目的:调查分析神经外科护士工作压力因素,采取相应对策以减轻压力,积极应对工作。方法:采用问卷调查法,对在神经外科工作的护士工作压力程度,工作压力源,压力源前五位,与其它科室护士进行比较,并通过统计学方法进行分析。结果:神经外科护士工作压力程度以重度压力为主。排序前5位的压力源为:工作量大,担心工作出差错,社会地位低,上班护士数量少,护理的患者病情过重。结论:正确分析神经外科护士工作压力因素,采取有效的对策,对于提高护理质量,保障护理安全,具有十分重要的意义。
【摘要】 目的 探讨结直肠癌致肠梗阻的诊断和治疗。方法 回顾性分析2003年1月—2008年12月间72例结直肠癌致肠梗阻的外科诊治资料。结果 72例患者中肿瘤位于右半结肠23例,左半结肠29例,直肠16例,回盲部4例。其中63例手术治疗,一期切除吻合46例,Hartmann术7例,单纯造口10例。有9例因肿瘤全身广泛转移等因素自动放弃手术治疗。结论 重视对结直肠癌致肠梗阻的认识、合理选择手术方式、做好围手术期处理是减少并发症、提高疗效的重要措施。
ObjectiveTo systematic review the efficacy and safety of acupuncture on patients with sepsis.MethodsThe PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were searched. The retrieval time was from the inception to October 1st, 2019. The randomized controlled trials (RCTs) about acupuncture on the sepsis were screened. Two researchers independently screened the articles, extracted and analyzed the data, evaluated the risk of bias included in the study. Meta-analysis was performed by RevMan 5.3 software.ResultsA total of 20 RCTs involving 1 337 patients were included. Meta-analysis showed that there were significant differences between the acupuncture group with conventional treatment in 28-day mortality [RR=0.69, 95%CI (0.5, 0.9), P=0.03], APACHE II score at 3rd day [MD=−2.4, 95%CI (−3.68, −1.12), P=0.0002] and 7th day [MD=−4.37, 95%CI (−6.32, −2.21), P<0.0001], length of the ICU stay [MD=−1.54, 95%CI (−2.81, −0.27), P=0.02], the effective rate for improved gastrointestinal function [RR=1.5, 95%CI (1.09, 2.06), P=0.01], concentrations of PCT [MD=−2.23, 95%CI (−3.33, −1.13), P<0.001] and TNF-α [MD=-14.86, 95%CI (−23.74, −5.97), P=0.001] at 7th day. However, there was no significant difference between the two groups about the CD8+ count at 7th day [MD=1.65, 95%CI (−0.32, 3.62), P=0.1].ConclusionAvailable evidence suggests that acupuncture may be a potential treatment method for sepsis patients. Due to the limited quantity and quality of included studios, the above conclusions are needed to be verified by more high-quality studies.
ObjectiveDetermine the effect of Semen ziziphi spinosae decoction combined Sodium valproate (VPA) sustained-release tablets on treating patients with Post-traumatic epilepsy (PTE).Methods30 patients are chosen among the patients who were hospitalised in Epilepsy Department of Kunshan Traditional Chinese Medicine Hospital from Jan 2017 to Jan 2019. The age ranges from 31 to 75, averaging at (42.5±13.5) years old, and composed of 16 male samples and 14 female, randomly divided into experimental group (Semen ziziphi spinosae decoction combined VPA, n=15) and control group (VPA, n=15). In general, imaging data and EEG data are collected. Regular follow-up is also carried out for these 30 patients. The results are analysed to determine the effect of treatment.ResultsAfter 9-months treatment of Semen ziziphi spinosae decoction combined VPA, morbidity of experiment group is significantly lower than that of the control group. It is also found that the differenes of imaging data and EEG data of patients were of no statistical significance.ConclusionIt is demonstrated that Semen ziziphi spinosae decoction combined VPA has superior performance in treating patients with PTE. The efficiency of Semen ziziphi spinosae decoction combined VPS in treating PTE is 93.3%, higher than the 80% of VPA. It can serve as reference for clinical diagnosis and treatment.
Objective To analyze the clinical features of rickettsial infection complicated with pulmonary embolism and to improve clinicians’ knowledge of rickettsial infection complicated by thromboembolism events. Methods We retrospectively analyzed the clinical data of a patient with pulmonary thromboembolism complicated by Rickettsial felis infection and conducted a review of the relevant literature. The search terms "Rickettsia/Scrub typhus, thrombosis" or "Rickettsia/ Scrub typhus, embolism" were used to search the Wanfang ,VIP ,Chinese National Knowledge Infrastructure and PubMed databases from January 1985 to May 2023, respectively. Results The 81-year-old male patient was admitted to the hospital on June 1, 2021 due to "dizziness, sore throat for 11 days, fever for 7 days, and shortness of breath for 3 days". Physical examination revealed a eschar-like rash behind the left ear, venous thrombosis in both lower limbs was detected by color ultrasound, computed tomographic pulmonary angiography indicated multiple pulmonary embolism in both lungs, and positive rickettsiae on peripheral blood next-generation sequencing, confirming the diagnosis of Rickettsial felis infection complicated by venous thromboembolism (VTE) in both lower limbs and pulmonary embolism. Twenty manuscripts, including 20 cases, were retrieved from databases. Among them, Rickettsial felis infection combined with thromboembolism event was not found. With the addition of our case, a total of 21 cases were analyzed in detail. Six of the 21 cases were complicated with VTE, 10 with pulmonary embolism, 5 with intracranial venous thrombosis, 6 with thrombosis at other sites (jugular venous thrombosis, mesenteric thrombosis, aortic thrombosis, etc), and 8 of which had concurrently involved systemic thrombosis. Of the 4 deaths, 2 cases had mesenteric embolism, 1 case had cerebral infarction, and 1 case had systemic multiple thrombus. Conclusions Rickettsial infection symptoms and signs are often atypical, can be complicated with lower limb VTE or pulmonary embolism. Early identification, diagnosis and treatment are very important, especially for patients with dyspnea, chest pain and other related symptoms.
Objective To explore the clinical value of Persyst automatic detection of spike waves in adult patients with temporal lobe epilepsy. Methods EEG recordings were continuously concluded from the Epilepsy Unit of the First Affiliated Hospital of Soochow University during 2019.1.1 to 2019.12.31. Two EEG experts certified by the Chinese Anti-Epileptic Association marked interictal epileptic discharge in the long-time electroencephalogram that meet the criteria. Consistent results of the two experts were seen as the "golden standard". The sensitivity and false positive rates were calculated compared with the automatic test results of Persyst version 11, 13 and 14. Results 7 cases were included, each with a recording time of 24~25 hours and a total of 169 hours. Two expert readers achieved the consistency of 43.09%. Spike waves detected automatically were much more than manually. The sensitivity was as high as 62.26%, 77.0% and 67.28%. The lowest false positive rate was 0.37/min, 0.85/min and 0.46/min respectively. Automatic analysis achieved an average workload reduction of 14.59%~37.05%. Conclusions Persyst automatic spike detection has the acceptable sensitivity and false positive rate. It differs from versions and need to be further combined with expert readers.Less workload and accuracy can be balanced by setting reasonable perception parameter.
ObjectiveTo compare the effect and safety of basiliximab in ABO incompatible pediatric liver transplant recipients.MethodsABO incompatible pediatric liver transplantation operated between January 2019 and August 2020 were studied. The patients were allocated randomized into two groups. Patients in experimental group were treated with basiliximab as immune induction therapy, but basiliximab was not used in patients of control group. Tacrolimus combined methylprednisolone were used after liver transplantation. The clinical characteristics, graft and recipient survival rate, rejection, infectious complications, and kidney functions after liver transplantation were observed. Donor specific antibody (DSA) was tested in 3 months after liver transplantation. The growth and development were assessed too after liver transplant.ResultsFourty-four patients were enrolled in the study, including 19 patients in the experimental group and 25 patients in the control group. The median follow-up time was 16.6 months (3.8–25.4 months), and there were no statistically differences between the two groups in terms of age, sex, weight, pediatric end-stage liver disease (PELD) score, and other basic conditions. There were no significant differences between the two groups in tacrolimus dose, tacrolimus trough concentration, kidney functions, height and weight growth after liver transplantation. There were no statistical differences in lung infection, blood stream infection within 3 months after liver transplantation, cytomegalovirus, EBV infection, graft/patient survival rate after liver transplantation (P>0.05). However, the acute rejection rate was lower and the DSA positive rate in 3 months after liver transplantation was lower in the experimental group (P<0.05).ConclusionsBasiliximab can be safely used in ABO incompatible pediatric liver transplant recipients. Acute rejection rate and DSA positive rate after transplantation can be decreased with the useof basiliximab.