Clinical effects investigation of continuous plasma filtration with adsorption and continuous hematodialysis on improving the immune level of patients with sepsis in ICU

Objective:To investigate the clinical effects of continuous plasma filtration with adsorption and continuous hematodialysis on improving the immune level of patients with sepsis in ICU. Methods:A total of 80 patients with sepsis were randomly divided into study group and control group, 40 patients in each group. All the patients were treated by routine treatment. Patients in study group were treated by continuous plasma filtration with adsorption and patients in control group were treated by continuous hematodialysis. The blood samples were collected before and after treatment. The immune cell level, inflammatory factors level, APACHEⅡ score and death rate were compared between two groups.Results:All immune cell indexes were significantly improved in both groups. All immune cell indexes in study group were significantly better than those in control group, after treatment. All inflammatory factors were significantly decreased in both groups. All inflammatory factors in study group were significantly better than those in control group, after treatment. The APACHEⅡ in study group was significantly better than that in control group, after treatment. The death rate in study group was significantly less than that in control group.Conclusion:Continuous plasma filtration with adsorption has a great clinical efficacy on patients with sepsis in ICU, which can improve the immune level and prognosis, makes it worth for clinical application.

Clinical efficacy and safety of flexible ureteroscopy and percutaneous nephrolithotomy for large kidney stones:A retrospective comparative study

BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with traditional treatment.AIM To investigate the clinical efficacy of flexible ureteroscopy(FURS)and percutaneous nephrolithotomy(PCNL)by postoperative stone clearance and changes in soluble vascular cell adhesion molecule 1(sVCAM-1)and kidney injury molecule 1(KIM-1)levels in patients with large kidney stones(>2 cm in diameter).METHODS This single-center observational study was performed at a Chinese hospital between January 1,2021,and October 30,2023.All 250 enrolled patients were diagnosed with large kidney stones(>2 cm)and divided into a FURS group(n=145)and a PCNL group(n=105)by the surgical method.The FURS group was treated with flexible ureteroscopy and the PCNL group was treated with percutaneous nephrolithotomy.The operation time,time to palinesthesia,intraoperative blood loss,drop in hemoglobin,length of hospital stay,stone clearance rate,and complications were recorded in the two groups.Preoperative and postoperative serum sVCAM-1 levels,erythrocyte sedimentation rate(ESR),urine KIM-1 levels,preoperative and postoperative pain visual analog scale(VAS)and Wisconsin Stone Quality of Life Questionnaire(WISQOL)scores were also documented.RESULTS All 250 eligible patients completed the follow-up.There were no significant differences in baseline characteristics between the two groups(P>0.05).The operation time in the FURS group was significantly greater than that in the PCNL group.The time to ambulation,intraoperative blood loss,decrease in hemoglobin,and length of hospital stay were significantly lower in the FURS group than in the PCNL group.The FURS group also had a significantly higher stone clearance rate and a lower incidence of postoperative complications.There was no significant difference in antibiotic use between the groups.Postoperative serum sVCAM-1 levels,urine KIM-1 levels,and VAS scores were lower in the FURS group than in the PCNL group,but postoperative ESR and WISQOL scores were greater in the FURS group than in the PCNL group.CONCLUSION FURS demonstrated superior clinical efficacy in treating large kidney stones(>2 cm in diameter)compared PCNL.It not only improved the postoperative stone clearance rate and reduced complications and recovery time but also positively affected serum SCM-1,ESR,and urine KIM-1 levels,subsequent improvement of patient quality of life.

Risk factors for recurrence of common bile duct stones after surgical treatment and effect of ursodeoxycholic acid intervention

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve cholesterol stones and prevent their development and reappearance by lowering the cholesterol concen-tration in bile.Despite these treatment options,there are still patients who experience stone recurrence.The clinical data of 100 patients with choledochal stones who were hospitalized at the Yixing People’s Hospital and underwent ERCP for successful stone extraction between June 2020 and December 2022 were retrospectively collected.According to the post-ERCP treatment plan,100 patients were classified into UDCA(n=47)and control(n=53)groups.We aimed to assess the clinical efficacy and rate of relapse in the two patient populations.We then collected information(basic demographic data,clinical characteristics,and serum biochemical indicators)and determined the factors contributing to relapse using logistic regression analysis.Our secondary goal was to determine the effects of UDCA on liver function after ERCP.Compared to the control group,the UDCA group demonstrated a higher clinical effectiveness rate of 92.45%vs 78.72%(P<0.05).No significant differences were observed in liver function indices,including total bilirubin,direct bilirubin,gamma-glutamyl transpeptidase,alanine aminotransferase,alkaline phosphatase,and aspartate aminotransferase,between the two groups before treatment.After treatment,all liver function indices were significantly reduced.Comparing the control vs UDCA groups,the UDCA group exhibited significantly lower levels of all indices(55.39±6.53 vs 77.31±8.52,32.10±4.62 vs 45.39±5.69,142.32±14.21 vs 189.63±16.87,112.52±14.25 vs 149.36±15.36,122.61±16.00 vs 171.33±22.09,96.98±10.44 vs 121.35±11.57,respectively,all P<0.05).The stone recurrence rate was lower in the UDCA group(13.21%)in contrast with the control group(44.68%).Periampullary diverticula(OR:6.00,95%CI:1.69-21.30),maximum stone diameter(OR:1.69,95%CI:1.01-2.85),stone quantity>3(OR:4.23,95%CI:1.17-15.26),and positive bile culture(OR:7.61,95%CI:2.07-27.91)were independent factors that influenced the relapse of common bile duct stones after ERCP(P<0.05).Furthermore,postoperative UDCA was identified as a preventive factor(OR:0.07;95%CI:0.08-0.09).CONCLUSION The intervention effect of UDCA after ERCP for common bile duct stones is adequate,providing new research directions and references for the prevention and treatment of stone recurrence.

Effects of Tube Depth and Infusion Rate of Continuous Humidification by Endotracheal Intubation on Humidification Effect

Objective: To investigate the continuous humidification tube insertion depth of endotracheal intubation and the flow rate of the wetting effect. Methods: From October 2008 to May 2010, among 132 patients of oral and maxillofacial surgery with tracheal intubation, continuous infusion can be adjusted to the wet method;according to the wet pipe, insertion depth of the flow rate is divided into four groups, by four different depths and velocities of the wetting effect, to be analyzed. Results: B group was significantly lower than other groups satisfied with indicators of four significantly different effects of humidification. Conclusion: When continuous humidification tube insertion depth of endotracheal intubation is 10 - 12 cm, and flow rate is 15 - 20 ml/h, the wetting effect will achieve greater satisfaction.

基于网状Meta分析对8个经典名方治疗不稳定型心绞痛的临床疗效评价

目的:运用网状Meta分析方法系统评价8种经典名方联合西医常规治疗不稳定型心绞痛(UAP)的临床疗效,并分别进一步比较不同经典名方治疗实证和虚证(包括虚实夹杂)2大证型的疗效。方法:检索并筛选中文科技期刊数据库(CCD)、中国生物医学文献数据库(CBM)、中国国家知识基础设施数据库(CNKI)与中国学术期刊数据库(CSPD)等数据库中关于8个经典名方(血府逐瘀汤、补阳还五汤、四妙勇安汤、丹参饮、炙甘草汤、枳实薤白桂枝汤、瓜蒌薤白半夏汤、化痰祛瘀通脉汤)联合西医常规治疗UAP的随机对照试验(RCT),检索时限从各数据库建库至2022年1月14日,采用Stata 16.0软件进行网状Meta分析。结果:共纳入60个RCT,总计5088例UAP患者,涉及9种干预措施。其中,UAP属实证的有41个RCT,UAP患者共3432例,涉及5种干预措施;虚证或虚实夹杂共13个,共1130例患者,涉及4种干预措施。网状Meta分析结果提示,枳实薤白桂枝汤+西医常规治疗总有效率最优,UAP属实证者,四妙勇安汤+西医常规治疗最佳;虚证或虚实夹杂者,补阳还五汤+西医常规治疗最佳;心电图改善方面,四妙勇安汤疗效最佳;枳实薤白桂枝汤+西医常规在降低超敏C反应蛋白(hs-CRP)改善炎症反应方面更优。结论:与西医常规治疗UAP比较,枳实薤白桂枝汤联合西药常规治疗疗效较显著。但仍需要纳入更多高质量的RCT证实。

腹腔镜手术治疗急性阑尾炎患者的临床效果

目的探究腹腔镜手术应用于急性阑尾炎治疗中的效果。方法随机选取2020年8月—2023年11月聊城市人民医院收治的80例急性阑尾炎患者作为研究对象,根据不同的手术方法将所有患者分为参照组(传统开腹手术治疗)和分析组(腹腔镜手术治疗),每组40例。对比两组患者的临床治疗效果、围术期主要指标及并发症发生率。结果分析组治疗总有效率为95.00%(38/40),高于参照组的80.00%(32/40),差异有统计学意义(χ^(2)=4.114,P<0.05)。两组手术持续时间比较,差异无统计学意义(P>0.05)。分析组的术后下床时间、术后首次排气时间、住院时间短于参照组,术中出血量低于参照组,差异有统计学意义(P均<0.05)。分析组的并发症总发生率低于参照组,差异有统计学意义(P<0.05)。结论急性阑尾炎治疗中,腹腔镜手术治疗有效率更高,术后恢复速度更快,且并发症发生率更低。

针刺合谷、内关、足三里联合药物治疗急性胆囊炎的临床研究

目的分析针刺合谷、内关、足三里联合药物治疗急性胆囊炎(AC)的效果。方法选择2021年3月至2022年3月郏县中医院收治的AC患者62例,按照随机数字表法分为A组(常规药物治疗)和B组(常规药物治疗+针刺合谷、内关、足三里),对比两组治疗有效率、并发症发生率、临床症状评分、胆囊指标、炎性因子指标、疼痛程度、生活质量评分。结果B组治疗有效率高于A组,并发症发生率低于A组,差异具有统计学意义(P<0.05);治疗后B组临床症状评分(厌食、黄疸、口苦、发热、便秘、恶心、腹痛)、胆囊指标(胆囊横径、胆囊壁厚度)、炎性因子指标[白细胞计数(WBC)、高敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白介素-6(IL-6)]、VAS、PPI、PRI评分低于A组,差异具有统计学意义(P<0.05);B组生活质量评分(躯体疼痛、社会功能、情感职能、活力、生理职能、生理机能、精神健康)高于A组,差异具有统计学意义(P<0.05)。结论AC患者在常规服用药物治疗的基础上联合针刺合谷、内关、足三里,能更好地改善患者临床症状、疼痛感,降低炎症指标、胆囊指标,在一定程度上降低并发症风险,提高患者生活质量。

分析临床基础护理强化与睡眠护理在消化道出血住院患者中的应用价值

目的:分析临床基础护理强化联合睡眠护理对消化道出血住院患者治疗效果及睡眠质量的影响。方法:选取2022年1月至2022年12月厦门大学附属第一医院消化内科收治的消化道出血住院患者60例作为研究对象,按照随机数字表法分为观察组和对照组,每组30例。采用匹兹堡睡眠质量指数(PSQI)比较2组患者睡眠质量的差异,并比较2组患者的临床疗效及止血情况。结果:干预后,观察组PSQI评分显著低于对照组,观察组的总有效率显著高于对照组,观察组的止血时间、住院时间均显著短于对照组,观察组输血量显著少于对照组,观察组的再出血率显著低于对照组,差异均有统计学意义(均P<0.05)。结论:在为消化道出血住院患者提供临床基础护理干预的前提下,强化联合睡眠护理干预能让治疗效果显著提高,并能快速止血,减少患者的出血量及再出血,提升睡眠质量,加快康复进程,值得推广应用。

Early filiform needle acupuncture for poststroke depression: a meta-analysis of 17 randomized controlled clinical trials

OBJECTIVE： To evaluate the effectiveness and safety of filiform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efficacy of antidepressant drugs. DATA RETRIEVAL： We retrieved data from the Chinese National Knowledge Infrastructure （1979-2012）, Wanfang （1980-2012）, VIP （1989-2012）, Chinese Biomedical Literature （1975- 2012）, PubMed （1966-2012）, Ovid Lww （-2012）, and Cochrane Library （-2012） Database using the internet. SELECTION CRITERIA： Randomized controlled trials on filiform needle acupuncture versus antidepressant drugs for treatment of poststroke depression were included. Moreover, the in- cluded articles scored at least 4 points on the Jadad scale. Exclusion criteria： other acupuncture therapies as treatment group, not stroke-induced depression patients, score 〈 4 points, non-ran- domized controlled trials, or animal trials. MAIN OUTCOME MEASURES： These were the Hamilton Depression Scale scores, clinical ef- fective rate, Self-Rating Depression Scale scores, Side Effect Rating Scale scores, and incidence of adverse reaction and events. RESULTS： A total of 17 randomized controlled clinical trials were included. Meta-analysis results displayed that after 4 weeks of treatment, clinical effective rate was better in patients treated with fill- form needle acupuncture than those treated with simple antidepressant drugs [relative risk = 1.11, 95% confidence interval （C/）： 1.03-1.21, P = 0.01]. At 6 weeks, clinical effective rate was similar between filiform needle acupuncture and antidepressant drug groups. At 2 weeks after filiform needle acupuncture, Hamilton Depression Scale （17 items） scores were lower than in the antide- pressant drug group （mean difference = -2.34, 95%CI： -3.46 to -1.22, P 〈 0.000,1）. At 4 weeks, Hamilton Depression Scale （24 items） scores were similar between filiform needle acupuncture and antidepressant drug groups. Self-Rating Depression Scale scores were lower in filiform needle acupuncture group than in the antidepressant drug group. Side Effect Rating Scale was used in only two articles, and no meta-analysis was conducted. Safety evaluation of the 17 arti- cles showed that gastrointestinal tract reactions such as nausea and vomiting were very common in the antidepressant drug group. Incidence of adverse reaction and events was very low in the filiform needle acupuncture group. CONCLUSION： Early filiform needle acupuncture for poststroke depression can perfectly con- trol depression. Filiform needle acupuncture is safe and reliable. Therapeutic effects of filiform needle acupuncture were better than those of antidepressant drugs.

亚甲蓝注射液治疗感染性休克的效果

目的:研究亚甲蓝(Methylene Blue,MB)注射液治疗感染性休克的效果。方法:选取2021年7月—2022年6月茂名市人民医院收治的80例感染性休克患者为研究对象。根据随机数表法将其分为对照组和观察组,各40例。对照组给予常规治疗,观察组在对照组基础上给予MB注射液。比较两组治疗前(T_(0))、治疗1 d后(T_(1))、治疗3 d后(T_(2))、治疗5 d后(T_(3))、治疗7 d后(T_(4))的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、外周血管阻力指数(systemic vascular resistance index,SVRI)、肺血管阻力指数(pulmonary vascular resistance index,PVRI)、心脏指数(cardiac index,CI)及无创脉搏氧灌注指数(noninvasive pulse oxygen perfusion index,PI),治愈率及不良反应。结果:T_(2)、T_(3)、T_(4),观察组MAP、HR、SVRI、PVRI、CI、PI均高于对照组,差异有统计学意义(P<0.05)。观察组的治愈率为85.00%(34/40),高于对照组的62.50%(25/40),差异有统计学意义(χ^(2)=5.230,P=0.022)。观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论:MB注射液治疗感染性休克能够获得更高的治愈率,有效改善患者机体的血流动力学,治疗安全性较好。

中国戒烟门诊医务人员戒烟行为改变技术使用情况及其与戒烟成功率的关系研究

背景戒烟行为改变技术(BCTs)是指可以改变参与者吸烟行为的干预内容的明确表述,目前尚缺乏研究探索我国戒烟门诊医务人员BCTs使用现状。目的了解我国戒烟门诊医务人员戒烟相关BCTs使用情况,并探讨医务人员BCTs使用情况、感知效果与所在门诊戒烟成功率之间的关系。方法于2022年2月—2023年3月,通过“问卷星”向我国戒烟门诊医务人员发放线上问卷,调查其44项戒烟相关BCTs使用情况、感知效果、所在门诊的戒烟成功率,以及年龄、性别等人口统计学特征。采用分层线性回归模型分析医务人员BCTs使用项数、感知效果对所在门诊戒烟成功率的影响及二者间的交互作用,采用简单斜率分析进一步检验BCTs使用项数和感知效果的交互作用。结果共回收有效问卷285份。285名戒烟门诊医务人员平均使用BCTs项数为(29±13)项,对BCTs的感知效果平均评分为(3.15±0.96)分,所在戒烟门诊的平均戒烟成功率为(37.0±24.3)%。不同最高学历、所在门诊追踪吸烟者戒烟效果情况医务人员的BCTs使用项数、感知效果比较,差异有统计学意义(P<0.05);不同戒烟门诊工作年限、医院职务、所在门诊追踪吸烟者戒烟效果情况医务人员的所在门诊戒烟成功率比较,差异有统计学意义(P<0.05)。分层线性回归模型分析结果显示:在控制了戒烟门诊工作年限、医院职务、所在门诊是否追踪吸烟者戒烟效果3项变量后,医务人员BCTs感知效果能正向预测戒烟门诊的戒烟成功率[b(95%CI)=10.070(7.066~13.075),P<0.05],而BCTs使用项数不是戒烟门诊戒烟成功率的影响因素(P>0.05);进一步纳入BCTs使用项数×感知效果后,模型对戒烟门诊戒烟成功率的解释度增加2.2%,BCTs感知效果[b(95%CI)=11.711(8.548~14.874),P<0.05]、BCTs使用项数×感知效果[b(95%CI)=2.921(0.958~4.884),P<0.05]对戒烟成功率有正向预测作用。结论医务人员戒烟相关BCTs使用情况对所在门诊的戒烟成功率有明显影响,且BCTs使用项数、感知效果对戒烟成功率的影响有明显交互作用。未来需要完善戒烟门诊干预技术培训方案,实现干预技术理论到实践的转化和落实,以帮助更多的吸烟者成功戒烟。

济川煎加减结合穴位埋线治疗对老年功能性便秘临床疗效、症状积分及复发率的影响

目的:分析济川煎加减结合穴位埋线治疗对老年功能性便秘临床疗效、症状积分及复发率的影响。方法:选取2020年7月~2023年1月本院治疗的老年功能性便秘患者122例,根据治疗手段分为对照组61例(济川煎加减治疗)、观察组61例(济川煎加减+穴位埋线)。两组均持续治疗1个月后,比较两组临床疗效、症状积分、完全自主排便次数(CSBMs)、血清肠神经递质水平[血管活性肠肽(VIP)、5-羟色胺(5-HT)]、血清水平[P物质(SP)、一氧化氮(NO)]安全性及复发率。结果:观察组总疗效率高于对照组(P<0.05)。两组治疗后,排便频率、粪便性状、排便费力程度、腹胀及腹痛症候积分均下降,但观察组排便频率、粪便性状、排便费力程度、腹胀及腹痛症候积分下降幅度更大(P<0.05)。两组治疗后,CSBMs均增加,且观察组CSBMs多于对照组(P<0.05)。观察组VIP水平低于对照组;5-HT水平高于对照组(P<0.05)。两组治疗后,血清SP水平均上升,NO水平均下降,且观察组SP、NO水平分别高、低于对照组(P<0.05)。3个月后,观察组复发率低于对照组(P<0.05)。结论:老年功能性便秘应用济川煎加减结合穴位埋线治疗疗效较为显著,对降低症状积分、复发率具有优势,且能进一步改善肠道功能,为老年功能性便秘治疗提供一定新思路。

真实案例式情景式模拟教学法在麻醉学临床教学中的应用

目的研究基于真实案例式情景式模拟教学法在麻醉学临床教学中的实践效果。方法2022年1—7月,选择2021级和2022级麻醉专业的60名学生(学习《临床麻醉学》课程)为研究对象,将上述学生按照随机模式进行分组,划分为研究组和对照组,对照组应用传统教学模式,研究组则实施真实案例式情景式模拟教学法,最终对比观察不同组别学生的理论知识与操作技能考试成绩、实施自我评价结果、对教学效果的满意状况。结果应用不同教学方法后,发现学生成绩得到提升,且研究组的成绩大于对照组,差异有统计学意义(P<0.05)。自评期间,研究组的认定提升率达到96.67%,对照组是86.67%,研究组的认定提升率明显大于对照组,差异有统计学意义(P<0.05)。对比观察上述学生对教学效果的评价,发现研究组的教学满意率(96.67%)大于对照组(83.33%),差异有统计学意义(P<0.05)。结论在麻醉学临床教学期间,通过采用真实案例式情景式模拟教学法能够提高学生的学习理论成绩、临床操作技能水平,并促使学生的自我评价及教学满意度明显提高。

宫腔镜电切术治疗子宫内膜息肉致异常子宫出血患者的效果

目的:探讨宫腔镜电切术治疗子宫内膜息肉致异常子宫出血患者的效果。方法:回顾性分析2022年1—12月该院收治的92例子宫内膜息肉致异常子宫出血患者的临床资料,根据治疗方法不同将其分为对照组和研究组各46例。对照组采用宫腔镜下刮宫术治疗,观察组采用宫腔镜电切术治疗。比较两组临床疗效、术中出血量、手术时间、月经恢复正常时间、住院时间、并发症发生率及复发率。结果:观察组治疗总有效率为95.65%(44/46),高于对照组的76.09%(35/46),差异有统计学意义(P<0.05);观察组住院时间、手术时间、月经恢复正常时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为4.35%(2/46),低于对照组的17.39%(8/46),差异有统计学意义(P<0.05)。观察组复发率为2.17%(1/46),对照组复发率为8.70%(4/46),组间比较差异无统计学意义(P>0.05)。结论:宫腔镜电切术治疗子宫内膜息肉致异常子宫出血患者可提高临床疗效,缩短手术时间、住院时间及月经恢复正常时间,减少术中出血量,降低并发症发生率,效果优于宫腔镜下刮宫术治疗。

短种植体的临床应用研究进展

种植修复时常面临可用骨高度不足的问题,使用短种植体可解决骨增量手术之需。短种植体作为骨增量手术的替代治疗方案,在临床上已取得较好的短期效果,但短种植体的远期存留率还偏低,仍需临床进一步验证。本文就短种植体的定义、结构特点、临床应用、临床效果及展望等相关进行综述。

老年慢性牙髓炎一次性根管治疗的临床效果评估

目的探究老年慢性牙髓炎采用一次性根管治疗的疗效。方法方便选取2022年1月—2023年6月泰州市第三人民医院接诊的86例慢性牙髓炎患者为研究对象,采用随机数表法分为对照组和观察组,各43例,分别予以多次根管和一次性根管治疗,对比两组术后疼痛情况及临床疗效。结果观察组患者疼痛反应率低于对照组,差异有统计学意义(P<0.05)。观察组和对照组的治疗有效率对比,差异无统计学意义(P>0.05)。观察组术后肿瘤坏死因子-α、白细胞介素-6、C-反应蛋白分别(2.87±0.56)ng/mL、(1.01±0.35)μg/L、(3.65±0.64)mg/L,均低于对照组,差异有统计学意义(t=9.639、9.623、14.447,P均<0.05)。两组并发症总发生率相比,差异无统计学意义(P>0.05)。结论老年慢性牙髓炎患者接受一次性根管治疗术有助于减轻术后疼痛度及术后并发症,并且临床效果显著。

吹氧联合蒙脱石散治疗新生儿尿布皮炎的效果分析

目的分析新生儿尿布皮炎进行吹氧联合蒙脱石散治疗对患儿皮炎程度的影响。方法回顾性选取2023年4—10月福建省晋江市医院(上海市第六人民医院福建医院)接受治疗的86例新生儿尿布皮炎患儿的临床资料,以治疗差异分组,每组43例,对照组患儿采用吹氧治疗,观察组则是在对照组基础上配合蒙脱石散治疗,比较两组新生儿治疗有效率、皮炎程度与相关临床指标。结果观察组的治疗有效率(97.67%)高于对照组(83.72%),差异有统计学意义(χ^(2)=4.962,P<0.05)。治疗前两组患儿皮炎程度对比,差异无统计学意义(P>0.05);治疗后观察组皮炎程度明显低于对照组,差异有统计学意义(P<0.05)。观察组红臀、湿疹与肛周皮肤破损等不良症状发生情况优于对照组,差异有统计学意义(P均<0.05)。观察组相关临床指标优于对照组,差异有统计学意义(P均<0.05)。结论吹氧联合蒙脱石散在新生儿尿布皮炎治疗期间可以缩短患儿症状缓解时间,且临床使用安全性高,可以将皮炎程度进一步改善,进而促使新生儿经临床治疗后能够尽快康复。

麻防犀角地黄汤治疗寒包火型银屑病临床疗效观察

目的:探讨麻防犀角地黄汤治疗寒包火型银屑病(Ps)的临床疗效。方法:选取2021年1月~2022年7月桐城市中医医院收治的60例寒包火型Ps患者,采用随机数字表法分为观察组和对照组各30例。两组均外用卡泊三醇软膏,对照组口服阿维A胶囊,观察组服用麻防犀角地黄汤,疗程均为8周。比较两组疗效和治疗前后中医症候积分、面积与严重性指数(PASI)评分、皮肤病生活质量指数(DLQI)评分及白介素-23(IL-23)、白介素-17(IL-17)、CD4+辅助型T1细胞/T2细胞(Th1/Th2),比较两组不良反应发生率和随访6个月复发率。结果:观察组有效率为70.00%,与对照组的83.33%无显著差异(P<0.05);治疗后,观察组病程迁延、秋冬疕重、受寒疕重中医证候积分和PASI评分、DLQI评分分别为(3.60±0.75)分、(3.24±0.76)分、(3.29±0.22)分、(28.12±4.95)分和(11.52±1.82)分,低于对照组的(4.49±0.87)分、(4.01±0.78)分、(3.54±0.30)分、(33.25±5.09)分和(13.97±2.03)分(P<0.05);观察组IL-23、IL-17水平为(2.25±0.37)pg/mL和(7.13±1.19)pg/mL,低于对照组(3.43±0.51)pg/mL和(9.04±1.36)pg/mL,Th1/Th2为(4.91±0.79),高于对照组(3.52±0.58)(P<0.05);观察组复发率为16.67%,低于对照组的43.33%(P<0.05)。结论:麻防犀角地黄汤治疗寒包火型Ps疗效确切,可降低复发率。

Effect of Continuous Nursing Model on Nursing Effect of Continuous Peritoneal Dialysis

Objective:To analyze and study the effect of continuous nursing mode for continuous peritoneal dialysis nursing.Methods:40 patients with continuous peritoneal dialysis received in our hospital were randomly selected as the research object.The research time was from June 2018 to June 2020.The patients were divided into two groups by random number table method.The patients with routine nursing mode were named as the control group and the patients with continuous nursing mode were named as the observation group(20 cases in each group).The clinical nursing effects of different nursing modes are compared.Results:After nursing,the nursing compliance of the observation group was 95%,which was higher than 70% of the control group.There was significant difference between the two groups(P<0.05).Comparing the blood routine related indexes of the two groups,the blood potassium,hemoglobin,serum creatinine and carbon dioxide binding force of the observation group were better than those of the control group(P<0.05).The incidence of peritonitis and rehospitalization rate in half a year in the observation group were lower than those in the control group(P<0.05).Conclusion:The continuous nursing model for patients undergoing continuous peritoneal dialysis can improve the treatment effect of patients,significantly improve the compliance of patients,significantly improve the serological indexes,promote the health of patients,reduce the incidence of peritonitis,and significantly reduce the rehospitalization rate in half a year.It has a broad prospect of clinical promotion.

半导体激光在牙周牙髓联合病变中的应用效果

目的评估半导体激光应用在牙周牙髓联合病变(EPL)辅助治疗中的临床效果。方法选取2021年1月至2023年12月合肥市口腔医院收治的96例EPL患者作为研究对象,按照随机数字表法将其分为对照组(48例)与观察组(48例),对照组患者采用牙周牙髓基础治疗+盐酸米诺环素软膏,观察组患者给予牙周牙髓基础治疗+半导体激光治疗。比较两组患者的临床有效率、牙周检查指标[牙周袋深度(PD)、菌斑指数(PLI)、龈沟出血指数(SBI)、临床附着丧失(CAL)、牙龈指数(GI)]、龈沟液炎症因子[白介素-4(IL-4)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]。结果观察组治疗后6个月的临床总有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后PD、PLI、SBI、CAL、GI、IL-6、TNF-α低于对照组,IL-4高于对照组,差异有统计学意义(P<0.05)。结论对EPL患者辅以半导体激光治疗,可以提高临床有效率,改善牙周检查指标,减轻牙周炎症状态。