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find Author "张莉" 33 results
  • Application status of titrated oxygen therapy in patients with acute exacerbation of COPD: a three-year literature review

    Objective To investigate the application status of titrated oxygen therapy in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by means of literature retrieving. Methods Database retrieving is taken on eight major domestic medical journals about the treatment for AECOPD patients during the period of January 2013 to December 2015. Results There were 70 articles involving the treatment of AECOPD in the eight major journals during 2013 to 2015. Oxygen therapy was not mentioned in 14 articles, oxygen therapy data were incomplete in 13 papers and relatively complete in 43 papers. None of the articals provided full description of oxygen therapy. The arterial blood gas of the patients was analyzed, and showed excessive or not enough on effect of oxygen treatment. Conclusion The clinicians did not pay enough attention to oxygen treatment for AECOPD patients, so treatment guideline and clinical pathway should be construed to standardize titrated oxygen therapy.

    Release date:2017-05-25 11:12 Export PDF Favorites Scan
  • 先天性心脏病合并重度肺动脉高压的诊断及外科治疗

    目的总结先天性心脏病合并重度肺动脉高压患者的诊断及治疗经验。方法2000年1月~2005年8月,收治87例先天性心脏病合并重度肺动脉高压患者,其中室间隔缺损(VSD)58例,房间隔缺损(ASD)4例,VSD合并动脉导管未闭(PDA)6例,VSD合并ASD16例,PDA3例。82例患者行手术治疗,其中75例行常规心脏畸形矫治手术,VSD采用间断缝合涤纶补片修补,7例室间隔水平双向分流平衡的患者进行了单向活瓣VSD修补术;5例因艾森门格综合征放弃手术治疗。结果行手术治疗的82例中共死亡4例,均死于术后低心排血量综合征,其中单向活瓣VSD修补者死亡2例。手术后呼吸机辅助呼吸时间38~178h(56±8h),血管活性药物使用时间58~244h(117±43h)。术后发生并发症3例,均为肺不张,经雾化吸入、吸痰和拍背等治疗后治愈。随访78例,随访时间6个月,气促症状明显减轻,超声心动图提示2例心脏补片处有少量分流,其余患者均恢复良好。结论非有创性检查方法能对肺动脉高压的性质作出准确的判断,采取合适的治疗方法能获得满意的疗效。术前对肺动脉高压性质的准确判定、心肺功能调整以及围手术期处理是此类患者安全康复的关键。

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • The role of location of retinal vessel trunk in diagnosis of glaucomatous optic nerve

    Objective To evaluate the influence of the location of retinal vessel trunk on neuroretinal rim width of inferior and superior sectors of optic disc, and explore its role in the diagnosis of glaucomatous optic nerve lesion. Methods The photographs of ocular fundus from 459 patients with clear location of retinal vessel trunk, including large disc in 131, medium disc in 145, horizontally oval disc in 75, and small disc in 108 were evaluated. Independent-sample t test was used to compare the difference of the superior and inferior rim widths between the higher-vessel group and the lower-vessel group, and to compare the difference of superior and inferior vessel distances between the narrow-superior-rim-width group and the narrow inferior-rim-width group. Results In most of the patients, or the ones with large and small disc, the ratio of superior rim width to summation of superior and inferior rim widths in the higher-vessel group(0.467plusmn;0.051,0.445plusmn;0.040,0.508plusmn;0.056)were less than which in the lowervessel group(0.500plusmn;0.066,0.474plusmn;0.062,0.546plusmn;0.048), and the differences were significant(P=0.000, 0.045, 0.018); the ratio of superior vessel distance to summation of superior and inferior vessel distance in the narrow-superior-rim-width group(0.510plusmn;0.051,0.508plusmn;0.055,0.512plusmn;0.036)were less than which in the narrow-inferior-rim-width group(0.528plusmn;0.045,0.533plusmn;0.048,0.534plusmn;0.045), and the differences were significant(P=0.000, 0.046, 0.022). Conclusions The position of optic disc vessel trunk influences its superior and inferior rim width. The rim closer to vessel trunk position has narrower width than which comparatively far away from the position. In patients with large, medium, horizontally oval optic disc, glaucoma optic nerve lesion would be considered if the optic disc has the shape of narrower inferior rim, broader superior rim, and vessel location in the superior half of the disc. In the ones with small disc, the optic disc with the shape of narrower superior rim, broader inferior rim, and vessel location in the inferior half of the disc may suggest glaucoma optic nerve lesion.  (Chin J Ocul Fundus Dis, 2007, 23: 118-121)

    Release date:2016-09-02 05:48 Export PDF Favorites Scan
  • Efficacy and Safety Mifepristone for Perimenopause Dysfunctional Uterine Bleeding: A Systematic Review

    Objective To evaluate the efficacy and safety of mifepristone for perimenopause dysfunctional uterine bleeding (PDUB). Methods Such databases as VIP, CNKI, Wanfang and CBM were retrieved for collecting randomized controlled trials (RCTs) on mifepristone for PDUB. The quality of included studies was evaluated and Meta-analysis was performed according to the Cochrane methods. Results Forty RCTs involving 3 850 PDUB patients were included. The control group was divided into two sub-groups according to the features of intervention drugs: the sub-group of diagnostic curettage plus progestational hormone, and the sub-group of diagnostic curettage plus antiestrogenic drugs. The Meta-analysis indicated that compared with the sub-group of diagnostic curettage plus progestational hormone, the diagnostic curettage plus mifepristone group was more effective to increase the total effective rate, such as improving symptoms and signs of PDUB (RR=1.11, 95%CI 1.06 to 1.16, Plt;0.000 01), and to reduce recurrence (RR=0.44, 95%CI 0.36 to 0.52, Plt;0.000 01). But no differences were found between the two groups in the change of endometrial thickness, contents of hemoglobin, and serum level of FSH, LH, E2 and P hormone. Both the intervention and control groups appeared mild adverse reactions, such as rashes, tidal fever, nausea, anorexia, vomiting and breast distending, but with no liver and kidney damages. The long-term safety failed to be evaluated due to short follow-up time. Conclusion Based on this review, diagnostic curettage plus mifepristone shows certain advantage in the treatment of PDUB including the total effective rate and reducing recurrence. But there is no difference in regulating sex hormone level, inhibiting endometrial proliferation and improving anemia compared with the group of diagnostic curettage plus progestational hormone. However, this evidence is not b enough due to the low quality of included trials, possible bias risk, and failure of evaluating its long-term safety.

    Release date:2016-09-07 10:59 Export PDF Favorites Scan
  • Using SYRCLE Tools to Evaluate the Methodological Quality of Animal Experiments of Stroke in China

    ObjectiveUsing SYRCLE tool (the SYstematic Review Centre for Laboratory animal Experimentation) to evaluate the risk of bias of animal studies in stroke field published in Chinese journals, identify problems of these studies in design, implementation and measurement, in order to provide references for improving the quality of animal studies in China. MethodsWe searched databases including CBM, VIP, CNKI and WanFang Data from inception to December 31st, 2014. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included animal studies using SYRCLE tool developed by the National Centre for the Replacement, Refinement and Reduction of Animals in Research. ResultsA total of 582 studies were included. The assessment results showed that the number of reported items with "Low Risk" in SYRCLE, which have 22 items, reported in >50% of the 4 items and in <30% the 16 items in articles of animals experiments. More than 99% of the studies fulfilled the 3 items and more than 17% of the articles to meet the 10 items while less than 1% of the documents met the 17 items. The quality of studies increased excepted the period of 2010 to 2014. The methodological quality of animal experiments presented a trend of increasing and no significant differences were found in CSCD indexed or not. ConclusionThe methodological quality of animal experiments of stroke is poor in China in terms of the selection bias, implementation bias, measurement bias, withdraw bias and reporting bias.

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  • 癌性脑膜炎患者双眼视网膜静脉阻塞一例

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  • Current status of self-management knowledge, attitude, behavior and influencing factors in patients with chronic obstructive pulmonary disease

    Objective To investigate the current status of self-management knowledge, attitude and behavior and influencing factors in patients with chronic obstructive pulmonary disease (COPD) in Qianbei area, and to analyze the influencing factors. Methods A total of 329 COPD patients were recruited and investigated with self-compiled questionnaire for self-management knowledge, attitude and behavior of chronic obstructive pulmonary disease, and SPSS 17.0 software was used to analyze the data. Results The mean score of self-management knowledge, attitude and behavior in COPD patients was 132.6±17.0, in which the scores of each dimension from high to low were as follows: smoking, medication treatment, exercise and family oxygen therapy. The analysis of stepwise regression indicated that the main influencing factors of self-management of COPD patients were age, sex, address, degree of education, course of disease and smoking. Conclusions The self-management level of the disease recognition, attitude and behavior in COPD patients should be improved, in which the knowledge is key factor to promote the health behavior of patients. So the healthy workers should pay close attention to the influence factors and apply the new thinking pattern and methods to improve the self-management ability and the quality of life of patients.

    Release date:2018-11-23 02:04 Export PDF Favorites Scan
  • A research on depression recognition based on voice pre-training model

    For the increasing number of patients with depression, this paper proposes an artificial intelligence method to effectively identify depression through voice signals, with the aim of improving the efficiency of diagnosis and treatment. Firstly, a pre-training model called wav2vec 2.0 is fine-tuned to encode and contextualize the speech, thereby obtaining high-quality voice features. This model is applied to the publicly available dataset - the distress analysis interview corpus-wizard of OZ (DAIC-WOZ). The results demonstrate a precision rate of 93.96%, a recall rate of 94.87%, and an F1 score of 94.41% for the binary classification task of depression recognition, resulting in an overall classification accuracy of 96.48%. For the four-class classification task evaluating the severity of depression, the precision rates are all above 92.59%, the recall rates are all above 92.89%, the F1 scores are all above 93.12%, and the overall classification accuracy is 94.80%. The research findings indicate that the proposed method effectively enhances classification accuracy in scenarios with limited data, exhibiting strong performance in depression identification and severity evaluation. In the future, this method has the potential to serve as a valuable supportive tool for depression diagnosis.

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  • 面动脉蒂下颌缘皮瓣全鼻再造一例

    Release date:2016-09-01 10:28 Export PDF Favorites Scan
  • Clinical Value of Selective Digestive Decontamination for Hospital Acquired Pneumonia in Intensive Care Unit

    【摘要】 目的 探讨在重症监护病房(intonsive cane tmit,ICU)行选择性消化道脱污染(selective digestive decontamination,SDD)的临床实用价值。 方法 选取2007年1月—2010年1月危重症患者376例,随机分为两组,对照组予常规口腔护理治疗,治疗组予选择性消化道脱污染治疗,比较两组患者病情疗效的参数。 结果 治疗组院内获得性肺炎发生率为18.4%、院内获得性肺炎发生时间(7.2±3.2)d、人工气道(气管插管/切开)保留天数(10.5±3.8)d、机械通气天数(8.4±3.1)d、入住ICU天数(14.7±4.8)d、病死率11.6%;对照组院内获得性肺炎发生率为30.1%、院内获得性肺炎发生时间(5.6±3.6)d、人工气道(气管插管/切开)保留天数(12.5±4.6)d、机械通气天数(10.2±4.2)d、入住ICU天数(17.2±6.2)d、病死率19.4%;两组比较差异均有统计学意义(Plt;0.05)。 结论 在ICU内行选择性消化道脱污染可有效控制院内获得性肺炎,改善患者病情,减少住院天数,降低病死率。【Abstract】 Objective To discuss the clinical value of selective digestive decontamination in the intensive care unit (ICU). Methods From January 2007 to January 2010, 376 critically ill patients were randomly divided into two groups. Patients in the control group received conventional oral cavity nursing treatment, and those in the treatment group underwent the selective digestive decontamination. Then, we compared the curative effect parameters of these two kinds of procedures for the two groups of patients. Results For patients in the treatment group, the rate of hospital-acquired pneumonia (HAP) was 18.4%, the occurring time of HAP was (7.2±3.2) days, the time of retaining artificial gas channel (trachea cannula / incision) was (10.5±3.8) days, the time of mechanical ventilation was (8.4±3.1) days, ICU stay time was (14.7±4.8) days, and the mortality rate was 11.6%. For the control group, the correspondent parameters were respectively 30.1%, (5.6±3.6) days, (12.5±4.6) days, (10.2±4.2) days, (17.2±6.2) days, and 19.4%. The differences of these parameters between the two groups were significant (Plt;0.05). Conclusion For patients in the ICU, the selective digestive decontamination can effectively control the occurrence of HAP, improve patient conditions, reduce hospitalization time, and decrease mortality rate.

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
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