BACKGROUND： Glutathione, as an in vivo free radical scavenger, plays an important role in the anti-oxidation defense mechanism in patients with acute cerebral infarction. OBJECTIVE： To observe the relationship betwe...BACKGROUND： Glutathione, as an in vivo free radical scavenger, plays an important role in the anti-oxidation defense mechanism in patients with acute cerebral infarction. OBJECTIVE： To observe the relationship between the levels of glutathione （GSH） and malonaldehyde （MDA）, the metabolite of lipid peroxidation, in erythrocyte and deformation index of erythrocyte in patients at various periods following acute cerebral infarction. DESIGN： Controlled observation.SETTING： Qilu Hospital of Shandong University and Institute of Cerebrovascular Disease of Qingdao Medical College. PARTICIPANTS： We chose 98 inpatients with acute cerebral infarction from Department of Neurology, Qilu Hospital of Shandong University from January to December 2000 , serving as cerebral infarction group, including 50 male and 48 female, with mean age of （62±7）years. There were 23 cases found on the 1^st day after onset; 25 cases on the 3^rd day after onset; 25 cases on the 7^th day after onset; 25 cases on the 14th days after onset, and they were all confirmed by craniocerebral CT or MRI. Another 30 homeochronous inpatients with neurosis, cervical syndrome, lumbar intervertebral disc herniation and motor neuron disease were chosen as control group, including 20 male and 10 female, with mean age of （52±8）years . There was no significant difference in age and gender distribution between two groups （P 〉 0.05）. Patients in the two groups were informed of detected index.METHODS：①Ulnar venous blood was chosen from the patients who were fasted on the 1^st, 3^rd,7^th and 14^th days after onset. Deformation index of erythrocyte was measured with BL88-CKX laser diffraction erythrocyte deformeter and photographing was performed. GSH level in erythrocyte was measured with DTNB assay introduced by Beu-tler. MDA level in erythrocyte was measured with modified thiobarbituric acid colorimetric method.②At each sample collecting , according to the criteria accepted by the Fourth National Conference of Cerebrovascular Disease, intergrant of neurologic impairment 〈 15 points was regarded as mild （n=46）, 15 to 30 points as moderate （n=40）and, 〉 30 points as severe （n=12）. ③ t test was used to compare data between two groups , and linear correlation analysis was used in relationship analysis among indexes. MAIN OUTCOME MEASURES ：① Comparison of erythrocyte GSH and MDA levels and deformation index of erythrocyte at various periods between patients with acute cerebral infarction and controls. ②Correlation of erythrocyte GSH level with erythrocyte MDA level and with deformation index of erythrocyte in patients with cerebral infarction . ③ Relationship between erythrocyte GSH level and severity of disease in patients with acute cerebral infarction. RESULTS： Totally 98 patients with acute cerebral infarction and 30 controls all entered the stage of result analysis. ① Erythrocyte GSH level and deformation index of erythrocyte were lower on the 1^st, 3^rd, 7^th and 14^th days after onset in cerebral infarction group than in control group （P 〈 0.05-0.01）, and erythrocyte MDA level was significantly higher in cerebral infarction group than in control group （P 〈 0.05-0.01）. The three indexes changed most significantly on day 3 after onset in patients, and began to recover or decrease on day 7 after onset and inclined to be normal on day 14 after onset. ② Erythrocyte GSH level was significantly negatively correlated with erythrocyte MDA level in patients with acute cerebral infarction on the 1^st, 3^rd, 7^th and 14^th days after onset （r=-0.534, -0.713, -0.645, -0.656, respectively, P 〈 0.05-0.01 ） ,and significantly positively correlated with erythrocyte deformation index （t-=0.502, 0.560, 0.455, 0.504, respectively, P 〈 0.05）. ③Erythrocyte GSH level was significantly lower in moderate or severe patients with acute cerebral infarction than in mild patients[（0.215±0.088）,（0.192±0.102）, （0.281±0.090） g/L, P〈 0.05]. CONCLUSION：①Erythrocyte GSH and MDA levels and deformation index of erythrocyte change significantly on the 3^rd day following acute cerebral infarction. Index detection results gradually tended to be normal on from the 7^th day to 14^th days day after onset. ② Change of erythrocyte GSH level can reflect the severity of disease of patients with acute cerebral infarction.③Decrease of erythrocyte GSH level in patients with acute cerebral infarction is one of reasons that result in the decrease of deformation ability of erythrocyte.展开更多
BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from...BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway.However,when the sputum is thick,the cough is weak,or the tracheal cilia are abnormal,sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung.Furthermore,the presence of pathogenic microorganisms in sputum may cause or aggravate the symptoms of pulmonary infection in patients,which is the main factor leading to AECOPD.Therefore,promoting effective drainage of sputum and maintaining airway opening are key points requiring clinical attention.AIM To explore the effect of refined nursing strategies in patients with AECOPD and dysphagia.METHODS We selected 126 patients with AECOPD and difficulty of expectoration at our hospital,and divided them into a refined care group and a routine care group,with 63 cases each,using a random number table.The two groups of patients were treated with expectorant,anti-infection,oxygen inhalation,and other basic treatment measures;patients in the refined care group were given refined nursing intervention during hospitalization,and the routine care group received conventional nursing intervention.The differences in sputum expectoration,negative pressure suction rate,blood gas parameters,dyspnea score measured through the tool developed by the Medical Research Council(MRC),and quality of life were compared between the two groups.RESULTS After 7 d of intervention,the sputum expectoration effect of the refined care group was 62.30%,the effective rate was 31.15%,and the inefficiency rate was 6.56%.The sputum expectoration effect of the routine care group was 44.07%,the effective rate was 42.37%,and the inefficiency rate was 13.56%.The refined care group had better sputum expectoration than the routine care group(P<0.05).The negative pressure suction rate in the refined care group was significantly lower than that of the routine care group during the treatment(22.95%vs 44.07%,P<0.05).Before the intervention,the arterial oxygen saturation(PaO2)and arterial carbon dioxide saturation(PaCO2)values were not significantly different between the two groups(P>0.05);the PaO2 and PaCO2 values in the refined care group were comparable to those in the routine care group after 7 d of intervention(P>0.05).Before the intervention,there was no significant difference in the MRC score between the two groups(P>0.05);the MRC score of the refined care group was lower than that of the routine care group after 7 d of intervention,but the difference was not statistically significant(P>0.05).Before intervention,there was no significant difference in the symptoms,activities,disease impact,or St.George’s Respiratory questionnaire(SGRQ)total scores between the two groups(P>0.05).After 7 days of intervention,the symptoms,activities,and total score of SGRQ of the refined care group were higher than those of the routine care group,but the difference was not statistically significant(P>0.05).CONCLUSION AECOPD with thick sputum,weak coughing reflex,and abnormal tracheal cilia function will lead to sputum accumulation and affect the exchange of oxygen and carbon dioxide in the lung.Patients with AECOPD who have difficulty expectorating sputum may undergo refined nursing strategies that will promote expectoration,alleviate clinical symptoms,and improve the quality of life.展开更多
文摘BACKGROUND： Glutathione, as an in vivo free radical scavenger, plays an important role in the anti-oxidation defense mechanism in patients with acute cerebral infarction. OBJECTIVE： To observe the relationship between the levels of glutathione （GSH） and malonaldehyde （MDA）, the metabolite of lipid peroxidation, in erythrocyte and deformation index of erythrocyte in patients at various periods following acute cerebral infarction. DESIGN： Controlled observation.SETTING： Qilu Hospital of Shandong University and Institute of Cerebrovascular Disease of Qingdao Medical College. PARTICIPANTS： We chose 98 inpatients with acute cerebral infarction from Department of Neurology, Qilu Hospital of Shandong University from January to December 2000 , serving as cerebral infarction group, including 50 male and 48 female, with mean age of （62±7）years. There were 23 cases found on the 1^st day after onset; 25 cases on the 3^rd day after onset; 25 cases on the 7^th day after onset; 25 cases on the 14th days after onset, and they were all confirmed by craniocerebral CT or MRI. Another 30 homeochronous inpatients with neurosis, cervical syndrome, lumbar intervertebral disc herniation and motor neuron disease were chosen as control group, including 20 male and 10 female, with mean age of （52±8）years . There was no significant difference in age and gender distribution between two groups （P 〉 0.05）. Patients in the two groups were informed of detected index.METHODS：①Ulnar venous blood was chosen from the patients who were fasted on the 1^st, 3^rd,7^th and 14^th days after onset. Deformation index of erythrocyte was measured with BL88-CKX laser diffraction erythrocyte deformeter and photographing was performed. GSH level in erythrocyte was measured with DTNB assay introduced by Beu-tler. MDA level in erythrocyte was measured with modified thiobarbituric acid colorimetric method.②At each sample collecting , according to the criteria accepted by the Fourth National Conference of Cerebrovascular Disease, intergrant of neurologic impairment 〈 15 points was regarded as mild （n=46）, 15 to 30 points as moderate （n=40）and, 〉 30 points as severe （n=12）. ③ t test was used to compare data between two groups , and linear correlation analysis was used in relationship analysis among indexes. MAIN OUTCOME MEASURES ：① Comparison of erythrocyte GSH and MDA levels and deformation index of erythrocyte at various periods between patients with acute cerebral infarction and controls. ②Correlation of erythrocyte GSH level with erythrocyte MDA level and with deformation index of erythrocyte in patients with cerebral infarction . ③ Relationship between erythrocyte GSH level and severity of disease in patients with acute cerebral infarction. RESULTS： Totally 98 patients with acute cerebral infarction and 30 controls all entered the stage of result analysis. ① Erythrocyte GSH level and deformation index of erythrocyte were lower on the 1^st, 3^rd, 7^th and 14^th days after onset in cerebral infarction group than in control group （P 〈 0.05-0.01）, and erythrocyte MDA level was significantly higher in cerebral infarction group than in control group （P 〈 0.05-0.01）. The three indexes changed most significantly on day 3 after onset in patients, and began to recover or decrease on day 7 after onset and inclined to be normal on day 14 after onset. ② Erythrocyte GSH level was significantly negatively correlated with erythrocyte MDA level in patients with acute cerebral infarction on the 1^st, 3^rd, 7^th and 14^th days after onset （r=-0.534, -0.713, -0.645, -0.656, respectively, P 〈 0.05-0.01 ） ,and significantly positively correlated with erythrocyte deformation index （t-=0.502, 0.560, 0.455, 0.504, respectively, P 〈 0.05）. ③Erythrocyte GSH level was significantly lower in moderate or severe patients with acute cerebral infarction than in mild patients[（0.215±0.088）,（0.192±0.102）, （0.281±0.090） g/L, P〈 0.05]. CONCLUSION：①Erythrocyte GSH and MDA levels and deformation index of erythrocyte change significantly on the 3^rd day following acute cerebral infarction. Index detection results gradually tended to be normal on from the 7^th day to 14^th days day after onset. ② Change of erythrocyte GSH level can reflect the severity of disease of patients with acute cerebral infarction.③Decrease of erythrocyte GSH level in patients with acute cerebral infarction is one of reasons that result in the decrease of deformation ability of erythrocyte.
文摘BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway.However,when the sputum is thick,the cough is weak,or the tracheal cilia are abnormal,sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung.Furthermore,the presence of pathogenic microorganisms in sputum may cause or aggravate the symptoms of pulmonary infection in patients,which is the main factor leading to AECOPD.Therefore,promoting effective drainage of sputum and maintaining airway opening are key points requiring clinical attention.AIM To explore the effect of refined nursing strategies in patients with AECOPD and dysphagia.METHODS We selected 126 patients with AECOPD and difficulty of expectoration at our hospital,and divided them into a refined care group and a routine care group,with 63 cases each,using a random number table.The two groups of patients were treated with expectorant,anti-infection,oxygen inhalation,and other basic treatment measures;patients in the refined care group were given refined nursing intervention during hospitalization,and the routine care group received conventional nursing intervention.The differences in sputum expectoration,negative pressure suction rate,blood gas parameters,dyspnea score measured through the tool developed by the Medical Research Council(MRC),and quality of life were compared between the two groups.RESULTS After 7 d of intervention,the sputum expectoration effect of the refined care group was 62.30%,the effective rate was 31.15%,and the inefficiency rate was 6.56%.The sputum expectoration effect of the routine care group was 44.07%,the effective rate was 42.37%,and the inefficiency rate was 13.56%.The refined care group had better sputum expectoration than the routine care group(P<0.05).The negative pressure suction rate in the refined care group was significantly lower than that of the routine care group during the treatment(22.95%vs 44.07%,P<0.05).Before the intervention,the arterial oxygen saturation(PaO2)and arterial carbon dioxide saturation(PaCO2)values were not significantly different between the two groups(P>0.05);the PaO2 and PaCO2 values in the refined care group were comparable to those in the routine care group after 7 d of intervention(P>0.05).Before the intervention,there was no significant difference in the MRC score between the two groups(P>0.05);the MRC score of the refined care group was lower than that of the routine care group after 7 d of intervention,but the difference was not statistically significant(P>0.05).Before intervention,there was no significant difference in the symptoms,activities,disease impact,or St.George’s Respiratory questionnaire(SGRQ)total scores between the two groups(P>0.05).After 7 days of intervention,the symptoms,activities,and total score of SGRQ of the refined care group were higher than those of the routine care group,but the difference was not statistically significant(P>0.05).CONCLUSION AECOPD with thick sputum,weak coughing reflex,and abnormal tracheal cilia function will lead to sputum accumulation and affect the exchange of oxygen and carbon dioxide in the lung.Patients with AECOPD who have difficulty expectorating sputum may undergo refined nursing strategies that will promote expectoration,alleviate clinical symptoms,and improve the quality of life.
