BACKGROUND Depression is a common and serious psychological condition,which seriously affects individual well-being and functional ability.Traditional treatment methods include drug therapy and psychological counselin...BACKGROUND Depression is a common and serious psychological condition,which seriously affects individual well-being and functional ability.Traditional treatment methods include drug therapy and psychological counseling;however,these methods have different degrees of side effects and limitations.In recent years,nonconvulsive electrotherapy(NET)has attracted increasing attention as a noninvasive treatment method.However,the clinical efficacy and potential mechanism of NET on depression are still unclear.We hypothesized that NET has a positive clinical effect in the treatment of depression,and may have a regulatory effect on serum inflammatory factors during treatment.AIM To assess the effects of NET on depression and analyze changes in serum inflammatory factors.METHODS This retrospective study enrolled 140 patients undergoing treatment for depression between May 2017 and June 2022,the observation group that received a combination of mindfulness-based stress reduction(MBSR)and NET treatment(n=70)and the control group that only received MBSR therapy(n=70).The clinical effectiveness of the treatment was evaluated by assessing various factors,including the Hamilton Depression Scale(HAMD)-17,self-rating idea of suicide scale(SSIOS),Pittsburgh Sleep Quality Index(PSQI),and levels of serum inflammatory factors before and after 8 wk of treatment.The quality of life scores between the two groups were compared.Comparisons were made using t and χ^(2) tests.RESULTS After 8 wk of treatment,the observation group exhibited a 91.43%overall effectiveness rate which was higher than that of the control group which was 74.29%(64 vs 52,χ^(2)=7.241;P<0.05).The HAMD,SSIOS,and PSQI scores showed a significant decrease in both groups.Moreover,the observation group had lower scores than the control group(10.37±2.04 vs 14.02±2.16,t=10.280;1.67±0.28 vs 0.87±0.12,t=21.970;5.29±1.33 vs 7.94±1.35,t=11.700;P both<0.001).Additionally,there was a notable decrease in the IL-2,IL-1β,and IL-6 in both groups after treatment.Furthermore,the observation group exhibited superior serum inflammatory factors compared to the control group(70.12±10.32 vs 102.24±20.21,t=11.840;19.35±2.46 vs 22.27±2.13,t=7.508;32.25±4.6 vs 39.42±4.23,t=9.565;P both<0.001).Moreover,the observation group exhibited significantly improved quality of life scores compared to the control group(Social function:19.25±2.76 vs 16.23±2.34;Emotions:18.54±2.83 vs 12.28±2.16;Environment:18.49±2.48 vs 16.56±3.44;Physical health:19.53±2.39 vs 16.62±3.46;P both<0.001)after treatment.CONCLUSION MBSR combined with NET effectively alleviates depression,lowers inflammation(IL-2,IL-1β,and IL-6),reduces suicidal thoughts,enhances sleep,and improves the quality of life of individuals with depression.展开更多
Objective:To observe the clinical effects of detail-oriented nursing in health checkups at a health management center.Methods:A total of 240 individuals undergoing health checkups at the hospital’s health management ...Objective:To observe the clinical effects of detail-oriented nursing in health checkups at a health management center.Methods:A total of 240 individuals undergoing health checkups at the hospital’s health management center from June 2023 to June 2024 were enrolled and randomly divided into two groups according to a random number table method.The control group received routine nursing care,while the observation group received detail-oriented nursing care,with 120 cases in each group.Differences in checkup quality and nursing risk incidence were compared.Results:The form submission rate,project completion rate,and one-time checkup completion rate in the observation group were higher than those in the control group,while the checkup time was shorter(P<0.05).The incidence of nursing risks such as item loss,falls,and patient-nurse disputes was lower in the observation group compared to the control group(P<0.05).Conclusion:Applying detail-oriented nursing in health checkups at a health management center can effectively improve checkup quality and reduce the occurrence of nursing risks.展开更多
Objective:To observe and analyze the clinical effect of prefabricated fiber posts and plastic fiber posts in oral repair.Methods:A total of 128 patients admitted to our hospital from January 2023 to June 2024 underwen...Objective:To observe and analyze the clinical effect of prefabricated fiber posts and plastic fiber posts in oral repair.Methods:A total of 128 patients admitted to our hospital from January 2023 to June 2024 underwent oral prosthesis treatment,of which the control group(n=64)was treated with prefabricated fiber posts and the observation group(n=64)with plastic fiber posts.The efficacy,retention rate,and complication rate of the two groups were compared.Results:The total effective rate of the observation group was 96.88%,which was significantly higher than that of the control group(84.38%)(P<0.05).The restoration retention rate in the observation group was 95.31%,which was significantly higher than that in the control group(85.94%)(P<0.05).The incidence of postoperative complications in the observation group was 4.69%,which was significantly lower than that in the control group(15.63%)(P<0.05).Conclusion:For patients with oral prostheses,the use of plastic fiber posts for treatment shows better clinical effects,effectively improving the retention rate of the prosthesis and reducing the incidence of complications.Thus,it is worthy of popularization and application.展开更多
Tai Chi,a traditional Chinese martial art and health exercise,has gained significant global attention and recognition.The clinical benefits of Tai Chi have been studied extensively in recent decades.We conducted a sys...Tai Chi,a traditional Chinese martial art and health exercise,has gained significant global attention and recognition.The clinical benefits of Tai Chi have been studied extensively in recent decades.We conducted a systematic search of PubMed,Web of Science,EMBASE databases,and the China National Knowledge Infrastructure,identifying and reviewing 241 clinical trials on the benefits of Tai Chi from their inception to June 1,2023.Most of these studies have consistently demonstrated the positive impact of Tai Chi on balance,cognitive function,mood regulation,sleep quality,pain relief,cardiorespiratory function,and overall health.In the future,the key to fostering the ongoing development of this field lies in comprehensive research on standardized study designs and reporting,the scope of Tai Chi applications,and the core factors influencing its efficacy.展开更多
BACKGROUND Perimenopausal syndrome(PMS)is a chronic disease associated with estrogen deficiency.Because of the unsatisfactory outcomes of current conventional treatments for this condition,its treatment must be contin...BACKGROUND Perimenopausal syndrome(PMS)is a chronic disease associated with estrogen deficiency.Because of the unsatisfactory outcomes of current conventional treatments for this condition,its treatment must be continuously explored and optimized.AIM To assess the clinical effectiveness ofγ-oryzanol in combination with Femoston for PMS.METHODS A total of 119 patients with PMS were selected from June 2023 to December 2023,which included 59 and 60 patients in the control and observation group,respectively.The control and observation groups were treated with Femoston andγ-oryzanol+Femoston,respectively.Comparative analyses were performed in terms of clinical effectiveness,safety(dizziness and headache,nausea and vomiting,and breast tenderness),sex hormones[estradiol(E2),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)],lumbar spine(L1-4)and bilateral femoral bone mineral density(BMD),and sleep quality(sleeping time and frequency of awakenings from sleep).RESULTS Compared with the control group,the observation group had statistically higher total effective rates of treatment;lower overall incidence of adverse events;higher post-treatment E2 levels and L1-4 and bilateral femoral BMD;and lower LH and FSH levels,sleeping time,and frequency of awakenings from sleep after treatment.CONCLUSION Therefore,for the treatment of PMS,γ-oryzanol combined with Femoston is significantly better than Femoston alone in terms of clinical effectiveness,exhibiting more pronounced clinical advantages in improving safety,sex hormone levels,BMD,and sleep quality.展开更多
Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are ...Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.展开更多
BACKGROUND Tooth defects can cause elongation of occlusal teeth,leading to insufficient repair space.The combination of dental implant restoration and orthodontic treatment of oblique adjacent teeth has a significant ...BACKGROUND Tooth defects can cause elongation of occlusal teeth,leading to insufficient repair space.The combination of dental implant restoration and orthodontic treatment of oblique adjacent teeth has a significant therapeutic effect.AIM To explore clinical efficacy,bone density,and follow-up of implant and orthodontic treatment for patients with inclined adjacent teeth.METHODS In total,98 patients with oblique adjacent teeth were randomly assigned to implant restoration combined with orthodontic treatment(group A,n=49)or to receive implant restoration alone(group B,n=49).Changes in alveolar ridge bone density and apical bone density were observed before and after treatment in the two groups.Changes in chewing function and language function were compared between the two groups of patients.Follow-up lasted for 12 mo after repair to observe any adverse reactions in the oral cavity.RESULTS The clinical effective rates of group A and group B were 97.96%and 85.71%,respectively,with group A having a higher clinical effective rate than group B.After treatment,the bone density of the alveolar ridge and apical bone in both groups decreased compared to before treatment,while the chewing and language functions improved.The changes in various indicators in group A were more significant.After treatment,the satisfaction rate of group A(97.96%)was higher than that of group B(79.59%).The incidence of adverse reactions in group A(2.04%)was lower than that in group B(24.49%).CONCLUSION The amalgamation of implant restoration and orthodontic treatment for adjacent tilted teeth demonstrates notable clinical efficacy,diminishes alveolar bone resorption,and fosters patient functional rehabilitation while exhibiting negligible adverse reactions.展开更多
BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with ...BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with traditional treatment.AIM To investigate the clinical efficacy of flexible ureteroscopy(FURS)and percutaneous nephrolithotomy(PCNL)by postoperative stone clearance and changes in soluble vascular cell adhesion molecule 1(sVCAM-1)and kidney injury molecule 1(KIM-1)levels in patients with large kidney stones(>2 cm in diameter).METHODS This single-center observational study was performed at a Chinese hospital between January 1,2021,and October 30,2023.All 250 enrolled patients were diagnosed with large kidney stones(>2 cm)and divided into a FURS group(n=145)and a PCNL group(n=105)by the surgical method.The FURS group was treated with flexible ureteroscopy and the PCNL group was treated with percutaneous nephrolithotomy.The operation time,time to palinesthesia,intraoperative blood loss,drop in hemoglobin,length of hospital stay,stone clearance rate,and complications were recorded in the two groups.Preoperative and postoperative serum sVCAM-1 levels,erythrocyte sedimentation rate(ESR),urine KIM-1 levels,preoperative and postoperative pain visual analog scale(VAS)and Wisconsin Stone Quality of Life Questionnaire(WISQOL)scores were also documented.RESULTS All 250 eligible patients completed the follow-up.There were no significant differences in baseline characteristics between the two groups(P>0.05).The operation time in the FURS group was significantly greater than that in the PCNL group.The time to ambulation,intraoperative blood loss,decrease in hemoglobin,and length of hospital stay were significantly lower in the FURS group than in the PCNL group.The FURS group also had a significantly higher stone clearance rate and a lower incidence of postoperative complications.There was no significant difference in antibiotic use between the groups.Postoperative serum sVCAM-1 levels,urine KIM-1 levels,and VAS scores were lower in the FURS group than in the PCNL group,but postoperative ESR and WISQOL scores were greater in the FURS group than in the PCNL group.CONCLUSION FURS demonstrated superior clinical efficacy in treating large kidney stones(>2 cm in diameter)compared PCNL.It not only improved the postoperative stone clearance rate and reduced complications and recovery time but also positively affected serum SCM-1,ESR,and urine KIM-1 levels,subsequent improvement of patient quality of life.展开更多
BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the...BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the effects of treatments comprising simple Western medicine are not optimal.With the promotion and implementation of integrated Chinese and western medicine treatments,remarkable results have been achieved for many diseases.To this end,we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.AIM To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.METHODS Through a retrospective analysis,123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO.7 People’s Hospital from January 2021 to October 2022 and were selected as study subjects.After rigorous screening,100 patients with early DN were enrolled.The control group(CG,n=50)and the observation group(OG,n=50)were divided according to the treatment method.The CG were treated with sitagliptin,and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction.Both groups were treated for 3 mo.For both groups,the baseline data and clinical efficacy were compared,and changes in blood glucose levels,lipid levels,renal function,and hematological indicators before(T0)and after(T1)treatment were assessed.RESULTS The total effective rate for the OG was 94.00%and that of the CG was 80.00%(P<0.05).After treatment(T1),the levels of fasting blood glucose,2 h postprandial glucose,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG(P<0.05),and cystatin C,homocysteine,urinary microalbumin,and blood creatinine values in OG patients were also obviously lower than those in the CG(P<0.05);erythrocyte deposition,plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were markedly lower in OG patients than in the CG(P<0.05).CONCLUSION Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN.Further,it is helpful in improving hemorheological indices and controlling disease progression.展开更多
Objective: Carbon ion therapy, a new radiotherapy technology, has shown its remarkable efficacy and potential in cancer treatment, especially in the treatment of refractory tumors. Methods: This paper clarifies the ph...Objective: Carbon ion therapy, a new radiotherapy technology, has shown its remarkable efficacy and potential in cancer treatment, especially in the treatment of refractory tumors. Methods: This paper clarifies the physical basis, technological change, and clinical practice effect of carbon ion therapy, comprehensively discusses the future prospects, and evaluates the clinical application effect. Results: The technology has significantly improved the treatment effectiveness and received a positive response from patients. Conclusion: Carbon ion therapy technology has become a major innovation in the field of cancer treatment. It not only has a profound impact on many current cancer therapy methods but also indicates the application blueprint for a wider range of cancer types in the future, showing a new chapter of medical technology advancement.展开更多
Objective:To evaluate the clinical effect of full femtosecond laser surgery in the treatment of myopia patients.Methods:120 myopia patients admitted to our hospital from January 2022 to June 2023 were selected.Accordi...Objective:To evaluate the clinical effect of full femtosecond laser surgery in the treatment of myopia patients.Methods:120 myopia patients admitted to our hospital from January 2022 to June 2023 were selected.According to the random number table method,60 patients in the observation group underwent full femtosecond laser surgery,and 60 patients in the control group underwent femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery.The clinical effects of the two groups were compared.Results:10 days postoperatively and 6 months after operation,the visual acuity level of the observation group was higher than that of the control group,the postoperative corneal asphericity coefficient and corneal full-thickness were lower than those of the control group,and the total effective rate 6 months after operation was higher than that of the control group(P<0.05).Conclusion:Full femtosecond laser surgical treatment can improve the postoperative visual acuity of patients with myopia,enhance the corneal asphericity coefficient(Q)and corneal full-thickness,and exert significant clinical effects.展开更多
BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years...BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years for hepatocellular carcinoma treatment in later lines,it is essential to assess clinical effectiveness of older therapies in actual clinical practice to inform healthcare practitioners’decisions for better patient care.AIM To assess patient characteristics/clinical effectiveness of 1L sorafenib in uHCC patients treated in United States academic and community practice settings.METHODS A retrospective observational study was conducted among adult patients(≥18 years)in the United States initiating sorafenib monotherapy as 1L systemic therapy for uHCC with Eastern Cooperative Oncology Group status of 0 or 1 between January 2016 and December 2019 at City of Hope and Advent Health.Data were extracted by trained abstractionists from individual patients’electronic health records and captured in electronic case report forms.Institutional Review Board approvals were obtained prior to study initiation.Data were captured from the time of sorafenib initiation until death or the end of follow-up.All data were de-identified prior to analyses.Clinical outcomes assessed included provider-reported best response,progression-free survival(PFS),and overall survival(OS).PFS and OS were estimated using Kaplan-Meier methods.RESULTS Among 134 uHCC patients treated with 1L sorafenib,majority were male(75%),and most were Caucasian(62%)or Asian(19%).Median patient age was 64 years.The most common etiologies of liver disease were hepatitis C(54%),alcohol-related liver disease(16%),and hepatitis B(11%).Most patients were reported to have Barcelona Clinic Liver Cancer stage B(19%)or stage C(70%)disease.Of 134 patients,110(82%)were reported to have discontinued treatment or died during follow-up.Primary reasons for sorafenib discontinuation were reported as progression(35%)and toxicity(30%).Best overall response was reported for 124 patients,of which 7.3%reported complete or partial response.Median time to treatment discontinuation was 2.3 mo.Overall,103 patients(77%)had disease progression or died during sorafenib therapy.Median PFS was estimated to be 2.9 mo.At the end of follow-up,82 patients(61%)were deceased.Median OS was 8.5 mo.CONCLUSION Newer therapeutic options that have reported higher PFS and OS in real-world clinical practice should be considered to enhance patient outcomes.展开更多
Objective:To study the application effect of short video combined with BOPPPS teaching mode in clinical anesthesia practice.Method:48 students assigned to clinical anesthesia in digestive endoscopy of Shanxi Bethune H...Objective:To study the application effect of short video combined with BOPPPS teaching mode in clinical anesthesia practice.Method:48 students assigned to clinical anesthesia in digestive endoscopy of Shanxi Bethune Hospital from July 1,2022 to April 1,2023 were selected as research objects.They were randomly divided into the control group(PowerPoint presentation teaching group)and the observation group(short video combined with BOPPPS teaching group),with 24 students in each group.After the internship,the students’theoretical and technical scores were tested,the effects of the two teaching modes were compared,and the students’satisfaction was investigated.Results:The test scores of students in the observation group were significantly better than those in the control group(P<0.05).The short video combined with BOPPPS teaching mode can significantly improve students’learning interest,operation skills,and memory(P<0.05).The students’satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:In clinical practice,the application of short video combined with BOPPPS teaching mode has achieved great effect,which is worth further promotion and research.展开更多
BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relative...BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.AIM To explore the clinical features,curative effects,and prognostic factors of FL.METHODS Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined.These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining.The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas.Ann Arbor staging was performed according to the imaging and bone marrow examination results.Risk stratification of all patients was performed based on the International Prognostic Index(IPI),age-adjusted IPI,Follicular Lymphoma International Prognosis Index(FLIPI),and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.RESULTS The age of onset in patients ranged from 24 to 76 years,with a median age of 51 years.Most patients developed the disease at 40–59 years of age,and the male:female ratio was 1.6:1.No significant difference was noted in the curative effect between the non-chemotherapy,combined chemotherapy,and other chemotherapy regimens(P>0.05).Hemoglobin(Hb)level<120 g/L,Ki-67 value>50%,bone marrow involvement,and clinical stagesⅢ–IV were associated with a poor prognosis of FL(P<0.05).However,the influence of other indicators was not statistically significant.Risk grouping was performed using the FLIPI,and the results showed that 24.5%,40.8%,and 34.7%of patients were in the low-,moderate-,and high-risk groups,respectively.According to the survival analysis results,the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups(P<0.05).CONCLUSION FL mainly occurs in middle-aged and elderly men,primarily affecting lymph nodes and bone marrow.Hb level,Ki-67 value,bone marrow involvement,and clinical staging were used to evaluate prognosis.展开更多
BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniq...BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniques that has been described in recent years.All-inside anterior cruciate ligament(ACL)reconstruction is based on a tibial socket instead of a full tunnel.This method has many potential advantages.AIM To compare clinical outcomes of knee ACL autograft reconstruction using allinside quadrupled semitendinosus(AIST)and traditional hamstring tendon(TBT)techniques.METHODS From January 2017 to October 2019,the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed,including 67 males and 13 females.The patients had an average age of 24.3±3.1 years(age range:18-33 years).The AIST technique was used in 42 patients and the TBT technique was used in 38 patients.The time between operation and injury,operative duration,postoperative visual analogue scale(VAS)score and knee functional recovery were recorded and compared between the two groups.The International Knee Documentation Committee(IKDC)and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.RESULTS Eighty patients were followed for 24-36 mo,with an average follow-up duration of 27.5±1.8 mo.There were no significant differences in the time between surgery and injury,operative duration,IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups.There were significant differences in VAS scores 1 d,3 d,7 d,2 wk and 1 mo after surgery(P<0.05).There was no significant difference in VAS score at 3 mo,6 mo and 1 year after operation.CONCLUSION The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique,but the postoperative pain was less with the AIST technique.Thus,the AIST technique is an ideal treatment choice for ACL reconstruction.展开更多
Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly ...Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly assigned to five drug treatment regimens. Results: Combination therapy with doxycycline, rifampin and sulfamethoxazole for 56 consecutive days showed the highest cure rate of 20% after a single course and of 85% after a double course with affectivity rates of 55% and 95%. Cure rate and affectivity rate was significant better (P 0.05) than for patients receiving doxycycline, rifampin and streptomycin for the same period and regimens containing doxycycline were significant better than regimens without this drug. Conclusion: Combination therapy of doxycycline, rifampin and sulfamethoxazole for 8 weeks using one or two full courses should be recommended for Brucella spondylitis.展开更多
BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE...BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE： Four different time points were selected for acupuncture treatment of cerebral infarction to evaluate the appropriate time course for Xingnao Kaiqiao therapy in terms of improved neurological function. DESIGN： Controlled observation. SETTING： Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy of the Affiliated Hospital of Medical College of Chinese Armed Police Forces. PARTICIPANTS： A total of 120 inpatients with cerebral infarction of different stages, including 75 males and 45 females, aged 41-75 years, were selected from November 2005 to December 2006 at the Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy in Affiliated Hospital of Medical College of Chinese Armed Police Forces. Diagnostic criteria： in accordance with ＂main points of diagnosis on different cerebrovascular disease＂ secondly revised in the Second Cerebrovascular Disease Academic Meeting of Chinese Medicine Association in 1986. All accepted subjects provided confirmed consent, and the experiment received ethical permission from the hospital＇s ethics committee. METHODS： ① Experiment grouping： All inpatients were divided into four groups with non-stochastic concurrent control method according to the disease course： Group Ⅰ （onset within 7 hours）, group Ⅱ （onset from 7 hours to 3 days）, group Ⅲ （onset within 4-7 days）, and group IV （onset within 21-180 days）. On the basis of symptomatic treatment with western medicine, each group received Xingnao Kaiqiao therapy after onset within 7 hours, 7 hours to 3 days, 4 to 7days, and 21 to 180 days. ① The principal acupoints were Neiguan, Renzhong, and Sanyinfiao. ② The auxiliary acupoints were Jiquan, Chize, and Weizhong. ③Acupuncture manipulations： initially, Neiguan （PC6, bilateral） was needled at 0.5-1.0 cun vertically with a reducing technique achieved by rotating-swirling and lifting-inserting for l minute. Subsequently, Renzhong （GV26） was needled at 0.3-0.5 cun obliquely towards the nasal septum, with a heavy bird-pecking method until eyeballs were moist or shed tears. Sanyinjiao （SP6, affected limb） was needled at 1.0-1.5 cun obliquely along the medial border of the tibia with a 45° angle between the needle and skin. The technique of reinforcing was achieved by a lifting-inserting method until the affected lower limb twitched three times. The auxiliary acupoint, Jiquan, was selected when the patient extended the affected upper limb abduction. Jiquan was along the downward channel, l cun from the quondam Jiquan （HT1） acupoint; the armpit hair was avoided. Jiquan （affected limb） was needled vertically at 1.0-1.5 cun. The technique of reduction was achieved by lifting-inserting until the affected upper limb twitched three times. Chize （LU5） was selected when the patient flexed the elbow at 120°. Chize was vertically needled at l cun with a lifting-inserting reducing technique until the affected forearm and fingers twitched three times. Weizhong （BL40） was selected when the patient＇s leg was raised straight in a supine position. Weizhong was vertically needled at 0.5 1.0 cun with a lifting-inserting reducing technique until the affected lower limb twitched three times. ⑤ Acupuncture manipulations were achieved by the doctor who is an associate chief physician and doctor of acupuncture and moxibustion and has aptitude for the post＇s specification. ⑥One course of treatment lasted for 10 days and each group was treated for two courses of treatment. ⑦Experiment evaluation： To apply neurological impairment scores for evaluating clinical curative effects before and after treatment with Xingnao Kaiqiao therapy on day 7, 14, and 21（range of 0 45; decreasing score indicates functional improvement）.To evaluate clinical curative effect by clinical effective power： Basic recovery： equal to or more than 81%; significant improvement： 56% to 81% （including 56%）; Improvement： between 36% to 56% （including 36%）; Slight Improvement： 11% to 36% （including 11%）; No change： less than 11%; Aggravation （including death）： negative value. Total effective rate was computed at the same time. MAIN OUTCOME MEASURES： The total effective rate and amelioration of neurological impairment of the patients after treatment. RESULTS： All 120 patients with cerebral infarction were included in the final analysis, without deletion. ① Comparison of the total effective rate： the total effective rate of group Ⅰ, group Ⅱ, group Ⅲ and group IV was 97%, 93%, 93%, and 67%, respectively. There were significant differences of interclass synthetic curative effects （x^2 = 36.351 7, P 〈 0.01）. ② Amelioration of neurological impairment： A decreased neurological impairment score was observed in group Ⅰ on day 7, 14, and 21 after Xingnao Kaiqiao therapy. The differences between group Ⅳ and the remaining three groups were significant （P 〈 0.05）. CONCLUSION： Xingnao Kaiqiao therapy is helpful for amelioration of neurological impairment in patients during the acute stage cerebral infarction.展开更多
Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effe...Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effect of self-efficacy on relationship between EI and communication skills.Methods:A total of 865 nurses were recruited and investigated using Wong and Law's Emotional Intelligence Scale,General Self-Efficacy Scale,and nurse clinical communication scale.Results:The scores for EI and self-efficacy of nurses were 14.23±2.61 and 25.36±5.67,respectively,which were lower than the international norm(p<0.01).The score for clinical communication ability of nurses was 4.14±0.53.The clinical communication competency of nurses was positively correlated with EI and general self-efficacy.Furthermore,selfefficacy played an intermediary role between EI and clinical communication commitment.Conclusion:Nursing administrators can improve the clinical communication ability of nurses by enhancing their self-efficacy and EI.展开更多
BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglect...BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.展开更多
Chemotherapy(CT)is the most impor-tant therapeutic means in treating post-oper-ational patients with colorectal carcinoma(CA),but its efficacy is often affected bythe toxic side-effects of CT agents.TCMcould reinforce...Chemotherapy(CT)is the most impor-tant therapeutic means in treating post-oper-ational patients with colorectal carcinoma(CA),but its efficacy is often affected bythe toxic side-effects of CT agents.TCMcould reinforce body resistance and tonifythe qi,alleviate the toxic side-effects of CT,thus strengthening the efficacy of organismagainst tumor.Shenqi Fuzheng(参芪扶正,展开更多
基金Supported by Guangdong Provincial Medical Scientific Research Fund Project,No.B2016109.
文摘BACKGROUND Depression is a common and serious psychological condition,which seriously affects individual well-being and functional ability.Traditional treatment methods include drug therapy and psychological counseling;however,these methods have different degrees of side effects and limitations.In recent years,nonconvulsive electrotherapy(NET)has attracted increasing attention as a noninvasive treatment method.However,the clinical efficacy and potential mechanism of NET on depression are still unclear.We hypothesized that NET has a positive clinical effect in the treatment of depression,and may have a regulatory effect on serum inflammatory factors during treatment.AIM To assess the effects of NET on depression and analyze changes in serum inflammatory factors.METHODS This retrospective study enrolled 140 patients undergoing treatment for depression between May 2017 and June 2022,the observation group that received a combination of mindfulness-based stress reduction(MBSR)and NET treatment(n=70)and the control group that only received MBSR therapy(n=70).The clinical effectiveness of the treatment was evaluated by assessing various factors,including the Hamilton Depression Scale(HAMD)-17,self-rating idea of suicide scale(SSIOS),Pittsburgh Sleep Quality Index(PSQI),and levels of serum inflammatory factors before and after 8 wk of treatment.The quality of life scores between the two groups were compared.Comparisons were made using t and χ^(2) tests.RESULTS After 8 wk of treatment,the observation group exhibited a 91.43%overall effectiveness rate which was higher than that of the control group which was 74.29%(64 vs 52,χ^(2)=7.241;P<0.05).The HAMD,SSIOS,and PSQI scores showed a significant decrease in both groups.Moreover,the observation group had lower scores than the control group(10.37±2.04 vs 14.02±2.16,t=10.280;1.67±0.28 vs 0.87±0.12,t=21.970;5.29±1.33 vs 7.94±1.35,t=11.700;P both<0.001).Additionally,there was a notable decrease in the IL-2,IL-1β,and IL-6 in both groups after treatment.Furthermore,the observation group exhibited superior serum inflammatory factors compared to the control group(70.12±10.32 vs 102.24±20.21,t=11.840;19.35±2.46 vs 22.27±2.13,t=7.508;32.25±4.6 vs 39.42±4.23,t=9.565;P both<0.001).Moreover,the observation group exhibited significantly improved quality of life scores compared to the control group(Social function:19.25±2.76 vs 16.23±2.34;Emotions:18.54±2.83 vs 12.28±2.16;Environment:18.49±2.48 vs 16.56±3.44;Physical health:19.53±2.39 vs 16.62±3.46;P both<0.001)after treatment.CONCLUSION MBSR combined with NET effectively alleviates depression,lowers inflammation(IL-2,IL-1β,and IL-6),reduces suicidal thoughts,enhances sleep,and improves the quality of life of individuals with depression.
文摘Objective:To observe the clinical effects of detail-oriented nursing in health checkups at a health management center.Methods:A total of 240 individuals undergoing health checkups at the hospital’s health management center from June 2023 to June 2024 were enrolled and randomly divided into two groups according to a random number table method.The control group received routine nursing care,while the observation group received detail-oriented nursing care,with 120 cases in each group.Differences in checkup quality and nursing risk incidence were compared.Results:The form submission rate,project completion rate,and one-time checkup completion rate in the observation group were higher than those in the control group,while the checkup time was shorter(P<0.05).The incidence of nursing risks such as item loss,falls,and patient-nurse disputes was lower in the observation group compared to the control group(P<0.05).Conclusion:Applying detail-oriented nursing in health checkups at a health management center can effectively improve checkup quality and reduce the occurrence of nursing risks.
文摘Objective:To observe and analyze the clinical effect of prefabricated fiber posts and plastic fiber posts in oral repair.Methods:A total of 128 patients admitted to our hospital from January 2023 to June 2024 underwent oral prosthesis treatment,of which the control group(n=64)was treated with prefabricated fiber posts and the observation group(n=64)with plastic fiber posts.The efficacy,retention rate,and complication rate of the two groups were compared.Results:The total effective rate of the observation group was 96.88%,which was significantly higher than that of the control group(84.38%)(P<0.05).The restoration retention rate in the observation group was 95.31%,which was significantly higher than that in the control group(85.94%)(P<0.05).The incidence of postoperative complications in the observation group was 4.69%,which was significantly lower than that in the control group(15.63%)(P<0.05).Conclusion:For patients with oral prostheses,the use of plastic fiber posts for treatment shows better clinical effects,effectively improving the retention rate of the prosthesis and reducing the incidence of complications.Thus,it is worthy of popularization and application.
基金The National Natural Science Foundation of China(82474657,82305362,82305360)the Sichuan Philosophy and Social Science Foundation(SCJJ24ZD101)+1 种基金the Science popularization project of Sichuan Science and Technology Department(2024JDKP0051)the Xinglin Promotion Program of Chengdu University of Traditional Chinese Medicine(QJJJ2022019,MPRC2022022,KPZX2022022).
文摘Tai Chi,a traditional Chinese martial art and health exercise,has gained significant global attention and recognition.The clinical benefits of Tai Chi have been studied extensively in recent decades.We conducted a systematic search of PubMed,Web of Science,EMBASE databases,and the China National Knowledge Infrastructure,identifying and reviewing 241 clinical trials on the benefits of Tai Chi from their inception to June 1,2023.Most of these studies have consistently demonstrated the positive impact of Tai Chi on balance,cognitive function,mood regulation,sleep quality,pain relief,cardiorespiratory function,and overall health.In the future,the key to fostering the ongoing development of this field lies in comprehensive research on standardized study designs and reporting,the scope of Tai Chi applications,and the core factors influencing its efficacy.
文摘BACKGROUND Perimenopausal syndrome(PMS)is a chronic disease associated with estrogen deficiency.Because of the unsatisfactory outcomes of current conventional treatments for this condition,its treatment must be continuously explored and optimized.AIM To assess the clinical effectiveness ofγ-oryzanol in combination with Femoston for PMS.METHODS A total of 119 patients with PMS were selected from June 2023 to December 2023,which included 59 and 60 patients in the control and observation group,respectively.The control and observation groups were treated with Femoston andγ-oryzanol+Femoston,respectively.Comparative analyses were performed in terms of clinical effectiveness,safety(dizziness and headache,nausea and vomiting,and breast tenderness),sex hormones[estradiol(E2),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)],lumbar spine(L1-4)and bilateral femoral bone mineral density(BMD),and sleep quality(sleeping time and frequency of awakenings from sleep).RESULTS Compared with the control group,the observation group had statistically higher total effective rates of treatment;lower overall incidence of adverse events;higher post-treatment E2 levels and L1-4 and bilateral femoral BMD;and lower LH and FSH levels,sleeping time,and frequency of awakenings from sleep after treatment.CONCLUSION Therefore,for the treatment of PMS,γ-oryzanol combined with Femoston is significantly better than Femoston alone in terms of clinical effectiveness,exhibiting more pronounced clinical advantages in improving safety,sex hormone levels,BMD,and sleep quality.
文摘Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.
基金the Review Committee of General Hospital of Central Theater Command(Approval No.05901).
文摘BACKGROUND Tooth defects can cause elongation of occlusal teeth,leading to insufficient repair space.The combination of dental implant restoration and orthodontic treatment of oblique adjacent teeth has a significant therapeutic effect.AIM To explore clinical efficacy,bone density,and follow-up of implant and orthodontic treatment for patients with inclined adjacent teeth.METHODS In total,98 patients with oblique adjacent teeth were randomly assigned to implant restoration combined with orthodontic treatment(group A,n=49)or to receive implant restoration alone(group B,n=49).Changes in alveolar ridge bone density and apical bone density were observed before and after treatment in the two groups.Changes in chewing function and language function were compared between the two groups of patients.Follow-up lasted for 12 mo after repair to observe any adverse reactions in the oral cavity.RESULTS The clinical effective rates of group A and group B were 97.96%and 85.71%,respectively,with group A having a higher clinical effective rate than group B.After treatment,the bone density of the alveolar ridge and apical bone in both groups decreased compared to before treatment,while the chewing and language functions improved.The changes in various indicators in group A were more significant.After treatment,the satisfaction rate of group A(97.96%)was higher than that of group B(79.59%).The incidence of adverse reactions in group A(2.04%)was lower than that in group B(24.49%).CONCLUSION The amalgamation of implant restoration and orthodontic treatment for adjacent tilted teeth demonstrates notable clinical efficacy,diminishes alveolar bone resorption,and fosters patient functional rehabilitation while exhibiting negligible adverse reactions.
基金the Clinical Research Ethics Committees of Wuxi Taihu Hospital(Approval Number THH-YXLL-2021-0103).
文摘BACKGROUND Renal stones ranging 20–40 mm are very common in China.Although no largesample clinical studies have confirmed the clinical efficacy and safety of this method,there is also a lack of comparative data with traditional treatment.AIM To investigate the clinical efficacy of flexible ureteroscopy(FURS)and percutaneous nephrolithotomy(PCNL)by postoperative stone clearance and changes in soluble vascular cell adhesion molecule 1(sVCAM-1)and kidney injury molecule 1(KIM-1)levels in patients with large kidney stones(>2 cm in diameter).METHODS This single-center observational study was performed at a Chinese hospital between January 1,2021,and October 30,2023.All 250 enrolled patients were diagnosed with large kidney stones(>2 cm)and divided into a FURS group(n=145)and a PCNL group(n=105)by the surgical method.The FURS group was treated with flexible ureteroscopy and the PCNL group was treated with percutaneous nephrolithotomy.The operation time,time to palinesthesia,intraoperative blood loss,drop in hemoglobin,length of hospital stay,stone clearance rate,and complications were recorded in the two groups.Preoperative and postoperative serum sVCAM-1 levels,erythrocyte sedimentation rate(ESR),urine KIM-1 levels,preoperative and postoperative pain visual analog scale(VAS)and Wisconsin Stone Quality of Life Questionnaire(WISQOL)scores were also documented.RESULTS All 250 eligible patients completed the follow-up.There were no significant differences in baseline characteristics between the two groups(P>0.05).The operation time in the FURS group was significantly greater than that in the PCNL group.The time to ambulation,intraoperative blood loss,decrease in hemoglobin,and length of hospital stay were significantly lower in the FURS group than in the PCNL group.The FURS group also had a significantly higher stone clearance rate and a lower incidence of postoperative complications.There was no significant difference in antibiotic use between the groups.Postoperative serum sVCAM-1 levels,urine KIM-1 levels,and VAS scores were lower in the FURS group than in the PCNL group,but postoperative ESR and WISQOL scores were greater in the FURS group than in the PCNL group.CONCLUSION FURS demonstrated superior clinical efficacy in treating large kidney stones(>2 cm in diameter)compared PCNL.It not only improved the postoperative stone clearance rate and reduced complications and recovery time but also positively affected serum SCM-1,ESR,and urine KIM-1 levels,subsequent improvement of patient quality of life.
文摘BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the effects of treatments comprising simple Western medicine are not optimal.With the promotion and implementation of integrated Chinese and western medicine treatments,remarkable results have been achieved for many diseases.To this end,we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.AIM To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.METHODS Through a retrospective analysis,123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO.7 People’s Hospital from January 2021 to October 2022 and were selected as study subjects.After rigorous screening,100 patients with early DN were enrolled.The control group(CG,n=50)and the observation group(OG,n=50)were divided according to the treatment method.The CG were treated with sitagliptin,and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction.Both groups were treated for 3 mo.For both groups,the baseline data and clinical efficacy were compared,and changes in blood glucose levels,lipid levels,renal function,and hematological indicators before(T0)and after(T1)treatment were assessed.RESULTS The total effective rate for the OG was 94.00%and that of the CG was 80.00%(P<0.05).After treatment(T1),the levels of fasting blood glucose,2 h postprandial glucose,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG(P<0.05),and cystatin C,homocysteine,urinary microalbumin,and blood creatinine values in OG patients were also obviously lower than those in the CG(P<0.05);erythrocyte deposition,plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were markedly lower in OG patients than in the CG(P<0.05).CONCLUSION Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN.Further,it is helpful in improving hemorheological indices and controlling disease progression.
文摘Objective: Carbon ion therapy, a new radiotherapy technology, has shown its remarkable efficacy and potential in cancer treatment, especially in the treatment of refractory tumors. Methods: This paper clarifies the physical basis, technological change, and clinical practice effect of carbon ion therapy, comprehensively discusses the future prospects, and evaluates the clinical application effect. Results: The technology has significantly improved the treatment effectiveness and received a positive response from patients. Conclusion: Carbon ion therapy technology has become a major innovation in the field of cancer treatment. It not only has a profound impact on many current cancer therapy methods but also indicates the application blueprint for a wider range of cancer types in the future, showing a new chapter of medical technology advancement.
文摘Objective:To evaluate the clinical effect of full femtosecond laser surgery in the treatment of myopia patients.Methods:120 myopia patients admitted to our hospital from January 2022 to June 2023 were selected.According to the random number table method,60 patients in the observation group underwent full femtosecond laser surgery,and 60 patients in the control group underwent femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery.The clinical effects of the two groups were compared.Results:10 days postoperatively and 6 months after operation,the visual acuity level of the observation group was higher than that of the control group,the postoperative corneal asphericity coefficient and corneal full-thickness were lower than those of the control group,and the total effective rate 6 months after operation was higher than that of the control group(P<0.05).Conclusion:Full femtosecond laser surgical treatment can improve the postoperative visual acuity of patients with myopia,enhance the corneal asphericity coefficient(Q)and corneal full-thickness,and exert significant clinical effects.
文摘BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years for hepatocellular carcinoma treatment in later lines,it is essential to assess clinical effectiveness of older therapies in actual clinical practice to inform healthcare practitioners’decisions for better patient care.AIM To assess patient characteristics/clinical effectiveness of 1L sorafenib in uHCC patients treated in United States academic and community practice settings.METHODS A retrospective observational study was conducted among adult patients(≥18 years)in the United States initiating sorafenib monotherapy as 1L systemic therapy for uHCC with Eastern Cooperative Oncology Group status of 0 or 1 between January 2016 and December 2019 at City of Hope and Advent Health.Data were extracted by trained abstractionists from individual patients’electronic health records and captured in electronic case report forms.Institutional Review Board approvals were obtained prior to study initiation.Data were captured from the time of sorafenib initiation until death or the end of follow-up.All data were de-identified prior to analyses.Clinical outcomes assessed included provider-reported best response,progression-free survival(PFS),and overall survival(OS).PFS and OS were estimated using Kaplan-Meier methods.RESULTS Among 134 uHCC patients treated with 1L sorafenib,majority were male(75%),and most were Caucasian(62%)or Asian(19%).Median patient age was 64 years.The most common etiologies of liver disease were hepatitis C(54%),alcohol-related liver disease(16%),and hepatitis B(11%).Most patients were reported to have Barcelona Clinic Liver Cancer stage B(19%)or stage C(70%)disease.Of 134 patients,110(82%)were reported to have discontinued treatment or died during follow-up.Primary reasons for sorafenib discontinuation were reported as progression(35%)and toxicity(30%).Best overall response was reported for 124 patients,of which 7.3%reported complete or partial response.Median time to treatment discontinuation was 2.3 mo.Overall,103 patients(77%)had disease progression or died during sorafenib therapy.Median PFS was estimated to be 2.9 mo.At the end of follow-up,82 patients(61%)were deceased.Median OS was 8.5 mo.CONCLUSION Newer therapeutic options that have reported higher PFS and OS in real-world clinical practice should be considered to enhance patient outcomes.
基金Shanxi Bethune Hospital Teaching Reform Project(2022JX06)Shanxi Provincial College Teaching Reform and Innovation Project(J20230467)。
文摘Objective:To study the application effect of short video combined with BOPPPS teaching mode in clinical anesthesia practice.Method:48 students assigned to clinical anesthesia in digestive endoscopy of Shanxi Bethune Hospital from July 1,2022 to April 1,2023 were selected as research objects.They were randomly divided into the control group(PowerPoint presentation teaching group)and the observation group(short video combined with BOPPPS teaching group),with 24 students in each group.After the internship,the students’theoretical and technical scores were tested,the effects of the two teaching modes were compared,and the students’satisfaction was investigated.Results:The test scores of students in the observation group were significantly better than those in the control group(P<0.05).The short video combined with BOPPPS teaching mode can significantly improve students’learning interest,operation skills,and memory(P<0.05).The students’satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:In clinical practice,the application of short video combined with BOPPPS teaching mode has achieved great effect,which is worth further promotion and research.
基金Supported by Zhejiang TCM Science and Technology Project,No.2023ZL653。
文摘BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.AIM To explore the clinical features,curative effects,and prognostic factors of FL.METHODS Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined.These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining.The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas.Ann Arbor staging was performed according to the imaging and bone marrow examination results.Risk stratification of all patients was performed based on the International Prognostic Index(IPI),age-adjusted IPI,Follicular Lymphoma International Prognosis Index(FLIPI),and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.RESULTS The age of onset in patients ranged from 24 to 76 years,with a median age of 51 years.Most patients developed the disease at 40–59 years of age,and the male:female ratio was 1.6:1.No significant difference was noted in the curative effect between the non-chemotherapy,combined chemotherapy,and other chemotherapy regimens(P>0.05).Hemoglobin(Hb)level<120 g/L,Ki-67 value>50%,bone marrow involvement,and clinical stagesⅢ–IV were associated with a poor prognosis of FL(P<0.05).However,the influence of other indicators was not statistically significant.Risk grouping was performed using the FLIPI,and the results showed that 24.5%,40.8%,and 34.7%of patients were in the low-,moderate-,and high-risk groups,respectively.According to the survival analysis results,the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups(P<0.05).CONCLUSION FL mainly occurs in middle-aged and elderly men,primarily affecting lymph nodes and bone marrow.Hb level,Ki-67 value,bone marrow involvement,and clinical staging were used to evaluate prognosis.
文摘BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniques that has been described in recent years.All-inside anterior cruciate ligament(ACL)reconstruction is based on a tibial socket instead of a full tunnel.This method has many potential advantages.AIM To compare clinical outcomes of knee ACL autograft reconstruction using allinside quadrupled semitendinosus(AIST)and traditional hamstring tendon(TBT)techniques.METHODS From January 2017 to October 2019,the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed,including 67 males and 13 females.The patients had an average age of 24.3±3.1 years(age range:18-33 years).The AIST technique was used in 42 patients and the TBT technique was used in 38 patients.The time between operation and injury,operative duration,postoperative visual analogue scale(VAS)score and knee functional recovery were recorded and compared between the two groups.The International Knee Documentation Committee(IKDC)and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.RESULTS Eighty patients were followed for 24-36 mo,with an average follow-up duration of 27.5±1.8 mo.There were no significant differences in the time between surgery and injury,operative duration,IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups.There were significant differences in VAS scores 1 d,3 d,7 d,2 wk and 1 mo after surgery(P<0.05).There was no significant difference in VAS score at 3 mo,6 mo and 1 year after operation.CONCLUSION The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique,but the postoperative pain was less with the AIST technique.Thus,the AIST technique is an ideal treatment choice for ACL reconstruction.
文摘Objective: To evaluate five drug treatment regimens in the treatment of Brucella spondylitis. Methods: Patients with clinical symptoms compatible and diagnostic test consistent with Brucella spondylitis were randomly assigned to five drug treatment regimens. Results: Combination therapy with doxycycline, rifampin and sulfamethoxazole for 56 consecutive days showed the highest cure rate of 20% after a single course and of 85% after a double course with affectivity rates of 55% and 95%. Cure rate and affectivity rate was significant better (P 0.05) than for patients receiving doxycycline, rifampin and streptomycin for the same period and regimens containing doxycycline were significant better than regimens without this drug. Conclusion: Combination therapy of doxycycline, rifampin and sulfamethoxazole for 8 weeks using one or two full courses should be recommended for Brucella spondylitis.
基金the Major State Basic Research and Development Pro-gram of China, No.2006CB504504
文摘BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE： Four different time points were selected for acupuncture treatment of cerebral infarction to evaluate the appropriate time course for Xingnao Kaiqiao therapy in terms of improved neurological function. DESIGN： Controlled observation. SETTING： Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy of the Affiliated Hospital of Medical College of Chinese Armed Police Forces. PARTICIPANTS： A total of 120 inpatients with cerebral infarction of different stages, including 75 males and 45 females, aged 41-75 years, were selected from November 2005 to December 2006 at the Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy in Affiliated Hospital of Medical College of Chinese Armed Police Forces. Diagnostic criteria： in accordance with ＂main points of diagnosis on different cerebrovascular disease＂ secondly revised in the Second Cerebrovascular Disease Academic Meeting of Chinese Medicine Association in 1986. All accepted subjects provided confirmed consent, and the experiment received ethical permission from the hospital＇s ethics committee. METHODS： ① Experiment grouping： All inpatients were divided into four groups with non-stochastic concurrent control method according to the disease course： Group Ⅰ （onset within 7 hours）, group Ⅱ （onset from 7 hours to 3 days）, group Ⅲ （onset within 4-7 days）, and group IV （onset within 21-180 days）. On the basis of symptomatic treatment with western medicine, each group received Xingnao Kaiqiao therapy after onset within 7 hours, 7 hours to 3 days, 4 to 7days, and 21 to 180 days. ① The principal acupoints were Neiguan, Renzhong, and Sanyinfiao. ② The auxiliary acupoints were Jiquan, Chize, and Weizhong. ③Acupuncture manipulations： initially, Neiguan （PC6, bilateral） was needled at 0.5-1.0 cun vertically with a reducing technique achieved by rotating-swirling and lifting-inserting for l minute. Subsequently, Renzhong （GV26） was needled at 0.3-0.5 cun obliquely towards the nasal septum, with a heavy bird-pecking method until eyeballs were moist or shed tears. Sanyinjiao （SP6, affected limb） was needled at 1.0-1.5 cun obliquely along the medial border of the tibia with a 45° angle between the needle and skin. The technique of reinforcing was achieved by a lifting-inserting method until the affected lower limb twitched three times. The auxiliary acupoint, Jiquan, was selected when the patient extended the affected upper limb abduction. Jiquan was along the downward channel, l cun from the quondam Jiquan （HT1） acupoint; the armpit hair was avoided. Jiquan （affected limb） was needled vertically at 1.0-1.5 cun. The technique of reduction was achieved by lifting-inserting until the affected upper limb twitched three times. Chize （LU5） was selected when the patient flexed the elbow at 120°. Chize was vertically needled at l cun with a lifting-inserting reducing technique until the affected forearm and fingers twitched three times. Weizhong （BL40） was selected when the patient＇s leg was raised straight in a supine position. Weizhong was vertically needled at 0.5 1.0 cun with a lifting-inserting reducing technique until the affected lower limb twitched three times. ⑤ Acupuncture manipulations were achieved by the doctor who is an associate chief physician and doctor of acupuncture and moxibustion and has aptitude for the post＇s specification. ⑥One course of treatment lasted for 10 days and each group was treated for two courses of treatment. ⑦Experiment evaluation： To apply neurological impairment scores for evaluating clinical curative effects before and after treatment with Xingnao Kaiqiao therapy on day 7, 14, and 21（range of 0 45; decreasing score indicates functional improvement）.To evaluate clinical curative effect by clinical effective power： Basic recovery： equal to or more than 81%; significant improvement： 56% to 81% （including 56%）; Improvement： between 36% to 56% （including 36%）; Slight Improvement： 11% to 36% （including 11%）; No change： less than 11%; Aggravation （including death）： negative value. Total effective rate was computed at the same time. MAIN OUTCOME MEASURES： The total effective rate and amelioration of neurological impairment of the patients after treatment. RESULTS： All 120 patients with cerebral infarction were included in the final analysis, without deletion. ① Comparison of the total effective rate： the total effective rate of group Ⅰ, group Ⅱ, group Ⅲ and group IV was 97%, 93%, 93%, and 67%, respectively. There were significant differences of interclass synthetic curative effects （x^2 = 36.351 7, P 〈 0.01）. ② Amelioration of neurological impairment： A decreased neurological impairment score was observed in group Ⅰ on day 7, 14, and 21 after Xingnao Kaiqiao therapy. The differences between group Ⅳ and the remaining three groups were significant （P 〈 0.05）. CONCLUSION： Xingnao Kaiqiao therapy is helpful for amelioration of neurological impairment in patients during the acute stage cerebral infarction.
文摘Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effect of self-efficacy on relationship between EI and communication skills.Methods:A total of 865 nurses were recruited and investigated using Wong and Law's Emotional Intelligence Scale,General Self-Efficacy Scale,and nurse clinical communication scale.Results:The scores for EI and self-efficacy of nurses were 14.23±2.61 and 25.36±5.67,respectively,which were lower than the international norm(p<0.01).The score for clinical communication ability of nurses was 4.14±0.53.The clinical communication competency of nurses was positively correlated with EI and general self-efficacy.Furthermore,selfefficacy played an intermediary role between EI and clinical communication commitment.Conclusion:Nursing administrators can improve the clinical communication ability of nurses by enhancing their self-efficacy and EI.
文摘BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.
文摘Chemotherapy(CT)is the most impor-tant therapeutic means in treating post-oper-ational patients with colorectal carcinoma(CA),but its efficacy is often affected bythe toxic side-effects of CT agents.TCMcould reinforce body resistance and tonifythe qi,alleviate the toxic side-effects of CT,thus strengthening the efficacy of organismagainst tumor.Shenqi Fuzheng(参芪扶正,
