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Objective@#To investigate the effects of Shuxuening injection combined with edaravone on neurological function, serum vascular endothelial growth factor (VEGF) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in patients with cerebral infarction.@*Methods@#A total of 112 patients with cerebral infarction admitted to Zhejiang Provincial Armed Police Hospital from August 2016 to August 2018 were enrolled in the study.They were divided into observation group and control group according to the digital table, with 56 patients in each group.The two groups were given routine symptomatic treatment.On the basis of this, the control group was given edaravone treatment, and the observation group was given Shuxuening injection combined with edaravone.The changes of NIHSS, GCS score, serum NSE, NGF, NTF, VEGF and sVCAM-1 levels before and after treatment were compared between the two groups, and the clinical efficacy was compared.@*Results@#After treatment, the effective rate of the observation group was 92.86%(52/56), which was higher than that of the control group 73.21%(41/56), the difference was statistically significant (χ2=7.669, P<0.05). After treatment, the NIHSS score, NSE, sVCAM-1 of the two groups were decreased, which of the observation group were lower than those of the control group[(3.27±1.16)points vs.(6.32±2.12)points, (13.15±1.14)μg/L vs.(17.64±1.89)μg/L, (648.56±134.67)ng/mL vs.(1 078.36±131.23)ng/mL], while the GCS score, NGF, NTF, VEGF levels of the two groups were elevated, which of the observation group were higher than those of the control group[(13.64±3.86)points vs.(11.89±3.41)points, (76.13±8.72)μg/L vs.(68.24±7.25)μg/L, (5.14±0.36)μg/L vs.(3.74±0.29)μg/L, (831.51±91.67)ng/L vs.(752.83±91.24)ng/L], the differences were statistically significant (t=9.414, 2.543, 15.223, 5.205, 22.663, 4.552, 15.672, all P<0.05).@*Conclusion@#Shuxuening injection combined with edaravone can improve the curative effect of patients with cerebral infarction, improve neurological function, effectively improve serum VEGF level and decrease sVCAM-1 level.It is worthy of clinical application.
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Objective@#To investigate the efficacy and safety of rosuvastatin combined with memantine hydrochloride in the treatment of vascular dementia.@*Methods@#Sixty-six patients with vascular dementia admitted to the Hospital of Zhejiang Provincial Armed Police Force and Haining Kanghua Hospital from January 2016 to January 2018 were enrolled.According to the digital table, the patients were divided into the observation group and the control group, with 33 cases in each group.Both two groups were given routine treatment.The control group was treated with rosuvastatin, and the observation group was given rosuvastatin combined with memantine hydrochloride.Both two groups were treated for 12 weeks.The ADL score and MoCA score, oxidative stress index, inflammatory factor, cerebral kinetic index changes, clinical efficacy and adverse reactions after treatment were compared between the two groups.@*Results@#The therapeutic effect of the observation group was 87.88%(29/33), which was significantly higher than 63.64%(21/33) of the control group (χ2=5.280, P=0.022). After treatment, the ADL, MoCA, SOD levels, Vmax and BHI of the observation group were (41.26±5.37)points , (24.23±1.71)points, (112.27±15.35)μU/L, (65.15±11.75)cm/s, (0.79±0.36), respectively, which were higher than those of the control group [(36.19±4.07)points, (20.25±1.46)points, (93.84±12.76)μU/L, (59.15±11.74)cm/s, (0.58±0.26)], the differences were statistically significant (t=4.322, 10.168, 5.304, 2.075, 2.846, all P<0.05). The levels of MDA, HCy, TNF-α, IL-6 and IL-1β in the observation group were (6.37±1.05)μmol/L, (31.36±9.59)μmol/L, (184.15±15.12)ng/L, (229.85±27.69)ng/L, (127.64±17.86)ng/L, respectively, which were lower than those in the control group [(7.32±1.07)μmol/L, (42.27±11.34)μmol/L, (208.72±15.26)ng/L, (262.75±25.64)ng/L, (148.75±18.64)ng/L], the differences were statistically significant (t=3.640, 4.220, 6.570, 5.008, 4.698, all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).@*Conclusion@#The clinical efficacy of rosuvastatin combined with memantine hydrochloride in the treatment of patients with vascular dementia can significantly reduce oxidative stress and inflammatory response, improve cerebral hemodynamics and cognitive function, and improve patients’ quality of life.
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To investigate the effects of Shuxuening injection combined with edaravone on neuro -logical function,serum vascular endothelial growth factor ( VEGF) and soluble vascular cell adhesion molecule -1 (sVCAM-1) in patients with cerebral infarction.Methods A total of 112 patients with cerebral infarction admitted to Zhejiang Provincial Armed Police Hospital from August 2016 to August 2018 were enrolled in the study.They were divided into observation group and control group according to the digital table ,with 56 patients in each group.The two groups were given routine symptomatic treatment.On the basis of this, the control group was given edaravone treatment,and the observation group was given Shuxuening injection combined with edaravone .The changes of NIHSS, GCS score,serum NSE,NGF,NTF,VEGF and sVCAM -1 levels before and after treatment were compared between the two groups,and the clinical efficacy was compared.Results After treatment,the effective rate of the observation group was 92.86%(52／56),which was higher than that of the control group 73.21%(41／56),the difference was statistically significant (χ2 ＝7.669,P＜0.05).After treatment,the NIHSS score,NSE,sVCAM-1 of the two groups were decreased,which of the observation group were lower than those of the control group [(3.27 ±1.16)points vs. (6.32 ±2.12)points,(13.15 ±1.14)μg／L vs.(17.64 ±1.89)μg／L,(648.56 ±134.67)ng／mL vs.(1 078.36 ± 131.23 ) ng／mL], while the GCS score, NGF, NTF, VEGF levels of the two groups were elevated , which of the observation group were higher than those of the control group [(13.64 ±3.86) points vs.(11.89 ±3.41) points, (76.13 ±8.72) μg／L vs.( 68.24 ±7.25 ) μg／L, ( 5.14 ±0.36 ) μg／L vs.(3.74 ±0.29) μg／L, (831.51 ± 91.67)ng／L vs.(752.83 ±91.24) ng／L],the differences were statistically significant (t＝9.414,2.543,15.223, 5.205,22.663,4.552,15.672,all P ＜0.05).Conclusion Shuxuening injection combined with edaravone can improve the curative effect of patients with cerebral infarction ,improve neurological function,effectively improve serum VEGF level and decrease sVCAM -1 level.It is worthy of clinical application.
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Objective To investigate the efficacy and safety of rosuvastatin combined with memantine hydrochloride in the treatment of vascular dementia.Methods Sixty-six patients with vascular dementia admitted to the Hospital of Zhejiang Provincial Armed Police Force and Haining Kanghua Hospital from January 2016 to January 2018 were enrolled.According to the digital table,the patients were divided into the observation group and the control group,with 33 cases in each group.Both two groups were given routine treatment.The control group was treated with rosuvastatin,and the observation group was given rosuvastatin combined with memantine hydrochloride.Both two groups were treated for 12 weeks.The ADL score and MoCA score,oxidative stress index,inflammatory factor,cerebral kinetic index changes,clinical efficacy and adverse reactions after treatment were compared between the two groups.Results The therapeutic effect of the observation group was 87.88％ (29/33),which was significantly higher than 63.64％ (21/33) of the control group (x2 =5.280,P =0.022).After treatment,the ADL,MoCA,SOD levels,Vmax and BHI of the observation group were (41.26 ± 5.37) points,(24.23 ± 1.71) points,(112.27 ± 15.35) μU/L,(65.15 ± 11.75) cm/s,(0.79 ± 0.36),respectively,which were higher than those of the control group [(36.19 ± 4.07) points,(20.25 ± 1.46) points,(93.84 ± 12.76) μU/L,(59.15 ± 11.74) cm/s,(0.58 ± 0.26)],the differences were statistically significant (t =4.322,10.168,5.304,2.075,2.846,all P ＜ 0.05).The levels of MDA,HCy,TNF-α,IL-6 and IL-1β in the observation group were (6.37 ± 1.05) μmol/L,(31.36 ± 9.59) μmol/L,(184.15 ± 15.12) ng/L,(229.85 ± 27.69) ng/L,(127.64 ± 17.86) ng/L,respectively,which were lower than those in the control group [(7.32 ± 1.07) μmol/L,(42.27 ± 11.34) μmol/L,(208.72 ± 15.26) ng/L,(262.75 ± 25.64) ng/L,(148.75 ± 18.64) ng/L],the differences were statistically significant (t =3.640,4.220,6.570,5.008,4.698,all P ＜ 0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusion The clinical efficacy of rosuvastatin combined with memantine hydrochloride in the treatment of patients with vascular dementia can significantly reduce oxidative stress and inflammatory response,improve cerebral hemodynamics and cognitive function,and improve patients' quality of life.
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Objective To explore the effects of surgery treatment on the diagnostic delay of Crohn's dis-ease(CD)in early stage. Methods The effects of surgical operation on diagnostic delay of early stage CD were an-alyzed,and the risk factors that in high surgical rate on early diagnosis were evaluated by comparing the surgical cases with non-surgical cases before the diagnosis of CD.Results The ratio of male and female in the total 215 pa-tients with CD was 1.7 to 1.There were 114 cases with complications including 75 cases with surgery before diagno-sis,39 cases with non-surgical complications and 101 cases with no complications.The age of onset and age of di-agnosis in the three groups were significantly different(P < 0.05),and there was no significant difference in the time of diagnosis(P > 0.05). The most common complications were perianal lesion(p,abscesses and/or fistula) (49.1%),intestinal obstruction(23.7%),and the diseases of appendix(12.3%).The most common causes of pre-operative diagnosis were perianal lesion(38.7%),the lesion of appendix(17.3%),intestinal obstruction(16.0%) and the abdominal surgery(10.5%)whereas intestinal perforation is most easily recognized by histopathology. The rate of male surgery was high whereas the incidence of female complications was low. All three groups of lesions were found to be in ileocolon(L3)in which the operation group with pure small intestine was significantly higher than that in the group with no complications and in the group with non-surgical complications(P<0.05).Also the proportion of diseases behaving stricturing(B2)+penetrating(B3)was 60%,but the complication group behaving inflammatory(B1)+B2 was 87.2%,the group with no complications behaving B1 reached 68.3%.and The compli-cation group behaving P was 61.5% which was higher than the operation group(44.0%).There was a significant dif-ference between the three groups(P<0.001).Conclusions Diagnostic delay of CD on the early was significantly associated with surgery operation. Male,age 17~40,lesion site L3 or intestinal-type,disease behaving B2 and B3,were the high risk factors for preoperative surgery;while women,aged 17-40,with or without chronic compli-cations,were more likely to obtain early diagnosis,less surgical risk,and relatively good prognosis.Perianal lesion were early characteristic expressions of CD and could be used as an regularization indicator for screening.The sec-ond was the recurrent intestinal obstruction.most of the stomach resection and the repeated diarrhea after gallblad-der should be awared of CD.
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Objective To investigate the effect of different endoscopic sclerotherapy for esophageal variceal bleed-ing caused by rupture. Methods 66 cases of liver cirrhosis with esophageal variceal bleeding were randomly divided into treatment group A, endoscopic lauromacrogol sclerotherapy group B and endoscopic aethoxysklerol 1% German agents in treatment of group C, then observe the successful hemostasis, the curative effect and follow-up of patients with varices, bleeding, fever and other adverse conditions. Results Group B and group C with success rate of hemostasis has obvious advantages compared with group A, 0.05, the difference was not statistically significant; adverse conditions such as fever, ulcers, pain in group B was less than that in group C, <0.05, the difference was statistically significant. Conclusion Endoscopic lauromacrogol injection sclerotherapy for esophageal variceal bleeding is a safe, fast speed, timely, effective and repeatable treat-ment, it is worthy of promoting clinical application.
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Objective To understand the status and features of nursing care adverse events and to offer scientific basis for improving patient safety management of nursing at high altitude area. Methods Data such as categories, causes, time distribution and other factors of nursing care adverse events were collected from January 2013 to August 2014 in the People′s Hospital of Tibet Autonomous Region were analyzed. Results Over the study period, 50 adverse events were recorded and the most common types were tube emersion(26%,13/50), pressure sores(14%,7/50) and scald(12%,6/50) respectively. The proportions of different severity of adverse events were hidden events (48%,24/50), events without bad consequence(36%,18/50), adverse events(14%,7/50) and warning events(2%,1/50) respectively. The ineffective communication, inadequate assessment, and not abiding by the rules accounted for 70%(35/50) of the causes of adverse events. 7:00-10:59 and 19:00-22:59 period was the high incidence of adverse events, respectively accounted for 32%(16/50) and 26%(13/50). Conclusions The management of nursing adverse events at high altitude area need to consider the geographical characteristics,besides, to guarantee the implementation of the system,reduce the bed / nurse ratio, improve the comprehensive quality of nurses and other measures can be taken to reduce the occurrence of adverse events.
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A survey was conducted on a sample of 67 general practitioners ( GPs ) receiving in-service training in Beijing in 2012.Hypertension knowledge mastering and training status were investigated through a self-administered questionnaire .Results showed that the accuracy rates of the 4 domainitems (basic knowledge and skill, lifestyle modification, drug therapy, health management ) were 42.3%(340/804), 48.0%(225/469), 27.8%(96/335) and 70.6%(473/670), respectively with an overall accuracy rate of 49.8%(1 134/2 278).Trainees from urban scored higher than those from rural areas (P<0.01).About one third of trainees indicated that the 3 main teaching sessions they took part in did not cover the content of hypertension management .The hypertension guideline ( primary care version 2009) was most frequently used for training GPs , but only 33.9%(21/62) accessed such training .The results indicate that hypertension knowledge level seems to be generally low among GPs on in-service training in Beijing and the current training situation need to be further improved , particularly for those from rural areas .
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ObjectiveTo investigate the effects of treadmill testing guided-rehabilitation exercises upon quality of life (QOL) of patients who underwent revascularization for coronary heart disease (CHD).Methods All the participants received routine therapy and rehabilitation for 6 weeks.A 36-item short-form (SF-36) was used to assess QOL of the patients.Results Injured functioning of patients who received revascularization for CHD were physiological function ( 37.86 ),social function ( 43.67 ),vitality (45.58),physical performance ( 65.45 ),mental health ( 68.73 ),role emotion ( 71.30 ),physical pain ( 79.52 ),and general health ( 86.75 ).After intervention,physiology function ( 37.86 ± 8.49 vs 62.13 ± 10.53 ),social function (43.67 ±26.23 vs 56.98 ± 18.89),vitality (45.58 ±27.01 vs 77.42 ±23.48),and physical pain (79.52 ±9.05 vs 87.32 ± 13.14) were significantly improved.Conclusion Rehabilitation exercises and behavioral psychological treatment may be beneficial to improve QOL of patients undergoing revascularization for CHD.
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Objective To judge the hospital crisis and to provide the approaches and strategies to avoid the hospital crisis. Methods To conduct specific diagnosis of important risk factors of hospitals using expert diagnostics and crisis identification. Results Combined with the index system and weight affecting public hospitals' crisis, to focus on preventing risk factors directly, which had severe affection and put great weight on hospital crisis. To raise up the containments, managing strategies and mechanisms for public hospitals' crisis. Conclusions It is an effective method to warn and prevent hospital crisis by the way of establishing public hospital crisis value with fuzzy comprehensive evaluation system.
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Objective To study the causes, epidemiology and control measures of outbreak of MRSA nosocomial infections. Methods The epidemiologic survey was carried out for 7 cases infected with MRSA within short term in the department of neurosurgery. The risk factors and epidemiological trends was analyzed. Results Some measures, such as strengthening training of health worker with MRSA prevention and control knowledge, enhancing their awareness of infection prevention and control, and controlling patients infected with MRSA effectively using warning mechanisms of MRSA infection outbreaks, should be taken to control the outbreak and spread of MRSA promptly. Conclusions Nosocomial MRSA infection is preventable and controllable.
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To study the effect of nursing intervention on the incidences of complications caused by intracerebral hemorrhage. Methods One hundred and fifty two inpatients of intracere-bral hemorrhage were randomly divided into nursing intervention group and control group. The effects of the two groups were compared. Results The control group was higher than the nursing intervention group on the incidences of complications in constipation and hypostatic pneumonia and the average inpa-tient days(P