Objective To evaluate the effect of crisis prediction score nursing in reducing complication and nursing deficiencies in patients with myasthenia gravis complicated with thymoma.Methods 46 patients were randomly divided into the study group and the control group,the study group was given with crisis prediction score nursing,the control group was given with individual nursing.The postoperative complications incidence,hospitalization time,nursing defect rate,patient satisfaction were compared between two groups,and Osserman efficacy evaluation was implemented.Results Compared with the control group,postoperative complications (hemorrhage,pneumothorax,respiratory tract infections and myasthenia gravis crisis)rates and nursing defect rate in the study group were lower,hospitalization time shortened,and patients' satisfaction degree increased.Conclusions The crisis prediction score care can significantly reduce postoperative complications and nursing defect rate,which is important for patients' health.

0.05).But only 23 lesions(38.3%)showed high signal on T1WI.Conclusion:This research confirmed the MRI-guided HIFU equipment is useful to monitor the HIFU treatment and evaluate the curative effect accurately,which provids a basis for the latter treatment of liver tumors.

Surgery is the main treatment for Cushing's syndrome.The disturbed metabolic consequences such as prolonged exposure to excessive glucocorticoid,high glucose and hypertension will add the risks and difficulties to surgery.This paper reviews the perioperative glucocorticoid replacement,correction of the hypercotisolaemia before operation,and prevention of complications after operation.

Accidents, Occupational ; Acetic Anhydrides ; Adult ; Blast Injuries ; complications ; therapy ; Burns, Inhalation ; etiology ; therapy ; Humans ; Lung Injury ; etiology ; therapy ; Male ; Middle Aged

Objective To explore the effect, safety and value of propofol combined with fentanyl in painless gastrointestinal endoscopy.Methods 1 200 patients were collected and divided into normal group and painless group,600 cases in each group.Normal gastrointestinal endoscopy was performed on unanesthetic patients,while painless gastrointestinal endoscopy was operated on anesthetic patients with Propofol and Fentanyl.The safety and clinical effect were compared between the two groups.Results 1 200 cases of patients were able to complete the gastrointestinal endoscopy examination successfully with no serious side effects.Compared with normal gastrointestinal endoscopy,the patients undergoing painless gastrointestinal endoscopy examination guaranteed more comfortable experiences,suffering less pain and side effects.The differences were significant between the two groups (all P < 0.05 ).Conclusion Propofol combined with fentanyl in painless gastrointestinal endoscopy was a safe,effective and painless process and was worthy of promoting widely.

Objective To study the flurbiprofen axetil (FA) for postoperative analgesia of gynecological laparoscopic surgery and the changes of interleukin-6 in blood.Methods80 cases were selected for gynecologic laparoscopic surgery,the patients were randomly divided into 4 groups with 20 cases each group.Group A was given FA 50 mg and tramadol 1 mg/kg 30 minutes before the end of surgery.Group B was given FA 50 mg 5 minutes before induction of anesthesia and given tramadol 1 mg/kg 30 minutes before the end of surgery,and group C was given FA 50 mg five minutes before induction of anesthesia.Group D was given tramadol 2 mg/kg 30 minutes before the end of surgery.After the surgery,the VAS was observed in real-time of wake up (T1),and 2 hours (T2),6 hours (T6) and 24 hours (T24) after operating.The blood of each group was taken at the different time points including arriving in the room (T0),waking up (T1) and 6 hours (T6) after operating.The blood samples were hold for 30 minutes and centrifuged (3000 r/min,10 min),and IL-6 was detected using double-antibody sandwich ABC-ELISA.ResultsThe experiments showed that VAS in T1 time point of group A,B,C were lower than that of group D(1.40±0.26,1.67±0.37,1.60±0.42 vs 3.13±2.32).In T24 time point,VAS of group A,B were also lower than that of group D(2.13±1.24,2.00±1.25 vs 3.53±1.87),the differences were significant (P＜0.05).The experiments showed that concentration of IL-6 in group D was higher than that in group A,B,C at the T1 time point (12.26±6.56 vs 2.94±2.55,3.37±2.43 vs 2.93±1.16,P＜0.05).ConclusionsThe postoperative analgesic effect of Flurbiprofen axetil combined with tramadol on the ogynecological laparoscopic was superior to using any of the drug alone.Flurbiprofen axetil could inhibit increasing of IL-6 and have an effect against the inflammatory response induced by surgical trauma,and it has a good analgesic effect.

Objective To investigate the effect of isoflurane preconditioning on Bcl-2 and Bax mRNA expression and the signaling pathway of nitric oxide against brain ischemia-reperfusion(I/R).Methods Seventy-five male gerbils were randomly divided into 5 groups(n=15):SHAM,I/R,ISO,AG+ISO and AG group.Global cerebral I/R was produced by occlusion of bilateral common carotid arteries for 5 minutes and confirmed by isoelectric potential on EEG.In ISO group,the animals inhaled 1.2%-1.5% isoflurane for 30 minutes followed by 30 minutes wash-out period before I/R.In AG+ISO group,30 minutes after aminoguanidine,200 mg/kg i.p.isoflurane was inhaled as ISO group,and aminoguanidine was injected 30 min before I/R in AG group.After 24 hours,the forebrains were collected,and the expression of Bcl-2 and Bax mRNA was determined by reverse transcriptase polymerase chain reaction.Results Bcl-2 mRNA expression in ISO group(1.22±0.12) was significantly higher than that in sham(0.83±0.16),I/R(0.83±0.11) and AG+ISO group(0.82±0.12)(P<0.05).Bax mRNA expression in I/R and AG group was significantly higher than that in sham group(P<0.05),and the expression in ISO group was higher than that in AG+ISO group.Conclusion Nitric oxide is involved in the signaling pathway of isoflurane preconditioning and has the protection effect on gerbil brain against I/R.

Child ; Humans ; Urolithiasis ; diagnosis ; therapy

Objective To evaluate the clinical efficacy of atorvastatin combined with salvianolate in treatment of chronic obstructive pulmonary disease (COPD) complicated with pulmonary arterial hypertension (PH) , and its influence on hypoxia inducible factor-1 alpha (HIF-1α), endothelin-1 (ET-1), adrenomedullin (ADM) in serum.Methods 30 cases of COPD patients with PH were randomly divided into 2 groups, each of 15 cases.The two groups were given conventional treatment, including rest, continuous low flow oxygen, anti infection, relieving cough and phlegm, relaxing tracheal, correcting water and electrolyte balance.Control group was received Atorvastatin Calcium Tablets 20 mg orally, once daily.Observation group was received Atorvastatin Calcium Tablets 20 mg once daily, once daily;salvianolic 200 mg+0.9% sodium chloride solution 250 mL, intravenous drip, once daily.The course of treatment was 10 d.Before and after treatment, 6 min walking distance(6 MWD) and hemodynamic parameters were detected, including pulmonary artery systolic blood pressure (PASP), cardiac output (CO), right ventricular end diastolic pressure (RVEDP) , and HIF-1, ET-1 and ADM level in serum.Results After treatment, 6MWD, PASP, CO, RVEDP of the two groups were significantly improved compared with the same group before treatment.But compared with control group, observation group was improved significantly, the difference was statistically significant (P<0.05).After treatment, HIF-1 alpha, ET-1 of the two groups were significantly lower than the same group before treatment, but ADM were significantly increaser( P <0.05 ) .Compared with control group, HIF-1 alpha, ET-1 of observation group were significantly decreased, while the ADM was significantly increased, the difference was statistically significant (P<0.05).Conclusion Atorvastatin combined with salvia miltiorrhiza polyphenols can significantly reduce the pulmonary artery pressure in patients with COPD and PH, increase exercise tolerance, and its mechanism maybe related to the regulation of the expressions of HIF-1, ET-1 and ADM.

Objective To compare the application value of routine electrocardiogram and dynamic electrocardiogram in the diagnosis of arrhythmia and heart rate variability in children.Methods In our hospital,pediatric arrhythmia patients were given routine electrocardiogram and dynamic electrocardiogram.The relationship between arrhythmia and heart rate variability in children was analyzed.Results Supraventricular tachycardia (13.33%),ventricular tachycardia(5.56%),premature ventricular contraction (21.11%),premature atrial contraction (14.44%),block (12.22%) in the dynamic electrocardiogram were significantly better than the conventional electrocardiogram,and the differences were statistically significant x2=11.93,4.56,9.22,10.74,11.55,all P<0.05).There were significant differences in the heart rate variability between ventricular arrhythmias and non-ventricular arrhythmias in children[(78.85±0.88),(4.68±2.43),(24.78±2.56),(21.66±0.94), t=10.88,11.79,9.84,9.92,all P<0.05].Conclusion Compared with routine electrocardiogram, dynamic electrocardiogram has better diagnostic value for pediatric arrhythmia of ventricular tachycardia.The detection rate of ventricular tachycardia,ventricular tachycardia,premature ventricular contraction,atrial premature contraction,conduction block and other arrhythmias are obviously superior.And dynamic ECG measurement of heart rate variability is helpful to assess the severity of the disease.