Ineffective Rate Research Articles

Clinical efficacy analysis of 5-aminolevulinic acid photodynamic therapy for vulvar lichen sclerosus

ObjectiveThe purpose of this study is to analyze the efficacy of photodynamic therapy in the treatment of vulvar lichen sclerosus who do not respond to topical glucocorticoid therapy, analyze whether there are factors that affect the efficacy, and identify adverse reactions to the treatment. MethodThis retrospective study included 42 patients with vulval lichen sclerosis treated with ALA-PDT. Basic data of all patients were collected, and the clinical symptoms and signs of the patients before treatment were evaluated. After one year of treatment, the clinical efficacy was evaluated and analyzed whether there were any factors that affected the treatment effect. ResultOne year after the ALA-PDT treatment, the clinical effective rate was 64.29 % (27/42), the general effective rate was 19.05 % (8/42), the ineffective rate was 4.76 % (2/42), and the recurrence rate was 11.90 % (5/42). There was no correlation between menopause, number of births given, body mass index, duration of disease, treatment times and treatment effect. For patients with severe itching and atrophy, PDT was less effective. Adverse effects were minimal and no structural complications were reported. ConclusionALA-PDT can obviously alleviate itching in VLS patients, improve skin elasticity, skin color and reduce lesion area. ALA-PDT for VLS has a low recurrence rate and few side effects.

Combination of Traditional Chinese and Western Medicine to Improve the Cure Rate of Elderly Patients with Severe Novel Coronavirus Infection

Objective: To study the curative effect of traditional Chinese and western medicine on novel coronavirus's (COVID-19) patients in Jiangmen Central Hospital. Methods: This study was a retrospective cohort study. A total of 582 cases of COVID-19 patients admitted to Jiangmen Central Hospital from January 2020 to March 31, 2023 were collected, and five indicators, such as cure rate, improvement rate, inefficiency rate, mortality rate and hospitalization time, were analyzed, and the curative effects and treatment days under different treatment methods were compared among the integrated traditional Chinese and western medicine group, the western medicine group and the Chinese medicine group. Results: There was no significant difference in the cure rate, improvement rate, inefficiency rate and mortality rate of ordinary patients of all ages and severe middle and light years (≤65 years old) after treatment with integrated traditional Chinese and western medicine, pure western medicine or pure Chinese medicine (P > 0.05). The cure rate and effective rate of severe elderly patients (> 65 years old) were significantly higher than that of pure western medicine group (P < 0.05) and the ineffective rate was significantly lower than that of western medicine group (P < 0.01). There was no significant difference in improvement rate and mortality (P > 0.05). Except severe young patients (≤40 years old), the treatment time of western medicine group was significantly shorter than that of traditional Chinese medicine group and traditional Chinese and western medicine treatment group (P < 0.05). Conclusion: The combination of traditional Chinese and western medicine can significantly improve the cure rate and effective rate of elderly patients and reduce the inefficiency of their treatment. Compared with Chinese medicine, western medicine has a better effect in shortening hospitalization time.

Atrioventricular nodal ablation is an effective management strategy for atrial fibrillation in patients with hypertrophic cardiomyopathy

Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM) and can be challenging to manage. Atrioventricular nodal (AVN) ablation may be an effective management strategy for AF in these patients. The purpose of this study was to assess the efficacy of AVN ablation in HCM patients who have failed medical therapy and/or catheter ablation for AF. A multicenter study with retrospective analysis of a prospectively collated HCM registry was performed. AVN ablation patients were identified. Baseline characteristics and device and procedural indications were collected. Symptoms defined by New York Heart Association and European Heart Rhythm Association classification and echocardiographic findings during follow-up were assessed. Fifty-nine patients were included in the study. Indications for AVN ablation were 6 (10.2%) inappropriate implantable cardioverter-defibrillator shock, 35 (59.3%) ineffective rate control, and 18 (30.5%) to regularize rhythm for symptom improvement. During post-AVN ablation follow-up of 79.4 ± 61.1 months, left ventricular ejection fraction (LVEF) remained stable (pre-LVEF 48.9% ± 12.6% vs post-LVEF 50.1% ± 10.1%; P = .29), even in those without a cardiac resynchronization therapy (CRT) device (pre-LVEF 54.3% ± 8.0% vs post-LVEF 53.8% ± 8.0%; P = .65). Forty-nine patients (83.1%) reported an improvement in symptoms regardless of AF type (17/21 [81.0%] paroxysmal vs 32/38 [84.2%] persistent; P = 1.00), presence of baseline left ventricular impairment (22/26 [84.6%] LVEF ≤50% vs 27/33 [81.8%] LVEF ≥50%; P = 1.00) or CRT device (27/32 [84.4%] CRT vs 22/27 [81.5%] no CRT; P = 1.00). Symptoms improved in 16 patients (89.0%) who underwent AVN ablation to regularize rhythm. AVN ablation improved symptoms without impacting left ventricular function in the majority of patients. The data suggest that AVN ablation is an effective and safe management approach for AF in HCM and should be further evaluated in larger prospective studies.

PO-02-158 PACE AND ABLATE IS AN EFFECTIVE MANAGEMENT STRATEGY FOR ATRIAL FIBRILLATION IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY

Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM). In this cohort, the sequel of rapid ventricular response and symptoms associated with an irregular rhythm can be challenging to manage with medical therapy and catheter ablation (CA). Pace and ablate (PAb) strategy may offer an effective treatment alternative. Assess the efficacy of PAb in patients with HCM who have failed medical therapy and/or catheter ablation for AF. Single centre study with retrospective analysis of a prospectively collated HCM registry. PAb patients were identified. Baseline characteristics, procedural indication and procedural data was collected and symptoms defined by NYHA and EHRA classification plus echocardiographic findings in follow-up assessed. Forty-two patients (17 (40%) male and age 67±11 years) were included (Table 1) of which 18 (43%) patients had undergone previous CA ablation. Indications for PAb: 5 (12%) inappropriate shock, 24 (57%) ineffective rate control and 13 (31%) to regularise rhythm to improve symptoms. Procedural parameters: procedure time 70±12mins and immediate success in 40 patients (95%) with no complications. During a follow-up time of 62±54 months, left ventricular ejection fraction (LVEF) post PAb remained stable (LVEF Pre 52±10%, LVEF Post 50±9%, p=0.6). Those without a CRT also had no change in LV function during follow-up post PAb (LVEF pre 55±8% vs post 51±19%, p=0.21). Thirty-three (83%) patients reported an improvement in symptoms post procedure. In patients with symptom improvement there was no difference in AF type (14/15, 93% paroxysmal vs. 19/25, 76% persistent AF; p=0.22), presence of at least moderate mitral regurgitation (MR) (12/33, 36% moderate MR. 1/7, 14% no moderate MR; p=0.39), LV impairment (10/11, 91% LVEF <50% vs. 23/29, 79% LVEF ≥50%; p=0.65) or CRT device in situ (22/24, 92% CRT vs. 11/16, 69% no CRT; p=0.09). Symptoms improved in 10 (76%) patients who underwent PAb to regularise rhythm. In the majority of patient with HCM and AF, PAb improves symptoms without impacting LV function regardless of AF type, device implanted or the presence of pre-existing LV impairment. PAb was also shown to effectively improve symptoms through regularising the rhythm. Post PAb, LV function remains stable regardless of the type of device implanted. PAb is an effective treatment strategy for AF in patients with HCM.

Mathematical analysis and optimal control of an epidemic model with vaccination and different infectivity.

This paper aims to explore the complex dynamics and impact of vaccinations on controlling epidemic outbreaks. An epidemic transmission model which considers vaccinations and two different infection statuses with different infectivity is developed. In terms of a dynamic analysis, we calculate the basic reproduction number and control reproduction number and discuss the stability of the disease-free equilibrium. Additionally, a numerical simulation is performed to explore the effects of vaccination rate, immune waning rate and vaccine ineffective rate on the epidemic transmission. Finally, a sensitivity analysis revealed three factors that can influence the threshold: transmission rate, vaccination rate, and the hospitalized rate. In terms of optimal control, the following three time-related control variables are introduced to reconstruct the corresponding control problem: reducing social distance, enhancing vaccination rates, and enhancing the hospitalized rates. Moreover, the characteristic expression of optimal control problem. Four different control combinations are designed, and comparative studies on control effectiveness and cost effectiveness are conducted by numerical simulations. The results showed that Strategy C (including all the three controls) is the most effective strategy to reduce the number of symptomatic infections and Strategy A (including reducing social distance and enhancing vaccination rate) is the most cost-effective among the three strategies.

Correlation between galectin-3, RDW, Hepc, HS and ferritin and prognosis of patients with acute onset of chronic heart failure

BackgroundChronic heart failure (CHF) is characterized by a high hospitalization rate and a high mortality rate. It is particularly important to identify biomarkers for predicting the prognosis of patients with acute attack of CHF.PurposeTo observe the correlation between galectin-3, RDW, Hepc, HS and ferritin and the prognosis of patients with acute onset of CHF.MethodsThe study included 92 patients with acute onset of CHF who received treatment at our hospital between August 2020 and December 2021. After treatment, the patients were divided into the effective group and the non-effective group based on the effectiveness of treatment. The levels of galectin-3, RDW, Hepc, HS and ferritin before and after treatment were compared between the two groups and the correlation between prognosis of patients with acute attack of CHF and galectin-3, RDW, Hepc, HS and ferritin was observed.ResultsThe effective rate was 71.74% (66/92) and the ineffective rate was 28.26% (26/92) in the 92 patients with acute attack of CHF in the study. Before and after treatment, the levels of galectin-3, RDW, Hepc, and HS were lower in the effective group than those of the non-effective group while the level of ferritin was higher in the effective group than that of the non-effective group (P < 0.05). Spearman correlation analysis showed that the level of prognosis of patients with acute attack of CHF was positively correlated with galectin-3, RDW, Hepc, and HS (r = 0.217, 0.109, 0.376, 0.765, P = 0.026, 0.032, 0.021, 0.006), and negatively correlated with ferritin (r = − 0.127, P = 0.037). The independent variables were galectin-3, RDW, Hepc, HS and ferritin and the dependent variable was prognosis of patients with acute attack of CHF. Univariate logistic regression analysis showed that alectin-3, RDW, Hepc, HS, and ferritin were protective factors for the prognosis of patients with acute attack of CHF. The independent variables were galectin-3, RDW, Hepc, HS and ferritin, dependent variables and the dependent variable was prognosis of patients with acute attack of CHF. Multivariate logistic regression analysis revealed that galectin-3, RDW, and Hepc were risk factors of the prognosis of patients with acute attack of CHF.ConclusionGalectin-3, RDW, Hepc, HS and ferritin were closely related with the prognosis of patients with acute attack of CHF and galectin-3, RDW, and Hepc were risk factors of the prognosis of patients with acute attack of CHF.

Curative effect of pop light music on depression patients based on improved fuzzy algorithm

With the aggravation of many social psychological and psychological stress factors, the high incidence rate of depression and depression has become a major problem which puzzles people’s health and even endangers life. Non drug therapy has become an effective alternative to drug therapy, which is in line with the new trend of natural medicine in the world. This paper will use the real world research method (RWS) to conduct a clinical trial of pop light music in the treatment of depression. Based on the fuzzy algorithm, a comprehensive evaluation system for the treatment of depression was established. By comparing and analyzing the main efficacy indexes between music group and traditional medicine group, we found that the cure rate, clinical control rate, significant efficiency, effective rate and ineffective rate of music therapy group were significantly better than those of drug group. Through the analysis of seven factors of HAMD (Hamilton Depression Scale) scale, we found that pop light music can improve the sleep status and physical symptoms of patients, and the improvement degree of music therapy is significantly better than that of drug therapy.

Use of folic acid supplementation to halt and even reverse the progression of gastric precancerous conditions: a meta-analysis

BackgroundCurrent data indicate that supplements such as folic acid and vitamin B may be beneficial in halting and even reversing atrophic gastritis, intestinal metaplasia and intraepithelial neoplasia, generally referred to as gastric precancerous conditions(GPC). However, there is no Meta-analysis article to evaluate the prevention and treatment of folic acid in the gastric precancerous conditions. We therefore conducted a meta-analysis to confirm the efficacy of folic acid in treating GPC.MethodsUsing a systematic review method, consider randomized controlled trials (RCT), including clinical trial reports, unpublished clinical trial data, and conference papers. The search time was been set from the database’s establishment to June 2, 2021. The language was not limited, using PubMed, SinoMed, Lancet, Web of Science, CNKI, Cochrane, Ovid, Science Direct, Embase, and EBSCO databases. Data were extracted using a pre-designed extraction tool and analysis was undertaken using RevMan5.2.Besides,we use Origin software to construct the Time-dose interval analysis.ResultsOf the 225 records identified, 13 studies involving 1252 patients (including 11 clinical controlled trials, 1 conference paper report and 1 unpublished research report) met the inclusion conditions. Folic acid dose maintained at 20–30 mg / d for 3–6 months may be beneficial to pathological changes of GPC. Moreover, in the 3 month treatment of 5 trials, the effect was more obvious when the folic acid dose was maintained at 30 mg / d. In the 7 trials, the symptom ineffective rate of GPC treated with folic acid was 32% (RR:0.32, 95% confidence interval CI:0.21–0.48), which was combined using a fixed analysis model; The effect of folic acid on gastric mucosal atrophy in 5 trials (RR: 1.61, 95%CI 1.07–2.41). The changes of folic acid on intestinal metaplasia in the 2 experiments (RR: 1.77, 95% CI: 1.32–2.37).The 2 results are combined using a fixed analytical model. However, the subgroup analysis of 9 trials revealed no significant effectiveness of symptom.ConclusionsOur research showed that folic acid supplementation brings benefits in preventing and even reversing the progression of GPC in the stomach, and provided evidence for its potential clinical use in management of GPC.Registration: The logn number of our Meta-anlysis on PROSPERO is CRD420223062.

Safety and Effectiveness of Moxibustion and Abdominal Massage in Hospitalized Older Patients With Constipation: A Retrospective Study

BACKGROUND: Evidence about moxibustion and abdominal massage for treating constipation in older hospitalized patients is limited. PURPOSE: To investigate the safety and effectiveness of moxibustion and abdominal massage in hospitalized older patients with constipation. METHODS: Hospitalized older patients (age ≥60 years) with constipation were retrospectively categorized as 2 cohorts according to whether the patients received moxibustion and abdominal massage in addition to routine nursing care. Gastrointestinal symptoms, Constipation Assessment Scale (CAS) scores, and Geriatric Depression Scale (GDS) scores were compared before and after treatment between cohorts. RESULTS: The 2 cohorts (n = 100 for each) had similar baseline characteristics and gastrointestinal symptoms; the control cohort and the additional intervention cohort also had similar CAS scores (7.14 ± 3.67 vs 7.48 ± 2.96, respectively), and GDS scores (&gt;17: 31% vs 29%, respectively). Improvement in the 2 scores from baseline was observed after 2 weeks in both the control cohort and the additional intervention cohort (CAS, 5.37 ± 5.34 and 3.80 ± 4.47, respectively; GDS, &gt;17: 28% and 15%, respectively). The cohort with additional interventions had a lower ineffective rate (defined as persistent symptoms or absence of decrease in CAS, 49% vs 32%; P = .028) but had more diarrhea (9% vs 21%; P = .017). CONCLUSION: Moxibustion and abdominal massage may help relieve constipation in hospitalized elderly patients, but attention should be paid to the increased occurrence of diarrhea. More study is needed.

Discovering Factors that Influence Physician Scientist Success in Academic Medical Centers.

This study investigated factors influencing success of physician scientists in Academic Medical Centers. These organizations and individuals drive healthcare in the United States. Translation of scientific discovery to medical practice moves at an astoundingly slow and ineffective rate. We must understand what contributes to physician scientist success to speed up translation. Through a lens of dialectic process theory, a grounded theory approach identified emergent factors from lived experiences of 31 individuals, at various experience levels, with MD and PhD degrees. Role balance, autonomy, organizational support, teamwork, life-cycle mentorship, and relational capacity were relevant factors impacting success. Role balance was important for success. Teamwork, organizational support, and life-cycle mentorship helped individuals grow, achieve balance, and respect, but relational capacity emerged as a critical driver for realizing both individual and organizational success. One person cannot execute these complex roles on their own, but development of deep and meaningful relationships through teamwork, collaboration, and life-cycle mentorship are essential for life satisfaction and success.

Clinical Effect of Side-Approach Laparoscopic Splenectomy for Neuropathic Splenomegaly.

Objective In order to investigate the clinical effect of side entry laparoscopic splenectomy in the treatment of splenomegaly caused by neurodegenerative diseases. Methods 62 patients who underwent endoscopic splenectomy in our hospital from July 2020 to June 2021 were randomly divided into two groups, including 3 cases in the observation group and 31 cases in the reference group. Clinical trials were conducted to compare different laparoscopic surgery methods, and follow-up investigation records were made; the drainage time and drainage volume, postoperative bleeding volume, postoperative complications, and comprehensive effective rate of the two groups were observed and analyzed. Results Most of the drainage volume in the observation group was less than 800 ml, and most of the drainage volume in the reference group was more than 500 ml. Compared with the reference group, the average drainage time of patients in the observation group was lower, mostly within 6 days, while the drainage time of patients in the reference group was more than 8 days. The amount of bleeding in the observation group was mostly about 500 ml, with the largest number in the range of 300-500 ml, while the amount of bleeding in the reference group was mostly 800 ml and above, with the largest number in the range of 500-800 ml. The incidence of complications in the observation group was lower than that in the reference group. The effective, markedly effective and comprehensive effective rates of patients in the observation group were higher than those in the reference group, and the ineffective rate and deterioration rate were also lower. Conclusion The treatment of lateral laparoscopic splenectomy is very safe and effective and has obvious advantages, because it can reduce the occurrence of postoperative complications and provide a good basis for the recovery of patients. It is worthy to be widely used in clinical splenic surgery.

Analysis of coagulation state in sudden deafness patients with total deafness and vertigo

Objective:To analyze the coagulation status and prognosis of sudden deafness patients with total deafness accompanied by vertigo, and to provide basis for improving the treatment of this disease. Methods:From January 2017 to December 2020, 33 patients with total deafness and vertigo sudden deafness who were hospitalized in the Department of Otolaryngology Head and Neck Surgery, Hebei Provincial People's Hospital were selected as the research group. During the same period, 33 cases of low frequency type, full frequency type, total deafness and 26 cases of high frequency type were treated as control group.Thirty-three cases of inpatients without history of middle ear and inner ear diseases were treated as normal control group. The levels of fibrinogen（FIB）, D-Dimer（D-D）, Prothrombin Time（PT）, Activated Partial Thrombin Time（APTT） between the research group and the control group were analyzed, and the therapeutic effects of different types of sudden deafness patients were analyzed. Results:FIB and D-D of total deafness with vertigo were 2.50（2.11, 2.95）and 0.27（0.16, 0.51） respectively, which were higher than 2.31（1.92, 2.50） and 0.17（0.12, 0.21） of normal group. APTT was 25.2（23.1, 28.1）, lower than 27.3（26.4, 29.7） in the normal group, the differences were statistically significant（P<0.01）. ② FIB of total deafness with vertigo was 2.50（2.11, 2.95）, which was higher than that of low frequency group 2.37（1.81, 2.68）. D-D was 0.27（0.16, 0.51）, higher than low frequency group 0.16（0.12, 0.25）, high frequency group of 0.13（0.11, 0.23）, the whole frequency group 0.16（0.11, 0.28）, total of 0.18（1.45, 0.30）. APTT was 25.75±3.18/25.2（23.1, 28.1）, lower than 27.72±2.22 in low frequency group and 26.7（25.8, 28.7） in full frequency group, with statistical significance（P<0.05）. ③ The total deafness with vertigo group had the worst curative effect（ineffective rate was 63.6%）, and the low frequency group had the best curative effect（recovery rate was 75.8%）. The difference of curative effect among different types of sudden deafness groups was statistically significant（P<0.05）. Conclusion:Hypercoagulability and thrombosis may be one of the influencing factors of total sudden deafness. The hypercoagulable state of sudden deafness patients with total deafness and vertigo is more serious than that of total deafness and other types of sudden deafness, and the prognosis is the worst.

Effect and Safety Analysis of PRP and Yifu Combined with Ultrapulsed CO2 Lattice Laser in Patients with Sunken Acne Scar.

Objective To investigate the effect and safety of PRP and Yifu combined with ultrapulsed CO2 lattice laser in patients with sunken acne scar. Methods 700 subjects were selected from the group of patients with sunken acne scar treated in our hospital from November 2010 to December 2020. They were divided into control group (n = 350) and study group (n = 350). The grouping was mainly based on the random number table method. Patients in the control group were treated with ultrapulse CO2 lattice laser, while those in the study group were treated with ultrapulse CO2 lattice laser combined with PRP and Yifu. The clinical effect, scar improvement and quality of life before and after treatment, and adverse events during treatment were compared between the two groups. The clinical effect was categorized into cure after treatment, significant effect, effective, and ineffective. The total effective rate = 1 − ineffective rate. Results After treatment, the total effective rate of the study group (81.43%) was higher than that of the control group (70.00%). After treatment, ECCA, VSS scores, daily activities, symptoms and feelings, work and study, leisure and entertainment, interpersonal relationship, treatment status, and total scores were all lower in both groups than before treatment, and the study group was lower than the control group. During the treatment, the incidence of adverse events in the study group (17.33%) was lower than that in the control group (28.57%), P < 0.05. Conclusion PRP and Yifu combined with ultrapulse CO2 lattice laser in the treatment of sunken acne scar can effectively improve the scar, reduce the incidence of adverse events, and the treatment effect is obvious, which can improve the quality of life of the patients.

The effect of endoscopic dacryocystorhinostomy on different lacrimal duct obstruction

Objective:To observe the effect of endoscopic dacryocystorhinostomy on different lacrimal duct obstruction. Methods:Eighty eyes with the lacrimal passage obstruction were collected, and treated with endoscopic dacryocystorhinostomy. Meanwhile, the abnormal structures of the nasal cavity were corrected and the pathological changes of the nasal cavity and sinuses were treated. The patients were followed up and the curative effect was observed. Follow-up period ranged from 10 months to 8 years. Results:The first operation cure rate was 78.8%, the effective rate was 17.5%, the ineffective rate was 3.8%, and the success rate was 96.2%. Two of the 3 eyes failed in first operation were cured by reoperation. The total success rate was 98.8%. Conclusion:Endoscopic dacryocystorhinostomy can be used as a routine operation in the treatment of different lacrimal duct obstruction. The structural abnormalities and pathological changes of the nasal cavity and paranasal sinuses can be treated simultaneously. Combined with postoperative treatment and follow-up, long-term curative effect can be obtained.

Clinical Efficacy of Cefoperazone-Sulbactam versus Piperacillin-Tazobactam in the Treatment of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia.

ObjectiveThe aim of this study was to compare the usefulness of cefoperazone-sulbactam and that of piperacillin-tazobactam in the treatment of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP).MethodsThis retrospective study included the adult patients receiving cefoperazone-sulbactam or piperacillin-tazobactam against HAP/VAP in nine hospitals in Taiwan from March 1, 2018 to May 30, 2019. Primary outcome was clinical cure rate.ResultsA total of 410 patients were enrolled. Among them, 209 patients received cefoperazone-sulbactam and 201 patients received piperacillin-tazobactam. Overall, cefoperazone-sulbactam group had similar distribution of age, sex, or SOFA scores as piperacillin-tazobactam group. However, cefoperazone-sulbactam had higher comorbidity score and disease severity than piperacillin-tazobactam group (Charlson score: 6.5 ± 2.9 vs 5.7 ± 2.7, p < 0.001; APACHE II score: 21.4 ± 6.2 vs 19.3 ± 6.0, p = 0.002). Regarding clinical outcomes, no significant difference in clinical cure and failure rates was observed between cefoperazone-sulbactam and piperacillin-tazobactam group (clinical cure rate: 80.9% vs 80.1% and clinical failure rate: 17.2% vs 18.4%, p = 0.943). Moreover, no significant difference in clinical effectiveness and ineffectiveness rates was observed between cefoperazone-sulbactam and piperacillin-tazobactam group (clinical effective rate: 80.9% vs 80.6% and clinical ineffective rate: 17.7% vs 18.9%, p = 0.711). The all-cause mortality rates of the cefoperazone-sulbactam and piperacillin-tazobactam groups were similar (23.9% vs 20.9%, p = 0.48). After adjustment of Charlson score and APACHE II score, the similarities in these clinical outcomes did not change in overall patients and patients with HAP or VAP.ConclusionFor treating adult patients with nosocomial pneumonia, cefoperazone-sulbactam was as effective as piperacillin-tazobactam.

Efficacy of supplemented Er-xian decoction combined with acupoint application for poor ovarian response.

This study aims to observe the efficacy of supplemented Er-xian decoction combined with acupoint application in treating poor ovarian response (POR). This study was a randomized controlled trial. A total of 80 patients, who were treated in the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2016 to December 2017, were divided into two groups by tables of random numbers: experimental group (n = 40), and control group (n = 40). In the experimental group, patients orally received supplemented Er-xian decoction with acupoint application. In the control group, a Kuntai capsule was administered according to the course of treatment. The therapeutic effects in the two groups were observed and compared. In the experimental group, the total effective rate was 90%, the cure rate was 15% (six patients), the markedly effective rate was 35% (14 patients), the effective rate was 40% (16 patients), and the ineffective rate was 10% (four patients). In the control group, the total effective rate was 50%, the cure rate was 5% (two patients), the markedly effective rate was 15% (six patients), the effective rate was 30% (12 patients), and the ineffective rate was 50% (20 patients). The differences were statistically significant (P > 0.05). Definite efficacy was observed when a poor ovarian response was treated by supplemented Er-xian decoction combined with acupoint application. Improvements in perimenopausal symptoms, menstruation conditions, hormone levels, inhibin B (INHB), and antral follicle count (AFC) were markedly better in the experimental group than in the control group. In addition, the treatment was safe and had few side effects.

Evaluation of Efficacy and Safety of Blood Transfusion and Hormone Therapy in 40 Patients with Autoimmune Hemolytic Anemia

To evaluate the efficacy and safety of different types of red blood cell (RBC) transfusion and hormone therapy in patients with autoimmune hemolytic anemia (AIHA). The clinical data and serological characteristics of 40 patients with AIHA treated in our hospital from 2014 to 2018 were collected and analyzed retrospectively. The efficacy and safety of different type of RBC transfusion and hormone therapy were evaluated according to the principle of minimally incompatible RBC transfusion after cross-matching. Among 40 patients with AIHA, the female cases were more than the male cases, the cases of secondary AIHA was more than cases of primary AIHA, and the warm autoantibodies were in the majority. 11 cases of AIHA underwent 26 times minimally incompatible red blood cell transfusions. The total effective rate was 46.2%, the partial efficiency was 23.1%, and total inefficiency was 30.8%. Among them, the same type of non-washing red blood cell group showed efficiency of 42.1%, partial effective rate of 21.1%, and inefficiency of 36.8%; the same type of washed red blood cell group showed efficiency of 57.1%, partial effective rate of 28.6%, and inefficiency of 14.3%. the infusion effects was not significanly different between the two groups, and no hemolytic transfusion reaction occurred. In the hormone-treated group, the complete remission rate was 15.2%, the partial remission rate was 63.6%, and the ineffective rate was 21.2%. Among them, the side effects appeared in 2 patients after using hormones. When AIHA patients need blood transfusion, use the same type of non-washed red blood cells or homologous washed cells is relatively safe, and the difference in efficacy is not significant. The partial remission of patients received hormone therapy is much higher than that of red blood cell transfusion, but the side effects easily happen.

Effect of Sodium Hyaluronate on Inflammatory Cytokine Levels in Synovial Fluid of Patients with Knee Osteoarthritis

This study evaluated the efficacy of intraarticular injection of sodium hyaluronate in the treatment of knee osteoarthritis and its influence on the levels of stromal cell-derived factor-1 and matrix metalloproteinases 3, 9 and 13 in the synovial fluid of patients with knee osteoarthritis. A total of 180 patients with knee osteoarthritis treated in the orthopaedic outpatient department of the Hubei Provincial Hospital from April 2015 to April 2017 were selected as the research objects and all of them were given intraarticular injection of sodium hyaluronate with synovial fluid extracted before the injection, 1 and 3 mo after the injection, and the level of stromal cell-derived factor-1 and matrix metalloproteinases 3, 9, 13 were determined using a sandwich enzyme-linked immunosorbent assay method. After 3 mo of treatment, the effect on the efficacy of patient’s gender, age, body mass index, swollen joint degree, involved joint space, Kellgren and Lawrence grading as well as tibiofemoral angle were observed and studied. Among the 180 cases there were 132 cases with 73.3% effective rate and 48 cases of with ineffective rate of 26.7%. Significant differences were found in the levels of stromal cell-derived factor-1, matrix metalloproteinases 3, 9 and 13 in the synovial fluid before the treatment, 1 and 3 mo after the treatment (p 1.7 in joint effusion and osteoarthritis involving tibiofemoral joint gap. In the treatment of knee osteoarthritis, the intraarticular injection of sodium hyaluronate could effectively reduce the levels of stromal cell-derived factor-1, matrix metalloproteinases 3, 9 and 13 in synovial fluid and decrease inflammatory reaction. But it should be used with great caution for treating patients with moderate and severe knee osteoarthritis involving tibial and femoral joints with the joint effusion graded above II or bone contusion.

Comparison of clinical efficacy between two kinds of comprehensive therapy for refractory lacrimal duct obstruction

Objective To compare the clinical efficacy between two kinds of comprehensive therapy for the treament of refractory lacrimal duct obstruction. Methods The clinical data of 96 eyes of 72 cases with refractory lacrimal duct obstruction from Jan.2017 to Mar.2018 in this hospital were analyzed retrospectively. In trial group, 48 eyes, were treated with cyclosporine A eye drops after lacrimal passage laser recanclization and intubation, and the control group, 48 eyes, were treated with tobramycin dexamethasone eye ointment. The lacrimal passage stent was retained for 3 months and followed up for 6 months after extubation. Results At the end of follow-up, the cure rate of trial group was 83.33%(40/48), the improvement rate was 12.50%(6/48), and the ineffective rate was 4.17%(2/48). The cure rate of control group was 66.67%(32/48), the improvement rate was 20.83%(10/48) and the ineffective rate was 12.50% (6/48). The total effective rate of the trial group was 95.83% (46 /48), which was better than that of the control group (87.50%, 42/48). The difference was statistically significant(χ2=2.136, P=0.001). Conclusion On the basis of operation, application of cyclosporine A eye drops are more effective than tobramycin dexamethasone eye ointment in the treatment of refractory lacrimal passage obstruction. Key words: Obstruction, lacrimal passage, refractory; Laser, lacrimal passage; Catheterization; Eye drops, cyclosporine A; Eye ointment, tobramycin dexamethasone

Uterine compression suture is an effective mode of treatment of postpartum haemorrhage.

Objective:To compare the effects of uterine compression suture versus conventional mode of treatment for the management of postpartum haemorrhage after caesarean section.Methods:This study enrolled 84 women with postpartum hemorrhage who were admitted to Binzhou People’s Hospital from August 2017 to October 2018 as the research subjects. They were divided into a control group and an observation group according to random number table method, 42 each group. The patients in the control group were treated by conventional treatment, while those in the observation group were treated by uterine compression suture. The hemorrhage, hemostasis, postoperative recovery and frequency of adverse reactions were compared between the two groups.Results:The amount of bleeding in the observation group was less than that in the control group, and the bleeding time was shorter than that in the control group; the differences had statistical significance (P<0.05). The success rate of hemostasis in the observation group was significantly higher than that in the control group, and the ineffective rate of hemostasis was significantly lower than that in the control group (P<0.05); the differences were statistically significant. The cleaning time of lochia, the recovery time of uterus and the recovery time of menstruation in the observation group were significantly shorter than that in the control group (P<0.05); the differences between the two groups were statistically significant (P<0.05). The frequency of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05), and the difference was statistically significant (P<0.05).Conclusion:Uterine compression suture is effective for postpartum hemorrhage of cesarean section, which can effectively reduce postpartum hemorrhage, shorten postpartum hemorrhage time and accelerate the recovery. It is safe and worth clinical promotion.