目的 探讨Ｃ反应蛋白(CRP)在慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前、后的变化和临床意义。方法 纳入2008年1月-9月住院治疗的80例AECOPD患者，分别测定应用抗生素治疗前后CRP、白细胞计数(WBC)、中性粒细胞百分比(N%)、血沉和体温，并比较这些指标的变化情况。结果 AECOPD患者在感染期CRP总阳性率为100.00%，显著高于治疗前WBC、N%、血沉和体温的阳性率(Plt;0.05)；也显著高于感染控制后(Plt;0.05)。 结论 CRP作为细菌性感染的敏感指标之一，也可作为指导临床及时、正确使用或评价抗生素疗效的一个指标。
Objective To systematically review literature on the influencing factors related to adolescent sub-health problems. Methods We electronically searched the following four databases including CBM, VIP, CNKI and WanFang Data to collect Chinese literature on adolescent sub-health status and problems in China published before May 2012. Two reviewers independently screened literature, extracted data, and cross checked records. Then qualitative analysis was applied. Results According to the inclusion and exclusion criteria, 41 cross-sectional studies were included. The results of qualitative analysis showed that the influencing factors of adolescent sub-health could be classified into four categories including social factors, family factors, school factors, and interpersonal relationships. The main ones were social support, employment pressure, family economic conditions, learning burden, unhealthy habits, etc. Conclusions There are many influencing factors of adolescent sub-health with interaction. Due to the limitation of the included studies, more prospective cohort studies are needed to provide high quality evidence.
Objective To assess the effect of problem-based learning (PBL) versus traditional methods in nursing students. Methods Computer retrieval was conducted to search for controlled studies comparing PBL and traditional methods. The quality of included studies was critically evaluated and data were analyzed by using The Cochrane Collaboration’s RevMan 5.0 software. Results A tota1 of 321 articles were retrieved, but only l1 were included. Metaanalyses showed that there was no significant difference between PBL and traditional methods in the objective knowledge of nursing students (SMD 0.12, 95%CI -0.32 to 0.56, P=0.6gt;0.05); but PBL was superior to traditional methods in the training of critical thinking (WMD 11.52, 95%CI 6.29 to 16.74), conflict resolution skills (WMD 8.09, 95%CI 5.02 to 11.16), clinical problem-solving skills (WMD 0.43, 95%CI 0.22 to 0.64), and communication skills (WMD 1.56, 95%CI 0.17 to 2.95). Although no significant difference was identified in the training of clinical decision-making skills, collaborative skills, and self-directed learning skills, PBL tended to be superior to traditional methods. Conclusion PBL tends are associated with better learning results among nursing students compared with traditional methods. However, most trials included in the review were of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.
【摘要】 目的 分析护理干预对纤维支气管镜检查患者的心理影响。方法 2008年1月—12月，通过对100例患者的问卷调查及临床观察,总结分析其心理特点及所采取的护理干预措施的影响。结果 纤维支气管镜检查患者的心理特点有:恐惧心理、紧张心理、消极心理等；相应的护理干预:教育性干预、行为训练、情感支持、药物干预等。结论 正确评估患者的心理特点,采取有效的护理干预,改善患者的心理状况,有利于提高患者的依从性,从而提高检查的成功率。【摘要】 目的 分析护理干预对纤维支气管镜检查患者的心理影响。方法 2008年1月—12月，通过对100例患者的问卷调查及临床观察,总结分析其心理特点及所采取的护理干预措施的影响。结果 纤维支气管镜检查患者的心理特点有:恐惧心理、紧张心理、消极心理等；相应的护理干预:教育性干预、行为训练、情感支持、药物干预等。结论 正确评估患者的心理特点,采取有效的护理干预,改善患者的心理状况,有利于提高患者的依从性,从而提高检查的成功率。
Objective Based on images of pelvic CT three-dimensional reconstruction, to establish three-dimensional coordinate system of pelvis and investigate the three-axis displacement classification of pelvic fracture and its reduction principles. Methods Between June 2015 and May 2016, 21 cases of normal pelvic CT data were included in the study, and the mean pelvic three-dimensional model was established. The pelvic three-dimensional axis was established by defining the origin as the midpoint of the anterior superior iliac spine. Based on this coordinate system, a three-axis displacement classification of pelvic fracture were built. To assess the clinical guidance value of the three-axis classification, 55 cases (29 males and 26 females, aged 11-66 years with an average of 35.6 years) of pelvic fractures were analyzed by this classification, and replaced and fixed according to the principles of the reverse reduction. Results According to the theory of three-axis, pelvic fractures were divided into x-axis positive displacement/negative displacement, positive rotation/negative rotation; y-axis positive displacement/negative displacement, positive rotation/negative rotation; z-axis positive displacement/negative displacement, positive rotation/negative rotation. The average incision of included patients with pelvic fractures was 7.1 cm. The average reduction time was 12.2 minutes and the average radiation time was 55.3 s. The average time of screw implantation was 27.2 minutes. Postoperative pelvic X-ray films or three-dimensional CT showed all pelvic fracture was reducted well and the screw or plate was implanted correctly. The average intraoperative blood loss was 96.5 mL, the average operation time was 2.1 hours, and the average hospitalization time was 18.7 days. All patients were followed up 6-53 months (mean, 16.7 months). At last follow-up, according to Matta standard by pelvic radiography evaluation, there were excellent in 39 cases, good in 13 cases, and fair in 3 cases, the excellent and good rate was 94.55%. Conclusion Based on three-dimensional coordinate system, three-axis displacement classification of pelvic fracture can illustrate the displacement mode of patient simply and accurately, and can also guide the intraoperative reduction precisely.
ObjectiveTo evaluate the efficacy and safety of bronchoscope in the treatment of transbronchial broncholiths.MethodsThe clinical data, treatment methods, clinical efficacy and complications of 18 patients who were diagnosed with transbronchial broncholiths were etrospectively reviewed in the Respiratory Department of the Second Hospital of Lanzhou University during January 2010 to December 2017.ResultsEighteen patients were diagnosed by bronchoscopy with a total of 22 pieces of stone for transbronchial broncholiths. An elective surgical procedure was performed in 2 cases. Six cases were treated with removing broncholiths once by foreign body forceps under bronchoscope. Repeated treatments were performed in 10 patients. Two cases underwent massive hemorrhage in the process of one-time broncholiths removal by foreign body forceps under bronchoscope, and one case suffered from bronchial fistula after the broncholiths removal, all of the above 3 patients underwent surgical treatment. All patients were followed up for 5 months without any long-term complications.ConclusionsRemoval of broncholithiasis by bronchoscopic forceps can effectively treat transbronchial broncholiths with low complication and high safety. If the broncholiths cause severe distal lung tissue injury, massive hemoptysis, bronchial fistula, or the diagnosis is unclear, surgical treatment is required. When the transbronchial broncholith is difficult to remove completely at once, batch could be chosen. First, to remove one portion which causes the obstruction of airway; and then, to remove the left part of the transbronchial broncholith by stages.
Objective To investigate the clinical effect of orthopedic robot-assisted sacroiliac joint screws in the treatment of posterior pelvic ring fractures. Methods Patients who underwent sacroiliac joint screw fixation in People’s Hospital of Deyang City between January 2018 and August 2021 were included, and the patients were divided intoa robotic group and a manual group by randomization. The robot group used robot-assisted insertion of sacroiliac joint screws, and the manual group used manual insertion of sacroiliac joint screws. The general condition, time of sacroiliac joint screw placement, intraoperative fluoroscopy times, guide needle drilling times, surgical blood loss, and Majeed pelvic function score were compared between the two groups. Results A total of 42 patients were included, and there was no significant difference in gender, age, body mass index , injury type or injury cause between the two groups (P>0.05). Finally, 21 screws were placed in 19 patients in the robotic group and 23 screws in 23 patients in the manual group. The wounds of the two groups were completely healed after operation, and there was no wound infection, iatrogenic vascular and nerve injury, and no loosening of internal fixation. There was no significant difference in screw placement time, blood loss or Majeed score between the two groups (P>0.05). The number of fluoroscopy (14.53±4.54 vs. 19.87±5.48) and drilling times (1.00±0.00 vs. 7.24±3.77) in the robotic group were less than those in the manual group, and the differences were statistically significant (P<0.05). Conclusion Orthopedic surgical robots have the advantages of minimally invasive, less fluoroscopy, and accurate screw placement in sacroiliac joint screw placement, and have good clinical results in the treatment of pelvic fractures.
Objective To systematically analyze the factors influencing the left-behind children’s mental health. Methods After the search term and strategy were confirmed by researchers, four Chinese databases including Chinese Biological Medical Literature Database (CBM), Chinese Science and Technology Periodical Database (VIP), China National Knowledge Infrastructure (CNKI) and WanFang Database (WF) were searched to collect papers, published before March 2011, on relevant factors influencing mental health of left-behind children in China. Then two reviewers independently screened, extracted and cross-checked the data, and the disagreements were resolved by discussion or by consulting a third reviewer. Qualitative synthesis method was used to analyze the study results. Results Of the total 3 252 records, 49 studies were included. The results of qualitative analysis showed that factors influencing left-behind children’s mental health could be classified into four categories including social factors, family factors, school factors and personal factors. Of the nearly 30 kinds of specific factors, the main ones were gender, age, parent-child relationship, social support, personality and characteristics, and outgoing condition of parents, etc. Conclusion Current research results indicate that many factors have influences on mental health of left-behind children, but the research quality is not high with low argument efficiency. There are still controversies on several factors’ impact. Longitudinal studies with rigorous design are needed to analyze the impact of different factors on the left-behind children’s mental health and to summarize the interaction between various factors, so as to provide scientific evidence for developing practical and effective intervention measures.
Objective To study the effect of surgical treatment of carpal tunnel syndrome (CTS) by endoscope through a transparent combined with dilation conductor to cut the transverse carpal l igament. Methods Between April 2003 and April 2008, 56 patients with CTS were treated with endoscopic carpal tunnel release through a transparent combined with dilation conductor. There were 8 males and 48 females with an average age of 50 years (range, 38-65 years). CTS was caused bywrist injury in 5 cases, by forearm fracture in 12 cases, and by wrist strain in 39 cases. The locations were left hand in 14 cases and right hand in 42 cases with a disease duration range of 2-7 years (4 years on average). According to Hamada classification of CTS, 38 cases were classified as stage I, 12 cases as stage II, and 6 cases as stage III. Results All cases achieved the primary heal ing of incision. All patients were followed up 14-68 months (40 months on average). According to Kelly’ s evaluation, the results were excellent in 25 cases, good in 22 cases, fair in 4 cases, and poor in 5 cases with an excellent and good rate of 83.93%. The distal motor latency of median nerve was (4.48 ± 0.50) ms at 1 months, (4.06 ± 0.35) ms at 3 months, (3.79 ± 0.25) ms at 6 months, and (3.42 ± 0.24) ms at 12 months after operation, showing significant differences when compared with the preoperative one [(5.09 ± 0.61) ms, P lt; 0.05]. There were significant differences among different time points after operation (P lt; 0.05). Conclusion The method of endoscope through a transparent combined with dilation conductor to cut the transverse carpal l igament is a simple and effective surgical procedure for treament of CTS, which can precisely cut the transverse carpal l igament and completely release the pressure of carpal tunnel.
Objective To learn the impact of health education on schistosomiasis among high school students in Wanzhou area of Three Gorges Reservoir, and to evaluate its effects. Methods The stratified multi-level cluster randomized sampling was used to survey 566 high school students in Wanzhou and Yunyang areas, and the questionnaire was used to investigate their recognition of schistosomiasis. Results After one-year health education on schistosomiasis, the passing rate of the knowledge about schistosomiasis prevention among high school students in demonstration area raised from 9.43% to 98.87% (χ2=463.46, P=0.000), which was higher than that of the inside and outside control areas (χ2=312.92, P=0.000); the passing rate of the attitude and belief of schistosomiasis prevention were 98.12%, which was higher than that of the inside and outside control areas (χ2=109.49, P=0.000); 56.02% of high school students in demonstration area had no susceptible behavior of schistosomiasis, which was higher than that of the inside and outside control areas (χ2=237.53, P=0.000). Conclusion Health education on schistosomiasis can efficiently improve the awareness of schistosomiasis prevention among high school students, and has important meanings for controlling potential epidemics and spread of schistosomiasis in Wanzhou area of Three Gorges Reservoir.