Patients In Observation Group Research Articles

Effects of simulated presence therapy on agitated behavior, cognition, and use of protective constraint among patients with senile dementia

The research was conducted to investigate the improvement of agitated behaviors, cognitive functions, and negative emotions among patients with senile dementia and the burden of caregivers after simulated presence therapy (SPT) intervention. 85 Patients with senile dementia were included as the research subjects and divided into control group (40 cases performed with routine nursing) and observation group (45 cases undergoing routine nursing combined with SPT) via a random number table method. Cohen-Mansfield agitation inventory (CAMI) and protective constraint were used to assess the improvement of agitated behaviors among patients. Besides, apathy evaluation scale-informant (AES-I), functional independence measure (FIM), self-rating depression scale (SDS), self-rating anxiety scale (SAS), clock drawing test, and caregiver burden inventory (CBI) were adopted to evaluate the differences in apathy, daily living and sociability, depression, anxiety, cognitive functions, and caregiver burden between the two groups. It was demonstrated that CAMI score, the duration of protective constraint use, AES-I score, SDS score, SAS score, and CBI score among patients in observation group all apparently decreased compared with those in control group after the intervention. In contrast, FIM and clock drawing test scores both notably increased (p < 0.05). The above findings suggested that SPT could obviously reduce the incidence of agitated behaviors, improve the level of apathy, daily living and sociability, depression, anxiety, and cognitive functions, and relieve caregiver burden among patients with senile dementia during SPT intervention for patients with senile dementia.

Correlation Between Serum 1,25(OH)2D3, Serum Phosphorus, and Parathyroid Hormone and Parathyroid Function After Central Lymph Node Dissection in Patients with Papillary Thyroid Carcinoma.

This work was to demonstrate the relationship between serum 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), serum phosphorus (SP), and parathyroid hormone (PTH) and parathyroid function after central lymph node dissection (CLND) in patients with papillary thyroid carcinoma (PTC). 200 PTC patients after CLND were included, who were rolled into a control group (CG) (n = 89 cases without hypoparathyroidism) and an observation group (OG) (n = 111 cases with complicated hypoparathyroidism). The 1,25(OH)2D3, SP, and PTH levels were detected, and the diagnostic effect of these indicators was assessed. The serum PTH levels of patients in CG after surgery were normal relative to those before surgery, while the serum PTH of patients in OG was relatively lower. 1,25(OH)2D3 concentration of patients in OG was also inferior to CG, while the SP level was superior (P < 0.05). Hypoparathyroidism was positively correlated with serum PTH (r = 0.382) and 1,25(OH)2D3 (r = 0.321) and negatively correlated with SP (r = - 0.211). The area under the curve (AUC) (0.893), sensitivity (90.83%), and specificity (94.77%) of the joint diagnosis of 1,25(OH)2D3 + SP + PTH were greatly superior to those of the single diagnosis and the pairwise diagnosis with the three indicators (P < 0.05). Hypoparathyroidism in patients with PTC after CLND surgery was positively correlated with 1,25(OH)2D3 and PTH and negatively correlated with SP concentration. In addition, the combination diagnosis of 1,25(OH)2D3, PTH, and SP worked well.

Analysis on the Effect of Yiqi Huoxue Decoction Combined with Neuromuscular Electrical Stimulation in Improving ICU-Acquired Debility in Mechanically Ventilated Patients

To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit (ICU) acquired debility in mechanically ventilated patients. Methods: 50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected, and randomly grouped using the randomized envelope method into two groups: a control group with 25 patients who received neuromuscular electrical stimulation alone; observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction. Comparison indexes: treatment efficiency, degree of emotional recovery (APACHE Ⅱ score), muscle strength status (MRC score), motor status (FAC rating), and self-care ability (BI index score). Results: The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group (P &lt; 0.05). There was no significant difference in the comparison of the results of the scores (ratings) of each index between the two groups before treatment (P &gt; 0.05). After the treatment, the APACHE Ⅱ scores of patients in the observation group were significantly lower as compared to those in the control group, while the MRC scores, FAC ratings, and BI index scores were higher in the observation group than those of the control group patients (P &lt; 0.05). Conclusion: The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy, the patient’s muscle strength, motor status, and ability of self-care. Hence, it has high application value and is worthy to be popularized.

Small Incision Apocrine Glands Excision Combining Original Vacuum Sealing Drainage Technique for the Treatment of Axillary Bromhidrosis

Aim: To observe the therapeutic effect by small incision apocrine glands excision combining original vacuum sealing drainage technique in treating axillary bromhidrosis and its complication. Methods: 120 patients with bromhidrosis were included and randomly divided into two groups. Observation group (60 patients) by small incision apocrine glands excision combining original vacuum sealing drainage technique. Control group (60 patients) by regular small incision apocrine glands excision and rubber drains typically were placed. Results: Therapeutic effect and complications in two groups were compared. Total effective rate in both groups was 100%. 5 patients in observation group (8.33%) had epidermal erosion or dehiscence at medial margin of the incision and 21 patients control group (35.00%) had epidermal erosion or dehiscence at medial margin of the incision. Incidence in control group is obviously higher than that in observation group and such a difference has statistical significance. Conclusion: Complication incidence is significantly reduced by small incision apocrine glands excision with application of original vacuum sealing drainage technique than regular small incision apocrine glands excision and rubber drains.

Efficacy of antiplatelet drugs combined with Argatroban in treating acute ischemic stroke and its impact on patients’ coagulation function and neurological function: a preliminary trial

This retrospective study analyzed the efficacy of combined antiplatelet therapy with Argatroban in treating acute ischemic stroke (AIS) and its impact on patients’ coagulation and neurological functions. Clinical data of 113 AIS patients admitted between January 2021 and January 2023 were retrospectively analyzed. Patients were divided into control (n = 56) and observation (n = 57) groups based on treatment interventions. The control group patients were treated with antiplatelet drugs, while the observation group patients received combination therapy with apatinib on the basis of the control group treatment. Compared to the control group, the observation group demonstrated higher clinical efficacy, improved coagulation parameters, reduced stroke severity (measured by NIHSS), enhanced daily living abilities (BI scores), and lowered inflammatory and neural injury markers post-treatment. Adverse reaction incidence was similar between groups. Combining Argatroban with antiplatelet drugs in AIS management showed superior efficacy without increasing adverse effects, suggesting its potential for clinical application.

Application of improved Beck oral score in oral care of burn patients with mechanical ventilation

Objective: To explore the application effect of improved Beck oral score in oral care of burn patients with mechanical ventilation, to provide practical basis for oral care of such patients.Methods: A total of 42 patients with tracheotomy and mechanical ventilation in the Department of Burn Surgery of Baogang Hospital in Inner Mongolia from January 2021 to December 2022 were selected as the study objects, and the patients were randomly divided into observation group and control group, with 21 cases in each group. The control group was given routine oral care, and the observation group was given oral care according to improved Beck oral score. The following were compared between the two groups: Age, total burn area, third-degree burn area, acute physiological and chronic health assessment scores, as well as improved Beck oral scores; the incidence of oral odor, plaque index, mouth ulcer and ventilator-associated pneumonia (VAP) after 7 days; the detection of microorganism in oral secretions.Results: After 7 days, the oral condition of patients in observation group was effectively improved, and the oral comfort level was significantly improved. The incidence of oral odor (2.57±1.59), dental plaque index (2.62±1.47), oral ulcer evaluation (2.24±1.09), VAP incidence (9.52%) and improved Beck oral score (8.09±1.92) in observation group were all lower than those in control group, which was (3.95±1.82), (3.57±1.21), (3.14±1.24), (38.09%), and (9.90±2.21) respectively. The difference was statistically significant (p &lt; .05). The oral normal flora in observation group (71.43%) was higher than that in control group (28.57%), and the difference was statistically significant (p &lt; .05). The oral gram-positive bacteria (19.05%) and Gram-negative bacteria (23.81%) in observation group were lower than those in control group, which was 52.38% and 57.14% respectively, and the difference was statistically significant (p &lt; .05).Conclusions: The application of the improved Beck oral assessment method in dynamic oral care can effectively reduce the content of oral pathogens, lower the incidence of pulmonary infection, and improve the quality of life of patients.

Efficacy and safety of different nerve block methods for the treatment of pudendal neuralgia

Objective: To identify efficacy and safety of pudendal nerve block in tubing through the third posterior sacral foramen for the treatment of pudendal neuralgia (PN). Methods: A retrospective study with 222 PN patients was conducted in the Department of Pain Management of Beijing Tsinghua Changgung Hospital from January 2020 to April 2023. These patients were divided into two groups based on their treatment methods: pudendal nerve block in tubing through the third posterior sacral foramen (observation group, n=101) and ultrasound-guided pudendal nerve block (control group, n=121). Primary outcome measure was the 90-day postoperative pain relief rate. Secondary outcome measures included visual analog scale (VAS) at 1, 7, 14, 30 and 90 d after surgery, the incidence of tramadol uses after surgery, postoperative self-rating anxiety scale (SAS) scores and the incidence of adverse events. Factors that influenced pain relief within 90 days after surgery were analyzed by using binary logistic regression analysis. Results: Observation group included 34 males and 67 females, aged (49.8±16.0) years old. Control group included 38 males and 83 females, aged (43.7±14.0) years old. The 90-day postoperative pain relief rate of the observation group patients was 38.6% (39/101), which was higher than the 24.0% (29/121) of the control group patients (P=0.018). Both the observation group and the control group showed an interaction effect of time and group after treatment for VAS scores (both P<0.05). In intra-group comparison, the VAS scores at 1, 7, 14, 30 and 90 d after treatment in both groups were lower than those before treatment (all P<0.05). In inter-group comparison, the differences of the VAS scores were not statistically significant in the observation group compared with those in the control group at 1, 7, 14, 30 and 90 d after surgery (all P>0.05). The SAS score of the observation group at 90 d after surgery was 51.5±6.2, which was lower than the 53.4±5.8 of the control group (P=0.022). There was no statistically significant difference in the incidence of postoperative tramadol uses and adverse events between the two groups (both P>0.05). Pudendal nerve block in tubing through the third posterior sacral foramen was a protective factor for pain postoperative relief in PN patients at 90 d after surgery (OR=1.92, 95%CI: 1.05-3.48, P=0.033). Conclusion: Pudendal nerve block in tubing through the third posterior sacral foramen is a safe and effective minimally invasive treatment. It has a higher postoperative pain relief rate within 90 d after surgery, without increasing the uses of postoperative rescue analgesics and the incidence of adverse events.

Neutrophil-to-lymphocyte ratio at admission for early diagnosis, severity assessment, and prognosis of acute traumatic spinal cord injury.

A retrospective study. This study examined the value of neutrophil-to-lymphocyte ratio at admission for early diagnosis, severity assessment, and prognosis of acute traumatic SCI. The First People's Hospital of Neijiang, China. This was a single-center, retrospective, cohort study of patients treated within 12 h of acute SCI between January 2018 and October 2022. Ninety-four SCI patients were selected as the Observation group, including 26 with complete injury (AIS grade A) and 68 with incomplete injury (AIS grade B-D), while 94 patients with simple spinal fracture were randomly selected as the Control group. Eighty-one observation group patients underwent surgical treatment, of which 33 had a higher AIS grade (Good prognosis subgroup) and 48 a lower or equal grade post-surgery (Poor prognosis subgroup). Univariate and multivariate analyses were performed to assess predictors of early diagnosis, severity, and 6-month outcome. Initial white blood cell count, neutrophil count, monocyte count, and NLR were higher in the Observation group than the Control group, while lymphocyte count was lower in the Observation group. Multivariate logistic regression analysis identified NLR as an independent predictor of early diagnosis. Spinal canal encroachment ≥50%, neutrophil count, and NLR were higher in the complete injury subgroup, and spinal canal encroachment ≥50% was an independent predictor of complete injury, while NLR was not. The NLR was higher in the poor prognosis subgroup and was an independent risk factor. Peripheral blood NLR is useful for early diagnosis of acute SCI and is predictive of clinical outcome.

Diagnostic efficacy and safety of radial probe endobronchial ultrasound-guided transbronchial needle aspiration for adjacent lesions in segmental or subsegmental bronchi: a single-center retrospective study

BackgroundPeripheral lung lesions can be sampled using various techniques, including computer tomography-guided transthoracic needle aspiration, electromagnetic navigation bronchoscopy, virtual navigation bronchoscopy, and radial probe endobronchial ultrasound transbronchial lung biopsy. Mediastinal lesions can be sampled using techniques like convex probe endobronchial ultrasound-guided transbronchial needle aspiration (CEBUS-TBNA) and endoscopic ultrasound-fine-needle aspiration. However, effective, safe techniques for lesions adjacent to the segmental or subsegmental bronchi are lacking. Herein, we retrospectively evaluated the diagnostic yield and safety of radial probe endobronchial ultrasound-assisted transbronchial needle aspiration (REBUS-TBNA) for lesions adjacent to the segmental bronchi, and explored the factors related to diagnostic yield.MethodsWe retrospectively analyzed the diagnostic yield and safety of REBUS-TBNA cases performed in our department from January 2019 to December 2022. Observation group patients had undergone REBUS-TBNA for lesions adjacent to the segmental bronchi; control group patients had undergone CEBUS-TBNA for mediastinal or hilar lesions. Patient characteristics and lesion sizes, diagnostic yield, adverse events, and relations between diagnostic yield and clinical characteristics were analyzed.ResultsThere were not statistically significant between-group differences in sex, age, diagnostic yield, or rate of adverse events. The observation group (n = 25; 17 male, 8 female) had a mean age of 64.76 ± 10.75 years. The average lesion size was 4.66 ± 1.07 cm, and lesions were predominantly in the upper lobes (80%). REBUS-TBNA diagnostic yield was 84%, with no adverse events reported. Diagnostic yield was not associated with lesion size or extent of bronchial stenosis; however, it was positively correlated with number of punctures. Patients with > 3 punctures had a significantly higher diagnostic yield than those with ≤ 3 punctures.ConclusionsREBUS-TBNA is a safe, effective diagnostic technique, particularly for lesions adjacent to the segmental or subsegmental bronchi of the upper lobe. Performing more than three punctures during the procedure improves the diagnostic yield. Larger-scale studies are warranted to confirm these results, and to further explore the clinical value of REBUS-TBNA.

Analysis of changes in serum high t-PINP/β-CTX ratio and risk of re-fracture after vertebral osteoporotic fracture surgery.

This study's aim was to investigate the expression changes of total type I procollagen amino-terminal peptide (t-PINP) and type I collagen C-terminal peptide (β-CTX) in serum after vertebral osteoporotic fracture surgery and the clinical value of predicting the risk of refracture. The clinical data of 100 patients with vertebral osteoporotic fractures treated in our hospital from January 2019 to January 2020 were retrospectively analyzed, and the patients were divided into the control group (patients without re-fracture, n = 68) and the observation group (patients with re-fracture, n = 32) according to whether they had re-fracture at 2-year follow-up. The risk factors of postoperative re-fracture were analyzed using Multivariate logistic regression analysis. The serum contents of t-PINP, β-CTX, osteocalcin (BGP), and calcium (Ca) were measured. Bone mineral density (BMD) was measured by bone densitometer. The correlation between the t-PINP/β-CTX ratio and the bone metabolic index was analyzed by Pearson correlation. The area under the curve (AUC), sensitivity, and specificity of t-PINP/β-CTX in predicting the risk of re-fracture were determined by the receiver operating characteristic (ROC) curve. There was a significant difference in age, the number of vertebral bodies with initial fracture, and whether there was leakage of bone cement between the two groups (p < 0.05). Age, the number of vertebral bodies with primary fracture, and the leakage of bone cement were risk factors affecting re-fracture after operation (p < 0.05). Compared with those in the control group, the level of t-PINP and the ratio of t-PINP/β-CTX were higher, and the β-CTX level was lower in the observation group (p < 0.05). The BGP level was higher, and the levels of BMD and Ca were lower in the observation group than those in the control group (p < 0.05). Pearson correlation analysis showed that t-PINP had a positive correlation with BGP (r = 0.222, p < 0.05). β-CTX was positively correlated with BMD and Ca (r = 0.230, 0.269, p < 0.05). The ratio of t-PINP/ β-CTX was negatively correlated with BMD and Ca (r = -0.621 and -0.660, p < 0.05), but positively correlated with BGP (r = 0.517, p < 0.05). ROC curve analysis showed that the AUC of t-PINP, β-CTX, and the ratio of t-PINP/β-CTX in predicting the risk of re-fracture after vertebral osteoporotic fracture surgery was 0.724, 0.736, and 0.838, respectively. The t-PINP/β-CTX ratio was significantly correlated with the bone metabolic indexes in patients with vertebral osteoporotic fractures. The detection of the changes in its index can help predict the risk of postoperative re-fracture, providing a new idea for clinical assessment of the risk of postoperative re-fracture.

Ceftazidime/Tazobactam Sodium Combined with Levofloxacin and Enteral Nutrition Nursing Intervention for Heart Failure Complicated with Pulmonary Infection

This study aimed to investigate the clinical efficacy of ceftazidime/tazobactam sodium combined with levofloxacin and enteral nutrition nursing interventions in treating older adults with heart failure complicated with pulmonary infection. Control group patients (59) received ceftazidime tazobactam sodium injection (3:1). Observation group patients (59) received ceftazidime/tazobactam sodium with levofloxacin hydrochloride injection and enteral nutrition. The observation group had a higher total effective rate (χ2 = 5.94) and lower levels of inflammatory factors (interleukin-4, interleukin-6, and tumor necrosis factor-alpha) than the control group. Left ventricular end-systolic diameter and end-diastolic diameter were lower in the observation group than in the control group, and the left ventricular ejection fraction and pathogenic bacteria clearance rate were higher in the observation group than in the control group. The observation group had fewer adverse reactions than the control group. The levels of serum transferrin, prealbumin, and albumin were higher in the observation group than in the control group. No significant difference in satisfaction rate was found between the groups (χ2 = 3.01). Ceftazidime/tazobactam sodium, combined with levofloxacin and enteral nutrition, can reduce inflammatory factor levels in older adults with heart failure complicated with pulmonary infection. It improves the bacterial clearance rate and treats body infections without increasing adverse reactions.

The effect of continuous care on the recovery of patients with advanced colorectal cancer undergoing chemotherapy.

To explore the impact of continuous care on chemotherapy patients with advanced colorectal cancer. Six hundred forty patients who received chemotherapy from June 2015 to December 2022 were included in this retrospective study and divided into the observation group (n = 332) and control group (n = 308) based on different care methods that they received. The observation group patients were followed up using the continuous care team model, the control group patients using the traditional telephone follow-up model. A comparative analysis was conducted on the effects of 2 modes on patients self-care ability, treatment compliance, anxiety, depression, communication ability with nurses, level of hope, as well as the effects of toxic side effects and cancer-related fatigue. The self-care ability and treatment compliance of patients in the observation group were significantly better than those in the control group (P < .05), with lower anxiety and depression scores, toxic side effects, and cancer-related fatigue compared to the control group (P < .05). The communication ability and patient hope level of nurses in the observation group were also significantly stronger than those in the control group (P < .05). The application of continuous care can improve patients self-care ability and treatment compliance, effectively reduce anxiety and depression in in patients with advanced colorectal cancer undergoing chemotherapy, and improve nurses communication skills and patients hope level. Therefore, this practice is worth promoting clinically.

ANAMNESIS, CLINICAL AND PARACLINICAL CHARACTERISTIC OF CHILDREN WITH AUTOIMMUNE THYROIDITIS

Purpose. &#x0D; To conduct a comparative characterization of anamnesis and clinical and paraclinical data of children suffering from autoimmune thyroiditis and those with no thyroid pathology in order to optimize early diagnosis of the disease.&#x0D; Materials and Methods. &#x0D; This examination was carried out on 132 children (55 boys and 77 girls) diagnosed with autoimmune thyroiditis at the age of 11.68±0.35. For comparison, 577 children (268 boys and 309 girls) without thyroid pathology at the age of 11.49±0.17 were included in the control group. Statistical study techniques were applied using the licensed software package Statistica. The differences of р&lt;0.05, р&lt;0.01, р&lt;0.001 were considered statistically significant.&#x0D; Results. &#x0D; The comparative study of children diagnosed with autoimmune thyroiditis and those with no thyroid pathology showed that euthyroidism was diagnosed in 78.31% of patients in the primary observation group, hypothyroidism in 17.39%, and hyperthyroidism in 4.3% of patients. Children diagnosed with autoimmune thyroiditis showed thyroperoxidase antibody levels ranging from 209.7 to 694.7 IU/mL, TSH from 0.01 to 5.93 to 89.9 IU/mL, and free T4 from 1.14 to 28.8 ng/dL. The criteria for early diagnosis of autoimmune thyroiditis included: a burdened familial history of thyroid disease (15.9%); complaints of psychoemotional, neurological (35.6%) and heart rhythm disorders (14.4%), predominantly in boys (58.2% and 18.18%), prolonged low-grade fever (5.3%), predominantly in girls (6.5%); comorbid conditions: respiratory tract diseases (25.76%) and lymphadenitis (28.03%); ultrasonic changes of the thyroid gland with increased (31.06%) or decreased (4.55%) volume, cystous nodules (40.15%), increased vascular pulsation (39%) and changes in echogenicity of the thyroid gland.&#x0D; Conclusion. &#x0D; At the current stage, early diagnosis of autoimmune thyroiditis in children is important for the timely prevention of the negative impact of the disease on the functional state and development of the child's body.

Management and outcomes with 5-year mortality of patients with mildly elevated high-sensitivity troponin T levels not meeting criteria for myocardial infarction.

To examine management and outcomes of patients presenting to EDs with symptoms suggestive of acute coronary syndrome, who have mild non-dynamically elevated high-sensitivity troponin T (HsTnT) levels, not meeting the fourth universal definition of myocardial infarction (MI) criteria (observation group). Consecutive patients presenting to the ED with symptoms suggestive of acute coronary syndrome at Liverpool Hospital, Sydney, Australia, those having ≥2 HsTnT levels after initial assessment were adjudicated according to the fourth universal definition of MI, as MI ruled-in, MI ruled-out, or myocardial injury in whom MI is neither ruled-in nor ruled-out (>1 level ≥15 ng/L, called observation group); follow-up was 5 years. Of 2738 patients, 547 were in the observation group, of whom 62% were admitted to hospital, 52% to cardiac services, whereas 97% of MI ruled-in patients and 21% of MI ruled-out patients were admitted; P < 0.001. Non-invasive testing occurred in 42% of observation group patients (36% had echo-cardiography), and 16% had coronary angiography. Of observation group patients, MI rates were 1.5% during hospitalisation and 4% during the following year, similar to that in those with MI ruled-in, among those with MI ruled-out, the MI rate was 0.2%. The 1-year death rate was 13% among observation group patients and 11% MI ruled-in patients (P = 0.624), whereas at 5 years among observation group patients, type 1 MI and type 2 MI were 48%, 26% and 58%, respectively (P = 0.001). Very few unselected consecutive patients attending ED, with minor stable HsTnT elevation, had MI, although most had chronic myocardial injury. Late mortality rates among observation group patients were higher than those with confirmed type 1 MI but lower than those with type 2 MI.

Lumbar plexus block combined with general anesthesia in treating postoperative delirium of hip fracture in elderly patients

To explore lumbar plexus nerve block combined with general anesthesia in elderly patients undergoing hip operation could improve analgesia effect, reduce consumption of analgesics, prevent inflammatory reaction, and avoid postoperative delirium(POD). Totally 200 elderly patients underwent hip fracture surgery from February 2020 to September 2021 were selected and were divided into observation group and control group according to different anesthesia methods. There were 97 patients in observation group including 66 males and 33 females; aged (70.23±6.60) years old;body mass index (BMI) was (23.13±1.94) kg·m-2;19 patients with hemi arthroplasty, 46 patients with total hip arthroplasty, and 32 patients with femur intertrochanteric fixation;treated with lumbar plexus block combined with general anesthesia. There were 94 patients in control group, including 66 males and 33 females;aged (68.80±6.24) years old;BMI was (22.88±1.85) kg·m-2;14 patients with hemi arthroplasty, 39 patients with total hip arthroplasty, and 41 patients with femur intertrochanteric fixation;treated with only general anesthesia. Nine patients were separated due to the change of surgical protocol or chronic disease. The incidence of POD at 1, 2 and 3 days after surgery, mini-mental state examination (MMSE) score, visual analogue scale (VAS) in resting state, serum inflammatory factors levels [such as C-reactive protein(CRP), interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)] at 1 d before operation, 1 and 6 h after surgery, consumption of sufentanil between two groups were compared. The incidences of POD in observation group were lower than control group at 1, 2 and 3 days of operation (P<0.05), MMSE score in observation group was higher than that of control group (P<0.05), VAS in observation group was lower than that of control group (P<0.01). The incidences of POD decreased and MMSE score were increaed in both groups day by day (P<0.01). The levels of CRP, IL-1β, IL-6 and TNF-α in observation group were lower than that of control group at 1 h after operation (P<0.01). The levels of CRP, IL-6 and TNF-α in observation group were lower than that of control group at 6 h after operation (P<0.01), while no statisitical difference in IL-1β between two groups(P>0.05). The consumption of sufentanil in observation group was lower than that of control group (P<0.01). Compared with general anesthesia, lumbar plexus nerve block combined with general anesthesia for the operations of hip fracture in elderly patients has better analgesic effect, has advantages of slight inflammatory reaction, and could decrease consumption of opioid and incidence of POD.

Application of Midline Catheter Placed Under Ultrasound Guidance in Intravenous Therapy for Oral and Maxillofacial Tumor

To examine the application effect of ultrasound-guided placement of midline catheter and to select the appropriate placement method of intravenous catheter for patients with oral and maxillofacial tumors. We retrospectively analyzed the general data and venous catheter-related information of 143 oral and maxillofacial tumor patients who received treatment between June 2019 and December 2021. There were two patient groups, a control group of patients with inserted peripheral venous catheters (PVC) and an observation group of patients with midline catheters placed under ultrasound guidance. We made a comparative analysis of the incidence of catheter-related complications, including bleeding at the insertion site, phlebitis, catheter blockage, extravasation, etc., in the two groups. When the baseline data from the two groups were not balanced, we used propensity score matching (PSM) to match the general data before comparing the complication incidence between the two groups. There were 71 patients who underwent 215 times of PVC placement in the control group and 72 patients who underwent 72 times of midline catheter placement in the observation group. There was no significant difference between the patients in the two groups in terms of age, sex, diagnosis, or the use of anticoagulant medication ( P>0.05) . The observation group had longer average length-of-stay than the control group did ( P<0.01). The cost of catheter placement in the observation group was 1080 yuan per set, with the average daily cost being about (56.27±20.23) yuan. Patients in the control group had PVC placement for an average of (3.03±0.93) times. The cost for PVC placement was 96 yuan per time and the average daily cost was about (19.94±7.50) yuan. There was significant difference in the average daily cost between the observation group and the control group ( P<0.01). PSM was performed for the two groups. Before PSM, the incidence of catheter-related complications in the observation group (8.3%, 6/72) was lower than that of the control group (30.2%, 65/215) and the difference was statistically significant ( P<0.01). After PSM, 72 times of catheter placement from each group were included in comparative analysis. The incidence of catheter-related complications in the observation group (8.3%, 6/72) was lower than that of the control group (54.2%, 39/72) and the difference was statistically significant ( P<0.01). Patients have low incidence of catheter-related complications when they have midline catheter placed under ultrasound guidance, which helps reduce the pain of repeated venous insertion that patients incur and the workload of clinical nurses. The use of midline catheters is appropriate for and should be popularized among patients with oral and maxillofacial malignant tumors, especially patients who have poor peripheral venous conditions and those who are undergoing repair and reconstruction surgeries.

Occupational health issues and respiratory toxicity of a complex of harmful factors in electrolytic and hydrometallurgical copper production

Introduction. In recent decades, there has been a decrease in occupational morbidity at enterprises producing rough and refined copper, in the structure of which, nevertheless, bronchopulmonary pathology retains a leading position.The aim is to study the occupational risk of developing respiratory pathology in workers engaged in obtaining cathode copper by electrolysis and electorowinning methods, based on the study of working conditions of workplaces and clinical observation.Materials and methods. The object of the study were: Uralelectromed, V. Pyshma (UEM); Uralhydromed, Polevskoy (RMK). The subject of the study were 100 employees of the electrolysis shop of UEM – the 1st observation group; 102 people of the auxiliary workshops of UEM – the 2nd observation group; 92 workers of the extraction and electorowinning department of UGM – the 3rd observation group.Results. During electrolytic refining of copper, the leading harmful factors with respiratory toxicity are sulfuric acid aerosol, selenium dioxide, nickel, arsenic, and during electrovinig – sulfuric acid aerosol. Violations of ventilation function and pulmonary gas exchange were observed in 21.0 % of cases in persons of the 1st and in 15.7% of cases in patients of the 3rd observation group).Discussion. Changes in the function of external respiration (FVD) were established mainly by the obstructive type, namely, an increase in RV, FRC and RV/TLC and a decrease in FEV1, VC, FEV1/VC, FEV25-75 of mild and moderate severity were noted. The bronchodilation test revealed the reversibility of bronchial obstruction in both groups 1 and 3. Obstructive disorders and dynamic hyperventilation of the lungs in copper refining workers are probably a consequence of hyperreactivity of the bronchi in response to the irritating properties of sulfur-containing gases, arsenic and nickel compounds.Conclusion. The results of the study indicate respiratory toxicity of harmful factors in workers of electrolysis and electrovining, which corresponds to a high and average occupational risk of class 3.3 and class 3.2 assessment of working conditions and the results of mandatory periodic medical examinations.

Application of periodontal tissue regeneration combined with orthodontics in oral prosthodontics and its influence and significance on the expressions of IL-1β, TNF-α and IL-5 in periodontal tissue

ABSTRACT The aim is to investigate the application of periodontal tissue regeneration combined with orthodontics in oral restoration, and explore its effect and significance on the expressions of Interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-5 (IL-5) in periodontal tissue. The patients in observation group were treated with orthodontics combined with periodontal tissue regeneration, and the control group was treated with periodontal tissue regeneration. The total effective rate, adverse reactions, recurrence rate and treatment satisfaction were compared. The masticatory function, language function, aesthetic level, VAS score, quality of life, gingival index (GI), plaque index (PLI), periodontal pocket probing depth (PD), sulcus bleeding index (SBI), IL-1β, TNF-α and IL-5 levels were compared. The recurrence rate of observation group was lower than control group, while the treatment satisfaction was higher after treatment. After treatment, the scores of masticatory, language, aesthetics, physiological, social, emotional, cognitive, and emotional functions and overall health score were higher than before treatment. After treatment, the scores of masticatory and language functions, aesthetics and quality of life of observation group were significantly higher than control group. After treatment, the VAS score, GI, PLI, SBI, PD, IL-1β, TNF-α and IL-5 levels were lower than before. The VAS score, GI, PLI, SBI, PD levels, IL-1β, TNF-α and IL-5 levels of observation group were lower after treatment. Orthodontics combined with periodontal tissue regeneration can help improve the periodontal condition of patients with periodontitis, reduce inflammatory response, improve the level of efficacy and overall safety, and further improve patients’ quality of life and treatment satisfaction.

Analysis of the Effect of Shenghua Zhuyu Herbal Acupoint Plaster in the Treatment of Postpartum Malodor

Objective: To assess the clinical effect of Shenghua Zhuyu ointment, which was applied onto the Zhongji, Qihai, and Guanyuan acupoints, on postpartum lochia. Methods: We randomly divided 166 patients who were admitted in 2018–2021 into an observation group and a control group. The control group was treated with conventional clinical methods, whereas the observation group was treated by applying Shenghua Zhuyu ointment on the Zhongji, Qihai, and Guanyuan acupoints. The amount and duration of lochia, abdominal pain, hospitalization time were observed; B-scan ultrasonography was performed to check whether the placenta was discharged. Results: The treatment received by the observation group of patients was shown to be more effective than that of the control group. Besides, the experimental group had less lochia than that of the control group. The observation group also had shorter duration of lochia and hospital stay than those of the control group (P &lt; 0.05). The placenta excretion was better, and the degree of abdominal pain was lower in the observation group than those of the control group (P &lt; 0.05). Conclusion: The acupoint application of Shenghua Zhuyu herbal acupoint plaster has a significant impact on retained placenta, in which it can aid the discharge of residual placenta and improve the patients’ physical functions and symptoms.

Comparative analysis of clinical efficacy between posterior percutaneous endoscopic discectomy and anterior cervical discectomy and fusion in the treatment of cervical spondylotic radiculopathy

To explore the clinical efficacy of posterior percutaneous endoscopic discectomy(PPECD) in the treatment of cervical spondylotic radiculopathy. A total of 56 patiens with single segment cervical spondylotic radiculopathy from December 2017 to October 2020, were randomly divided into observation group and control group. In observation group, there were 16 males and 11 females, including 8 cases of C4,5, 13 cases of C5,6 and 6 cases of C6,7 performed posterior percutaneous endoscopic discectomy, aged from 34 to 61 years old with an average of (51.15±6.29) years old. In control group, there were 19 males and 10 females with single segment cervical spondylotic radiculopathy including 10 cases of C4,5, 14 cases of C5,6 and 5 cases of C6,7 performed anterior cervical discectomy and fusion, aged from 40 to 65 years old with an average of (53.24±5.31) years old. The operative time, intraoperative blood loss, postoperative time of lying in bed and length of postoperative hospital stay were recorded. Visual analogue scale(VAS) and neck disability index(NDI) were used to evaluate the clinical efficacy. Cervical plain films or MRIs, CTs were taken for re-visiting patients. All patients were followed up more than 2 years. The observation group patients were followed up, the duration ranged from 24 to 42 months with an average of (30.48±4.91) months. The control group patients were followed up, the duration ranged from 25 to 47 months, with an average of (32.76±4.53) months. Compared with control group, operative time, intraoperative blood loss, postoperative time of lying in bed and length of postoperative hospital stay were decreased(P<0.05). Compared with pre-operation, VAS of neck and upper limb and NDI at the latest follow-up between two groups were significantly improved(P<0.05). Compared with control group, VAS of neck and upper limb at 1 day after operation in observation group were significantly reduced(P<0.05). There was no significant difference in VAS of neck and upper limb and NID at 1, 3 months and the latest follow-up after operation between two groups(P>0.05). In the observation group, one patient's deltoid muscle strength was weakened to grade 4 after operation, and returned to normal after 12 weeks of conservative treatment. In control group, there was 1 case of postoperative adjacent spondylosis with symptoms of spinal compression after 2 years operation, then underwent cervical artificial intervertebral disc replacement. And there was 1 case of dysphagia after operation in control group and improved after 1 year. There was no significant difference in incidence of complications between two groups. PPECD has advantages of shortening operative time, decreasing intraoperative blood loss, reducing postoperative time of lying in bed and length of postoperative hospital stay. However, applicable age range of patients and long-term clinical efficacy needs further study.