Objective To research the effects of mechanic auxiliary expectoration on prevention of pneumonia of patients with artificial airway.Methods According to the admission number,116 patients with establishment of artificial airway were divided into treatment group and control group,and 58 cases in each group.Hama mechanic assisted expectoration was used in the treatment group,while traditional chest percussion in the control group.Then,expectoration effect,pulmonary infection,comfort of patients and operation feeling of nursing staff were observed and statistical analyzed.Results The incidence of pneumonia (5 vs 14),sputum volume [(38.6 ± 4.1 ml/d vs 33.8 ± 3.3 ml/d)],expectoration effective cases (18 vs 12),expectoration markedly effective cases (32 vs 26) between treatment group and control group were significantly significant (t/x2 =5.098,2.021,-2.334,respectively; P ＜0.05).Significant difference were found in the comfort of the patients and operating experience of nursing staff (x2/Z =-5.097,11.226,-3.250,respectively; P ＜ 0.01).Conclusions Mechanic auxiliary expectoration can improve sputum drainage of patients with artificial airway,reduce the rates of lung infection and nursing workload,improve patient comfort.It' s worth popularizing in the clinical application.

Objective:To investigate the clinical characteristics in older adult patients with sepsis and heart failure, and to analyze the influential factors of prognosis.Methods:Eighty-eight older adult patients with sepsis and heart failure who received treatment at Lishui Central Hospital from January 2020 to December 2022 were retrospectively included in the heart failure group. Eighty-eight older adult patients with sepsis, who did not have heart failure, were selected in a 1:1 ratio to form a non-heart failure group. Based on their survival status during hospitalization, the patients in the heart failure group were divided into two subgroups: the survival group and the death group. Logistic regression analysis was performed to identify the risk factors associated with the development of heart failure and adverse disease outcomes in older adult patients with sepsis.Results:There were no statistically significant differences in sex, smoking history, alcohol consumption history, history of hypertension, and history of diabetes between the heart failure group and the non-heart failure group (all P > 0.05). However, the proportion of patients aged 75 years or older in the heart failure group was 52.27% (46/88), which was significantly higher than the proportion in the non-heart failure group [34.09% (30/88), χ2 = 5.93, P < 0.05]. The proportion of patients with respiratory system infections in the heart failure group was 53.41% (47/88), which was significantly higher than the proportion in the non-heart failure group [29.55% (26/88), χ2 = 10.37, P < 0.05]. Logistic regression analysis showed that advanced age and respiratory system infections are independent risk factors for the development of heart failure in patients with sepsis. Among patients with sepsis and heart failure, 45 survived and 43 died, resulting in a mortality rate of 48.86%. The average age of patients in the death group was (76.27 ± 4.14) years, which was significantly higher than that in the survival group [(72.29 ± 4.06) years, t = 4.55, P < 0.05]. The brain natriuretic peptide level and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in the death group were (636.70 ± 70.29) pg/mL and (31.93 ± 3.08) points, respectively, both of which were significantly higher than those in the survival group [(552.80 ± 54.66) pg/mL, (27.06 ± 3.80) points, t = 6.27, 6.59, both P < 0.05]. The lactate clearance rate and serum albumin level in the death group were (13.63 ± 4.84)% and (26.09 ± 4.77) g/L, respectively, both of which were significantly lower than those in the survival group [(19.94 ± 5.07)%, (30.55 ± 5.17) g/L, t = 5.97, 4.20, both P < 0.05]. Logistic regression analysis showed that in patients with sepsis and heart failure, advanced age, elevated serum brain natriuretic peptide levels, and high APACHE II scores are risk factors for poor prognosis and death. A high lactate clearance rate at 24 hours and elevated serum albumin levels are protective factors for survival. Conclusion:Advanced age and respiratory system infections increase the risk of heart failure in patients with sepsis. Advanced age, elevated brain natriuretic peptide levels, and high APACHE II scores are associated with an increased risk of death in these patients. High lactate clearance rates and elevated serum albumin levels are indicative of a reduced risk of death in patients with sepsis.

Objectives To investigate the epidemiological and clinical characteristics of dyslipidemia as well as its treatment and influence on accompanying diseases in impaired glucose status among inpatients. Methods A cross-sectional survey was conducted among the inpatients registered in ten university hospitals of Guangdong, China during the week before the Diabetes Day in 2004. The fasting blood glucose (FBG), lipid profiles, BMI, waist to hip ratio (WHR) and concomitant disorders of the first screen during the hospitalization period were recorded. Those who had FBG level from 5.6 to 6. 9 mmol/L and not been previously diagnosed diabetes (PDM) underwent oral glucose tolerance test (OGTF). Results Of the 8753 inpatients investigated, 1067 eases had complete medical records(CMR case) including PDM cases and previously non-diagnosed diabetes ones with FBG ≥ 5. 6 mmol/L. Of the previously non-diagnosed diabetes cases with FBG levels from 5.6 to 6.9 mmmol/L, 65.8% accepted OGTT. Of the CMR cases, 41.9% had PDM, 21.7% was newly diagnosed diabetes mellitus (NDM), 29. 1% had impaired glucose regulation (IGR) and only 7.3% had normal glucose tolerance (NGT). The TG levels in NDM and PDM group were higher than those in IGR and NGT group (P < 0.05, respectively). The HDL-C levels in IGR, NDM and PDM group were lower than those in NGT group (P < 0.05, respectively). Sixty-nine point six percent of the diabetes mellitus (DM) inpatients was accompanied with dyslipidemia and the rate was higher than those in NGT (56.4%) and IGR inpatients (52.5%, P <0.05, respectively). Only 22. 8% of the PDM inpatients underwent treatment of dyslipidaemia and just 3.4% achieved the target suggested by the guideline of ATP-Ⅲ. BMI was higher and waistline longer in the PDM and NDM inpatients than those in the NGT cases (P <0.05, respectively). Seventy-two point eight percent of the PDM inpatients was complicated with more than one type of vascular diseases. Nine point seven percent and 0. 2% of the NDM inpatients were tormented by diabetic nephropathy and diabetic retinopathy respectively. Conclusions More inpatients with accompany DM or IGR had concomitant dyslipidemia than those with NGT, which included hypertriglyccridemia, hypo-high-density lipoproteinemia and metabolic syndrome. Concomitant vascular diseases were more frequently found in PDM inpatients than in the others. Some of the NDM and IGT inpatients were complicated with microvascular diseases.

Increasing lines of evidence has been accumulated that nitric oxide (NO) and nitric oxide synthase (NOS) distribute plentifully in the rostral ventrolateral medulla (RVLM) and contribute to cardiovascular regulation. In the present study, the expressions of neuronal and inducible isoform of NOS (nNOS and iNOS) were observed in the RVLM of acute myocardial ischemia (AMI) Wistar rats experienced electroacupuncture (EA) treatment, thereby the cardiovascular effects of NO in the RVLM were investigated and the mechanism of acupuncture effect on AMI was inferred. The results indicated that in the AMI rats, cardiac functions were markedly attenuated with high serum level of brain natriuretic peptide (BNP) and norepinephine (NE), the number of nNOS-immunoreactive cells and nNOS mRNA exprossion in the RVLM area were increased, while those of iNOS were lowered. EA at "Neiguan" acupoints (Pe 6) 30 min daily for successive 5 d resulted in an improvement of the cardiac functions, decreases in NE and BNP levels; it also increased the expression of iNOS and decreased the expression of nNOS in the RVLM. These results suggest that the curative effect of acupuncture on AMI is possibly attributable to the differential regulation of NOS/NO in the RVLM, leading to decreased sympathetic outflow and improvement of cardiac functions.
Acupuncture Therapy ; Animals ; Electroacupuncture ; Medulla Oblongata ; metabolism ; Myocardial Ischemia ; metabolism ; therapy ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type I ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Rats ; Rats, Wistar

This article reviewed the application of virtual reality in motor functional training,management of pain,psychological therapy,and so on,and discussed the further development in China.

Objective To explore the effect of clinical nursing pathway on the patients with enterostomy.Methods Totals of 36 patients with enterostomy were randomly divided into experimental group and control group,and the experimental group received the nursing of the clinical nursing pathway while the control group received the routine nursing.The complications of enterpstomy,the patient satisfaction,the average hospitalization days and the expenses were observed and compared between two groups.Results There was significantly difference between experimental group and control group in the complication rate (0％ vs 27.77％ ),the length of the mean hospitalization ( 16.12 ± 5.46 d vs 21.18 ± 4.88 d),and the expenses (20325.68 ±5676) vs (22348.18 ±4 479.90),(x2 =4.587 8,t =-2.88,-3.372,respectively;P ＜0.05 ).Patients' satisfaction of experimental group (94.44％) was significantly higher than that of control group (55.55％),( x2 =7.251 7,P ＜ 0.05 ).Conclusions The application of clinical nursing pathway can reduce the complications of enterostomy and patients' sufferings,shorten the mean hospitalization,reduce the expenses,improve the nursing quality and patients' satisfaction.

OBJECTIVE: To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture, China. METHODS: A total of 16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers. A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December, 2016 to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia. RESULTS: Of the 22 294 neonates born alive, 733 (3.29%) were diagnosed with neonatal asphyxia, among whom 627 had mild asphyxia and 106 had severe asphyxia. The neonates with low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight had a higher incidence of severe asphyxia (P<0.05). CONCLUSIONS The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher. Low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight may be related to the development of severe neonatal asphyxia.
Asphyxia Neonatorum ; epidemiology ; China ; Humans ; Incidence ; Infant, Newborn ; Retrospective Studies

OBJECTIVEGlycogen debranching enzyme (AGL) plays an important role in complete degradation of the glycogen, and has two independent catalytic activities, i.e., those of alpha-1, 4-glucanotransferase (EC 2.4. 1.25) and amylo-1,6-glucosidase (EC 3.2. 1.33). A deficiency in activities of AGL causes excessive accumulation of glycogen with short branched outer chains and results in glycogen storage disease type III (GSD III; MIM #232 400), an autosomal recessive inborn disorder of glycogen metabolism. The present study aimed to investigate the mutation of AGL in 10 Chinese patients with GSD III.

METHODClinical and laboratory data of 10 patients with typical clinical manifestations of GSD III suggesting hypoglycemia, hyperlipidemia, increased creatine-phosphokinase and its isozyme were collected. The coding regions and their flanking introns of AGL gene of the 10 patients were amplified by PCR and analyzed by direct DNA sequencing. All the mutated alleles were confirmed by bidirectional DNA sequencing. The 3 novel splicing mutations were analyzed by restriction fragment length polymorphism (RFLP) in 50 healthy children (control). The 2 small deletions (c.408-411delTTTG, c.2717-2721delAGATC) were analyzed by fluorescent polymerase chain reaction and gene scan analysis to confirm the number of deleted bases.

RESULTThirteen different mutations were identified, including 4 splicing mutations (IVS6 + 1G > A, IVS6-1G > A, IVS14 + 1G > T, IVS26-2A > C), 5 nonsense mutations (R469X, R864X, S929X, R977X, Y1428X), 3 small deletions (c.408-411delTTTG, c.2717-2721delAGATC, c.2823delT) and 1 insert mutation (c.4234insT). Except for IVS14 + 1G > T, R864X, and R977X, the other 10 mutations are novel; 18 mutated alleles were identified in the 20 alleles (90%). IVS14 + 1G > T was the most frequently seen mutation, accounting for 5 of 20 (25%) alleles examined. None of homozygote and heterozygote of the 3 novel splicing mutations was found in the 50 healthy controls by RFLP analysis. With the fluorescent polymerase chain reaction and gene scan analysis, c.408411deTTTG mutation and c.2717-2721delAGATC mutation were confirmed to have 4 and 5 bases deletion respectively.

CONCLUSIONThirteen mutations were identified in the 10 cases with GSD III, with 10 novel mutations. IVS14 + 1G > T was a relatively common mutation. This study revealed the heterozygosity of AGL gene in Chinese patients with GSD III.

Adolescent ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; Child, Preschool ; DNA Mutational Analysis ; Glycogen Debranching Enzyme System ; genetics ; Glycogen Storage Disease Type III ; genetics ; Humans

Objective: To observe the clinical efficacy of addition and subtraction therapy of Xuanshen Ganju Tang combined with Sanniutang to post infection cough (PIC) with lung injury caused by dryness and heat, and investigate its effects on allergic inflammation and neurogenic inflammatory mediators.Method: One hundred and eighty eligible patients with PIC were randomly divided into control group (58 cases) and observation group (122 cases) according to the visiting sequence. Patients in control group got compound methoxyphenamine capsules, 2 capsules/time and tid. Patients in observation group got addition and subtraction therapy of Xuanshen Ganju Tang,combined with Sanniutang, 1 dose/day. The treatment course was 7 days in both groups. Symptom scores for cough (day and night), visual analogue scale of coughing (VAS) and scores for lung injury caused by dryness and heat injury were graded. Time to relieve a cough, time to relieve symptoms, time to vanish cough, and cough recurrence were recorded. Life quality was evaluated by cough-specific quality of life questionnaire (CQLQ), and the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, IL-8 and substance P in sputum neurogenic inflammatory mediators (SP), neuropeptide A (NKA) and calcitonin gene related peptide (CGRP) were detected.Result: Ridit analysis showed that the clinical efficacy in observation group was better than that in control group (P<0.05). After treatment, scores of coughing at daytime and night, VAS and lung injury caused by dryness and heat were all lower than those in control group (P<0.01). Time to relieve a cough, time to relieve symptoms, and time to vanish cough were all shorter than those in control group (P<0.01). Remission rate of cough and vanishing rate of cough in observation group were higher, while recurrence rate of cough was lower than those in control group (P<0.05). Expect for emotional health and fear of personal safety, scores of other items in CQLQ, the total score and levels of TNF-α, IL-1β, IL-6, IL-8, SP, NKA and CGRP in observation group were all lower than those in control group (P<0.01).Conclusion: Addition and subtraction therapy of Xuanshen Ganju Tang combined with Sanniutang can control systems of cough, shorten coughing course, reduce recurrence rate, improve patients' life of quality, and can inhibit allergic inflammation and neurogenic inflammatory mediators in the treatment of PIC with symptom of lung injury caused by dryness and heat, with a better clinical efficacy than pure compound methoxyphenamine capsules.

【Objective】 To strengthen the detail management of plateletpheresis venipuncture so as to reduce repeated puncture and further retain apheresis donors. 【Methods】 1 930 donations, involving 324 donors(including 92 first-time donors), with conventional venipuncture from October 1, 2018 to September 30, 2019 (controls) were compared with 1 873 donations, involving 353 donors(including 101 first-time donors), with optimized venipuncture from October 1, 2019 to September 30, 2020(experiment). The repeated puncture rate of the two groups and that contributed by rotating and fixed phlebotomists, respetively, the profile of donors suffered several repeated puncture and the re-donation rate of first-time apheresis donors were analyzed. 【Results】 The rate of secondary puncture in the experimental group(1.07%, 20/1 873) was lower than that in the control group(3.52%, 68/1 930)(P<0.05). the rate of secondary puncture in the experimental group of rotating blood collection nurses(2.04%, 7/343) was lower than that in the control group(4.87%, 52/1 067)(P<0.05). the rate of secondary puncture in the experimental group of fixed blood collection nurses(0.85%, 13/1 530) was lower than that in the control group(1.85%, 16/863)(P<0.05). Experimental group fixed blood collection nurses secondary puncture rate and rotation blood collection nurses no difference(P>0.05). Control group fixed blood collection nurses had secondary puncture rate(1.85%, 16/863)lower than rotation blood collection nurses(4.87%, 52/1 067)(P<0.05). Experimental group of the same blood donor observation period occurred 1, 2 and above the rate of secondary puncture [5.10%(18/353)、0.28%(1/353)] were lowerthan the control group [10.19%(33/324)、4.01%(13/324)] (P<0.05). the re-donation rate of first-time platelet donors(67.33%, 68/101)was higher in experimental group than in control group(50.00%, 46/92)(P<0.05). 【Conclusion】 The repeated puncture rate has been significantly decreased by strengthening the detail management of apheresis venepuncture, which promotes, caring for blood donors and conducive to the recruitment and retention of apheresis donors.