OBJECTIVETo explore the effective therapy for maintenance hemodialysis patients in dificiency syndrome in end-stage renal disease.

METHODSNinety-seven cases were divided into an observation group (51 cases) and a control group (46 cases) randomly, and routine western medicine was used in both of them. On this base, moxibustion was used in Zusanli (ST 36) and Sanyinjiao (SP 6) in paper-tube-moxibustion equipment in the observation group. Evaluate the therapeutic effect on symptoms by comparing the symptom scores in two groups before and after treatment.

RESULTSAll the symptom scores in the observation group were improved after treatment, and the differences were significant (all P < 0.05). Among all symptoms, the most improved ones included lassitude and fatigue, short breath and aversion to talk, poor appetite, soreness and softness of waist and knees, aversion to cold, cold extremities and so on. In the aspect of therapeutic effect on symptoms, the total effective rate in observation group (64.7%, 33/51) was higher than that in control group (23.9%, 11/46), and the difference was significant (P < 0.05).

CONCLUSIONMoxibustion can improve the clinical symptoms of maintenance hemodialysis patients in end-stage renal disease, and can generate some therapeutic effect to the dificiency syndrome of this disease.

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Kidney Failure, Chronic ; therapy ; Male ; Middle Aged ; Moxibustion ; Renal Dialysis ; Young Adult

Objective To explore the correlation between asymptomatic bacteriuria(AB)and surgical site infection(SSI)in middle-aged and elderly women undergoing open hysterectomy.Methods The clinical data of 1469 middle-aged and elderly women undergoing open hysterectomy in the Third Affiliated Hospital of Guizhou Medical University from June 2011 to August 2018 were retrospectively analyzed.Factors associated with SSI after operation were analyzed by univariate and multivariate regression models to identify the relationship of AB with SSI after open hysterectomy.Results Of these 1469 patients,101(6.88%)had SSI and 124 had AB[including 14 patients(11.29%)with infections].In addition,1345 patients had no AB,among whom 87(6.47%)had infections.Thus,the infection rate in patients with AB was significantly higher than that in patients without AB(=4.123,=0.042).Univariate analysis showed AB,history of diabetes mellitus,surgical procedure,length of stay(>15 d),season(summer and autumn),body mass index(≥25 kg/m ),nature of lesions(malignant tumors),ASA grade(>grade Ⅱ),incision length(≥10 cm),and operative time(≥3 h),bleeding volume(≥1000 ml),serum albumin concentration(<30 g/L),blood glucose(≥10 mmol/L),and hemoglobin concentration(<90 g/L)were associated with SSI(all <0.05).Multivariate analysis showed that AB,nature of lesions(malignant tumors),blood glucose(≥10 mmol/L),operative time(≥3 h),and ASA grade(>grade Ⅱ)were risk factors for SSI in these patients(all <0.05). Conclusions AB is one of the risk factors for SSI in middle-aged and elderly women undergoing open hysterectomy.Screening and treatment of AB before surgery can reduce the risk of SSI.ASA grading shall be performed before surgery before corresponding preparation was offered.Effective control of blood glucose,improved surgical skills,and shorter operative time are helpful for lowering postoperative SSI.
Aged ; Bacteriuria ; complications ; Blood Glucose ; Female ; Humans ; Hysterectomy ; adverse effects ; Middle Aged ; Operative Time ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; complications

Objective: To investigate the economic burden of bacillus Calmette-Guérin (BCG) lymphadenitis in Shandong Province. Methods: From May 2011 to December 2019, 304 patients applying for the province-level compensation of BCG lymphadenitis was selected from Shandong Province in this study. The basic situation, vaccination, outpatient (inpatient) records, cost and relevant information of those patients were collected to calculate the direct economic burden (including direct medical costs and direct non-medical costs), indirect economic burden and total economic burden. Comparison of the difference of economic burden of cases with different characteristics was taken. Results: The M(Q₁,Q₃) of age of BCG lymphadenitis patients was 3 (2, 4) months, among which 239 cases (78.6%) were male, 71 cases (23.4%) had lymphadenopathy, and 227 cases (74.7%) underwent surgery.The number of outpatient only, inpatient only and outpatient then inpatient was 25.7% (78 cases), 7.2% (22 cases) and 67.1% (204 cases), respectively. The M(Q₁,Q₃) of direct, indirect and total economic burden of single case after discount was 9 910 (5 713, 16 074), 2 081 (1 547, 3 122) and 12 262 (7 694, 18 571) yuan, respectively.The direct medical expenses accounted for 89.4% of the direct economic burden, the direct economic burden accounted for 84.9% of the total economic burden, the total economic burden of 80.0% cases accounted for only about 20.0% of the compensation amount, and the total economic burden of only 2.3% cases accounted for more than 60.0% of the compensation amount.The direct, indirect and total economic burden of patients with inpatient only and outpatient then inpatient was higher than that of patients with outpatient only; the direct, indirect and total economic burden of patients with operation was higher than that of patients with non-operation; the direct and total economic burden of patients with unulcerated lymph node was higher than that of patients with ulcerated lymph node(all P values<0.05). Conclusion: The economic burden of BCG lymphadenitis cases in Shandong Province is influenced by the mode of diagnosis and treatment, with direct medical expenses as the predominant component.
BCG Vaccine ; Cost of Illness ; Financial Stress ; Humans ; Infant ; Lymphadenitis/epidemiology* ; Male ; Vaccination

It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus (a comminuted fracture in the right ankle joint) and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient's feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon.

To analyze the risk factors for postoperative recurrence of chronic suppurative otitis media(CSOM) and explore the intervention measures to prevent postoperative recurrence of CSOM. A total of 1066 patients with CSOM who underwent concurrent surgical treatment and achieved clinical cure in our hospital from January 2012 to December 2018 were enrolled.The clinical data and laboratory findings were reviewed by using an electronic medical record system and the patients were followed up for 1 year.The patients were divided into the non-recurrent group and the recurrent group.Chi-square test and multivariate logistic regression were used to compare the factors may contribute to the postoperative recurrence. The recurrence rate of CSOM was 6.38%.Multi-drug-resistant(MDR) infection before surgery(=16.338,=0.000),aged ≥60 years(=5.182,=0.023),frequency of occurrence ≥3 times/year(=4.388,=0.036),duration of active period>7 d(=4.729,=0.030),repeated upper respiratory tract infection>3 times/year(=11.913,=0.001),accompanied by chronic sinusitis(=11.077,=0.001),blood glucose>6.11 mmol/L(=15.327,=0.000),postoperative serum procalcitonin(PCT)>0.5 μg/L(=8.337,=0.004) were the risk factors for postoperative recurrence.The use of snorkel was a protective factor for postoperative recurrence(=5.308,=0.021).Multivariate analysis showed that MDR infection(=3.373,95%:1.825-6.234,=0.000),repeated upper respiratory tract infection>3 times/year(=2.727,95%:1.479-5.030,=0.001),accompanied by chronic sinusitis(=2.980,95%:1.654-5.369,=0.000),blood glucose>6.11 mmol/L(=3.219,95%:1.741-5.953,=0.000),and postoperative serum PCT>0.5 μg/L(=2.085,95%:1.106-3.931,=0.023) were independent risk factors for postoperative recurrence in CSOM patients. Effective prevention and control of MDR infection,control of blood sugar,prevention of upper respiratory tract infection,and lowering the recurrence of chronic sinusitis are the main measures to reduce postoperative recurrence of CSOM.Monitoring of the infection marker PCT can help to achieve early intervention.

Objective To explore the prognostic factors of central venous catheter-related bloodstream infection(CR-BSI)and provide reference for clinical practice. Methods The clinical data of 346 CR-BSI patients from February 2014 to July 2019 were retrospectively reviewed,and the prognostic factors were analyzed. Results Of the 346 CR-BSI patients,62 died,yielding a case-fatality rate of 17.92%.Univariate analysis showed that 18 factors including age(
Anti-Bacterial Agents ; Carbapenem-Resistant Enterobacteriaceae ; Central Venous Catheters/adverse effects* ; Humans ; Hyperglycemia ; Hypoproteinemia ; Klebsiella Infections ; Klebsiella pneumoniae ; Methicillin-Resistant Staphylococcus aureus ; Mycoses ; Prognosis ; Pseudomonas Infections ; Retrospective Studies ; Risk Factors ; Sepsis/mortality*

Objective: To analyze the differences between adults and children in the epidemic characteristics and clinical manifestations of chickenpox and provide a reference for the prevention strategy adjustment of chickenpox. Methods: The incidence data of chickenpox surveillance in Shandong Province from January 2019 to December 2021 were collected. Descriptive epidemiological methods were used to analyze the distribution of cases, and the chi-square test was used to compare the differences in epidemiological characteristics and clinical manifestations of varicella cases between adults and children. Results: A total of 66 182 cases of chickenpox were reported from 2019 to 2021, including 24 085 cases of adults chickenpox, the male to female sex ratio was 1∶1 (12 032∶12 053), basically the same for men and women, and 42 097 cases of children chickenpox, with a gender ratio of 1.4∶1, the male to female ratio was 1.4∶1 (24 699∶17 398). Fever in chickenpox cases was mainly low and moderate, but the proportion of moderate fever with temperature between 38.1 and 39.0 ℃ in children cases (35.0%,14 744/42 097) was significantly higher than that in adults (32.0%,7 696/24 085). The number of herpes in chickenpox cases was mainly less than 50, but the proportion of severe cases with 100-200 herpes in children was higher than that in adults. The incidence rate of complications was 1.4% (333/24 085) in adults chickenpox, the incidence rate of complications was 1.7% (731/42 097) in children chickenpox. The incidence of encephalitis and pneumonia in children was higher than in adults, and the difference was statistically significant (P<0.05). The proportion of chickenpox cases was mainly outpatient, but the hospitalization rate of children cases was 14.4% (6 049/42 097), higher than that of adults, which was 10.7% (2 585/24 085). Conclusions: There were differences between adult chickenpox and child chickenpox in terms of epidemic and clinical manifestations; the symptoms of child chickenpox were more serious than adult chickenpox. However, the adult chickenpox population is generally susceptible and lacks immune strategy protection, which calls for more attention.
Child ; Humans ; Adult ; Male ; Female ; Infant ; Chickenpox/prevention & control* ; Hospitalization ; Incidence ; Pneumonia/epidemiology* ; Epidemics ; Fever/epidemiology* ; Chickenpox Vaccine