Objective To observe the clinical effect of moxibustion on body sub-health fatigue state.Methods 120 cases of body sub-health patients were randomly divided into A,B,C three groups,with 40 cases in each group.Group A was treated with moxibustion,group B was treated with acupuncture therapy,and group C (control group) did not receive any measure of treatments.Fatigue scale (FS) was adopted to the three groups respectively for measuring physical fatigue score,mental fatigue score and total fatigue score before and after the treatment.Treatment efficacy was evaluated and analyzed after three weeks of continuous treatment.Results The total score of fatigue scale was 6.10 ± 2.47、6.82± 2.36、and 10.10±2.66 respectively in group A,group B and group C.Compared with group C,the difference in group A and group B was statistically significant (P＜0.01).Compared with group B,the difference in group A was not statistically significant (P＞0.05) ; The Physical fatigue points of group A,B,C was 2.46± 2.06、3.60 ± 2.24 and 5.03 ± 2.66 respectively.Compared with C group,the difference in group A and group B was statistically significant (P＜0.01).Compared with group B,the difference in group A was statistically significant (P＜0.05).Conclusions Moxibustion and acupuncture can effectively improve patients total body sub-health state of fatigue.Moxibustion treatment showed better effects in alleviating physical fatigue,

Objective To evaluate the impact of sepsis bundle treatment on morbidity of sepsis or septic shock in burned patients. Methods A retrospective clinical study was conducted on burned patients with severe sepsis or sepsis shock in burn intensive care unit. 95 patients were divided into control group(43 patients) and study group (52 patients)according to their treatment. The relationship between sepsis bundle index and sepsis, septic shock and 28-day mortality respectively were analyzed with logistic regression analysis. The compliance of sepsis bundles,and 28-day mortality were noted. Results The 28-day mortility rate,the mobidity of sepsis and septic shock in study group was lower than that of control group (P ＜ 0. 05). It could be found that 6-hour EGDT and 24-hour EGDT was the independent protective factor of sepsis and septic shock through logistic regression analysis ,and blood gas analysis, EGDT and vasoactive drug were correlated with 28-day mortality(P ＜0. 05). Compliance with sepsis bundles of 6-hour EGDT and 24-hour EGDT in study group was only 51.9%, and 63.2% respectively. Conclusion Sepsis bundle was able to improve survival rate in severe burn patients. Compliance with sepsis bundles in burn medical staff needed a buring improve.

Objective To analyze the clinical features of patients with hemophagocytic syndrome (HPS) in autoimmune diseases (AID). Methods We collected the data of 11 patients with AID complicated with HPS in Peking Union Medical College Hospital from 2004 to 2009. The underlying diseases, clinical features, laboratory findings and treatment outcomes were retrospectively analyzed. Results Of the 11 patients,3 were male,8 were female. Mean age was (30. 7 ± 18. 3) years. The underlying diseases included Still disease ( n = 4 ), systemic lupus erythematosus ( n = 3 ), and rheumatoid arthritis, primary Sj(o)gren's syndrome, Wegener granulomatosis and Crohn disease in each one case. HPS was associated with the onset of AID ( n = 4), active infection alone ( n = 1 ) and both factors ( n = 6 ). HPS was clinically characterized by high fever ( 100% ), hepatosplenomegaly ( 72. 7% ) , lymphadenopathy ( 63.3% ) and central nervous system involvement (36. 3% ). 4 patients presented with disseminated intravascular coagulation(DIC) (36. 3% ). Laboratory data mainly manifested with cytopenia ( 100% ), liver dysfunction ( 100% ), hypofibrinogenemia ( 62. 5% ), hypertriglyceridemia ( 81.8% ), serum ferritin ＞ 500 μg/L (100%), low NK-cell activity(80% ) and hemophagocytosis in bone marrow( 100% ). Based on treating underlying infections and use of corticosteroids and immunosuppressive agents in combination with intravenous immunoglobulins(IVIG) therapy, 5 patients recovered , 6 patients died. The mortality rate was 54. 5%. DIC were associated with mortality ( r = 0. 69, P = 0. 019 ). Conclusion The episode of HPS always occurs simultaneously with multiple system involvement that was often difficult to distinguish from active AID. The present of DIC on HPS related with poor prognosis and high mortality. Corticosteroids and immunodepressant and IVIG may improve the prognosis of HPS, while anti-infection therapy is very important and necessary for the patients accompany with active infection.

Objective Through early systemic nursing intervention of cervical cancer patients for promotion of the recovery of urinary bladder function, to remove the urethral catheter in advance,and reduce the occurrence of urinary bladder dysfunction. Methods 80 cervical cancer patients after total hysterectomy were divided into the treatment group and the control group with 40 cases in each group stochastically. The treatment group was given systemic nursing( psychological nursing,pelvis bottom muscles exercising,urination discontinuance exercising,abdominal muscle exercising,Valsalva maneuver exercising, Crede press exercising,open the urethral catheter timely and individually,cheiropractic with hot roller), the control group received conventional nursing and some simple training of urinary bladder function. The time of indwelling urethral catheter after the hysterectomy was compared. Results The time of indwelling urethral catheter in the treatment group and in the control group were (9.65±49)days and (15.88±03)days respectively. The incidence rate of residual urine,urine retention and infection of urinary system after surgery in the treatment group was lower than that of the control group. Conclusions Early systemic nursing intervention can shorten the time of indwelling urethral catheter after hysterectomy, reduce the occurrence of urinary bladder dysfunction .improve the surgery effect for the cervical cancer patients and ameliorate their quality of life.

Objective To study the mechanism of glutamine dipeptide on wound healing after operations on bums. Methods Totally, 30 burned patients were randomly divided into study group and control group (15 cases in each group). All patients received parental nutrition support after operation. Study group patients were supplemented with glutamine dipeptide at a dose of 0. 5 g · kg±1 · d±1. The plasma free hydroxyproline level was measured by a standard amino acid analyzer 1 day before operation and 7 days after operation and the wound healing time was recor± ded. Results The plasma free hydroxyproline levels of both groups were higher than the normal values before opera± tion but without significant difference [control group: (2. 24 ±0. 84) fig/ml, study group: (2. 32 ±0.92) μg/ml, normal value: (1.27 ±0.44) μg/ml]. On the post±operative 7 day, the plasma free hydroxyproline level of study group [ (4. 31 ±1. 05) μg/ml] was significantly higher than that of control group [ (3. 04± 1. 01) μ/ml] (P = 0.002). The wound healing time of study group [ (29. 7±5.3) d] was shorter than that of control group but with± out significant difference [ (33. 3 ±7.5) d, P = 0. 14 ]. Conclusion The intravenous supplementation of glutamine dipeptide may increase the plasma hydroxyproline level after operation and thus promote wound healing.

Objective To study the clinical application effect of X-ray computed tomography (DR) and spiral CT in the diagnosis of emergency thoracic and abdominal trauma. Methods A total of 174 patients with emergency thoracic and abdominal trauma admitted in our hospital from November 19, 2016 to November 19, 2017 were enrolled in this study. All patients underwent DR and spiral CT examinations. The pathological diagnosis coincidence rate between the two diagnostic methods and the satisfaction with the diagnostic methods between the two groups was compared. Results In terms of pathological diagnosis, the coincidence rate of spiral CT in subcutaneous emphysema, rib fractures, scapular fractures, clavicle fractures, pulmonary contusion, pleural effusion, pneumothorax, atelectasis, mediastinal emphysema, liver injury, spleen injury, kidney injury, pancreas injury, celiac hemorrhage, mesentery laceration and diaphragmatic injury was 100. 00％. Except for pulmonary contusion, mediastinal emphysema, hematoma and kidney injury and pancreatic injury, the pathological diagnosis coincidence rate of spiral CT in the other chest trauma was higher than that of DR diagnosis, and the difference was statistically significant (P＜0. 05). The patients' satisfaction score of spiral CT diag nosis was significantly higher than that of DR diagnosis(P＜0. 05). Conclusion The spiral CT in the diagnosis of emer gency thoracic and abdomen trauma is better, which can improve the clinical diagnosis of coincidence rate, and is worthy of further recommendation.

Objective To analyze the diagnostic value of multi-slice spiral CTin patients with emergency chest pain. Methods 81 patients with chest pain admitted in the Department of Emergency in our hospital from October 27, 2016 to October 27, 2017 were investigated. All patients underwent multi-slice spiral CTexamination. The examination results of multi-slice spiral CTexamination were compared with those of conventional coronary angiography. At the same time, the patient's heart rate and satisfaction during different examinations was compared. Results There were 64 patients with coronary artery stenosis, 9 patients with aortic dissection, 8 patients with pulmonary embolism were detected by multi-slice spiral CT, accounting for 79. 01％, 11. 11％ and 9. 88％ respectively. There were 64 cases of coronary artery stenosis, 10 cases of aortic dissection and 7 cases of pulmonary embolism detected by routine coronary angiography examination, accounting for 79. 01％, 12. 35％ and 8. 64％, respectively. There was no significant difference between the results of the two examination methods (P＞0. 05). There was no significant difference in the level of heart rate between patients with multi-slice spiral CTand those with conventional coronary angiography(P＞0. 05). The patient's satisfaction with multi-slice spiral CTwas 96. 30％, which was significantly higher (P＜0. 05). Conclusion For patients with emergency chest pain, the detection of multi-slice spiral CTis similar to that of routine coronary angiography in the cause of the disease, and has little influence on the patient's heart rate, which is an ideal method for clinical diagnosis of chest pain.