Objective To study factors used to predict 30-day mortality and favorable outcomes to intracerebral hemorrhage (ICH) in young adult subjects and to estimate the reliability of these predictors.Methods Data of 175 acute ICH patients selected from 201 patients admitted to our hospital from 2008 to 2011 were reviewed retrospectively.Patients were assessed with Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) and routine laboratory examinations after admission.Independent predictors of 30-day mortality or good outcome (modified Rankin score,0-2) were identified by stepwise logistic regression.Results There were 90 male and 85 female,and 142 survivals and 33 deaths.The modified Rankin score (mRS) of survival group was ＜6 and mRS =6 in death group,and mRS ＜3 in good outcome group and mRS ＞ or =3 in poor outcome group.Independent factors for 30-day mortality were hypertension (P =0.023) or hyperglycemia (P =0.007),infra-tentorial ICH (P =0.000),large ICH volume (P =0.008),low Glasgow Coma Scale (GCS) scores (P =0.000),high white blood cell count (P =0.000),higher blood glucose level (P =0.039) and prothrombin time (PT) (P =0.001) after admission.Independent factors for 30-day good outcome were younger age (P =0.001),normal blood pressure (P=0.010) or absence of hyperglycemia (P=0.028),lower NIHSS scores (P=0.000),small ICH volume (P =0.000),low white blood cell (WBC) count (P =0.000),lower blood glucose level (P =0.012) or lower systolic blood pressure (SBP) level (P =0.000) at admission.The NIHSS score and GCS score were excellent predictors,while the SBP level,WBC count and ICH volume were fine predictors.Conclusions Overall prognostic factors should be integrated to get high reliabilities for predicting the outcomes of ICH in young people.

OBJECTIVETo observe therapeutic effect of the method for nourishing blood and moisturizing eye on xerophthalmia.

METHODSFifty-one cases of xerophthalmia were randomly divided into a treatment group and a control group. The treatment group were treated by acupuncture, moxibustion with Chinese medicine, and auricular point pressing, and the control group were treated with dripping of artificial tears. Local symptoms of eyes, tear secretion amount (Schirmer method) and BUT were observed before and after treatment.

RESULTSThe total effective rate of 88.5% in the treatment group was better than 52.0% in the control group (P<0.05).

CONCLUSIONThe method for nourishing blood and moisturizing eye is a better therapy for xerophthalmia.

Acupuncture ; Acupuncture Therapy ; Eye ; Humans ; Moxibustion ; Xerophthalmia ; therapy

Objective? To explore the effects of "1+N" extended nursing on medication compliance, self-management ability and metabolic indicators among discharged type 2 diabetes patients. Methods? From October to December 2017, we selected 300 discharged type 2 diabetes patients from Department of Endocrinology from Shaanxi Provincial People's Hospital as subjects. All of the patients were divided into intervention group and control group with the method of random number table, 150 cases in each group. Control group carried out telephone follow-up post discharge. On the basis of telephone follow-up, intervention group implemented "1+N" extended nursing. We compared the fasting blood glucose (FBG), bisphosphoglyceric acid (BPG), glycosylated hemoglobin (HbA1c), body mass index (BMI), scores of 8-item Morisky Medication Adherence Scale (MMAS-8) and the scoring rate of Diabetes Self-care Scale (2-DSCS) of patients between two groups 6 months after follow-up. Results? After intervention, the FBG, BPG and BMI of intervention group were lower than those of control group with statistical differences (P＜0.05). The number of patients with the high level of compliance of MMAS-8 in intervention group was more than that in control group with a statistical difference (P＜0.05).The item scoring rate of 2-DSCS of patients in intervention group were higher than those in control group with statistical differences. Conclusions "1+N" extended nursing can improve metabolic indicators, medication compliance and self-management ability among type 2 diabetes patients.

Objective To investigate the efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with unresectable or advanced hepatocellular carcinoma(HCC).Methods A retrospective analysis was performed for the patients with unresectable/advanced HCC who attended six hospitals from January 1,2019 to March 31,2021,and all patients received camrelizumab monoclonal antibody treatment,among whom 84.8%also received targeted therapy.According to the age of the patients,they were divided into elderly group(≥65 years)and non-elderly group(＜65 years).The two groups were assessed in terms of overall survival(OS),progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),and immune-related adverse events(irAE).The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups;the independent samples t-test was used for comparison of normally distributed continuous data,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups.The Kaplan-Meier method was used for survival analysis,and the log-rank test was used for comparison of survival curves.Univariate and multivariate Cox proportional hazards regression analyses were used to determine the independent influencing factors for PFS and DCR at 6 months.Results A total of 99 HCC patients were enrolled,with 27 in the elderly group and 72 in the non-elderly group.The elderly group had an OS rate of 67.8%,an ORR of 44.4%,and a DCR of 74.1%at 12 months and a median PFS of 6.4(95%confidence interval[CI]:3.0-12.4)months,with no significant differences compared with the non-elderly group(all P＞0.05).The median OS was unavailable for the elderly group,while the non-elderly group had an OS of 18.9(95%CI:13.0-24.8)months;there was no significant difference between the two groups(P=0.485).The univariate and multivariate Cox regression analyses showed that major vascular invasion(MVI)was an independent risk factor for PFS(hazard ratio[HR]=2.603,95%CI:1.136-5.964,P=0.024)and DCR(HR=3.963,95%CI:1.671-9.397,P=0.002)at 6 months,while age,sex,etiology of HBV infection,presence of extrahepatic metastasis,Child-Pugh class B,and alpha-fetoprotein＞400 ng/mL were not associated with PFS or DCR at 6 months.For the elderly group,the incidence rates of any irAE and grade 3/4 irAE were 51.9%and 25.9%,respectively,with no significant differences compared with the non-elderly group(P＞0.05),and skin disease was the most common irAE in both groups(39.4%).Conclusion Camrelizumab monoclonal antibody combined with molecular-targeted therapy has similar efficacy and safety in patients with unresectable/advanced HCC aged≥65 years and those aged＜65 years.MVI is associated with suboptimal response to immunotherapy and poor prognosis.

Objective:To evaluate the optimization effect of ultrasound-guided erector spinae plane block (ESPB)combined with general anesthesia on Nuss procedure in pediatric patients with pectus excavatum undergoing Nuss procedure.Methods:One hundred and eight pediatric patients of either sex, aged 7-18 yr, with body mass index within the normal range, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective Nuss procedure, were randomized into 3 groups ( n=36 each) using a random number table method: ultrasound-guided ESPB combined with general anesthesia group (group E), thoracic epidural anesthesia plus general analgesia group (group T), and general analgesia group (group G). Pediatric patients received ultrasound-guided bilateral ESPB (0.3% ropivacaine was injected, 0.5 ml/kg bilateral total volume [maximum 20 ml]) or thoracic epidural anesthesia (0.3% ropivacaine 0.5 ml/kg [maximum 20 ml/side]) after induction of anesthesia in group E and group T, respectively. All the three groups underwent general anesthesia, anesthesia was induced with propofol 2-3 mg/kg, sufentanil 0.3-0.5 μg/kg and cis-atracurium 0.1-0.2 mg/kg and maintained with propofol 6-10 mg·kg -1·h -1 and remifentanil 0.1-0.3 μg·kg -1·min -1. The patients were endotracheally intubated and mechanically ventilated after anesthesia induction. The parent-controlled intravenous analgesia (PCIA) was used for patients in all the three groups postoperatively. The consumption of intraoperative remifentanil and postoperative consumption of sufentanil for PCIA in each period after surgery were recorded. The time to the first rescue analgesia, consumption of ibuprofen and postoperative complications were also recorded. Results:Compared with group G, the intraoperative consumption of remifentanil and postoperative consumption of sufentanil for PCIA in each period were significantly decreased, the time to the first rescue analgesia was prolonged, and the consumption of ibuprofen was decreased in group E ( P<0.05). There was no significant difference among the three groups ( P>0.05). Conclusions:ESPB combined with general analgesia is helpful in reducing postoperative hyperalgesia in pediatric patients undergoing the Nuss procedure.