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Objective:To compare the efficacy of catheter-directed thrombolysis versus catheter-directed thrombectomy for high-risk pulmonary embolism.Methods:The clinical data of 105 patients with high-risk pulmonary embolism from April 2020 to January 2023 in Hebei China Petroleum Central Hospital were retrospectively analyzed. Among them, 52 patients were treated with catheter-directed thrombolysis (thrombolysis group), and 53 patients were treated with catheter-directed thrombectomy (thrombectomy group). The efficacy, symptom relief time, oxygen saturation recovery time, mortality rate, Qanadli embolic index, pulmonary artery pressure and complications were compared between two groups.Results:There were no statistical differences in total effective rate, symptom relief time, oxygen saturation recovery time, mortality rate and total incidence of complications between two groups ( P>0.05). Compared with before treatment, the Qanadli embolic index and pulmonary artery pressure after treatment in thrombolysis group and thrombectomy group were significantly lower, thrombolysis group: 22.08 ± 8.57 vs. 45.18 ± 13.27 and (24.18 ± 5.19) mmHg (1 mmHg = 0.133 kPa) vs. (34.15 ± 6.22) mmHg, thrombectomy group: 23.11 ± 8.62 vs. 44.82 ± 13.14 and (23.66 ± 5.02) mmHg vs. (34.89 ± 6.27) mmHg, and there were statistical differences ( P<0.01); but there was no statistical difference the Qanadli embolic index and pulmonary artery pressure before and after treatment between two groups ( P>0.05). Conclusions:In patients with high-risk pulmonary embolism, both catheter-directed thrombolysis and catheter-directed thrombectomy have good efficacy and can promote the relief of clinical symptoms and the recovery of oxygen saturation, improving the prognosis.
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Objective:To investigate the effect of citric acid-induced cough on swallowing function and serum substance P in stroke patients with early tracheotomy.Methods:Forty-nine post-stroke tracheotomy patients admitted to the Department of Neurosurgery at the First Affiliated Hospital of Soochow University from January 2018 to July 2019 were selected as study subjects. They were divided into intervention group ( n=24) and control group ( n=25) using the random digit table. The control group was subjected to routine nursing, while the intervention group was given citric acid to induce cough based on routine care. The intervention time was 1 week. The swallowing function and serum substance P levels were compared between the two groups before and after the intervention. Results:After the intervention, 45.8% (11/24) of the patients in the intervention group were assessed as having "strong" swallowing function, compared to 28.0% (7/25) in the control group, with a statistically significant difference in swallowing function between the two groups ( Z= -2.22, P<0.05), and the level of substance P in the intervention group was (283.40 ± 134.82) ng/L, significantly higher than that of the control group (203.59 ± 126.16) ng/L ( t=2.14, P<0.05). Conclusions:Citric acid-induced cough helped stroke patients with early tracheotomy to produce effective swallowing action and up-regulate substance P in serum to promote recovery of swallowing function.
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ObjectiveTo investigate the effect of hypoxia-inducible factor-1α (HIF-1α) on the stemness and epirubicin sensitivity of hepatoma cells. MethodsHepatoma cells were selected for experiment. HepG2 hepatoma cells transfected with HIF-1α overexpression plasmid were selected as experimental group, and those transfected with pcDNA3.1 empty plasmid were selected as control group; HepG2 cells alone were selected as HepG2 group. Quantitative real-time PCR was used to measure the mRNA expression of HIF-1α; Western blot was used to measure the protein expression of HIF-1α; flow cytometry was used to measure the expression of CD133 on the surface of hepatoma cells. The three groups of cells were treated with epirubicin at different concentrations (0, 6.25, 12.5, 25, and 50 μmol/L) for 24 hours; MTT assay was used to measure cell viability, and flow cytometry was used to measure apoptosis after treatment with epirubicin (50 μmol/L). A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the t-test was used for further comparison between two groups. ResultsCompared with the HepG2 group and the control group, the experimental group had a significant increase in the mRNA expression of HIF-1α (both P＜0.001), and Western blot showed high expression of HIF-1α in the experimental group. The percentage of CD133 cells was 0.040%±0.003% in the HepG2 group, 0.030%±0.010% in the control group, and 20.110%±0.600% in the experimental group, and the experimental group had a significantly higher positive rate of CD133+ than the HepG2 group and the control group (both P＜0.001). At an epirubicin concentration of 25 and 50 μmol/L, the HepG2 group and the control group had significantly inhibited cell viability and a significantly lower cell viability than the experimental group (both P＜005). After the treatment with 50 μmol/L epirubicin for 48 hours, the experimental group had a significantly lower cell apoptosis rate than the HepG2 group (67.9%±2.5% vs 93.6%±1.5%, P＜0.001) and the control group (67.9%±2.5% vs 93.0%±1.2%, P＜0001). ConclusionHepG2 cells are successfully transfected with HIF-1α overexpression plasmid, and HIF-1α can increase the percentage of liver cancer stem cells and improve their resistance to epirubicin.
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Objective@#To evaluate the effect of abdominal massage on gastrointestinal tolerance in critically patients with nasogastric tube feeding.@*Methods@#The Chinese Biomedical Literature Database, China National Knowledge Infrastructure, The Wang fang database, Chinese Science and Technology Periodical Database, Cochrane Libraty, PubMed, Embase, CENTRAL were searched. Two researchers conducted quality evaluation and data extraction on studies that met the inclusion criteria. Data were analyzed with RevMan5.3 software.@*Results@#Eight randomized controlled trials were included, including 628 patients. The results of Meta-analysis showed that abdominal massage could reduce the gastric residual volume of critically ill patients (WMD=-45.45, 95%CI -56.62--34.28, P<0.01), and reduce the incidence of gastric retention (OR=0.13, 95%CI 0.06 -0.29, P<0.01), incidence of abdominal distension (OR=0.23, 95% CI 0.13-0.43, P<0.01), incidence of vomiting (OR=0.14, 95% CI 0.06-0.36, P<0.01).@*Conclusions@#For critically ill patients with nasogastric tube feeding, abdominal massage can reduce the gastric residual volume and reduce the incidence of gastric retention, distension and vomiting.
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Objective:To evaluate the effect of abdominal massage on gastrointestinal tolerance in critically patients with nasogastric tube feeding.Methods:The Chinese Biomedical Literature Database, China National Knowledge Infrastructure, The Wang fang database, Chinese Science and Technology Periodical Database, Cochrane Libraty, PubMed, Embase, CENTRAL were searched. Two researchers conducted quality evaluation and data extraction on studies that met the inclusion criteria. Data were analyzed with RevMan5.3 software.Results:Eight randomized controlled trials were included, including 628 patients. The results of Meta-analysis showed that abdominal massage could reduce the gastric residual volume of critically ill patients ( WMD=-45.45, 95%CI -56.62--34.28, P<0.01), and reduce the incidence of gastric retention ( OR=0.13, 95%CI 0.06 -0.29, P<0.01), incidence of abdominal distension ( OR=0.23, 95% CI 0.13-0.43, P<0.01), incidence of vomiting ( OR=0.14, 95% CI 0.06-0.36, P<0.01). Conclusions:For critically ill patients with nasogastric tube feeding, abdominal massage can reduce the gastric residual volume and reduce the incidence of gastric retention, distension and vomiting.
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Objective To investigatethe status of physician-nurse collaboration in nutritional support among neurosurgical patients in secondary and tertiary hospitals in Suzhou, and to analyze the influence factors and to provide the basis for promoting cooperation consciousnes and quality of work. Methods One hundred and seventy-seven physicians and 506 nurses were investigated by the Nurse-Physician Collaboration Scale(NPCS) in 15 secondary hospitals and 15 tertiary hospitals in Suzhou. Results The cooperative status of physicians in tertiary hospitals was better than that of nurses (t=2.597, P=0.010). The cooperative status of nurses in tertiary hospitals was better than that in secondary hospitals (t=2.080, P=0.009). There was no significant difference in the cooperation between physicians and nurses in secondary hospitals (t=1.845, P=0.066). Multiple regression analysis showed that sex, profession, professional title, age, education degree and work seniority were the influence factors of physician-nurse collaboration intertiary hospitals (t=2.771, 2.597,F=3.745-12.513,P<0.01 or 0.05). Conclusions The physician-nurse collaboration in nutritional support among neurosurgical patients in secondary and tertiary hospitals is in good shape.Administrators should pay attention to influence factors of physician-nurse collaboration, and take measures to promote quality of medical care and nursing care.
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Objective To establish a basic information database of hospital medical records management and improve the management process.Methods The system was developed with C# programming language,basic information from Oracle 10g databases of HIS and electronic medical record system (EMRS),which stored corresponding information during the process into SQL 2005 database and generated early warning information based on statistical analysis on medical records.Results The system realized standardized filing of medical records,synchronized filing of electronic medical record and the first page of medical record,normalized lending of medical record,auto generation of statistical reports,auto alarming in case of standard-exceeded information and etc,which could be used as a platform for medical record management.Conclusion The system enhances the efficiency and management of medical record section,and thus is worthy promoting practically.
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Objective To discuss the intervention effect of four oral care model on compliance of atomizing inhalation and mouth and throat complications in outpatient infants and young children patients. Methods A total of 480 cases of children patients using budesonide inhalation for the treatment of respiratory tract infection were divided into the observation group(n=260)and the control group (n=220) according to the time sequence. The control group received conventional nursing, the observation group used quaternity oral care model in nursing care. The compliance and occurrence of complications in the mouth and throat were observed between the two groups. Results In the observation group with nebulae inhalation compliance was 79.2% (206/260), evidently higher than that in the control group the compliance of 58.6%(129/220) (χ2=23.97,P0.05). The incidence of thrushes was 3.64%(8/220) in the control group, and none occurred in the observation group, which showed significant difference (χ2=9.62, P<0.01). Conclusions Using quaternity oral care model in corticosteroid nebulae inhalation patientscan increase compliance and decreasecomplications of oral and throat of outpatient children.
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Objective To investigate the status and influencing factors of the methods used by nurses verifying the nasogastric tube placement blinded inserted in adult, and to explore the best practice of nursing staff to verify the nasogastric tube placement. Methods We designed the questionnaire and conducted survey to the clinical nursing staff in accordance with the American Association of Critical-Care Nurses practice alert. Results Air bolus auscultation (70.53％,675/957) and aspirate appearance (68.97％,660/957) were the most used method during insertion procedure. There was insufficient in the cognition of X-ray as the gold standard and the use in clinical.The department, work years, specialist nursesand hospitallevel impact X-ray use(all P <0.05).Age, education,title,hospital level, specialist nurses and department impact the cognition of X-ray as the gold standard(all P <0.05). Conclusions Nurses still use the traditional methods to verify the nasogastric tube placement. There is a certain gap between clinical practice and AACN practice alert in themethods used to verify nasogastric tube placement.As the gold standard to verify gastric tube placement, the use and cognition of X-ray are impacted by many factors, including the department, specialist nurses, hospital level, et al. Therefore, hospital should establish a knowledge sharing platform, which will help to spread the advantages and disadvantages of various methods used in verifying the nasogastric tube placement, and then to strengthen the cognition with different people. Furthermore, based on potential influencing factors, it is necessary to further explore new bedside effective method of verifying the nasogastric tube placement and seek the best practice to validate the method of blind intubation of nasogastric tube.
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Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.
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Prader-Willi syndrome( PWS) is a type of genetic disease,which is associated with low mus-cle tone,growth and development,progressive fatal obesity and sleep related respiratory disorders(SRBD). Ob-structive sleep apnea hypopnea syndrome( OSAHS) is the most common type of SRBD. The cause,influencing factors and treatment of OSAHS in patients with PWS are described in this paper. To understand the degree of OSAHS in children with PWS,the polysomnography is recommended.
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Objective To explore the expression of V-ATPase in colon cancer and its clinical significance. Methods Detecting the expression of V-ATPase mRNA in 20 paired of colon tumor tissues and normal tissues by using reverse transcription-polymerase chain reaction ( RT-PCR) and real-time quantitative polymerase chain reaction( Real-time PCR) , and testing the expression of V-ATPase protein by immu-nohistochemistry of EnVinsion. Results The expression of V-ATPase mRNA in tumor tissues and its paired normal tissues were (5. 37 ± 0. 44) and (2. 03 ± 0. 35)(P<0. 01). The positive immunohistochemistry of V-ATPase in tumor tissues and its paired normal tissues were 69. 1%(47/68) and 5. 8%(4/68) respectively, and the positive expression were primarily in cytoplasm and cytomembrane. Overexpression of V-ATPase was associated with tumor stage (P<0. 05), lymph node metastasis (P=0. 044), distant metastasis (P=0. 049), vessel in-vasion (P=0. 044) and differentiation (P<0. 001). Conclusion Overexpression of V-ATPase plays a significant role in the carcinogene-sis and the progression of colon cancer, which might be an important postoperative therapeutic target.