目的 探討Ｃ反應蛋白(CRP)在慢性阻塞性肺疾病急性加重期(AECOPD)患者治療前、后的變化和臨床意義。方法 納入2008年1月-9月住院治療的80例AECOPD患者，分別測定應用抗生素治療前后CRP、白細胞計數(WBC)、中性粒細胞百分比(N%)、血沉和體溫，并比較這些指標的變化情況。結果 AECOPD患者在感染期CRP總陽性率為100.00%，顯著高于治療前WBC、N%、血沉和體溫的陽性率(Plt;0.05)；也顯著高于感染控制后(Plt;0.05)。 結論 CRP作為細菌性感染的敏感指標之一，也可作為指導臨床及時、正確使用或評價抗生素療效的一個指標。
【摘要】 目的 分析護理干預對纖維支氣管鏡檢查患者的心理影響。方法 2008年1月—12月，通過對100例患者的問卷調查及臨床觀察,總結分析其心理特點及所采取的護理干預措施的影響。結果 纖維支氣管鏡檢查患者的心理特點有:恐懼心理、緊張心理、消極心理等；相應的護理干預:教育性干預、行為訓練、情感支持、藥物干預等。結論 正確評估患者的心理特點,采取有效的護理干預,改善患者的心理狀況,有利于提高患者的依從性,從而提高檢查的成功率。【摘要】 目的 分析護理干預對纖維支氣管鏡檢查患者的心理影響。方法 2008年1月—12月，通過對100例患者的問卷調查及臨床觀察,總結分析其心理特點及所采取的護理干預措施的影響。結果 纖維支氣管鏡檢查患者的心理特點有:恐懼心理、緊張心理、消極心理等；相應的護理干預:教育性干預、行為訓練、情感支持、藥物干預等。結論 正確評估患者的心理特點,采取有效的護理干預,改善患者的心理狀況,有利于提高患者的依從性,從而提高檢查的成功率。
ObjectiveTo evaluate the efficacy and safety of bronchoscope in the treatment of transbronchial broncholiths.MethodsThe clinical data, treatment methods, clinical efficacy and complications of 18 patients who were diagnosed with transbronchial broncholiths were etrospectively reviewed in the Respiratory Department of the Second Hospital of Lanzhou University during January 2010 to December 2017.ResultsEighteen patients were diagnosed by bronchoscopy with a total of 22 pieces of stone for transbronchial broncholiths. An elective surgical procedure was performed in 2 cases. Six cases were treated with removing broncholiths once by foreign body forceps under bronchoscope. Repeated treatments were performed in 10 patients. Two cases underwent massive hemorrhage in the process of one-time broncholiths removal by foreign body forceps under bronchoscope, and one case suffered from bronchial fistula after the broncholiths removal, all of the above 3 patients underwent surgical treatment. All patients were followed up for 5 months without any long-term complications.ConclusionsRemoval of broncholithiasis by bronchoscopic forceps can effectively treat transbronchial broncholiths with low complication and high safety. If the broncholiths cause severe distal lung tissue injury, massive hemoptysis, bronchial fistula, or the diagnosis is unclear, surgical treatment is required. When the transbronchial broncholith is difficult to remove completely at once, batch could be chosen. First, to remove one portion which causes the obstruction of airway; and then, to remove the left part of the transbronchial broncholith by stages.
Objective To systematically review literature on the influencing factors related to adolescent sub-health problems. Methods We electronically searched the following four databases including CBM, VIP, CNKI and WanFang Data to collect Chinese literature on adolescent sub-health status and problems in China published before May 2012. Two reviewers independently screened literature, extracted data, and cross checked records. Then qualitative analysis was applied. Results According to the inclusion and exclusion criteria, 41 cross-sectional studies were included. The results of qualitative analysis showed that the influencing factors of adolescent sub-health could be classified into four categories including social factors, family factors, school factors, and interpersonal relationships. The main ones were social support, employment pressure, family economic conditions, learning burden, unhealthy habits, etc. Conclusions There are many influencing factors of adolescent sub-health with interaction. Due to the limitation of the included studies, more prospective cohort studies are needed to provide high quality evidence.
Objective To investigate the clinical effect of orthopedic robot-assisted sacroiliac joint screws in the treatment of posterior pelvic ring fractures. Methods Patients who underwent sacroiliac joint screw fixation in People’s Hospital of Deyang City between January 2018 and August 2021 were included, and the patients were divided intoa robotic group and a manual group by randomization. The robot group used robot-assisted insertion of sacroiliac joint screws, and the manual group used manual insertion of sacroiliac joint screws. The general condition, time of sacroiliac joint screw placement, intraoperative fluoroscopy times, guide needle drilling times, surgical blood loss, and Majeed pelvic function score were compared between the two groups. Results A total of 42 patients were included, and there was no significant difference in gender, age, body mass index , injury type or injury cause between the two groups (P>0.05). Finally, 21 screws were placed in 19 patients in the robotic group and 23 screws in 23 patients in the manual group. The wounds of the two groups were completely healed after operation, and there was no wound infection, iatrogenic vascular and nerve injury, and no loosening of internal fixation. There was no significant difference in screw placement time, blood loss or Majeed score between the two groups (P>0.05). The number of fluoroscopy (14.53±4.54 vs. 19.87±5.48) and drilling times (1.00±0.00 vs. 7.24±3.77) in the robotic group were less than those in the manual group, and the differences were statistically significant (P<0.05). Conclusion Orthopedic surgical robots have the advantages of minimally invasive, less fluoroscopy, and accurate screw placement in sacroiliac joint screw placement, and have good clinical results in the treatment of pelvic fractures.
Objective Based on images of pelvic CT three-dimensional reconstruction, to establish three-dimensional coordinate system of pelvis and investigate the three-axis displacement classification of pelvic fracture and its reduction principles. Methods Between June 2015 and May 2016, 21 cases of normal pelvic CT data were included in the study, and the mean pelvic three-dimensional model was established. The pelvic three-dimensional axis was established by defining the origin as the midpoint of the anterior superior iliac spine. Based on this coordinate system, a three-axis displacement classification of pelvic fracture were built. To assess the clinical guidance value of the three-axis classification, 55 cases (29 males and 26 females, aged 11-66 years with an average of 35.6 years) of pelvic fractures were analyzed by this classification, and replaced and fixed according to the principles of the reverse reduction. Results According to the theory of three-axis, pelvic fractures were divided into x-axis positive displacement/negative displacement, positive rotation/negative rotation; y-axis positive displacement/negative displacement, positive rotation/negative rotation; z-axis positive displacement/negative displacement, positive rotation/negative rotation. The average incision of included patients with pelvic fractures was 7.1 cm. The average reduction time was 12.2 minutes and the average radiation time was 55.3 s. The average time of screw implantation was 27.2 minutes. Postoperative pelvic X-ray films or three-dimensional CT showed all pelvic fracture was reducted well and the screw or plate was implanted correctly. The average intraoperative blood loss was 96.5 mL, the average operation time was 2.1 hours, and the average hospitalization time was 18.7 days. All patients were followed up 6-53 months (mean, 16.7 months). At last follow-up, according to Matta standard by pelvic radiography evaluation, there were excellent in 39 cases, good in 13 cases, and fair in 3 cases, the excellent and good rate was 94.55%. Conclusion Based on three-dimensional coordinate system, three-axis displacement classification of pelvic fracture can illustrate the displacement mode of patient simply and accurately, and can also guide the intraoperative reduction precisely.
Objective To assess the effect of problem-based learning (PBL) versus traditional methods in nursing students. Methods Computer retrieval was conducted to search for controlled studies comparing PBL and traditional methods. The quality of included studies was critically evaluated and data were analyzed by using The Cochrane Collaboration’s RevMan 5.0 software. Results A tota1 of 321 articles were retrieved, but only l1 were included. Metaanalyses showed that there was no significant difference between PBL and traditional methods in the objective knowledge of nursing students (SMD 0.12, 95%CI -0.32 to 0.56, P=0.6gt;0.05); but PBL was superior to traditional methods in the training of critical thinking (WMD 11.52, 95%CI 6.29 to 16.74), conflict resolution skills (WMD 8.09, 95%CI 5.02 to 11.16), clinical problem-solving skills (WMD 0.43, 95%CI 0.22 to 0.64), and communication skills (WMD 1.56, 95%CI 0.17 to 2.95). Although no significant difference was identified in the training of clinical decision-making skills, collaborative skills, and self-directed learning skills, PBL tended to be superior to traditional methods. Conclusion PBL tends are associated with better learning results among nursing students compared with traditional methods. However, most trials included in the review were of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.
Objective To explore the application of peer education in TB prevention at middle schools in Kai County of Chongqing and compare it with traditional education, and to provide theory support for further policy making. Methods Four complete middle schools were randomly selected as the control group, the peer education group, the traditional education group and the combined group of peer education and traditional education, respectively. Effect evaluation was performed one month later (instant evaluation) and six months later (long-term evaluation), respectively, after the intervention period. Results The instant and long-term evaluation showed that the knowledge, attitude and practice scores of the three intervention groups were higher than the scores before intervention or those of the control group (Plt;0.01). Besides, the behavior score of the peer education group had no significant difference between instant and longterm evaluation. All scores in the instant evaluation were higher than those of long-term evaluation both in the peer education group and the traditional education group (Plt;0.01). For the knowledge, attitude and practice scores, there was no significant difference between instant and long-term evaluation in the combined group of peer education and traditional education. Conclusion Compared with the peer education group and the traditional education group, the combined group achieves an enduring effect. There is obvious instant effect in the traditional education group, and peer education has a long-term influence on students’ behavior.
Objective To evaluate the effect of maternal and child health care training at the primary levelin Chongqing, and to detect and solve the existing problems so as to provide evidence for the further training andmonitoring. Methods The rural maternal and children health staff of Rongchang County, Chongqing were trained. A test and, in-depth interviews and field observation wereused to evaluate the training process and results. Results Seventynine members of the Clinical Skill Group (CS) and 73 members of Health Education Group (HE) have taken the test. The median score of CS before training was 11 while it was 23 after training (Plt;0.01); the median score of HE was 18 before training while it was 25 after training (Plt;0.01). The scores change of thetest before and after training showed that the training had a good result. Conclusion Primary level health staff members had poor knowledge of maternal and children health care. This training enhanced their knowledge of maternal and child health care improved their skill. Organizers should ensure that the training contents are rich,novel, and varied. Maternal and child health staff should be willing to join the training.
ObjectiveTo investigate the effect of hydrogel from acellular porcine adipose tissue (HAPA) on the survival of transplanted adipose tissue.MethodsFor in vitro study, adipose tissue and HAPA-adipose tissue complex were cultured in normoxia and hypoxia atmospheres for 24 and 72 hours. TUNEL and Perilipin immunofluorescence staining were performed to observe the effect of HAPA on apoptosis and survival of adipocities. For in vivo study, 42 healthy male nude mice (4-6 weeks old) weighing 15-18 g were randomly divided into adipose group (group A), 10%HAPA group (group B), 20%HAPA group (group C), 30%HAPA group (group D), 40%HAPA group (group E), and 50%HAPA group (group F) according to different HAPA/adipose tissue volume ratio (n=7). For each group, 1 mL adipose tissue or HAPA-adipose tissue complex was injected subcutaneously into the dorsum of the nude mice. At 4 weeks after transplantation, 7 nude mice in each group were sacrificed and grafts were harvested, gross observation, volume measurement, ultrasound examination, and histologic staining (HE staining, CD31 and Perilipin immunofluorescence stainings) were applied.ResultsHypoxia showed a tendency of promoting adipose tissue necrosis and apoptosis, while HAPA exhibited an obvious effect of inhibiting cell apoptosis in vitro study (P<0.05). For in vivo study, grafts of all groups had intact fibrocapsule. No obvious signs of infection and necrosis were observed at 4 weeks. Volume shrinkage was observed in all groups, however, the groups A-D had significantly higher volume retention rate than groups E and F (P<0.05). Ultrasound examination showed that there were no significant difference in the number and volume of liquify area of the grafts in each group (P>0.05). With the increase of HAPA’s volume ratio, HE staining proved an improved fat integrity while a gradually decreased vacuoles and fibrosis. CD31 immunohistochemical staining showed that the number of neo-vascularisation in groups E and F were significantly higher than those in groups A-D (P<0.05). Perilipin immunofluorescence staining showed that with the increase of HAPA volume ratio, the number of living adipocytes increased gradually, and more new adipocytes could be seen in the field of vision.ConclusionAs the volume ratio of HAPA gradually increased, the survival of transplanted adipose tissue also increased, but the volume retention rate decreased gradually. 30%HAPA was considered the relative optimal volume ratio for its superior adipose tissue survival and volume retation rate.