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find Author "张金梅" 4 results
  • 先天性心脏病术后中心静脉导管相关血行感染危险因素分析

    目的讨论先天性心脏病患儿术后发生经颈内中心静脉导管相关血行感染(CRBSI)的危险因素。 方法对2011年11月-2012年9月入住的224例先天性心脏病患儿经颈内中心静脉置管后发生CRBSI危险因素进行单因素和多因素logistic回归分析。 结果39例患儿(16.07%)发生CRBSI,单因素logistic回归分析提示:体外循环时间>60 min(OR=14.400,P<0.001)、经导管操作次数>6次/d(OR=2.692,P=0.006)、导管留置时间>10 d(OR=5.439,P<0.001)、未采取抗生素治疗(OR=3.992,P<0.001)是颈内中心静脉置管患儿发生CRBSI的危险因素。非条件多因素logistic回归分析显示:体外循环时间>60 min(OR=14.109,P<0.001)、导管留置时间>10 d(OR=4.878,P=0.001)、未采取抗生素治疗(OR=3.828,P=0.005)是颈内中心静脉置管的独立危险因素。 结论伴有体外循环时间长,导管留置时间>10 d,应该采取针对性干预及护理措施,以预防导管感染。

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  • Effects of Tiotropium Bromide on Inflammatory Factors in Serum, BALF and Lung Tissue of COPD Rats

    ObjectiveTo investigate the changes of interleukin-8 (IL-8), tumor necrosis factor-α(TNF-α) and phospholipase A2 (PLA2) in serum, bronchoalveolar lavage fluid (BALF) and lung tissue of COPD rats and the effects of tiotropium.To identify the anti-inflammatory function of tiotropium. MethodsRat COPD model was established by passive smoking as well as intratracheal instillation of lipopolysaccharide(LPS).Thirty male SD rats were randomly divided into a control group, a COPD group and a tiotropium bromide treatment group (n=10 in each group).The pathologic changes of the lung tissue and airway were observed by HE staining.The total and differential cell counts in BALF were observed.The levels of IL-8, TNF-α, PLA2 in serum, BALF and lung tissue were measured by enzyme-linked immunosorbent assay. ResultsHE staining revealed that the rat COPD model was successfully established.The COPD group appeared obvious emphysema, while the treatment group appeared mild emphysema.The total inflammatory cells, the proportion of neutrophils and lymphocyte, and the levels of IL-8, TNF-α, PLA2 in serum, BALF and lung tissue in the COPD group were obviously higher than those in the control group (P < 0.01).The total inflammatory cells, the proportion of neutrophils and lymphocyte, and the levels of IL-8, TNF-α, PLA2 in serum, BALF and lung tissue in the treatment group were significantly lower than those in the COPD group but higher than those in the control group (P < 0.01). ConclusionsTiotropium bromide can reduce the levels of IL-8, TNF-α, PLA2 in serum, BALF and lung tissue of COPD rats by reducing the leakage of inflammatory cells, and alleviate the airway inflammation and the degree of emphysema.

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  • Full-field flash electroretinogram following up for children with history of pre-threshold or threshold retinopathy of prematurity

    ObjectiveTo evaluate the characteristics of electroretinagram (EGR) in children with history of pre-threshold or threshold retinopathy of prematurity (ROP). MethodsA total of 24 children (48 eyes) with history of pre-threshold ROP or threshold ROP received F-ERG examination.Ten age and body weight-matched children with a history of premature birth (20 eyes) but without ROP were recruited as control group. The rod response, maximal rod-cone response and cone response of F-ERG were recorded respectively following the International Standard Protocal of ISCEV (2000 version).The latency and amplitude of a-wave and b-wave of various responses were analyzed. The trial was approved by the Ethic Committee of Hunan Children's Hospital and informed consent was obtained from the parents of patients prior to any medical procedure. ResultsThere was significant difference between ROP and control group in rod response,the latency was longer (t=5.643,P<0.05) and the amplitude was lower in ROP group(t=7.068,P<0.05).In maximal rod-cone response both in a and b wave, the latency wave was longer(t=3.099, 2.886;P<0.05) and the amplitude was lower(t=5.614, 2.850;P<0.05) in ROP group. But there is no difference between ROP and control group in cone response latency(t=0.819, 0.948)and amplitude(t=0.904, 0.850). ConclusionERG in ROP children with history of pre-threshold or threshold ROP is abnormal, which mainly in rod response,but the cone response remains normal.

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  • Urgent recommendation and practice of prevention and control of novel coronavirus disease 2019 (COVID-19) in intensive care units in West China Hospital of Sichuan University during the epidemics

    ObjectiveTo provide recommendations for the management of intensive care unit patients without novel coronavirus disease 2019 (COVID-19).MethodsWe set up a focus group urgently and identified five key clinical issues through discussion. Total 23 databases or websites including PubMed, National Guideline Clearing-House, Chinese Center for Disease Control and Prevention and so on were searched from construction of the library until February 28, 2020. After group discussion and collecting information, we used GRADE system to classify the evidence and give recommendations. Then we apply the recommendations to manage pediatric intensive care unit in the department of critical care medicine in our hospital. ResultsWe searched 13 321 articles and finally identified 21 liteteratures. We discussed twice, and five recommendations were proposed: (1) Patients should wear medical surgical masks; (2) Family members are not allowed to visit the ward and video visitation are used; (3) It doesn’t need to increase the frequency of environmental disinfection; (4) We should provide proper health education about the disease to non-medical staff (workers, cleaners); (5) Medical staff do not need wear protective clothing. We used these recommendations in intensive care unit management for 35 days and there was no novel coronavirus infection in patients, medical staff or non-medical staff. ConclusionThe use of evidence-based medicine for emergency recommendation is helpful for the scientific and efficient management of wards, and is also suitable for the management of general intensive care units in emergent public health events.

    Release date:2020-04-26 03:44 Export PDF Favorites Scan
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