The effect of trauma advanced practice nurse programme at a Level I regional trauma centre in mainland China.

AIMS: Trauma is the fifth-leading cause of death in China. Despite the establishment of the Chinese Regional Trauma Care System (CRTCS) in 2016, advanced trauma nurse practice has not been incorporated. This study aimed to identify the roles and responsibilities of trauma advanced practice nurse (APN), and to investigate the impact on patient outcomes in a Level I regional trauma centre in mainland China. DESIGN: A single-centre pre- and post-control design was used. METHODS: The trauma APN programme was established based on multidisciplinary experts' consultation. A retrospective study was conducted on all Level I trauma patients over a period of 5 years, spanning from January 2017 to December 2021, with a sample size of 2420. The data were divided into two comparison groups: a pre-APN programme (January 2017-December 2018; n = 1112) and post-APN programme (January 2020-December 2021; n = 1308). A comparison analysis was conducted to evaluate the effectiveness of trauma APN who were integrated into the trauma care team, with a focus on patient outcomes and time-efficiency indicators. RESULTS: The certification of the regional Level I trauma centre resulted in a 17.63% increase in the number of trauma patients. The integration of advanced practice nurses (APN) into the trauma care system led to significant improvements in time-efficiency indicators, with the exception of advanced airway establishment time (p < 0.05). The average emergency department length of stay (LOS) decreased 21%, from 168 to 132 min (p < 0.001); additionally, the mean intensive care unit LOS decreased by nearly 1 day (p = 0.028). Trauma patients who were treated by trauma APN had a higher likelihood of survival, with an odds ratio of 1.816 (95%CI: 1.041, 3.167; p = 0.033), compared to patients who received care prior to the implementation of the trauma APN program. CONCLUSION: A trauma APN programme has the potential to enhance the quality of trauma care in the CRTCS. IMPACT: This study elucidates the roles and responsibilities of trauma advanced practice nurses (APN) in a Level I regional trauma centre in mainland China. Trauma care quality was significantly improved after the application of a trauma APN programme. In regions with inadequate medical resources, the utilization of advanced practice trauma nurses can enhance the quality of trauma care. In addition, trauma APN can provide a trauma nursing education programme within the regional centres as a strategy to augment the proficiency of regional trauma nursing. No patient or public contribution, the research data all from trauma data bank.

Evidence Summary of the nursing of spinal fixation in emergency adult patients with traumatic spinal cord injury / 中国实用护理杂志

Objective:To summarize the relevant evidence for the management of fixation in traumatic spinal cord injury patients, which provides a reference for the clinical care and care of patients.Methods:A systematic search was conducted for evidence related to spinal injuries from domestic and foreign databases, relevant guideline websites, etc. The types of literature were best practice, expert consensus, systematic review, evidence summary, clinical decision-making, etc. The search time was from the establishment of databases to January 31, 2022. Three researchers used the Multidimensional Systematic Review Tool to evaluate systematic review literature. Five researchers used the guideline research and evaluation tool AGREE Ⅱ to evaluate clinical practice guidelines, and used the Australian JBI Evidence-Based Health Care Center (2016) to evaluate expert consensus and expert opinion with the authenticity evaluation tool for expert opinions and professional consensus articles. And extracted and summarized evidence according to the subject.Results:Finally, 10 articles were included, including 4 clinical decision-making, 4 guidelines and 2 systematic evaluations. The 30 pieces of evidence include the assessment, prevention, cervical spinal fixation, and management after traumatic spinal cord injury.Conclusions:The evidence emphasizes the importance of standardized assessment of cervical risk factors in all emergency adult patients with traumatic spinal cord injury. In the emergency department, we need to improve the ability of spinal evaluation and fixation in patients with penetrating neck injury, optimize the timeliness process of emergency trauma, reduce the occurrence of potential complications, and improve patient outcomes.

The application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the coordination of multi-branches / 中华急诊医学杂志

Objective:To summarize the application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the cooperation of multiple hospitals and districts, and to provide a reference for medical institutions to improve the risk response ability.Methods:Based on the collaborative management of multi-branches, the "Trinity" emergency chain of pre-hospital-emergency-critical care, identification-triage-treatment, expansion-training-dispatch was implemented to optimize and integrate medical resources.Results:During the two months, 43,000 patients were admitted to the fever clinic, with an increase of 36.08%. The average waiting time for treatment was 19.83 min, and the average admission time to ICU was 25.35 min.Conclusions:The "Trinity" emergency chain treatment scheme under the coordination of multi-branches can effectively deal with the public health events of respiratory tract infectious diseases, improve the efficiency of rescue and treatment, and enhance the risk response ability of medical institutions.

Distribution of pathological types and epidemiological characteristics based on kidney biopsy in Northwest China

The spectrum of biopsy-confirmed kidney disease varies with regions and periods. We describe the distribution of pathological types and epidemiological characteristics of kidney diseases in Northwest China due to regional differences in geographical environment, social economy, and dietary habits. Methods: Kidney biopsy cases from 2005 to 2020 in Xijing Hospital were retrospectively analyzed. Pathological characteristics of patients in different periods were analyzed using the t test or chi-square test. Joinpoint regression was used to analyze trends in pathological types and disease spectrum. Results: A total of 10,528 eligible patients were included. Primary glomerular disease (PGD) accounted for the majority of the cases and exhibited an obvious downward trend, whereas secondary glomerular disease (SGD) showed an obvious upward trend. Among PGD, immunoglobulin A nephropathy (IgAN) remained the most common pathological type, and the detection rate of membranous nephropathy (MN) was significantly increased. Among SGD, Henoch-Schönlein purpura nephritis (HSPN) was the most common pathological type and may present a significant characteristic of Northwest China. Diabetic nephropathy (DN) exhibited the most obvious upward trend in the whole process, whereas the fastest growth since 2012 was in hypertensive nephropathy. Conclusion: The proportion of SGD increased whereas PGD declined. IgAN remained the most common PGD, and HSPN was the most common SGD. MN and DN showed the most obvious upward trend among PGD and SGD, respectively. Changes in the spectrum of kidney disease, especially the constituent ratio of SGD, pose a great challenge to public health.

Inhibitory effects of naringenin on the activation of hepatic stellate cells through activating the apoptosis signal / 中国药房

OBJECTIVE To study the inhibitory effects and possible mechanism of naringenin on the activation of hepatic stellate cells. METHODS Using human hepatocytes LO2 as reference， based on drug intervention concentration screened by MTT assay， the effects of naringenin （Western blot assay and trypan blue staining test in 10， 20， 40 μmol/L， immunofluorescence assay in 40 μmol/L） on the expressions of liver fibrosis markers protein （collagen Ⅰ， α-SMA） and mRNA （α1-pro collagen Ⅰ， α-SMA） in human hepatic stellate cells LX2， and the expressions of cell apoptosis and apoptosis-related proteins （Bcl-2， Bax， cleaved caspase-3） were investigated. The apoptosis agents （Z-VAD-FMK， FMK）， ferroptosis pathway inhibitor ferrostatin-1， and programmed death pathway inhibitor necrostatin-1 were used to verify the mechanism of the above effects. RESULTS The naringenin could significantly down-regulate protein expressions of collagen Ⅰ （except for naringenin 10 μmol/L） and α-SMA， mRNA expressions of α1-pro collagen Ⅰ （except for naringenin 10 μmol/L） and α-SMA （P＜0.05）； it also induced LX2 cell apoptosis and increased its apoptotic ratio， down-regulated the protein expression of Bcl-2 while up-regulated the protein expressions of Bax （except for naringenin 10 μmol/L） and cleaved caspase-3 （except for naringenin 10 μmol/L）. FMK could reverse above effects of naringenin on LX2 cells （P＜0.05）. CONCLUSIONS Naringenin can inhibit the activation of hepatic stellate cells LX2 through activating the cell apoptosis signal， which plays ameliorative role in liver fibrosis.

Role of bone morphogenetic protein-4 in the pathogenesis of nonalcoholic fatty liver disease / 临床肝胆病杂志

Nonalcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver diseases in the world, and it seriously harms human health. Recent studies have found that bone morphogenetic protein 4 (BMP4) might be associated with NAFLD. This article reviews the latest advances in the research on the association between BMP4 and NAFLD in China and globally and explores the potential mechanism of action of BMP4 on NAFLD, in order to provide new ideas for the prevention and treatment of NAFLD.

Ruscogenin alleviates LPS-triggered pulmonary endothelial barrier dysfunction through targeting NMMHC IIA to modulate TLR4 signaling

Pulmonary endothelial barrier dysfunction is a hallmark of clinical pulmonary edema and contributes to the development of acute lung injury (ALI). Here we reported that ruscogenin (RUS), an effective steroidal sapogenin of Radix Ophiopogon japonicus, attenuated lipopolysaccharides (LPS)-induced pulmonary endothelial barrier disruption through mediating non-muscle myosin heavy chain IIA (NMMHC IIA)‒Toll-like receptor 4 (TLR4) interactions. By in vivo and in vitro experiments, we observed that RUS administration significantly ameliorated LPS-triggered pulmonary endothelial barrier dysfunction and ALI. Moreover, we identified that RUS directly targeted NMMHC IIA on its N-terminal and head domain by serial affinity chromatography, molecular docking, biolayer interferometry, and microscale thermophoresis analyses. Downregulation of endothelial NMMHC IIA expression in vivo and in vitro abolished the protective effect of RUS. It was also observed that NMMHC IIA was dissociated from TLR4 and then activating TLR4 downstream Src/vascular endothelial cadherin (VE-cadherin) signaling in pulmonary vascular endothelial cells after LPS treatment, which could be restored by RUS. Collectively, these findings provide pharmacological evidence showing that RUS attenuates LPS-induced pulmonary endothelial barrier dysfunction by inhibiting TLR4/Src/VE-cadherin pathway through targeting NMMHC IIA and mediating NMMHC IIA‒TLR4 interactions.

He-Wei Granule enhances anti-tumor activity of cyclophosphamide by changing tumor microenvironment / 中草药·英文版

Objective: He-Wei Granule (HWKL) is a modern product derived from the modified formulation of traditional Chinese medicine Banxia Xiexin Decoction (BXD), which remarkedly enhanced the anti-proliferation activity of cyclophosphamide (CTX) on HepG2 and SGC-7901 cell lines in vitro in our previous research. The aim of the study was to investigate the synergistic effects of HWKL and CTX using a transplanted H22 hepatocellular carcinoma mouse model. Methods: The CTX-toxic-reducing efficacy of HWKL was evaluated by hematology indexes, organ indexes and marrow DNA detection. To investigate the underlying mechanisms, histopathology test, immunohistochemistry test and TUNEL staining were conducted. The efficacy of HWKL on the micro-vessel density (MVD) in tumor tissue was also evaluated by measuring CD34 level. Results: High dose HWKL (6.75 g/kg) markedly attenuated CTX-induced hepatotoxicity and myelosuppression while significantly enhanced CTX anticancer efficacy in vivo. Further mechanism investigation suggested that high dose HWKL significantly increased cleaved Caspase 3 level and promoted apoptosis in tumor tissue by up-regulating Bax expression and down-regulating Bcl-2 and FasL expressions. Compared with CTX alone group, the decrease in LC-3B and Beclin 1 levels suggested that the autophagy in H22 carcinoma was significantly inhibited with addition of high dose HWKL. ELISA assay results indicated that the autophagy inhibition was achieved by decreasing p53 expression, blocking PI3K/AKT/mTOR pathway and recovering Th1/Th2 cytokine balance. In addition, CD34 and EGFR immunohistochemistry assay suggest that high dose HWKL could significantly decrease micro-vessel density (MVD) and inhibit angiogenesis in H22 carcinoma. Conclusion: It can be concluded that high-dose HWKL enhanced CTX efficacy by promoting apoptosis, inhibiting autophagy and angiogenesis in tumor tissue while significantly alleviated CTX-induced toxicity, and could be applied along with CTX in clinical treatment as a supplement agent.

Construction of the pharmacoeconomic evaluation system of Chinese patent medicine in the prevention and treatment of major chronic diseases / 中国药房

OB JECTIVE To explore the construction of system of pharmacoeconomic evaluation fo r Chinese patent medicine in preventing and treating major chronic diseases. METHODS The problems in pharmacoeconomic evaluation of Chinese patent medicine for preventing and treating major chronic diseases were analyzed. Based on the problem ，the pharmacoeconomic theory ， tools and methods that can be used to systematically evaluate the prevention and treatment of major chronic diseases by Chinese patent medicine were explored to build the relevant pharmacoeconomic evaluation system. RESULTS & CONCLUSIONS Traditional Chinese medicine shows the advantages in the prevention and treatment of major chronic diseases. This unique advantage needed to be explored ，reflected and proved in the pharmacoeconomic evaluation. The pharmacoeconomic evaluation of Chinese patent medicine had made some progress in recent years. However ，there were still deficiencies of theory and methodology in the pharmacoeconomic evaluation for the advantages of Chinese patent medicine in preventing and treating major chronic diseases. It was difficult to truly and comprehensively reflect the value of Chinese patent medicine by simply applying the economic evaluation indicators and technologies of chemical medicine. It is necessary to focus on the unique pharmacoeconomic attributes of Chinese patent medicine ，excavate the economic value indicators of Chinese patent medicine for “preventive treatment of disease ” and playing the self-regulation role of human body ，comprehensively consider the pharmacoeconomic particularity of Chinese patent medicine in respects of research design ，research angle ，target population ，intervention measures and control selection ，research time limit and evaluation method ，etc. Through the use of system modeling ，real-world research and the establishment of Chinese medicinal quality of life scale that reflects the characteristics of TCM ，the economic value of Chinese patent medicine in the prevention and treatmen t of major chronic diseases is reflected comprehensively，so as to reflect the advantage of Chinese patent medicine in preventing and treating major chronic diseases.

Da Chaihutang Inhibits Hepatocellular Carcinoma by Regulating p38 MAPK/IL-6/STAT3 Signaling Pathway / 中国实验方剂学杂志

ObjectiveThis study aims to investigate the efficacy and underlying mechanism of Da Chaihutang （DCHT） in treating hepatocellular carcinoma （HCC） in vitro and in vivo. MethodWe employed methyl thiazolyl tetrazolium （MTT） assay and crystal violet staining to observe the proliferation of Hepa1-6 liver cancer cells treated with DCHT at different doses （0， 125， 250， 500， 1 000 mg·L-1） for different time periods （1， 2， 4， 8 days）. The orthotopic liver cancer model was established by injection of 1×106 Hepa1-6 cells into mouse， and then the model mice were randomly assigned into six groups： blank， model， DCHT （0.21， 0.625， 1.875 g·kg-1， ig， qd）， and positive control （5-fluorouracil， 25 mg·kg-1， ip， qod）. After 14 days of administration， the mice were sacrificed， and the liver samples were collected and fixed in 4% paraformaldehyde for hematoxylin-eosin （HE） staining. The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， Cytoscape 3.7.2， STRING， and DAVID were used for the searching of the key targets of DCHT in treating HCC， the construction of protein-protein interaction （PPI） network， and the Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment. Quantitative real-time PCR was performed to determine the mRNA level of interleukin-6 （IL-6） in Hepa1-6 cells and liver tissue. Western blotting was employed to measure the protein levels of the proteins involved in the mitogen-activated protein kinase （MAPK） and signal transducers and activators of transcription 3 （STAT3） signaling pathways. ResultDCHT （500， 1 000 mg·L-1） treatment for 4 and 8 days inhibited the proliferation of Hepa1-6 cells in a dose- and time-dependent manner （P<0.05）. The in vivo assay showed that DCHT （high dose， 1.875 g·kg-1） treatment for 14 days led to high differentiation and unobvious heterogeneity of HCC cells and small necrotic area compared with the model group. Network pharmacology analysis predicted that the potential targets of DCHT in the treatment of HCC were mainly the inflammation cytokines such as IL-6， interleukin-1β （IL-1β）， and tumor necrosis factor-alpha （TNF-α） in HCC microenvironment. The potential signaling pathways involved in the treatment were mainly associated with HCC growth and differentiation， including MAPK and STAT3 signaling pathways. Compared with the blank group， DCHT （1 000 mg·L-1） treatment for 1， 2， 4， and 8 days down-regulated the mRNA level of IL-6 in Hepa1-6 cells （P<0.05）. Similar results were observed in the livers of mice treated with DCHT （0.625， 1.875 g·kg-1）. The in vitro assay demonstrated that DCHT （1 000 mg·L-1） treatment for 4 and 8 days and DCHT （500， 1 000 mg·L-1） treatment inhibited the phosphorylation of extracellular signal-regulated kinases 1/2 （ERK1/2）， c-Jun NH2-terminal kinase/stress-activated protein kinase （JNK）， p38 MAPK， and STAT3 in a dose- and time-dependent manner （P<0.05）. The in vivo assay showed that DCHT （0.625 and 1.875 g·kg-1） treatment only inhibited the phosphorylation of p38 MAPK and STAT3 （P<0.05）. ConclusionThe present study indicates that DCHT can inhibit liver cancer cell proliferation by regulating p38 MAPK/IL-6/STAT3 signaling pathway.

Erratum: Author correction to 'Ruscogenin alleviates LPS-triggered pulmonary endothelial barrier dysfunction through targeting NMMHC IIA to modulate TLR4 signaling' Acta Pharmaceutica Sinica B 12 (2022) 1198-1212

[This corrects the article DOI: 10.1016/j.apsb.2021.09.017.].

Role of retinal microglia-mediated parainflammation in age-related macular degeneration / 中华实验眼科杂志

Age-related macular degeneration (AMD) is a disease caused by multiple factors such as age, genetics and environmental risks.Inflammation plays an important role in the pathogenesis of AMD.Between the basal level and the classic inflammatory response, the parainflammation plays an important role in maintaining tissue homeostasis.The dysregulated parainflammation is manifested as uncontrollable chronic inflammation.In recent years, a large number of studies have focused on the contribution of chronic non-resolving inflammation to the development of AMD, in which microglial dysfunction plays a significant part.The abnormal activation of microglia caused by various factors can lead to the disorder of the parainflammation.The causes and results of retinal microglial dysfunction were reviewed in this article, so as to focus on dysregulated parainflammation in AMD.

ADR Signal Mining of Paclitaxel for Injection （Albumin-bound Type ）Based on FDA Adverse Event Database / 中国药房

OBJECTIVE：To utilize ADR signal of Paclitaxel for injection （albumin-bound type ）by using FDA adverse event reporting system （FAERS），and to provide reference for rational use of drugs in the clinic. METHODS ：The reporting odds ratio （ROR）method was used for data mining of adverse events （AEs）related to Paclitaxel for injection （albumin-bound type ）reported by FDA public data program （Open-FDA）during Jan. 1st，2004-Dec. 31th，2019. The demographic characteristics ，constituents and signals of ADR were analyzed. RESULTS ：A total of 1 659 AEs were identified for Paclitaxel for injection （albumin-bound type）. The female （1 169 cases，70.5％）was more than the male （345 cases，20.8％）. The age was mainly 45-64 years old （519 cases，31.3％）. ADR signal mainly involved nerve system ，blood and lymphatic system ，gastrointestinal system ，hepatobiliary system，respiratory system ，thoracic and mediastinal system and general ADR. Twenty positive ADR signals which were not recorded in the drug instructions were found in the study ，mainly including leucopenia ，lymphopenia，macular edema ，abdominal pain，dysphagia，shivering，jaundice，liver failure ，cirrhosis，urinary tract infection ，purulent secretion ，decreased ejection fraction，hypocalcemia，hypokalemia，hyponatremia，bone pain ，facial paralysis ，mental state change ，epistaxis，atelectasis. Among them ，lymphopenia，macular edema and mental state changes were not recorded in the drug instructions ，while others were the specific manifestations of ADR recorded in the drug instructions. CONCLUSIONS ：In the clinical application of Paclitaxel for injection（albumin-bound type ），in addition to ADR mentioned in the drug instructions ，great importance should be closely paid to neurotoxicity，lymphocyte changes ，regular eye monitoring 2021MSXM041） and mental state monitoring ，so as to avoid drug withdrawal or organ injury induced by ADR.

Clinical characteristics and risk factors for mortality in cancer patients with COVID-19 / 医学前沿

Patients with cancer are at increased risk of severe infections. From a cohort including 3060 patients with confirmed COVID-19, 109 (3.4%) cancer patients were included in this study. Among them, 23 (21.1%) patients died in the hospital. Cancer patients, especially those with hematological malignancies (41.6%), urinary carcinoma (35.7%), malignancies of the digestive system (33.3%), gynecological malignancies (20%), and lung cancer (14.3%), had a much higher mortality than patients without cancer. A total of 19 (17.4%) cancer patients were infected in the hospital. The clinical characteristics of deceased cancer patients were compared with those of recovered cancer patients. Multivariate Cox regression analysis indicated that a Nutritional Risk Screening (NRS2002) score ⩾ 3 (adjusted hazard ratio (HR) 11.00; 95% confidence interval (CI) 4.60-26.32; P < 0.001), high-risk type (adjusted HR 18.81; 95% CI 4.21-83.93; P < 0.001), tumor stage IV (adjusted HR 4.26; 95% CI 2.34-7.75; P < 0.001), and recent adjuvant therapy (< 1 month) (adjusted HR 3.16; 95% CI 1.75-5.70; P < 0.01) were independent risk factors for in-hospital death after adjusting for age, comorbidities, D-dimer, and lymphocyte count. In conclusion, cancer patients showed a higher risk of COVID-19 infection with a poorer prognosis than patients without cancer. Cancer patients with high-risk tumor, NRS2002 score ⩾ 3, advanced tumor stage, and recent adjuvant therapy (< 1 month) may have high risk of mortality.

Reliability and validity of the four-level Chinese emergency triage scale in mainland China: A multicenter assessment.

BACKGROUND: An effective emergency triage system is lacking in mainland China. The Chinese Emergency Triage Scale (CETS) was developed based on vital complaints and vital parameters, according to Chinese data. OBJECTIVE: The aim of this study was to assess the reliability and validity of the CETS by emergency department (ED) nurses in eight EDs in mainland China. DESIGN: A cross-sectional multi-center study was conducted. SETTINGS: Eight EDs in the eastern, western, northern, and central areas of mainland China. PARTICIPANTS: A total of 51 ED nurses and 8000 active ED patients participated in the study between May and September 2018 in eight EDs. METHODS: Standardized triage scenarios and active patients were assigned to nurses who used the CETS for evaluative purposes. Accuracy was defined by concordance with the key for the scenarios and was calculated as percentages. Inter-rater reliability was measured by weighted κ to compare the triage nurse's rating with the research nurse's acuity level for each patient. The triage time and clinical outcome of 1000 active patients per site also were collected. The criterion-related validity of the CETS was evaluated; criteria included ED mortality, number of patients discharged, and admission to ICU or general ward. The relationship between the CETS acuity levels triaged by the research nurse and four possible outcomes was assessed with a cross-classification table, using a chi-square test. The ability of the CETS to predict ED mortality was assessed via the receiver-operating characteristic (ROC) area under the curve (AUC). RESULTS: Mean pooled accuracy from all sites was 89.4% (95% CI = 86.9%-91.8%), and the proportion of over-triage slightly exceeded under-triage (6.5% vs. 4.1%). There was no difference in accuracy between sites or according to nurse experience. Inter-rater reliability values for triage nurses and research nurses were 0.96 (95% CI = 0.95-0.97), based on the quadratic weight κ. Trauma cases were assigned to triage with greater accuracy than were nontrauma cases, both for the scenarios and for active patients. The average triage time of ED nurses in all sites was 151.5 ±â€¯26.3 s, using the computer-based triage instrument. The chi-square test showed that there was a significant difference in triage time between the CETS levels (p < 0.001). The AUC was 0.968 (95% CI = 0.958-0.979). CONCLUSIONS: The CETS is a reliable system for ED triage and can promote rapid and effective triage in mainland China.

Status quo of DNR application and influencing factors of decision-making in emergency department patients / 中国实用护理杂志

With the aging of the population and the change of disease spectrum in China, the number of emergency department patients at the elderly, chronic end-stage, advanced tumor and cerebrovascular accident is increasing gradually, and the quality of life in emergency end of life patients is getting more and more attention. This paper reviews the relevant literature of "do not resuscitate" (DNR) in emergency department at home and abroad, introduces the current status of DNR application and the influencing factors of decision-making in emergency department at home and abroad, in order to provide reference for the application and practice of DNR in emergency department in China.

The application timing and curative effect of carprostol tromethamine in the treatment of postpartum hemor-rhage due to uterine atony / 中国基层医药

Objective To explore the application timing of carprostol tromethamine in the treatment of postpartum hemorrhage due to uterine atony ,and to observe the clinical efficacy.Methods From January 2016 to June 2018,62 patients with uterine atony and postpartum hemorrhage admitted to the Second People 's Hospital of Lianyungang were selected as study objects ,and they were randomly divided into two groups according to the digital table,with 31 cases in each group.In the control group,after the delivery of the fetus ,20U of oxytocin was intrave-nously injected.If there was active hemorrhage on the dissection surface of the placenta ,40U of oxytocin was contin-ued.If there was still hemorrhage,the uterus was injected with 250μg of carprostol tromethamine.In the observation group,after the delivery of the fetus ,20U of oxytocin was intravenously injected.If there was active hemorrhage on the dissection surface of the placenta ,250μg of carprostol tromethamine was injected immediately.If the patients in the two groups still had active bleeding in the uterus after the above treatments ,the uterine cavity was filled with gauze or uterine artery ligation was performed to stop bleeding.The blood loss during the operation ,2h and 24h after surgery were recorded and compared between the two groups.The 24h postpartum hemoglobin (Hb) decreased value,treatment efficacy and the incidence of adverse reactions were also recorded and compared between the two groups . Results The intraoperative blood loss was (1 066.1 ±71.3) mL in the observation group,which was significantly lower than that in the control group [(1 163.6 ±70.9) mL],the difference was statistically significant ( t＝5.393, P＜0.001).There were no statistically significant differences in 2h and 24h postoperative blood loss between the two groups (all P＞0.05).The decrease of Hb in the observation group at 24h after birth was (20.80 ±6.25)g／L,which was lower than that in the control group [(26.90 ±9.21) g／L],and the difference was statistically significant ( t＝ 3.033,P＜0.01).The treatment effective rate of the observation group was 87%(27／31),which of the control group was 77%( 24／31 ), there were no statistically significant differences between the two groups ( P ＞0.05 ). Conclusion Postpartum hemorrhage caused by uterine atony can be treated by early use of carprostol tromethamine , which can effectively reduce postpartum bleeding and promote the rehabilitation of patients .The curative effect is better than oxytocin,and it is worthy of clinical application.

The application timing and curative effect of carprostol tromethamine in the treatment of postpartum hemorrhage due to uterine atony / 中国基层医药

Objective@#To explore the application timing of carprostol tromethamine in the treatment of postpartum hemorrhage due to uterine atony, and to observe the clinical efficacy.@*Methods@#From January 2016 to June 2018, 62 patients with uterine atony and postpartum hemorrhage admitted to the Second People′s Hospital of Lianyungang were selected as study objects, and they were randomly divided into two groups according to the digital table, with 31 cases in each group.In the control group, after the delivery of the fetus, 20U of oxytocin was intravenously injected.If there was active hemorrhage on the dissection surface of the placenta, 40U of oxytocin was continued.If there was still hemorrhage, the uterus was injected with 250μg of carprostol tromethamine.In the observation group, after the delivery of the fetus, 20U of oxytocin was intravenously injected.If there was active hemorrhage on the dissection surface of the placenta, 250μg of carprostol tromethamine was injected immediately.If the patients in the two groups still had active bleeding in the uterus after the above treatments, the uterine cavity was filled with gauze or uterine artery ligation was performed to stop bleeding.The blood loss during the operation, 2h and 24h after surgery were recorded and compared between the two groups.The 24h postpartum hemoglobin(Hb) decreased value, treatment efficacy and the incidence of adverse reactions were also recorded and compared between the two groups.@*Results@#The intraoperative blood loss was (1 066.1±71.3)mL in the observation group, which was significantly lower than that in the control group [(1 163.6±70.9)mL], the difference was statistically significant(t=5.393, P<0.001). There were no statistically significant differences in 2h and 24h postoperative blood loss between the two groups (all P>0.05). The decrease of Hb in the observation group at 24h after birth was (20.80±6.25)g/L, which was lower than that in the control group [(26.90±9.21)g/L], and the difference was statistically significant(t=3.033, P<0.01). The treatment effective rate of the observation group was 87%(27/31), which of the control group was 77%(24/31), there were no statistically significant differences between the two groups(P>0.05).@*Conclusion@#Postpartum hemorrhage caused by uterine atony can be treated by early use of carprostol tromethamine, which can effectively reduce postpartum bleeding and promote the rehabilitation of patients.The curative effect is better than oxytocin, and it is worthy of clinical application.

Forecasting CO2 emissions in Hebei, China, through moth-flame optimization based on the random forest and extreme learning machine.

The surge of carbon dioxide emission plays a dominant role in global warming and climate change, posing an enormous threat to the development of human being and a profound impact on the global ecosystem. Thus, it is essential to analyze the carbon dioxide emission change trend through an accurate prediction to inform reasonable energy-saving emission reduction measures and effectively control the carbon dioxide emission from the source. This paper proposed a hybrid model by combining the random forest and extreme learning machine together for the carbon dioxide emission forecasting in this paper; the random forest is applied for influential factors analysis and the extreme learning machine for the prediction. To improve the performance of the prediction model, moth-flame optimization is adopted to optimize initial weight and bias in extreme learning machine. A case study whose data is derived from Hebei Province, China, during the period 1995-2015 is conducted to verify the effectiveness of the proposed model. Results show that the novel model outperforms the compared parallel models in carbon dioxide emission prediction and has the potential to improve the accuracy of CO2 emission forecasting.

Effects of heating intravenous fluid infusion and blood transfusion based on guidelines in sever trauma patients with hypothermia / 中华急诊医学杂志

Objective To explore the effects of heating intravenous fluid infusion and blood transfusion based on guidelines in severe trauma patients with hypothermia. Methods A total of 40 severe trauma patients with hypothermia admitted from July 2014 to December 2015 were enrolled as the control group treated with routine measures to maintain the body temperature at normothermia by such as electrical heating blanket; other 40 severe casualties with hypothermia admitted from January 2016 to July 2017 were recruited as the warming up group treated with heating intravenous fluid infusion and blood transfusion by hot water bath in addition to the routine measures for keeping body temperature at normothermia. The differences in core body temperature, prothrombin time, activated partial thromboplastin time, incidence of shivering and mortality rate were compared between the two groups. Results There was statistically signifi cant difference in core body temperature at 0.5 h, 1.0 h, 1.5 h, 3.0 h between the two groups (P<0.05). Though the prothrombin time and shivering were improved after warming up in both groups, and there were significant differences in prothrombin time at 3.0 h after warming up and the incidence of shivering between two groups(P<0.05).There was no signifi cant difference in mean arterial pressure at all seven intervals between two groups. Conclusion The heating intravenous fl uid infusion and blood transfusion had remarkable effects to prevent hypothermia, improves blood coagulation and reduced the incidence of shivering to provide more simple and convenient warming up intervention for clinical practice.