目的 探讨联合检测视黄醇结合蛋白(RBP)、糖化血红蛋白(HBA1c)、胱抑素C(CysC)、尿微量白蛋白与肌酐比值(ACR)对2型糖尿病(T2DM)早期肾损伤的诊断价值.方法 回顾性分析,收集2021年1月-2022年1月都昌县人民医院收治的T2DM早期肾损伤患者40例临床资料,作为观察组,并收集同期该院收治的T2DM患者40例临床资料,作为对照组.两组患者均接受RBP、HBA1c、CysC、ACR测定并比较,重点分析联合检测RBP、HBA1c、CysC、ACR对T2DM早期肾损伤的诊断价值.结果 观察组RBP、HBA1c、CysC、ACR水平均比对照组高,有统计学差异(P<0.05);绘制ROC曲线,结果 显示,RBP、HBA1c、CysC、ACR水平诊断T2DM早期肾损伤的AUC均大于0.80,诊断价值理想,且以联合诊断价值更佳.结论 RBP、HBA1c、CysC、ACR联合诊断T2DM早期肾损伤价值较高,若RBP、HBA1c、CysC、ACR过表达,则提示T2DM早期肾损伤风险高,应采取积极的治疗措施.
目的 探讨音乐放松结合复合保温策略对腹腔镜手术患者围术期应激反应及术后并发症影响.方法 抽取张家港市第一人民医院普外科2018年8月-2021年8月期间收治的腹腔镜手术患者135例作为研究对象,按照双色球随机分组法分为对照组与研究组,对照组采用常规术前心理护理及术中常规保温,研究组采用音乐放松训练结合复合保温策略,比较两组围术期应激反应指标水平及并发症发生情况.结果 入室时,两组患者HR、SBP、DBP、T、AD、NE指标水平比较,均无统计学意义,P＞0.05;气腹建立前、后及术后,研究组HR、SBP、DBP、NE指标水平均低于对照组,T均高于对照组,P＜0.05;气腹建立后及术后,研究组AD水平均低于对照组,P＜0.05;研究组低氧血症、寒颤、血压异常、低体温等并发症发生率均低于对照组,P＜0.05.结论 音乐放松结合复合保温策略能够有效改善腹腔镜手术患者应激反应,维持患者围术期体温,降低低氧血症、寒颤、低体温等术后并发症发生率.
Objective To analyze the related influencing factors of diabetes complicating pregnancy and Infant respiratory distress syndrome,and to establish a risk early warning model.Methods 196 pregnant women with diabetes who underwent regular prenatal examination in our hospital from February 2022 to February 2023 were selected.They were divided into Infant respiratory distress syndrome group and non Infant respiratory distress syndrome group according to whether Infant respiratory distress syndrome occurred.Logistic regression analysis was carried out on related factors to build a risk early warning model.Results The incidence of Infant respiratory distress syndrome in 196 pregnant women with diabetes was 24.5%.Multivariate analysis showed that pre pregnancy overweight and obesity,delivery mode,intrauterine distress,gestational age,intrauterine infection,gestational glucose management,Hypoproteinemia,Glycated hemoglobin were independent risk factors for Infant respiratory distress syndrome in pregnant women with diabetes(P＜0.05);the results of the Hosmer-Lemeshow goodness of fit test show that,χ2=10.734,P=0.151;the area under the Receiver operating characteristic was 0.864(95%CI:0.805-0.924,P＜0.001),the sensitivity was 72.9%,and the specificity was 89.2%;Model regression equation Logit(P)=1.286×Prepregnancy overweight and obesity+0.899×Delivery method+1.482×Intrauterine distress+1.439×Fetal age+1.725×Intrauterine infection+1.343×Pregnancy blood glucose management+1.019×Hypoproteinemia+1.260×Glycated hemoglobin.Conclusion The prediction model based on risk factors has a good prediction effect,which can provide a reference basis for clinical workers to prevent and intervene,and reduce the incidence of Infant respiratory distress syndrome in pregnancy with diabetes.
近日,湘雅医院泌尿外科齐琳主任领衔的泌尿肿瘤团队采用国际最先进的腹腔镜分支肾动脉阻断肾部分切除术为一名孤肾肾癌患者成功实施了手术.腹腔镜下分支肾动脉阻断肾部分切除手术乃属当今国际肾癌手术治疗的最新技术,手术难度极大,要求主刀医师对肾血管解剖有准确的把握,且具备娴熟的腹腔镜手术技巧.目前国内仅少数几家大型三甲医院能够开展此项手术.
Objective To explore the application effect of acupuncture combined with intravenous general anesthesia in hard tracheoscopy interventional therapy.Methods 40 patients who received hard tracheoscopy interventional therapy in our hospital from September 2021 to April 2023 were selected and divided into experimental group and control group by random numerical table method,with 20 cases in each group.The control group received intravenous general anesthesia,and the experimental group received acupuncture combined with intravenous general anesthesia.Hemodynamic indexes,dosage of anesthetic drugs,postoperative recovery time and complication rate were compared between the two groups.Results There were no significant differences in heart rate,diastolic blood pressure and systolic blood pressure at T0,T1 and T4 between the two groups(P＞0.05).The heart rate,diastolic blood pressure and systolic blood pressure of the experimental group were lower than those of the control group at T2 and T3,with statistical differences(P＜0.05).The dosage of fentanyl in the experimental group was less than that in the control group,and the postoperative recovery time was shorter than that in the control group,with statistical difference(P＜0.05).There was no significant difference in complication rate between the two groups(P＞0.05).Conclusion Acupuncture combined with intravenous general anesthesia can effectively stabilize the hemodynamics of the body,promote the stability of vital signs,reduce the dosage of anesthetic drugs,shorten the postoperative recovery time,without obvious complications,and is safe,worthy of popularization and application.
Objective To exploring the clinical effect of Xingnaojing combined with mild hypothermia in the treatment of acute massive cerebral infarction(AMCI).Methods A total of 92 AMCI patients admitted to our hospital from March 2020 to September 2022 were selected and divided into control group with 46 cases and observation group with 46 cases in the observation group by random number table method,and both groups took first aid after admission,on this premise,the control group was further treated with mild hypothermia therapy.Based on the medical measures of the control group,the observation group patients were further treated with wake-up therapy,and the analysis was conducted around the treatment effectiveness between groups,inflammatory factors before and after treatment,cerebral hemodynamics,and adverse reactions.Results The total effective rates of treatment in the observation group and the control group were 93.48%and 78.26%,respectively,and the observation group was higher than that in the control group(P＜0.05).There was no significant difference in serum tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and C-Reactive Protein(CRP)levels before treatment between groups(P＞0.05),the level of inflammatory factors in the two groups 7 days after treatment was lower than before treatment,and the observation group was lower than that in the control group(P＜0.05).The difference between the groups was not obvious(P＞0.05)in the middle cerebral artery resistance index(RI),mean flow velocity(Vm),and pulsatility index(PI)before treatment,and the indicators above 7 days after treatment in the two groups had good changes,the observation group was better than the control group(P＜0.05).The total incidence of adverse reactions in the observation group and the control group was 6.52%and 4.35%,respectively,and the difference between the groups was not obvious(P＞0.05).Conclusion The efficacy of AMCI combined with mild hypothermia can significantly reduce the level of inflammatory factors and improve cerebral hemodynamics,and the safety is good.
Objective To explore the value of FMFA management in outpatient blood drawing nursing.Methods From April 2020 to April 2021,150 patients with blood drawing in the outpatient department of our hospital were selected to participate in the study and divided into two groups with 75 cases each according to random number table method.The control group adopted conventional management measures,and the observation group adopted FMFA management measures.The nursing quality,incidence of unsafe events and blood collection compatibility were compared between the two groups.Result The nursing quality scores of the observation group,including puncture technique(92.32±3.15)points,waiting time(93.42±3.23)points,safe transportation(93.65±3.18)points and health education(93.48±3.65)points,were higher than those of the control group,and the difference between groups was significant(P＜0.05).There was no significant difference in anxiety score between the two groups before nursing(P＞0.05).After nursing,the anxiety score of the observation group(28.35±3.12)points was lower than that of the control group(35.12±3.21)points,and the difference between groups was significant(P＜0.05).The blood collection compatibility of the observation group was higher than that of the control group,and the difference between groups was significant(P＜0.05).The incidence of unsafe events in the observation group(2.67%)was lower than that in the control group(12.00%),and the difference between groups was significant(P＜0.05).Conclusion FMFA management in outpatient blood drawing nursing can alleviate patients'negative emotions,reduce the incidence of patients'unsafe events,improve patient care quality and blood collection cooperation,and can be used for reference and promotion in clinical practice.
Objective To observe the current status of health self-management in patients with chronic hepatitis B(CHB)and analyze its related influencing factors.Method 84 CHB patients admitted to our hospital from August 2020 to May 2023 were selected.The current status of CHB patients'health self-management was evaluated using the Adult Health Self Management Ability Scale.The investigator self-designed a patient general information questionnaire and analyzed the relevant influencing factors of CHB patients'health self-management through linear regression.Results The score on the Health Self Management Ability Scale of 84 CHB patients was(134.94±12.25),which is at a moderate level.There was a statistically significant difference(P＜0.05)in the health self-management scores of patients with different disease courses,monthly family income,lifestyle,perceived stress,and self-efficacy data;there was no statistically significant difference(P＞0.05)in the scores of patients with different educational backgrounds,marital status,and other data.Through linear regression analysis,the results showed that the duration of the disease was less than 5 years,the average monthly income of the family was less than 5000 yuan,living alone,feeling high pressure,and low self-efficacy were all influencing factors for the health self-management of CHB patients(P＜0.05).Conclusion The self-management of CHB patients'health is at a moderate level,which may be influenced by factors such as family economy,course of illness,perceived stress,self-efficacy,and lifestyle.
Objective To analyze and discuss the clinical effect of nursing risk early warning and monitoring in preventing venous thrombosis of lower limbs.Methods 110 patients who underwent orthopedic surgery in our hospital from November 2021 to October 2022 were randomly selected and included in the discussion.They were randomly divided into two groups,with 55 patients in each group.The control group received routine care and the observation group received early warning and monitoring of nursing risks.The clinical effects of the two groups were observed and compared.Results The indexes of APTT and PT in the observation group after nursing were significantly higher than those in the control group,and the indexes of D-dimer after nursing were significantly lower than those in the control group,with statistical significance(P＜0.05).The satisfaction of the observation group(98.18%)was significantly higher than that of the control group(85.45%),with statistical significance(P＜0.05).Conclusion Nursing risk early warning and monitoring can effectively reduce patients'health risks,improve the work efficiency of medical staff and patients'nursing satisfaction,and has significant clinical effects.
Objective To investigate the effects of epirubicin,cyclophosphamide and docetaxel sequential chemotherapy on ANG2(ANG-2)and VEGF(vascular endothelial growth factor)levels in patients with breast cancer.Methods 96 cases of breast cancer patients admitted to our hospital were selected from December 2020 to December 2022,and divided into two groups by numerical random table method,with 48 cases in control group and 48 cases in study group.The control group was treated with TEC,and the study group was treated with EC-T sequential chemotherapy.The efficacy,ANG2 level,VEGF level,tumor marker level and adverse drug reaction were compared between the two groups.Results The effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P＜0.05).After treatment,the levels of ANG2,VEGF and tumor markers(CEA,CA125,CA135,CA199)in the study group were lower than those in the control group,and the data were statistically significant(P＜0.05).The incidence of adverse drug reactions in the study group was lower than that in the control group(P＜0.05).Conclusion For patients with breast cancer,epirubicin,cyclophosphamide and docetaxel sequential chemotherapy regimen can achieve significant efficacy,improve the levels of ANG2,VEGF and tumor markers,and help reduce adverse drug reactions in patients with high safety.
Objective Exploring the value of spinal anesthesia combined with dexmedetomidine in elderly hip replacement surgery.Method During the period from January 2020 to December 2022,30 elderly patients who underwent hip replacement surgery in our hospital were randomly divided into a control group and an observation group.Both groups of patients received spinal anesthesia before the surgery,and the observation group was combined with dexmedetomidine on this basis.Analyze the anesthesia effect and its impact on cognitive function of two groups of patients.Result The onset time of sensory nerve block and motor nerve block in the observation group was shorter than that in the control group(P＜0.05),while the maintenance time of sensory nerve block and sensory nerve block in the observation group was longer than that in the control group(P＜0.05),with statistically significant data;there was no statistically significant difference in the levels of S100 protein and NSE before surgery between the two groups of patients(P＞0.05);after 3 days of surgery,the S100 protein level and NSE level in the observation group were lower than those in the control group(P＜0.05),and the data were statistically significant.Conclusion Intraspinal anesthesia combined with dexmedetomidine can effectively ensure the anesthesia effect of elderly patients undergoing hip replacement surgery,reduce the impact of anesthetic drugs on their cognitive function,and the anesthesia method is worth promoting.
Objective To understand the satisfaction of outpatients in a tertiary hospital in Beiliu City through a cross-sectional survey and analyze its influencing factors,to clarify the current situation of outpatients'satisfaction in the area,to put forward reference opinions and suggestions for improving the outpatient consultation process in the future,and to promote the improvement of outpatients'satisfaction in the area.Methods A total of 120 patients attending the outpatient clinic of Beiliu People's Hospital from February to April 2023 were selected as the study subjects,and our"Outpatient Satisfaction Questionnaire"was used as the research tool.Results In the questionnaire results,"Are you satisfied with the nurses'operation techniques(blood draw,injection,drug change,disposal)?"had the highest satisfaction rate was found in the item,"Are you satisfied with the order of outpatient waiting(queuing,calling)?and"Did the nurse take the initiative to inform you of the approximate waiting time?"had the lowest scores were found in two items.The results of univariate analysis showed that there was a statistical difference between gender,age,education level,and per capita monthly household income of this group and the satisfaction level of outpatients(P＜0.05);there was no statistical difference between the occupation type of this group and the satisfaction level of outpatients(P＞0.05).The results of multiple linear regression analysis showed that the age,education level,and per capita monthly household income of this population were correlated with the level of outpatient satisfaction.Conclusion There are still more shortcomings in outpatient satisfaction in a tertiary hospital in Beiliu,and in the future,we need to set up a better consultation process for special groups,give more attention and help during the consultation process,and establish a reasonable consultation mechanism to improve the overall satisfaction of patients.
Objective To explore the application effect of standardized process operations in disinfection supply centers in nursing defect management.Method 150 items and 28 nursing staff from the disinfection supply center were selected as the research subjects.From January to June 2022,as the pre management period,routine standards were implemented for standardized management.From July to December 2022,as the post management period,procedural work standards were implemented for standardized management.The pass rate of process operations,pass rate of items,and overall satisfaction with work quality scores before and after management were analyzed.Result There was a statistically significant difference in the pass rate of process operations and the pass rate of items before and after management(P＜0.05);the comparison of work quality scores and management satisfaction before and after management showed that after management,it was higher,and the data comparison was statistically significant(P＜0.05).Conclusion During the management period of the disinfection supply center,the standardized process operation can ensure that the items are qualified,improve the quality of nursing staff work,and reduce the risk of nursing defect management,which can be promoted.
Objective To study the effect of colloidal bismuth tartrate capsule plus mesalazine on patients with ulcerative colitis.Methods This study officially started in January 2020 and ended in December 2022.112 patients with ulcerative colitis admitted to our hospital during this period were taken as research objects,and the patients were divided into two groups by digital randomization.Patients in group A were treated with mesalazine,and patients in group B were treated with colloidal bismuth tartrate capsules on this basis.The levels of inflammatory factors,oxidative stress indexes,quality of life and clinical efficacy of the two groups were compared before and after treatment.Results Before treatment,the correlation indexes of group A and group B were similar(P＞0.05).After treatment,all indexes of group B were better than those of group A,and the treatment effective rate of group B was significantly higher than that of group A,and the data difference between groups was large(P＜0.05).Conclusion For patients with ulcerative colitis symptoms,the use of colloidal bismuth tartrate combined with mesalazine in the course of treatment is effective,worthy of clinical recommendation.
先天性心脏病是胎儿的心脏在母体内发育缺陷或部分停顿导致的,先天性心脏病是儿科常见疾病.对于没有分流的或左向右分流的先天性心脏病患者,其在疾病的早期常常没有任何症状,他们的日常活动与正常儿童是一样的,因此会导致家长忽略对其进行体格检查.房间隔缺损、室间隔缺损及动脉导管未闭是先天性心脏病中常见的疾病,虽然这一类疾病在疾病早期常常没有任何症状,但是这类患者在活动量大时可以出现一过性口唇青紫,当活动量减少或停止活动时口唇青紫立即消失,该临床征象是这类先天性心脏病独特的临床表现,临床上将这一类疾病称为潜伏青紫型先天性心脏病.然而有些家长却忽略了这种征象,认为儿童活动时出现一过性口唇青紫是活动量大导致的缺氧现象,属于正常情况.
Objective Combined with clinical experience,the clinical efficacy of laparoscopic radical resection for colon cancer and its influence on gastrointestinal function and immune function were discussed.Methods A total of 206 patients with colon cancer admitted to our hospital from January 2021 to June 2022 were selected and divided into laparoscopy group and laparotomy group according to random number table method.Laparoscopic radical resection of colon cancer and traditional open surgery were used respectively to compare the clinical efficacy of the two groups,and the operation time,intraoperative blood loss,gastrointestinal function recovery time and length of hospital stay were compared between the two groups.The immune function indexes and serum tumor markers were compared between the two groups before and after treatment,and the incidence of complications was observed between the two groups.Results The total effective rate of laparoscopy group(95.15%)was significantly higher than that of laparotomy group(75.73%),the difference was statistically significant(χ2=15.606,P=0.000).The operation time,intraoperative blood loss,gastrointestinal function recovery time and hospital stay of the laparoscopic group were less(shorter)than those of the laparotomy group,and the differences were statistically significant(t=12.126,41.197,73.905,41.818,all P=0.000).There was no significant difference in the level of immune function indexes between the two groups before surgery(P＞0.05).The levels of IgA,IgG and IgM in laparoscopic group were higher than those in laparotomy group(P＜0.05).There was no significant difference in serum tumor markers between the two groups before surgery(P＞0.05).The levels of CEA,CA199 and CA125 in postoperative laparoscopic group were lower than those in laparotomy group,and the difference was statistically significant(P＜0.05).The complication rate in laparoscopy group(4.85%)was significantly lower than that in laparotomy group(15.53%),and the difference was statistically significant(χ2=6.416,P=0.011).Conclusion Compared with traditional open surgery,laparoscopic radical resection of colon cancer has significant clinical efficacy in the treatment of colon cancer,can significantly improve the gastrointestinal function of patients,shorten the length of hospital stay,improve immune function,reduce complications,and is worthy of further clinical promotion and use.
Objective To study the application of Qizhi granules combined with three needles and three divisions for the treatment of ischemic stroke recovery period.Methods Selection Yantai Yuhetang vascular disease of traditional Chinese medicine hospital from March 2021 to March 2023 treated 180 patients with ischemic stroke recovery,randomly divided into needle medicine combined group(n=60),Qizhi granules group(n=60),three needle group(n=60).Separately for each relevant treatment,comparing treatment of 21d between groups in symptom integral,clinical curative effect of traditional Chinese medicine,blood flow velocity of index and adverse events.Results After treatment,each group of patients with Chinese medicine symptom integral are reduced compared with before treatment,and the needle medicine after treatment the symptoms integral joint group was obviously lower than the other two groups(P＜0.05),Qizhi granules group after treatment compared with three needle grouping symptoms integral no statistically significant difference(P＞0.05).Needle medicine combined group,three needle treatment group,Qizhi granules total effective rate was 95.00%,81.67%,75.00%respectively,the needle medicine joint group total effective rate is higher than the other two groups(P＜0.05).After treatment between groups bilateral vertebral artery and basilar artery systolic blood flow velocity was increased,the biggest needle medicine group joint velocity index is higher than the other two groups(P＜0.05).Each group the incidence of adverse events in patients with there was no statistically significant difference(P＞0.05).Conclusion Take Qizhi granules combined three needle points method with the treatment of ischemic stroke recovery,to improve the patient's symptoms and signs and bilateral vertebral artery and basilar artery blood flow velocity,increase the total effective rate and low incidence of adverse events during treatment.
Objective Exploring the effect of open reduction and interlocking intramedullary nail internal fixation in the treatment of traumatic lower limb long bone fractures,and its impact on the recovery of lower limb function.Method 264 patients with traumatic lower limb long bone fractures admitted to our hospital from January 2020 to December 2021 were randomly divided into two groups.The control group was treated with open reduction and internal fixation with steel plates;the intervention group was treated with open reduction and interlocking intramedullary nail internal fixation treatment.Compare the treatment effects,intraoperative bleeding,joint function recovery time,pain,lower limb function,and fracture healing between the two groups.Result The intervention group had a higher therapeutic effect(P＜0.05);the intervention group had less intraoperative bleeding(P＜0.05),shorter joint function recovery time(P＜0.05),and lower pain scores(P＜0.05);the intervention group had higher lower limb function(P＜0.05);the intervention group showed better fracture healing(P＜0.05).Conclusion In the treatment of traumatic lower limb long bone fractures,the use of open reduction interlocking intramedullary nails for internal fixation is effective,which is beneficial for accelerating the recovery of lower limb function and fracture healing,reducing intraoperative bleeding,and reducing pain.It has high clinical application value.
Alanyl glutamine(Ala-Gln)can be used in the parenteral nutrition to supplement glutamine for patients.In this article,the clinical application of Ala-Gln,especially the special population,is summarized and analyzed by referring to the relevant literature at home and abroad in recent years,and providing references for its safe and rational application in clinic.
