目的:评价氯喹那多普罗雌烯阴道片对产后阴道黏膜修复及防治生殖道感染的作用。方法:对212例产后6～8周复诊患者随机分为实验组92例和对照组120例。实验组给予氯喹那多普罗雌烯阴道片阴道上药,每日一片共18日;对照组仅给予温盐水清洁阴部。治疗前后检查两组的阴道分泌物情况。结果:用药前实验组与对照组比较生殖道状况均无统计学差异(Pgt;005)。用药后实验组生殖道状况正常为80%,而对照组正常仅为36%,两组比较差异有显著性(Plt;005)。实验组生殖道感染12例,无真菌和滴虫感染,均为非特异性阴道炎,患病率1304%,有效率8695%。对照组生殖道感染84例,有效率3000%,患病高低顺序依次为非特异性阴道炎4167%,真菌性阴道炎2083%,滴虫性阴道炎 750%。结论:氯喹那多普罗雌烯阴道片能有效治疗生殖道非特异性炎症,真菌性、滴虫性阴道炎,促进产后的阴道黏膜修复,防治产后生殖道感染。
目的 总结妊娠合并尿毒症患者血液透析的护理措施。 方法 回顾性分析2001年3月－2012年6月收治的15例妊娠合并尿毒症患者行血液透析的临床资料。患者年龄平均30.5岁；2例为早期妊娠，孕13周，其中1例伴有尿毒症急性发作，其余均为中晚期妊娠，孕24+周，均血清肌酐＞445 μmol/L（5 mg/dL），尿氮素＞20 mmol/L。15例患者入院后即刻行血液透析治疗，治疗过程中进行必要的心理干预，在透析前、中、后护理中，密切观察患者心理状况，孕妇各项生命体征及胎儿胎心胎动等，择期终止妊娠。 结果 9例经维持性血液透析治疗后，病情稳定，顺利产下胎儿；另外3例患者经血液透析治疗后病情稳定，其中1例产下一死婴，另2例行人工钳取术终止妊娠；还有3例患者由于经济条件限制而中途退出治疗。 结论 适时的干预和加强妊娠合并尿毒症患者血液透析的护理，可取得很好的治疗效果，有可能改变妊娠的结果。
The postictal state which describes changes in behavior, motor function, and neuropsychological performance that occur after a seizure and persist until these variables return to their normal baseline, which can take anywhere from a few seconds to a few hours to a few days. The degree and intensity of the postictal state significantly affects the patient's quality of life and is strongly associated with the patient's rating of the severity of the seizure, but receives little attention in the treatment of epilepsy, and anti-seizure medications prevent postictal events by making the patient seizures-free, or will attenuate or shorten the time after the seizure. Therefore, it is of great clinical significance to evaluate the efficacy of anti-seizure medications in the post-seizure state. This article reviews the effects of the main anti-seizure medications on the postictal state
ObjectiveTo explore the osteogenesis effect of advanced-platelet-rich fibrin (A-PRF) and β-tricalcium phosphate (β-TCP) composite. MethodsThirty-two healthy female New Zealand rabbits were randomly selected. A-PRF was prepared by collecting blood from middle auricular artery. Rabbits were randomly divided into 6 groups: groups A, B, C, D, and E (6 rabbits in each group) and group F (2 rabbits). Bone defects (6 mm in diameter, 8 mm in depth) were drilled into femur condyle of each rabbit’s both back legs. Then A-PRF and β-TCP composites manufactured by different proportion were planted into bone defects of group A (1∶1), group B (2∶1), group C (4∶1), group D (1∶2) and group E (1∶4) (V/V). The bone defect was not repaired in group F. The specimens were collected at 8 and at 12 weeks after operation. Then gross observation, X-ray examination, Micro-CT examination, and biomechanical test were performed. The bone volume/total volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular spacing (Tb.Sp), compressive strength, and modulus of elasticity were calculated. ResultsThe gross observation and X-ray examination showed that the osteogenesis effect at 12 weeks was better than that at 8 weeks. At the same time point, the repair of bone defect and the formation of new bone in group B were better than those in other groups. Micro-CT examination showed that the trabeculae of new bone in group B were the most and the trabeculae arranged closely at 8 and 12 weeks. Besides there were significant differences in BV/TV, Tb.N, and Tb.Sp between group B and the other groups (P<0.05). There were significant differences in Tb.N and Tb.Th in group B, BV/TV and Tb.Sp in group C, Tb.Sp in group D between 8 weeks and 12 weeks (P<0.05). Biomechanical tests showed that the compression strength and elastic modulus of group B were the highest, and the compression strength and elastic modulus of group C were the lowest at 8 and at 12 weeks, showing significant differences (P<0.05). There were significant differences in compression strength and elastic modulus of each group between 8 weeks and 12 weeks (P<0.05). ConclusionThe A-PRF and β-TCP composite can repair femoral condylar defects in rabbits, and the osteogenesis is better in proportion of 2∶1.
Objective To establish a prediction model for the 1-, 3-, and 5-year survival rates in patients with gastric cancer liver metastases (GCLM) by analyzing prognostic factors based on the Surveillance, Epidemiology, and End Results (SEER) database. Methods Clinical and pathological data from 591 patients diagnosed with GCLM between 2010 and 2015 were obtained from the SEER database. The population was randomly divided into a training cohort and an internal validation cohort at a 7 to 3 ratio. Independent predictors of GCLM were analyzed using univariate and multifactorial Cox regression. Consequently, nomograms were constructed. The model's accuracy was verified by calibration curve, ROC curve, and the C-index, and the clinical utility of the model was analyzed through decision curve analysis. Results Tumor differentiation grade, surgical status, and chemotherapy were significantly associated with the prognosis of GCLM patients, and these three factors were included in constructing the prognostic model and plotting the nomogram. The C-index was 0.706 (95%CI 0.677 to 0.735) and 0.749 (95%CI 0.710 to 0.788) for the training set and the internal validation cohort, respectively. The results of the ROC curve analysis indicated that the area under the curve (AUC) was over 0.7 at 1, 3, and 5 years for both the training and validation cohorts. Conclusion The prediction model of the GCLM is developed based on the 3 factors, i.e., tumor differentiation grade, surgery, and chemotherapy, and shows good prediction accuracy and thus may promote clinical decision making and individualized treatment of GCLM patients.
Objective To investigate the predictive value of mechanical power (MP) in the weaning outcome of adaptive mechanical ventilation plus intelligent trigger (AMV+IntelliCycle, simply called AMV) mode for acute respiratory distress syndrome (ARDS) patients. Methods From November 2019 to March 2021, patients with mild to moderate ARDS who were treated with invasive mechanical ventilation in the intensive care unit of the First Affiliated Hospital of Jinzhou Medical University were divided into successful weaning group and failed weaning group according to the outcome of weaning. All patients were treated with AMV mode during the trial. The MP, oral closure pressure (P0.1), respiratory rate (RR) and tidal volume (VT) of the two groups were compared 30 min and 2 h after spontaneous breathing trial (SBT). The correlation between 30 min and 2 h MP and shallow rapid respiratory index (RSBI) was analyzed by Pearson correlation. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of 30 min MP in ARDS patients with AMV mode weaning failure. Results Sixty-eight patients were included in the study, 49 of them were successfully removed and 19 of them failed. There was no statistical significance in age, gender, body mass index, oxygenation index, acute physiology and chronic health evaluation Ⅱ score, reasons for mechanical ventilation (respiratory failure, sepsis, intracranial lesions, and others) between the two groups (all P>0.05). The MP, P0.1 and RR at SBT 30 min and 2 h of the successful weaning group was lower than those of the failed weaning group (all P<0.05), but the VT of the successful weaning group was higher than the failed weaning group (all P<0.05). There was a significant relation between the MP at SBT 30 min and 2 h and RSBI (r value was 0.640 and 0.702 respectively, both P<0.05). The area under ROC curve of MP was 0.674, 95% confidence interval was 0.531 - 0.817, P value was 0.027, sensitivity was 71.73%, specificity was 91.49%, positive predictive value was 0.789, negative predictive value was 0.878, optimal cutoff value was 16.500. The results showed that 30 min MP had a good predictive value for the failure of weaning in AMV mode in ARDS patients. Conclusion MP can be used as an accurate index to predict the outcome of weaning in ARDS patients with AMV mode.