The coexistence of cognitive impairment and physical frailty in maintenance hemodialysis (MHD) patients is known as cognitive frailty. It has emerged as a novel complication in MHD patients and increases the risk of adverse outcomes such as falls, fractures, functional impairment and death. Timely intervention can delay or even reverse the development of cognitive frailty to dementia, thereby reducing the risk of adverse outcomes and improving the quality of life of patients. Based on this literature review method, this article summarizes the domestic and foreign research progress on the epidemiology, assessment tools, influencing factors and intervention measures of cognitive frailty in MHD patients, aiming to provide reference for clinical staff to carry out early screening and intervention of cognitive frailty in MHD patients.
Objective To investigate the protective effects of ulinastatin on acute lung injury ( ALI)induced by seawater drowning in rats. Methods Thirty male SD rats were randomly divided into three groups, ie. a control group, a model group, and an ulinastatin treatment group. The rats in the model group and the ulinastatin treatment group received intratracheal artificial seawater ( 4 mL/kg) instillation. Then the ulinastatin treatment group received ulinastatin ( 100 000 U/kg) injection after infusion of seawater while the model group received an injection of same amount of saline. The rats were sacrificed at 4 hours after instillation. The pathological changes of lung were evaluated by hematoxylin-eosin stain under light microscope. Lung wet/dry weight ratios were measured to assess the level of pulmonary edema.Concentrations of tumor necrosis factor ( TNF) -α, interleukin ( IL) -1β, IL-6, and IL-10 in bronchoalveolar lavage fluid ( BALF) were detected by enzyme-linked immunosorbent assay ( ELISA) . The myeloperoxidase activity in lung tissue homogenates were measured by colorimetric method. Results Ulinastatin treatmentsignificantly relieved the decline of PaO2 and lung pathological changes, inhibited myeloperoxidase activity,and reduced lung wet/dry weight ratios. Ulinastatin also inhibited the release of TNF-α, IL-1β, and IL-6,whereas increased the expression of IL-10 simultaneously. Conclusion Ulinastatin attenuates seawater induced ALI, which may be related to its inhibitory effects on inflammation reaction through regulating cytokine secretion.
The Second People’s Hospital of Yibin was taken over by West China Hospital of Sichuan University into its close hospital alliance, and simultaneously undertook the task of construction of regional hospital alliance in Yibin city. The article introduces the experiences of the Second People’s Hospital of Yibin in the high-quality development of novel healthcare system. Led by West China Hospital of Sichuan University and based on all-level medical institutions in Yibin, the Second People’s Hospital of Yibin preliminarily established a four-level hierarchical medical system as “province, city, county, village” model, according to the guide of governments within the whole region. It aims to propose a “Yibin model exploration” in hospital alliance construction based on the western regional situation.
目的 應用128層螺旋CT冠狀動脈成像，探討冠狀動脈不同成分斑塊與狹窄程度的診斷價值。 方法 對2010年3月－2012年10月150例臨床擬診冠心病及確診冠心病患者的128層螺旋CT冠狀動脈成像檢查，冠狀動脈影像表現由兩位心血管CT診斷醫師獨立判斷冠狀動脈斑塊成分及測量冠狀動脈狹窄程度。應用Circulation血管分析軟件，分析冠狀動脈斑塊成分與狹窄程度之間的相關性。 結果 150例患者中，共發現319處斑塊，其中軟斑塊104處，纖維、混合斑塊103處，鈣化斑塊112處。冠狀動脈輕度狹窄114處中，鈣化斑塊86處 （75.4%）；冠狀動脈中度狹窄113處中，纖維、混合斑塊75處（66.3%）；冠狀動脈重度狹窄92處中，軟斑塊68處（73.9%）。 結論 128層螺旋CT冠狀動脈成像能夠有效檢測患者冠狀動脈斑塊的成分及準確判斷冠狀動脈狹窄程度。