Objective To observe the diagnostic value of serum irisin levels in hypertensive patients with severe obstructive sleep apnea syndrome(OSAS).Methods A total of 156 hypertensive patients were selected.According to apnea hypopnea index(AHI),the patients were divided into severe OSAS group(79 cases)and non-severe OSAS group(77 cases).The baseline data,polysomnography(PSG)and ambulatory blood pressure monitoring(ABPM)were collected and serum irisin levels were measured.The baseline data and serum irisin levels of the two groups were compared,and the correlation between serum irisin levels and various indicators,as well as receiver operating characteristic(ROC)curve of serum irisin levels were analyzed.Results There were no significant differences in body mass index(BMI),office systolic blood pressure(SBP),office diastolic blood pressure(DBP)and 24-h mean SBP and DBP between the two groups(P>0.05).The age,male proportion,abdominal circumference,neck circumference,AHI in severe OSAS group were higher than those in non-severe OSAS group;the severe OSAS group had lower lowest oxygen saturation(LSpO2)and mean blood oxygen saturation(MSpO2)than those in non-severe OSAS group;the differences were statistically significant(P<0.05).The median serum irisin level in 156 patients was 25.17 ng/ml,the median serum irisin level in the severe OSAS group was 14.94(4.45,28.93)ng/ml,and the median serum irisin level in the non-severe OSAS group was 42.34(21.93,74.31)ng/ml.The median serum irisin level was significantly different between the two groups(P<0.001).In 156 hypertensive patients,serum irisin level was negatively correlated with age and AHI(r=-0.175,-0.359;P=0.029,0.000<0.05),and was positively correlated with MSpO2(r=0.188,P=0.020<0.05).ROC curve analysis showed that the critical value of serum irisin concentration was 38.07 ng/ml,the area under the curve(AUC)was 0.761,the sensitivity was 86.08%(68/79),the specificity was 61.04%(47/77),the positive predictive value was 69.39%(68/98),and the negative predictive value was 81.03%(47/58).Conclusion In hypertensive population,the serum irisin concentration of OSAS patients is negatively correlated with the severity of OSAS.Serum irisin level can be used as a diagnostic index for severe OSAS patients.
Chemotherapy-induced nausea and vomiting (CINV) is a common adverse event associated with many anticancer therapies and can negatively impact patients' quality of life and potentially limit the effectiveness of chemotherapy. Currently, CINV can be prevented in most patients with guideline-recommended antiemetic regimens. However, clinicians do not always follow guidelines, and patients often face difficulties adhering to their prescribed treatments. Therefore, approaches to increase guideline adherence need to be implemented. NEPA is the first and only fixed combination antiemetic, composed of netupitant (oral)/fosnetupitant (intravenous) and palonosetron, which, together with dexamethasone, constitute a triple antiemetic combination recommended for the prevention of CINV for patients receiving highly emetogenic chemotherapy and for certain patients receiving moderately emetogenic chemotherapy. Thus, NEPA offers a convenient and straightforward antiemetic treatment that could improve adherence to guidelines. This review provides an overview of CINV, evaluates the accumulated evidence of NEPA's antiemetic activity and safety from clinical trials and real-world practice, and examines the preliminary evidence of antiemetic control with NEPA in daily clinical settings beyond those described in pivotal trials. Moreover, we review the utility of NEPA in controlling nausea and preserving patients' quality of life during chemotherapy, two major concerns in managing patients with cancer.
总结按摩治疗瘢痕的研究进展,为临床治疗和未来科研方向提供依据和思路.本文通过检索运用按摩疗法治疗瘢痕的相关文献,整理总结按摩治疗瘢痕的具体操作方法和效果.研究证实按摩治疗瘢痕有效,联合其他疗法效果更佳,不仅能减轻甚至完全修复瘢痕,还能从多个角度帮助改善患者生活质量,包括瘢痕引起的疼痛、瘙痒、失眠,关节、皮肤、肌肉粘连导致的功能障碍,甚至瘢痕导致的心理异常,如焦虑、抑郁.但目前研究多存在证据质量低、评价指标少且不规范等问题.临床治疗上对于瘢痕的治疗,应当在创面愈合后尽早采取按摩联合其他疗法介入.未来研究上,仍需更多大样本随机对照试验进行按摩治疗瘢痕的机理研究以提升按摩治疗瘢痕的质量.
Objective To study the effect of milrinone combined with levosimendan in the treatment of severe low cardiac output syndrome after heart valve replacement.Methods A total of 58 patients with severe low cardiac output syndrome after heart valve replacement were randomly divided into a control group and an observation group,with 29 cases in each group.The control group was treated with milrinone injection,and the observation group was treated with levosimendan on the basis of the control group.Both groups were compared in terms of hemodynamic indexes[heart rate(HR),central venous pressure(CVP),left ventricular ejection fraction(LVEF)]before and after treatment,dosage of vasoactive drugs(dopamine,epinephrine),and incidence of complications.Results After treatment,HR and CVP in both groups were lower than those before treatment in this group,and LVEF was higher than that before treatment in this group;HR of(81.29±3.69)beats/min and CVP of(7.48±0.92)cm H2O(1 cm H2O=0.098 kPa)in the observation group were lower than those of(96.85±5.52)beats/min and(11.05±1.16)cm H2O in the control group;LVEF of(60.84±6.43)% in the observation group was higher than that of(52.08±4.35)% in the control group;the difference were statistically significant(P<0.05).The doses of epinephrine of(0.03±0.01)μg/(kg·min)and doses of dopamine of(5.68±0.36)μg/(kg·min)in the observation group were lower than those of(0.19±0.04)and(8.23±0.72)μg/(kg·min)in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 6.90%,which was lower than that of 27.59% in the control group,and the difference was statistically significant(P<0.05).Conclusion In the clinical treatment of patients with severe low cardiac output syndrome after cardiac valve replacement,the combination of milrinone and levosimendan has an ideal effect,which has the value of further promotion and application.
Objective To analyze the effectiveness and safety of laparoscopic right hemicolectomy in the treatment of colon cancer.Methods A total of 60 patients with colon cancer who underwent surgical treatment were divided into the control group and the observation group according to the difference of surgical methods,with 30 cases in each group.The control group underwent open surgery,and the observation group underwent laparoscopic right hemicolectomy.The operative indexes,postoperative complications,local tumor recurrence,and distant metastasis were compared between the two groups.Results The operative duration of(198.76±24.59)min in the observation group was longer than that of(145.23±27.45)min in the control group;the observation group had incision length of(5.42±1.07)cm,postoperative exhaust time of(25.01±7.89)h and hospital stay of(6.44±1.09)d,which were shorter than those of(19.24±2.64)cm,(62.12±12.24)h and(10.07±2.11)d in the control group;the intraoperative blood loss of(55.01±15.27)ml in the observation group was less than that of(137.56±34.54)ml in the control group;the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 6.67%,which was significantly lower than that of 30.00% in the control group,and the difference was statistically significant(P<0.05).At 2 years after surgery,there was no statistically significant difference in rate of local tumor recurrence and distant metastasis rate between the two groups(P>0.05).Conclusion Laparoscopic right hemicolectomy for colon cancer patients can optimize surgical indicators and shorten postoperative rehabilitation time,and the incidence of postoperative complications,long-term local recurrence rate and metastasis rate are lower,so the effectiveness and safety of surgical treatment can be guaranteed,and the application value is higher than that of open surgery.
Objective To observe the application effect of pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)after neoadjuvant chemotherapy for breast cancer.Methods A total of 40 patients with neoadjuvant chemotherapy for breast cancer were divided into a control group and an experimental group by silver coin tossing method,with 20 cases in each group.The control group received recombinant human granulocyte colony-stimulating factor(rhG-CSF)at 48 h after neoadjuvant chemotherapy,and the experimental group received pegylated recombinant human granulocyte colony-stimulating factor at 48 h after neoadjuvant chemotherapy.Both groups were compared in terms of occurrence of granulocytopenia,duration of agranulocytosis,duration of fever,quality of life score and white blood cell count(WBC)/absolute neutrophil count(ANC)after treatment,occurrence of adverse reactions and myelosuppression after treatment.Results After treatment,the incidence of granulocytopenia in the experimental group was 10% (2/20),which was lower than that of 40% (8/20)in the control group,and the difference was statistically significant(χ2 = 4.800,P=0.028<0.05).The duration of agranulocytosis and fever in the experimental group were(5.31±2.41)and(6.71±1.40)d,which were shorter than those of(7.14±2.93)and(10.47±2.58)d in the control group,and the differences were statistically significant(P<0.05).After treatment,the quality of life score of(92.62±5.16)points in the experimental group was significantly higher than that of(74.12±3.25)points in the control group,and the difference was statistically significant(P<0.05).WBC/ANC recovery time of(4.26±0.58)d in the experimental group was shorter than that of(7.98±1.02)d in the control group,and WBC/ANC maintenance time of(10.29±2.74)d was longer than that of(6.18±2.88)d in the control group.The differences were statistically significant(P<0.05).The incidence of adverse reactions of 20% in the experimental group was lower than that of 60% in the control group,and the difference was statistically significant(P<0.05).The incidence of myelosuppression of 15% in the experimental group was significantly lower than that of 45% in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of pegylated recombinant human granulocyte colony-stimulating factor after neoadjuvant chemotherapy for breast cancer can effectively improve the quality of life of patients,promote the prognosis,and reduce adverse reactions,which has widespread application value.
Objective To discuss the clinical efficacy and safety of glucocorticoid combined with doxofylline in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods A total of 60 patients with acute exacerbation of chronic obstructive pulmonary disease were divided into the control group and the observation group by simple random method,with 30 cases in each group.The control group was treated with glucocorticoid[methylprednisolone sodium succinate for injection(trade name:Miloxone)],and the observation group was treated with doxofylline on the basis of the control group.Both groups were compared in terms of clinical efficacy,lung function indexes[peak expiratory flow rate(PEF),forced vital capacity(FVC),and forced expiratory volume in one second(FEV1)],clinical symptom score,COPD assessment test(CAT)score,serum levels of inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)],and incidence of adverse reactions.Results The total clinical effective rate of 96.7% in the observation group was significantly higher than that of 80.0% in the control group,and the difference was statistically significant(P<0.05).After treatment,PEF,FEV1 and FVC in both groups were higher than those before treatment in this group;the observation group had PEF of(7.12±1.38)L/s,FEV1 of(2.35±1.33)L and FVC of(3.54±1.67)L,which were higher than those of(6.32±1.31)L/s,(1.57±1.29)L and(2.15±0.48)L in the control group;the differences were statistically significant(P<0.05).After treatment,the clinical symptom score and CAT score in both groups were lower than those before treatment in this group;the clinical symptom score of(1.48±0.19)points and CAT score of(9.94±1.62)points in the observation group were lower than those of(3.59±0.27)and(15.59±2.38)points in the control group;the differences were statistically significant(P<0.05).After treatment,the levels of IL-6,TNF-α and IL-8 in both groups were lower than those before treatment in this group;the observation group had IL-6 of(33.32±4.31)ng/L,TNF-α of(12.27±2.09)ng/L and IL-8 of(21.64±3.85)ng/L,which were lower than those of(56.92±5.38),(35.85±4.63)and(38.48±4.69)ng/L in the control group;the differences were statistically significant(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 effect of glucocorticoid combined with doxofylline in patients with acute exacerbation of chronic obstructive pulmonary disease is significant.After drug combination treatment,the clinical symptoms and lung function of the patients are significantly improved,the levels of serum inflammatory indicators of IL-6,IL-8 and TNF-α are significantly reduced,and the incidence of drug adverse events is significantly reduced,which has clinical application value.
Objective To discuss the clinical effect of Danhong injection on subcortical atherosclerotic encephalopathy.Methods A total of 90 patients with subcortical atherosclerotic encephalopathy were divided into a control group and an observation group according to the random numerical table,with 45 cases in each group.Patients in both groups received routine neurological intervention.On this basis,the control group was treated with citicoline and edaravone,and the observation group was treated with Danhong injection on the basis of the control group.Both groups were compared in terms of hemorheology index,European Stroke Scale(ESS)score and language ability score before and after treatment,clinical effect and total length of hospital stay.Results After treatment,the plasma viscosity of(1.4±0.2)mPa·s in the observation group was shorter than that of(2.9±0.6)mPa·s in the control group,and the erythrocyte electrophoresis time of(15.2±0.7)s was higher than that of(18.1±0.3)s in the control group.The differences were statistically significant(P<0.05).After treatment,ESS score and language ability score in both groups were higher than those before treatment in this group,and ESS score and language ability score in the observation group were higher than those in the control group.The differences were statistically significant(P<0.05).The total effective rate of 97.8% in the observation group was higher than that of 77.8% in the control group,and the difference was statistically significant(P<0.05).The total hospitalization time of(10.5±2.2)d in the observation group was significantly shorter than that of(13.1±3.5)d in the control group,and the difference was statistically significant(t=4.219,P=0.000<0.05).Conclusion Danhong injection in the treatment of subcortical atherosclerotic encephalopathy can effectively reduce the plasma viscosity of patients,improve the neurological function of patients,ensure clinical therapeutic effect and shorten hospital stay.
Objective To study the clinical effect of laser photocoagulation combined with vascular endothelial growth factor(VEGF)inhibitor on diabetes retinopathy.Methods A total of 80 patients with diabetes retinopathy were divided into the conventional group and the study group according to the random numerical table,with 40 cases in each group.The conventional group was treated with laser photocoagulation,and the study group was treated with laser photocoagulation and VEGF inhibitor.The therapeutic effect,VEGF levels,central macular thickness(CMT),corrected visual acuity and intraocular inflammatory factors before and after treatment were compared between the two groups.Results The total effective rate of 97.50% in the study group was significantly higher than that of 62.50% in the conventional group,and the difference was statistically significant(P<0.05).After treatment,VEGF of(121.36±1.21)ng/L and central macular thickness of(216.33±2.01)μm in the study group were lower than those of(165.33±2.01)ng/L and(242.36±2.01)μm in the conventional group;the corrected visual acuity of(4.53±0.33)in the study group was higher than that of(4.16±0.33)in the conventional group;the differences were statistically significant(P<0.05).After treatment,the intraocular tumor necrosis factor-α of(21.51±0.33)ng/L and interleukin-6 of(14.51±0.32)ng/L in the study group were lower than those of(33.53±1.01)and(22.56±0.33)ng/L in the conventional group,and the difference were statistically significant(P<0.05).Conclusion The combination of laser photocoagulation and VEGF inhibitor is effective in the treatment of diabetes retinopathy,and can help patients improve their visual acuity,central macular thickness and inflammatory factors in the eye,which is worthy of clinical promotion.
Objective To discuss the application effect of ultrasound-guided supraclavicular nerve block combined with periclavicular infiltration anesthesia in internal fixation of clavicle fracture.Methods A total of 100 patients with clavicular fracture who underwent open reduction and internal fixation were divided into the observation group and the control group according to the random numerical table,with 50 cases in each group.The observation group was treated with ultrasound-guided supraclavicular nerve block and periclavicular infiltration anesthesia,while the control group was treated with ultrasound-guided superficial cervical plexus and interscalene brachial plexus block.Both groups were compared in terms of anesthesia operation time,anesthesia onset time and anesthesia effect,hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2)]at different time points[at entering the operating room(T0),anesthesia(T1),skin incision(T2),fracture reduction(T3)and end of surgery(T4)],modified Bromage score of the affected upper limb at the end of the surgery,visual analogue scale(VAS)score at different time points(6,12,24 h after the surgery),and the satisfaction of anesthesia;the occurrence of complications in the two groups was analyzed.Results The anesthesia operation time of(5.0±0.5)min and the anesthesia onset time of(3.1±1.1)min in the observation group were shorter than those of(6.4±0.5)and(11.2±1.8)min in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in total effective rate of anesthesia between the two groups(P>0.05).At T0,T1,T2,T3 and T4,there was no statistically significant difference in terms of MAP,HR and SpO2 between the two groups(P>0.05).The modified Bromage score of the affected upper limb was(3.7±1.5)points in the observation group at the end of the surgery,which was higher than that of(0.8±0.1)points in the control group,and the difference was statistically significant(P<0.05).At 6,12 and 24 h after surgery,there was no statistically significant difference in VAS scores between the two groups(P>0.05).The satisfaction rate of anesthesia in the observation group was 90% ,which was higher than that of 74% in the control group,and the difference was statistically significant(P<0.05).No significant anesthesia-related complications occurred in both groups.Conclusion Ultrasound-guided supraclavicular nerve block combined with periclavicular infiltration anesthesia has satisfactory anesthetic effect in internal fixation of clavicle fracture,with shorter operation time,rapid onset,no influence on the upper limb movement and high patient satisfaction,which contains the value of promotion in clavicular surgery.
Objective To analyze the value of ultrasonic monitoring inferior vena cava(IVC)diameter in guiding fluid resuscitation of patients with traumatic hemorrhagic shock.Methods A total of 80 patients with traumatic hemorrhagic shock were randomly divided into the observation group and the control group,with 40 cases in each group.In the observation group,IVC diameter was monitored by ultrasound to guide fluid resuscitation,while in the control group,conventional fluid resuscitation was performed.Comparison was made on resuscitation indexes[mean arterial pressure(MAP),central venous pressure(CVP),central venous oxygen saturation(ScvO2)]before and after resuscitation between the two groups,as well as the levels of inferior vena cava variation(IVCV),inferior vena cava collapse index(IVC-CI),lactic acid level before and after resuscitation,vasoactive drug dosage and blood transfusion volume and prognosis of the observation group.Results MAP,CVP and ScvO2 in both groups at 2,6,12 and 24 h after resuscitation were higher than those before resuscitation in this group;MAP in the observation group at 2,6,12 and 24 h after resuscitation were higher than those of the control group,CVP at 12 h after resuscitation was higher than that of control group,and ScvO2 at 6,12 and 24 h after resuscitation were higher than those of the control group.The differences were statistically significant(P<0.05).In the observation group,IVCV at 2,6,12 and 24 h after resuscitation were lower than those before resuscitation in this group,and IVC-CI at 24 h after resuscitation was lower than that before resuscitation in this group.The differences were statistically significant(P<0.05).At 6,12 and 24 h after resuscitation,the lactic acid levels in the observation group were(4.55±1.04),(3.34±1.25)and(1.43±0.76)mmol/L,which were lower than those of(6.60±1.03),(5.37±2.67)and(3.38±1.12)mmol/L in the control group,and the differences were statistically significant(P<0.05).The dosage of dopamine,5% sodium bicarbonate,deoxyadrenaline,suspended red blood cells and plasma in the observation group were(96.25±18.07)mg,(78.68±10.02)ml,(67.34±8.25)mg,(5.28±1.67)U and(688.55±13.04)ml,which were all lower than those of(120.61±21.18)mg,(150.67±21.02)ml,(80.37±9.67)mg,(8.82±2.35)U and(835.60±25.03)ml in the control group,and the differences were statistically significant(P<0.05).The mortality rate,incidence pulmonary edema and acute respiratory distress syndrome in the observation group were 5.0%,7.5% and 12.5%,which were lower than those of 20.0%,25.0% and 32.5% in the control group,and the differences were statistically significant(P<0.05).Conclusion For patients with traumatic hemorrhagic shock,ultrasonic monitoring the diameter of the inferior vena cava to guide fluid resuscitation can accurately assess the patient's blood volume,which can be more effective for fluid infusion and improve the prognosis of patients.
Objective To analyze the clinical efficacy of Mammotome minimally invasive surgery for benign breast tumors.Methods A total of 100 patients with benign breast tumor were divided into a control group and an observation group according to different surgical regimens,with 50 cases in each group.The control group was treated with open surgery,and the observation group was treated with Mammotome minimally invasive surgery.Both groups were compared in terms of surgical indexes(operative time,intraoperative blood loss,complications,incision healing time,hospital stay,rate of good breast appearance),postoperative inflammatory indexes[tumor necrosis faction-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)],and immune indexes(CD3+,CD4+/CD8+).Results The observation group had operative time of(17.59±8.12)min,incision healing time of(4.07±1.31)d and hospital stay of(1.23±0.21)d,which were shorter than those of(29.12±11.34)min,(5.56±1.71)d and(4.45±0.67)d in the control group;the intraoperative blood loss of(23.12±7.64)ml in the observation group was less than that of(54.45±17.59)ml in the control group;the complication rate of 2.00% (1/50)in the observation group was lower than that of 16.00% (8/50)in the control group;the rate of good breast appearance of 100.00% (50/50)in the observation group was higher than that of 80.00% (40/50)in the control group;the differences were statistically significant(P<0.05).After surgery,TNF-α of(1.56±0.21)ng/L and hs-CRP of(7.19±1.02)mg/L in the observation group were lower than those of(3.75±0.34)ng/L and(13.25±3.23)mg/L in the control group;CD3+ of(78.91±5.21)% and CD4+/CD8+ of(1.98±0.26)in the observation group were higher than those of(53.11±3.40)% and(1.13±0.12)in the control group;the differences were statistically significant(P<0.05).Conclusion Mammotome minimally invasive surgery can significantly reduce the surgical trauma of patients with benign breast tumors,reduce postoperative complications,and also reduce the damage to the patient's immune system,thereby promoting the postoperative recovery of patients and improving the rate of good breast appearance.It is worthy of clinical promotion.
Objective To discuss the clinical efficacy of partial tarsorrhaphy in the treatment of lagophthalmos.Methods All 5 cases of lagophthalmos were treated with partial tarsorrhaphy.The score of eyelid levator function,orbicularis oculi muscle function and oculomotor function,upper and lower eyelid distance,eyelid muscle strength grading,corneal epithelial repair index before and after surgery and pain level at different time points were compared after surgery,and the incidence of adverse events and complications were analyzed.Results After surgery,the eyelid levator function score was(2.41±0.22)points,the orbicularis oculi muscle function score was(1.60±0.16)points and the oculomotor function score was(6.17±0.45)points,which were higher than those of(1.02±0.13),(0.87±0.12)and(2.04±0.23)points before surgery.The differences were statistically significant(P<0.05).After surgery,the upper and lower eyelid distance of(1.48±0.18)mm was shorter than that of(3.07±0.32)mm before surgery,and the eyelid muscle strength grading of(3.45±0.32)grades was higher than that of(1.87±0.19)grades before surgery.The differences were statistically significant(P<0.05).After surgery,the tear film break-up time(BUT)of(7.45±0.76)s was longer than that of(3.81±0.42)s before surgery,and the corneal fluorescence staining(FL)score of(1.30±0.21)points was lower than that of(5.04±0.47)points before surgery.The differences were statistically significant(P<0.05).At 1,3 and 7 d after surgery,the visual analogue scale(VAS)scores were lower than those before surgery,and the differences were statistically significant(P<0.05).In the perioperative period,the VAS scores of patients showed a continuous decreasing trend,and the difference was statistically significant(P<0.05).All the 5 patients successfully completed the surgical treatment,and the corneal epithelium was repaired and improved after surgery,and no complications such as lid margin angular deformity and no abnormal hemorrhagic reactions,resulting in a favorable prognostic outcome.Conclusion The application of partial tarsorrhaphy in the treatment of lagophthalmos has significant effects,which can effectively improve the eyelid function of patients,improve the eyelid muscle strength,promote corneal epithelial repair,and continuously reduce the postoperative pain of patients,and there are basically no surgical related risk events,which is worthy of promotion and application.
Objective To discuss the nosocomial infection status in intensive care unit of three A general hospital and its influencing factions.Methods The general demographic data of 230 critically ill patients in intensive care unit were investigated.The hand hygiene compliance of medical staff was evaluated by Hand Hygiene Behavior Questionnaire(HHBQ).The risk factors of nosocomial infection in intensive care unit of three grade A general hospitals were analyzed by Logistic regression model.Results 48 cases of nosocomial infections occurred in 230 patients,with an incidence rate of 20.87% .Among them,there were 32 cases of respiratory tract infections,with an incidence rate of 13.91% ;21 cases of gastrointestinal tract infections,with an incidence rate of 9.13%,18 cases of catheter-associated urinary tract infections,with an incidence rate of 7.83%,and 1 case of catheter-associated bloodstream infections,with an incidence rate of 0.43% .24 out of the 48 cases were complicated with two types of nosocomial infections.The HHBQ scores of 55 healthcare professionals involved in clinical work were(89.35±6.52)points,of which,the HHBQ score of nurses were(94.42±4.27)points and those of doctors were(83.26±5.39)points.Univariate analysis showed that there were statistically significant differences in terms of age,underlying disease,skin mucosal injury,immune dysfunction,bacterial imbalance,multiple drug resistance and antimicrobial drug abuse between the two groups(P<0.05).There was no statistically significant difference in terms of gender,marital status,monthly income,type of medical insurance and smoking history between the two groups(P>0.05).Logistic regression model analysis showed that the independent risk factors for nosocomial infection were age,underlying disease,skin mucosal injury,immune dysfunction,bacterial imbalance,antimicrobial drug abuse and multiple drug resistance(P<0.05).Conclusion Nosocomial infection in our hospital was at a moderate level,and the independent risk factors for nosocomial infection in intensive care unit patients are old age,underlying diseases,skin mucosal injury,immune dysfunction,bacterial imbalance,antimicrobial drug abuse and multiple drug resistance.Hand hygiene compliance among healthcare workers needs to be continuously improved to minimize nosocomial infections by raising awareness of prevention,increasing preventive and curative measures,and actively detecting and responding to them.
Traditional Chinese medicine is a species that has been preserved by ancient and powerful survival genes on the earth,with complete genetic genes and trace elements suitable for growth.Therefore,the fundamental principle of traditional Chinese medicine is the"homology of medicine and food",which uses the supplement,activation,correction and repair process of natural animal and plant species genes.The author emphasizes that"kidney deficiency"is the basic principle of syndrome differentiation and treatment of malignant tumor,and puts forward the view that the selection and application of gene characteristics of medicinal materials should be emphasized in the legislative formulation of malignant tumor treatment.
Objective To analyze the effect of doxofylline tablets combined with budesonide formoterol powder inhalation in the treatment of patients with coal workers'pneumoconiosis.Methods A total of 100 patients with pneumoconiosis were divided into experimental group and reference group according to the difference of treatment drugs,with 50 cases in each group.The reference group was treated with budesonide formoterol powder inhalation alone,and the experimental group was treated with doxofylline tablets on the basis of reference group.The efficacy,the level of arterial blood gas index and lung function index before and after treatment,and the incidence of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the experimental group was 98.00%,which significantly higher than that of 84.00% of the reference group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in partial pressure of oxygen and partial pressure of carbon dioxide between the two groups(P>0.05).After treatment,the partial pressure of oxygen of(83.33±7.24)mm Hg(1 mm Hg= 0.133 kPa)in the experimental group was higher than that of(74.51±6.97)mm Hg in the reference group;the partial pressure of carbon dioxide of(44.47±3.29)mm Hg in the experimental group was lower than that of(53.64±4.15)mm Hg in the reference group;the differences were statistically significant(P<0.05).Before treatment,the ratio of forced expiratory volume in one second to forced vital capacity,peak expiratory flow rate and forced expiratory volume in one second between the two groups had no statistical significance(P>0.05).After treatment,in the experimental group,the ratio of forced expiratory volume in one second to forced vital capacity was(79.14±4.45)%,the peak expiratory flow rate was(4.41±0.46)L/s and the forced expiratory volume in one second was(1.28±0.29)L/s,which were significantly better than those of(60.05±4.62)%,(3.52±0.38)L/s and(1.01±0.22)L in the reference group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Doxofylline tablets combined with budesonide formoterol powder inhalation can significantly improve the arterial blood gas and lung function of patients with coal workers'pneumoconiosis,and improve the overall effect,without significantly increasing adverse reactions.The efficacy and safety are relatively high.
Objective To observe the efficacy of intra-aortic balloon pump(IABP)in emergency percutaneous coronary intervention(PCI)in patients with acute myocardial infarction.Methods A total of 60 patients with acute myocardial infarction were randomly divided into a single treatment group and a supportive treatment group,with 30 cases in each group.Before treatment,both groups were given routine adjuvant therapy such as oxygen inhalation,cardiotonic,diuretic,analgesia,sedation and complication management.Patients in the single treatment group received single emergency PCI,while patients in the supportive treatment group received emergency PCI supported by IABP.The heart rate,systolic blood pressure and diastolic blood pressure before and after treatment,surgical success,mortality and complications were compared between the two groups.Results Before treatment,the heart rate,systolic blood pressure and diastolic blood pressure in the supportive treatment group were(80.2±21.3)beats/min,(131.2±12.5)mm Hg(1 mm Hg= 0.133 kPa)and(62.3±19.4)mm Hg,and those in the single treatment group were(78.2±17.6)beats/min,(130.5±13.5)mm Hg and(63.5±17.2)mm Hg.After treatment,the heart rate,systolic blood pressure and diastolic blood pressure in the supportive treatment group were(81.2±11.2)beats/min,(129.3±10.4)mm Hg and(67.5±18.2)mm Hg,and those in the single treatment group were(98.2±21.5)beats/min,(102.5±8.6)mm Hg and(47.1±12.6)mm Hg.Before treatment,there was no statistically significant difference in heart rate,systolic blood pressure and diastolic blood pressure between the two groups(P>0.05).In the supportive treatment group,there was no statistically significant difference in heart rate,systolic blood pressure and diastolic blood pressure after treatment compared with those before treatment in this group(P>0.05).The heart rate in single treatment group was higher than that before treatment in this group;the systolic blood pressure and diastolic blood pressure were lower than those before treatment in this group;the differences were statistically significant(P<0.05).The surgical success rate of 100.0% in the supportive treatment group was higher than that of 86.7% in the single treatment group;the mortality rate of 0 in the supportive treatment group was lower than that of 13.3% in the single treatment group;the differences were statistically significant(P<0.05).The incidence of arrhythmia,hypotension,gastrointestinal hemorrhage,intracranial hemorrhage and acid-base imbalance were 0,3.3%,0,0 and 0 in the supportive treatment group,which were all lower than those of 16.7%,20.0%,13.3%,13.3% and 13.3% in the single treatment group,and the differences were statistically significant(P<0.05).Conclusion IABP has good efficacy in emergency PCI of patients with acute myocardial infarction,which can effectively promote the recovery of cardiac function in patients,further improve clinical efficacy,and is worthy of clinical promotion and application.
Objective To discuss and analyze the effect of traditional Chinese medicine rehabilitation therapy combined with acupuncture in the rehabilitation of stroke patients.Methods A total of 60 patients with stroke were divided into a control group and an observation group according to the random numerical table,with 30 cases in each group.The control group was given conventional traditional Chinese medicine rehabilitation treatment,and the observation group was combined with acupuncture treatment on the basis of the control group.The rehabilitation effect and treatment satisfaction were compared between the two groups.Results Before treatment,there was no statistically significant difference in the scores of National Institutes of Health Stroke Scale(NIHSS),Modified Rankin Scale(MRS),Hasegawa Dementia Scale(HDS)and Activities of Daily Living Scale(ADL)between the two groups(P>0.05).After treatment,the scores of NIHSS and MRS in both groups were significantly lower than those before treatment in this group,and the scores of HDS and ADL were significantly higher than those before treatment in this group;NIHSS score of(9.77±1.27)points and MRS score of(0.56±0.66)points in the observation group were significantly lower than those of(11.51±2.50)and(1.21±0.25)points in the control group;HDS score of(27.13±2.25)points and ADL score of(76.26±7.25)points in the observation group were significantly higher than those of(23.93±2.19)and(61.81±6.39)points in the control group;the differences were statistically significant(P<0.05).The treatment satisfaction of 96.67% in the observation group was higher than that of 70.00% in the control group,and the difference was statistically significant(P<0.05).Conclusion The combination of traditional Chinese medicine rehabilitation therapy and acupuncture for can significantly improve the body state of stroke patients and promote the recovery of body function,which is widely recognized by patients.
Objective To observe the effect of glucocorticoids on pulmonary function and levels of inflammatory factors in patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection.Methods A total of 100 patients with COPD and pulmonary infection were divided into a control group and an observation group,with 50 cases in each group.The control group received routine anti-infection treatment,and the observation group was treated with glucocorticoid on the basis of the control group.The pulmonary function indexes and the levels of inflammatory factors before and after treatment were compared between the two groups.Results After treatment,the observation group had forced expiratory volume in one second(FEV1)of(1.68±0.42)L,forced vital capacity(FVC)of(2.34±0.54)L and peak expiratory flow rate(PEF)of(4.96±1.25)L/s,which were significantly higher than those of(0.78±0.26)L,(1.86±0.31)L and(3.12±1.30)L/s in the control group,and the differences were statistically significant(P<0.05).After treatment,the C-reactive protein(CRP),procalcitonin(PCT)and neutrophil CD64(nCD64)levels in both groups were significantly lower than those before treatment in this group;the observation group had CRP of(28.46±7.16)mg/L,PCT of(1.86±0.42)ng/ml and nCD64 of(1.61±0.86),which were significantly lower than those of(52.34±9.75)mg/L,(5.23±1.69)ng/ml and(2.21±0.56)in the control group;the differences were statistically significant(P<0.05).Conclusion The use of glucocorticoids in COPD complicated with pulmonary infection patients can improve the pulmonary function indexes and reduce the serum level of CRP,PCT and nCD64.
Objective To study and compare the clinical efficacy of interlocking intramedullary nail fixation versus insertion of medial locking plate fixation with minimally invasive percutaneous plate osteosynthesis(MIPPO)technique in the treatment of distal tibia and fibula fracture.Methods A total of 40 patients with distal tibia and fibula fracture were studied and divided into an observation group and a control group according to the random numerical table,with 20 cases in each group.The control group was treated with interlocking intramedullary nail fixation,and the observation group was treated with insertion of medial locking plate fixation with MIPPO technique.The surgery-related indexes,fracture healing time,knee and ankle functional scores before and after treatment,postoperative complications and postoperative pain severity score were compared between the two groups.Results The operative time of(58.96±4.15)min in the observation group was shorter than that of(82.23±4.57)min in the control group,and the intraoperative blood loss of(72.19±2.16)ml was less than that of(89.97±2.55)ml in the control group.The differences were statistically significant(P<0.05).There was no statistically significant difference in postoperative hospital stay and fracture healing time between the two groups(P>0.05).Before and after treatment,there were no statistically significant differences in knee functional score and ankle functional score between the two groups(P>0.05).After treatment,the knee functional score and ankle functional score in both groups were higher than those before treatment in this group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 5.0%,which was lower than that of 30.0% in the control group,and the difference was statistically significant(P<0.05).The pain severity scores of the observation group were(2.56±0.48),(2.01±0.14)and(1.65±0.23)points at 1,2 and 3 d postoperatively,which were lower than those of(3.45±0.17),(3.03±0.25)and(2.87±0.44)points of the control group,and the differences were statistically significant(P<0.05).Conclusion The use of interlocking intramedullary nail fixation and the insertion of medial locking plate fixation with MIPPO technique for the treatment of distal tibia and fibula fracture is beneficial to the recovery of joint function in patients,but MIPPO has shorter operative time,less blood loss,higher safety and less postoperative pain.Therefore,the appropriate surgical method can be selected according to the actual situation of patients in clinical practice.
