摘要:目的：观察厄贝沙坦治疗非杓型高血压患者降压效果及其杓型血压昼夜节律恢复情况,并观察治疗后血浆醛固酮水平的影响。方法:对杓型和非杓型两组原发性高血压患者分别给予150300 mg/d,观察降压效果及对血压昼夜节律的影响,并监测用药前后血浆醛固酮水平的变化。结果:所有高血压患者应用厄贝沙坦治疗前后收缩压及舒张压均有不同程度的下降,非杓型组夜间收缩压及舒张压的下降值与杓型相比有统计学差异,出现了明显的昼夜节律,血浆醛固酮水平出现了明显差异。结论:厄贝沙坦对非杓型高血压患者有良好的降压作用,并能恢复非杓型高血压患者的昼夜节律,向杓型血压变化。Abstract: Objective: To investigate the effect of blood pressure control and circadian variability of dipper blood pressure induced by irbesartan in patients with nondipper essential hypertension and to observe levels of aldosterone.after treatment.Methods:The patients were divided into dipper and nondipper groups. All patients were treated with irbesartan (150300 mg/d). The variability of circadian blood pressure were observed, and the levels of plasma aldosterone were monitored before and after treatment Results: After the treatment with irbesartan, the blood pressure in all patients were evidently reduced. The night blood pressure of the patient with nondipper essential hypertension had more significant improvement . The circadian variability was appeared. The levels of aldosterone had a significant difference between day and night. Conclusion:Irbesartan has significant effects for the patients with nondipper essential hypertension. It can induce a circadian variability and recover the dipper blood pressure from nondipper blood pressure.
OBJECTIVE To observe the effects of sodium hyaluronate on nerve root adhesion after operation of lumbar disc protrusion (LDP). METHODS From April 1996 to June 2001, 152 cases with LDP were performed the removal of nucleus pulposus under endoscope. After operation, 2 ml of sodium hyaluronate were injected. The clinical results were evaluated by clinical symptom, straight leg raising test, patient’s satisfaction degree and back pain. RESULTS All the patients were followed for 1 month to 3 years. The average angle of straight leg raising test increased from 26 degree preoperatively to 62 degree postoperatively. The patient’s pain were markedly relieved. Patient’s satisfactory degree were 86.8%. CONCLUSION The injection of sodium hyaluronate after operation of LDP has effect on preventing postoperative nerve root adhesion.
Objective To observe the efficiency and security of enhanced external counter pulsation (EECP) as an adjunctive therapy for nonarteritic anterior ischemic optic neuropathy (NAION). Methods This was a retrospective casecontrol study. Forty-eight patients (48 eyes) with NAION were enrolled in this study. Thirty-two patients (32 eyes) who had been treated with blood vessel dilation and nerve nutrition drugs comprised the medicated group. Sixteen of the patients (16 eyes) in the medicated group were treated with EECP combined with blood vessel dilating and nerve nutrition drugs as EECP group. The differences were not statistically significant between groups in gender(chi;2=0.000), age (t=1.096), course (t=1.613) and visual acuity (chi;2=0.000,P＞0.05). EECP was done once a day, one hour per time, five times a week. Fourteen eyes were treated 12 times EECP and two eyes were treated 36 times EECP within the EECP group. Systemic and ocular side effects were observed during EECP treatment. Corrected visual acuity was examined after treatment and the differences of visual acuity between medicated group and EECP group treated six times and or 12 times with EECP treatment were analyzed. The correlation of visual acuity level, and course, and acuity before treatment were analyzed. A significant improvement in visual acuity was defined as a sustained improvement of three or more visual acuity gradations. An effective of treatment was defined as a sustained improvement of two or less visual acuity gradations. No effective of treatment was defined as visual acuity dropped or showed no progress. Results After six treatments of EECP, within the 16 eyes of EECP group, two eyes achieved significant improvement, five eyes had effective improvement, and nine eyes did not show any improvement. Within the 32 eyes of medicated group, three eyes achieved significant improvement, eight eyes had effective improvement, and 21 eyes did not show any improvement. There was no statistically significant difference in vision between the two groups (chi;2=0.404,P＞0.05). After 12 treatments of EECP, within the 16 eyes of EECP group, six eyes achieved significant improvement, nine eyes had effective improvement, and one eye did not show any improvement. Within the 32 eyes of medicated group, four eyes achieved significant improvement, 10 eyes had effective improvement, and 28 eyes did not show any improvement. The difference was statistically significant comparing the vision level between the two groups (chi;2=11.621,P＜0.05）. The curative effect of patients negatively correlated with course of the disease (r=-0.860，P＜0.05), but positively correlated with visual acuity before treatment (r=1.380,P＜0.05). Skin bruises, hematoma, new retinal bleeding and other side effects did not occur in patients during EECP treatment. Conclusions Many time therapy of EECP can improve vision of NAION patients. There is no local and general complications after a certain number of therapy.
Objective To study the special traits of primiparae’s compliance with labor analgesia, so as to offer individualized analgesia solutions during spontaneous labor. Methods The uniparous primiparae with cephalic presentation between gestational weeks 38 and 40 were divided into two groups based on their educational background (college education or above, and high school education or below), each group with 20 cases. The demographical statistics of the two groups including their State-Trait Anxiety Inventory (STAI) grading, PCA results, and delivery situation were recorded and analyzed. Results Differences in age, height, and weight were not statisticallysignificant (Pgt;0.05); differences in T-AI were not statistically significant (Pgt;0.05); differences in S-AI were statistically significant (Plt;0.05); differences in anxiety and numbers of adding anesthetics were not statistically significant (Pgt;0.05); differences in failure to tolerate labor pains and requiring caesarean section were statistically significant (Plt;0.05). Conclusion Primiparae with higher educational degree tend to have higher S-AI grading and perform poorly in compliance with labor analgesia.
【摘要】 目的 观察窄谱中波紫外线联合复方甘草酸苷治疗寻常性银屑病的疗效。 方法 2007年2月—2010年11月，将收治的126例银屑病患者随机分为治疗组和对照组，治疗组72例采用注射复方甘草酸苷与窄谱中波紫外线联合治疗，对照组54例则仅采用窄谱中波紫外线治疗，以银屑病皮损面积和疗效指数（PASI）评价对比两组疗效。 结果 两组治疗后PASI评分均明显低于治疗前；治疗后治疗组PASI评分低于对照组，且差异有统计学意义（Plt;0.05）；两组治疗有效率分别为87.5%和79.6%，治疗组疗效明显优于对照组（Plt;0.05）。 结论 窄谱中波紫外线与复方甘草酸苷联合治疗寻常性银屑病，不良反应小，治愈率高，值得临床推广。【Abstract】 Objective To observe the clinical efficacy of compound glycyrrhizin combined with narrow-band ultraviolet B (NB-UVB) in treating patients with psoriasis vulgaris. Methods A total of 126 patients with psoriasis vulgaris treated in our hospital from February 2007 to November 2010 were randomly divided into the treatment group and the control group. Seventy-two patients in the treatment group were treated with NB-UVB radiotherapy combined with compound glycyrrhizin, and 54 patients in the control group were treated with NB-UVB radiotherapy alone. The curative effects were evaluated in terms of the area of injury and therapeutic effect indexes. Results The PASI score after treatment for both groups was obviously lower than before, and the score of the treatment group was significantly lower than the control group after treatment. The efficacy rate was respectively 87.5% and 79.6% for the treatment group and the control group, with a significant difference (Plt;0.05). Conclusion NB-UVB combined with compound glycyrrhizin is safe and effective in treating psoriasis vulgaris, and it is worth popularizing.
Family members are crucial for medical disputes. From the psychology and social perspective, the paper analyzes a specific medical dispute case, and discusses the psychological care for (potential) " shidu” (loss of the only child) family. Based on the current social context, an early intervention suggestion is proposed, that is to provide the whole-process psychological intervention to the special patients’ families. The intervention includes: regular psychological evaluation and psychological support if necessary; providing disease knowledge and death education; providing continuous psychological care by the hospital and community; offerring more psychological care for " shidu” family by society.
Sample size calculation is an important factor to evaluate the reliability of the diagnostic test. In this paper, a case study of the clinical diagnostic test of artificial intelligence for identification of liver contrast-enhanced ultrasound was performed to conduct two-category and multi-categories studies. Based on sensitivity and specificity, the sample size was then estimated in combination with the statistical characteristics of disease incidence, test level and one/two-sided test. Eventually, the sample size was corrected by integrating the factors of the proportion of training/test dataset and the dropout rate of cases in the medical image recognition system. Moreover, the application of Sample Size Calculator, MedCalc, PASS, and other software can accelerate sample size calculation and reduce the amount of labor.
ObjectiveTo systematically review the incidence of financial toxicity among cancer patients in China. MethodsThe Cochrane Library, Web of Science, PubMed, Embase, CINAHL, CNKI, and WanFang databases were searched to collect studies on the prevalence of financial toxicity among cancer patients in China from January 2016 to April 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was performed by using Stata 16.0 software. ResultsA total of 24 studies involving 8 799 participants were included. Meta-analysis results showed that the prevalence of financial toxicity among cancer patients was 67.4% (95%CI 60.9% to 74.0%) in China. The subgroup analysis showed that sex, educational level, type of medical insurance, cancer site and stage, the cut-off of the instrument, and region were all influential factors of financial toxicity among cancer patients. ConclusionCurrent evidence shows that high prevalence of financial toxicity among cancer patients. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To develop and validate a nomogram for predicting the risk of weaning failure in elderly patients with severe pneumonia undergoing mechanical ventilation. Methods A retrospective analysis was conducted on the clinical data of 330 elderly patients with severe pneumonia undergoing mechanical ventilation who were hospitalized in our hospital from July 2021 to July 2023. According to their weaning outcomes, they were divided into a successful group (n=213 ) and a failure group (n=117). Univariate analysis and multivariate non-conditional logistic regression analysis were used to explore the factors influencing the weaning failure of mechanical ventilation in elderly patients with severe pneumonia. Results Univariate analysis showed that there were significant differences in age, smoking status, chronic obstructive pulmonary disease, ventilation time, albumin, D-dimer, and oxygenation index levels between the two groups (all P<0.05). Multivariate logistic regression analysis revealed that age ≥65 years, smoking, presence of chronic obstructive pulmonary disease, ventilation time ≥7 days, D-dimer ≥2 000 μg/L, and reduced oxygenation index were risk factors for weaning failure in the elderly patients with severe pneumonia. The nomogram model constructed based on these factors had an area under ROC curve of 0.970 (95%CI 0.952 - 0.989), and the calibration curve demonstrated good agreement between predicted and observed values. Conclusions Age, smoking status, chronic obstructive pulmonary disease, ventilation time, D-dimer, and oxygenation index are influencing factors for weaning failure in elderly patients with severe pneumonia receiving mechanical ventilation. The nomogram model constructed based on these factors exhibits good discrimination and accuracy.