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Objective:To explore the effectiveness of patient participation and Internet plus in fall prevention management strategies of elderly inpatients and analyze the causes of falls, so as to provide a basis for continuous improvement in fall prevention to investigate their continuous improvement.Methods:A pre- and post-control study was conducted. Totally 8 480 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2020 to 31 May 2021 in Chenzhou NO. 1 People′s Hospital were selected by convenient sampling as the control group, and 8 662 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2021 to 31 May 2022 were in the experimental group. The routine fall prevention measures were used in the control group, and on this basis, the experimental group formulated and implemented fall prevention management strategies involving patients based on the patient participation framework "informing, participating, empowering, cooperating, and electronic information support" and introduced Internet plus. Then the differences between the two groups in terms of the incidence of falls and the satisfaction rate of nursing care were compared.Results:The experimental group included 8 662 cases (5 110 males and 3 552 females) with (73.96 ± 8.78) years old, while the control group included 8 480 cases (4 918 males and 3 562 females) with (74.11 ± 8.59) years old. The incidence of falls in experimental group (0.092%, 8/8 662) was lower than that in control group (0.224%, 19/8 480), and the difference was statistically significant ( χ 2=4.71, P<0.05); the nursing care satisfaction rate of experimental group (98.880%, 8 565/8 662) was higher than that of control group (96.450%, 8 179/8 480), and the difference also was statistically significant ( χ 2=106.50, P<0.01); the analysis of the fall causes of the patients revealed that the toilet squatting commode was an important hidden risk of falls in elderly patients. Conclusions:Fall prevention management strategies based on patient participation can reduce the incidence of falls in elderly patients and improve the satisfaction rate of nursing care. Patient participation introduced "Internet plus" can prevent patient falls. The root causes of patient falls will continue to change, and care managers should continually track real-time changes in the root causes of falls to identify problems, develop and adjust prevention strategies accordingly, and pay attention to the importance of infrastructure in the safety of older patients.
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Objective To investigate the prevalence of hepatitis D virus (HDV) infection among patients with chronic hepatitis B virus (HBV) infection in some regions of China. Methods Serum samples were collected from 3 131 patients with chronic HBV infection in 10 provinces, cities, and autonomous regions of China from March 2021 to June 2022, and anti-HDV IgG ELISA was used for the detection of all serum samples. Nested reverse transcription-polymerase chain reaction (nRT-PCR) was used to detect HDV RNA in anti-HDV IgG-positive samples, and the nRT-PCR amplification products of HDV RNA-positive samples were sequenced and analyzed to determine HDV genotype. The clinical features of anti-HDV IgG-positive patients were analyzed. The Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results The positive rate of anti-HDV IgG in the 3 131 patients with chronic HBV infection was 0.70% (22/3 131), and that in the patients with chronic HBV infection in Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, Beijing, and Hunan Province was 1.81% (16/886), 0.88% (2/226), 0.28% (2/708), and 1.00% (2/200), respectively; the patients with chronic HBV infection in Inner Mongolia Autonomous Region had a significantly higher positive rate of anti-HDV IgG than those in Beijing ( P =0.004), and there was no significant difference between the other regions ( P > 0.05). Clinical features of the patients with chronic HBV infection in Inner Mongolia Autonomous Region showed that compared with the anti-HDV IgG-negative group, the anti-HDV IgG-positive group had a significantly higher proportion of patients with Mongol nationality ( P =0.001), abnormal alanine aminotransferase ( P =0.007), or antiviral treatment ( P =0.029), as well as a significantly lower median HBV DNA level ( P =0.030). A total of 19 HDV RNA-positive samples were identified, all of which had HDV genotype 1. Conclusion The prevalence rate of HDV varies greatly across different regions of China, with a higher prevalence rate of HDV in patients with chronic HBV infection from Inner Mongolia Autonomous Region. HDV genotype 1 is the predominant genotype in some provinces and cities of northern China.
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Objective :To explore therapeutic effect of percutaneous coronary intervention (PCI ) combined hydro‐chloride tirofiban on aged patients with acute coronary syndrome (ACS) complicated diabetes mellitus (DM) and its safety .Methods :A total of 218 ACS + DM patients were selected .According to randomization method ,they were divided into routine treatment group (n＝107 ,received standard PCI) and tirofiban group (n＝111 ,received tirofi‐ban injection in coronary artery based on routine treatment group ).Operation indexes ,incidence rates of hemor‐rhage during hospitalization and major adverse cardiovascular events (MACE) within six months after PCI were ob‐served and compared between two groups .Results : There was no significant difference in door‐to‐balloon time , number and length of implanted stents between two groups , P＞0.05 all.Compared with routine treatment group , there were significant rise in percentages of TIMI grade 3 blood flow (75. 70% vs.91.89%) ,MBG grade 2 ～3 (69.16% vs.85.56%) and ST segment regression ＞50% within 90min after PCI (77. 57% vs.92.79%) ,and sig‐nificant reduction in corrected TIMI frame count (CTFC)[(33. 05 ± 8.37) frames vs.(26.54 ± 5.47) frames]in tiro‐fiban group , P＜0.01 all.There was no significant difference in incidence rate of hemorrhage events during hospi‐talization between two groups , P＝0.375. Incidence rate of MACE within six months in tirofiban group was signifi‐cantly lower than that of routine treatment group ,P＝0.001 .Conclusion :Intracoronary tirofiban injection based on routine PCI can significantly improve postoperative myocardial perfusion level ,reduce incidence rate of short‐term MACE after PCI without increasing incidence rate of hemorrhage in aged ACS patients .Its safety is good .
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@#Objective To investigate the clinical efficacy of low-frequency transcranial magnetic stimulation (rTMS) on post-stroke upper limb spasticity and its mechanism. Methods From September, 2015 to December, 2017, 23 patients with post-stroke upper limb paralysis were randomly divided into control group (n=13) and experimental group (n=10). Both groups received routine rehabilitation, and the experimental group received 1 Hz rTMS at primary motor area (M1) for eight weeks. They were assessed with modified Ashworth Scale (MAS), modified Barthel Index (MBI) and Fugl-Meyer Assessment-Upper Extremities (FMA-UE) before and after treatment, while the activation under fMRI in the task state was observed and the laterality index (LI) was calculated. Results The scores of MAS, FMA-UE and MBI improved after treatment in both groups (Z>2.121, t=6.248, P<0.05), and improved more in the experimental group than in the control group (Z>2.084, t=-2.095, P<0.05). The ipsilateral M1, ipsilateral sensory motor cortex and bilateral supplementary motor area were activated more in the control group than in the experimental group during the movement of affected hand. LI in the M1 increased after treatment in both groups (Z>2.366, P<0.05), and was more in the experimental group than in the control group (Z=-2.430, P<0.05). There was a positive correlation between the change of LI in the M1 and the improvement of the MAS and FMA-UE (r>0.612, P<0.05). Conclusion Low-frequency rTMS may improve the motor function and spasticity of upper limb after stroke by promoting reorganization of the cortex and inducing normalization of cortical function.
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Objective To explore the effects of acceptance and commitment therapy on psychological resilience and perceived benefit of breast cancer patients.Methods From January to June in 2015,39 inpatients were enrolled as the control group,where routine nursing and functional exercise were carried out.From July 2015 to January 2016,41 inpatients were treated as the observation group,where acceptance and commitment therapy was implemented apart from the treatment for the control group.Before and after the intervention,the Conor-Davision resilience scale (CD-RISC) and the Chinese version of perceived benefits of diagnosis and treatment of breast cancer (PB-DTBC) were used for evaluation.Result After the intervention,the scores of psychological resilience and the perceived benefit of the observation group were significantly higher than those of the control group and before intervention (P＜0.01).Conclusion Acceptance and commitment therapy can effectively improve the psychological resilience and disease-perceived benefit of breast cancer patients.
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The spirit of contract, with freedom, equality and reciprocity of power and responsibility as basic connotation and containing credit consciousness, is the core content of the concept of rule of law. People′s desire for justice, recognition of fairness, reliance on integrity contained in the concept of rule of law all originate from the spirit of contract, such as contract party's expectation of fairness, performance of obligation, abiding by the valid contract. Not only does the concept of rule of law reflect the essence requirement of the spirit of contract, but also is the external form of realization. Therefore, in order to enhance the concept of rule of law of the college students, it is a certain choice to cultivate the spirit of contract. However, the current paths to cultivate the spirit of contract are mainly theoretical research, environmental influence and system perfection.
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<p><b>OBJECTIVE</b>To investigate the therapeutic effect of drug treatment for patients with sudden sensorineural hearing loss (SSNHL) accompanied with feeling of ear fullness (FEF).</p><p><b>METHODS</b>A prospective clinical multicenter research was carried out from August 2007 to October 2011. SSNHL patients aged between 18 to 65 years old and accepted no medication were recruited, with a duration less than two weeks. The patients were divided into four types according to the hearing curve: type A was acute SSNHL in low tone frequencies, type B was acute SSNHL in high tone frequencies, type C was acute SSNHL in all frequencies, and type D was total deafness. Each type was subdivided into two groups by the accompaniment of SEF or not. And each type had four different treatment programs, based on the unified designed randomized table. All patients were followed up for four weeks from the initial examination.</p><p><b>RESULTS</b>A total of 1 024 cases with single side SSNHL were recruited in the study from 33 hospitals in China, including 565 cases accompanied with FEF (55.18%), and 459 cases without FEF (44.82%). By classification of audiogram, 205 cases were type A (20.20%), of whom 122 were accompanied with FEF (59.51%); 141 cases belonged to type B (13.77%), of whom 74 were accompanied with FEF (52.48%); 402 cases were type C (39.25%), of whom 229 were accompanied with FEF (56.97%); and 276 cases were classified as type D (26.95%), of whom 140 were accompanied with FEF (50.72%). No significant difference was observed in total effective rate between the SSNHL patients accompanied with FEF or not in four acoustic types (P > 0.05). Among four acoustic types, the clinical cure rate of patients accompanied with FEF in type A was 93.44%, ranking the first; followed by 84.28% for type C; 75.71% for type D; and 70.27% for type B, respectively.</p><p><b>CONCLUSIONS</b>The therapeutic effect for patients accompanied with FEF in type A is satisfactory. The presence of FEF do not impact the therapeutic effect for SSNHL patients.</p>
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Adolescent , Adulte , Sujet âgé , Humains , Adulte d'âge moyen , Jeune adulte , Chine , Surdité neurosensorielle , Thérapeutique , Perte auditive soudaine , Thérapeutique , Tests auditifs , Études prospectivesRÉSUMÉ
Objective To develop a technique of aesthetic repair procedures for the skin and soft tissue defect after injury.Methods Nineteen cases of patients with skin and soft tissue defects after injury were chosen in this study,in which there were 19 wounds involved.Thirty-seven expanders were inserted into the subcutaneous pockets beside the wounds in the right time and were inflated by a fast expansion model (one time every two days). After completion of inflation,the expanded skin flaps were made and transferred to repair the wounds.Results All the 37 expanders were inflated successfully in duration of 46-63 days.Five expansion areas presented complications that were correctly controlled.All of the wounds were covered and healed well after the expanded skin flap transplantation.Twelve patients were followed up for 6 months after operation.The long-term results showed that the color and texture of the flaps matched the recipient sites well without swelling.The aesthetic appearance of the repaired sites looked satisfactory.Conclusions The rapid tissue expansion is a better option for repairs of some skin and soft tissue defects after injury in certain areas.
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Objective To investigate the stress distributions on implant-bone interface and fatigue behaviors of biomimetic titanium implant under static and dynamic loading conditions to provide theoretical basis for a new implant which may effectively transfer the stress to surrounding bones. Methods A 3-D finite element model of a posterior mandible segment with an implant bone was constructed by a CAD (Pro/E Widefire 2.0) software. Two different implant models (a dense implant No.1 and a biomimetic implant No.2) were designed. The stress distributions on bone-implant interface under dynamic and static loading conditions were analyzed by Ansys Workbench 10.0 software, as well as the fatigue beha-vior of the biomimetic implant. Results The cervical cortical bones in the 2 implants were all high stress region under the same loading condition. The maximum von Mises stress on the interface and high-stress region in the cancellous bone region, and the maximum stress in the root region of the biomimetic implant were lower than those of the dense implant. The stress on the implant-bone interface decreased from the top to the bottom. The stress in the cervical cortical bone under the dynamic loading was 17.15% higher than that of the static loading. There was no significant difference in maximum stress at the cortical bone region between the dynamic and static loading conditions. The maximum stress of the dense implant in the cancellous bone region was 75.97% higher and that in the root region was 22.46% higher than that of the biomimetic implant. The maximum stress on the implant-bone interface was far less than the yield strength of pure titanium. The stress distribution in the cortical region of the biomimetic implant was 7.85% higher than that of the dense implant, and the maximum stress in the cortical bone was smaller than the yield stress of cortical bone. Within the dynamic loading of 50-300 N, the safety coefficient was all higher than 10, and with the increase of loading pressure, interface stress in the cancellous region increased linearly. Under the loading of 300 N in the axial and 25 N in the lingual 45°, the maximum stress was 11.38 MPa. Conclusion Biomimetic style implant can effectively transfer the implant-bone interface stress to surrounding bones in the cancellous bone and root region, and the structure with the improved design is safe under normal loading pressure.
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Objective To observe the pharmacological effect of Jiaweisinisan (JWSNS) on alcohol liver diseases. Methods Feeding Wistar rats with alcohol induced the alcohol liver diseases model. Then JWSNS was used on the alcohol liver diseases model to observe the histological variation of liver and detect the effect on the liver’s expression of SOD, GSH-PX, CAT and MDA. At the same time, Xiaochaihu granule group was used as control. Results On the alcohol liver diseases model group processed with JWSNS, obvious decrease of pathological injury with expression of MDA in liver was observed, while a markedly increased expression of SOD, GSH-PX and CAT was detected. Conclusions JWSNS can prevent liver cells from peroxided injury by alcohol.
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Objective To observe the clinical effect of Jiawei Sinisan (JWSNS) on patients with alcohol liver diseases. Methods 80 patients of alcohol liver diseases were divided into two groups, JWSNS and Xiaochaihu (as control) were used respectively to observe the variation of lipoprotein and the expression of hepatic fibrosis markers. Results The symptoms and indicators of patients were improved by JWSNS. The high variation of lipoprotein and the expression of hepatic fibrosis markers were obviously detected on alcohol liver diseases patients who were treated with JWSNS (with an effectivity of 97.5%). However, patients treated with Xiaochaihu had less therapeutic effect. Conclusions JWSNS can obviously regulate the fat metabolism, resist hepatic fibrosis, and improve the symptom of patients suffering from alcohol liver diseases.
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0 05].The sensitivities in pSS patients with lower lip biopsy and in pSS patients without lower lip biopsy were 88 3% and 84 6% respectively.The total sensitivity was 87 0% and the specificity was 97 8%.At least 11 2% of pSS patients with negative anti SSA/SSB antibodies were diagnosed by lower lip biopsy.Conclusion The new international classification criteria for pSS are feasible in Chinese patients.It has a high sensitivity of 87 0% and a high specificity of 97 8% which may serve as diagnosis criteria in routine clinical practice
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Objective To evaluate the clinical safety for outpatients over 80 years old after phacoemul sification surgery. Methods The 184 cases (226 eyes) of aged patients with cataracts were operated on with phacoemulsification and IOL implantation. The safety, complications during and after operation, visual recovery and others were followed up over that period. Results All eyes were operated on without any danger and no serious complications were found. The vision acuity was 0 5 or better in 198 cases (87 6%), 1 0 or better in 102 eyes (45 1%). The main complication was corneal edema in 58 eyes(26 2%), rupture of posterior capsule in 12 eyes (5 3%) and posterior capsular opacity in 16 eyes (7 1%). Conclusions The phacoemulsification and IOL for over 80 years outpatients were safe and effective. The key points are systemic physical examination and careful eye examination. Stimulations during operation and postoperative complications should be prevented.
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Objective To evaluate the intraoperative complication and postoperative visual acuity effect of phacoemulsification in patients with pseudoexfoliation syndrome. Methods Phacoemulsification and intraocular lens(IOL) implantation was performed on 21 eyes of 19 pseudoexfoliation patients, aged 67-92 years old and (80.24?7.46) years old on average with the history of the disease being (7?4.3) years. Five eyes in Group 1 were complicated with glaucoma. In Group 2, phacoemulsification and IOL implantation was performed on 50 eyes in 42 patients with non-pseudoexfoliation syndrome, 〔aged 61-91 years, mean age (79.52?8.53) years〕. All operations were completed by one surgeon, and followed up for 1 year. Results In both Group 1 and Group 2, the occurrence of posterior capsular tear and vitreous body loss were 9.5% and 2.0%, respectively(P
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Objective To analyze the reasons and mechanisms of stereoscopic function abnormality in elder patients after the cataract extraction with intraocular lens implantation. Methods 150 cases with artificial lens implantation were randomly selected.Routine eye examinations were carried out and the associated refractive error and presbyopia were corrected.Bilateral simultaneous visual perception and fusion function were examined.The stereoscopic function was tested using "the stereoscopic function examination diagram"created by Yan Shao-ming.Ninety-seven patients who were found to have unrecover-ed or abnormal stereoscopic function were enrolled for analysis. Results In these 97 cases,53(54.6%)were found to have preexisting eye disorders that could affect visual acuity and binocular single vision before the operation.Macular problem was the most prevalent problem in this group.Twenty-seven(27.8%)patients had complicated with corneal astigmatism,after cataract,paralysing strabismus and diplopia as well as macular edema after the operation.In addition,the contralateral unoperated cataract in 17(17.5%)patients and post-operative anisometropia in 9(9.3%)patients were also the causes of stereoscopic function abnormality.There was no reason could be identified in 8 cases. Conclusions The pre-existing eye disorders before lenses implantation,complications of the operation,contralateral unoperated cataract and anisometropia are all the major factors that affect visual acuity recovery and bilateral stereoscopic function rehabilitation.
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Objective To explore the influence of stereoscopic vision on the development of posterior capsule opacification (PCO) after intraocular lens implantation. The efficacy of Nd: YAG laser was studied. Design Case-controlled study. Participants 57 consecutive patients with POC(59 eyes with phacoemulsification and IOL implantation). Methods A prospective observational study was conducted comprising 57 patients (59 eyes) who had postoperative PCO. Neodymium: YAG (Nd: YAG) laser posterior capsulatomy was performed on all patients following a standardizes procedure. Preoperative and postoperative evaluation included LogMAR visual acuity, best-corrected visual acuity (BCVA), contrast sensitivity and stereoscopic vision. Main Outcome Measures LogMAR visual acuity, BCVA, contrast sensitivity and stereoscopic vision. Results The average LogMAR eyesight median of sick eye before laser treatment was (0.22?0.31) and the contrast sensitive degree of each frequency area was relatively lower than the opposite eye; After the treatment, there was evident improvement of the sick eye, and the LogMAR eyesight median of that was 0.00; The ratio of reaching the central spatial eyesight and the average sharpness degree both improve much than ahead of treatment. Those whose spatial eyesight sharpness don't get normal after the low best remedy eyesight. Irregular dipodic and previous eye disease. Conclusions LogMAR visual acuity, BCVA, contrast sensitivity and stereoscopic vision were damaged markedly with PCO. Our results indicate that Nd: YAG capsulotomy may affect the reconstruction of stereoscopic vision. Nd:YAG laser posterior capsulotomy is a valuable and clinically relevant method for clinical treatment of PCO.