Objective:To explore the application effect of optimizing the anti-epileptic drug (AED) administration nursing procedure for patients with severe epilepsy at the first time after ICU admission.Methods:A quasi-experiment study was conducted by convenience sampling. The 44 patients with severe status epilepticus admitted in our department from January 2016 to December 2017 were selected as the control group .The 44 patients with status epilepticus admitted in our department from January 2018 to December 2019 were selected as the experimental group .The experimental group was implemented the optimized administration procedure after ICU admission. The control group was implemented the routine administration procedure after ICU admission. Some data of the two groups were compared, including baseline data, first administration time after admission, administration step time, AED dose reserve, and seizures at different time periods and so on.Results:Comparative analysis of the time of the first drug administration after admission into the two groups .The administration time of the control group was 31.0 (10.0-69.0) min, which was significantly longer than that of the experimental group, 25.0 (16.0-31.8) min ( χ2 value was -2.760, P<0.05). Comparison and analysis of the time taken for each step of drug administration: The time taken for step 1(Patient admission—medical order confirmation) in the control group was significantly greater than that in the experimental group ( χ2 value was -2.811, P<0.05); step 2 (medical order confirmation—Prepare medicines)in the control group was significantly greater than that in the experimental group ( χ2 value was -4.327, P<0.05).There was no significant difference in the time taken for step 3(Prepare medicines—Drug delivery to complete)between the two groups ( χ2 value was -1.137, P>0.05). Control group AED reserve ratio 63.6% (28/44), experimental group AED reserve was 100.0% (44/44), and the difference was statistically significant ( χ2 value was 19.556, P<0.05). Epilepsy control in two groups of patients: the total control rate after the first administration of the experimental group was 93.2% (41/44), which was significantly higher than 61.4% (27/44) of the control group ( Z value was -3.445, P<0.001). Conclusion:It can shorten the time to first give AED and improve the patient's clinical symptoms that optimizing the first drug administration procedure for patients with status epilepticus after admission.

Objective To investigate relationship between obstructive sleep apnea hypoventilation syndrome(OSAHS) and hypertension.Methods Questionnaire survey was conducted among 1573 local permanent residents in Guangzhou during March and June 2006 to understand prevalence of hypertension and snoring,and polysomnography monitoring was performed for 347 of them with moderate and severe snoring to estimate prevalence of OSAHS.Risk factors for hypertension was screened with multivariate logistic regression analysis.Results In total,1547 copies of valid questionnaires were collected,and 184 cases (11.9%) of hypertension were found with a prevalence of 10Department of Endocrinology,Shanxi Provincial People's Hospital,Taiyuan 030012,China 0%,49 of diabetes with a prevalence of 2.7%,and 212 of dyslipidemia with a prevalence of 10.4%.Prevalence of OSAHS was found in 34 of them (2.2% ) with Epworth sleepiness scale (ESS) score equal to or greater than nine.Prevalence of hypertension in OSAHS group was 32.5%,much higher than that in non-snoring group (8.3% ) and snoring group ( 17.1% ).Results of logistic regression analysis showed that age,gender,OSAHS,diabetes and dyslipidemia all were high-risk factors for hypertension,with OSAHS ranking the third.Conclusion OSAHS is one of high-risk factors for hypertension.

OBJECTIVETo investigate the relation of plasma vascular endothelial growth factor(VEGF) and tumor necrosis factor-α (TNF-α) with obstructive sleep apnea-hypopnea syndrome(OSAHS) in children.

METHODSEighty children were recruited from October 2008 to March 2009, including 60 children with snoring and 20 healthy children without snoring as control. Plasma VEGF or TNF-α concentration was measured by enzyme-linked immunosorbent assay (ELISA) respectively. Sixty children with snoring underwent an overnight polysomnography test their PSG data, including whole night mean saturation (MSaO2), lowest oxygen saturation (LSaO2), desaturation cumulate time/total sleep time (DCT/TST), oxygen desaturation index 3 (ODI3), apnea-hypopnea index (AHI), obstructive apnea index (OAI), were collected and analysed. SPSS 13.0 software was used to analyze the data.

RESULTSThe levels of plasma VEGF and TNF-α in children with OSAHS(540.45 pg/ml and 311.94 pg/ml) were higher than those in children with snoring alone (234.45 pg/ml and 97.55 pg/ml) or those in healthy children (259.80 pg/ml and 120.70 pg/ml), with statistically significant differences(HC value:14.176 and 15.571, P < 0.05, respectively), but with no statistical difference between children with snoring alone and healthy children (P > 0.05). The differences in plasma VEGF or TNF-α levels between children with moderate and severe hypoxemia and children with mild hypoxemia were not statistically significant (P > 0.05). Spearman rank correlation analysis showed no significant correlation between plasma level of VEGF or TNF-α and LSaO2, MSaO2, ODI3, DCT/TST, OAI, AHI or BMI (r values were <0.5, P > 0.05).

CONCLUSIONPlasma levels of VEGF and TNF-α increase in children with OSAHS.

Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Male ; Sleep Apnea, Obstructive ; blood ; Tumor Necrosis Factor-alpha ; blood ; Vascular Endothelial Growth Factor A ; blood