1.Application of clinical pathway in the management of single disease cost
Dongmei JIANG ; Pinglan JIANG ; Lingli YU ; Juan LAI ; Yaping LI ; Lili TANG
Chinese Journal of Practical Nursing 2008;24(14):4-6
Objective To explore the application of clinical pathway in the management of single disease cost. Methods Inpatients with breast cancer from June 2006 to June 2007 were divided into the test group and the control group according to different payment models.Patients in the test group had medical insurance while patients in the control group did not.The general data in the two groups had no statistical difference.The test group were given nursing intervention by clinical pathway while the control group received routine nursing measures. Results The mean inhospital days,mean days waiting for operations and mean inhospital expenses in the test group were shorter or lower than those in the control group (P < 0.05).The mastering degree of health knowledge and the satisfaction degree of patients in the test group were higher than those in the control group (P < 0.05). Conclusions The application of chnical pathway in the single disease cost patients with medical insurance could effectively control the medical expenses and guarantee the quality.So we consider that the application of clinical pathway in single disease cost is applicable.
2.Limb ischemic preconditioning reduces rabbit hepatic ischemia-reperfusion injury through inhibition the phosphorylation of proteins in the MAPK signal pathway in the late phase.
Lijun CAO ; Guixiu YUAN ; Yaping WANG ; Yetian CHANG ; Junmei XU ; Dingquan ZOU ; Lai WEI
Journal of Central South University(Medical Sciences) 2012;37(6):591-597
OBJECTIVE:
To investigate the liver protection mechanisms of MAPK signaling pathway of limb ischemia preconditioning in the late phase.
METHODS:
Thirty-six adult male New Zealand white rabbits, weighing 1.8-2.0 kg, were randomly divided equally into 3 groups: group C (sham operation), group L (liver ischemia-reperfusion 24 h after limb ischemia preconditioning), group IR (liver ischemia-reperfusion without limb ischemia preconditioning). Serum alanine transaminase (ALT) was measured during ischemia reperfusion. The tissue and cell injury of liver were examined by optical and electron microscopy. Activation of P38MAPK, P44/P42MAPK, and JNK in hepatic tissue was assessed by western blot after 30 min of reperfusion.
RESULTS:
Serum ALT and cell injury in the liver as examined by optical and electron microscopy was decreased in group L as compared with the group IR. Phosphorylation of P38MAPK, P44/ P42MAPK, and JNK were all increased significantly after 30 min of reperfusion. Phosphorylation of P38MAPK and JNK was reduced by limb ischemia pre-treatment.
CONCLUSION
Limb ischemia pre-treatment can induce the late phase of preconditioning in rabbit liver through the inhibition of the phosphorylation of P38MAPK and JNK.
Animals
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Extremities
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blood supply
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Ischemic Preconditioning
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methods
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Liver
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blood supply
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MAP Kinase Signaling System
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Male
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Phosphorylation
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Rabbits
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Reperfusion Injury
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prevention & control
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p38 Mitogen-Activated Protein Kinases
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chemistry
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physiology
3.The clinical effects of propofol and etomidate in patients with general anesthesia
Ke LIU ; Yaping LU ; Lan LAI ; Xuyan ZHOU ; Ming YAO
China Modern Doctor 2014;(23):55-57
Objective To observe the effect of propofol and etomidate for anesthesia induction on hemodynamics and adverse reactions during the perioperative period. Methods One hundred patients undergoing elective abdominal surgery were randomly divided into the propofol group (Group P) and etomidate group(Group E). For anesthesia induc-tion, successively injected midazolam-propofol-fentanyl-rocuronium in Group P, and the propofol was replaced by eto-midate in Group P. The circulation,stress and the adverse reactions before induction(T0), before intubation(T1), 3 min after intubation (T2), two groups were recorded. Results Compared with the P group, the T1 SBP, HR, T2 SBP, DBP, and HR were higer in E group; The incidence of injection pain was higher in Group P , but the incidence of muscle tremors was lower in Group P(P<0.05). Conclusion The etomidate is more suitable for the patients with hemodynamic instability. Both etomidate and propofol has no effect on blood sugar.
4. Prospective association between early adiposity rebound and adolescent development in girls
Ying SUN ; Jiao FANG ; Rong YANG ; Yaping LAI ; Jingjing HU ; Xiaonan DUAN ; Puyu SU ; Yuhui WAN ; Fangbiao TAO
Chinese Journal of Preventive Medicine 2017;51(9):796-800
Objective:
To determine possible relations between early adiposity rebound and adolescent development.
Methods:
Prospective children cohort from 2 kindergartens selected through clustering convenience sampling method in Anhui Province was established since Sep. 2010. Participants were classified as Cohort 1 (2010), Cohort 2 (2011) and Cohort 3 (2012) according to the recruiting year. Till Sep. 2015, a toal of 802 girls were included in this study, and received follow-up till primary school. During kindergarten period, physical examination was carried out every 3 months, 8 times in total. In primary school, physical examination was carried out annually; till Sep.2015, the cohort 1, 2, 3 took physical examination for 12, 11, 10 times, respectively. Information on household economic status and child physical activity was acquired through parents questionnaire survey, and breast development were assessed through visual inspection and palpation. Adiposity rebound was determined according to Rolland-Cachera's method for each girl. Differences between early adiposity rebound and normal adiposity rebound groups were compared by using
5.Application of dynamic coronary roadmap in coronary artery low-dose mode
Xiaomin WU ; Zi YE ; Yaping WANG ; Yang LIU ; Yi'an YAO ; Fei CHEN ; Yiping WANG ; Yu TANG ; Yan LAI
Journal of Interventional Radiology 2024;33(3):236-239
Objective To clarify whether the use of dynamic coronary artery roadmap(DCR)technology in a low-dose mode with 7.5 frames per second during coronary intervention can further reduce the total radiation dose,fluoroscopy time,and contrast agent usage.Methods A total of 94 patients,who received coronary angiography at the Shanghai Tongji Hospital of China between July 2022 and December 2022,were enrolled in this study.The patients were randomly divided into DCR group(n=53)and control group(n=41).DCR technology was used in the DCR group to guide the performance of percutaneous coronary intervention(PCI),while low-dose mode coronary angiography was adopted in the control group.The total air kerma(AK),dose-area product(DAP),intraoperative fluoroscopy time,and contrast agent usage were compared between the two groups.Results In the DCR group AK was(597.9±222.8)mGy,which was significantly lower than(717.0±326.8)mGy in the control group(P=0.039);DAP was(33.2±13.3)Gycm2/s,which was also remarkably lower than(41.3±21.5)Gycm2/s in the control group(P=0.027).In the DCR group and the control group,the intraoperative fluoroscopy time was(9.8± 3.3)min and(12.1±4.3)min respectively(P<0.01),and the contrast agent usage was(122.3±19.0)mL and(130.5± 28.5)mL respectively(P=0.116).Conclusion In a low-dose mode during coronary intervention,the use of DCR technology can further reduce radiation dose,fluoroscopy time,and contrast agent usage.(J Intervent Radiol,2024,33:236-239)
6.Application of stroke volume variation-guided liquid therapy in laparoscopic precision hepatectomy.
Xiping MEI ; Jitong LIU ; Yaping WANG ; Lai WEI ; Suhong TAN
Journal of Central South University(Medical Sciences) 2019;44(10):1163-1168
To observe the safety and impact on the short-term prognosis for patients of stroke volume variation (SVV) goal-directed fluid therapy (GDFT) in laparoscopic precision hepatectomy.
Methods: A total of 120 patients (18-65 years old) undergoing laparoscopic precision hepatectomy were randomly divided into the fluid therapy group (group S) guided by SVV and the fluid therapy group (group C) guided by central venous pressure group (CVP), with 60 cases in each group. Mean arterial pressure (MAP) and heart rate (HR) were recorded at the following time: at home calm (T0), the operation started (T1), began to cut the liver (T2), the hepatectomy was acheived (T3), and in the end (T4). The lactic acid was measured at T0 to T4 and 1 day after surgery (T5). The amount of blood loss, urine output and fluid supplement, the incidence of intraoperative hypotension, and the use of neophryn were recorded. The recovery of liver function, Hb, and so on were also recorded.
Results: Compared with the group C, the number of hypotension cases, the amount of blood loss and the amount of neophryn in the group S were decreased during the operation (P<0.05), while the lactic acid values in the group S were not significantly increased than those in the group C at T3 and T4 (P<0.05) and the elevation of AST, ALT, DBIL and TBIL in the group S was significantly decreased than those in the group C at 1 and 2 d after the operation (P<0.05). Hb and Hct in the group S were higher than those in the group C at 1 d after the surgery (P<0.05). Compared with the group C, the postoperative exhaust time and hospitalization time were shortened in the group S (P<0.05), and the infection rate and ICU admission rate were decreased in the group S (P<0.05).
Conclusion: SVV-guided GDFT in laparoscopic precise hepatectomy is safe and effective. It reduces intraoperative blood loss and benefits the short-term prognosis of patients after operations. High SVV value (13%-17%) is adopted at the liver resection stage, and SVV value with 8%-12% at the end of trans-section may be used as one of intraoperative liquid therapy in laparoscopic precise hepatectomy.
Adolescent
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Adult
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Aged
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Central Venous Pressure
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Fluid Therapy
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Hepatectomy
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Humans
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Laparoscopy
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Middle Aged
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Stroke Volume
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Young Adult
7. Effects of two different anesthesia methods on temperature, perfusion index and coagulation function
Ke LIU ; Lan LAI ; Qinhua DING ; Yaping LU ; Yongxiang LUO ; Jieyan GAO
Chinese Journal of Primary Medicine and Pharmacy 2019;26(22):2756-2759
Objective:
To observe the effects of general anesthesia and intravertebral anesthesia on the patients' temperature, perfusion index(PI) and coagulation function.
Methods:
From January 2016 to December 2017, 60 patients in the First Hospital of Jiaxing undergoing elective line of great saphenous varicose veins surgery were selected.According to the random number table, the patients were divided into the general anesthesia group(group G,