Objective To evaluate the clinical effect of levocarnitine in the treatment of continuous blood purification and its effect on matrix metalloproteinase-2(MMP-2),interleukin-18(IL-18)and heart function.Methods 118 patients with continuous blood purification were randomly divided into the control group(n=59)and treatment group group(n=59).Two groups were treated with hemodialysis treatment.Control group was given folic acid,vitamin B and alpha keto acid,treatment group intravenous given levocarnitine injection 20mg/kg+0.9％NaCl 20mL on the basis of control group.A cycle of treatment was 28 days,and treated for 3 cycles.Serum levels of MMP-2 and IL-18,heart function,clinical effect and adverse drug reaction were compared between the two groups.Results After treatment,the total effective rate in control group was 84.74％,lower than 94.92％in treatment group(P<0.05).After treatment,serum MMP-2,IL-18,left atrial diameter(LAD),left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT),ventricular septal thickness(IVST),left ventricular volume index(LVMI)in two groups were lower than pre-treatment(P<0.05),and the indexes in treatment group were more lower than control group(P<0.05).The E/A and left ventricular ejection fraction(LVEF)in two groups were all increased after treatment,and those in treatment group were higher than control group,the differences were significant(P<0.05).There was no significant in the incidence rate of adverse drug reactions between two groups.Conclusion Levocarnitine in the treatment of continuous blood purification was effective,and significantly reduce the serum MMP-2,IL-18 level and improve the heart function.

Objective To evaluate the efficacy and safety of levothyroxine sodium combined with Guipi pills in the treatment of hypothyroidism . Methods A total of 114 cases from August 2013 to November 2015 in Lanxi Traditional Chinese Medicine Hospital with hypothyroidism were selected and randomly divided into control group and experiment group, 57 cases in each group.The patients in the both groups were given conventional treatment and symptomatic treatment.Patients in the control group were given levothyroxine sodium tablets 25 μg orally once a day, two weeks after continuous treatment according to the patient’s condition to 50μg.Patients in the experiment group were given levothyroxine sodium tablets 25μg orally once a day combined with Guipi pills 1.2g, three times a day.Two groups of patients a cycle of 28days, a total of 6 cycles of treatment.The clinical efficacy, thyroid hormone, lipid metabolic indexes and adverse drug reactions were compared between two groups.Results After treatment, the total effective rate of the control group was 78.95%, significantly lower than 92.98% of experimental group (P <0.05).The level of serum TSH, TC and TG were significantly decreased in two groups after treatment, and the experimental group was significantly lower than the control group(P<0.05); the levels of FT3 and FT4 were significantly increased, and the experimental group was significantly higher than the control group ( P <0.05 ).The incidence of adverse reactions was 10.53% in the control group and 5.26% in the experimental group, the difference was not statistically significant. Conclusion Levothyroxine sodium combined with Guipi pills in the treatment of hypothyrosis was effective with high safety.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.