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Objective:To summarize the management experience of helicopter medical transport in patients with critical heart disease, so as to provide reference for transport of patients with critical heart disease under the background of major natural disasters.Methods:The clinical and transport data of 36 critically ill cardiac patients in Fuwai Central China Cardiovascular Hospital from 16:30 on July 21 to 19:30 on July 22, 2021 due to historically rare heavy rainstorms were collected. All 36 critically ill cardiac patients were transported by helicopter. The safe transportation was implemented under the measures of quickly forming a transport leadership and coordination group, clarifying responsibilities and division of labor, doing a good job in the pretreatment of the patient's condition, pipeline assessment and mechanical circulation support (MCS) equipment, simulating and practicing the transfer process, improving the safety of the transfer implementation process, and effectively handing over with the target hospital. The gender, age, disease type, MCS, transport and outcome of patients were collected.Results:Thirty-six patients with cardiac critical illness were from adult extracardiac intensive care unit (ICU), adult cardiac care unit (CCU), children's CCU, comprehensive ICU and department of neurology. There were 24 males and 12 females; age (50.93±20.86) years old. There were 12 patients using respirator, 7 patients needing MCS, 2 of whom needed both extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP), and 7 patients with post-cardiac surgery. The total distance of transportation of 36 patients was 1 638.4 km, the transit time was 10.5 hours, one way flight time of helicopter was about 8 minutes, and the average transport time per patient was about 17.5 minutes. The vital signs of 36 patients during transport were basically stable, without complications, and all of them reached the target hospital safely.Conclusion:Under the seamless connection of the rapid establishment of the transfer leadership coordination group, assessment of the patient's condition and pretreatment, the simulation of the transfer process, and the effective handover with the receiving hospital, the use of helicopter for medical transport for critically ill heart patients is feasible and safe, which can buy valuable time for saving patients' lives and further treatment.
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Objective:To investigate the application value of paradoxical intention therapy in patients undergoing PCI.Methods:A total of 116 patients who undergoing PCI in Fuwai Center China Cardiovascular Hospital from January 2018 to December 2019 were enrolled in the present study. They were divided into experimental group and control group with 58 cases in each group. The control group received routine therapy and nursing care, while the experimental group carried out paradoxical intention therapy based on the control group. The effects were evaluated by physiological stress index (blood pressure, heart rate), Symptom Checklist-90 (SCL-90) and General Comfort Questionnaire (GCQ) respectively.Results:At 1 day before surgery, once on the operative day and 1 day after surgery, the systolic pressure were (129.58 ± 13.89), (132.08 ± 12.28), (125.58 ± 12.28) mmHg(1 mmHg=0.133 kPa) in the experimental group, significantly lower than those in the control group (137.22 ± 11.18), (138.35 ± 14.94), (132.35 ± 14.89) mmHg, the differences were statistically significant ( t=3.14, 2.38, 2.59, all P<0.05). At 1 day before surgery and once on the operative day, the heart rate were (74.17 ± 4.18), (76.39 ± 5.14) times/minutes in the experimental group, significantly lower than those in the control group (76.62 ± 5.19), (78.78 ± 6.22) times/minutes, the differences were statistically significant ( t=2.69, 2.17, both P<0.05). After 4 weeks of intervention, the scores of somatization, compulsion, anxiety, depression and total SCL-90 were (1.25 ± 0.19), (1.42 ± 0.23), (1.19 ± 0.28), (1.20 ± 0.16), (121.66 ± 9.66) points in the experimental group, significantly lower than those in the control group (1.84 ± 0.25), (1.68 ± 0.37), (1.84 ± 0.39), (1.73 ± 0.33), (146.47 ± 8.64) points, the differences were statistically significant ( t values were 4.45-14.08, all P<0.05). The scores of physiological dimension, psychological dimension and total GCQ were (10.89 ± 2.22), (24.49 ± 4.92), (77.91 ± 6.20) points in the experimental group, significantly higher than those in the control group (8.51 ± 2.27), (21.84 ± 4.61), (72.09 ± 6.66) points, the differences were statistically significant ( t=5.50, 2.89, 4.69, all P<0.05). Conclusions:Paradoxical intention therapy can effectively alleviate physiological and psychological stress and decrease postoperative discomfort of patients undergoing PCI.
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Objective:To explore the effect of follow-up information platform combined with full-course health education on compliance and cardiac function in patients with chronic heart failure.Methods:A total of 150 patients with chronic heart failure treated in He′nan People′s Hospital between November 2018 and November 2019 were selected for study. Patients were divided into observation group and control group by random number table method, and each group had 75 cases. The control group received routine health education intervention, and the observation group implemented follow-up information platform combined with full-course health education intervention. The intervention time was 6 months, and then the compliance behavior, cardiac function and quality of life of the two groups of patients were compared.Results:The overall compliance rate of the observation group was significantly higher than that of the control group ( Z value was -5.634, P<0.01), and the total compliance rate of the observation group was 92.00% (69/75), which was significantly higher than 74.67% (56/75) of the control group ( χ2 value was 8.112, P<0.01). After the intervention, both the 6-minute walking test and the left ventricular ejection fraction in the observation group were (482.75±81.45) m, (48.34±6.10)%], which were significantly higher than (406.92±68.20) m, (39.61±5.73) % of the control group ( t values were 6.182, 9.034, P<0.01). After the intervention, the physical limitation, psychological mood, disease symptoms, and social relationship scores of the observation group patients were (11.00±1.58), (10.06±1.55), (6.06±1.29), and (5.09± 1.14) points, which were significantly lower than (17.15±1.90), (11.79±1.55), (9.52±1.23), and (8.09±1.02) points of the control group ( t values were 6.835-21.533, P<0.01). Conclusion:Compared with conventional health education, the whole course of health education combined with the follow-up information platform is beneficial to improve the compliance rate, quality of life and cardiac function of patients with chronic heart failure.
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Chronic atrophic gastritis (CAG) is a common and refractory disease of the digestive system in clinic.Apoptosis is the important reason which relates CAG pathological changes.As one of the important means of clinical prevention and treatment of digestive diseases, traditional Chinese medicine (TCM) in the role and mechanism of CAG related research has become an important direction in recent years.Based on the collection of related literatures and data, the paper analyzed the possible mechanism of CAG pathogenesis grasped the key aspect of apoptosis and clarified the research status of TCM on the regulation of gastric mucosal cell apoptosis in CAG in recent years through focusing on the specific signaling pathways in mitochondrial pathway, death receptor pathway, endoplasmic reticulum pathway.Through the above analysis, the paper provided some ideas for further systematic and in-depth research and explored CAG effective TCM program.
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Chronic atrophic gastritis is a common and intractable disease of digestive in clinical. Chinese medicine is an important treatment method of this disease. It is said in Yellow Emperor that you must know the reason to seize the key. So explore the pathogenesis of the disease is the key to understanding the disease and the premise of Chinese medicine treatment of disease in traditional Chinese medicine. In recent years, many medical literature for chronic atrophic gastritis were reported. This article focuses on organizing the etiology and pathogenesis of the research literatures to comprehensively analyze the formation mechanism of the disease, and lay a solid foundation for further effective treatment search.
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Objective To explore the management model of chronic disease like myocardial infarction through the effect of collaborative work pattern of doctors and nurses on acute myocardial infarction patients with percutaneous coronary intervention(PCI) after 1 year follow up.Methods A total of 852 patients from October 1,2011 to September 30,2013 with collaborative work pattern of doctors and nurses were as collaborative work pattern group,and 734 patients without collaborative work pattern of doctors and nurses at the same time were as control group.The patients were followed up for 1 year.The differences of treatment compliance,risk factors control,and the incidence of cardiovasc~ar events were compared between collaborative work pattern group and control group.Results The improvement of treatment compliance in collaborative work pattern group was better than that in control group.The improvement rate of improve lifestyle initiatively,completely medication,check regularly were 83.3％(710/852),97.9％(834/852),75.4％(642/852) in collaborative work pattern group and 63.5％(466/734),93.7％(688/734),59.0％(433/734) in control group,x2=81.02,17.57,26.22,P＜0.01.The control rate of risk factors including hypertension,diabetic mellitus,high blood low density lipoprotein cholesterol were 78.5％ (252/321),68.4％ (214/313),84.8％ (491/579) in collaborative work pattern group and 55.8％ (168/301),58.1％ (168/289),79.9％ (381/477) in control group,x2=36.47,6.79,4.41,P＜0.01 or ＜0.05.The incidence of treatment compliance and total cardiovascular events in collaborative work pattern group were better than those in control group.There were significant differences in the above indices,P＜0.05.Conclusions Collaborative work pattern of doctors and nurses is an effective method and supplement for patients with myocardial infarction after PCI to improve treatment compliance and control risk factors.The prognosis of patients can be improved and this pattern is an effective exploration of chronic disease management.
