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2017 Vol. 23, No. 9
Published: 2017-09-20
1409
Effect of CO
2
Pneumoperitoneum on Early Cognitive Function in Patients with Gynecological Uterine Leiomyoma after Laparoscopic Surgery
MA Yulin, LU Xinxing, GONG Yongjuan, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.001
Objective:
To investigate the effect of CO
2
pneumoperitoneum at different pressures on early postoperative cognitive function in patients undergoing laparoscopic surgery for uterine fibroids.
Methods:
99 patients with uterine leiomyoma were enrolled from January 2015 to December 2015 were randomly divided into three groups. Group L was given low-pressure CO
2
pneumoperitoneum. The patients of group M were given an intermediate pressure level of CO
2
pneumoperitoneum. The patients of group H were given high pressure level of CO
2
pneumoperitoneum. The three groups of patients with clinical observation, neurochemical markers and cognitive function were compared.
Results:
T2 and T3 PaCO
2
levels and T1, T2 and T3 COR of group H were significantly higher than those in group L and group M|T2 and T3 PaCO
2
levels and T1, T2 and T3 COR of group M were significantly higher than those in group L|T5 PaO
2
level in patients with group H and group M was significantly lower than that in group L|T2, T3 and T4 NE the level was significantly higher than that of group L, T2, T1|T3 and T4 PGE2 were significantly higher than those in group L|group H of T1 patients with T2 NSE were significantly higher than those in group L and group M. S100β levels significantly higher than that in group L|T1 and T2 NSE of group M were significantly higher than those in group L, there was significant difference (P<0.05).
Conclusion:
Different air pressure pneumoperitoneum has little effect on the early cognitive function of patients with uterine leiomyoma after laparoscopic surgery, but low pressure CO
2
pneumoperitoneum can relieve the body stress and reduce the release of neurochemical markers.
2017 Vol. 23 (9): 1409-1411 [
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183
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1412
Clinical Study of Fogarty Balloon Catheter Under DSA in Vascular Crisis after Replantation of Limb (finger)
LI Xiaodong, YAN Xiaowei, LIU Shibo, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.002
Objective:
To observe the clinical effect of Fogarty balloon catheter under DSA in vascular crisis after replantation of limb (finger).
Methods:
From January 2010 to January 2016, 23 patients underwent a vascular crisis with Fogarty balloon catheter in the DSA, 21 patients survived, and the incision was healed, 1 case of acute heart failure, cardiac medical treatment, recovery is good. 1 case of osteofascial compartment syndrome, to be surgical treatment, recovery is good. 2 cases of postoperative vascular crisis again, line incision exploration, 1 case of successful treatment, 2 cases of arterial occlusion, limb partial necrosis, amputation.
Results:
Exclude 2 patients with incision exploration, of the 21 patients treated with Fogarty catheter, an average follow-up of 10 months (6 months to 28 months), limb blood supply improved, and arterial pulsation, swelling improved, sensory improvement, activity improve. According to CMA hand surgery branch of the limb replantation function evaluation criteria evaluation of the efficacy of this group of excellent 12 cases, good in 6 cases, poor in 3 cases, excellent rate of 85.7%.
Conclusion:
Fogarty balloon catheter was used in DSA to determine the vascular crisis after the replantation of the limb (finger), and the clinical curative effect was determined.
2017 Vol. 23 (9): 1412-1414 [
Abstract
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145
)
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1415
Effect of Color Doppler Ultrasound Monitoring on Blood Circulation of Kidney and Uterus Placenta in Pregnancy-induced Hypertension Syndrome
WANG Ling, HUA Yang
DOI: 10.3969/j.issn.1006-6233.2017.09.003
Objective:
To analyze the effect of color ultrasound monitoring on blood circulation of kidney and uterus placenta in pregnancy-induced hypertension (PIH) syndrome.
Methods:
138 cases of PIH patients were divided into the study group, among which there were 45 cases of mild PIH, 60 cases of moderate PIH and 33 cases of severe PIH|62 cases of normal pregnancy people were selected as the control group. The basic situations such as SA, RA, IRA, UT-A, PI of MCA, RI, S/D, umbilical vein blood flow at 20~25,26~30,31~35,36~41 weeks during pregnancy of the two groups were compared.
Results:
The control group's age, gestational weeks, educational level, economic income showed no statistical significance (P>0.05) with those of the study group|The study group's proportion of patients with disease history was sharply higher than that of the control group, the difference had statistical meaning (P<0.05). Distance about PI , RI of RA, RI of UT-A, RI of MCA in the mild PIH and the control group showed no statistical significance (P>0.05)|SA, RA, IRA, PI of UT-A, RI, S/D of the moderate PIH and severe PIH were significantly higher than those of the control group, the differences had statistical significance (P<0.05)|PI of MCA , RI, S/D of the moderate PIH and severe PIH in the study group were significantly smaller than those of the control group, the differences had statistical significance (P<0.05). At 20~25 weeks, 26~30 weeks of gestation, compared with the control group, umbilical vein blood flow of the mild PIH of the study group showed no statistical significance (P>0.05)|At 20~25 weeks of gestation, umbilical vein blood flow of moderate PIH, severe PIH of the study group showed no statistical significance (P>0.05) when compared with that of the control group|At 26~30 weeks, 31~35 weeks, 36~41 weeks of gestation, umbilical vein blood flow of moderate PIH, severe PIH of the study group was significantly higher than that of the control group, the differences had statistical significance (P<0.05).
Conclusion:
Color doppler ultrasound monitoring can be used to predict hemodynamics changes of kidney and uterus placenta in pregnancy, and provide a more sensitive indicator of science for clinical prevention and control of occurrence and development of PIH.
2017 Vol. 23 (9): 1415-1418 [
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130
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1419
Effect of Rosuvastatin Combined with Fenofibrate on Type 2 Diabetes Mellitus Complicated with Hyperlipidemia
SUN Yezi, SHEN Limin, SUN Huanhuan, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.004
Objective:
To investigate the efficacy of rosuvastatin combined with fenofibrate in the treatment of type 2 diabetes with hyperlipidemia.
Methods:
80 patients with type 2 diabetes mellitus complicated with hyperlipidemia enrolled in our hospital from September 2014 to September 2016 were randomly divided into two groups. 40 patients in the control group were treated with rosuvastatin alone. The experimental group 40 Patients were treated with rosuvastatin combined with fenofibrate, and the overall efficacy was compared between the two groups before and after treatment.
Results:
The total effective rate was 85.5% and 97.5% in the control group and experimental group. The total effective rate in the experimental group was higher than that in the control group, and the difference was statistically significant (P<0.05).
Conclusion:
Risuvastatin combined with fenofibrate has a good therapeutic effect in the treatment of type 2 diabetes mellitus with hyperlipidemia. The effective rate of treatment is improved, and low fat lipoprotein cholesterol is reduced, and the level of blood lipid is improved and the safety is higher, which provide a theoretical basis for clinical research.
2017 Vol. 23 (9): 1419-1422 [
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257
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1423
Analysis of Influential Factors of Depression in Breast Cancer Patients
YANG Xiufang
DOI: 10.3969/j.issn.1006-6233.2017.09.005
Objective:
To investigate the incidence of depression and its influencing factors in breast cancer patients.
Methods:
A total of 123 patients with breast cancer admitted in our hospital from September 2015 to May 2017 were enrolled in this study. The self - made survey scale was used to evaluate the clinical treatment information, life behavior, population characteristics and other information collected statistics.
Results:
The results of univariate analysis showed that the types of complications, the degree of family support, the degree of pathological stage and the degree of disease cognition were all important factors in the depression of breast cancer patients, the difference was significant (P <0.05). The analysis showed that the types of treatment complications, the degree of family support and the degree of disease cognition were the key factors influencing the emergence of depression in patients with breast cancer. There was no complication after operation, the family was fully supported and the disease awareness was higher. The risk of depression in patients with breast cancer was significantly different (P <0.05).
Conclusion:
The degree of disease cognition, the degree of family support and the type of treatment complication are closely related to the appearance of depression in breast cancer patients. Among them, more than two kinds of complications, low degree of awareness of breast cancer and poor family support important factors in the risk of depression in the course of treatment.
2017 Vol. 23 (9): 1423-1426 [
Abstract
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150
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1427
Prognostic Value of MSI in Patients with Acute non-ST-Segment Elevation Myocardial Infarction
ZHAO Chunsheng, WANG Yanfei, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.006
Objective:
To investigate the value of modified shock index in evaluation of the prognosis of patients with acute non-ST-segment elevation myocardial infarction (NSTEMI).
Methods:
462 cases of patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) were recruited in this study in affiliated hospital of Chengde medical college from January 2013 to January 2016. All 462 cases were divided into 2 groups depend on the final prognosis: survival group (421 cases) and in-hospital death group (41 cases). Heart rate, systolic blood pressure and modified shock index (MSI) were recorded and analyzed.
Results:
There was no significant difference between the two groups on age, gender, chronic disease history and family disease history (P>0.05). The MSI in the group of death (1.042±0.413) were significantly higher than the group of survival (0.842±0.267) (P<0.05). The risk of death was elevated in the group with "MSI>1.2", which odds ratio (7.1) higher than the other evaluated index.
Conclusion:
MSI in emergency department are simple and effective predictor for short-term outcomes in patients with NSTEMI.
2017 Vol. 23 (9): 1427-1428 [
Abstract
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102
)
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1429
Observation on Curative Effect of Total Laminectomy and Internal Fixation for Treatment of Senile Degenerative Lumbar Spinal Stenosis Treated by
LU Siyuan, XIONG Fujun, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.007
Objective:
To explore the effect of total laminectomy and spinal fixation in senile degenerative lumbar spinal stenosis.
Methods:
100 patients with senile degenerative lumbar spinal stenosis admitted from May 2015 to May 2016 were randomly divided into two groups. The patients in the control group were given selective selective decompression. The patients in the experimental group were treated with laminectomy Spinal fixation, compared the two groups of patients with disease-related parameters, the overall treatment effect, complications and quality of life.
Results:
Compared with the control group, the VAS score and the ODI score were significantly lower in the experimental group than in the control group. The JOA score, walking distance, intervertebral height, lumbar lordosis angle and lumbar sagittal diameter group were all lower in the experimental group than in the control group (P <0.05) . There is significant difference between the two groups ((P <0.01). The excellent and good rate was significantly higher than that of the control group (P <0.05).
Conclusion:
The application of total laminectomy in the treatment of senile degenerative lumbar spinal stenosis is significant and has reference significance.
2017 Vol. 23 (9): 1429-1432 [
Abstract
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129
)
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1433
Thoracoscopy and Traditional Surgery on Clinical Effect and Postoperative Humoral and Cellular Immune Function in Esophageal Carcinoma
E Dexiu, YE Zhi, GAO Zhejun, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.008
Objective:
To investigate the effect of thoracoscopy and traditional surgery on the clinical efficacy of esophageal carcinoma and postoperative humoral and cellular immune function.
Methods:
80 patients with esophageal cancer who were enrolled from January 2014 to March 2017 were randomly divided into two groups. Thoracoscopic surgery was performed in patients undergoing thoracoscopic surgery. The patients in the traditional group were given traditional surgery. The clinical short-term efficacy, complications, body fluids and cellular immune function and quality of life of two groups were compared.
Results:
The incision length, intraoperative blood loss and overall complication rate were significantly lower in the thoracoscopic group than in the traditional group. The number of lymph node dissection was significantly higher than that of the conventional group. After 7 days, the levels of IgG, IgM, CD3 +, CD4 + / CD8 + and NK were significantly higher than the traditional group, CRP level were significantly lower than the traditional group|12 weeks later the physical function scores were significantly higher than the traditional group. nausea and vomiting, pain and difficulty breathing was significantly lower than the traditional group, the difference was statistically significant (P <0.01).
Conclusion:
Compared with traditional surgery, the clinical effect of thoracoscopic surgery is more significant, which has little effect on immune function and has reference significance.
2017 Vol. 23 (9): 1433-1436 [
Abstract
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138
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1437
The Value of Neutrophil Lymphocyte Ratio in Predicting Recurrence of Postoperative Cervical Lymph Node Metastatic in Papillary Thyroid Carcinoma
ZHENG Xucai, WANG Shengying, LIU Jianjun, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.009
Objective:
To investigate the relationship between preoperative neutrophil lymphocyte ratio (NLR) and cervical lymph node recurrence in patients with thyroid papillary carcinoma (PTC).
Method:
PTC Patients from our hospital in January 2009 to December 2014 were retrospective analyzed. The relationship between those patients&apos|serum routine markers and postoperative recurrence were analyzed by Cox analysis.
Results:
A total of 211 patients were included in the analysis, of which 50 (23.7%) patients had postoperative cervical lymph node metastasis. Preoperative peripheral blood NLR higher than 2.6 is an independent risk factor for postoperative cervical lymph node recurrence in PTC patients.
Conclusion:
Higher NLR is a high risk factor for lymph node metastasis after PTC. NLR higher than 2.6 patients in the process of follow-up routine examination of cervical lymph nodes.
2017 Vol. 23 (9): 1437-1439 [
Abstract
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149
)
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1440
Effects of Laparoscopic Surgery on Stress and Immune Function in Patients with Gallstones Complicated with Acute Cholecystitis
LI Jin
DOI: 10.3969/j.issn.1006-6233.2017.09.010
Objective:
To investigate the effects of laparoscopic surgery on the stress and immune function of patients with cholecystolithiasis complicated with acute cholecystitis.
Methods:
60 patients with cholecystolithiasis combined with acute cholecystitis from May 2014 to May 2017 were randomly divided into two groups. Laparoscopic group patients underwent laparoscopic surgery. The patients in the traditional group were given traditional surgery. The related clinical indicators, complications, stress levels, immune function and quality of life were compared.
Results:
The incision scar length, length of hospital stay and total complication rate in laparoscopic group were significantly lower than those in the traditional group. The levels of IL-6, CRP, cortisol, ACTH and blood glucose were significantly lower than those of the traditional group (P <0.05). There was significant difference between the two groups (P <0.05). The difference of CD3, CD4 and CD4/CD8 levels between the two groups was significantly higher than that of the conventional group (P <0.01).
Conclusion:
Laparoscopic surgery has a significant effect on the body's stress and immune function in patients with gallstone and acute cholecystitis.
2017 Vol. 23 (9): 1440-1443 [
Abstract
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149
)
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1444
Urokinase Thrombolysis Combined with Tirofiban or Ticagrelor Antiplatelet in the Treatment of Acute STEMI
LU Chaoling, ZHANG Xiaoxin, LIAO Peijuan, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.011
Objective:
To investigate the effects of urokinase thrombolysis combined with tirofiban or ticagrelor antiplatelet therapy in the treatment of acute ST segment elevation myocardial infarction (STEMI).
Methods:
According to the treatment
Methods
, 148 cases of patients with STEMI were divided into tirofiban group, ticagrelor group and clopidogrel group. The three groups were treated with urokinase thrombolysis for 7 days. The myocardial reperfusion indexes, cardiac function, myocardial injury markers, inflammation related indicators and 30d adverse events were compared among groups.
Results:
Compared with clopidogrel group, the ratios of ST segment decline >|50%, grade 3 blood flow of thrombolysis in myocardial infarction (TIMI) and grade 3 myocardial perfusion (TMP) and left ventricular ejection fraction (LVEF) were significantly higher in tirofiban group and ticagrelor group after treatment|while the left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), levels of serum creatine kinase isoenzyme (CK-MB), cardiac troponin (cTnI), high-sensitivity C reactive protein (hs-CRP) and tumor necrosis factor α (TNF-α) were significantly lower (P <|0.05). There were no statistically significant differences between the tirofiban and the ticagrelor group (P >|0.05). There was no significant difference in the incidence of adverse events in 30 days among the three groups (P >|0.05).
Conclusion:
The application of urokinase thrombolysis combined with tirofiban or ticagrelor antiplatelet therapy in the treatment of STEMI can significantly improve cardiac function and reduce myocardial injury and inflammatory response. The short-term prognosis is similar, and the curative effect of tirofiban and ticagrelor is similar.
2017 Vol. 23 (9): 1444-1447 [
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109
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1448
The Effect and Safety of Linezolid and Vancomycin on Methicillin-resistant Staphylococcus Aureus Infection
GAO Yongmin
DOI: 10.3969/j.issn.1006-6233.2017.09.012
Objective:
To investigate the efficacy and safety of linezolid and vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia.
Methods:
60 patients with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia were enrolled from January 2016 to March 2017 were randomly divided into two groups according to the random number table. The patients in the control group were treated with vancomycin, The patients in the experimental group were treated with linezolid, and the overall treatment efficiency, the white blood cell concentration before treatment and the concentration of C-reactive protein and the incidence of adverse reactions were compared between the two groups.
Results:
Compared with the control group, the total effective rate of the experimental group was significantly higher than that of the control group (P <0.01). After treatment, WBC and CRP were significantly lower than those before treatment, the difference was significant, and there was no significant difference between the two groups before and after treatment.WBC and CRP were significantly lower than those in the control group (P <0.05). There was no significant difference in the adverse reaction rate between the experimental group and the control group, (P>|0.05), while the experimental group of patients mainly diarrhea, nausea and other gastrointestinal adverse reactions, the control group of patients mainly to skin reactions, renal dysfunction adverse reactions.
Conclusion:
The efficacy of linezolid in the treatment of MRSA pneumonia is lower than that of vancomycin, and it is better to control inflammatory response, and the total effective rate of treatment is higher. The treatment of linezolid is mainly caused by diarrhea, nausea and so on. Gastrointestinal adverse reactions, and vancomycin treatment of patients mainly to skin reactions, renal dysfunction adverse reactions, two groups of less adverse reactions, higher safety, worthy of clinical promotion, with reference.
2017 Vol. 23 (9): 1448-1451 [
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175
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1452
The Clinical Comparison between Mini-invasive Technique Combined with Holmium Laser and Traditional Technique in Treatment of Hepatolithiasis
JING Dongshuai, LV Zongjun, ZHENG Jianzhong, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.013
Objective:
To explore the clinical effect between mini-invasive technique combined with holmium laser and traditional operation in treating hepatolithiasis.
Methods:
A retrospective study was carried out on the clinical data of 45 patient s with intrahepatic lithiasis treated by our hospital from May 2013 to July 2016,randomly divided into two groups, of which 20 patients was treated by traditional technique (open-abdomen and intraoperative choledochoscope technique)(control group) and 25 cases underwent mini-invasive technique (laparoscopy and intraoperative choledochoscope technique) combined with holmium laser lithotripsy(observation group).
Results:
The intraoperative bleeding in observation group was (30.23±5.55) mL, the postoperative hospitalization time was (8.20 ± 1.50) d, the incision infection or liquefaction rate was 0, the incidence of biliary fistula was 4% and the residual rate of stones was 7%. In the control group,the amout of bleeding in operation was (51.76 ± 5.92) mL, the postoperative hospital stay time was (10.25 ± 1.97) d, the incision infection or liquefaction rate was 25%, the incidence of biliary fistula was 15% and the residual rate of stones was 35%.There were statistically significantly differences in intraoperative bleeding,postoperative hospitalization time,the incision infection or liquefaction and residual calculus in the two group (P<0.05).
Conclusion:
Mini-invasive technique combined with holmium laser has the advantages of shorter hospitalization time, fewer bleeding, low residual calculus and fewer complications than traditional technique in the treatment of hepatolithiasis. It deserves further promotion and application.
2017 Vol. 23 (9): 1452-1454 [
Abstract
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179
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1455
The Role and Mechanism of LGR5 in Cervical Carcinogenesis
CHEN Qing, LI Xianghong, ZHAO Jinyan, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.014
Objective:
To investigate the role and mechanism of LGR5 in cervical carcinogenesis.
Methods:
The expression of LGR5 and β-catenin in normal cervix, cervical intraepithelial neoplasias and squamous cervical cancer were determined by immunohistochemistry and western blot, and analyze the relationship between LGR5 and clinical pathological features of cervical cancer and β-catenin expression. The effect of LGR5 on cervical carcinogenesis was examined using tumorsphere formation.
Results:
The positive rate of LGR5 and β-catenin in normal cervix, cervical intraepithelial neoplasias and cervical cancer were 17% (5/30), 65% (11/17), 84% (54/64) and 13%(4/30),53%(9/17),92%(59/64),respectively. The difference was statistically significant (P<0.01). The expression of LGR5 was associated with pathological grade of cervical cancer, but not with patient's age, clinical stage and lymph node metastasis. β-catenin expression in cervical cancer was positively related to LGR5 expression(r=0.69, P<0.01). Moreover, the rate of tumorsphere formation of LGR5 overexpression SiHa cell was significantly higher than the GFP control group (P<0.01).
Conclusion:
LGR5 and promoted cervical carcinogenesis and its mechanismmay be associated with high expressio0n of β--catenin
2017 Vol. 23 (9): 1455-1458 [
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155
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1459
Comparison of the Short-term and Long-term Effects of three Surgical methods in treating Type II and III High-energy Tibial Pilon Fractures
CHEN Jianrong
DOI: 10.3969/j.issn.1006-6233.2017.09.015
Objective:
To compare the short-term and long-term effects of three surgical
Methods
in treating type II and III high-energy tibial pilon fractures.
Methods:
103 patients with type II and III high-energy tibial pilon fractures treated in our hospital between March 2010 to March 2014 were selected as study subjects, and according to different surgical
Methods
, they were divided into group A (one-stage open reduction and internal fixation), group B (limited internal fixation and external fixation) and group C (stepwise delayed surgery). All patients were followed up for 12 ~ 30 months with an average of 18 months. The short-term and long-term effects were compared between groups.
Results:
The operation time, intraoperative blood loss, fracture healing time and incidence of postoperative complications in group C were significantly less and lower than those in group A and group B (P <|0.05)|The excellent and good rate of ankle functional recovery, scores of overall health, pain, vitality, physical function and physical role in group C were significantly higher than those in group B (P <|0.05), and those in group A were significantly higher than those in group B at the end of follow-up (P <|0.05).
Conclusion:
Compared with one-stage open reduction and internal fixation, limited internal fixation and external fixation, the effect of stepwise delayed surgery is the best which can significantly reduce the incidence of complications, promote the recovery of ankle joint function, improve the quality of life of patients, and can be used as the preferred surgery for treating type II and III high-energy tibial pilon fractures.
2017 Vol. 23 (9): 1459-1462 [
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123
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1463
The Application and Clinical analysis of Platelet - rich Plasma in the Treatment of Knee Osteoarthritis
FU Ligong, CHEN Lianxu
DOI: 10.3969/j.issn.1006-6233.2017.09.016
Objective:
To investigate the effect of platelet-rich plasma in the treatment of knee osteoarthritis.
Methods:
67 Patients with osteoarthritis of the knee were selected from January 2015 to December 2016. The patients were divided into sodium hyaluronate injection control group (34 cases) and platelet-rich plasma injection group (33 cases). The scores of Lysholm knee function scores and VSA pain scores were compared between the two groups before and after treatment.
Results:
Compared with the control group, the total effective rate of the patients was significantly higher than that of the control group, and the difference was significant (P＜ 0.05). The difference of Lysholm knee function scores between the two groups before treatment was no significant (P ＞0.05). After 1 months of treatment, the Lysholm knee function scores increased significantly, and the difference was significant (P <0.01). After 6 months of treatment, Lysholm knee function scores were down, the control group scores fell as that before injection. While the experimental group, although reduced, but still better than pre-injection score. There was still significant difference between the two groups (P＜0.05). There was no significant difference of the VSA scores between the two groups (P>|0.05). After 1 months of treatment, the VSA scores of the two groups were improved, with the VSA scores of experimental group lower than that of the control group (P＜0.05). But after 6 months of treatment, the VSA scores were significantly decreased in the two groups. The VSA scores of experimental group were still lower than that of the control group, the difference was statistically significant (P <0.05).
Conclusion:
The use of platelet-rich plasma injection for the treatment of osteoarthritis of the knee is more effective than the sodium hyaluronate injection method, with better knee function recovery and more pain remission, and the effective time is longer. It's worthy for clinical promotion, with reference.
2017 Vol. 23 (9): 1463-1466 [
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138
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1467
Pathological Consistence Analysis of CIN2/3 Patients before and after the Cervical Excisional Procedures
SONG Jie, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.017
Objective:
To compare the differences of cervical pathology between colposcopy-directed punch biopsies and excisional procedures, and to evaluate the diagnostic role of colposcopy-directed punch biopsies for the patients with high-level cervical lesions (CIN 2 and CIN 3).
Methods:
840 cases with CIN 2 and CIN 3 diagnosed by pathology of punch biopsy were followed by excisional procedures, and comparison of histological pathology was made between the two procedures.
Results:
The histological consistence rate between colposcopy-directed punch biopsy and excisional procedures was 72.9%, the coincidence rate in Cin2 and CIN3 were 62.1% and 81.8% respectively,cervical inwasive cancer rate of missed diagnosis under colposcopy-directed punch biopsies is 0.2% and 6.6% respectively.
Conclusion:
Under the guidance of colposcope cervical punch biopsy is a simple and effective method for diagnosis of CIN 2,3, which has a high consistence rate with excisional procedures. Further management depends on comprehensive evaluation.
2017 Vol. 23 (9): 1467-1469 [
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252
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1470
Analysis of Risk Factors of Hypoxemia after CPB in Children with Congenital Heart Disease
ZHOU Chunlong, ZHANG Libing, GUO Langtao, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.018
Objective:
To investigate the risk factors of hypoxemia after CPB in congenital patients with congenital heart disease.
Methods:
A total of 98 children with congenital heart disease received from January 2016 to January 2017 were selected, all children underwent surgical treatment, CPB after 45 cases of hypoxemia, the remaining 53 cases did not appear hypoxemia, risk factors for hypoxemia after CPB were analyzed by single factor and Logistic multivariate regression.
Results:
The PaO
2
/FiO
2
levels of 2h, 6h, 12h and 24h in children with hypoxemia were lower than those in non hypoxic group, and there was significant difference between the two groups (P <|0.05). Univariate analysis showed that there were significant differences in age, body weight, preoperative right-to-left shunt, preoperative pulmonary hypertension, and intraoperative ventilation patterns (P <0.01);Logistic multivariate regression analysis showed that low age, obesity, preoperative combined right to left shunt, pulmonary hypertension was congenital heart disease in children after CPB hypoxemia occurred in high risk factors.
Conclusion:
The incidence of hypoxemia in children with congenital heart disease is closely related to the low age, obesity and preoperative right - to - left shunt and pulmonary hypertension.
2017 Vol. 23 (9): 1470-1473 [
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149
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1474
The Relationship between EATV and the Stability of Coronary Artery Plaque in Patients with Coronary Heart Disease
CHEN Yuxiang, WU Xinqi, WU Xiaoqiu, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.019
Objective:
To study the effects of epicardial adipose tissue volume(EATV) on coronary artery plaque stability in patients with coronary heart disease.
Methods:
Selected 430 patients suspected with coronary heart disease in The Third Affiliated Hospital of Guangxi Medical University from May 2014 to October 2016. Analyzed the relationship between EATV and coronary artery plaque, and compared the EATV in patients with different plaque types,coronary artery plaque stability status of patients with different EATV in plaque group,as well as plaque related indicators diagnosed by intravenous ultrasound (IVUS) in patients with different EATV.
Results:
The incidence rate of EATV≥85mL in plaque group was significantly higher than non plaque group(P<0.05). There was no significant difference on EATV among patients with different plaque types(P>0.05).The incidence rate of unstable plaque of EATV≥85mL was significantly higher than the EATV<85mL in plaque group (P<0.05)|The sizes of the plaque,lipid and necrotic in patients with EATV≥85mL were significantly higher than EATV<85mLt (P<0.05).
Conclusion:
EATV has great influence on the coronary artery plaque stability in patients with coronary heart disease, and the higher the level of EATV, the greater the impact.
2017 Vol. 23 (9): 1474-1476 [
Abstract
] (
126
)
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1477
Application of Multi-slice Spiral CT in Diagnosis of Small Intestinal Obstruction
WU Jinfeng
DOI: 10.3969/j.issn.1006-6233.2017.09.020
Objective:
To study the application value of multi-slice spiral CT in the diagnosis of small intestinal obstruction.
Methods:
88 cases of patients with small intestinal obstruction confirmed by surgery in our hospital from January 2012 to December 2016 were selected for the study and treated with multi-slice spiral CT examination. The accuracy rates of the site, degree and etiology of small intestinal obstruction were calculated by the multi-slice spiral CT diagnosis.
Results:
There were 80 cases of small intestinal obstruction correctly detected by CT with the accuracy rate of 90.9%, including 6 cases of duodenal obstruction, 17 cases of jejunum obstruction and 57 cases of ileal obstruction. There were 60 cases of complete small intestinal obstruction and 21 cases of incomplete small intestinal obstruction correctly detected by CT with the accuracy rate of 92.1%. And there were 79 cases of small intestine obstruction detected with etiology by CT with the accuracy rate of 89.8%, including 39 cases of intestinal adhesions, 14 cases of inflammation, 11 cases of tumors, 5 cases of external hernia, 4 cases of intestinal torsion, 2 cases of traumatic small intestinal obstruction, 2 cases of blood-borne small intestinal obstruction and 2 cases of congenital small intestinal obstruction.
Conclusion:
Multi-slice spiral CT can accurately diagnose the site, degree, etiology of small intestinal obstruction, and have an important guiding role in surgical treatment.
2017 Vol. 23 (9): 1477-1479 [
Abstract
] (
119
)
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1480
The Clinical Efficiency and Application Study of Comprehensive Interventional Treatment for Severe Pulmonary Embolism with Deep Vein Thrombosis
ZHANG Qingyun, DING Meng, CHEN Lei, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.021
Objective:
To evaluate the clinical efficacy and application value of comprehensive interventional treatment for severe pulmonary embolism with deep vein thrombosis.
Methods:
14 patients confirmed with severe pulmonary embolism with deep vein thrombosis were treated by comprehensive interventional therapy. Pulmonary arteriography and lower extremity phlebography were performed after placement of inferior vena cava filter, opened the pulmonary artery and deep vein of lower limb through the catheter mechanical processing and catheter thrombolysis. Clinical manifestations, hemodynamic changes, the recanalization of obstructed blood vessels as well as the occurrence complications were observed.
Results:
Improvement in clinical symptoms was achieved in all cases. The shock index and arterial partial pressure of oxygen before and 1d of procedure were(0.95±0.09)vs(0.74±0.22)(P<0.01), (69.7±7.2)mmHg vs(80.6±1.2)mmHg(P<0.01), the pulmonary artery systolic pressure and Miller score before ,7d and 14d of procedure were(57.2±8.5)mmHg vs(32.7±2.9)mmHg vs(27.7±3.4)mmHg(P<0.01),(18.3±3.1)vs(3.4±2.5)vs(2.1±2.4)(P<0.01). Except for hematuria in 1 case, there were no other severe surgical complications occurred.
Conclusion:
Comprehensive interventional treatment for severe pulmonary embolism with deep vein thrombosis is a safe, rapid, effective method and worth promoting.
2017 Vol. 23 (9): 1480-1483 [
Abstract
] (
165
)
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1484
Determination of Protein C in Serum and Cerebrospinal Fluidin Children with Viral Encephalitis and Clinical Research
WANG Yan
DOI: 10.3969/j.issn.1006-6233.2017.09.022
Objective:
To study the changes of protein C levelsin serum and cerebrospinal fluid(CSF) of children with viral encephalitis and its clinical significance.
Method:
From October 2013 to December 2015,102 cases of children with viral encephalitis as the observation group, the other in the same period randomly selected 100 cases of children with upper respiratory tract infection with headache as control group.In hospital within 24 h (acute phase) and the clinical therapy (recovery) after 1 weeks to collect children venous blood samples and cerebrospinal fluid samples for detection of protein C levels;collecting and the detecting protein C levels of healthy children in the venous blood samples and samples of cerebrospinal fluid.
Results:
Observation group with acute phase protein C levels in serum and cerebrospinal fluid were relatively lower than recovery children and healthy children, the differences were statistically significant (P<0.05).Observation group children with acute mild protein C levels in serum and cerebrospinal fluid were higher than children with severe, differences were statistically significant (t=2.542, 2.115, P<0.05).
Conclusion:
Protein C levels can be used for the early diagnosis of viral encephalitis and judge the severity of infection, having important clinical value for diagnosis and treatmentof children with viral encephalitis.
2017 Vol. 23 (9): 1484-1486 [
Abstract
] (
115
)
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1487
Beauty's Microphones Set Right Decannulation Period of General Anesthesia in Patients with High Blood Pressure Heart Rate, Systolic Blood Pressure Product (RPP) Ratio (PRQ) the Influence of Heart Rate and Blood Pressure
CHENG Zhou, LIAO Xiaozu, WANG Lijiang, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.023
Objective:
To observe the tora microphones set decannulation period of general anesthesia in patients with high blood pressure heart rate, systolic blood pressure product (RPP) ratio (PRQ) the effects of heart rate and blood pressure.
Method:
Choose 97 cases of general anesthesia, surgery combined with hypertension patients as the research object, all the patients were given general anesthesia, it can be divided into two groups at random, the observation group (n = 49) in preoperative 30 min intravenous 0.5 mu g/kg right beautiful mi set, the control group (n = 48) intravenous injection amount of normal saline in the same time, compared two groups of patients with medication (T0), tube drawing before (T1), when the tube drawing (T2), 5 min after extubation (T3), 10 min after extubation (T4) HR, SBP, DBP, MAP and other indicators, calculate the RPP and PRQ differences.
Results:
Observation group T1, T2 of HR was significantly lower than control group (P <|0.05), T1, T2, T3, SBP, DBP, MAP was significantly lower than the control group (P <|0.05);Observation group of T1 ~ T4 RPP was significantly lower than the control group (P <|0.05), but the T0 ~ T4 PRQ was similar between the two groups had no statistical significance (P >|0.05);Two groups of patients in the study were no serious adverse reaction.
Conclusion:
Right beautiful mi set which can effectively reduce the high blood pressure patients decannulation period of general anesthesia RPP, guarantee better stability and lower cardiovascular hemodynamic parameters reaction, improve the quality of tube drawing.
2017 Vol. 23 (9): 1487-1489 [
Abstract
] (
175
)
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1490
Correlation Analysis of Collapsible Index of Inferior Vena Cava and Blood Flow Spectrum with Pulmonary Arterial Pressure in Patients with Pulmonary Hypertension
HAO Hong, HU Yuan
DOI: 10.3969/j.issn.1006-6233.2017.09.024
Objective:
To analyze the correlation of the collapsible index of inferior vena cava (cIVC) and the Doppler flow pattern with pulmonary artery pressure by echocardiography technology in the patients with pulmonary hypertension.
Methods:
The internal diameter of the inferior vena cava was measured in 76 cases of pulmonary hypertension patients (including 34 cases of mild severity, 27 cases of moderate severity, and 15 severe cases) and 46 healthy subjects as the control group at the end of expiration and inspiration by conventional transthoracic echocardiography, the collapsible index of inferior vena cava was calculated, at the same time, inferior vena caval flow spectrum feature was compared.
Results:
The internal diameter of inferior vena cava of three group of patients with pulmonary hypertension (mild group, moderate group and severe group) at the end of expiration and inspiration was higher than that of the control group (P<0.05), cIVC of the treatment group was lower than that of the control group (P<0.05). S wave and D wave, a wave of inferior vena cava spectrum of moderate and severe pulmonary hypertension group were different from that of the control group (P<0.05) in comparison.
Conclusion:
Collapsible index of inferior vena cava and blood flow spectrum feature have important predictive value for pulmonary hypertension.
2017 Vol. 23 (9): 1490-1492 [
Abstract
] (
312
)
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1493
Clinical Observation with Lung Cancer Undergoing Shenqifuzheng Combined Themotherapy
LI Qingshan, BAI Lu, GAO Dongqi, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.025
Objective:
To investigate the effects of Shenqifuzheng Injection on quality of life and immune function in patients with chemotherapy of lung cancer.
Methods:
We analyzed 74 cases of lung cancer patients randomly divided into treatment group (Shen Qi Fu Zheng group), positive control group (Addie injection group) and blank control group.
Results:
In terms of total effective rate, the treatment group was higher than the blank group, the difference was significant (P <|0.05). After treatment, the CD3
+
, CD4
+
, CD4
+
/CD8
+
and NK cells were no difference between the treatment group and the control group (P>0.05), While the control group after treatment, CD3, CD4
+
, CD8
+
, CD4
+
/CD8
+
ratio were lower than before treatment (P<0.05 or P<0.01).After treatment, the CD3
+
, CD4
+
, CD4
+
/CD8
+
ratio and the blank control group had statistical significance with the treatment group (P<0.05).
Conclusion:
Shen Qi Fu Zheng Injection combined with chemotherap can improve the curative effect and the immune function in the lung cancer patients.
2017 Vol. 23 (9): 1493-1495 [
Abstract
] (
193
)
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1496
The Application of LAMP Technique in Detection of the Bacillary Dysentery
WANG Wei, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.026
Objective:
To establish and apply the Methods of LAMP assay for the detection of Shigella of infectious diarrhea patients from the enteric clinicsin.
Methods:
The specific primers of the conserved regions of Shigella by using Primer Explorer V5 online and composed to establish the LAMP assay for detection of Salmonella. The 760 fecal specimens among diarrhea patients visiting the enteric clinicsin in Hospital of Chengde Medical College from 2016 was collected and test by Real-time PCR ,LAMP and the Traditional Method. The specificity and sensibility of LAMP were evaluated by comparing with Real-time PCR and the Traditional.
Results:
There was no statistical difference in the specificity of 3 method(P＞0.05). LAMP showed fine specificity and high sensitivity.
Conclusion:
LAMP assay was performed in water oven and the results could be directly determined by eyes under visible light or UV lamp. Because of its rapidity and minimal equipment requirement,LAMP assay for detection of Shigella in primary diseases control and prevention agency and primary health institutions.
2017 Vol. 23 (9): 1496-1497 [
Abstract
] (
112
)
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1498
Clinical Efficacy of Intravenous Thrombolysis combined with Mechanical Thrombectomy for Acute Cerebral Infarction and its Effect on Prognosis
XIAO Wen, PU Xiaolong, BAI Zhangyong, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.027
Objective:
To investigate the clinical efficacy of intravenous thrombolysis combined with mechanical thrombectomy for acute cerebral infarction and its effect on prognosis.
Method:
96 patients with acute cerebral infarction in our hospital were selected and divided into Intravenous thrombolysis group and Thrombectomy group. There were 12 cases in the mechanical thrombectomy group, and the other in the intravenous thrombolysis group, including thrombolysis in 22 cases, intravenous thrombolysis in 46 cases, and intravenous thrombolysis in patients with arteriovenous shunt in 16 cases.The clinical efficacy and NIHSS score of the two groups were compared.
Results:
The total effective rate was 83.33%,higher than Bridging group (62.50%), artery group (54.55%) and the venous group (39.13%), the difference was statistically significant (P<0.05)|After treatment, the NIHSS scores of the four groups were decreased|and arterial thrombolysis group and intravenous thrombolysis group and arteriovenous thrombolysis bridging group, thrombectomy group total vascular recanalization rate, lower NIHSS score, the difference has statistical significance (P<0.05)|The incidence of intracranial hemorrhage occurred in 4 cases of arterial thrombolysis group (18.18%),Venous group of 8 cases (17.39%), Arteriovenous bridging group of 2 case(12.5%), The thrombectomy group 2 case (16.67%),there was no significant difference (P>0.05).
Conclusion:
The use of thrombectomy and thrombolysis method has certain therapeutic effect on acute cerebral infarction, but mechanical thrombectomy can effectively improve the recanalization rate, NIHSS score and clinical curative effect, promote the recovery of physiological function of the patients.
2017 Vol. 23 (9): 1498-1501 [
Abstract
] (
141
)
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1502
Clinical Observation of Vitreous Cavity Injection of Ranibizumab in the Treatment of Wet Age-related Macular Degeneration
HAO Xuelian
DOI: 10.3969/j.issn.1006-6233.2017.09.028
Objective:
To investigate the efficacy of vitreous cavity injection in the treatment of senile wet macular degeneration.
Methods:
90 elderly patients with age-related wet macular degeneration who were enrolled from May 2014 to May 2016 were randomly divided into three groups. Group A was given vitreous cavity injection of ranibizumab and photocoagulation. Group B patients were given only ranibizumab injection the patients were given only photocoagulation in group C, and the best corrected visual acuity, central macular thickness and the trend and complication were compared between the three groups.
Results:
Compared with group B and group C, the difference between 1m, 3m, 6m and 12mBCVA scores was significantly higher than that of group B and group C (P <0.01). There was a significant difference between the two groups (P <0.01). There was a significant difference between the two groups (P <0.05) |There was no significant difference in the incidence of complications between the three groups (P>|0.05).
Conclusion:
Vitreous cavity injection of ranibizumab photocoagulation in the treatment of senile wet macular degeneration in the most significant effect, high safety, with reference.
2017 Vol. 23 (9): 1502-1505 [
Abstract
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120
)
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1506
Targeted Surveillance to Neurological Hospital Infection in 2016
ZHANG Guixin
DOI: 10.3969/j.issn.1006-6233.2017.09.029
Objective:
To investigate the effect of infection target monitoring and intervention in the prevention of nosocomial infection in neurology department, and to provide reference for preventing and reducing nosocomial infection.
Methods:
A total of 1561 hospitalized patients admitted to the Department of Neurology in Pingquan County Hospital from January 2016 to January 2017 were enrolled in this study. The incidence of nosocomial infection was observed.
Results:
Among the 1561 patients admitted to neurology, 82 cases had nosocomial infection. The rate of hospital infection was 5.25%. The infection rate of respiratory infection was 75.61%, followed by urinary tract infection, abdominal digestive system infection, skin Soft tissue infection, the infection rate composition ratio were 14.63%, 6.10%, 3.66%. Patients with age ≥65 years, with basic diseases, irrational use of antibiotics, hospital stay ≥ 14 days, the existence of invasive operation and other factors associated with the occurrence of nosocomial infection, and the difference was statistically significant, P <0.05.
Conclusion:
In order to effectively reduce the incidence of nosocomial infection, we should focus on: hospitalized patients with age ≥65 years of age, combined with underlying diseases, irrational use of antibiotics, hospital stay ≥14 days and invasive operation, To effectively reduce the incidence of nosocomial infection.
2017 Vol. 23 (9): 1506-1507 [
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101
)
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1545
Clinical Nursing for Patients with Acute Myocardial Infarction (AMI) and Treated by Transradial Emergency PCI (TE-PCI)
DU Yue
DOI: 10.3969/j.issn.1006-6233.2017.09.042
Objective:
To study the clinical nursing effect for patients with acute myocardial infarction (AMI) and treated by transradial emergency PCI (TE-PCI).
Methods:
A total of 82 cases of AMI patients treated by TE-PCI in our hospital from January 2014 to December 2016, After TE-PCI, give comprehensive care. Before TE-PCI treatment and 7d after TE-PCI treatment, Quality of life in angina pectoris, anxiety status, depressedand perioperative complications of patients in thewere observed.
Results:
After TE-PCI treatment, The scores of Quality of life in angina pectoris in all patients were higher than those before treatment, anxiety and depression scores were lower than those before treatment, and the difference was statistically significant (p<0.05). The incidence of perioperative complications was 13.61%, the rate of two infarction was 0%.
Conclusion:
Comprehensive nursing in combination with TE-PCI in treating patients with AMI can effectively improve the levels of markers of myocardial injury and inflammatory factors, enhance the quality of life of the patients, and the incidence rate of postoperative complications is low, so the therapy is worthy of clinical application.
2017 Vol. 23 (9): 1545-1548 [
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136
)
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1549
Study on Clinical Nursing Safety and Quality Standards and Evaluation Index System in Zunyi City
WANG Huilan, PU Hengping, YANG Ping, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.043
Objective:
To develop the Zunyi clinical nursing safety and quality standards and evaluation index system, promote the further development of the reform and nursing care service in our city.
Methods:
After clinical investigation, review of the relevant literatures, a careful reading of "three level general hospital accreditation standards implementation rules"|(2011 Edition) and "three class hospital high quality nursing service evaluation standard", the modified Delphi expert consultation method was used, by experts&apos|repeated discussion and demonstration, Zunyi City clinical nursing safety and quality standards and evaluation index system was developed eventually.
Results:
After 2 rounds of experts&apos|consultation, eventually formed a unified "Zunyi City nursing quality assessment standards and evaluation rules"|and established a 4 level indicators, 24 indicators in level two, the safety evaluation index system of clinical nursing of 48 level three indexes.
Conclusion:
The clinical nursing safety and quality standards and evaluation index system is the implementation of "three level general hospital accreditation standards rules"|(2011 Edition), and "three class hospital high quality nursing service evaluation standard"|as the basis, verified in the clinical practice,which is practical,scientific and strong operability.
2017 Vol. 23 (9): 1549-1551 [
Abstract
] (
108
)
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1552
Effects of Graphic and Health Education on PICC Catheter Complications in Patients with Cancer
HUANG Yichun
DOI: 10.3969/j.issn.1006-6233.2017.09.044
Objective:
To investigate the effect of graphic and health education on peripherally inserted central catheter (PICC) catheter complications in patients with cancer.
Methods:
146 patients with cancer receiving PICC catheter from the Department of Oncology in our hospital were selected and divided into 2 groups, 73 cases in the control group received traditional oral health education, 73 cases in the experiment group received graphic health education on the basis of the control group, the self care ability score, health promotion behavior, quality of life score and complication rate were compared after intervention.
Results:
Compared with the control group, each item score of self care ability scale (ESCA) and the total score were higher after intervention in the experiment group, each item score of health promoting lifestyle scale II (HPLP II) and the total score were higher after intervention,each dimension score of comprehensive quality of life questionnaire -74 (GQOL-74) and the total score were higher after intervention, with significant difference (P<0.05).
Conclusion:
The graphic and health education can improve self-care ability of patients with cancer receiving PICC catheter, significantly improve the level of health promotion behavior, improve the quality of life, reduce the incidence of complications.
2017 Vol. 23 (9): 1552-1556 [
Abstract
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139
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1557
Analysis of the Effects of Two Methods on Dental Fear in Children and Their Minimum Costs
LIU Rui, REN Yunhui, YIN Xuelian, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.045
Objective:
To make an assessment of the effects of the whole-course psychological intervention method and the local anesthetic method in the prevention of dental fear in the treatment of inlay repair after dental defect in children.
Method:
120 children who suffered from dental defect in the first mandibular molar in need of inlay restoration were divided, according to the random number table, into three groups with 40 cases in each group (including 56 female ones and 64 male ones). Group One (treated with psychological intervention): in the six-handed operation, the circuit nurse applied psychological intervention in the whole course of the treatment for the diseased children. Group Two (treated with local anesthesia): in the six-handed operation, the doctor performed local anesthesia on the defective teeth of the diseased children before treatment. Group Three (treated with the regular six-handed operation): in the six-handed operation, no intervention was performed against dental fear. The children in all the three groups received the inlay repair treatment of the defective teeth. A comparison was made in the occurence of dental fear in the three groups and an analysis was conducted of the minimum costs.
Result:
A great difference was found in the occurence of dental fear in the three groups(χ
2
＝12.950,P＝0.002), but the difference between Group One and Group Two was not remarkable(χ
2
＝0.949,P＝0.330). The per capita cost inputs in the three groups were ￥1573.46, ￥1630.48 and ￥1712.03 respectively, and that in Group One was the lowest.
Conclusion:
In children's dental treatment, the whole-course psychological intervention method is more economical than the local anesthetic method in the prevention of dental fear.
2017 Vol. 23 (9): 1557-1559 [
Abstract
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138
)
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1565
The Clinical Features of 56 cases of Pediatric Narcolepsy
ZHANG Meijie
DOI: 10.3969/j.issn.1006-6233.2017.09.048
Objective:
To analyze the clinical characteristics of narcolepsy.
Methods:
The clinical data of 56 narcoleptic children were analyzed. Video-EEG monitoring and multiple sleep latency tests were performed in all patients.
Results:
Excessive daytime sleepiness was manifested in all the patients, with disrupted nocturnal sleep. Cataplexy appeared in 38cases, and hypnagogic hallucination in 4, hypnopompic hallucination in 2, and sleep paralysis in 2, respectively.EEG and VEEG of all patients were normal. The multiple sleep latency test demonstrated a short sleep la-tency (<5 minutes) and two or more sleep onset REM periods(SOREMPs) in all patients. Four patients were misdiag-nosed with myasthenia gravis. Six children were misdiagnosed with epilepsy. Two patients were misdiagnosed with schizo-phrenia. Twenty-eight mild patients were followed up at the neurological out-patient department. Two cases of sleepiness, cata-plexy and sleep hallucination was given just behavior guidance because the parents refused to receive drug treatment. Twenty six children with severe sleepiness was treated with methylphenidate along with behavior guidance.
Conclusion:
Narcolepsy is likely to be misdiagnosed because of its mildsymptoms at onset and atypical clinical manifestations. Misdiagnosis can be reduced by means of VEEG and MSLT.
2017 Vol. 23 (9): 1565-1567 [
Abstract
] (
137
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1579
Analysis of Presciption of Antibiotics in Outpatient Department of a General Hospital
TANG Haibo, et al
DOI: 10.3969/j.issn.1006-6233.2017.09.053
Objective:
To analyze the conditions of antimicrobial drugs use in outpatient department and to provide the theoretical basis for rational use of antibiotics in the hospital.
Method:
This research was based on data collected on drug prescriptions from the hospital information system. The use of antimicrobial agents in the outpatient department was analyzed from 2013 to 2015. Ten percent of yearly antibiotic prescriptions were included in the analysis.
Result:
The results for antibiotic usage for the three year period were as follow: the outpatient department was 11.38%, 10.58% and 10.62% respectively,while the emergency department was 23.34%, 25.85% and 21.92% respectively. Our findings were consistent with the ministry of health recommendations|however, the proportion of the outpatient department was less than 20%,whereas the percentage of the emergency department was not up to 40%. As regards the prescription of 10301 antibacterial drugs,oral cephalosporin was found to be the main medicine used by OPD patients and it accounted for a hefty 85.34% of the total prescriptions. By contrast, intravenous infusions (12.61%) and intramuscular injections (2.04%) were less prescribed in the OPD. Finally, the proportion of antimicrobial agents use was found to be different in various departments, with the surgical department having the highest prescription rate. Similarly, the respiratory, pediatric and infectious diseases departments were among the departments who used most antibiotics. These results were based on systematic analysis of reviewed antibiotic prescriptions, and the error margin for the calculation was 5.85%.
Conclusion:
In summary, it can be said that the selection of antimicrobial agents and the proportion of antibiotics used in the hospital were reasonable, although, there were still some unreasonable problems caused by empirical use of antibiotics in individual departments. All said and done, the prescription of antimicrobial agents in outpatient department still need further strengthening to effectively manage their use.
2017 Vol. 23 (9): 1579-1582 [
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168
)
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