Cross-Sectional Studies ; Urodynamics ; China

Objective To construct the sequential management model of networked drug-cognitive behavior in patients with chronic insomnia,and to explore the effects of this model on treatment and management of patients with chronic insomnia. Methods A total of 160 patients with chronic insomnia treated from January 2014 to June 2015 were randomly divided into the experimental group and the control group. The experimental group was treated with networked drug-cognitive behavior sequential therapy and management. Through the establishment of patient management files in the network management system,the disease was assessed,treatment programs were developed, remote implementation of 8 weeks of drug-cognitive behavior sequential treatment was conducted,12 months of net-work remote dynamic management and efficacy evaluation was performed. The control group received 8 weeks of traditional medical care with face-to-face drug-cognitive behavior sequential treatment and 12 months outpatient fol-low-up management. Results Comparison of management core indicators:there were significant differences between two groups in number of visiting hospital,exit status,treatment completion and documentation,sleep diary comple-tion,sleep scale completion and patient satisfaction. Comparison of sleep quality:after 2 months of treatment,there was no difference in quality of sleep between two groups; after 12 months of treatment,there were significant dif-ferences in sleep latency,awakening time after sleep,total sleep time and sleep efficiency between two groups. Scale score:after 12 months of treatment,there were significant differences in Pittsburgh sleep quality index,sleep personal beliefs and attitude scale score between two groups. Conclusion Network-based management improves the compliance of patients with chronic insomnia,reduces the loss of follow-up rate,improves sleep cognition,increases sleep quality,saves patients' time and cost,increases patient satisfaction,which is worth promoting in clinical application.

Objective To investigate the prophylactic effects of pancreatic duct stenting (PDS) combined with non-storied anti-inflammatory drug (NSAID) on post endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in difficult bile duct cannulation .Methods One hundred and eight patients who experienced difficult bile duct cannulation during hospitalization from January 2012 to November 2016 in the Department of Gastroenterology of the hospital were enrolled for the study .The patients were ran-domly divided into 4 groups:i.e.Group A that underwent simple PDS , Group B that received NSAID , Group C that were treated with PDS combined with NSAID and Group D that had routine ERCP without preventive measures for PEP .The levels of serum amylase be-fore surgery, 4 and 24 hours after ERCP were observed closely .The scores of abdominal pain were evaluated by VAS method , and the levels of serum amylase , the rate of post ERCP and scores of abdominal pain after ERCP were compared between the 4 groups.Results Four hours after ERCP, serum amylase levels of group B and group C were all significantly lower that those of group D (P<0.05). Serum amylase levels of group A, B and C 24 hours after ERCP were all significantly lower that those of group D (P<0.05).The rate of PEP 24 hours after ERCP for group A and C was 0%, which was obviously lower than that of group D (7.4%)(P<0.05).The VAS scores of various groups 4 and 24 hours after ERCP were significantly higher than that before ERCP (P<0.05).The VAS scores of groups B and C 4 and 24 hours after ERCP were all significantly higher than that of group D (P<0.05), and the VAS scores of group B 4 and 24 hours after ERCP was obviously lower than that of group A (P<0.05).Only at hour 24 after ERCP, the VAS pain scores of group A were higher than that of group D (P<0.05).Conclusion After ERCP, pancreatic duct stenting combined with non-storied anti-inflammatory drug could reduce the rates of hyperamylasemia and PEP , as well as the scores of abdominal pain scores after ERCP, and also could effectively prevent the incidence of pancreatitis after PEP .