中国基层医药最新文献

{"title":"Analysis of the effect of three-dimensional titanium mesh repair at different stages after decompression of craniectomy for intracerebral hemorrhage","authors":"Lin Wei, Minglei Han, Wenqing Zhao, Y. Du, G. Yang, Z. Yang, Baowang Miao","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.018","url":null,"abstract":"Objective \u0000To investigate the effects of three-dimensional titanium mesh repair on cerebral perfusion, intracranial pressure and nerve function after decompression with bone flap. \u0000 \u0000 \u0000Methods \u0000From October 2015 to October 2018, 132 hypertensive cerebral hemorrhage patients of bone disc decompression in the Fifth People's Hospital of Jinan were selected and divided into observation group(66 cases) and control group(66 cases) by double blind random method .The observation group received three-dimensional titanium mesh repair at 24 ~ 42 d after bone disc decompression surgery.The control group received three-dimensional titanium mesh repair at 90 ~ 150 d(3 ~ 5 months) after surgery.The changes of operation, cerebral perfusion, intracranial pressure and nerve function were compared between the two groups. \u0000 \u0000 \u0000Results \u0000The operative time, blood loss and free time of the flap in the observation group were (92.5±12.4)min, (354.3±17.5)mL and (13.2±3.1)min, respectively, which were shorter or less than those in the control group [(142.8±15.3)min, (518.3±22.3)mL and (38.3±4.3)min], the differences between the two groups were statistically significant(t=4.745, 6.831, 4.963, all P<0.05). After treatment, the abnormal indices of intracranial pressure and cerebral perfusion in the observation group were (0.1±0.0) and (0.2±0.1), respectively, which were lower than those in the control group[(0.2±0.1), (0.3±0.1)] (t=3.657, 2.579, all P<0.05). There were statistically significant differences in neurological deficit scores between the two groups at different time points(all P<0.05). The incidence of treatment complications in the observation group was 10.94%(7/64), which was significantly lower than that in the control group [38.7%(24/62)](χ2=14.094, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Three-dimensional titanium mesh repair is helpful to shorten the operation time, restore the intracranial pressure on the affected side, improve the abnormal cerebral perfusion, and reduce the neurological damage in patients with hypertensive cerebral hemorrhage. \u0000 \u0000 \u0000Key words: \u0000Intracranial hemorrhage, hypertensive; Decompression, surgical; Skull defect; Neural prostheses; Cerebral perfusion; Intracranial pressure; Neurological function; Postoperative complications","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"466-470"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41792682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application value of immune index detection in differential diagnosis between infectious mononucleosis and chronic active EB virus infection","authors":"Jianfeng Qi, Jingna Shu","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.020","url":null,"abstract":"目的 \u0000探讨免疫指标检测对传染性单核细胞增多症(IM)与慢性活动性EB病毒(EBV)感染(CAEBV)的鉴别诊断价值。 \u0000 \u0000 \u0000方法 \u0000选取宁波市第七医院儿科2017年1月至2019年3月收治的EBV感染患儿80例，根据不同诊断分为IM组和CAEBV组，另将在该院接受体检的健康儿童50例作为对照组。比较IM组、CAEBV组和对照组之间白细胞计数、淋巴细胞计数、外周血淋巴细胞各表型、免疫球蛋白水平的差异；比较IM组和CAEBV组EBV DNA载量的差异，评估其与各免疫指标水平的相关性。 \u0000 \u0000 \u0000结果 \u0000三组间白细胞计数、淋巴细胞计数和外周血淋巴细胞亚群差异均有统计学意义(F＝80.423、60.442、110.203、30.109、51.425、110.323、60.312、14.234，均P 0.05)。 \u0000 \u0000 \u0000结论 \u0000IM患儿以T淋巴细胞大量增殖、B淋巴细胞显著减少为主，而CAEBV患儿T淋巴细胞、B淋巴细胞和NK细胞均显著减少，尤其是CD3＋，IM和CAEBV患儿处于相反的状态；另外，虽然EBV DNA载量与各免疫指标水平并无相关性，但IM患儿EBV DNA载量显著低于CAEBV患儿，该指标仍然可作为辅助鉴别IM和CAEBV的依据。外周血淋巴细胞亚群检测以及EBV DNA载量检测有助于IM和CAEBV的鉴别诊断，可在临床上广泛应用。","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"475-478"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45441063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of correlation between serum NSE, hs-CRP levels and NIHSS score in patients with cerebral infarction","authors":"Hui-Mei Wu","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.007","url":null,"abstract":"Objective \u0000To investigate the correlation between the changes of serum neuron specific enolase (NSE) and hypersensitive C-reactive protein (hs-CRP) levels and the degree of neurological deficit (NIHSS) score in patients with cerebral infarction. \u0000 \u0000 \u0000Methods \u0000From January 2017 to January 2019, 63 patients with cerebral infarction admitted to Lishui Central Hospital were selected.According to NIHSS score, they were divided into 13 mild cases, 30 moderate cases and 20 severe cases.According to infarction area, they were divided into large area group (16 cases), small area group (27 cases) and lacunar infarction group (20 cases). Another 60 cases underwent health examination in our hospital from January 2017 to January 2019 were selected as the control group.Enzyme-linked immunosorbent assay (ELISA) was used to determine the content of NSE, and immunoturbidimetric assay was used to determine the content of hs-CRP.The changes of serum NSE and hs-CRP levels in the cerebral infarction group and control group, serum NSE, hs-CRP levels and NIHSS scores in different severity and infarction area, and the correlation between serum NSE and hs-CRP changes and NIHSS scores were compared. \u0000 \u0000 \u0000Results \u0000The serum levels of NSE [(21.34±3.27)ng/mL] and hs-CRP [(10.48±2.14)mg/L] in the cerebral infarction group were significantly higher than those in the control group [(6.23±1.08)ng/mL, (2.83±0.46)mg/L] (t=34.061, 27.095, all P<0.05). The serum levels of NSE [(26.98±3.64) ng/mL], hs-CRP [(15.36±2.57)mg/L] and NIHSS score[(38.49±3.25)points] in the severe group were higher than those in the moderate group and mild group, which in the moderate group [(20.98±3.21)ng/mL, (10.25±2.09)mg/L and (22.18±3.48)points] were higher than those in the mild group [(12.64±2.78)ng/mL, (5.47±1.40)mg/L and (7.38±2.56)], the differences were statistically significant (F=14.975, 9.132, 15.873, all P<0.05). The serum levels of NSE [(25.43±3.35)ng/mL], hs-CRP [(16.54±2.71)mg/L] and NIHSS score[(37.34±3.75)points] in the large area group were higher than those in the small area group and lacunar infarction group, which in the small area group [(21.67±3.12)ng/mL, (10.86±2.21)mg/L and (21.25±3.26)points] were higher than those in the lacunar infarction group [(13.45±2.97)ng/mL, (4.79±1.35)mg/L and (8.49±2.15)points], the differences were statistically significant (F=13.241, 9.893, 17.482, all P<0.05). The serum levels of NSE and hs-CRP were positively correlated with NIHSS score (r=0.829, 0.713, all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The levels of serum NSE and hs-CRP in patients with cerebral infarction increase with the progression of the disease, and there is a linear positive correlation between NSE and hs-CRP and NIHSS score.It is considered that NSE and hs-CRP are of great value in evaluating the degree of neurological impairment, the severity of the disease and the size of the infarct. \u0000 \u0000 \u0000Key words: \u0000Infarction, middle cerebral artery; Neuron-specific enolase; C-reactive protein; Neurologica","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"412-416"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44893675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress of laparoscopic hepatectomy for hepatocellular carcinoma","authors":"Ying-hai Xie","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.029","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.029","url":null,"abstract":"Liver cancer is one of the common malignant tumors in the digestive system, which has a high incidence and mortality.With the development and innovation of laparoscopy, laparoscopic hepatectomy has shown great advantages in the treatment of liver malignant tumors.In this paper, the indications and contraindications of laparoscopic hepatectomy, surgical methods, key points of operation technology, feasibility and safety, postoperative complications and prevention were reviewed. \u0000 \u0000 \u0000Key words: \u0000Liver neoplasms; Digestive system; Surgical procedures, operative; Laparoscopes; Postoperative complications; Review","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"510-512"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43548884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical value of color Doppler ultrasonography in evaluating the degree of atherosclerotic renal artery stenosis in the elderly by ROC curve analysis","authors":"Yuanxin Zhang","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.013","url":null,"abstract":"Objective \u0000To evaluate the clinical value of color Doppler ultrasonography (CDFI) in evaluating the degree of atherosclerotic renal artery stenosis (ARAS) in the elderly by using ROC curve analysis. \u0000 \u0000 \u0000Methods \u0000From March 2015 to September 2018, 117 patients with ARAS admitted to Anji Branch of the First Affiliated Hospital of Medical College of Zhejiang University were selected.All patients underwent color Doppler ultrasonography and renal artery angiography.Renal artery angiography was used as the gold standard.The diagnostic value of color Doppler ultrasonography for ARAS was analyzed.The changes of color Doppler ultrasonography indicators of renal artery in different degrees of stenosis were compared.The ROC curve was used to analyze the value of color Doppler ultrasound in evaluating the degree of atherosclerotic renal artery stenosis in the elderly. \u0000 \u0000 \u0000Results \u0000Using renal arteriography as the gold standard, the sensitivity of color ultrasonography for ARAS was 82.17% (129/157), and the specificity of diagnosis was 80.52% (62/77). The PSV [(227.59±34.28)cm/s] and EDV [(57.39±6.48)cm/s] in the severe stenosis group were higher than those in the moderate stenosis group [(183.84±41.05) cm/s and (50.29±5.22)cm/s] (t=6.269, 6.506, all P<0.05) and the mild stenosis group [(128.47±52.35)cm/s and (37.52±7.15)cm/s] (t=10.517, 12.813, all P<0.05) and the non-stenosis group [(86.49±28.94)cm/s and (26.48±5.02)cm/s] (t=18.598, 21.971, all P<0.05). The RI in the severe stenosis group[(0.41±0.07)] was lower than that in the moderate stenosis group [(0.47±0.06)] (t=4.966, P<0.05) and the mild stenosis group [(0.52±0.07)] (t=8.496, P<0.05) and the no stenosis group [(0.70±0.11)] (t=17.101, P<0.05). The ROC curve was used to analyze the diagnostic value of color ultrasound parameters for moderate and severe stenosis.The area under the diagnostic curve of PSV, EDV and RI for moderate and severe stenosis was 0.869, 0.932 and 0.937, respectively. \u0000 \u0000 \u0000Conclusion \u0000CDFI plays an important role in the early diagnosis and clinical screening of elderly patients with ARAS.It is helpful to judge the degree of renal artery stenosis and evaluate the condition of the patients.It is non-invasive, simple and inexpensive, and worthy of clinical application. \u0000 \u0000 \u0000Key words: \u0000Ultrasonography, doppler, color; ROC curve; Atherosclerotic renal artery stenosis; Blood flow velocity; End-diastolic flow velocity; Peak velocity ratio; Resistance index; Aged","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"443-447"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48846688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Huangkui extract powder on the expression of nephrin and podocin in podocyte induced by high glucose","authors":"Chunli Yu, Sisi Dai, Junli Gao","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.012","url":null,"abstract":"Objective \u0000To investigate the effect of Huangkui extract powder (HK) on the expression of nephrin and podocin proteins in mouse podocytes induced by high glucose, which is involved in the treatment of diabetic nephropathy (DN). \u0000 \u0000 \u0000Methods \u0000Cultured mouse podocytes (MPC5) were incubated in high glucose and HK at 5.6 mmol/L NG, 5.6 mmol/L NG+ 0.45 g/L HK, 25 mmol/L HG, 25 mmol/L HG+ 0.45 g/L HK, respectively.The 5.6 mmol/L NG group was used as normal control.After 24 hours of intervention, we detected podocyte apoptosis by Annexin-V FITC/PI double staining, measured the mRNA and protein expression of nephrin and podocin by qRT-PCR and Western blot. \u0000 \u0000 \u0000Results \u0000Compared with the control group (5.6 mmol/L, NG), the apoptosis rate of podocytes in the high glucose concentration group (25 mmol/L, HG) was significantly higher[(20.39±0.03)% vs.(17.70±0.91)%, t=2.947, P<0.05)]. The apoptosis rate of podocytes in the 25 mmol/L HG+ 0.45 g/L HK group was significantly lower than that in the 25 mmol/L HG group[(11.96±1.11)% vs.(20.39±0.03)%, t=7.586, P<0.01]. The results of qRT-PCR and Western blot showed that the expression of nephrin and podocin was significantly inhibited by high glucose concentration compared with the control group[(0.489±0.040) vs.(0.721±0.022), t=4.992, P<0.01; (0.387±0.014) vs.(0.778±0.036), t=10.050, P<0.01], and the expression of podocin and nephrin was increased by appropriate concentration of HK [(0.603±0.013) vs.(0.489±0.040), t=2.653, P<0.05; (0.640±0.024) vs.(0.387±0.014), t=8.946, P<0.01]. \u0000 \u0000 \u0000Conclusion \u0000Podocyte apoptosis can be induced by prolonged high glucose treatment, but a certain concentration of HK can inhibit podocyte death induced by high glucose.The possible mechanism is that HK may inhibit the apoptosis of podocytes by regulating the expression of podocin and nephrin in podocytes at high glucose concentration, thus plays a protective role on podocytes. \u0000 \u0000 \u0000Key words: \u0000Diabetic nephropathy; Huangkui extract powder; Glucose; Podocyte; Nephrin; Podocin; Gene regulation; Apoptosis","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"437-442"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47354871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application value of protagonist teaching method in tumor radiotherapist teaching","authors":"Yan Zhou, Geng-ming Wang, Zelai He, Yajun Zhang, Hongwei Li","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.023","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.023","url":null,"abstract":"目的 \u0000分析主角式教学法在肿瘤放射治疗学教学中的应用价值。 \u0000 \u0000 \u0000方法 \u0000选择2018年9月至2019年6月在蚌埠医学院第一附属医院放疗科接受肿瘤放射治疗学实习的学生60名，采用简单数表法分为对照组和观察组，对照组采用常规教学法，观察组在对照组的基础上采用主角式教学法，比较两组考核成绩、肿瘤放射治疗学相关知识掌握情况、教学效果及教学方式接受度。 \u0000 \u0000 \u0000结果 \u0000考核成绩：观察组学习态度和学习表现评分均高于对照组[学习态度：(90.41±6.34)分比(81.65±5.27)分，t/P＝5.820/0.000；学习表现：(92.36±8.50)分比(74.68±5.63)，t/P＝9.498/0.000]；肿瘤放射治疗学相关知识掌握情况：观察组专业成绩分数显著高于对照组[(93.42±6.4)分比(86.18±6.25)分，t/P＝4.429/0.000]；教学效果：观察组参与主动性与积极性、交流能力、应变能力、解决问题能力及综合分析能力评分均显著高于对照组[参与主动性与积极性：(4.29±0.84)分比(3.26±0.72)分，t/P＝5.099/0.000；交流能力：(4.12±0.93)分比(2.91±0.74)分，t/P＝3.642/0.000；应变能力：(4.58±0.86)分比(2.91±0.74)分，t/P＝8.062/0.000；解决问题能力：(4.34±0.98)分比(3.06±0.53)分，t/P＝6.293/0.000；综合分析能力：(4.23±0.81)分比(3.14±0.67)分，t/P＝5.679/0.000]；教学方式接受度：观察组在激发学习兴趣、提高参与意识、沟通能力、应变能力、问题解决能力、协作精神及综合分析能力方面均优于对照组[激发学习兴趣：100.00%(30/30)比80.00%(24/30)，χ2/P＝33.132/0.000；提高参与意识：96.67%(29/30)比70.00%(21/30)，χ2/P＝18.913/0.000；沟通能力：100.00%(30/30)比73.33%(22/30)，χ2/P＝31.899/0.000；应变能力：93.33%(28/30)比63.33%(19/30)，χ2/P＝31.405/0.000；问题解决能力：96.67%(29/30)比56.67%(17/30)，χ2/P＝28.127/0.000；协作精神：100.00%(30/30)比46.67%(14/30)，χ2/P＝31.286/0.000；综合分析能力：100.00%(30/30)比50.00%(15/30)，χ2/P＝40.336/0.000]。 \u0000 \u0000 \u0000结论 \u0000主角式教学法在肿瘤放射治疗学教学中应用效果显著，可优化常规教学法，激发学生学习兴趣，提高其综合能力，且学生接受度较高。","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"485-488"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41317565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term curative effect of Buqi Yishen decoction combined with chemotherapy in the treatment of patients with colorectal cancer and its influence on immune function and tumor markers","authors":"Guoqun Gu, Yaohua Fan","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.019","url":null,"abstract":"目的 \u0000探讨补肾益气方联合化疗治疗结直肠癌的近期疗效及对患者免疫功能、肿瘤标志物的影响。 \u0000 \u0000 \u0000方法 \u0000选择嘉兴市第二医院2017年1月至2019年1月收治的结直肠癌患者102例为研究对象，采用随机数字表法分为观察组51例与对照组51例。对照组患者予化疗治疗，观察组在对照组基础上联合补气益肾方治疗。两组均以21 d为1个疗程，共3个疗程。比较两组近期疗效，治疗前后卡氏功能状态量表(KPS)评分、免疫功能和肿瘤标志物变化及不良反应发生情况。 \u0000 \u0000 \u0000结果 \u0000观察组近期总有效率(76.47%)高于对照组(54.90%)(χ2＝5.263，P<0.05)；观察组治疗后KPS评分[(86.54±5.28)分]高于对照组[(78.98±5.32)分](t＝7.203，P<0.05)。观察组治疗后CD3＋[(63.28±5.64%)]、CD4＋[(39.82±4.21%)]和CD4＋/CD8＋[(1.67±0.23)]均高于对照组[(46.71±4.25%)、(29.34±2.43%)和(0.86±0.14)](t＝16.756、15.397、21.483，均P<0.05)。观察组治疗后癌胚抗原(CEA)[(8.98±1.89)μg/L]和糖类抗原724(CA724)[(7.98±1.74)μg/L]均低于对照组[(15.79±2.54)μg/L和(14.19±2.09)μg/L](t＝15.361、16.308，均P<0.05)。观察组血小板减少(13.73%)、白细胞减少(11.76%)、肝肾异常(7.84%)、胃肠道反应(15.09%)和乏力(13.73%)均低于对照组(35.29%、29.41%、27.45%、49.02%和37.25%)(χ2＝6.411、4.875、6.746、12.946、7.433，均P<0.05)。 \u0000 \u0000 \u0000结论 \u0000补气益肾方联合化疗对结直肠癌患者近期疗效明显，可增强机体免疫功能，降低血清CEA和CA724水平，不良反应少。","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"471-474"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41824623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of prolonged sedation with propofol and dexmedetomidine on acute gastrointestinal dysfunction injury and prognosis in ICU patients","authors":"Jing Wang","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.016","url":null,"abstract":"Objective \u0000To investigate the effect of prolonged sedation with propofol and dexmedetomidine on acute gastrointestinal dysfunction injury(AGI) and prognosis in intensive care unit(ICU) patients. \u0000 \u0000 \u0000Methods \u0000A prospective cohort study was conducted to collect 200 cases of mechanical ventilation patients admitted to ICU in the Second People's Hospital of Hefei, and the patients were divided into two groups according to the simple random grouping principle, with 100 cases in each group.The control group was given propofol sedation, and the research group was given propofol combined with dexmedetomidine sedation.Both two groups were given sufentanil for analgesia, and the basic clinical data of the patients were recorded, including age, gender, weight, BMI index, serum albumin levels, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, triglycerides (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST). On the 0th and 7th day after the use of sedatives, the intestinal singing score, cases of acute gastrointestinal dysfunction injury, cases of delirium, length of stay in the ICU and hospitalization costs, TG, TC, ALT and AST in the two groups were observed and compared. \u0000 \u0000 \u0000Results \u0000The TG, TC, ALT and AST levels were all increased in the two groups compared with those at the 0d, but the increase degree in the study group was lower than that in the control group, and the differences were statistically significant (t=3.87, 4.58, 5.26, 4.38, P=0.00, 0.00, 0.00, 0.00). A total of 85 patients in the control group developed AGI, and 70 patients in the study group developed AGI.The difference between the two groups was statistically significant (χ2=8.62, P=0.03), and the difference in intestinal sound score between the two groups was statistically significant (χ2=11.48, P=0.00). There were 13 delirium cases in the control group and 2 delirium cases in the study group, and the difference was statistically significant (χ2=11.83, P=0.00). There were no statistically significant differences in the length of hospital stay(t=1.64, P=0.10) and hospital expenses(t=1.28, P=0.20) between the two groups. \u0000 \u0000 \u0000Conclusion \u0000For ICU patients requiring long-term mechanical ventilation, dexmedetomidine can significantly reduce the incidence of delirium and the occurrence of AGI, especially for obese patients, the use of dexmedetomidine sedation has little impact on their liver function and blood lipid metabolism, and can significantly improve the prognosis. \u0000 \u0000 \u0000Key words: \u0000Drug therapy, combination; Deep sedation; Intensive care units; Critical illness; Respiration, artificial; Gastrointestinal dysfunction; Delirium; Propofol; Dexmedetomidine","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"456-460"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47284474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of nursing risk assessment combined with preventive nursing intervention on the incidence of complications and cardiovascular risk events in patients with cardiovascular disease","authors":"J. Sun, Zhimin Wang, Yuanyuan Cai, H. Mao","doi":"10.3760/CMA.J.ISSN.1008-6706.2020.04.024","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6706.2020.04.024","url":null,"abstract":"目的 \u0000探讨护理风险评估联合预防式护理干预对心血管疾病患者并发症以及心血管风险事件发生率的影响。 \u0000 \u0000 \u0000方法 \u0000选取2016年8月至2018年10月台州市第一人民医心内科治疗的心血管疾病住院患者66例作为研究对象，按照随机数字表法分成对照组和观察组，每组33例。对照组患者应用常规护理方法；观察组患者采用护理风险评估联合预防式护理干预。观察两组患者的心血管风险事件的发生率、并发症发生率、护理效果以及护理满意率。 \u0000 \u0000 \u0000结果 \u0000观察组总有效率为96.97%(32/33)，高于对照组的60.61%(20/33)，差异有统计学意义(χ2＝8.093，P<0.05)。观察组并发症发生率为12.12%(4/33)，明显低于对照组的45.45%(15/33)，差异有统计学意义(χ2＝7.144，P<0.05)。观察组患者的满意率为96.97%(32/33)，明显高于对照组的63.64%(21/33)，差异有统计学意义(χ2＝7.873，P<0.05)。观察组心血管风险事件发生率为9.09%(3/33)，明显低于对照组的33.33%(11/33)，差异有统计学意义(χ2＝9.083，P<0.05)。 \u0000 \u0000 \u0000结论 \u0000对心血管疾病患者行护理风险评估联合预防式护理干预可以明显降低患者心血管风险事件以及并发症的发生概率，还能提高患者的临床护理效果，从而进一步增强患者对护理的满意程度。","PeriodicalId":10226,"journal":{"name":"Chinese Journal of Primary Medicine and Pharmacy","volume":"27 1","pages":"489-492"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43688839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}