目的:观察血清C-反应蛋白(CRP) 水平与急性心肌梗死(AMI)患者6个月时心功能及病死率的关系。方法:入选我院572例AMI住院患者,根据入院时CRP水平分为CRP升高组及CRP正常组,随访6个月,记录超声心动图结果及死亡例数。结果:两组基线资料无明显差异。与入院时CRP正常组比较,CRP升高组患者6个月时LVEDD、LVESD,住院期间及随访期间病死率显著增加,而6个月时LVEF显著降低 (P lt; 0.05)。多因素分析结果显示入院时CRP升高是AMI患者住院期间及6个月病死率的独立危险因素。结论:血清CRP升高是AMI患者心功能及病死率的预测因素,关注AMI患者血清CRP水平,尽早开始控制,有利于改善AMI的预后。
Objective To study the distribution and drugresistance of pathogens isolated from patients who suffered from lower respiratory infections after thoracotomy and provide basis for rational use of antibiotics in clinical practice. Methods A total of 118 patients suffered from lower respiratory infections after thoracotomy in Beijing Lung Cancer Center and the Thoracic Surgery Department of Xuanwu Hospital between January 1,2006 and December 31, 2009. We performed a retrospective study on pathogens from their lower respiratory tract. Of these patients, 89 are male and 29 are female with a mean age of 64.6 years. Sputum specimens were obtained by sterile sputum collectors or bronchofibroscopes, and then were sent to microorganism laboratory immediately. Cytological screening was carried out before specimen inoculation. Bacterial culture, identification and drug sensitivity test were performed with routine methods. Results A total of 201 strains of pathogens from the lower respiratory tract were identified. There were 126(62.7%) strains of gramnegative bacilli, 66(32.8%) strains of grampositive cocci, and 9(4.5%) strains fungi. The four prevalent gramnegative bacilli strains with the highest isolating rate between 2006 and 2009 included 34(27.0%) strains of acinetobacters, 28(22.2%) strains of verdigris Pseudomonas, 19(15.1%) strains of Klebsiellas and 19(15.1%) strains of Escherichia coli. Verdigris Pseudomonas ranked first in isolating rate among prevalent gramnegative bacilli strains from 2006 to 2008, but it was replaced by cinetobacters (9 strains, 40.9%) in 2009. The most prevalent strains of grampositive cocci were staphylococcus aureus (35 strains, 53%) from 2006 to 2009. Gramnegative bacilli were most sensitive to imipenem and no grampositive cocci were resistant to vancomycin. Conclusion Gramnegative bacilli are the most common pathogens in lower respiratory infections after thoracotomy and show extremely high drugresistance rate. Drugresistance monitoring of pathogens should be promoted. It may contribute to rational antimicrobial therapy and effective control of infections.
Objective To evaluate the effect of clinical pathway (CP) teaching methods versus traditional methods in nursing clinical teaching. Methods The following electronic databases as PubMed, EMBASE, The Cochrane Library, CBM and CNKI were retrieved on computer from their establishment to April 2011 to search for randomized controlled trials (RCTs) of comparing CP with traditional methods in nursing clinical teaching. The methodological quality of the included RCTs was assessed by two reviewers independently according to the scale of criteria for methodological quality developed by Smits PB, and the meta-analysis was conducted by using the Cochrane Collaboration’s RevMan5.1 software. Results A total of 12 RCTs involving 1 269 participants were included, and nine of them were of high quality. The meta-analyses showed that compared with the traditional teaching method, the CP teaching tended to be superior (Plt;0.05) in improving nursing students’ objective knowledge, nursing operating skills, professional ability and satisfaction with teaching methods, and in improving patients’ satisfaction as well. Conclusion The clinical pathway teaching method is a scientific teaching model in nursing clinical teaching; it standardizes the teaching procedure, promotes students’ active learning and further enhances the teaching effect. But it is necessary to unify the method of assessment with more researches. In addition, researchers should pay more attention to improving the comprehensive quality of nursing students.
目的:观察辛伐他汀、吡格列酮和苯磺酸左旋氨氯地平联合治疗代谢综合征疗效。方法:76例初诊代谢综合征患者,服用吡格列酮15mg/d、苯磺酸左旋氨氯地平25mg/d、辛伐他汀10mg/d,疗程1个月。观察治疗前后血压、腰围、体重指数、血糖、血胰岛素、血尿酸和血脂水平等变化。结果:患者治疗后血糖、血脂、胰岛素水平、血压均明显降低,差别有统计学意义(Plt;001)。腰围、体重指数略有下降,无统计学意义,血尿酸变化不明显。结论:吡格列酮、辛伐他汀和苯磺酸左旋氨氯地平联合治疗代谢综合征能够改善胰岛素抵抗和代谢异常,疗效可靠、服药简单、依从性好,效价比合理,无不良反应。
ObjectiveTo compare the quality of life in the early stage of treatment in patients who accepted renal transplantation with those who still were undergoing long-term hemodialysis. MethodsPatients undergoing long-term hemodialysis in December 2011 and adult patients who planned to accept renal transplantation within 6 months were chosen to be our study subjects. The Medical Outcomes Study 36-item Short Form Health Survey Questionnaire (SF-36) was used for the study. After 6 months of following up, they were assessed with the same questionnaire again. Those hemodialysis patients who accepted renal transplantation within this period were divided into the intervention group. The quality of life between the two groups was compared then. ResultsA total of 124 end-stage renal failure patients were involved in our study, in which 79 patients successfully accepted renal transplantation (intervention group) and the other 45 patients who still underwent hemodialysis (control group). No other complications were observed during this period. There was no significant difference in life quality between the two groups before treatment (P>0.05). Six months after the treatment, SF-36 total score and each of the 8 dimension scores for the intervention group were all significantly higher than those for the control group (P<0.05). ConclusionRenal transplantation recipients have a totally better life quality than those who depend on hemodialysis.
ObjectiveTo compare the analgesic effect of different treatment for herpes zoster neuralgia, and optimize herpetic neuralgia treatment. MethodsWe collected hospital inpatient data with herpes zoster by the First Military Medical Case Management System between January 1st, 2009 and December 20th, 2013. All the patients were divided into five groups according to different treatments. Patients in group A accepted valaciclovir capsules and doxepin hydrochloride tablets; patients in group B accepted valaciclovir capsules; patients in group C accepted valaciclovir capsule, nefopam hydrochloride tablets and doxepin hydrochloride tablets; patients in group D accepted valaciclovir capsules and nefopam hydrochloride tablets; patients in group E accepted valaciclovir capsules and non-steroidal anti-inflammatory drugs (including nimesulide capsules and ibuprofen sustained-release capsules). We collected such statistic data as sex, age, time of onset, time of pain disappearing after treatment. Then, we analyzed the difference among the groups on the time of pain disappearing. ResultsThere were 336 cases compliant with the standard in all the 898 cases of medical record data. The number of the patients was 72, 86, 66, 60 and 52; while the pain disappearing time after treatment was (5.94±2.54), (8.60±3.09), (5.77±1.85), (5.80±1.96) and (6.86±2.18) days, respectively in group A, B, C, D and E. Pain disappearing time after treatment of group B was significantly different from groups A, C, D, and E (P<0.05); group E was significantly different from groups A, C, and D (P<0.05); there was no significant difference between group A and groups C and D, and between group C and D (P>0.05). ConclusionThe combination of nefopam hydrochloride tablets, doxepin hydrochloride tablets, nimesulide capsules, and ibuprofen sustained-release capsules is effective in the treatment of herpes zoster neuralgia. The use of nefopam hydrochloride tablets with doxepin hydrochloride tablets is more effective than the combination of nimesulide capsules and ibuprofen sustained-release capsules. Doxepin hydrochloride tablets are not significantly different from nefopam hydrochloride tablets. Nefopam hydrochloride tablets and doxepin hydrochloride tablets are not associated with increased efficacy.
To explore the effects of tissue expansion on the anastomoses and the survival of the axial pattern flap with a crossing area supply so as to improve the survival of crossing area axial pattern flap and to provide a new idea for the development of original crossing area axial flap. Methods The experiment included two parts. Experiment A was divided into expansion group and control group. Square flaps were randomly designed on own control bilaterally in each animal with a boundary of midl ine. Experiment B was divided into expansion group and delay group. The flaps were also randomly designed on own control bilaterally. Angiographic analysis and gross survival observation were carried on. Results ExperimentA: Angiography showed that there were abundant anastomoses with big cal iber between deep il iac circumflex artery and superior epigastric artery in expansion group and there were only 3-4 anastomoses in control group. Experiment B: Angiography showed that there were abundant anastomoses with big cal iber in expansion group and there were two arterial systems with relatively less anastomoses and smaller cal iber in delay group. The survival rates in expansion group was significantly higher than that in the control group (90.16% ± 3.61% vs 72.67% ± 5.35%) in experiment A, and in experiment B the survival rate was 92.08% ± 3.30% in the expansion group and 80.79% ± 4.52% in the delay group, showing significant difference (P lt; 0.01). Conclusion Expansi on prefabrication can and improve the survival of the crossing area supply axial pattern flap. The mechanism is the bridging effect.
Magnetic susceptibility is an intrinsic physical quantity which describes the relationship between material magnetization and applied external magnetic field. Quantitative susceptibility mapping (QSM) is an MRI technology which can quantify the buck magnetic susceptibility of tissue in vivo. It is particularly effective at elucidating anatomy with paramagnetic or diamagnetic components. QSM technology is a method for solving the ill-pose problem of un-conventional de-convolution of the measured tissue magnetic field with the unit magnetic dipole field to obtain the susceptibility source map. Many multi orientation scan based QSM and clinically acceptable single orientation QSM methods have been proposed to solve this ill-posed problem. In this paper, the QSM concept is introduced and the various QSM methods are systematically categorized and discussed. The aim of this paper is to summarize the current research progress of QSM, popularize the knowledge of QSM and promote the improvements and the rational application of QSM in clinical field.
Objective To evaluate effect of hypoxia condition (1% or 5% oxygen concentration) on proliferation, adhesion, migration, or viability ability of bone morrow-derived endothelial progenitor cells (EPCs). Methods The bone marrow mononuclear cells of SD rat were acquired with density gradient centrifugation method. They were cultured, induced, and differentiated to the EPCs. Then they were cultured respectively in three different oxygen concentrations (1%, 5%, or 21%). On the 3rd day and the 7th day, the effects of the different oxygen concentrations (1%, 5%, or 21%) on the EPCs’ neovascularization characteristics (including proliferation, adhesion, migration, and viability abilities) were evaluated. Results Whether cultured for the 3rd day or 7th day, the proliferation, adhesion, migration, and viability abilities of the cultured cells in the 1% and 5% oxygen concentrations were significantly better than those of the cultured cells in the 21% oxygen concentration (all P<0.05). Except for the proliferation ability of the cultured cells in the 5% oxygen concentration was significantly better than that of the cultured cells in the 1% oxygen concentration (P<0.05) on the 3rd day, and the adhesion ability on the 3rd day and the proliferation ability on the 7th day had no significantly differences, the other abilities (adhesion, migration, and viability abilities) of the cultured cells in the 1% oxygen concentration were significantly better than those of the cultured cells in the 5% oxygen concentration (allP<0.05). Conclusion Different oxygen concentration has an effect on proliferation, adhesion, migration, or viability ability of bone morrow-derived EPCs, appropriate hypoxia condition (1% or 5% oxygen concentration ) can enhance these abilities.