【摘要】 目的 评价临床心血管系统药物的利用情况与趋势。 方法 利用excel表格对四川省建筑医院2008年1月－2010年12月全部心血管系统药物处方的种类、销售金额、用药频度值（DDDs）等进行统计分析。 结果 3年中，心血管系统药物的销售金额呈逐年上升趋势。在销售金额和DDDs的前10名排名中主要包括钙通道阻滞类药物、调血脂药物和中成药等。 结论 临床心血管系统药物应用基本合理，对于疗效显著、不良反应轻微、价格合理的药物患者依从性好，临床使用广泛。【Abstract】 Objective To investigate the use of cardiovascular drugs in our hospital (Sichuan Architecture Hospital) from 2008 to 2010, and evaluate its future tendency. Methods Excel was used to analyze the variety, consumption, defined daily dose (DDDs) of cardiovascular drugs used during 2008 to 2010 statistically in our hospital. Results During these three years, the consumption of cardiovascular drugs increased from year to year. The calcium channel blockers, lipid-modulating drugs and traditional Chinese medicines ranked high in the sum and DDDs column in Excel. Conclusion The use of cardiovascular drugs is rational in our hospital. The safe and effective drugs with reasonable price and better compliance are widely applied.
目的:評价益生菌在预防和治疗儿童喘息性疾病中的效果。方法:将393例喘息性疾病患儿分为观察组206例,对照组187例,对照组187例常规治疗,观察组206例在对照组187例常规治疗的基础上给予口服双歧杆菌三联活菌肠溶胶囊。结果:观察组治愈时间明显少于对照组,两组比较差异有显著性(Plt;005),观察组总复发率为342%,对照组总复发率为433%,两组比较差异有显著性(Plt;005)。结论:添加益生菌对预防和治疗儿童喘息性疾有积极的效果。
Objective To summarize the optimal evidence for improving the management of chronic wounds exudate, so as to provide evidence-based references for medical professionals, therapists, patients, and their caregivers. Methods PubMed, Wanfang, CNKI, Medlive, UpToDate, etc., were searched by computer for literature about chronic trauma exudate management. The retrieval time limit was from 1998 to 2023. Two researchers trained in evidence-based practice evaluated the quality of the included literature and finally extracted evidence from the literature that met the quality evaluation criteria. Results A total of 11 articles were included, including 2 expert consensuses, 7 systematic reviews, 1 randomized controlled trial, and 1 guideline, covering 7 aspects of the assessment of the nature of chronic wounds exudate, selection of exudate assessment tools, management of antimicrobial concerns, selection and application of wound dressings, negative pressure wound drainage therapy, wound drainage bags, and affected limb elevation or compression therapy for patients with venous leg ulcers. A total of 13 best evidences were extracted. Conclusions When applying evidence, medical professionals should fully evaluate and combine the individual circumstances of the patient, make full use of existing resources, new treatment concepts and technologies, and carry out comprehensive integrated management. This can optimize the management of chronic wounds exudate and improve the quality of life of patients.
ObjectiveTo investigate the clinical features, differential diagnosis and treatment for chromophobe cell renal carcinoma (CRCC) and renal oncocytoma. MethodsFrom December 2009 to May 2013, we selected 41 cases of CRCC and 22 cases of renal oncocytoma, retrospectively analyzed their clinical features, ultrasonography and CT findings and performed immunohistochemical staining for CK7, CD10, PAX-2, and Ksp-cadherin. ResultsCRCC could be associated with lower back pain or hematuria, and renal oncocytoma generally did not have clinical symptoms. Ultrasonography and CT examination were not specific for the differentiation between the two diseases. The expression rates of CK7, CD10, PAX-2, and Ksp-cadherin in CRCC were 66% (21/32), 22% (7/32), 23% (3/13) and 93% (14/15), respectively. In patients with oncocytoma, 7% (1/15) were positive for CK7, 7% (1/15) were positive for CD10, 86% (13/15) were positive for PAX-2, and 31% (4/13) were positive for Ksp-cadherin. Pearson chi-square analysis was performed with a significant P value set at <0.05. The results of CK7(-)CD10(-)PAX-2(+) and CK7(-)CD10(-)Ksp-cadherin(-) immunohistochemistry were integrated, which also showed the differences. ConclusionThe combination of CK7(-)CD10(-)PAX-2(+) and CK7(-)CD10(-)Ksp-cadherin(-) immunohistochemistry may be useful for differentiating between CRCC and oncocytoma. Combined with imaging examination, it can further improve the differential diagnosis of the two diseases.
Objective To systematically search for evidence related to the prevention and management of kinesiophobia in patients undergoing total knee arthroplasty at home and abroad, evaluate and integrate the evidence, and to provide reference for clinical nursing practice. Methods Domestic and international evidence-based resource databases, including UpToDate, BMJ (British Medical Journal) Best Practice, National Institute for Health and Clinical Excellence guidelines network, JBI (Joanna Briggs Institute) evidence-based healthcare center database, Cochrane Library, Registered Nurses’ Association of Ontario website, China guidelines network, Web of Science, PubMed, SinoMed, China National Knowledge Infrastructure, and Wanfang were searched. Evidence related to the prevention and management of kinesiophobia after total knee arthroplasty was collected, and the search period was until June 30, 2023. The evidence extraction and integration were conducted on the literature that meets the requirements. Results A total of 10 papers were ultimately included, including 1 guideline, 1 expert consensus, 2 systematic evaluations, 4 randomized controlled studies, and 2 cohort studies. A total of 17 pieces of evidence were extracted from 5 aspects, including risk assessment, health education, intraoperative pain management, rehabilitation exercise, and patient participation. Conclusion The prevention and management of kinesiphobia after total knee arthroplasty include evidence from multiple aspects, which can provide evidence-based basis for orthopedic and rehabilitation medical staff to develop intervention plans for kinesiphobia and promote rapid recovery of patients with total knee arthroplasty.
Objective To explore the relationship between immune state and disease progression or severity of patients with hepatitis B virus (HBV). Methods A total of 332 patients infected with HBV diagnosed and treated from January 2012 to December 2013 were divided into acute hepatitis B (AHB) group (n=25), chronic hepatitis B (CHB) group (n=237) and cirrhosis group (n=70) according to disease progression. Moreover, CHB group was divided into mild (n=24), moderate (n=103), serious (n=72) and severe group (liver failure group,n=38) according to disease severity, while cirrhosis group was divided into hepatocellular carcinoma (HCC) group (n=13) and non-HCC group (n=57). The immune indexes including immunoglobulin (Ig), complement (C) and T-lymphocyte subsets were tested and compared. Results The immune indexes were not significantly different between AHB group and CHB group (P>0.05). Compared with AHB group and CHB group, cirrhosis group had higher levels of IgG and IgA, and lower levels of CD3+, CD4+ and CD8+ T cells count (P<0.05). Compared with non-HCC group, HCC group had more male patients without antiviral therapy, who had higher levels of C3 and C4 (P<0.05). As disease progressed, the levels of alanine fcell couaminotransferase, aspartate aminotransferase, total cholesterol, Fibroscan index, IgG, and IgA of CHB patients all gradually increased, while the levels of C3 and C4 and the counts of CD3+ and CD4+ T cells gradually declined. Conclusions The immune state of patients infected with HBV has a certain relationship with disease progression or severity, and immunoglobulin, complement and T cells count can partly reflect the severity of the disease. Cirrhosis patients accompanied with high levels of C3 and C4 should pay high attention to antiviral therapy and be vigilant on HCC.
Objective To investigate the effectiveness of tibial transverse transport (TTT) in treating Wagner grade 3-4 type 2 diabetic foot ulcers and analyze dynamic changes in immunoglobulin levels. Methods The clinical data of 68 patients with Wagner grade 3-4 type 2 diabetic foot ulcers treated with TTT between May 2022 and September 2023 was retrospectively analyzed. The cohort included 49 males and 19 females, aged 44-91 years (mean, 67.3 years), with 40 Wagner grade 3 and 28 grade 4 ulcers. The duration of type 2 diabetes ranged from 5 to 23 years, with an average of 10 years. The number of wound healing cases, healing time, amputation cases, death cases, and complications were observed and recorded. Serum samples were collected at 6 key time points [1 day before TTT and 3 days, 7 days (the first day of upward transverse transfer), 14 days (the first day of downward transverse transfer), 21 days (the first day after the end of transfer), 36 days (the first day after the removal of the transfer device)], and the serum immunoglobulin levels were detected by flow cytometry including immunoglobulin G (IgG), IgA, IgM, IgE, complement C3 (C3), C4, immunoglobulin light chain κ (KAP), immunoglobulin light chain λ (LAM). Results All the 68 patients were followed up 6 months. Postoperative pin tract infection occurred in 3 cases and incision infection in 2 cases. Amputation occurred in 5 patients (7.4%) at 59-103 days after operation, and 8 patients (11.8%) died at 49-77 days after operation; the wounds of the remaining 55 patients (80.9%) healed in 48-135 days, with an average of 80 days. There was no recurrence of ulcer, peri-osteotomy fracture, or local skin necrosis during follow-up. The serum immunoglobulin levels of 55 patients with wound healing showed that the levels of IgG and IgM decreased significantly on the 3rd and 7th day after operation compared with those before operation (P<0.05), and gradually returned to the levels before operation after 14 days, and reached the peak on the 36th day. IgA levels continued to decrease with time, and there were significant differences at all time points when compared with those before operation (P<0.05). The level of IgE significantly decreased at 21 days after operation compared with that before operation (P<0.05), while it was higher at other time points than that before operation, but the difference was not significant (P>0.05). The level of C3 showed a clear treatment-related increase, which was significantly higher on the 7th, 14th, and 21st days after operation than that before operation (P<0.05), and the peak appeared on the 14th day. The change trend of C4 level was basically synchronous with that of C3, but the amplitude was smaller, and the difference was significant at 7 and 14 days after operation compared with that before operation (P<0.05). There was no significant difference in KAP/LAM between different time points before and after operation (P>0.05). Conclusion TTT can accelerate wound healing, effectively treat diabetic foot ulcer, and reduce amputation rate, and has definite effectiveness. The potential mechanisms of TTT in the treatment of diabetic foot ulcers include the dynamic regulation of IgG, IgA, IgM, and IgE levels to balance the process of inflammation and repair, and the periodic increase of C3 and C4 levels may promote tissue cleaning, angiogenesis, and anti-infection defense.