RÉSUMÉ
Objective:To investigate the preventive effects of hydroxyethyl starch and methoxamine on complications of combined spinal and epidural anesthesia in older adult patients and its influence on hemodynamics.Methods:The clinical data of 120 older adult patients who underwent combined spinal and epidural anesthesia in General Hospital of Armed Police and Marine Police between February 2017 and April 2019 were retrospectively analyzed. The included patients were divided into two groups according to the adverse reactions of drugs used to induce anesthesia: control group (methoxamine injection, n = 55) and observation group (methoxamine + hydroxyethyl starch, n = 65). The changes in hemodynamic index, complications and cognitive function were analyzed in each group. Results:Systolic blood pressures measured at 5, 15 and 30 minutes after anesthesia were (127.53 ± 10.63) mmHg, (119.85 ± 10.86) mmHg, (125.45 ± 10.74) mmHg, respectively in the observation group, which were significantly higher than (118.23 ± 11.32) mmHg, (114.34 ± 10.32) mmHg, (119.01 ± 10.34) mmHg in the control group ( t = 3.66, 2.24, 2.63, all P < 0.05). Diastolic blood pressures measured at 5, 15 and 30 minutes after anesthesia were (76.65 ± 9.07) mmHg, (78.43 ± 9.32) mmHg, (80.19 ± 9.43) mmHg, respectively in the observation group, which were significantly higher than (63.30 ± 9.43) mmHg, (65.98 ± 9.26) mmHg, (70.38 ± 9.17) mmHg in the control group ( t = 6.24, 5.78, 4.55, all P < 0.05). Heart rates measured at 5, 15 and 30 minutes after anesthesia were (73.65 ± 7.67) beats/min, (83.27 ± 9.57) beats/min, (84.10 ± 9.67) beats/min respectively in the observation group, which were significantly higher than (69.76 ± 7.82) beats/min, (64.70 ± 9.38) beats/min, (65.80 ± 9.43) beats/min in the control group ( t = 2.17, 8.46, 8.27, all P < 0.05). The incidences of hypotension and bradycardia in the observation group were 3.08% (2/65) and 3.08% (2/65), respectively, which were significantly lower than 25.45% (14/55) and 21.82% (12/55) in the control group ( χ2 = 12.91, 10.15, both P < 0.05). The Mini Mental State Examination scores measured at 1, 6 and 24 hours after surgery were (26.69 ± 2.51) points, (26.74 ± 2.75) points, and (26.99 ± 2.36) points, respectively in the observation group, which were significantly higher than (23.17 ± 2.41) points, (23.43 ± 2.36) points, and (24.18 ± 2.12) points in the control group ( t = 6.17, 5.55, 5.39, all P < 0.05). Conclusion:Hydroxyethyl starch combined with methoxamine for combined spinal and epidural anesthesia in older adult patients can effectively reduce the hemodynamic fluctuations, decrease the incidences of hypotension and bradycardia, and does not produce a remarkable effect on postoperative cognitive function.
RÉSUMÉ
Objective:To explore the efficacy and safety of mechanical thrombectomy (MT) in patients with minor stroke with large vessel occlusion (LVO).Methods:Twenty-three patients with minor stroke with LVO, admitted to our hospital from January 2017 to July 2019, were consecutively collected in our study; patients with contraindications of intravenous thrombolysis should be treated with direct thrombectomy, and the left were given bridging therapy (intravenous thrombolysis combined with MT). NIHSS scores were used to assess the degrees of neurological impairment at admission, and 12 h and 7 d after treatment. Vascular recanalization was assessed by modified cerebral infarction thrombolysis (mTICI) grading, with grading 2B-3 defined as successful recanalization. The prognoses 90 d after treatment were assessed by modified Rankin scale (mRS), and mRS scores≤2 was classified as having good prognosis. Safety indicators included symptomatic intracranial hemorrhage, incidence of complications, and mortality 90 d after treatment.Results:Twenty-two patients had successfully recanalization; 19 patients had mTICI grading 3 and 3 patients had grading 2B. The NIHSS scores were 3 (2, 5) at admission, 2 (2, 3) 12 h after treatment, and 2 (1, 2) 7 d after treatment, with significant difference ( χ2=14.028, P=0.001); NIHSS scores 12 h and 7 d after treatment were significantly lower than those at admission ( P<0.05). Sixteen patients (69.6%) enjoyed good prognosis and 7 patients (30.4%) had poor prognosis. In terms of safety, two patients had symptomatic intracranial hemorrhage,10 had systemic complications, and one died during 90-d of follow-up. Conclusion:MT is effective and safe in minor stroke patients with LVO.
RÉSUMÉ
Objective To explore the relationship among job stressors,sleep quality and psychological health of nurses.Methods 708 female nurses in a 3-A-grade general hospitals of Guangxi were chosen and asked to fill out the Nurse Job Stressors Questionnaire-Revised (NJSQ-R),Pittsburgh Sleep Quality Index (PSQI) and Symptom Checklist 90 (SCL-90).Results ① The total mean score of NJSQ-R (1.50± 0.62) and the five job stressors,including the job environment and characters (1.60±0.65),personal relation ship(1.21±0.73),the attitude of patient and their relatives(1.63±0.74),professional skill(1.38±0.71) and social status and career development(1.97±0.72) were positively related with the total mean score of SCL-90 (1.64±0.69) (r=0.32-0.50,P＜0.01)and the total score of PSQI(8.11±3.52) (r=0.28-0.35,P＜0.01).There was a positive relationship between SCL-90 and PSQI(r=0.46,P＜0.01)).② SCL-90(β=0.387,P＜ 0.01)and the job stressor of the social status and career development(β=0.120,P＜0.05)were directly sig nificantly associated with PSQI.The job stressor of job environment and characters(β=0.235,P＜0.01) and professional skill(β=0.117,P＜0.05)were indirectly associated with PSQI mediated by SCL-90.③ PSQI was directly significantly associated with SCL-90(β=0.344,＜0.01).The job stressor of the social status and career development was indirectly significantly associated with SCL-90 mediated by PSQI(β=0.113,P＜0.05).And the job stressor of job environment and characters was directly (β=0.172,P＜0.01)and indirectly (β=0.184,P＜0.01) associated with PSQI mediated by SCL-90.Conclusion The higher the job stress,the more the mental health problem,and the poor the sleep quality among nurses.Job stressors have direct or in direct influence on psychological health and sleep quality,depending on the nature of job stressors.In addition,the result suggests that a bidirectional relationship exists between sleep quality and psychological health.
RÉSUMÉ
From January 2000 to December 2006, 78 hypertensive patients with intracerebral hemorrhage(80～130 ml)underwent minimally invasive surgery(n=41)or small bone window craniotomy(n=37). Neurological deficit scores and mortality were estimated to evaluate the therapeutic efficacy among those two group patients. The success rate was significantly higher in the micro-invasive surgery group than the small bone window craniotomy group(P＜0. 05). However, no significantly lower mortality was detected in the micro-invasive surgery group(P＞0. 05). In summary, micro-invasive surgery may reduce the mortality, largely increase the success rate of treatment, and improve patients' quality of life.
RÉSUMÉ
Objective To study the effect of anti-IL-5 monoclony antibody (TRFK-5) on migration of Eos from BM to the airways in sensitized mice. Methods Male C57BL/6 (6-8wk of age) murine model of Asthma and control group were estabolished with routine method. The outcome measurements include white blood cell (WBC) total count, differential count of bronchoalveolar lavage fluid (BALF) and peripheral blood (PB), nuclear cell count and eosinophil percentage of BM. These parameters were collected 12 h after the final allergen challenge. To cheek Eos infiltration, the histology of lung tissues was also observed. Further, the effects of intranasal TRFK-5 on above changes were investigated. Results Eosinophil numbers of BALF, PB, BM and the infiltration of Eos in pulmovnary tissues were increased considerably 12 h after final OVA challenge compared with negative group(P