The modified systemic inflammation score is a predictor of ICU admission of COVID-19 patients

Objective:To evaluate the effect of the modified systemic inflammation score(mSIS)on prognosis in patients diagnosed with COVID-19.Methods:In this retrospective cross-sectional study,181 patients were selected and divided into two groups:patients with and without admission to the intensive care unit(ICU).An albumin level of≥4.0 g/dL and lymphocyte-to-monocyte ratio(LMR)of≥3.4 was scored 0,an albumin level of<4.0 g/dL or LMR of<3.4 was scored 1,and an albumin level of<4.0 g/dL and LMR of<3.4 was scored 2.Results:A total of 242 COVID-19 positive patients were initially included in this study.Of these patients,61 were excluded and 181 patients remained.Among the 181 participants,94(51.9%)were female,and the median age was 61(51,75)years.The mSIS scale ranged from 0 to 2.After analysis,the median score was 0(0,0)in the non-ICU group and 2(0,2)in the ICU group(P<0.001).The median white blood cell,lymphocyte counts,and albumin levels were lower in the ICU group(P<0.001,P<0.001,and P<0.001,respectively).In logistic regression analysis lymphocytopenia(OR=5.158,95%CI=1.249-21.304,P=0.023),hypoalbuminemia(OR=49.921,95%CI=1.843-1352.114,P=0.020),AST elevation(OR=3.939,95%CI=1.017-15.261,P=0.047),and mSIS=2(OR=5.853,95%CI=1.338-25.604,P=0.019)were identified as independent predictors of ICU admission.Conclusion:The mSIS can be used as an independent parameter for establishing the intensive care needs of patients with COVID-19.

Poor performance of the modified early warning score for predicting mortality in critically ill patients presenting to an emergency department

BACKGROUND:This study was undertaken to validate the use of the modified early warning score(MEWS) as a predictor of patient mortality and intensive care unit(ICU)/ high dependency(HD)admission in an Asian population.METHODS:The MEWS was applied to a retrospective cohort of 1 024 critically ill patients presenting to a large Asian tertiary emergency department(ED) between November 2006 and December2007.Individual MEWS was calculated based on vital signs parameters on arrival at ED.Outcomes of mortality and ICU/HD admission were obtained from hospital records.The ability of the composite MEWS and its individual components to predict mortality within 30 days from ED visit was assessed.Sensitivity,specificity,positive and negative predictive values were derived and compared with values from other cohorts.A MEWS of ≥4 was chosen as the cut-off value for poor prognosis based on previous studies.RESULTS:A total of 311(30.4%) critically ill patients were presented with a MEWS ≥4.Their mean age was 61.4 years(SD 18.1) with a male to female ratio of 1.10.Of the 311 patients,53(17%)died within 30 days,64(20.6%) were admitted to ICU and 86(27.7%) were admitted to HD.The area under the receiver operating characteristic curve was 0.71 with a sensitivity of 53.0%and a specificity of 72.1%in addition to a positive predictive value(PPV) of 17.0%and a negative predictive value(NPV)of 93.4%(MEWS cut-off of ≥4) for predicting mortality.CONCLUSION:The composite MEWS did not perform well in predicting poor patient outcomes for critically ill patients presenting to an ED.

Selection of treatment modality for hepatocellular carcinoma according to the modified Japan Integrated Staging score

AIM： To compare the prognosis of patients who underwent hepatectomy and ablation using the modified Japan Integrated Staging score （mJIS）. METHODS： We examined the clinicopathologic records and patient outcomes in 278 HCC patients including 226 undergoing hepatectomy and 52 undergoing ablation therapy. RESULTS： Cirrhosis was more frequent in the ablation group. Tumor size, number and presence of vascular invasion were significantly higher in the operation group compared to the ablation group. The local recurrence rate adjacent to treated lesions was significantly higher in the ablation group compared to the operation group （P 〈 0.05）. The 3- and 5-year survival rates in the ablation and the operation group were 66% and 78%, and 50% and 63%, respectively, but not significantly different. Over 50% survival rates were observed in patients with a m.lIS score of 0-2 in both groups. However, survival rates with a score of 3-5 in both groups were significantly lower. CONCLUSION： According to the mJIS system, both local treatments could be selected for patients with a score of 0-2. However, for patients with a score more than 3, liver transplantation might be a better option in patients with HCC.

Comparison of transvaginal cervical length and modified Bishop's score as predictors for labor induction in nulliparous women

Objective: To compare the transvaginal cervical length (TVCL) to the modified Bishop's score for prediction of successful labor induction in nulliparous women. Methods: A total of 210 nulliparous women who were diagnosed as premature rupture of membranes were recruited in this comparative prospective study, which was carried out in the Obstetrics and Gynecology Department of Ain Shams University, Egypt over two years for labor induction. The studied women were examined by trans-vaginal ultrasound for measurement of the cervical length (CL) and vaginally to calculate the modified Bishop's score, followed by induction of labor. Collected data were analyzed to compare the TVCL to the modified Bishop's score for prediction of successful labor induction in nulliparous women. The success of induction process was defined as vaginal birth after the induction of labor. Results: One hundred and forty-three women of studied women had CL <28 mm;122 of them delivered vaginally (P=0.030). One hundred and forty-six women of studied women had modified Bishop's score >4;128 of them delivered vaginally (P=0.006). The CL <28 mm was significantly more specific with more positive predictive value as predictor of successful labor induction compared to modified Bishop's score. Induction to delivery time was significantly shorter in women with CL <28 mm than women with CL ≥28 mm (P=0.02;95% confidence interval: 4.9-8.4). In addition, induction to delivery time was significantly shorter in women with Bishop's score >4 than women with Bishop's score of 曑4 (P=0.01;95% confidence interval: 1.6-4.5). Conclusions: Both TVCL and the modified Bishop's score are complementary tools in pre-induction cervical assessment before induction of labor, while the TVCL at <28 mm is significantly more specific with more positive predictive value as predictor of successful induction than the modified Bishop's score.

The applied value of modified POSSUM score in evaluating lung cancer surgery’s risk

Objective: The aim of this study was to explore the modified physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) scoring system and the relationship between predicted data and actual data of complication and surgical mortality of lung cancer radical surgery made by such score system. Methods: Retrospective analysis on the 86 cases of the clinical materials of patients with primary lung cancer radical surgery for thoracic surgery of line lung cancer in the 81st Hospital of PLA from October 2010 to October 2011 and using the POSSUM scoring system to predict the cases of postoperative complication and death toll, then making a comparison with the actual cases. Results: The POSSUM scoring system predicting 29 cases of postoperative complications, but 32 cases of practical complications, the difference between them has no statistical significance (P﹥0.05), 8 cases of predicted postoperative deaths, 2 cases of practical deaths, by comparison, there was statistical significance (P﹤0.05). Conclusion: The modified POSSUM scoring system can be used to predict the postoperative complication of lung surgery patients, but sometimes overestimates the postoperative death cases.

Statistical Analysis of Thunderstorms on the Eastern Tibetan Plateau Based on Modified Thunderstorm Indices

The Tibetan Plateau, with an average altitude above 4000 m, is the highest and largest plateau in the world. The frequency of thunderstorms in this region is extremely high. Many indices are used in operational forecasting to assess the stability of the atmosphere and predict the probability of severe thunderstorm development. One of the disadvantages of many of these indices is that they are mainly based on observations from plains. However, considering the Plateau＇s high elevation, most convective parameters cannot be applied directly, or their application is ineffective. The pre-convective environment on thunderstorm days in this region is investigated based on sounding data obtained throughout a five-year period（2006–10）.Thunderstorms occur over the Tibetan Plateau under conditions that differ strikingly from those in plains. On this basis,stability indices, such as the Showalter index（including SI and SICCL）, and the K index are improved to better assess the thunderstorm environments on the Plateau. Verification parameters, such as the true-skill statistic（TSS） and Heidke skill score（HSS）, are adopted to evaluate the optimal thresholds and relative forecast skill for each modified index. Lastly, the modified indices are verified with a two-year independent dataset（2011–12）, showing satisfactory results for the modified indices. For determining whether or not a thunderstorm day is likely to occur, we recommend the modified SICCLindex.

Modified Xiaochaihu Decoction for gastroesophageal reflux disease:A randomized double-simulation controlled trial

BACKGROUND Gastroesophageal reflux disease(GERD)has a high prevalence worldwide,and its incidence is increasing annually.Modified Xiaochaihu Decoction(MXD)could relieve the symptoms of GERD,but the effects of MXD on GERD manifestations and relapse prevention need to be further explained.Therefore,we performed a prospective,double-blind,and double-simulation study.AIM To verify the efficacy of MXD for GERD and its effect on esophageal motility.METHODS Using randomization,double-blinding,and a simulation design,288 participants with GERD were randomized to the treatment group and control group and received herbs(MXD)plus omeprazole simulation and omeprazole plus herbs simulation,respectively,for 4 wk.The GERD-Q scale score and esophageal manometry were measured at baseline,after treatment,and at 1 mo and 3 mo follow-up visits when medication was complete to evaluate recurrence indicators.RESULTS The GERD-Q scale score in both groups decreased significantly compared to those before treatment(P<0.01).However,no significant difference was observed between the two groups(P>0.05).Esophageal manometry showed that participants with lower esophageal sphincter pressure reduction and the proportion of ineffective swallowing(more than 50%)improved in both groups from baseline(P<0.01),especially in the treatment group(P<0.05).The percentage of small intermittent contractions,large intermittent contractions,and increased pre-phase contractions in the treatment group significantly improved compared with baseline(P<0.05)but did not improve in the control group(P>0.05).There was no significant difference between the groups after treatment(P>0.05).The percentage of weak esophageal contractility(distal contractile integral<450 mmHg·s·cm),improved in both groups(P<0.01),but no significant difference was observed between the groups after treatment(P>0.05).The relapse rate in the treatment group was lower than that in the control group at the 1 mo(P<0.01)and 3 mo follow-up(P<0.05).CONCLUSION MXD has a similar therapeutic effect to omeprazole in mild-to-moderate GERD.The therapeutic effect may be related to increased pressure in the lower esophageal sphincter and reduced ineffective swallowing.

血清PSA水平下降速率联合改良PI-RADS评分在鉴别前列腺良性疾病与前列腺癌中的价值

目的探讨血清前列腺特异性抗原(PSA)水平下降速率联合改良前列腺影像报告和数据系统(PI-RADS)评分在鉴别前列腺良性疾病和前列腺癌中的价值。方法回顾分析80例行前列腺穿刺活检患者的临床资料,根据病理结果分为前列腺良性疾病组和前列腺癌组,绘制受试者工作特征曲线(ROC)确定阈值,比较两组PSA水平下降速率、PI-RADS评分、血常规和尿液白细胞等相关参数,采用t检验或Z检验等统计方法探讨这些参数在鉴别前列腺良性疾病和前列腺癌中的价值。结果两组相比,PSA水平下降速率、改良PI-RADS评分、淋巴细胞百分比和尿液白细胞差异有统计学意义(P<0.01)。两组血常规中白细胞计数、中性粒细胞计数、中性粒细胞百分比、单核细胞百分比差异无统计学意义(P>0.01)。通过ROC确定,PSA下降速率阈值为3.175 ng/mL时,对前列腺疾病鉴别诊断符合率最高。再结合改良PI-RADS评分,使得前列腺疾病诊断符合率大幅提升。结论使用血清PSA水平下降速率联合改良PI-RADS评分鉴别前列腺良性疾病和前列腺癌,可提高前列腺穿刺阳性率。

Functional and clinical outcome with modified lateral approach total hip arthroplasty in stiff hips with ankylosing spondylitis

BACKGROUND Ankylosing spondylitis at total hip arthroplasty(THA)has significant hip stiffness with flexion deformity,restricted mobility,and function.Range of movement(ROM)improvement with good functional outcome is seen following THA in these hips.The modified Hardinge approach without abductor compromise is helpful in these stiff hips with associated flexion deformity.AIM To assess improvement in ROM and functional outcomes with a modified lateral approach THA in ankylosing spondylitis with stiff hips.METHODS A total of 69 hips that underwent THA with a modified Hardinge approach in 40 patients were evaluated at a mean follow-up of 38.33 mo.All individuals ambulated with weight-bearing as tolerated and ROM exercises from the 1st postoperative day.Modified Harris hip score and ROM were assessed during follow-up.Quality of life assessments using the 36-item and 12-item short form health surveys were done along with clinical and functional outcomes at followup.SPSS 22.0 was used for statistical analysis.The correlation of ROM and functional score change was performed using Pearson’s correlation coefficient.RESULTS Sixty-nine hips with a significant decrease in ROM preoperatively with 32 clinically fused hips showed significant improvement in flexion range.The mean flexion in 69 hips improved from 29.35±31.38 degrees to 102.17±10.48 degrees.The mean difference of 72.82 with a P value<0.0001 was significant.In total,45 out of 69 hips had flexion deformity,with 13 hips having a deformity above 30 degrees.The flexion during the follow-up was below 90 degrees in 3 hips.Eleven hips had flexion of 90 degrees at follow-up,while the remaining 55 hips had flexion above 100 degrees.Modified Harris hip score improved from 17.03±6.02 to 90.66±7.23(P value<0.0001).The 36-item short form health survey at the follow-up indicated health status in 40 patients as excellent in 11,very good in 20,good in 5,fair in 3,and poor in 1.The mean mental health score was 84.10±11.58.Pain relief was good in all 69 hips.Altogether,28/40 patients(70%)had no pain,9 patients(22%)had occasional pain,and 3 patients(8%)had mild to moderate pain with unusual activity.Heterotopic ossification was seen in 21 hips with Brooker class 1 in 14 hips.CONCLUSION Modified Hardinge approach THA in ankylosing spondylitis with stiff hips with flexion deformity significantly improved ROM,Harris hip score,and quality of life indicated by the 36-item and 12-item short form health surveys.

Comparing the Surgical Outcomes of Modified Quad and Triangle Tilt Surgeries to other Procedures Performed in Obstetric Brachial Plexus Injury

Purpose: To compare results from our surgical treatment experiences in children with obstetric brachial plexus injuries (OBPI), to those who have had other surgical treatments. Methods: We conducted a retrospective study in our medical records consisting of two groups of OBPI patients. Group 1: 26 OBPI children (16 girls and 10 boys), age range between 2.0 and 12.0 (mean age 6.9), who have undergone surgical treatments at other institutions between 2005 and 2010. Group 2: 45 OBPI children (20 boys and 25 girls), age between 0.7 and 12.9 (mean age 3.7), who have had modified Quad and triangle tilt surgical treatment between 2005 and 2010 at our institution. In both groups Mean modified Mallet scores and radiological scores were measured and compared. All measurements were made at least one year post surgery in both groups. Results: Post-operative mean modified Mallet score was 11.8 ± 2.4 in group 1 patients, whereas post-mean modified Mallet score was 20 ± 2.7 (P 0.0001) following modified Quad and triangle tilt surgeries in group 2 patients. Further, their radiological scores such as posterior subluxation, and glenoid version were 13.4 ± 21.3 and ﹣30.2 ± 19.1 in group 1, whereas 32.1 ±13.5 (P 0.0004), and ﹣16.3 ± 11.5 (P 0.008) in group 2 patients, when compared to normal values of 50, and 0 respectively. Conclusion: Patients who have had mod Quad and triangle tilt for OBPI obtained significantly better functional outcomes in modified total Mallet score as well as in radiological scores, when compared to those OBPI children, who underwent other procedures such as posterior glenohumeral capsulorrhaphy, biceps tendon lengthening, humeral osteotomy, anterior capsule release, nerve transfer/graft, botox and muscle/tendon transfer and release.

Growth of the Pulmonary Valve Annulus after the Modified Blalock-Taussig Shunt in Patients with Tetralogy of Fallot

Background:The surgical outcomes of tetralogy of Fallot(TOF)have evolved dramatically and have resulted in lower mortality rate.Currently,the many cardiac centers have a trend to early single-stage complete repair more than a staged repair.However,the patients who have an early primary repair were required transannular patch augmentation of a pulmonary valve frequently.This effect has been developed a chronic pulmonary insufficiency may lead to right ventricular dilation,dysfunction.In this era,the aim of treatment of TOF is attempted to preserve pulmonary valve annulus for prevent right ventricular dysfunction in the future.The systemic to pulmonary artery shunt is a palliative procedure or known as staged repair for symptomatic patients with TOF.The modified Blalock-Taussig shunt(mBTS)is the most useful systemic to pulmonary shunt and perform as an initial procedure before complete repair.The mBTS can provide increase pulmonary blood flow as well as improve oxygenation and also promote pulmonary artery(PA)growth.However,the effect of this procedure to promote growth of a pulmonary valve annulus is still debate.Objectives:To compare a growth of pulmonary valve annulus between after staged repair and primary repair in patients with TOF(without pulmonary atresia).Methods:A retrospective case-control study,review of patients with TOF underwent total repair at our hospitals from January 2005 and December 2017 was performed,a total number of 112 patients underwent TOF repair.Twenty-nine patients(26%)underwent a staged repair(mBTS group)and 83(74%)underwent total repair only or primary repair(PR group).We evaluated diameter of pulmonary valve annulus by using echocardiography at the time of first diagnosis and before complete repair on both groups.Results:The age of diagnosis of mBTS group were younger than PR group(p=0.011).Therefore,pulmonary valve annuls were smaller in mBTS group.(Z-score,−2.93±1.42 vs.−1.89±0.97;p=0.001).However,the growth potential of pulmonary valve annulus was increase more than PR group significantly(Z-score,−1.46±1.02 vs.−2.11±1.19;p=0.009)Even though a patent ductus arteriosus was found commonly in PR group(p=0.018).Conclusions:Our results suggest the systemic to pulmonary shunt or mBTS can promote growth of pulmonary valve annulus in patients with TOF.

两种早期预警评分系统对急性冠状动脉综合征患者发生心搏骤停的预测效果分析

目的探讨两种早期预警评分系统对急性冠状动脉综合征患者发生心搏骤停的预测效果。方法采取回顾性病例-对照研究,便利选取2018年12月至2022年12月因急性冠状动脉综合征入某医院急诊科进行治疗的300例患者作为研究对象,按入院24 h后是否发生心搏骤停分为病例组(158例)和对照组(142例)。病例组收集患者在心搏骤停发生前30 min、1 h、2 h、4 h、8 h、16 h、24 h的生命体征,并带入改良早期预警评分量表和重要性早期预警评分量表;对照组随机选择24 h内具有完整资料的时间点与病例组相对应,收集内容及方法同病例组。结果病例组患者心搏骤停前30 min至24 h各个时间点,两个量表评分均明显高于对照组(P<0.05)。心搏骤停前8 h,改良早期预警评分的ROC曲线下面积为0.642,具有较低的预测效能,重要性早期预警评分的ROC曲线下面积为0.783,预测效能中等。心搏骤停发生前的8 h内,重要性早期预警评分的ROC曲线下面积均>0.7,且各值比较差异均无统计学意义(P>0.05)。重要性早期预警评分对各种类型的急性冠状动脉综合征患者发生心搏骤停的ROC曲线下面积均>0.7。结论重要性早期预警评分比改良早期预警评分具有更高的预测效能,能够提前8 h预测心搏骤停的发生,且对各种类型的急性冠状动脉综合征患者均有良好的预测效果,建议临床推广应用。

血清乳酸脱氢酶、β2微球蛋白、铁蛋白联合改良WHO预后积分系统预测骨髓增生异常综合征预后不良的价值

目的探讨血清乳酸脱氢酶(LDH)、β2微球蛋白(β2-MG)、铁蛋白(SF)联合改良WHO预后积分系统(WPSS)评分对骨髓增生异常综合征(MDS)预后不良的预测价值。方法选取110例MDS患者作为研究对象,均检测血清LDH、β2-MG、SF水平。根据生存情况将患者分为病死组与存活组,比较2组血清LDH、β2-MG、SF水平和改良WPSS评分。分析MDS预后不良的危险因素及血清LDH、β2-MG、SF水平和改良WPSS评分单独及联合对MDS预后不良的预测价值。结果MDS预后不良发生率为40.20%(41/102)。病死组血清LDH、β2-MG、SF、改良WPSS评分和染色体核型预后不良比率均高于存活组,差异有统计学意义(P<0.05)。Cox回归模型分析结果显示,血清LDH、β2-MG、SF水平和改良WPSS评分升高、染色体核型预后不良是MDS预后不良的危险因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,血清LDH、β2-MG、SF水平联合改良WPSS评分预测MDS预后不良的灵敏度和曲线下面积(AUC)分别为95.12%、0.918,均显著高于各指标单独预测(P<0.05)。结论血清LDH、β2-MG、SF水平和改良WPSS评分对MDS预后不良均具有一定的预测价值,但4项指标联合预测价值更高。

宁夏南部山区围绝经期女性围绝经期综合征特点分析

目的分析宁夏南部山区围绝经期女性围绝经期的影响因素,为宁夏农村围绝经期女性预防保健提供依据。方法采取多阶段抽样方法,选择宁夏南部山区2个县,每个县2个乡,每个乡2个村,对40~55岁女性395人进行问卷调查,根据改良Kuppermonn量化评分表对其症状进行评分,并对围绝经期综合征的影响因素进行分析。结果395名女性中检出围绝经综合征162人,绝经期综合征患病率为41.0%。其中,轻度63人,占15.9%;中度91人,占23.1%;重度8人,占2.1%。年龄、产次、吃甜食、吃奶类豆类及其制品成为围绝经期综合征的影响因素。结论针对农村围绝经期女性围绝经期综合征特点,对此类人群进行健康教育和重点干预,以提高农村女性自我保健意识。

改良格拉斯哥预后评分和全身免疫炎症指数在宫颈癌患者预后预测中的价值

目的:探讨改良格拉斯哥预后评分(mGPS)和全身免疫炎症指数(SII)在宫颈癌患者预后预测中的价值。方法:回顾2010年-2017年我院的宫颈癌患者143例,收集完整病历并随访至2023年6月30日,采用Kaplan-Meier法绘制生存曲线,Log-rank检验和Cox回归分析影响患者预后的因素。结果:患者3年和5年生存率分别为85.31%和66.43%。受试者工作曲线(ROC)显示:mGPS、SII、白蛋白(ALB)、淋巴细胞(LYM)、中性粒细胞(NEU)和C反应蛋白(CRP)预测患者预后的曲线下面积分别为0.821、0.867、0.875、0.885、0.835和0.696,最佳截断值分别为0.5分、34.65 g/L、1.38×10^(9)/L、5.55×10^(9)/L、7.25 mg/L和475×10^(9)/L。Cox回归分析显示:mGPS、SII和FIGO分期是宫颈癌患者预后的影响因素,其HR分别为2.484(GPS=1)、7.096(mGPS=2)、0.121、9.507(FIGO为Ⅲ期)和23.715(FIGO为Ⅳ期)(P<0.05)。结论:mGPS、SII和FIGO分期是宫颈癌患者预后的重要预测因子。

改良Aldrete量表和DPART在全身麻醉术后复苏病人中的应用效果比较

目的:探讨中文版DPART量表与改良Aldrete量表对全身麻醉病人术后复苏效果的评估效果。方法:以全身麻醉术后入麻醉复苏室(PACU)接受治疗的病人为研究对象,按手术日期先后顺序分为改良Aldrete组和DPART组。改良Aldrete组105例病人采用改良Aldrete作为出室评估工具,DPART组109例病人采用DPART作为出室评估工具,比较两组病人PACU停留时间、出室时疼痛评分、镇静躁动得分、苏醒期躁动发生率、恶心呕吐评分和护士对于两种量表的可行性、实用性评价。结果:DPART组PACU停留时间长于改良Aldrete组(P<0.05),但出室时疼痛评分、恶心呕吐评分低于改良Aldrete组(P<0.05);两组出室时镇静躁动得分及苏醒期躁动发生率比较差异无统计学意义(P>0.05);DPART组量表的可行性评分低于改良Aldrete组(P<0.05),实用性评分高于改良Aldrete组(P<0.05)。结论:应用中文版DPART量表评估PACU病人,病人PACU停留时间较使用改良Aldrete量表评估延长,但病人出室时各项体征表现较好,更有利于保障全身麻醉术后病人安全转出PACU。

泻黄散加味治疗脾胃积热型小儿便秘疗效及对证候积分的影响

目的研究泻黄散加味与排便训练联合治疗脾胃积热型小儿便秘疗效以及对证候积分和复发的影响。方法将2019年7月—2021年7月共101例脾胃积热型便秘患儿纳入研究,采用随机数字表法将患儿分为两组,分别为对照组50例和观察组51例,对照组接受双歧杆菌三联活菌胶囊和排便训练,而观察组采用泻黄散加味颗粒和排便训练治疗。观察治疗后2组患儿用药前后便秘改善程度及临床疗效差异,比较治疗前后2组患儿中医证候积分、胃肠激素水平[血清胃动素(MTL)、胃泌素(GAS)、胃饥饿素(GHR)]、血清学指标水平[血清P物质(SP)、血管活性肠肽(VIP)、一氧化氮(NO)],统计2组不良反应以及半年内复发率并进行比较。结果治疗4周后,2组便秘患者症状自评量表(PAC-SYM)各项评分、大便干结、腹胀、舌红苔黄、口干口臭均较治疗前明显降低(P<0.05),且观察组低于对照组(P<0.05);2组患儿MTL、GAS、GHR、SP、VIP指标均较治疗前显著提升(P<0.05),且观察组比对照组更高(P<0.05),NO显著降低(P<0.05),且观察组比对照组更低(P<0.05)。2组患儿在治疗期间不良反应发生率相似,差异没有统计学意义(P>0.05)。所有患儿治疗2个月均已治愈,经过6个月的随访,观察组便秘复发率明显低于对照组(P<0.05)。结论泻黄散加味与排便训练联合治疗脾胃积热型患儿便秘表现出显著效果,使患儿便秘症状和胃肠激素表达均得到可观改善,纠正其消化系统的神经调节机制,有利于预防复发。

当归饮子加减联合穴位艾灸治疗乳腺癌化疗后手足综合征临床效果探究

目的探究当归饮子加减联合穴位艾灸治疗乳腺癌化疗后手足综合征(hand-foot syndrome,HFS)临床效果。方法选取2022年1月—2023年1月该院收治的115例乳腺癌化疗后HFS作为研究对象,按照治疗方法分为当归饮子组59例及常规治疗组56例,常规治疗组给予维生素B_(6)+尿素软膏常规治疗,当归饮子组常规治疗组基础上加用当归饮子加减方联合穴位艾灸治疗,比较两组患者临床疗效、中医证候积分、疼痛评分[现时疼痛强度(present pain intensity,PPI)]、血清水平[超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)]、生活质量[HFS生活质量量表(HRQL)]。结果治疗后,当归饮子组总有效率94.92%(56/59)高于常规治疗组82.14%(46/56)(P<0.05);治疗后,两组皮肤暗淡、皲裂脱屑、皮肤干燥、疼痛瘙痒评分均有所降低,且当归饮子组低于常规治疗组(P<0.05);治疗后,两组现时疼痛强度PPI评分均有所降低,且当归饮子组低于常规治疗组(P<0.05);治疗后,两组hs-CRP有所降低,且当归饮子组低于常规治疗组(P<0.05);治疗后,两组HRQL生活质量评分均有所降低,且当归饮子组低于常规治疗组(P<0.05)。结论当归饮子加减联合穴位艾灸治疗乳腺癌化疗后HFS能够取得良好的治疗效果,能够有效缓解中医证候,减轻患者现时疼痛,改善患者生活质量。

加减柴胡温经汤治疗对围绝经期失眠(肝郁阴虚夹瘀型)患者中医症候积分、神经递质及炎症因子的影响

目的:探究加减柴胡温经汤治疗对围绝经期失眠(肝郁阴虚夹瘀型)患者中医症候积分、神经递质及炎症因子的影响。方法:于2021年12月~2022年12月本院收治的围绝经期失眠患者中选取102例作为研究对象,并按随机数字表法分成对照组(51例)和研究组(51例)。对照组给予舒乐安定治疗,研究组给予加减柴胡温经汤治疗,时长均为8周。比较两组疗效、中医症候(长期失眠、健忘、心烦易怒、肌肤甲错瘙痒、疲乏酸痛)积分、神经递质因子[β-内啡肽(β-EP)、神经肽Y(NPY)、5-羟色胺(5-HT)]水平、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白介素-6(IL-6)]水平、睡眠结构[总睡眠时间(TST)、睡眠潜伏期(SL)、睡眠效率(SE)、觉醒时间(AT)]和不良反应发生率的变化。结果:治疗8周后,研究组的总有效率为92.16%高于对照组的76.47%(P<0.05);两组的各项症候积分低于治疗前(P<0.05),且研究组低于对照组(P<0.05);两组NPY、β-EP、5-HT水平高于治疗前,IL-6、TNF-α、IL-1β水平低于治疗前,且研究组变化的幅度高于对照组(P<0.05);两组TST、SE高于治疗前,SL、AT均低于治疗前,且研究组变化的幅度高于对照组(P<0.05);两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论:加减柴胡温经汤治疗肝郁阴虚夹瘀型围绝经期失眠患者的效果显著,能有效改善中医症候,提高神经递质含量,降低炎症因子水平,优化睡眠结构。

基于MEWS评分不同风险等级护理模式对重症肺炎患者的影响

目的探究分析基于改良早期预警评分系统(MEWS)评分的不同风险等级护理模式对重症肺炎患者的影响效果。方法以简单随机抽样法选取2020年5月至2023年5月在江苏省连云港市第一人民医院接受治疗的80例重症肺炎患者作为研究对象。用计算机随机编号的方式将研究对象分成对照组与治疗组,各40例。对照组男25例、女15例,年龄28~59(48.45±6.75)岁,病程5~13(8.25±2.02)d,采取常规化临床护理干预。治疗组男23例、女17例,年龄27~60(48.18±6.54)岁,病程6~15(8.30±2.18)d,采取基于MEWS评分的不同风险等级护理模式。比较分析两组患者入院次日和出院前1日的肺功能水平、症状改善效果、并发症发生情况。统计学方法采用χ^(2)检验、t检验。结果干预后,治疗组患者的第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC均高于对照组[(2.12±0.45)L比(1.81±0.40)L、(2.55±0.51)L比(2.30±0.45)L、(83.14±6.14)%比(78.69±6.65)%],差异均有统计学意义(t=3.26、2.33、3.11,均P<0.05)。治疗组退热时间、啰音消失时间、咳嗽持续时间、流涕持续时间均短于对照组[(4.36±1.25)d比(5.14±1.45)d、(6.85±1.20)d比(8.74±1.15)d、(9.74±1.96)d比(12.11±2.38)d、(7.11±1.30)d比(8.45±1.28)d],差异均有统计学意义(t=2.58、7.19、4.86、4.65,均P<0.05)。治疗组并发症总发生率低于对照组[2.50%(1/40)比20.00%(8/40)],差异有统计学意义(χ^(2)=4.51,P<0.05)。结论基于MEWS评分的不同风险等级护理模式在重症肺炎患者中的应用效果显著,对改善患者肺功能具有积极影响,可降低并发症发生风险,缩短临床症状持续时间。