OBJECTIVE: To explore the effect of auricular point pressure on anesthetic recovery in the patients undergoing laparoscopic cholecystectomy. METHODS: One hundred and forty patients undergoing laparoscopic cholecystectomy were randomized into a trial group (52 cases, 2 cases dropped out) and a control group (52 cases, 2 cases were eliminated). In the control group, the conventional anesthesia program and recovery intervention were adopted. In the trial group, on the basis of the regimen as the control group, the intervention of auricular point pressure was supplemented. The auricular points on the right side were selected, including sympathetic (AH_6a), brain (subcortex, AT₄), thalamus, exciting point, heart and sore center. One day before operation, the auricular point pressure started; and the auricular points were stimulated specially before anesthesia (T0), at the moment of operation ending (T1), when entering the recovery room, at the moment of the tube removal (T2) and in 10 min of the tube removal (T3), respectively; each auricular point was pressed for 1 min a time. The recovery time of spontaneous breathing, the time of eye opening, the removal time of endotracheal tube, the recovery time of orientation, and the time of exiting recovery room were compared between the two groups. The score of pain visual analogue scale (VAS) and that of Richmond agitation-sedation scale (RASS) at T2, T3 and when exiting recovery room (T4), and the relevant circulatory indexes (heart rate [HR], systolic blood pressure [SBP], diastolic blood pressure [DBP] and mean arterial pressure [MAP]) at T0, T1, T2 and T3 were observed in the two groups. RESULTS: In the trial group, the recovery time of spontaneous breathing, the time of eye opening, the removal time of endotracheal tube, the recovery time of orientation, the time of exiting recovery room were shorter than those of the control group (P<0.01, P<0.05). The pain VAS and RASS scores at T2, T3 and T4, as well as HR, SBP, DBP and MAP at T0, T1, T2 and T3 were not different statistically between the two groups (P>0.05). CONCLUSION Auricular point pressure can shorten the recovery time from anesthesia in the patients undergoing laparoscopic cholecystectomy.
Humans ; Cholecystectomy, Laparoscopic ; Male ; Female ; Middle Aged ; Adult ; Anesthesia Recovery Period ; Acupuncture Points ; Aged ; Young Adult

Objective:To investigate the effects of pressure gradient controlled carbon dioxide (CO 2) pneumoperitoneum establishment in patients with gynecological laparoscopic surgery on early circulatory and respiratory function. Methods:From November 1, 2018 to March 31,2019,100 case of gynecological laparoscopic surgery who were scheduled to undergo elective surgery in Jiangsu Hospital of Traditional Chinese Medicine were enrolled and divided into experimental group(50 cases) and control group(50 cases) by random number table method. The experimental group used pressure gradient control method to establish CO 2 pneumoperitoneum, that is, the pneumoperitoneum pressure was set to 5, 9, 12 mmHg(1 mmHg=0.133 kPa) gradually rising three gradients, and after reaching the corresponding gradient, they were maintained for 1 minute to 12 mmHg; the control group used conventional method, that was, the pneumoperitoneum pressure was set directly to 12 mmHg, and began to inflate until reaching the preset pressure. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), end-of-breath partial pressure of CO 2 (P ETCO 2), peak airway pressure (P peak), arterial blood partial pressure of CO 2 (PaCO 2) and the intervention of cirulation and respiration were compared between the two groups before and within 15 minutes after pneumoperitoneum. Results:The max values of SBP, DBP, MAP, HR, P ETCO 2, Ppeak and PaCO 2 within 15 minutes after pneumoperitoneum in the experimental group were (117.08±13.07) mmHg, (77.08±9.43) mmHg, (90.06±10.33) mmHg, (69.04±9.10) times/min, (36.00±3.37) mmHg, (20.18±2.74) cmH 2O(1 cmH 2O=0.098 kPa), (40.65±3.31) mmHg, higher than that of the control group (140.63±18.34) mmHg, (91.90±11.79) mmHg, (107.25±12.85) mmHg, (77.67±13.57) times/min, (38.31±4.31) mmHg, (24.81±4.26) cmH 2O, (45.19±4.49) mmHg, the differences were statistically significant( t values were-7.269--2.945, all P<0.01). The amplitudes of SBP, DBP, MAP, HR, P ETCO 2, Ppeak and PaCO 2 fluctuations before and after pneumoperitoneum in the experimental group were (10.14±6.34) mmHg, (8.98±5.88) mmHg, (9.14±5.44) mmHg, (5.80±2.48) times/min, (3.27±1.43) mmHg, (2.65±1.54) cmH2O, (4.08±1.74) mmHg, while the control group were (33.65±14.87) mmHg, (26.17±9.73) mmHg, (28.04±9.97) mmHg, (17.63±9.77) times/min, (6.98±2.89) mmHg, (7.44±2.35) cmH 2O, (9.52±3.92) mmHg, the differences were statistically significant( t values were -11.841--8.048, all P<0.01). Within 15 minutes after pneumoperitoneum, circulatory intervention was 4.08% (2/49) in the experimental group, lower than that in the control group 22.92% (11/48), the difference was statistically significant( χ2=7.412, P<0.01). Respiratory intervention in the experimental group was 0 (0/49), lower than that in the control group 10.42%(5/48), the difference was statistically significant(Fisher test, P<0.05). Conclusions:In gynecological laparoscopic surgery, using pressure gradient control method to establish CO 2 pneumoperitoneum is conducive to reducing the effect of early pneumoperitoneum on circulatory and respiratory function, maintaining the relative stability of circulatory and respiratory function, effectively reducing anesthesia-related interventions after circulatory and respiratory fluctuations, and is conducive to the safety of patients.

Objective To observe the effects of Siweiyuganzi prescription on anti-peroxidation and blood lipid levels in experimental rats with hyperlipidemia. Methods Sixty male Sprague-Dawley (SD) rats were divided into normal control group, hyperlipidemia model group, Xuezhikang group, Siweiyuganzi prescription large, medium and small dose group according to the random number table method, with 10 rats in each group. The hyperlipidemia rat model was established by intragastric feeding with high fat emulsion everyday 10 mL·kg-1·d-1; normal saline 10 mL/kg was given to the normal control group, twice a day by intragastric feeding; 3 dosages of Siweiyuganzi suspended fluid 12.8, 6.4, 4.3 g·kg-1·d-1 intragastric administrations were given to Siweiyuganzi prescription large, medium and small dose groups respectively; Xuezhikang suspended fluid 0.3 g·kg-1·d-1 was given to Xuezhikang group intragastrically;the same volume of normal saline was given to hyperlipidemia model group. After 4 weeks, the level changes of blood lipid, serum superoxide dismutase (SOD), malonaldehyde (MDA), hydroxymethylglutaryl Coenzyme A (HMG-CoA) were observed. Results Compared to those in the normal control group, the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), MDA, content and positive expression of HMG-CoA, alanine aminotransferase (ALT) were all higher in hyperlipidemia model group [TG (mmol/L): 6.59±0.72 vs. 4.32±0.36, TC (mmol/L): 7.10±0.25 vs. 5.98±0.40, LDL-C (mmol/L): 4.18±1.30 vs. 2.33±0.35, MDA (μmol/L): 26.05± 5.99 vs. 10.08±1.98, HMG-CoA content (ng/L): 54.60±2.90 vs. 48.73±3.09, HMG-CoA positive expression in liver tissue:(57.80±12.30)% vs. (22.00±4.92)%, ALT (U/L): 106.83±15.75 vs. 81.97±13.18]; SOD and high-density lipoprotein cholesterol (HDL-C) in hyperlipidemia model group were significantly decreased [SOD (kU/L): 295.47±37.51 vs. 345.13±19.76, HDL-C (mmol/L): 2.32±0.49 vs. 4.84±0.45, both P < 0.05]. Compared with the hyperlipidemia model group, the TG, TC, LDL-C, MDA, contents and positive expression of HMG-CoA in each group were significantly reduced, and the SOD and HDL-C were obviously increased, and the changes in the Siweiyuganzi high dose group were more significant than those of the Siweiyuganzi middle-and low-dose groups [TG (mmol/L): 4.70±0.46 vs. 5.40±0.31, 5.70±0.41, TC (mmol/L): 5.80±0.23 vs. 6.14±0.20, 6.56±0.32, LDL-C (mmol/L): 2.56±0.45 vs. 2.93±0.33, 3.28±0.32, HDL-C (mmol/L): 4.58±0.28 vs. 3.89±0.30, 3.59±0.08, SOD (kU/L): 381.45±20.68 vs. 360.60±30.16, 325.49±32.13, MDA (μmol/L): 16.98±5.39 vs. 17.89±5.37, 21.03±6.01, HMG-CoA content (ng/L): 50.58±0.77 vs. 52.16±0.66, 52.90±0.91, HMG-CoA positive expression in liver tissue: (27.90±6.03)% vs. (32.20±7.00)%, (43.00±8.39)%, all P < 0.05]. In the normal control group, there were positive cells scattered in the central vein area and loosely distributed around the portal area in the rat liver; in the hyperlipidemia model group, the positive cells were increased in the central vein area and the cells in relatively great number were seen around the portal area. While the positive cells in Xuezhikang group and in the high, medium and low dose Siweiyuganzi groups were decreased. Conclusion Siweiyuganzi prescription can regulate the levels of blood lipids, prevent and treat the lipid peroxidation caused by hyperlipidemia, and inhibit excessive expression of HMG-CoA in experimental rats with hyperlipidemia.

Objective To evaluate the curative effect of Huoxue-Xiaozhi capsule on non-alcoholic fatty liver disease (NAFLD). Methods A total of 100 patients with NAFLD who met the inclusion criteria were divided into 2 groups with 50 patients in each group by random number table method. The treatment group was treated with Huoxue-Xiaozhi capsule, while the control group was treated with Compound Methionine Choline Tablets. Both groups were treated for 8 weeks. The ALT, AST, γ-GT (γ- glutamyltranspeptidase ), ALP (alkaline phosphatase, alkaline phosphate) were detected by automatic blood biochemical analyzer. The serum high sensitivity-C reactive protein (hs-CRP) and Homocysteine (Hcy) were detected by supplementary detection method. The serum IL-18 was detected by ELISA method, and liver imaging was performed before and after treatment. The symptoms and signs were evaluated, and clinical efficacy was evaluated. Results The total effective rate was 90.0％ (45/50) in the treatment group and 74.0％ (37/50) in the control group. The difference between the two groups was statistically significant (Z=-2.328, P=0.020 ). After treatment, the serum hs-CRP (2.4 ± 2.9 mg/L vs. 3.6 ± 2.8 mg/L, t=2.105), Hcy (11.2 ± 5.5 μmol/L vs. 13.9 ± 6.4 μmol/L, t=2.262), IL-18 (690.6 ± 61.3 ng/L vs. 775.4 ± 60.5 ng/L, t=6.962) in the treatment group were significantly lower than those in the control group (P<0.05 or P<0.01). After treatment, the improvement of hypochondriac lump, sallow complexion, dark complexion and hypochondriac dull pain in the treatment group were superior to those in the control group (Z values were -2.563, -2.788, -2.780, -2.220 respectively, all Ps<0.05 ). The Serum ALT, AST,γ-GT and ALP levels were significantly lower than those of the control group (t values were 18.820, 19.811, 10.221 and 3.248 respectively, all Ps<0.001 ). Conclusions The Huoxue-Xiaozhi capsule can improve the liver function and reduce the levels of serum hs-CRP, HCY and IL-18, and its curative effect of NAFLD.

Objective To explore the status of cognition on hospice care of community health care providers in Changchun City so as to provide an effective reference for developing hospice care in community and relevant departments.Methods From January to March 2017,we extracted three districts(Chaoyang District,Luyuan District,Nanguan District of Changchun City)by convenience sampling and selected 260 eligible community health care providers from 10 community health service centers by chester sampling as respondents.The status of cognition on hospice care of community health care providers was investigated with the self-designed questionnaire.The SPSS 19.0 was used to data analysis.Results The score of knowledge,attitude and behavior on hospice care of community health care providers was(13.26±2.94),(138.29±13.16)and(20.89±3.42)respectively.Conclusions Community health care providers of Changchun City are with a positive attitude toward hospice care.At the same time,they do well in hospice care provided for the dying patients and their family members.However,their grasping state on knowledge of hospice care is weak due to lack systematic professional knowledge training in hospice care.We should strengthen knowledge education as well as training in hospice care for community health care providers and improve the whole cognition on hospice care of community health care providers.

Objective To observe the clinical therapeutic effect of Xiaozhong Sanjie prescription combined with Huayu powder external application for treatment of patients with nodular goiter (NG) and approach its mechanism. Methods A prospective randomized controlled study was conducted, including 128 patients who were definitely diagnosed as NG and admitted into Affiliated Hospital of Qinghai University from September 2014 to December 2016, and they were divided into a control group and a traditional Chinese medicine (TCM) treatment group by random number table method, 64 cases in each group. The control group received follow up observation; the TCM group was treated by Xiaozhong Sanjie prescription (the ingredients: rhizoma sparganii 15 g, zedoary 10 g, fritillary bulb 15 g, prunella vulgaris 20 g, bupleurum 6 g, dried tangerine 10 g, oyster 20 g, fructus aurantii 10 g, radix glycyrrhizae 5 g) in the mean time combined with Huayu powder (the ingredients: borneol 10 g, prunella vulgaris 20 g, pinellia ternata 15 g, oyster 15 g, radix curcumae 15 g, rhubarb 15 g); the ingredients of the prescription were immersed in water and decocted to form a decoction, a dose 400 mL daily, 200 mL taken orally in the morning and 200 mL in the evening after meal; the powder ingredients were mixed and stirred thoroughly with Chinese rice wine or vinegar (10 mL) to form a paste which was put uniformly flat onto a gauze about 15 cm in length and 1 cm in thickness, roasted by infrared lamp, as the paste temperature was lowered to body temperature, it was attached on the goiter skin of neck, then fixed by bandage before sleep to the next morning, afterwards the paste was removed and nodular skin washed, the length of external application being guaranteed to be over 4 hours a day; in the event when skin red swelling or pruritus occurred, promethazine should be used or the duration of application was shortened. Fifteen days constituted one therapeutic course, and after consecutive 3 courses of treatment, the therapeutic effects in the two groups were observed. Before and after treatment in the two groups, the changes of thyroid nodular size and TCM syndrome score were observed, meanwhile the thyroid functional index levels of serum vascular endothelial growth factor (VEGF), insulin-like growth factor Ⅰ(IGF-Ⅰ) and transforming growth factor-β1 (TGF-β1) were detected by enzyme-linked immunosorbent assay (ELISA). Results After treatment for 45 days, compared with control group, the thyroid nodule in TCM treatment group was significantly shrunken (mm: 8.75±3.41 vs. 15.89±4.51, P < 0.05) , and TCM syndrome score in TCM treatment group was significantly lowered (20.35±4.83 vs. 35.53±6.71, P < 0.05); before and after admission in the two groups, the thyroid function indexes of thyrotropic-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) were in the normal range, and there were no statistical significant differences between the two groups (all P > 0.05); the levels of serum VEGF, IGF-I were reduced in the TCM treatment group [VEGF (ng/L): 27.52±8.35 vs. 33.08±9.57, IGF-Ⅰ (μg/L): 24.12±6.74 vs. 35.57±11.39], TGF-β1 was increased in the TCM treatment group (ng/L: 363.67±97.83 vs. 225.87±47.71), and the differences were statistically significant (all P < 0.05). Conclusions Xiaozhong Sanjie decoction combined with Huayu powder external application can inhibit the levels of VEGF, IGF-Ⅰ and elevate the TGF-β1 level that possibly the mechanism of the combined therapy to shrink the thyroid nodule size.

Objective To explore the influence of whole course pain nursing on anxiety and sleep quality of patients having undergone knee replacement. Methods A total of 86 patients having undergone total knee replacement in Jiangsu Province Hospital of TCM from January 2015 to December 2016 were selected as subjects. According to their order of admission, 43 cases undergoing the surgery from January to December in 2015 were assigned to control group, other 43 from January to December in 2016 as observation group. Patients in the control group were treated with routine health care, while besides that, patients in the observation group were treated with whole course pain nursing. Scales VAS、SAS and PSQI were used to compare improvement of anxiety and sleep quality between the two groups. Results In both groups, pain scores decreased as time went by. The VAS scores in the observation group were (1.86±1.21) and (1.01±0.89) at 24 h and 48 h after the surgery, and (5.23±1.53) and (4.24±1.48) in the control group, meaning improvement of the patients' pain in the observation group was better than the control group (P<0.05). At 24 h and 48 h after the surgery, SAS scores in the observation group were (46.85±1.61) and (46.02±2.17), lower than those in the control group, (51.33±1.53) and (49.52±2.19); PSQI scores in the observation group were (4.65±1.11) and (2.25±0.96), (6.13 ± 1.16) and (4.63±1.11) in the control group, meaning that scores of anxiety and sleep quality in the observation group were less than those in the control group (P< 0.05). Conclusions Whole course pain nursing can relieve anxiety, depression and other negative emotions in patients with knee replacement, reduce their pain, improve their sleep quality, and promote rehabilitation.

rotein binding toxin and pathogenic components, and reduce clinical symptoms and patients'prognoses, which is more effective than HP or CVVHDF.