Hybrid coronary revascularization (HCR) combines the advantages of minimally invasive direct coronary artery bypass grafting (MIDCAB) and percutaneous coronary intervention (PCI), and avoids its relative shortcomings, which has received particular attention in recent years. HCR seems to have become the third revascularization strategy for multi-vessel disease in coronary heart diseases. However, the clinical researches on HCR are still limited. This article will systematically review the comparison of HCR with coronary artery bypass grafting (CABG) and PCI, the results of HCR in specific patients, and the clinical results of different HCR strategies.
Trans-radial access (TRA) has been a common approach to percutaneous coronary intervention (PCI). Comparing with trans-femoral access (TFA), TRA is used as an alternative approach for PCI with less local complications, higher comfort level, and better outcome. In recent years, TRA has been paid more and more attention in peripheral vascular interventions. We reviewed recent developments in peripheral vascular intervention using TRA, with detail summary of the effectiveness, safety, limits, and future developments of it, aiming to improve the understanding and performance of TRA in interventionalists to benefit patients.
With the post-disaster psychological crisis has aroused wide attention, psychological first aid which can relieve psychological trauma and prevent post-traumatic disorder has been valued by many countries. However, mainly domestic psychological first aid training is simply theoretical training while its popularizing rate is low, it is urgent to learn from international experience to carry out more effective psychological first aid training. In the context of combination of medicine and industry, the paper majorly embodied virtual simulation’s potential in improving psychological intervention ability, deep learning level and self-efficacy. Furthermore, the paper analyzed and illustrated theoretical basis and function module of constructing psychological first aid training platform in detail, and prospected further improvement, which laid foundations for follow-up studies.
ObjectiveTo systematically review the effect of different psychological intervention methods on depressive symptoms in patients with inflammatory bowel disease. MethodsPubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials(RCTs) on psychological interventions on depression of patients with inflammatory bowel disease from inception to January 12, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Network meta-analysis was then conducted by using software Stata and GeMTC. ResultsA total of 18 articles, 1 567 patients and 6 psychological intervention methods were included. The results of the network meta-analysis showed that, compared with conventional nursing, music therapy, mindfulness therapy and cognitive behavioral therapy had statistically significant differences in the intervention effect of depression in patients with inflammatory bowel disease (P<0.05); Among the six psychological intervention methods included, there was a statistically significant difference in relaxation therapy compared with music therapy, writing expression and mindfulness therapy (P<0.05); The difference between cognitive behavioral therapy and music therapy and mindfulness therapy was statistically significant (P<0.05), while there was no statistically significant difference in other interventions (P>0.05). The SUCRA ranking probability chart showed that music therapy was the best intervention method for depression in patients with inflammatory bowel disease, followed by mindfulness therapy and cognitive behavioral therapy. ConclusionThe current evidence suggests that music therapy has an advantage in relieving depression in patients with inflammatory bowel disease, followed by mindfulness therapy or cognitive behavioral therapy. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
【作者简介】〖KG2〗〖HTSS〗蒋青(1963-),女,四川遂宁人,主管护师,硕士,Email:jq0987@yahoo.cn
ObjectiveTo summarize the treatment and experience of percutaneous transhepatic portal vein recanalization by endovascular approach for treatment of cavernous transformation of the portal vein (CTPV) in a child. MethodThe clinical data of a child with idiopathic CTPV who underwent percutaneous transhepatic portal vein recanalization by endovascular approach were retrospectively analyzed. ResultsWe described a novel percutaneous transhepatic portal vein recanalization approach that had successfully treated a child with idiopathic CTPV following a multidisciplinary team evaluation. The operation time was 1.5 h and blood loss was approximately 1 mL. The child recovered uneventfully at 9-month follow-up, without any clinical evidence of CTPV complications. ConclusionIn light of our successful management, we can envision that the portal vein recanalization is an important therapeutic supplement for treating CTPV and will result in a paradigm change.
Shortly after the Wenchuan earthquake, we established headquarter of crisis intervention, which was responsible for reporting earthquake situation and training personnel to carry out psychological intervention and publicize earthquake-related knowledge. Then, urgent psychological intervention was provided to the target populations. We offered crisis intervention more than 100 times (40,000 person-times), provided individualized psychological services or therapies over 3,000 person-times and treated more than 200 patients with posttraumatic stress disorder. Meanwhile, we established relevant administration systems including registration, reporting, rapid screening and personnel work logs. Our preliminary survey conducted 1 month after the earthquake showed that the prevalence of posttraumatic stress disorder reached 43%. After the earthquake, the victims’ emotions of depression and anxiety were raised and the prevalence of posttraumatic stress disorder had a sharp increase. The victims’ requirements for psychological crisis intervention after earthquake were immense.
Objectives About 12.9-50% patients of SARS (Severe Acute Respiratory Syndrome), require brief mechanical ventilation (MV) to save life. All the reported principles and guidelines for therapy SARS were based on experiences from clinical treatments and facts of inadequacy. Neither prospective randomized controlled trials (RCT) nor other high quality evidences were in dealing with SARS. Our objective is to seek safe and rational non-drugs interventions for patients with severe SARS by retrospectively reviewing clinical studies about MV all over the world, which include clinical guidelines, systematic reviews (SR), Meta-analysis, economic researches and adverse events. Methods To search MEDLINE and Cochrane Library with computer. According to the standards of inclucion or exclusion, the quality of the article which as assessed, and relevant data which were extracted double checked. The Meta-analysis was conducted if the studies had no heterogeneity. Results 14 papers were eligible. Due to the significant heterogeneity between these studies, further Meta-analysis could not be conducted, and the authors’ conclusions were described only. Conclusions The outcome of PPV is better than that of VPV. Patients who underwent PPV had a significantly lower mortality than that of VPV. Of course, the volutrauma should be watched. With low tidal volume and proper PEEP, or decreased FiO2, even permissive hypercapnia, the mortality and length of stay were cut down. Non-invasive mechanical ventilation (NIMV) was effective in treating haemodynamical stable patients, minimizing complications and reducing medical staff infection. Patients with serious dyspnea with PaO2/FiO2lt;200, no profit of NIMV, or couldn’t tolerance hypoxaemia were unlikely to benefit from this technique and needed ventilation with endotracheal intubation. Prone position could improve PaO2/FiO2, NO maybe increased pulmonary perfusion, improved V/Q, and raised oxygenation. Furthermore, Inhaled NO sequentially (SQA) was better than Inhaled NO continuouly (CTA). Some studies implied that practice of protocol-directed weaning from mechanical ventilation implemented by nurses excelled that of traditional physician-directed weaning.
Evidence-based evidence translated into health care services requires three conversion processes, preclinical research-clinical research-implementation research, which might take a very long time. In order to speed up the process of research results translated into daily medical practice and health policy, an effectiveness-implementation hybrid design combining the effectiveness research of clinical and implementation research was emerging. This paper introduced the concept, classification and application of effectiveness-implementation hybrid design, to provide references for researchers in this area.
ObjectiveTo research on the influence of cluster management on the nutritional intervention for nasopharynx cancer patients undergoing intensity modulated radiation therapy (IMRT), in order to discuss effective and feasible nutrition management method. MethodEighty-three nasopharynx cancer patients undergoing IMRT between June 2013 and December 2014 were selected as the study subjects. They were divided into two groups randomly. Regular health education and nutritional guidance were carried out for the 41 patients in the control group, while nutritional risk screening (NRS)-2002 nutrition screening, nutrition assessment and nutritional intervention were carried out for the 42 patients in the intervention group. Nutrition risk, nutritional status and side-reaction were recorded and evaluated for both groups of patients. ResultsAfter treatment, NRS-2002 score of the intervention group was lower than the control group (P<0.05). Body weight, constitutional index, skinfold thickness of triceps brachii muscle, mid-arm circumference and mid-arm muscle circumference of the intervention group were better than the control group (P<0.05). Total serum protein, serum albumin, serum transferrin were better and the rate of levelⅢ-Ⅳ radiation-induced oral mucositis was lower in the intervention group than that in the control group (P<0.05). ConclusionsThe application of cluster management model in nutritional intervention is a way to promote patients' rehabilitation, which can effectively improve the whole body situation of nasopharynx cancer patients, and reduce malnutrition rate and side-reaction.