Effect analysis of information-guided enteral nutrition-associated diarrhea treatment process in patients with chronic obstructive pulmonary disease undergoing continuous non-invasive assisted ventilation: a mixed cohort study of pre- and post-control / 中华危重病急救医学

Objective:To clarify the application effect of information-guided enteral nutrition-associated diarrhea (ENAD) management process in patients with chronic obstructive pulmonary disease (COPD) undergoing non-invasive assisted ventilation.Methods:A mixed cohort study of pre- and post-control was conducted. Thirty-nine patients with COPD who were admitted to the emergency intensive care unit (ICU) of Huzhou First People's Hospital from July 1, 2021 to July 31, 2022 were enrolled. Taking the completion of the software development of ENAD management software for critically ill patients on January 28, 2022 as the time node, 20 patients admitted from July 1, 2021 to January 28, 2022 were set as the control group, and 19 patients admitted from January 29 to July 31, 2022 were set as the observation group. The two groups of patients received the same enteral nutrition support treatment, and the control group implemented the conventional ENAD treatment process with enteral nutrition intolerance disposal process as the core. On the basis of the control group, the observation group implemented the information-guided ENAD treatment process, and the system software actively captured the information of ENAD patients and reminded the medical team to improve the patient's diarrhea-related examination and provide alternative treatment plans. The duration of antidiarrhea, feeding interruption rate, and energy and protein intake, blood biochemical indexes, incidence of abnormal blood electrolyte metabolism, daily continuous non-invasive assisted ventilation and endotracheal intubation after 7 days of targeted diarrhea intervention were compared between the two groups.Results:Except for the basal pulse rate, there were no significant differences in gender distribution, age, and vital signs, basic nutritional status, arterial blood gas analysis and blood biochemistry at admission between the two groups, indicating comparability between the two groups. When ENAD occurred, the patients in the observation group obtained earlier cessation of diarrhea than those in the control group [days: 3.00 (2.00, 3.25) vs. 4.00 (3.00, 5.00), P < 0.01], and the feeding interruption rate was significantly lower than that in the control group [10.53% (2/19) vs. 65.00% (13/20), P < 0.01]. After 7 days of diarrhea intervention, the energy intake of the observation group was significantly higher than that of the control group [kJ·kg -1·d -1: 66.28 (43.34, 70.36) vs. 47.88 (34.60, 52.32), P < 0.01], the levels of hemoglobin (Hb), albumin (Alb) and serum prealbumin (PAB) were significantly higher than those in the control group [Hb (g/L): 119.79±10.04 vs. 110.20±7.75, Alb (g/L): 36.00 (33.75, 37.25) vs. 31.00 (30.00, 33.00), PAB (mg/L): 155.79±25.78 vs. 140.95±14.97, all P < 0.05], the daily continuous non-invasive assisted ventilation duration was significantly shorter than that of the control group [hours: 14 (12, 16) vs. 16 (14, 18), P < 0.01], and the arterial partial pressure of carbon dioxide (PaCO 2) was significantly lower than that of the control group [mmHg (1 mmHg ≈ 0.133 kPa): 66.00 (62.00, 70.00) vs. 68.00 (67.50, 70.05), P < 0.05]. However, there were no significant differences in protein intake, incidence of abnormal electrolyte metabolism, and incidence of endotracheal intubation due to acute respiratory failure between the two groups. Conclusion:The information-guided ENAD treatment process can enable the COPD patients undergoing continuous non-invasive assisted ventilation who experience ENAD to receive earlier cessation of diarrhea, and improve the protein energy metabolism and respiratory function of the patients.

Development of High-performance Hearing Test System / 中国医疗器械杂志

This paper analyzes the shortcomings of the existing pure tone audiometers, and proposes a system to realize pure tone audiometry and speech audiometry with a new DSP processor. The pure tone test signal produced by the system has accurate frequency, high signal-to-noise ratio, and small harmonic distortion. The noise generator that comes with DSP adds a band-pass filter to realize the generation of narrow-band noise. At the same time, due to the modular structure of software design, the system has good ease of use and scalability. The test results show that the hearing test system has excellent performance and can be better used in hearing medical diagnosis.

Trends of overweight and prevalence among Ningxia Han ethnic students during 2000-2019 / 中国学校卫生

Objective@#To investigate the trend of overweight and obesity among Han students aged 7-18 in Ningxia from the year of 2000 to 2019, and to provide scientific basis for obesity prevention and control among children and adolescents.@*Methods@#Based on the five waves of "National Student Physical Fitness and Health Survey" in Ningxia region during 2000 to 2019, body weight, height, waist circumference, hip circumference and other data of Han students aged 7-18 years were included was used for trend analysis.@*Results@#In 2019, the detection rates of overweight and obesity in children and adolescents aged 7 to 18 in Ningxia were 13.34% (1 181/8 855) and 9.19% (814/8 855), respectively. The increase rate of overweight and obesity in boys from 2000 to 2019 was 11.68% and 10.07% ( χ 2=27.60, P <0.01). The rate of overweight and obesity in female students from 2000 to 2019 was 6.95% and 5.77% ( χ 2=33.82, P <0.01). Urban boys had the highest rates of overweight and obesity, which were 11.38% and 10.45%. The growth rate of overweight and obesity in rural boys was higher than that in urban boys after 2010 ( χ 2=13.90,17.09, P < 0.05), and the growth rate of obesity in rural girls was higher than that in urban girls after 2014 ( χ 2=9.94, 33.39, P <0.05). Overweight and obesity prevalence showed positive associations with the economic status in both urban and rural areas ( χ 2=35.19, 35.35, P <0.01).@*Conclusion@#From 2000 to 2019, the prevalence of overweight and obesity and body mass index among children and adolescents in Ningxia increased consistently, with more rigirous in rural areas. Specific strategies and measures for overweight and obesity prevention in children and adolescents are in urgent need, to reduce potential social and economic burden.

Effect of Yishen Decoction on intestinal microflora and microinflammation for the patients with stage 3-5 chronic kidney disease / 国际中医中药杂志

Objective:To investigate the effects of Yishen Decoction via colonic dialysis on intestinal flora and microinflammation in patients with chronic kidney disease (CKD) stages 3-5. Methods:A total of 156 patients with stage 3-5 CKD from the Second Affiliated Hospital of Guizhou University of Chinese medicine from October 2019 to October 2020 who met the inclusion criteria were divided into 2 groups of 78 patients according to the random number table method. The control group was given colonic dialysis treatment, the treatment group was given Yishen Decoction transcolonic dialysis treatment on the basis of the control group, and both groups were treated for 8 weeks. TCM syndrome scores were performed before and after treatment, serum levels of CRP, IL-6, and TNF-α were measured by ELISA, and SCR, BUN, and uric acid (UA) levels were detected by a fully automated biochemical analyzer. Fresh feces were collected from the patients, anaerobic culture and aerobic culture were performed, and the numbers of Bifidobacterium, Lactobacillus acidophilus, and Escherichia coli were counted to evaluate the clinical efficacy. Results:The total effective rate was 97.4% (76/78) in the treatment group and 84.6% (66/78) in the control group, and the difference was statistically significant ( χ2=7.847, P=0.005). At 4 and 8 weeks after treatment, the scores of lumbar and knee tenderness( t=6.596, 8.792), eating less and being dull ( t=12.060, 24.140) and pale complexion ( t=7.983, 12.300) in the treatment group were significantly lower than those in the control group ( P<0.01); the levels of bifidobacterium ( t=4.037, 2.358) and Lactobacillus acidophilus ( t=7.352, 2.092) were significantly higher than those in the control group, while the levels of Escherichia coli ( t=3.822, 6.084) were significantly lower than those in the control group ( P<0.01 or P<0.05). The serum CRP ( t=9.326, 12.300), IL-6 ( t=4.591, 4.716), TNF-α ( t=9.304, 9.775), SCr ( t=17.630, 11.530), BUN ( t=2.674, 2.248), UA ( t=10.860, 13.160) were significantly lower than those in the control group ( P<0.01 or P<0.05). Conclusion:Yishen Decoction can improve intestinal microecological status, inhibit microinflammatory response and relieve clinical symptoms for the patients with stage 3-5 CKD.

Comparative study on ultrasound elastography and MRI for effect evaluation in T1-2N1-2M0 breast cancer neoadjuvant chemotherapy / 重庆医学

Objective To investigate the application value of ultrasound elastography and contrast enhanced magnetic resonance imaging (CEMRI) in assessing the effect of neoadjuvant chemotherapy (NAC) for T1-2 N1-2 M0 breast cancer.Methods Twenty-three cases of breast cancer operation and receiving preoperative NAC in Chongqing Municipal Tumor Institute from January 2015 to December 2016 were collected.They all underwent ultrasound elastography and CEMRI before the first time NAC and operation respectively.Results Based on the postoperative pathological response grading,the sensitivity and specificity of CEMRI for evaluating the NAC effect were 94.1 ％ and 83.3％ respectively,which of ultrasound elastography were 88.2％ and 83.3％ respectively.The two kinds of examination method showed medium consistency(Kappa values were 0.77 and 0.68 respectively).Conclusion Ultrasound elastography extends the ultrasound diagnostic basis,can more comprehensively display the lesion character and more effectively reflect the NAC effect.

Determination of Nipagin Esters and Metronidazole Illegally Added to Chitosan Medical Devices / 中国药师

Objective: To determine bacteriostatic drugs nipagin esters and metronidazole illegally added to chitosan medical devices.Methods: An HPLC method was used with a ZORBAX Eclipse XDB-C18(250 mm×4.6 mm, 5 μm)column.The mobile phase was water and acetonitrile(65∶35).The flow rate was 1.0 ml·min-1.The detection wavelength was 254 nm.The column temperature was 35℃ and the injection volume was 10 μl.Results: Nipagin esters were detected out in chitosan suppositories and gel.Metronidazole was detected out in chitosan lotion.Conclusion: The method is simple and fast, which has guiding significance for further comprehensive studies of bacteriostatic drugs illegally added to chitosan medical devices.

Exploration of the medical computer curriculum teaching reform in higher vocational colleges / 中华医学教育探索杂志

Currently,the curriculum of computer course in medical higher vocational colleges lacks social practical foundations and content,failing to combine teaching with medical professionalism,thus a medical hygiene industry-oriented reform is needed.First,we should follow the aims of cultivating medical talents,design and improve teaching plans of all medical professionals,integrate and update the teaching contents,and based on the above,form the four modules of curriculum with medical features.Second,we should reform the teaching methods of computer courses,update teaching concepts and create more ways of teaching.Third,we should form a team of computer teachers with medical technology information.

Discussion on Teaching Reform of the Computer Curriculum System in Higher Medical Vocational Colleges / 医学信息学杂志

By analyzing current situations of the computer curriculum in higher medical vocational colleges and combing the practice of Zhaoqing Medical College,the paper proposes setting up the computer curriculum system and reforming the teaching methods based on the health system of medical colleges,and provides suggestions such as stratified teaching,updating of teaching methods,construction of a web-based self-learning platform,offering of interactive lectures,organization of and participation in competitions,and optimization of the teaching staffs.

Effects of Mycobacterium Phlei on Funcitonal States of Th_1/Th_2 in Patients with COPD and Preventive Effects on AECOPD / 药物流行病学杂志

Objective:To investigate the effects of Mycobacterium Phlei on functional states of Th_1/Th_2 in patients with chronic obstructive pulmonary disease(COPD),and clinical effects on the prevention of acute exacerbation of chronic obstructive pulmonary diseases(AECOPD).Method:60 patients with COPD of gradeⅡwere randomly divided into a treatment group and controlled group.The controlled group were given a routine therapy,while the treatment group were given utilins in addition to the routine treatment.The contents of?-interferon(IFN-?) and interleukin-4(IL-4) in their peripheral blood and their clinical efficacy were observed before and after the treatment.Result:Before and after the treatment, IFN-?/IL-4 ratio in the treatment group was 1.39?0.20 and 1.94?0.31 respectively(P

Assessment of SCT Multiplanar Reformation in Dignosing and Staging of Cervical Cancer / 实用放射学杂志

Objective To evaluate the value of multiplanar reconstruction (MPR) of spiral CT in diagnosing and staging of cervical cancer .Methods SCT scan with a 3～5 mm collimation thickness and MPR in 1.5～2.5 mm reconstruction interval were performed in 20 patients with cervical cancer , confirmed by biopsy pathology. Results The sagittal imaging could show entirely the growing character of a carcinomal mass;the coronal and transverse imagings showed clearly parametrial invasion and pelvic lymph node metastases. Conclusion MPR images in the pelvic could show entirely the character of growing and invasion of a carcinomal mass. It is an important value in dignosing and staging of cervical cancer.