1.The causations and nursing of blood vessel complications of patients after percutaneous coronary intervention
Dongmei SHI ; Xuemei YIN ; Mu CHEN
Chinese Journal of Practical Nursing 2008;24(29):20-21
Objective To discuss the causations and nursing points of blood vessel complications of patients after percutaneons coronary intervention (PCI). Methods 2546 CHD patients underwent PCI during January 2005 to February 2008. We analyzed the cases with blood vessel complications, and dis-cussed nursing points of these patients. Results There were 99 cases with blood vessel complications. All patients recovered except one who died of ventricular fibrillation after cardiac tamponade. Conclu- sions The causations of blood vessel complications after PCI are complex. Proficient skills, nursing before operations, confirmation of the state of the patients in time, effective treatment combined with careful nurs-ing are all important to prevent these complications.
2.Treatment timing and method of glucocorticoids in abdominal type Henoch-Sch?nlein purpura
Xuewen SHI ; Juan CHEN ; Mingdong YIN ; Xiangqian CHEN ; Qing CAO
Journal of Clinical Pediatrics 2015;(4):352-356
ObjectivesTo study the treatment timing and method of glucocorticoids in the treatment of abdominal type Henoch-Sch?nlein purpura (HSP).MethodsA total of 201 children with abdominal type HSP hospitalized from September 2009 to April 2013 received either conventional glucocorticoids treatment or rapid titration treatment of glucocorticoids based on the same basic therapy. According to the treatment timing and method of glucocorticoids, all patients were divided into 4 groups including early convention group (n=46), late convention group (n=44), early titration group (n=56) and late titration group (n=55). The duration from the appearance of gastrointestinal symptoms to using glucocorticoids less than or equal to three days was deifned as early treatment and more than three days was deifned as late treatment. The patients in two convention groups (early and late) were treated with methylprednisolone (2-6mg/kg per day).The patients in two titration groups (early and late) received rapid titration of methylprednisolone from an initial low dose of 2mg/kg per day to the ifnal target dose. The gastrointestinal symptoms were evaluated every 12 hours. If the gastrointestinal symptoms were not alleviated, an additional dosage of methyl-prednisolone was given. On the next day, the total dose of methylprednisolone in previous 24 hours was used as the initial dose. The dosage was increased in such a way till the gastrointestinal symptoms disappeared and this dosage was remained for 3 days. Then the dosage was gradually reduced to the maintenance dose and stopped. If the gastrointestinal symptoms were relapsed, the patients were treated again. A follow-up of 3-6 months was performed. The dosage, recurrence of symptoms and the side effects were compared among four groups.ResultsThe time of remission, target dose of glucocorticoids, total dose of glucocorticoids, recurrence rate, incidence of severe symptoms and Henoch-Schonlein purpura nephritis were signiifcantly different among four groups (P<0.05). The curative effect was best in early titration group and worst in late convention group.ConclusionsIn the treatment of abdominal type HSP, early titration treatment with glucocorticoids can signiifcantly relieve the gastrointestinal symp-toms and reduce the total dosage of glucocorticoids.
3.The dynamic variation and significance of mbisoenzyme of creatine kinase in the infected course of respiratory syncytial virus
Xuewen SHI ; Xianqian CHEN ; Mingdong YIN ; Qing CAO
Chinese Pediatric Emergency Medicine 2014;21(2):89-92
Objective To study the dynamic variation of mbisoenzyme of creatine kinase(CK-MB) in the infected course of respiratory syncytial virus and explore the value of CK-MB/CK in the diagnosis of myocardial damage.Methods A total of 577 pediatric patients (317 males,260 females,aged 2 ~ 18 months) with CK-MB/CK >5% from 2010 to 2013 were enrolled in this study (44 complicated by myocardial damage).Five hundred and thirty-three patients with high values CK-MB simply were randomly divided into treatment group (n =243) and control group(n =290).The dynamic variation of CK-MB were investigated.The diagnosis analyzed by receiver operating characteristic (ROC)curve was used to explore the predictive value of differential diagnosis between the pediatric patients with myocardial damage and without myocardial damage.Results Approximately 46.5% of cases with rotavirus diarrhea had higher CK-MB and 3.5% of cases had myocardial damage.The time of CK-MB achieved peak and anomalous duration was different between the cases with myocardial damage and without myocardial damage.There was no statistical significance between the cases with or without protecting myocardial(P > 0.05).The ROC curves were constructed with area under the ROC curves of 0.663 (95 % CI 0.578,0.747).Conclusion The blood levels of CK-MB in children with respiratory syncytial virus infection existed obvious dynamic variety,which contributed little value to the diagnosis of myocardial damage.
4.Dynamic variation of creatine kinase MB isoenzymes and diagnostic value of myocardial damage in ;children with rotavirus diarrhea
Xuewen SHI ; Xiangqian CHEN ; Mingdong YIN ; Qing CAO
International Journal of Pediatrics 2015;(4):464-467
Objective To investagate the change of creatine kinase MB isoenzymes ( CK-MB ) in children with rotavirus diarrhea and to explore the value of CK-MB/CK in the diagnosis of myocardial damage. Methods A retrospective analysis of the clinical manifestation, laboratory test data and treatment was per-formed in children with rotavirus diarrhea and high CK-MB hospitalized in department of infectious disease, Si-hong Children Hospital. We investigated the dynamic changes of CK-MB in the rotavirus diarrhea patients with and without myocardial damage. Within the non-myocardial damage group, the fluctuation of CK-MB was compared between patients with nutrition therapy and patients with conventional therapy. Receiver operating characteristic ( ROC) curve was used to explore the predictive value of CK-MB/CK for the myocardial dam-age. Results A total of 603 patients (369 males, 234 females, aged 2~48 months) with high CK-MB were enrolled in this study ( 36 cases with myocardial damage ) . There were 54. 6% of enrolled patients showing higher CK-MB and 3. 3% of patients had myocardial damage. The levels of serum CK-MB in non-myocardial damage group reached the peak on day 7 and decreased to normal in 14 days. The levels of serum CK-MB in myocardial damage group reached the peak on day 14 and maintained at fairly high level for 8 weeks and then decreased to normal . Time for CK-MB to achieve peak is different between these two groups. There was no statistical significance in the levels of serum CK-MB on day1 to day 14 between patients with or without myocar-dial protection ( P >0. 05 ) . The ROC curves were constructed with area under the ROC curves of 0. 697 (0. 611, 0. 784, 95%CI). Conclusion Intrinsic dynamics of CK-MB existed in patients with rotavirus diar-rhea. The diagnostic value of CK-MB is limited in patients with myocardial damage.
5.Knowledge requested by patients with coronary artery disease after stent implantation
Zhaoxia YIN ; Tao XIAO ; Zuoxia SHI ; Jing YAN ; Yang CHEN
Chinese Journal of General Practitioners 2014;13(11):895-898
Objective To survey the knowledge requested by patients with coronary artery disease (CAD) after stent implantation.Methods A survey on CAD and stent-related knowledge requested by CAD patients with stent implantation was conducted with a self-designed questionnaire from September 2013 to November 2013.Total 362 patients (235 males and 127 females) aged (67 ± 12) years participated in the survey in Yuetan Community Health Service Center and Fuxing Hospital in Beijing.Open questions and heuristic questions were used together during the survey.Results The knowledge requested by patients were:diet management(255,70.4%),side effects of medication(241,66.6%),management of physical activity (221,61.0%),prevention of CAD(181,50.0%),withdrawal of medication(176,48.6%),the life of stents (168,46.4%),post-operation check-up items (162,44.8%),the causes of CAD (156,43.1%)and drug mechanisms(134,37.0%).Patients with stent implantation less than one year requested more knowledge about the cause of CAD (x2 =37.4,P < 0.001),life-time of stent (x2 =39.9,P <0.001),prevention of CAD (x2 =13.4,P =0.001),post-operation check-up items (x2 =21.2,P =0.001) and requested less knowledge about withdrawal of medication (x2 =9.56,P =0.008),diet management (x2 =6.49,P =0.04) than those with more than one year.Patients aged < 70 years requested more knowledge about the cause of CAD (x2 =31.6,P < 0.001),prevention of CAD (x2 =9.99,P =0.007),life-time of stent (x2 =79.1,P < 0.001),side effects of medication (x2 =7.84,P =0.02) than patients aged > 70 years.Patients with education higher than junior high school requested more knowledge about the cause of CAD (x2 =26.6,P < 0.001),prevention of CAD (x2 =14.4,P =0.001) and life-time of stents (x2 =7.82,P =0.02) than those with education lower than junior high school.Patients with education higher than junior college requested more knowledge about the cause of CAD (x2 =26.6,P < 0.001) and post-operation check-up items (x2 =10.7,P =0.005) than those with education lower than junior college.Conclusion Some factors affect the knowledge requested by patients with coronary artery disease (CAD) after stent implantation,which should be considered in health education for CAD patients.
6.Combination and transformation of toxin and blood stasis in etiopathogenesis of thrombotic cerebro-cardiovascular diseases.
Dazhuo SHI ; Hao XU ; Huijun YIN ; Jingchun ZHANG ; Keji CHEN
Journal of Integrative Medicine 2008;6(11):1105-8
According to the basic theory of traditional Chinese medicine (TCM), the pathogenetic factors such as platelet activation, adhesion, congregation and thrombosis fall into the category of blood stasis, while the pathological changes such as tissue necrosis, oxidative stress injury and inflammation, etc, are far beyond the etiological category of blood stasis. The toxin or the combination and transformation of toxin and blood stasis of TCM are involved in the pathogenesis of thrombotic cerebro-cardiovascular diseases. It is significant to recognize and stress the combination and transformation of toxin and stasis in pathogenicity so as to enrich TCM etiology and improve TCM clinical efficacy in the treatment of cerebro-cardiovascular and thrombotic diseases.
7.Clinical Study on Treatment of Simple Obesity Due to Spleen Deficiency by Acupuncture-moxibustion
Yin SHI ; Chen ZHAO ; Xiaoyun ZUO ; Jue HONG
Journal of Acupuncture and Tuina Science 2008;6(6):352-355
Objective: To investigate the clinical effect of acupuncture-moxibustion therapy on simple obesity due to spleen deficiency. Method: Sixty-eight cases of simple obesity due to spleen deficiency syndrome, including internal dampness due to spleen deficiency, qi deficiency of lung-spleen, yang deficiency of spleen-kidney, were randomly allocated into two groups, treatment group (36 cases) and control group (32 cases). The former group was treated with warm needling moxibustion method, and the latter was treated with electroacupuncture. The therapeutic effect and body weight (BW) were observed, respectively. Result: There was a significant difference between the two groups in the total effective rate (P<0.05); there was a significant difference between the two groups in the decrease of BW (P<0.01), furthermore, the long-term effect in warm needling moxibusiton group was better than that in the electroacupuncture group. Conclusion: The effect of needle wanning moxibustion therapy on simple obesity due to spleen deficiency is accurate, and it is worth to spread.
8.Regulative effects of herbs-partition moxibustion on neutrophil apoptosis in rats with ulcerative colitis
Huirong LIU ; Chen ZHAO ; Yin SHI ; Yejing GONG
Chinese Journal of Tissue Engineering Research 2005;9(23):236-238
BACKGROUND: Treatment of ulcerative colitis (UC) with herbs-partition moxibustion is of good intervenient effect, whether the effect is related to neutrophil apoptosis in the pathogenic process of UC?OBJECTIVE: To investigate the changes of neutrophil appptosis rate of rats with UC and the regulative effect of medicinal cake moxibustion. DESIGN: A randomized controlled trial based on SD rats.SETTING: Shanghai Research Institute of Acupuncture and Meridian.MATERIALS: The experiment was completed from August 2002 to June 2003. A total of 30 healthy male SD rats of clean grade, weighing (140±20) g,provided by Experimental Animal Center of Shanghai University of Traditional Chinese Medicine, were at random divided into 2 groups: model building group (n=20) and normal control group (n=10).METHODS: Rat UC models were set up with immunological method. After the models were successively set up, four model rats and two normal rats were randomly selected for pathological observation of distal colon tissue. The rest models were divided as model group and herbs-partition moxibustion group with 8 rats for each, and the rest 8 normal rats were taken as control group. The rats of herbs-partition moxibustion group were given herbs-partition moxibustion at tian shu (ST-25) of both sides and qi hai (CV-6) points; the herbs cones was made from Radix Aeoniti Praeparata,Cortex Cinnamoni, and so on. About 90 mg moxa cone was put on the herbs cones for moxibustion, once a day, for 10 times. After treatment, all rats of the three group were executed, then the peripheral monocytes were isolated for cell culture. A 1:50 diluted supernatants of each group were taken, and the same volume of RPMI-1640 culture fluid was used as blank control group. They were respectively incubated together with neutrophils of peripheral blood of normal rats. The neutrophil apoptosis rates were measured by using flow cytometry.MAIN OUTCOME MEASURES: Comparison of neutrophil apoptosis rates of rats in each group.RESULTS: Totally 20 rats in model group and 10 in normal control group were accepted. Then 4 rats in model group and 2 in normal group were sacrificed and observed with tissue pathology, and 16 and 8 rats entered the final analysis in model and normal control groups respectivelly. ① The neutrophil apoptosis rate of UC rats was significantly lower that that of rats in blank control group [(16.34±2.80) %, (52.33±9.94) %, q= -35.99, P< 0.01]; but there was no significant diffenence between normal control group [(48.79±11.33) %] and blank control group, (P>0.05). ② After treatment the neutrophil apoptosis rate of herbs-partition moxibustion group [(36.03±8.31) %] was significantly higher than that of UC model group (q=19.69, P < 0.01), but it was still lower than that of normal control group (q= -16.30, P < 0.05).CONCLUSION: One of the main mechanism for herbs-partition moxibustion to treat UC might be regulating and/or reducing the inhibited state of neutrophil apoptosis in UC.
9.Case Study of the Comprehensive Care for College Student with Depression in the Sight of Ethics
Huifang SHI ; Yonghua CHEN ; Nan WANG ; Yin LYU
Chinese Medical Ethics 2017;30(8):1006-1010
Objective:To explore the effectiveness of comprehensive care and help system to promote the rehabilitation of patients with depression,through the case study of 1 typical college student with depression.Method:Through the establishment of the community network support system:teacher's home visits and talk,professional counseling,love and support from dormitory roommates,classmates and relatives,we provided a three-in-one community comprehensive support system and comprehensively used health education,social support,cognitive therapy and other methods,in order to promote the rehabilitation of patients with depression.Results:Through the systematic and scientific comprehensive care,the patient basically freed from the shadow of depression and put into the clinical practice with a positive attitude.Conclusion:Comprehensive Care Education is possible to promote the rehabilitation of college students with depression.
10.Clinical significance of serum ProGRP detection in patients with small cell lung cancer
Zikun LIANG ; Yan CHEN ; Changli RONG ; Yanjun YIN ; Guangli SHI
International Journal of Laboratory Medicine 2016;37(13):1765-1766,1769
Objective To investigate the clinical significance of precursor of gastrin‐releasing peptide(ProGRP) for the differen‐tial diagnosis between small cell lung cancer (SCLC) and non‐small cell lung cancer(NSCLC) and efficacy assessment .Methods The levels of ProGRP were detected by ELISA in 210 healthy adults ,200 patients with lung benign disease ,260 patients with NSCLC and 182 patients with SCLC before treatment and after chemotherapy .Results The level of ProGRP in the SCLC group was significantly higher than that in the NSCLC group ,healthy control group and lung benign disease group(P<0 .01) .The sensi‐tivity of ProGRP for detecting SCLC was 56 .3% and the specificity was 92 .6% .When combination detection of ProGRP and NSE was used ,the sensitivity increased to 82 .6% ;the level of ProGRP in the patients with SCLC after 2‐cycle chemotherapy was signifi‐cantly lower than before treatment (P<0 .01) .Conclusion The tumor marker ProGRP has very important guidance significance to assisted diagnosis ,differential diagnosis and efficacy assessment of chemotherapy in the patients with SCLC .