocardiogram and imaging interpretation site, the scores of general practice residents were higher than those of Chinese and French undergraduates, and there was no significant difference between Chinese and French undergraduates. In clinical virtual case sites, except for few items in surgery site, general practice residents and Chinese undergraduates were better than French undergraduates in many evaluation items. In the internal medicine site, 6 out of 8 scoring items of French undergraduates were higher than those of Chinese undergraduates. In the medical team comprehensive first-aid site, 8 out of 10 scoring items of Chinese undergraduates were higher than those of French undergraduates.Conclusion:Clinical thinking and decision-making of undergraduates in our university need to be improved compared with that of French students. The general practice residents in our school need to be strengthened in the aspects of clinical thinking, decision-making and the cooperation with emergency team.
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Objective:To evaluate the effects of wearing N95 mask on the quality of chest compression and fatigue.Methods:A total of 80 participants from Zhongnan Hospital with basic life support (BLS) certification conferred by American Heart Association (AHA) within two years were enrolled. After reviewing the key points of cardiopulmonary resuscitation (CPR) and grasping the operation on the manikin, they were randomized (random number) into two groups: wearing surgical masks (SM group, n=40) and wearing N95 masks (N95 group, n=40) during CPR. Each participant performed a 2-minute chest compression-only CPR on the manikin. Participants' height, body weight, Borg scores and physiological parameters before and after CPR were recorded. The quality of chest compression (including compression depth, compression rate, adequate depth proportions, adequate rate proportions, hand position and complete chest recoil) were recorded by Laerdal QCPR ? software. Student's t test and Mann-Whitney test were used to compare the differences of chest compression quality indexes between the two groups. Results:Compared with the SM group, participants in the N95 group had significantly increased median of Borg scores after CPR (16 vs 14, P=0.027), and decreased quality of chest compression, including the decline in compression depth (mean 47 mm vs 52 mm, P=0.020), compression rate (107 times/min vs 118 times/min, P=0.004), complete chest recoil rate (89.8% vs 98.1%, P=0.046), adequate depth proportions (67.4% vs 89.6%, P<0.01) and adequate rate proportions (60.6% vs 74.8%, P<0.01). Conclusions:Wearing N95 masks during CPR decreases the quality of chest compression and aggravates rescuers’ fatigue. Therefore, it is necessary to exchange rescuers more frequently to ensure the quality of chest compression when wearing N95 masks.
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Objective To explore the relationship between meteorological conditions and emergency visiting of acute onset of renal colic caused by kidney stones. Methods Retrospective study design was applied to collect the emergency visiting data of acute renal colic attack in zhongnan hospital of Wuhan university from January 1, 2016 to December 31, 2017, as well as the average daily temperature and humidity in wuhan, hubei province during the same period. Pearson correlation analysis and linear regression analysis were used to study the relationship between meteorological conditions and emergency visiting of acute onset of renal colic caused by kidney stones. Results The results of multivariate linear regression analysis showed that the R 2 of daily visits of patients with renal colic and daily meteorological conditions was 0.309 (P < 0.05), and the R 2 of monthly visits of patients and monthly meteorological conditions was 0.642 (P<0.05). Conclusions Both temperature and humidity are correlated with the number of emergency visits of acute attack patients with renal calculi and colic.
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Objective To investigate the general knowledge of cardiopulmonary resuscitation (CPR), the attitudes and willingness of massive open online course (MOOC) students to perform CPR. Methods A questionnaire survey was carried out among 1212 MOOC students who participated in CPR training courses in July 2017. Data were obtained through electronic self-administered questionnaire consisting of individual information, knowledge, attitudes and perceptions of CPR, willingness to perform CPR in emergency scenarios, and changes in self-confidence before and after the CPR training courses. Results Totally 1092 questionnaires were qualified with a response rate of 90.1％. 97.2％ of the respondents understood the meaning of CPR, 83.2％ were willing to disseminate the first-aid knowledge, and 55.2％ had previous CPR training. When confronted with cardiac arrest in emergency scenarios, MOOC students were more likely to perform chest compressions (CC) than CC+mouth-to-mouth ventilation (MMV) (P<0.01). The willingness to implement CC+MMV is significantly stronger for family members than strangers (P<0.01). Furthermore, the barriers of performing CC+MMV were lack of confidence (33.8％), fear of disease transmission (29.5％), and fear of harming the victim (28.4％). Self-confidence in the implementation of CPR in emergency scenarios improved a lot compared with no experience of participating in CPR training (P<0.01). Conclusions MOOC students have a positive attitude toward CPR. Lack of confidence is the strongest hindrance to attempt CPR. MOOC training on CPR enhance the general public's self-confidence in the implementation of CPR.
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Due to the decline of motor ability and the impact of the diseases, abnormalities in gait is common in the elderly population, which will raise the risk of fall and cause serious injury. This study focuses on the analysis of the gait kinematics parameters of normal adults' gait, aiming to investigate the characteristics of gait parameters in different age groups and to explore the role of gait parameters in motor function assessment and clinical diagnosis. Based on the gait data gained by electronic walkway, the relationship among the toe out angles and their correlation with age and gender etc. were quantitatively analyzed. The results show that most normal subjects walk with positive toe out angles, and the angles increase with age. Such changes are slow in the young and middle age groups. However, the elevations of the left out toe angle and the angles between the feet are statistically significant after entering elder age ( >60 years). The results also suggest that the angle between the feet is a kind of practical gait parameter for varying applications. This study concludes that feet angle analysis is potential to provide a convenient and quantitative tool for the assessment of lower limb motor ability and the diagnosis of knee joint diseases.
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Objective To explore the role of receptor for advanced glycation end products (RAGE) in HMGBl-mediated CD4+ T cells differentiation to Th1/Th2.Methods CD4+ T lymphocytes isolated from the spleens of male BALB/C mice by magnetic beads were suspended in RPMI-1640 with 10％ FCS in 2× 106cell/well on 96-well cell culture plates in vitro.The cells were randomly divided 4 groups according to concentration of HMGB1 treatment:control group,10 ng/mL group,100 ng/mL group,1 000 ng/mL group after stimulation with ConA in 3 μg/mL for 12 hours.IL-4 and IFN-γ levels in culture supernatants were quantitated by ELISA kits after HMGB1 stimulation for 12,24,and 48 h.According to the results,cultured cells were exposed to HMGB1 in 100 ng/mL for 24 h in the following experiments.The cells were randomly divided into 4 groups:control group,A group,B group,C group,and each group were cultured with ConA in 3 μg/mL for 24 h.The cells of control group and other three groups were stimulated with PBS or 100 μg/L HMGB1 for 24 h.The cells of B,C groups were incubated with 1/200 diluted 5 μg/L anti-RAGE Abs (anti-bodies) or PBS for 2 h before HMGB1 stimulation.The cell suspension was obtained to detect the levels of IL-4 and IFN-γ by EILSA and the protein levels and mRNA expressions of RAGE,CATA-3 were detected by western-blot and real-time fluorescent quantitative PCR,respectively.ResuRs Compared with control group,CD4+ T cells incubated with increasing concentrations of HMGB1 (100,1 000 ng/mL) for 24 h resulted in a decrease in IFN-γ/IL-4 ratio (P＜0.05).When CD4+ T cells were exposed to 100 ng/mL HMGB1 for 12 h,IFN-γ/IL-4 ratio was markedly increased.However,CD4+ T cells treated with 100 ng/mL HMGB1 for 24,48 h,IFN-γ/IL-4 ratio was markedly inhibited (P＜0.05).Compared with control group,protein levels and mRNA expressions of RAGE and GATA3 of cells in A group were significantly increased (P＜0.05),and IFN-γ/IL-4 ratio of cell suspension in A group and B group was significantly down-regulated (P＜0.05).Compared with A group,IFN-γ/IL-4 ratio of cell suspension in C group was increased (P＜0.05),and expression of GATA3 mRNA was down-regulated (P＜0.05).Compared with A group,protein level of RAGE of cells in C group was significantly down-regulated (P＜0.05),but protein level of RAGE of cells in C group was still increased compared with control group (P＜0.05).Conclusion Th1/Th2 differentiation induced by HMGB1 on CD4+ T lymphocytes in vitro was at least partly mediated by over-activating RAGE/GATA3 pathway.
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BACKGROUND AND PURPOSE: The objective of this study was to determine the prevalence of and risk factors for dementia in residents aged 65 years and older in a Chinese nursing home. METHODS: A cross-sectional study was carried out in a nursing home located in Hangzhou, Zhejiang Province, China. Cognitive status, including the presence of dementia and mild cognitive impairment (MCI), was measured using a combination of medical history and objective cognitive assessments. Logistic regression analysis was conducted to predict the associated risk factors. RESULTS: In total, 943 residents (334 males and 609 females) aged 84.00±6.67 years (mean±SD) were included. Dementia was diagnosed in 420 (44.5%) residents, and MCI was diagnosed in 195 (20.7%). Mild, moderate, and severe dementia were present in 20.3%, 14.0%, and 65.7% of those in the dementia group, respectively. Logistic regression analysis revealed that dementia was associated with a low education level (p=0.000), an advanced age (p=0.010), and a history of stroke (p=0.023). CONCLUSIONS: Our study found a high prevalence of dementia in a Chinese nursing home, and a high prevalence of patients with severe dementia. Risk factors for dementia included a low educational level, an advanced age, and a history of stroke. Appropriate interventions need to be applied to this population.
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Humanos , Masculino , Povo Asiático , China , Estudos Transversais , Demência , Educação , Modelos Logísticos , Disfunção Cognitiva , Casas de Saúde , Enfermagem , Prevalência , Fatores de Risco , Acidente Vascular CerebralRESUMO
Objective To investigate the occurrence and severity of behavioral and psychological symptoms of dementia(BPSD)in elderly dementia patients,and to explore the relationship of the degree of dementia and the severity of BPSD with the burden of caregivers in pension agency.Methods Using a convenient sampling method,the Clinical Dementia Rating (CDR) scale,neuropsychiatric scale (NPI)and Zarit caregiver burden scale(ZBI)were used to evaluate 145 patients with Alzheimer's disease and caregiver burden in Hangzhou.Results The incidence rate of BPSD was 51.8 ％ (72 cases),with a higher incidence rate of delusions of 22.3％ (31 cases),a higher severity of sleep disorder/nocturnal behavior [NPI symptom score (5.95 ± 4.60) points].The symptom making a greatest burden on the caregivers was delusion [ZBI score (32.81 ± 17.66) points].There were positively correlations of the burden of caregivers with the degree of dementia and the severity of BPSD (r=0.434,0.710,all P＜0.01)in patients with senile dementia.Conclusions The incidence rate of BPSD in dementia patients is higher,and the occurrence of BPSD is associated with the severity of mini mental state examination(MMSE)and dementia,which increases the burden of caregivers.More attention should be paid to BPSD in patients with senile dementia.And the social support system serving patients with senile dementia and their caregivers should be further improved.
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Objective To examine the availability of emergency medical services(EMS) for patients with acute stroke and to investigate influential factors affecting the preference of patients'to EMS.Methods Consecutive information of patients with acute stroke who presented to the emergency department of Zhongnan Hospital of Wuhan University from June 1, 2014 to December 31, 2015 were analyzed.Gender, age of patients, transport modality, risk factors in cerebrovascular diseases, initial symptoms, stroke types, onset and admission time were included to make analysis in retrospective study.The participants were divided into two groups based on the preference of patients, namely EMS group and self-transport group.Wilcoxon rank sum test or Chi-squared test was used to statistical analysis as appropriate.A multiple binary logistic regression was used to determine the relationship between various patient-related factors with probability whether patients chose EMS or not.Results Among the 240 patients, only 29.2%of them asked for the EMS at the onset of symptoms (EMS group, n=70), and the rest patients called for other services(self-transport group, n=170).Logistic regression analysis revealed that the patients with the symptom of altered consciousness or convulsion (95%CI:0.107-0.403,OR=0.208,P<0.01) were more likely to use EMS.The time consumed from onset to visit of patients with acute stroke to emergency physician was significantly shorter in EMS group (M, 60 min vs.180 min,P<0.01).Conclusion The symptom of altered consciousness or convulsion was the independent factor to determine whether patients with acute stroke preferred EMS or not.
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To solve the problem that mostly gait analysis is independent from the treatment, this work proposes a system that integrates the functions of gait training and assessment for foot drop treatment. The system uses a set of sensors to collect gait parameters and designes multi-mode functional electrical stimulators as actuator. Body area network technology is introduced to coordinate the data communication and execution of the sensors and stimulators, synchronize the gait analysis and foot drop treatment. Bluetooth 4.0 is applied to low the power consumption of the system. The system realizes the synchronization of treatment and gait analysis. It is able to acquire and analyze the dynamic parameters of ankle, knee and hip in real-time, and treat patients by guiding functional electrical stimulation delivery to the specific body locations of patients.
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Humanos , Estimulação Elétrica , Terapia por Estimulação Elétrica , Terapia por Exercício , Marcha , Tecnologia sem FioRESUMO
<p><b>OBJECTIVE</b>To observe the efficacy and safety of acupuncture therapy on moderate and severe allergic rhinitis via the comparison evaluation of western medicine.</p><p><b>METHODS</b>Sixty cases of moderate and severe allergic rhinitis were divided into an acupuncture group (30 cases) and a western medicine group (30 cases). In the acupuncture group, the main acupoints included Yingxiang (LI 20), Shangxing (GV 23), Fengchi (GB 20), Quchi (LI 11), Xuehai (SP 10), Feishu (BL 13), Geshu (BL 17), Pishu (BL 20), etc. The supplementary points were selected according to syndrome differentiation. In the western medicine group, budesonide nasal spray and cetirizine tablets were prescribed. All the cases were treated for 8 weeks in the two groups. Separately, before treatment, in 4 weeks and 8 weeks of treatment, the scores of clinical symptoms and physical signs were observed and the clinical efficacy and safety were compared between the two groups.</p><p><b>RESULTS</b>In 4 weeks and 8 weeks of treatment, the scores of symptoms such as sneezing, nasal discharge, nasal obstruction, nasal itching, eye itching and turbinate hypertrophy, the score of physical signs and total score were all reduced apparently as compared with those before treatment (all P<0. 05). The differences were not significant between the acupuncture group and the western medicine group (all P>0. 05). The total effective rates were 90. 0% (27/30) and 93. 4% (28/30) in the acupuncture group after 4 and 8 weeks of treatment, and were 76. 6% (23/30) and 80. 0% (24/30) in the western medicine group separately, without significant difference in comparison (all P>0. 05).</p><p><b>CONCLUSION</b>Acupuncture achieves the similar efficacy on moderate and severe allergic rhinitis as western medicine. It is the safe therapy and has no apparent adverse reactions.</p>
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Pontos de Acupuntura , Terapia por Acupuntura , Rinite Alérgica , Terapêutica , Espirro , Resultado do TratamentoRESUMO
Objective:To investigate the effect of live lactobacillus preparation in the treatment of postpartum vagina microenviro-ment dysbiosis. Methods:Totally 300 cases of postpartum women were selected in our hospital from February 2013 to November 2013, including those with normal delivery, cesarean section and vaginal delivery after lochia, and each was with 100 cases. The vaginal se-cretion was withdrawn from vagina and the microenvironment was assessed. The patients with dysbiosis were randomly divided into two groups, the observation group was treated with living lactobacillus preparation and the treatment group was without treatment. The effi-cacy and incidence of bacterial vaginosis(BV) were observed. Results:Totally 88 cases (29. 3%) occurred vaginal dysbiosis. There were significant differences in the dysbiosis incidence rate, pH, H2 O2 results, microscopic examination results and the distribution of flora between the two groups (P <0. 05). The effective rate of the observation group was 95. 5%, which was significantly higher than that of the control group (29. 5%). The incidence rate of BV was 4. 5% in the observation group, which was significantly lower than that in the control group [75%] (P<0. 05). Conclusion: The effect of the lactobacillus preparation in the treatment of postpartum vagina microenviroment dysbiosis is promising and safe.
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Objective To develop a feasible method for evaluating uncertainty in colony forming units(CFU)on the disinfected skin of nurses of operation room.Methods A nurse of operation room in a hospital involved the study.Ten spots on her disinfected hand skin were selected for evaluation of uncertainty in the acquired data and analysis of reliability of the evaluation methods,according to Technical Norms for Monitoring the Disinfection and Sterilization Quality in Hospitals in Jiangsu Province and JJF1059-1999 Evaluation and Expression of Uncertainty in Measurement.Results The CFU on the disinfected skin of nurse was(4±2)cfu/cm2, which indicated that the disinfection of the nurse's hands was not qualified.Conclusion The evaluation method by our study is reliable for evaluating the uncertainty in CFU on nurse’s disinfected hand skin.It is simple and fitful for the uncertainty evaluation of hospital disinfection effect.
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Objective To explore the relationship between the amount of bleeding and the histopathologic grade of cerebral glioma with susceptibility weighted imaging (SWI), so that to assess the diagnostic value of SWI in grading cerebral glioma. Methods Totally 30 patients with cerebral glioma underwent SWI. The area of hemorrhage of every slice displayed in SWI was measured with software. The rate and amount of bleeding were compared between high and low grade tumors. Results There was no statistical significance in the incidence of detected bleeding on SWI (P=0.064), though it was higher in highly malignant group (80.00%) than that in low grade group (46.67%), while there was statistical significance in the amount of bleeding detected on SWI (Z=-2.275, P=0.026) between highly malignant group and low grade group. Conclusion The amount of tumor hemorrhage displayed in SWI is valuable for the preoperative grading of cerebral glioma.
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Objective To determine the toxicity of therapeutical Serratia marcescans vaccine when repeated intracerebral administration into rat brain.Methods SD rats are prepared by intracranial embedding location catheter and were randomly divided into 8 groups:namely normal control,lunar control group(give NS in same dose),low dosage group,middle dosage group and high dosage group of acute stage or restore stage.Three dosage of vaccine S311 were administrated(low 320 million/kg,middle 1600 million/kg,high 8000 million/kg).The embedding catheter rats were fixed point injecting vaccine,once per day for 15 days with microsyringe of microdialysis device.While continuously record the common status,appetite,body weight of animals.25 days later,Animals were killed to observe the morphology of brain.Results The main pathologic changes of high dosage group were inflammatory cell infiltration into the tissues around injecting location,subarachnoid space,and ependyma.The inflammatory cell is mainly gial cell,monocytes,lymphocytes.No degeneration and necrosis of brain tissue were observed.The inflammatory reaction of brain tissues around injecting location was correlated with the dosages.Except the inflammation around injecting location,the other brain tissues were normal and absent of organic pathological changes.After 25 days restoration,the inflammation around injecting location was absorbed.Conclusions The method of intracranial embedding catheter and fixed point injecting is successful.Intracranial administration of therapeutical Serratia marcescans vaccine is mainly effect on location around injecting to elicit localized,reversible,and non-specific inflammatory reaction.
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To sum up and analyze the representative point compatibility theory after Inner Canon of Huangdi to explore t he compatibility rules of point in acupuncture prescription.On base of references and predecessor,s experience,combined with clinical practice,compatibility rules of point can be concluded that zhu-ke-fu-ying points was the elementary compatibility,and shu-mu-qi points should be selected according to syndrome differentiation,thereby forming a traditional and orderly prescription which reflected principle-method-recipe-point.
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Objective: To determine the value of telomerase activity in urine exfoliated cells as clinical indicator of tumor presence, stage, and recurrence. Methods: The techniques of TRAP-PCR and TRAP-sliver staining were employed to detect telomerase activity in 73 patients with TCC before operation (study group) and 20 benign urothelial cancer patients (control group) and 21 normal individuals (normal group). Cytologic results were obtained simultaneously. The bladder tumor specimens were obtained from 73 patients during operation, and histologically evaluated for tumor content and grade. Results: Positive rate of telomerase activity detection in TCC patients (80.8%,59 of 73) was significantly higher than that of cytological examination (20.5%, 15 of 73). Positive telomerase activity was not found in 17 of 20 in control group and none was found in normal group. Analysis of the distribution of abnormalities with tumor stage revealed greater detection of high pathological stage (T 2-T 4) (89.7%, 26 of 29) compared with low stage (Tis-T 1) (75%, 33 of 44). Conclusion: Detection of telomerase activity in urine exfoliated cells may be a sensitive and effective marker in the diagnosis of TCC.
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Objective To study changes of telomerase activity in transitional cell carcinoma after intravesical instillation of Serratia Marcescens . Methods TRAP-PCR and TRAP-sliver staining were used to detect telomerase activity in 20 patients with TCC after intravesical instillation of Serratia Marcescens . Results Positive rate of telomerase activity detection in TCC patients after intravesical instillation of Serratia Marcescens was 50%(10/20),significantly lowed than before the intravesical instillation (90%,18/20), P
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Objective The purpose of this study was to determine the value of K-ras mutation in DNA extracted from the plasma as clinical indicator of colorectal cancer. Methods Point mutation at codon 12 of K-ras gene was assayed by polymerase chain reaction of sequence-specific primers in DNA extracted from the plasma and tumors from 32 patients with colorectal cancer. The mutation was further confirmed by dideoxy-mediated chain-termination method of DNA sequencing. Results Fourteen patients (44%) had a codon 12 K-ras mutation within their primary tumors and identical mutations were found in the plasma DNA of 13 patients (93%). Mutant DNA was not detected in the plasma specimens of 18 patients whose tumors tested negative for K-ras alterations or in 5 healthy control subjects. Conclusion Preliminary results suggest the detection of K-ras mutations in circulating DNA extracted from the plasma specimens may have some clinical uti- lity in the detection of colorectal cancer.