论著
目的 评价现有关于干预组仅涉及不同针具针刺或联合常规针刺治疗腰椎间盘突出症系统评价的方法学质量,以比较不同针具针刺治疗腰椎间盘突出症的治疗效果。方法 通过CNKI(中国知网)、万方数据库、VIP(维普)、PubMed、Web of Science等数据库以及其他相关电子资源,对诊断、治疗腰椎间盘突出症的多种针灸技术进行全面的研究。使用AMSTAR2软件,对所有参与的系统性评估结果进行地分析,并根据不同的检测结果,确定文献筛选标准。通过Revman5.4和Cochrance风险偏倚工具,以及Stata16.0的网格Meta分析,挑选了3 381个满足纳入排除要求的随机对照试验。结果 以Stata 16.0统计软件制作排序图可知,杵针+电针的临床有效率SUCRA=81.6%排名第一;目测类比评分显示,银质针SUCRA(用于评估疗效的指标)=95%,排名第一。结论 根据现有的研究证据,杵针+电针以及银质针优于其他9种干预措施,但确切的结果仍需要大量的随机对照试验来证明。
Objective To evaluate the methodological quality of the existing systematic evaluation of the intervention group involving only different needle sets of acupuncture or combined with conventional acupuncture in the treatment of lumbar disc herniation,in order to compare the therapeutic effect of different needle sets of acupuncture in the treatment of lumbar disc herniation.Methods Through CNKI,Wanfang database,VIP,PubMed,web of science and other databases as well as other relevant resources,a variety of acupuncture techniques for the diagnosis and treatment of lumbar disc herniation were comprehensively studied.Through the use of AMSTAR2 software,all participating systematic evaluation results were effectively analyzed,and according to different test results,which literature meets the requirements were determined.Through revman5.4,Cochrane risk bias tool,and grid meta-analysis of stata16.0,3 381 RCTs meeting the inclusion and exclusion requirements were selected.Results According to the ranking chart made by stata16.0 statistical software,the clinical effective rate of pestle needle + electroacupuncture ranked first with sucra=81.6%.According to the visual analogy score,the silver needle sucra=95%,ranking first.Conclusions According to the existing research evidence,pestle needle + electroacupuncture and silver needle are better than the other nine interventions,but the exact results still need a large number of randomized controlled trials to prove.
论著
目的 探讨复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效。方法 选择2019年6月—2023年1月在河南省许昌中医院诊治的79例缺血性脑卒中患者,按照入院就诊顺序采用奇偶法把患者分为联合组40例与传统组39例。传统组给予阿替普酶静脉溶栓治疗,联合组给予复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗,评价与记录联合组与传统组的疗效与安全性及治疗前、治疗14 d后Fugl-Meyer评定量表(FMA)与改良版Banhel评价指数(MBI)、血清β-内啡肽、前列腺素E2(PGE2)水平变化。结果 治疗14 d后联合组的总有效率更高(97.5% vs 82.1%,P<0.05),并发症发生率更低(5.0% vs 20.5%,P<0.05)。联合组与传统组治疗14 d后的FMA与MBI评分高于治疗前(P<0.05),联合组治疗14 d后的FMA评分、MBI评分比传统组提高(P<0.05)。联合组与传统组治疗14 d后的血清β-内啡肽、PGE2水平低于治疗前(P<0.05),联合组治疗14 d后的血清β-内啡肽、PGE2水平低于传统组(P<0.05)。结论 复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中能提高效果,降低患者的肺部感染、尿路感染、静脉血栓、褥疮等并发症发生率,改善患者的运动与日常生活功能,还可降低患者血清β-内啡肽、PGE2水平。
Objective To explore and analysis the efficacy and safety of compound brain peptide ganglioside injection combined with alteplase intravenous thrombolysis in the treatment of acute ischemic stroke. Methods From June 2019 to January 2023,79 patients with ischemic stroke who were diagnosed and treated at Henan Xuchang Traditional Chinese Medicine Hospital were selected as the research subjects.According to the order of admission,the patients were divided into the combination group of 40 cases and the traditional group of 39 cases.The traditional group received intravenous thrombolytic therapy with alteplase,while the combination group received treatment with compound brain peptide ganglioside injection on the basis of the traditional group.The efficacy and safety and changes of the Fugl-Meyer rating Scale(FMA)and modified Banhel Evaluation Index(MBI),serum β-endorphin,and PGE 2 levels in the combined and traditional groups were evaluated and recorded. Results After 14 days of treatment,the combined group had a higher overall response rate(97.5% vs 82.1%,P<0.05)and a lower complication rate(5.0% vs 20.5%,P<0.05).FMA scores and MBI scores of the two groups after 14 days of treatment were higher than those before treatment(P<0.05),and FMA scores and MBI scores of the combined group after 14 days of treatment were higher than those of the traditional group(P<0.05).The contents of β-endorphin and prostaglandin E2 in two groups after 14 days of treatment were lower than those before treatment(P<0.05),and the contents of β-endorphin and prostaglandin E2 in combination group after 14 days of treatment were lower than those in traditional group(P<0.05). Conclusions The combination of compound brain peptide ganglioside injection and alteplase intravenous thrombolysis in the treatment of acute ischemic stroke can improve the treatment effect,reduce the incidence of complications such as pulmonary infections,urinary tract infections,venous thrombosis and bedsores in patients,improve patients' motor and daily life functions,and also reduce patients' serum levels of β-endorphins and prostaglandin E2.
论著
目的 分析国产帕利哌酮缓释片治疗稳定期精神分裂症的疗效与安全性。方法 采用随机数字表法将驻马店市第二人民医院2021年10月—2023年10月收治的108例稳定期精神分裂症患者分为对照组(服用原研帕利哌酮缓释片)与观察组(服用国产帕利哌酮缓释片),每组各54例,以阳性与阴性症状量表(PANSS)评分变化为疗效衡量指标,以不良反应发生率及药物副反应量表(TESS)评分变化为安全性衡量指标。结果 治疗后,两组PANSS评分均比治疗前降低,组内不同时间点评分差异有统计学意义(t=22.147、4.513、3.431、21.369、3.927、3.601,P值分别为<0.001、<0.001、0.001、<0.001、<0.001、<0.001),但组间不同时间点评分比较差异无统计学意义(t=0.281、0.043、0.150,P=0.779、0.966、0.881);观察组不良反应发生率(14.81%)与对照组(12.96%)比较差异无统计学意义(χ2=0.090,P=0.765);两组TESS评分接近,不良反应皆轻微(t=0.185,P=0.856)。结论 国产帕利哌酮缓释片治疗稳定期精神分裂症患者可促进症状改善,且不良反应轻微,疗效及安全性与原研制剂相当。
Objective To analyze the efficacy and safety of domestic paliperidone sustained-release tablets in the treatment of stable schizophrenia.Methods A total of 108 patients with stable schizophrenia admitted to Zhumadian Second People's Hospital from October 2021 to October 2023 were divided into control group(taking the original paliperidone sustained-release tablet)and observation group(taking domestic paliperidone sustained-release tablet)by random number table method,with 54 cases in each group.The change of Positive and Negative Symptom Scale(PANSS)was used as the efficacy measure,and the change of incidence of adverse reactions and Treatment Emergent Symptom Scale(TESS) score was used as the safety measure.Results After treatment,PANSS scores in both groups were lower than before treatment,and the differences in scores at different time points in the groups were statistically significant(t=22.147,4.513,3.431,21.369,3.927,3.601,the P values were<0.001,<0.001,0.001,<0.001,<0.001,<0.001,respectively).However,there was no significant difference in scores at different time points between the groups(t=0.281,0.043,0.150,P=0.779,0.966,0.881).There was no significant difference in the incidence of adverse reactions between observation group(14.81%)and control group(12.96%)(χ2=0.090,P=0.765).TESS scores were similar between the two groups,and adverse reactions were mild(t=0.185,P=0.856).Conclusions The domestic paliperidone sustained-release tablets can improve the symptoms of stable schizophrenia patients,and the side effects are slight,and the efficacy and safety are comparable to the original agent.
医学教育
目的 探讨学生实验室安全知识盲区,以提高高校实验室安全管理工作的成效。方法 考试人数192人,共计235次考试,根据考试系统的统计分析结果,观察各题目错误率和各选项构成比;结合统计描述和χ2检验,探讨影响学生实验室安全考试成绩的原因和所存在的知识盲区。结果 41%的考生身份为在读硕士研究生,59%的考生为在读本科生,男生占48%,女生占52%,且比较不同身份的性别构成比,差异无统计学意义;题目被归纳分为“行为规范”“应急自救技能”和“事故防范能力”三大部分,比较“行为规范”和“应急自救技能”类题目的错误率,差异存在统计学意义(χ2=7.570,P=0.006),“应急自救技能”类题目的错误率为3.14%,高于其余两类。结论 高校学生对应急自救技能类可能存在较多的知识盲区,应以之作为实验室安全管理工作关键控制点,加强应急自救技能培训可以极大地降低事故的严重程度。
Objective To enhance the efficiency of laboratory safety management in colleges,we analyzed the insufficiency of students in the knowledge about laboratory safety. Methods A total of 192 college students had attended the education tests of laboratory safety and totally 235 tests had been successfully recorded.According to the statistical analysis results,we observed the error ratio and the and the composition of the options for each question in the tests.With statistical description and Chi-square test,the impact of the test scores and the main insufficiency in the knowledge about laboratory safety were discussed. Results 41% of the students were pursuing master's degree,59% of them were pursuing bachelor's degree,48% are males and 52% are females,there was no significant difference in gender composition among different identities.All the questions had been categorized into three types,which were principle for conduct in laboratory,the skills of self rescue and the capability to prevent accidence.There was statistical significance between types of questions on principle for conduct in laboratory and the skills of self rescue(χ2=7.570,P=0.006),the error ratio of the question type of skills of self rescue was 3.14%,which was higher than the other types. Conclusions The insufficiency in the knowledge of skills of self rescue might probably be the critical control point in laboratory safety management,which should set as the key point of lab security,improve the self rescue skill of students may decrease thu severity accidence.
论著
目的 探讨复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期患者的疗效。方法 选取张掖市第二人民医院2020年1月—2023年10月收治的128例特发性肺间质纤维化急性加重期患者,应用随机数字表法分为两组,每组各64例。对照组采取泼尼松治疗,观察组采取复方甘草口服液联合泼尼松治疗。对比其临床疗效,治疗前后血清肺纤维化指标及炎症因子水平,最后对比其不良反应发生率。结果 观察组总有效率93.75%,高于对照组的79.69%(χ2=5.490,P=0.019);治疗前两组层黏连蛋白(LN)、Ⅲ型前胶原肽(PC-Ⅲ)、透明质酸(HA)对比差异无统计学意义(P>0.05),治疗后两组患者LN、PC-Ⅲ、HA均降低,观察组[(89.25±7.61)μg/L;(68.33±7.68)mg/L;(81.53±8.54)μg/L]低于对照组[(96.17±8.34)μg/L;(75.68±8.25)mg/L;(95.68±9.25)μg/L],对比差异有统计学意义(t1=4.903,P1<0.001;t2=5.217,P2<0.001;t3=8.992,P3<0.001);治疗前两组患者肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、IL-10、转化生长因子(TGF-β1)对比差异无统计学意义(P>0.05),治疗后两组TNF-α、IL-4、IL-10、TGF-β1水平降低,观察组[(61.94±8.24)ng/L;(4.43±1.17)ng/mL;(65.49±13.24)g/L;(114.73±13.12)pg/mL]低于对照组[(75.52±9.43)ng/L;(6.31±1.28)ng/mL;(79.27±9.38)g/L;(147.76±15.46)pg/mL],对比差异有统计学意义(t1=8.675,P1<0.001;t2=8.673,P2<0.001;t3=6.794,P3<0.001;t4=13.032,P4<0.001);两组不良反应发生率对比差异无统计学意义(7.81% vs 6.25%,χ2=0.120,P=0.730)。结论 复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期疗效显著,可辅助延缓患者肺纤维化发展进程,减轻机体炎症反应,安全性较高。
Objective To investigate the efficacy of compound licorice oral liquid combined with prednisone in patients with acute exacerbations of idiopathic pulmonary interstitial fibrosis. Methods A total of 128 patients with acute exacerbation of idiopathic pulmonary interstitial fibrosis admitted to Zhangye Second People's Hospital from January 2020 to October 2023 were divided into two groups by random number table method,with 64 patients in each group.The control group received prednisone treatment,while the observation group received compound licorice oral liquid combined with prednisone treatment.Compare its clinical efficacy,serum pulmonary fibrosis indicators and inflammatory factor levels before and after treatment,and finally compare its incidence of adverse reactions. Results The total response rate in the observation group was 93.75%,which was higher than the 79.69% in the control group(χ2=5.490,P=0.019).There was no difference between the two groups of LN,PC-III,and HA(P>0.05),LN,PC-III and HA were decreased in both groups,while the observation group[(89.25±7.61)μg/L;(68.33±7.68)mg/L;(81.53±8.54)μg/L] was lower than the control group[(96.17±8.34)μg/L;(75.68±8.25)mg/L;(95.68±9.25)μg/L],the contrast difference was statistically significant(t1=4.903,P1<0.001;t2=5.217,P2<0.001;t3=8.992,P3<0.001).There was no difference in TNF-α,IL-4,IL-10,and TGF-β1 between the two groups before treatment(P>0.05),lower levels of TNF-α,IL-4,IL-10,and TGF-β1 in the two patient groups after treatment,the observation group[(61.94±8.24)ng/L;(4.43±1.17)ng/mL;(65.49±13.24)g/L;(114.73±13.12)pg/mL] was lower than the control group[(75.52±9.43)ng/L;(6.31±1.28)ng/mL;(79.27±9.38)g/L;(147.76±15.46)pg/mL],the contrast difference was statistically significant(t1=8.675,P1<0.001;t2=8.673,P2<0.001;t3=6.794,P3<0.001;t4=13.032,P4<0.001).There was no difference in the incidence of adverse effects between the two groups(7.81% vs 6.25%,χ2=120,P=0.730). Conclusions The combination of compound licorice oral liquid and prednisone has a significant therapeutic effect on the acute exacerbation of idiopathic pulmonary interstitial fibrosis.It can assist in delaying the progression of pulmonary fibrosis in patients,reducing the body's inflammatory response,and has high safety.
论著
目的 探讨血浆置换联合泼尼松(PDN)联合环磷酰胺(CTX)治疗抗黑色素瘤分化相关基因5(MDA5)抗体阳性皮肌炎(DM)伴肺间质纤维化(ILD)患者疗效及安全性。方法 回顾性分析2014年6月—2023年6月普洱市人民医院诊断的MDA5阳性DM伴ILD患者40例,其中治疗组20例,采用血浆置换联合PDN 1 mg/kg每日1次口服,4周后减量,每周减总量10%,CTX 1 g每月1次静脉滴注,共6次治疗;另20例设为对照组,采用PDN 1 mg/kg每日1次口服,4周后减量,每周减总量10%,CTX 1 g每月1次静脉滴注,共6次治疗,分别于治疗后3月、6月检测一氧化碳弥散量(DLCO)、第1秒用力呼气量(FEV1),血清铁蛋白(SF)、C-反应蛋白(CRP)、涎液化糖链抗原(KL-6)、MDA5转阴率行疗效评估。结果 在治疗3个月和6个月时,两组患者的DLCO、FEV1、SF、CRP、KL-6、MDA5转阴率等指标的完全缓解率不一致。其中,3个月时,治疗组上述指标的完全缓解率依次为95%、85%、90%、90%、90%、85%,对照组依次为15%、20%、20%、15%、0%、0%。两组患者在治疗3个月的DLCO、FEV1、SF、CRP、KL-6水平和MDA5转阴数均有所不同。其中治疗组的DLCO、KL-6、CRP水平均较对照组降低(P<0.01),治疗组FEV1水平较对照组升高(P<0.01),治疗组SF水平较对照组降低(P<0.05),两组治疗6个月时,治疗组上述指标缓解率依次为95%、85%、90%、90%、90%、85%,对照组依次为20%、25%、20%、20%、20%、5%。两组患者在DLCO、FEV1、SF、CRP、KL-6水平以及MDA5转阴数和死亡例数方面比较差异均有统计学意义,其中治疗组的DLCO、KL-6和CRP水平均较对照组降低(P<0.01),治疗组FEV1水平较对照组升高(P<0.01),SF水平治疗组较对照组降低(P<0.05)。结论 在MDA5抗体阳性DM伴ILD患者治疗中,给予血浆置换联合PDN、CTX治疗,可以提高疗效,降低病死率。
Objective To explore the effect of plasmapheresis combined with prednisone(PDN)plus cytoxan(CTX)on patients with anti-melanoma differentiation-associated gene 5(MDA 5)antibody-positive dermatomyositis(DM)with interstitial lung disease(ILD). Methods The data of 40 patients with MDA 5 positive DM and ILD diagnosed in the People's Hospital of Pu'er City from June 2014 to June 2023 were retrospectively was analyzed.Twenty patients of the treatment group were treated with plasmapheresis combined with PDN 1mg / kg once daily,which was reduced by 10% per week after 4 weeks.The other 20 patients of the control group were treated with PDN 1mg / kg once daily,which was reduced after 4 weeks by 10% per week,and CTX 1g once per month.diffusing capacity of the lungs for carbon monoxide(DLCO),forced expiratory volume in the first second(FEV1),serum ferritin(SF),C-reactive protein(CRP),Krebs Von den Lungen-6(KL-6)and MDA5 negative conversion rate were measured at 3 and 6 months after treatment,respectively. Results At 3 and 6 months of treatment,complete remission rates of DLCO,FEV1,SF,CRP,KL-6,MDA 5 conversion and other indicators were inconsistent.Among them,at 3 months,the complete response rate of the above indicators in the treatment group was successively:95%,85%,90%,90%,90% and 85%.The control group was 15%,20%,20%,15%,and 0%,0%.Statistical analysis showed that the levels of DLCO,FEV1,SF,CRP,KL-6 and MDA 5 significantly varied at 3 months of treatment.Pairwise comparison of LSD found that the DLCO,KL-6 and CRP levels in the treatment group were significantly lower than the control group(P<0.01),the FEV1 level in the treatment group was significantly higher(P<0.01),and the SF level in the treatment group was significantly lower(P<0.05).After 6 month of treatment,the complete response rate of the above indicators in the treatment group were 95%,85%,90%,90%,90% and 85%,and the complete response rate of the above indicators in the control group was 20%,25%,20%,20%,20% and 5%.Statistical analysis showed the levels of DLCO,FEV1,SF,CRP,KL-6 for the amount of MDA 5 and the number of deaths between two groups were significantly different.Further pairwise comparison of LSD showed that the DLCO,KL-6 and CRP levels in the treatment group were significantly lower compared with the control group(P<0.01),the FEV1 level was significantly increased compared with the control group(P<0.01),and the SF treatment group was significantly decreased compared with the control group(P<0.05). Conclusions In the treatment of patients with MDA 5 antibody positive DM with ILD,the treatment of plasmapheresis combined with PDN and CTX can significantly improve the efficacy and reduce the mortality rate.
论著
目的 探讨成人全身麻醉(全麻)腹腔镜下腹股沟疝修补日间手术的可行性及安全性。方法 回顾性分析2021年1月—2023年12月广州市第一人民医院收治的进行全麻腹腔镜下疝修补手术治疗的成人患者病历资料,根据患者住院手术模式分为日间手术组、传统手术组。日间手术组采用日间手术模式下全麻腹腔镜腹股沟疝修补术,传统手术组采用传统入院模式下择期全麻腹腔镜下腹股沟疝修补术,对比分析两组可行性(住院时间、住院费用、患者满意度)、安全性(手术时间、手术的出血量、手术并发症的发生率)等。结果 最终纳入199例病例,日间手术组52例(26.1%),传统手术组147例(73.9%)。与传统手术组相比较,日间手术组住院时间、术前住院时间、术后住院时间缩短,满意度评分升高,差异具有统计学意义(P<0.05)。在手术费用、住院总费用、术后24 h疼痛评分、手术时间、手术的出血量、手术并发症的发生率方面,组间比较差异均无统计学意义(P>0.05)。结论 成人全麻腹腔镜下腹股沟疝修补日间手术,能够缩短患者的住院时间,提高患者的住院满意程度,不增加手术风险和并发症发生率,是安全、有效的。
Objective To explore and analyze the feasibility and safety of laparoscopic inguinal hernia repair surgery under general anesthesia in adults.Methods A retrospective analysis was conducted on the medical records of patients admitted to a hospital from January 2021 to December 2023 who underwent laparoscopic hernia repair surgery under general anesthesia.The patients were divided into day surgery group and traditional surgery group based on their hospitalization surgery mode.The daytime surgery group underwent laparoscopic inguinal hernia repair under general anesthesia in the daytime surgery mode,while the traditional surgery group underwent elective laparoscopic inguinal hernia repair under general anesthesia in the traditional admission mode.The feasibility(hospitalization duration,hospitalization cost,patient satisfaction)and safety(surgery duration,surgical bleeding volume,incidence of surgical complications)of the two groups were compared and analyzed.Results A total of 199 cases were enrolled,with 52 cases(26.1%)in the day surgery group and 147 cases(73.9%)in the traditional surgery group.Compared with the traditional surgery group,the daytime surgery group showed a decrease in length of hospital stay,preoperative hospital stay,and postoperative hospital stay,while the satisfaction score increased,and the difference was statistically significant(P<0.05).There was no difference(P>0.05)between the two groups in terms of surgical costs,total hospitalization costs,postoperative 24-hour pain scores,surgical time,surgical bleeding volume,and incidence of surgical complications.Conclusion sLaparoscopic inguinal hernia repair under general anesthesia during the day for adults is safe and effective.
论著
目的 观察改良直接抽吸取栓术(ADAPT)治疗急性前循环大动脉栓塞性脑卒中的有效性与安全性。方法 回顾性分析2022年3月—2023年2月在广州市第一人民医院采用改良ADAPT治疗急性前循环大动脉栓塞性脑卒中的12例患者临床资料。该改良技术核心是血栓抽吸导管或颅内支持导管管头明确越过血栓后才开始直接使用20 mL的注射器进行手动持续抽吸;所有患者术后依据临床症状和影像表现启动规范抗凝药物治疗,每月门诊随访观察有无再发卒中。结果 12例患者闭塞血管均成功再通,其中改良脑梗死溶栓(mTICI )2b~2c级3例(25%),mTICI 3级9例(75%);从穿刺到血管再通平均时间为37.7 min,首次取栓再通8例(66.7%),其中颈内动脉闭塞首次取栓再通成功率达80%,出院时平均美国国立卫生研究院卒中量表(NIHSS)评分(9.00±9.22)分,与术前基础NIHSS评分相比,平均下降7分,术后90 d功能恢复良好(mRS评分0~2分)9例(75%);术后脑出血3例(25%),其中1例为小点状出血(HI1)而无明显症状、1例为血肿<梗死面积的30%并有轻微占位效应的出血(PH1)恢复良好、1例为血肿>梗死面积的30%并有明显占位效应的出血(PH2)术后自动出院,12例患者筛查病因均发现有心房纤颤,9例患者术后依据临床症状和影像表现在早期开展规范抗凝二级预防管理后无再复发。结论 改良ADAPT是治疗急性大动脉栓塞性脑卒中的一种安全可行选择,血管再通效率高,血栓逃逸概率低、临床疗效良好。对心房纤颤患者实施规范抗凝管理可有效预防脑卒中复发。
Objective To observe the efficacy and safety of modified-a direct aspiration first-pass technique(ADAPT)in the treatment of acute anterior circulation aorta embolic stroke.Methods The clinical data of 12 patients with acute anterior circulation arterial embolic stroke treated by modified-ADAPT in our hospital from March 2022 to February 2023 were analyzed retrospectively.The core of the modified technique is that the head of the thrombus aspiration catheter or intracranial support catheter clearly crosses the thrombus before manual continuous suction with a 20 mL syringe.After operation,all patients started standard anticoagulant therapy according to clinical symptoms and imaging manifestations,and monthly outpatient follow-up was conducted to observe whether there was recurrent stroke.Results Occlusive vessels were successfully recanalized in 12 patients,including 3 cases(25%)of mTICI 2b-2c grade and 9 cases(75%)of mTICI 3 grade.The average time from puncture to vascular recanalization was 37.7 min,and the first thrombectomy and recanalization was performed in 8 cases(66.7%).The success rate of internal carotid artery occlusion was 80%.The average NIHSSS score at discharge was(9.00±9.22).Compared with the preoperative NIHSS score,the average score decreased by 7 points.90 days after operation,the function recovered well in 9 cases(75%).Postoperative cerebral hemorrhage occurred in 3 cases(25%),including 1 case of punctate hemorrhage without obvious symptoms,1 case of good recovery of PH1 and 1 case of automatic discharge after PH2.12 patients were found to have atrial fibrillation after screening,9 patients had no recurrence after anticoagulation secondary prevention management according to clinical symptoms and imaging manifestations.Conclusions Modified-ADAPT is a safe and feasible choice for the treatment of acute arterial embolism stroke,with high recanalization efficiency,low thrombus escape probability and good clinical effect.Standardized anticoagulation management can effectively prevent the recurrence of stroke in patients with atrial fibrillation.
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目的 探讨药物服务干预对老年高血压患者的治疗及用药安全性的影响。方法 选取2020年6月—2021年12月潮州市中医药研究所门诊部和潮州市中医医院高血压患者90例为研究对象,采用随机数字表法分为观察组45例(给予药物服务干预),对照组45例(给予常规用药指导)。比较干预后血压控制水平、健康知识认知、治疗依从性、自我管理行为、生活质量及药物不良反应等情况。结果 干预后,观察组舒张压、收缩压、不良反应发生率均低于对照组(P<0.05)。干预后,观察组健康知识认知水平、治疗依从率、自我管理行为评分、生活质量评分均高于对照组(P<0.05)。结论 采用药物服务干预的方式能够较好控制老年高血压患者血压水平,提升其健康知识认知水平与治疗依从性,改善自我管理行为状况,提高生活质量。
Objective To investigate the effect of drug service intervention on the treatment and drug safety of elderly patients with hypertension.Methods From June 2020 to December 2021,a total of 90 patients with hypertension from Chaozhou Institute of traditional Chinese Medicine and Chaozhou Hospital of Traditional Chinese Medicine were selected as the study objects,and were divided into observation group(45 cases,given drug service intervention)and control group(45 cases,given routine drug guidance)by random number table method.The blood pressure control level,health knowledge cognition level,treatment compliance,self-management behavior,quality of life and adverse drug reactions of elderly patients with hypertension were compared after intervention.Results After intervention,the incidence of diastolic blood pressure,systolic blood pressure and adverse drug reactions in the observation group were lower(P<0.05).After intervention,the health knowledge cognition level,treatment compliance rate,self-management behavior score and quality of life score of the observation group were higher(P<0.05).Conclusions The use of drug service intervention can better control the blood pressure level of elderly patients with hypertension,improve their health knowledge cognition and treatment compliance,improve self-management behavior and improve quality of life.
论著
目的 本文旨在对全流程的生物安全管理问题进行梳理,为未来出现的大规模核酸筛查提供参考。方法 我们参考技术规范及其他医疗机构的实践总结,结合自身实际经验,梳理了核酸采集场所、个人防护、标本采集转运检测流程共3个方面的生物安全管理需注意的问题及解决措施。严格要求采样队伍按标准要求执行,以达到保质保量完成筛查任务的目的。结果 新冠核酸筛查期间我院共外派采集标本361 841人次。标本零污染零丢失,未发生一例生物安全事件,圆满完成采样任务。结论 大规模新冠核酸筛查是查清疫情源头、抑制疫情蔓延的重要手段。为了保证全流程的生物安全,应做好充足准备,严格落实各项生物安全措施。
Objective This article aims to sort out the problems in the whole process of biosafety management and provide reference for large-scale nucleic acid screening in the future. Methods We refer to the technical guidelines and the practice of other medical institutions, combined with our practical experience, summarized the problems and solutions needing attention in biosafety management in three aspects: nucleic acid sampling place, personal protection and the process from sample collection to detection. The sampling team was strictly required to implement the standard requirements, so as to complete the screening task with quality and quantity. Results A total of 361 841 samples were collected during SARS-CoV-2 nucleic acid screening. No samples were contaminated or lost, and no biosafety accident occurred. The sampling task were successfully completed. Conclusion Large-scale SARS-CoV-2 nucleic acid screening is an important method to find out the source of the epidemic and curb the spread of the SARS-CoV-2 pandemic. In order to ensure the biosafety of the whole process, sufficient preparations should be made and biosafety measures should be strictly implemented.