ABSTRACT
Objective To investigate the effect of daily quality checklist on intensive care unit (ICU) the incidence of severe patients with hospital associated infection (HAI). Methods A historical control study was conducted. In Tianjin Fifth Center Hospital from June 2016 to May 2017, 286 severe patients with mechanical ventilation (MV) and using ICU daily quality checklist were assigned as the experimental group, and from June 2015 to May 2016, 291 severe patients who did not use the daily quality checklist were selected as the control group. In the control group, the routine treatment, nursing care and ward rounds were the daily ordinary work; in the experimental group, the severe disease ICU quality checklist system was strictly carried out, and every day the doctor and nurse on duty applied the checklist to assess and verify the medical quality given to the patient, including sedation, analgesia, MV, glycemic control, nutrition, etc 16 items. The incidences of ventilation associated pneumonia (VAP), catheter-related bloodstream infection (CRBSI), catheter-associated urinary tract infection (CAUTI), 28-day mortality, time of MV and the length of ICU stay were compared between the two groups. Results Compared with the control group, the incidences of VAP, CRBSI and CAUTI of experimental group were obviously decreased (VAP: 1.78‰ vs. 5.09‰, CRBSI: 1.46‰vs. 5.21‰; CAUTI: 1.39‰ vs. 4.41‰, all P ＜ 0.05), the time of MV and the length of ICU stay in experimental group were significantly shorter than those in the control group [the time of MV (days): 7.81±2.74 vs. 10.62±3.67, the length of ICU stay (days): 8.40±1.94 vs. 11.35±2.47, both P ＜ 0.05]; there was a decreasing tendency of 28-day mortality in experimental group compared with that in control group [5.24% (15/286) vs. 6.19% (18/291)], but no statistical significant difference was seen (P ＞ 0.05). Conclusion Implementation of daily quality checklist can effectively decrease the incidence of HAI in ICU patients, reduce the time of MV and the length of ICU stay.
ABSTRACT
AIM: To study the effects of Huoxue Huayu and Yiqi Wenyang compound prescription (composition; ginseng, radix astragali, plantaginis semen, lignum sappan, chuanxiong, salvia miltiorrhiza, radix aconiti lateralis preparata, bitter orange, cassia twig) of TCM on the congestive heart failure in rats. METHODS:The rats were given doxorubicin hydrochloride by intraperitoneal injection to establish the model of congestive heart failure and were randomly divided into control group, congestive heart failure model group, Xinbao treatment group ( XB treatment) and Huoxue Huayu and Yiqi Wenyang compound prescription treatment group (QXYTM treatment). Normal saline, liquid medicine Xinbao and liquid medicine Huoxue Huayu and Yiqi Wenyang compound prescription were administered respectively to four groups by gavage. Radioimmunoassay, semi - quantitative RT - PCR and flow cytometry methods were used to determine the expressions of plasma atrial natriuretic peptide ( ANP) , renal medulla aquaporin - 2 ( AQP2 ) and heat shock protein70 (HSP70) in congestive heart failure rats before and after treatment. RESULTS: In congestive heart failure rats treated with Huoxue Huayu and Yiqi Wenyang compound prescription, the cardiac output and left ventricle systolic pressure increased significantly, the left ventricular end diastolic pressure decreased, and the maximum ascending and declining rate of left ventricular pressure ameliorated, thus the hemodynamics was effectively improved. Meanwhile, the level of plasma cardionatrin decreased, the abnormal expression of renal medulla AQP2 was markedly restored, and the transcription and expression of HSP70 gene were also increased. CONCLUSION: Huoxue Huayu and Yiqi Wenyang compound prescription promotes the recovery of the pathogenetic conditions of congestive heart failure in rare. The mechanism may be in association with a decrease in plasma ANP level, correction of renal medulla AQP2 abnormal expression and enhancement of HSP70 expression.
ABSTRACT
Objective The objective of this experiment was to find out the causes and mechanisms of vocal cord granulomas,to analyze the results of different treatments and to establish an effective protocol of treatment.Methods 24 patients with vocal cord granulomas were analyzed in terms of genders,ages,occupations,etiologies,such as voicing,gastroesophageal reflux,and treatment under general anesthesia and jet-ventilation,treatments and outcomes.Results Based on different etiologies,patients were divided into 4 groups: Group I of 9 patients with pathologic phonation,Group II of 8 patients with gastroesophageal reflux,Group III of 2 patients with treatment under general anesthesia and jet-ventilation,Group IV of 5 patients with unknown causes.9 patients received operations while 8 demonstrated good prognosis and one was completely cured.The vocal cord granulomas for 11 patients disappeared,8 had reduced vocal cord granulomas,and the vocal cord granulomas for 5 patients without any treatment were gone 6 months later.Conclusion The vocal cord granulomas can be caused by many factors with gastroesophageal reflux as a main etiology.Higher recurrences were noted after surgical treatment;therefore,treatment for gastroesophageal reflux and voice therapy should be considered as major approaches.