Résumé
Objective To test the effect of the cluster management strategy in the hospital of ICU patients, in order to ensure the safety of the transhipment of the ICU patients. Methods From February 2016 to November 2017, 351 cases of ICU patients in a three class first class cancer hospital were selected as the subjects, including 182 cases in the control group from February 2016 to December 2016 and 169 cases in the experimental group from January 2017 to November 2017. The patients in the control group carried out conventional traditional transport management measures, and the patients in the experimental group were transported by cluster management strategy. The incidence of adverse events in the hospital transhipment was observed and compared. Results The test group received the cluster management strategy intervention ICU hospital transport of patients with adverse events (associated with disease, correlation, and transfer of personnel information, poor communication pipeline displacement, arteriovenous catheter prolapse, monitor lead loose, monitor micro pump power supply, and related equipment) rates were 15.38%(26/169), 9.47%(16/169), 3.55%(6/169), 2.96%(5/169), 2.37%(4/169), 2.37%(4/169), 2.96%(5/169), 5.92%(10/169), significantly lower than the control group were 29.12%(53/182), 26.92%(49/182), 10.44%(19/182), 7.69%(14/182), 7.14%(13/182), 7.69% (14/182), 11.54% (21/182), 20.33% (37/182), the difference was statistically significant (χ2=3.835-17.695, P<0.01 or 0.05). Conclusion Cluster management strategy can improve the safety of ICU patients in hospital transport, and suggest extensive clinical promotion.
Résumé
Objective To discuss the clinical features of HbeAg-negative chronic hepatitis B patients associate with non-alcoholic fatty liver disease (NAFLD), to value the effect of combining treatment on fatty liver influence and antivi-ral therapy. Methods Nighty eight chronic hepatitis B patients with non-alcoholic fatty liver disease (NAFLD) (Liver pa-thology G≥2 or S≥2,HBV DNA>1 × 105 copies/mL), were observed and given antiviral therapy with interferon alpha 1 b for 24 weeks. These patients were divided into combined treatment group (55 cases treated with interferon alpha 1 b combined with Jian Gan Jiang Zhi pills) and control group (43 cases treated with interferon alpha 1 b) in accordance with random num-ber table. All these patients took Leucoson to prevent blood cells reduction. The combined treatment effect was analyzed by observing and comparing biochemical serum change and HBV DNA negative conversion ratio between two groups. Re-sults After 24 weeks of antiviral therapy in Chronic hepatitis B patients with negative HBeAg associated with NAFLD, ALT and AST decreased significantly in both treatment group and control group. And this change is more obvious in treat-ment group than in control group. TC and TG in treatment group and TC in control group were also dropped with treatment (P<0.05). There is significant difference on HBV DNA negative conversion ratio between treatment groupand control group (98.2%vs 86.0%,P<0.05). Conclusion The combination of antiviral treatment and anti fatty liver treatment can obviously improve liver function and blood lipids, increase negative conversion ratio of HBV DNA for chronic hepatitis B patients asso-ciated with NAFLD.
Résumé
Objective To investigate the clinical and neuroimaging features of Vogt-KoyanagiHarada syndrome ( VKH ).Methods Cerebrospinal fluid ( CSF ), neuroimaging examination, clinical manifestation and pharmacotherapy features were investigated in 5 patients diagnosed as VKH. ResultsAll 5 patients were diagnosed as uveitis in the early stage of disease.All patients suffered “ headache”.Meningeal irritation sign was appeared in 3 cases. The MRI enhanced scan of all 5 cases showed abnormal enhancement of meninges. CSF examination showed increased leukocyte number ((4--196) × 106/L). All patients were alleviatedwith combination therapyof high dose of steroid with cyclophosphamide.ConclusionsVKH is a systemic disease that usually involving the uvea, central nervous system, internal ear and the skin. MRI and CSF examination are valuable for diagnosis. High dose of steroid combined with cyclophosphamide is an effective therapeutic strategy.