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1.
China Pharmacy ; (12): 111-115, 2022.
Article in Chinese | WPRIM | ID: wpr-907022

ABSTRACT

OBJECTIVE To explore the role of the establishment of the trans-regional review system on rational drug use in second-grade general hospital ,and to promote the rational drug use. METHODS With the administrative support of Jiuquan Health Commission,5 second-grade general hospitals in Jiuquan Medical Association jointly established Jiuquan Rational Drug Use Review Training Center . A trans-regional review system was established to carry out cross-review of prescriptions and medical orders among 5 second-grade general hospitals. Totally 1 500 prescriptions and 900 medical records were collected from 5 second-grade general hospitals before (April to June ,2020)and after (July to September ,2020)the implementation of the project. The changes of rational drug use indicators ,the results of prescriptions and medical order review were investigated before and after the implementation of the project. RESULTS After the implementation of the project ,except for one hospital ,the proportion of drugs in other hospitals decreased to varying degrees with the highest decline rate of 22.56% . Compared with before the implementation of the project ,reasonable rate of outpatient and emergency prescription review increased by 5.72% averagely and the reasonable rate of medical order review increased by 10.10%(P<0.05). The average utilization rate of antibiotics in outpatients decreased by 14.45%,the average utilization rate of antibiotics in inpatients decreased by 7.98%,and the average use intensity of antibiotics decreased by 25.19%. CONCLUSIONS Through the establishment of trans-regional review system ,medical institutions can be forced to pay more attention to prescription review ,effectively improve the prescription review of pharmacists in medical institutions,and promote the rational use of drugs in medical institutions in the region. However ,there are still some problems , such as incomplete system coverage ,insufficient work experience ,lagging of informatization ,uneven pharmacist level ,and insufficient assessment and supervision of administrative functional departments.

2.
Journal of Clinical Hepatology ; (12): 381-386, 2022.
Article in Chinese | WPRIM | ID: wpr-920888

ABSTRACT

Objective To investigate the differences in platelet and platelet parameters between patients with different types and etiologies of acute-on-chronic liver failure (ACLF) and the influence of platelet and its dynamic change on the prognosis of ACLF patients. Methods Clinical data, liver function parameters, platelet, and platelet parameters were collected from 364 patients with ACLF who attended Tianjin Third Central Hospital from January 2014 to December 2018. Platelet level and platelet parameters (platelet distribution width and mean platelet volume) were compared between the patients with different types and etiologies of ACLF, and their influence on the 90-day mortality rate of ACLF patients was analyzed, as well as the association of the dynamic change of platelet at baseline and on days 7 and 14 after admission with the prognosis of patients. The chi-square test was used for comparison of categorical data between groups; the Kruskal-Wallis H test or Mann-Whitney U test was used for comparison of continuous data between groups; the Kaplan-Meier method was used for survival analysis; the univariate and multivariate Cox regression analyses were used to analyze the parameters associated with prognosis; the repeated measures analysis of variance was used to analyze the dynamic change of platelet; receiver operating characteristic (ROC) curve was plotted based on platelet level and overall survival. Results The patients with type C ACLF had a significantly lower platelet level than those with type A/B ACLF (all P < 0.001). Compared with the ACLF patients with hepatitis B, the ACLF patients with autoimmune liver diseases had a significant reduction in mean platelet volume ( P =0.035). Based on the cut-off value obtained by the ROC curve analysis, the patients with a platelet level of < 60.5×10 9 /L had a significantly higher mortality rate than those with a platelet level of ≥60.5×10 9 /L ( P =0.006). Platelet level was an independent protective factor against 90-day death in ACLF patients (hazard ratio=0.995, 95% confidence interval: 0.990-0.999, P =0.026), and the mortality rate increased with the reduction in platelet level. The patients with type C ACLF had a significantly higher mortality rate than those with type A ACLF ( P < 0.05), and the death group tended to have a significantly greater reduction in platelet level ( P < 0.05). Compared with the survival group, the 90-day death group had a significantly greater reduction in platelet ( P =0.032). Conclusion There is a difference in platelet level between ACLF patients with different types. Platelet level is an important indicator for the 90-day prognosis of ACLF patients, and patients with a greater dynamic reduction in platelet tend to have a higher 90-day mortality rate.

3.
Journal of Chinese Physician ; (12): 198-202, 2021.
Article in Chinese | WPRIM | ID: wpr-884031

ABSTRACT

Objective:To investigate the mechanism of sinomenine (SIN) in inducing the immunosuppressive effects of rat-derived dendritic cells (DCs).Methods:The bone marrow-derived precursor cells from Wistar rats were cultured in vitro. The morphological differences between sinomenine treated DCs (sinomenine modified group, SIN group) and conventional induced DCs (conventional induced group, control group) were observed under microscope. The CD phenotype of DCs was detected by flow cytometry. DCs were induced maturation by lipopolysaccharides (LPS) stimulation. The impact of SIN on the expressions of Toll-like receptor (TLR)2, TLR3 and TLR4 on the DCs surface were detected by flow cytometry. Results:In the conventional induction group, the cells showed clusters or suspension growth, with obvious granular sense on the cell surface; while in the sinomenine induction group, the cells were clustered together, with no significant change in cell volume and morphology. The relative expressions of CD80 and CD86 were 70.7% and 71.3% in the conventional induction group, while 51.7% and 49.4% in the SIN group. The relative expression of TLRs on DCs in SIN + LPS group was TLR2 (51.2±0.34)%, TLR3 (50.3±0.14)%, TLR4 (52.1±0.16)%, which were significantly lower than those in LPS group [(94.35±0.16)%, (97.55±0.16)%, (94.6±0.12)%].Conclusions:SIN may induce immune tolerance by inhibiting the maturation of DCs via inhibiting the TLRs signaling pathways.

4.
Article in Chinese | WPRIM | ID: wpr-883152

ABSTRACT

Bronchopulmonary dysplasia(BPD) is a common chronic respiratory disease in preterm infants.Severe BPD(sBPD) features a high mortality rate, while for survivors, sBPD usually results in developmental retardation of the nervous system, cardiovascular complications, and long-term respiratory problems that affect the quality of life.At present, there are no effective treatment measures, and comprehensive treatments are adeptly more commonly, including nutritional support, fluid restriction, respiratory support, glucocorticoids, pulmonary surfactants and so on.Yet the effectiveness and safety of these treatments are still controversial.The article reviewed the current status of sBPD management.

5.
Article in Chinese | WPRIM | ID: wpr-883108

ABSTRACT

Objective:To discuss the effect of improved supine position on the prevention of pressure injuries of emergency patients under observation and their comfort levels.Methods:A total of 114 patients in our Emergency Observation Ward were randomly divided into the intervention group and control group, 57 patients in each. Patients in the control group were treated with routine supine position and pressure injury prevention nursing; while patients in the intervention group were treated with improved supine position nursing intervention. Then, the incidence of pressure injury, its risk score and its comfort evaluation were compared between patients under observation in the two groups.Results:The incidence of pressure injury of the intervention group was obviously lower than that in the control group ( Z value was -2.426, P<0.05). The scores of sensation, humidity, activity, friction and shear force of patients in the intervention group were 3.36 ± 0.59, 2.92 ± 0.47, 3.21 ± 0.52 and 2.61 ± 0.29 respectively, which were significantly higher than those in the control group, specifically 2.87 ± 0.51, 2.24 ± 0.38, 2.76 ± 0.44 and 2.04 ± 0.32. The difference was statistically significant ( t value was 4.74-9.96, P<0.01). In addition, the scores of the physiological and psychological comfort level of patients in the prevention group were 15.41±2.49 and 27.26 ± 3.42 respectively, which were significantly higher than 11.01±1.97 and 22.14± 3.23 in the control group. The difference was statistically significant ( t value was 10.46, 8.21, P<0.05). Conclusions:The improved supine position nursing method can effectively lower the occurrence of pressure injury in emergency patients under observation and enhance patients’ comfort degree. Therefore, it is applicable to emergency patients under observation.

6.
Article in Chinese | WPRIM | ID: wpr-883098

ABSTRACT

Objective:To explore the effect of therapeutic communication on infusion safety, disease uncertainty, coping styles, anxiety and depression in patients with emergency infusion.Methods:A total of 126 patients treated with infusion patients in emergency department in Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University from July 2019 to December 2019 were selected and divided into two groups by random digits table method with 63 cases in each group. Patients in the control group received routine nursing, and patients in the intervention group received therapeutic communication nursing intervention on this basis. The incidence of adverse events of infusion during the intervention of the two groups of patients was observed. The disease uncertainty, coping styles, anxiety and depression were evaluated by Mishel's Uncertainty in Illness Scale (MUIS), Medical Coping Mode Questionnaire (MCMQ), Self-rating Anxiety Scale (SAS) and Self-rating Depressive Scale (SDS) before and after intervention.Results:The final collection of 109 patients with complete questionnaire, the recovery rate was 86.51% (109/126), including 55 cases in the intervention group, 54 cases in the control group. The incidence of adverse events of infusion was 16.36%(9/55) in the intervention group and 29.63%(16/54) in the control group, and there was significant difference( χ2 value was 5.057, P<0.05). There was no significant difference in the score of MUIS, MCMQ, SAS, SDS before the intervention between the two groups ( P>0.05). After the intervention, the uncertainty, unpredictability, lack of information and complexity dimension of the intervention group patients' MUIS scores were respectively (17.76 ± 2.49), (12.03 ± 2.51), (11.82 ± 2.12), (11.74 ± 2.24), which were lower than those in the control group (24.72 ± 2.94), (16.31 ± 2.27), (16.13 ± 2.51), (15.39 ± 2.31), the differences were significant( t values were -13.346- -8.375, P<0.05). The confront score of the intervention group patients' MCMQ was (19.13 ± 2.62) higher than that in the control group(13.79 ± 1.96), the avoidance and yield scores were respectively (8.71 ± 1.34), (9.81 ± 1.17), which were lower than those in the control group (14.57 ± 1.93), (15.12 ± 1.86), the differences were significant( t values were 12.031, -18.441, -17.875, P<0.05). The scores of SAS and SDS in the intervention group were (29.43 ± 3.62), (27.67 ± 3.11) respectively, which were lower than those in the control group (37.44 ± 5.31), (40.12 ± 4.92), the differences were significant( t values were -9.216, -15.821, P<0.05). Conclusions:Therapeutic communication can reduce the risk of emergency infusion, reduce the uncertainty of patients to the disease, improve patients' countermeasures to the disease, relieve patients' anxiety and depression, and improve the nursing quality of emergency infusion patients.

7.
Article in Chinese | WPRIM | ID: wpr-882861

ABSTRACT

Objective:To investigate the expression of long non-coding RNA MALAT1, interleukin 6(IL-6) and apoptosis induced factor(AIF) in peripheral venous blood of premature infants with bronchopulmonary dysplasia (BPD) and its clinical significance.Methods:Preterm infants admitted to the Department of Neonatology, Shanghai Children′s Hospital from January 2015 to December 2016 were enrolled.The selection criteria included gestational age (GA) ≥28 weeks and ≤32 weeks, and birth weight (BW) < 1 500 g. According to the diagnosis, they were divided into BPD group (20 cases) and control group (20 cases). The clinical data of the two groups of premature infants were collected and analyzed, and the levels of MALAT1, IL-6 and AIF in the blood of 40 premature infants were detected by real-time polymerase chain reaction (RT-PCR). T test was used to compare gestational age, birth weight, MALAT1, IL-6 and AIF between the two groups. Results:(1)There was no significant differences in sex ( χ2=1.76), gestational age ( t= 0.17) and birth weight ( t=1.25) of premature infants in BPD group, compared with the control group (all P >0.05). (2)Compared with the control group, the expression of MALAT1 in the peripheral blood of premature infants in BPD group were significantly increased (0.273 4±0.067 3 vs. 0.375 5±0.081 9, P<0.05). (3)Compared with the control group, the expression of IL-6 in the peripheral blood of premature infants in BPD group were obviously decreased (1.448 8±0.191 8 vs.4.444 6±0.165 7, P<0.05). (4)Compared with the control group, the expression of AIF in the peripheral blood of premature infants in BPD group were remarkably decreased(0.006 8±0.002 0 vs.0.004 5±0.001 9, P<0.05). Conclusions:MALAT1 and IL-6 levels of long non-coding RNA in BPD and non-BPD preterm infants are different, which may be related to the incidence of BPD.IL-6 may be a predictor of BPD, and MALAT1 may protect premature infants with BPD.

8.
Article in Chinese | WPRIM | ID: wpr-882770

ABSTRACT

Objective:To summarize the clinical features and experience in diagnosis and treatment of subglottic cysts in children.Methods:The clinical data of 5 children with subglottic cysts admitted in Qilu Children′s Hospital of Shandong University from April 2018 to June 2019 were retrospectively analyzed.Results:Among the 5 patients, 2 cases were premature infants and 3 cases were full term infants.All patients had an endotracheal intubation history.One patient was asymptomatic.Four patients had laryngeal stridor, 2 cases of whom were accompanied by hoarseness and dyspnea.These 2 patients were used to be misdiagnosed with laryngomalacia, laryngitis, etc.Bronchoscopy revealed subglottic gray-white cyst-like lesions, and enhanced CT showed low density without enhancement.All patients were treated with laser and forceps, and bronchoscope was applied in the follow up period for 5-12 weeks.There was no recurrence or subglottic stenosis.Conclusions:Laryngeal stridor in children with a history of endotracheal intubation must be examined by bronchoscopy in time to find out whether there is subglottic cysts.Laser therapy is an effective treatment for subglottic cysts.

9.
Article in Chinese | WPRIM | ID: wpr-905313

ABSTRACT

Results and Conclusion:The mean of articles published was 70.5 a year. Germany, USA, UK were the top countries of cooperative documents; Tübingen University, Keio University and Shanghai Jiao Tong University were the top institutions. The most cooperative articles were involved the team of Gharabaghi A. Motor imagery-brain computer interface, network, motor function, especially walking function, may be the focuses in the future. Objective:To summarize the research structure of motor imagery applied in stroke and identify the hotspots and development. Methods:Literatures about motor imagery applied in stroke collected in Web of Science core database between 2010 to 2020 were obtained, and analyzed with CiteSpace software to draw the relevant knowledge mapping of related countries, institutions, authors, and keywords, etc.

10.
Article in Chinese | WPRIM | ID: wpr-905141

ABSTRACT

Objective:To evaluate the effectiveness of single modal and multimodal exercise interventions on sarcopenia in the elderly. Methods:Randomized controlled trials about the effects of single modal and multimodal exercises on the improvement of sarcopenia in the elderly were retrieved from seven databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP and Wanfang data) from the establishment of the databases to July, 2021. Two researchers selected the literatures independently, and evaluated the quality of methodology. The meta-analysis was performed with RevMan 5.3. Results:A total of 15 studies were incorporated, including 816 cases of sarcopenia. Compared to the blank control group, the skeletal muscle mass index improved little with single (MD = -0.05, 95%CI -0.14 to 0.04, P > 0.05) and multiple (MD = 0.15, 95%CI -0.01 to 0.31, P > 0.05) exercises. The maximum grip force improved with both single (MD = 2.06, 95%CI 0.25 to 3.87, P < 0.05) and multiple (MD = 2.36, 95%CI 1.10 to 3.63, P < 0.001) exercises. The knee extensors strength (SMD = 0.49, 95%CI 0.26 to 0.73, P < 0.001) and the walking speed (MD = 0.24, 95% CI 0.19 to 0.29, P < 0.001) improved with multimodal exercises. Conclusion:Single modal exercise may improve maximal grip strength in the elderly with sarcopenia, and multimodal exercise may be effective on maximal grip strength, knee extensors strength and walking speed.

11.
Article in English | WPRIM | ID: wpr-874621

ABSTRACT

Background and Objectives@#Psoriasis is a chronic inflammatory skin disease, which the mechanisms behind its initiation and development are related to many factors. DMSCs (dermal mesenchymal stem cells) represent an important member of the skin microenvironment and play an important role in the surrounding environment and in neighbouring cells, but they are also affected by the microenvironment. We studied the glucose metabolism of DMSCs in psoriasis patients and a control group to reveal the relationship among glucose metabolism, cell proliferation activity,and VEC (vascular endothelial cell) differentiation in vitro, we demonstrated the biological activity and molecular mechanisms of DMSCs in psoriasis. @*Methods@#and Results: We found that the OCR of DMSCs in psoriatic lesions was higher than that in the control group, and mRNA of GLUT1 and HK2 were up-regulated compared with the control group. The proliferative activity of DMSCs in psoriasis was reduced at an early stage, and mRNA involved in proliferation, JUNB and FOS were expressed at lower levels than those in the control group. The number of blood vessels in psoriatic lesions was significantly higher than that in the control group (p<0.05), which the mRNA of VEC differentiation, CXCL12, CXCR7, HEYL and RGS5 tended to be increased in psoriatic lesions compared to the control group, in addition to Notch3. @*Conclusions@#We speculated that DMSCs affected local psoriatic blood vessels through glucose metabolism, and the differentiation of VECs, which resulted in the pathophysiological process of psoriasis.

12.
Article in Chinese | WPRIM | ID: wpr-879585

ABSTRACT

OBJECTIVE@#To explore the clinical and genetic characteristics of a child with frontometaphyseal dysplasia 1 (FMD1) due to variant of FLNA gene.@*METHODS@#Clinical phenotype of the patient was analyzed. Whole exome sequencing (WES) was carried out to detect pathogenic genetic variants. Sanger sequencing was used to verify the result in his parents.@*RESULTS@#The 2-year-and-9-month-old boy presented with facial dysmorphism (supraorbital hyperostosis, down-slanting palpebral fissure and ocular hypertelorism), skeletal deformities (bowed lower limbs, right genu valgum, left genu varus, slight deformity of index and middle fingers, and flexion contracture of little fingers). He also had limited left elbow movement. High-throughput sequencing revealed that he has carried a de novo heterogeneous c.3527G>A (p.Gly1176Glu) missense variant of the FLNA gene. The same variant was found in neither parent.@*CONCLUSION@#The clinical manifestations of FMD1 such as joint contracture and bone dysplasia can occur in infancy and deteriorate with age, and require long-term follow-up and treatment. Above finding has expanded the spectrum of FLNA gene variants.


Subject(s)
Child , Filamins/genetics , Forehead/abnormalities , Humans , Infant , Male , Osteochondrodysplasias/genetics , Phenotype , Whole Exome Sequencing
13.
Article in Chinese | WPRIM | ID: wpr-879459

ABSTRACT

OBJECTIVE@#To compare biomechanical characteristic of different high-strength sutures and suture sites for repairing posterior root tear of the medial meniscus with modified Mason-Allen technique.@*METHODS@#Forty-eight specimen of medial meniscus of knee joint from fresh porcine (female, aged from 5 to 9 months with an average of 7 months) were chosen and established experimental model. The samples were divided into red zone fixation group and red-white zone fixation group according to suture sites, 24 in each group; and then were randomly divided into 3 subgroups which 8 in each group, and fixed with Ethibond suture, Ultrabraid suture and FiberWire suture, respectively. Biomechanical tests were performedon universal electromagnetic and mechanical testing machine. Each specimen was underwent 1 000 cyclic tests on the first time, then pull out test until failure. The maximum failure load, yield load, stiffness and displacement were analyzed.@*RESULTS@#All specimen were successfully completed biomechanical tests. The failure mode of Ethibond group was caused by suture fracture; 6 cases of Ultrabraid suture group was caused by suture fracture which belong to red zone fixation group, 10 cases were caused by suture pull out, which 2 cases belong to red zone fixation group, 8 cases belong to red-white zone fixation group;8 cases of FiberWire group was caused by suture pull-out. Biomechanical test showed that:(1)In terms of suture strength, comparison of the maximum failure load, yield load and stiffness showed that Ethibond suture group

Subject(s)
Animals , Biomechanical Phenomena , Female , Menisci, Tibial/surgery , Rupture/surgery , Suture Techniques , Sutures , Swine
14.
Article in Chinese | WPRIM | ID: wpr-912528

ABSTRACT

Exosomes are nano-scale double-layer membrane structure vesicles that can be actively secreted by cells. They carry a large amount of biologically active substances and can serve as carriers for material transfer and information exchange between cells. In recent years, exosomes have become a frontier hotspot in biomedical research, and show broad application prospects in the field of laboratory diagnosis and clinical treatment of diseases. However, in general, most exosomes-related researchs are still in the laboratory research stage, and there are still many problems and challenges in separation and enrichment, technical operation specifications, and quality control. At the same time, it is urgent to carry out multi-center, large-sample clinical trials to provide evidence for exosomes from the laboratory to the clinical application.

15.
Article in Chinese | WPRIM | ID: wpr-911995

ABSTRACT

We report a case of fetal cerebellar vermis dysplasia diagnosed prenatally by ultrasonography. Ultrasonography of the 27-year-old woman at 20 +6 gestational weeks revealed partial separation of the cerebellar vermis (Dandy-Walker variants), unclosable upper and lower lips, and polydactyly, based on which a preliminary diagnosis of multiple fetal malformations was made. Karyotype and chromosomal microarray (CMA) analysis of the amniotic fluid showed no abnormality. After genetic counseling, amniocentesis was performed again for a whole-exome sequencing test. The results suggested that there are compound heterozygous variations of c.3435G>A(P.W1145X) and c.2941C>G(p. p981A) in the exon 19 and exon 17 of the CPLANE1 gene, which were both de novo mutations and inherited from the father and mother, respectively. The fetus was diagnosed as Joubert syndrome. Given the facial and limb deformities and a significant risk of neurological abnormalities of the fetus, the patient and her family decided to terminate the pregnancy.

16.
Article in Chinese | WPRIM | ID: wpr-911675

ABSTRACT

Objective:To compare the results of three detection methods, single antigen-bead assay(SAB), Luminex screening assay(LMX), and ELISA assay for detecting HLA antibody, and compares the two screening methods, LMX and ELISA with SAB detection as a reference method to provide a reference for organ transplantation laboratories to choose a reasonable HLA antibody test strategy.Methods:A lot of 124 consecutive samples were tested using SAB, ELISA, and LMX methods at the same time, and analyze the differences of these results. SAB testing was used as a reference method to analyze the sensitivity and specificity of the two screening assays. Chi-square analysis was used to compare the two methods, and P<0.05 was considered statistically significant. Results:Both ELISA and LMX methods showed low sensitivity of 34.4% and 31.3% for HLA class I, and 29.7% and 51.3% for class Ⅱ. Otherwise, the specificity of the ELISA and LMX method was much higher. For class, I both was 98.9%, and for class Ⅱ were 100% and 91.9% respectively. Out of 124 samples, the number of SAB(+ )ELISA(-)LMX(-) results was 17, and SAB(-)ELISA(+ )LMX(+ ) results was zero indicating that there were considerably screening assays probably with missed detection. In the cases of SAB(+ )ELISA(-)LMX(-), the distribution of MFI value of SAB assay ranges from 750 to 7000.Conclusions:Because the sensitivity of the two screening methods is relatively low, there is a greater risk of missed antibody detection in the scheme of testing for specific antibodies after the screening test is positive. This should be paid attention to, especially for patients with a history of sensitization. For negative screening test results, SAB or other assays should be considered to check the result. It could provide more accurate results when SAB which is recognized as higher sensitivity and specificity is directly used as an initial test. At the same time, the MFI value of the SAB test can serve as an indicator to determine whether to add other assays to check the ASB result.

17.
Article in Chinese | WPRIM | ID: wpr-911457

ABSTRACT

Rheumatic diseases are a kind of chronic inflammatory diseases mainly involving joints and surrounding tissues. Most patients with rheumatic diseases need long-term treatment, which is difficult to be avoided during pregnancy. Treatment efficacy, as well as maternal and fetal safety should be taken into account in the medical decision. Based on the domestic and foreign guidelines, consensus, diagnosis and treatment experience, Chinese Rheumatology Association developed the standardization of medication use in patients with rheumatic diseases preparing and during pregnancy, aiming on the application and precautions of commonly used medicines for rheumatic diseases in preparing pregnancy, pregnancy and lactation.

18.
Article in Chinese | WPRIM | ID: wpr-911206

ABSTRACT

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on perioperative anxiety and postoperative pain in living kidney donors (LKDs).Methods:Seventy-two American Society of Anesthesiologists physical status Ⅰ or Ⅱ LKDs, aged 18-64 yr, with body mass index of 18-28 kg/m 2, undergoing living kidney transplantation, were selected, and divided into 2 groups ( n=36 each) using a random number table method: TEAS group (group T) and sham stimulation group (group S). In group T, TEAS was performed on the forenoon at 1 day before surgery (T 0), at 30 min before anesthesia induction on the morning of the operation day (T 1) and on the forenoon at 1 day after surgery (T 2) at bilateral Neiguan, Taichong and Yintang with a frequency 2-100 Hz, disperse-dense waves and current intensity 6-15 mA, and each TEAS lasted for 30 min.Only electrode patches were applied at the same acupoint and at the same time point, but no stimulation was applied in group S. In T and S groups, brachial venous blood samples were collected before each stimulation for measurement of the plasma 5-hydroxytryptamine (5-HT) concentration.The Hospital Anxiety Depression Scale-Anxiety subscale (HADS-A) scores at T 0, T 1, T 2, on day 3 after surgery (T 3) and before discharge (T 4) in the 2 groups were recorded.The consumption of anesthetics during operation, laryngeal mask airway removal time, requirement for rescue analgesia within 72 h after surgery and the development of postoperative complications were recorded.The LKDs were followed up by telephone at 3 months after surgery (T 5) to record the scores of HADS-A and Leeds Assessment of Neuropathic Symptoms and Sign (LANSS) scale. Results:Compared to group S, the incidence of anxiety was significantly decreased T 1, T 2 and T 3, the incidence of rescue analgesia within 72 h after surgery was decreased, plasma concentration of 5-HT was increased at T 1 and T 2, the incidence of postoperative nausea and vomiting was decreased, and the time to first flatus was shortened in group T ( P<0.05). There was no significant difference in the consumption of anesthetics during operation, laryngeal mask airway removal time, and the incidence of anxiety and neuropathic pain within 3 months after surgery between the 2 groups ( P>0.05). Conclusion:TEAS can relieve early preoperative and postoperative anxiety and alleviate postoperative pain in LKDs.

19.
Article in Chinese | WPRIM | ID: wpr-908814

ABSTRACT

Objective:To explore the formulation of the evaluation system of nuclear emergency medical rescue drills.Methods:By using the analytic hierarchy process, theoretical analysis and expert consultation, the evaluation system was established, and online questionnaires were used to investigate student satisfaction. Excel software was used for data entry, Matlab 6.5 software was used for weight calculation, and questionnaire data were authorized to SPSSAU online platform to analyze the correlation coefficient between trainees' attitude towards drills and satisfaction of the evaluation system.Results:An evaluation system of nuclear emergency medical rescue drills composed of multiple indicators was constructed, and the weights of each indicator of the system were obtained. The corresponding weights for group comprehensive proficiency, topic theoretical oral examination, personal practice and virtual system were 0.108, 0.557, 0.280 and 0.054, respectively. Simultaneously, the evaluation of the system by the trainees was investigated, and it was found that there was a significant correlation between the trainee's attitude towards the drills and satisfaction with the system.Conclusion:The nuclear emergency medical rescue evaluation system formed in this research is expected to provide theoretical methods for comprehensive evaluation of students' knowledge and capabilities, and at the same time it's helpful to improve the nuclear emergency rescue capabilities of students.

20.
Article in Chinese | WPRIM | ID: wpr-908686

ABSTRACT

Objective:To explore the clinical characteristics and etiology of children with alimentary tract hemorrhage so as to optimize the diagnosis and treatment.Methods:The clinical data of 2 054 children with alimentary tract hemorrhage in Kunming Children′s Hospital from January 2014 to December 2018 were retrospectively analyzed.Results:Among 2 054 children with alimentary tract hemorrhage, males was in 1 274 cases, females was in 780 cases, and the ratio of males to females was 1.6∶1; <3.0 years old was in 647 cases (31.5%), 3.0 to 5.9 years old was in 488 cases (23.8%), 6.0 to 8.9 years old was in 413 cases (20.1%), 9.0 to 11.9 years old was in 281 cases (13.7%), and ≥12 years old was in 225 cases (11.0%); upper alimentary tract hemorrhage was in 991 cases, lower alimentary tract hemorrhage was in 1063 cases. The top three causes of children with upper alimentary tract hemorrhage were acute or chronic gastritis/ gastric ulcer, anaphylactoid purpura and systemic serious infection; the top three causes of children with lower alimentary tract hemorrhage were intestinal polyps, anaphylactoid purpura and food protein allergic colitis. A rare causes of alimentary tract hemorrhage had Peutz-Jeghers syndrome, cavernous transformation of portal vein, Bartter syndrome, systemic lupus erythematosus, Budd-Chiari syndrome, annular pancreas, Reye syndrome, Klippel-Trenaunay syndrome, Evans syndrome and perianal angiectasia and so on.Conclusions:Alimentary tract hemorrhage is a common disease in pediatrics. With the increase of age, the proportion of children with alimentary tract hemorrhage decreased. The main causes of upper and lower alimentary tract hemorrhage are different in different age stages. In addition to paying attention to common causes, the rare causes of alimentary tract hemorrhage should be vigilant and recognized.

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