RESUMEN
Objective:To discuss the clinical efficacy of minimally invasive pulmonary surfactant (PS) therapy technology (MIST) in the treatment of neonatal respiratory distress syndrome (NRDS) and analyze the high-risk factors for failure.Methods:A total of 91 NRDS infants treated in the Affiliated Hospital of Jining Medical College from July 2017 to July 2019 were selected as the research objects, and 46 cases were performed minimally MIST (MIST group), 45 cases performed intubate-surfactant-extubate to continuous positive airway pressure (INSURE group), the infants were given 70-100 mg/kg porcine pulmonary phospholipid injection through vascular catheter or endotracheal intubation, respectively. The clinical efficacy of the two groups was compared and the risk factors for failure in the treatment of NRDS by PS were analyzed.Results:The total operating time in the MIST group was longer than that in the INSURE group: (90.06 ± 14.38) min vs. (62.57 ± 11.44) min, there was statistical difference ( P<0.05). The duration of non-invasive auxiliary ventilation, total oxygen uptake time and length of hospitalization time in two groups had no significant differences ( P>0.05). The incidence of bronchopulmonary dysplasia in the MIST group was lower than that in the INSURE group :10.87%(5/46) vs. 31.11%(14/45), there was statistical difference ( χ2 = 5.64, P<0.05). Univariate analysis showed that the male, cesarean section, birth weight <1 500 g, maternal gestational diabetes, arterial partial blood oxygen pressure (PaO 2) <59 mmHg (1 mmHg = 0.133 kPa) before the application of PS, and PaO 2/inhaled oxygen concentration (FiO 2) <185 mmHg and arterial partial pressure of carbon dioxide>55 mmHg were high risk factors for failure ( P<0.05). Conclusions:Although the operation of MIST is difficult, it is safe and feasible. In clinical work, various risk factors should be comprehensively analyzed to select an appropriate early respiratory support model for NRDS children.
RESUMEN
Objective:To explore the effect of mini-clinical evaluation exercise (Mini-CEX) combined with simulation teaching + case-based learning (CBL) in pediatric clinical teaching.Methods:A total of 60 medical students who practiced in Department of Pediatrics, Affiliated Hospital of Jining Medical College from August 2019 to August 2020 were selected as the research objects. According to different teaching methods, they were divided into control group ( n=30) and observation group ( n=30). The control group received traditional teaching, and the observation group received Mini-CEX combined with simulated teaching + CBL. The assessment results, comprehensive ability of medical interview, critical thinking ability and teaching satisfaction of the two groups were compared. SPSS 20.0 was performed for t-test and Chi-square test. Results:The test scores and total scores of the observation group were significantly higher than those of the control group ( P<0.05). After teaching, the Mini-CEX scores, the CTDI-CV (critical thinking disposition inventory Chinese version) scores and the total scores of the two groups increased significantly, and the above scores were significantly higher in the observation group than the control group ( P<0.05). The scores of the teaching program satisfaction questionnaire in the observation group were significantly higher than those in the control group ( P<0.05). Conclusion:The application of Mini-CEX combined with simulation teaching + CBL in pediatric clinical teaching can help to cultivate the medical interview ability, clinical practice ability and critical thinking ability of interns, improve the examination results, and improve the teaching satisfaction.
RESUMEN
In recent years,the incidence and mortality rate of pediatric respiratory infection have been increasing globally,with rhinovirus being of particular correlation to pediatric respiratory infection.In addition to upper respiratory tract infection,rhinovirus RNA is also found in the lower respiratory tract during the infection period.The epithelial cells of the upper respiratory tract are the target cells of rhinovirus.In recent years,studies done on the relationship between rhinovirus infection and upper respiratory tract infection have provided evidence for clinical treatment.Further investigation is needed on the pathological mechanisms of rhinovirus-induced respiratory infections.
RESUMEN
Objective To evaluate the significance of fiberoptic bronchoscopic brush cytology in the diagnosis and histological classification of lung carcinoma.Methods Data of 309 patients with lung carcinoma were retrospectively analyzed.Both bronchoscopic cytology and histology diagnosis were available.The positive rate of bronchoscopic cytology and tissue biopsy were calculated respectively.The classification accuracy of cytological diagnosis for lung carcinoma was evaluated.In tissue biopsy standard,evaluated the significance of bronchoscopic cytology in diagnosis and histological diagnosis.Results The positive rate of bronchoscopic cytology and tissue biopsy were 86.1％ (266/309) and 83.8％ (259/309),respectively.Bronchoscopic cytology combined with bronchial biopsy could obviously improve the positive rate to 94.2％ (291/309) in lung carcinoma diagnosis.Taking the tissue biopsy histological type as a standard,the cytotyping accuracy for brush method was 85.1％(74/87) in squamous carcinoma,82.4％(108/131) in adenocarcinoma and 100％(11/11) in small cell carcinoma for higher.However,the accuracy in diagnosing poorly differentiated carcinomas was only 12.2％ (5/ 41).Conclusion Fiberoptic bronchoscopic brush cytology plays an stable and important role in diagnosing lung carcinomas and histological type determination.However,it has limited use in diagnosing poorly differentiated carcinomas.
RESUMEN
Objective To investigate the clinical efficacy and safety of transurthral electrovaporization of the prostate(TUVP) for benign prostatic hyperplasia( BPH) at high risk.Methods Forty-eight patients with BPH at high risk were treated with transurthral electrovaporization of the prostate(TUVP).The clinical data and therapeutic results were measured.Results All patients went through the perioperiative period safely and had been followed up for 3 to 14 months.Postvoid residual ( PVR) , the International Prostate Symptom Score (IPSS) and quality of life (QOL) before operations were (97.5 ± 16.9) ml, ( 28.4 ± 2.3 ) score and (5.5 ±0.6) score respectively.Three months after operation ,PVR ,IPSS and QOL were( 30.2 ± 12.3 ) ml, (8.2 ± 1.3 ) score and( 1.9 ±0.5) score respectively,there was significant difference between them(t =22.31,53.16,31.94,all P<0.05).Conclusion TUVP is an effective and safe method in treating BPH patients at high risk.
RESUMEN
T lymphocyte subpopulation and level of soluble interleuckin 2 receptor in peripheral bloodand serum of primary hepatocellular carcinoma and donor were tested.The results show that de-crease of T lymphocyte subpopulations is related with increase of level of soluble interleuckin2 re-ceptor in patients with primary hepatocellular carcinoma.