25 February 2018, Volume 25 Issue 1

    

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  Meta analysis on lornoxicam and phloroglucinol treating acute abdominal pain in patients with gallstone

  Yao Lili, Sun Chengfan, Yu Jianhua, Xu Jinlong

  journal1. 2018, 25(1): 1-4. https://doi.org/10.3969/j.issn.1006-5253.2018.01.001

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  Objective To evaluate the efficacy and safety of lornoxicam and phloroglucinol treating acute abdominal pain in patients with gallstone. Methods The randomized controlled studies (RCTs) of lornoxicam and phloroglucinol treating acute abdominal pain in patients with gallstone were conducted. Two reviewers independently screened the literatures, extracted data and evaluated the quality of studies. Meta analysis was performed by Revman 5.3 software. Results Compared with the phloroglucinol group (the control group), incidence of adverse drug reactions in the lornoxicam and phloroglucinol group (the combined group) had no significant difference (RR=0.82,95%CI:0.49~1.39, P=0.47). Pain relief time (MD=-28.77,95%CI:-30.39~-27.15, P<0.001), 1H-VAS (MD=-1.88,95%CI:-2.05~ -1.71, P<0.001) and pain recurrence rate (RR=0.46,95%CI:0.28~0.62, P<0.001) in the combined group were significantly better than those in the control group. Conclusion From this systematic review, lornoxicam and phloroglucinol treating acute abdominal pain in patients with gallstone is safe and effective. But there are some limitations in this study, which still need to be validated with traditional drug control, good design, multi centers and large scale clinical randomized controlled study.
     
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  Study of six sigma management in reducing the average length of stay of patients with lumbar disc herniation

  Sun Zhaozhong, Zhu Kai, Li Rui, Zheng Zhenyang, Liu Xin

  journal1. 2018, 25(1): 5-9. https://doi.org/10.3969/j.issn.1006-5253.2018.01.002

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  Objective To explore the effect of six sigma management in reducing the average length of stay of patients with lumbar disc herniation. Methods The study investigated the potential causes which extended the length of hospital stay, found the highly relevant and controllable factors, clarified the key points, and then developed the targeted solutions to improve it through the DMAIC process according to six sigma management. Results The study detected the key factors affecting the length of stay which included hospital consultation, holiday waiting, treatment planning, elderly patients, postoperative complications, and so on. The average hospital stay of patients with lumbar disc herniation dropped from the original 8.83±4.23days to 7.12±3.16 days after the improvement. Conclusion Six sigma management could be applied to identify the key factors, modify the hospital diagnosis and treatment process, improve work efficiency, and shorten the average length of stay of patients with LDH.
     
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  Effect of lamivudine on viral control in patients with chronic hepatitis B acute liver failure

  Zhao Qijie, Ye Weizhen, Li Weiping

  journal1. 2018, 25(1): 10-13. https://doi.org/10.3969/j.issn.1006-5253.2018.01.003

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  Objective To investigate the effect of lamivudine on viral control in patients with chronic hepatitis B acute liver failure. Methods Eight patients with acute hepatitis B liver failure admitted to our hospital from January 2015 to November 2016 were randomly divided into two groups. The control group were treated with conventional treatment measures, while the observation group was treated with the use of lamivudine treatment besides conventional treatment measures. The changes of virological indicators total bilirubin (TBil), serum alanine aminotransferase (ALT), prothrombin activity (PTA) and albumin (Alb) of the two groups were analyzed and detected, and the negative rate after treatment of the two groups were compared. The end-stage liver disease model (MELD) was used to assess the disease improvement after treatment. Results The changes of virological indicators of patients of two groups were obvious before and after the treatment. The levels of ALT and TBil reduced, and levels of PTA and Alb increased. TBil and ALT levels of the observation group after treatment were (188.2±67.5) and mmol/L (92.4± 34.1) U/L, PTA and Alb levels were (50.7±4.9)% and (37.1±4) g/L. The decreases and increases of the observation group were more significant than those in the control group, and the difference was statistically significant (P<0.05). (HBV) quantitative DNA of both groups of patients significantly decreased before and after the treatment. (HBV) quantitative DNA of the observation group was (3.2±0.1) copies/mL after the treatment, while that of the control group was (4±0.2) copies/mL. (HBV) quantitative DNA of the observation group was significantly lower than that of the control group, and there was statistical significance (P<0.05). After treatment, the observation group had 28 cases (70%) (HBV) DNA negative, 14 cases in the control group (35%) with (HBV) DNA negative, and there was statistical significance (P<0.05). After treatment, 27 cases (67.5%) in the observation group improved, and 5 cases died (12.5%). While 16 (40%) cases in the control group improved, and 18 cases died (45%). the mortality of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the Child-Pugh score of the observation group was (6.9 ± 1.6) points, significantly lower than that (9.7 ± 1.8), in the control group, with statistical significance (P<0.05). Conclusion The use of lamivudine in the treatment of patients with acute on chronic hepatitis B liver failure, can significantly improve the liver function and virological indicators, promote liver metabolism, improve prognosis effectively, have good clinical effect, reduce the mortality of patients, and improve the clinical efficacy, so it is worthy of promotion.
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  Influencing factor analysis of quality of life of Alzheimer′s disease patients

  He Weiliang, Pan Xingen, Wang Xing, Feng Min

  journal1. 2018, 25(1): 14-16. https://doi.org/10.3969/j.issn.1006-5253.2018.01.004

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  Objective To explore the influencing factors of quality of life of Alzheimer′s disease patients. Methods Eighty Alzheimer′s disease patients admitted in this hospital were selected as Alzheimer′s disease group and 86 healthy old people were selected as the control group. The quality of life-alzheimer′s disease (QOL-AD) was used to evaluate quality of life of all the subjects. The logistic analysis was used to analyze the relationship between quality of life of Alzheimer′s disease patients and 7 factors including age, sex and so on. Results The grade of QOL-AD′s 13 items and total grade of Alzheimer′s disease group were all lower than those of the control group, with significant difference (P<0.01). The binary logistic regression analysis showed age (≥75years) (OR=2.169) and being matelss (OR= 2.037) were the risk factors of Alzheimer′s disease patients (P<0.05), and caregivers (spouse) (OR=0.362) was the protective factor (P<0.05). Conclusion More attention to elderly patients and care from their family can improve the quality of life of Alzheimer′s disease patients effectively.
     
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  Survey analysis on characteristics and correlated risk factors of prognosis of children severe hand foot and mouth disease

  Zhou Lizhen, Zhao Xuepin

  journal1. 2018, 25(1): 17-19. https://doi.org/10.3969/j.issn.1006-5253.2018.01.005

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  Objective To explore the characteristics and correlated risk factors of prognosis of children server hand foot and mouth disease. Methods Totally 124 children with server hand foot and mouth disease were chose and divided into good prognosis group (86 cases) and poor prognosis group (38 cases). The methods of single factor comparison and multiple factors Logistic regression were used to screen the risk factors of prognosis of the children. Results Multiple factors Logistic regression analysis result showed that atypical eruption (OR=2.370), convulsion (OR=3.725), pulmonary exudative lesions (OR=3.522), disturbance of circulaton (OR=6.240) and lencocyte count (OR=1.972) were risk factors of poor prognosis of children with server hand foot and mouth disease. Conclusion There is a high incidence rate of poor prognosis of children with server hand foot and mouth disease. The independent risk factors include atypical eruption, recurrent tic, exudative lesions, disturbance of circulaton and high level of lencocyte count. We should adopt corresponding intervention measures to aim directly at these risk factors.
     
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  Influence factor analysis of nasal continuous positive airway pressure stability for newborn

  Wang Weina, Shen Ying

  journal1. 2018, 25(1): 20-22. https://doi.org/10.3969/j.issn.1006-5253.2018.01.006

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  Objective To explore the influence factors of nasal continuous positive airway pressure (NCPAP) stability for newborn, so as to provide data evidence to promote NCPAP quality. Methods The clinical data of totally 223 cases of neonatal respiratory distress syndrome was analyzed, and all the patients were treated with NCPAP and divided into 2 groups according to pressure anomaly time: ≥3 times group and ＜3 times group. SPSS19.0 was used to analyze the influence factors and risk factors of pressure anomaly. Results There was 602 times pressure anomaly in total, and 2.7 times per child. The birth body mass (t=2.601, P=0.040), NCPAP use time (t=14.217, P<0.001), stuffy nose off (χ²=12.043, P=0.001), nasal mucosa damage (χ²=11.314, P=0.001), fetus restless (χ²=4.814, P=0.028), pipe line leakage (χ²=4.332, P=0.037), secreta block (χ²=6.789, P=0.009) and excessive condensate water (χ2=5.026, P=0.025) were all influence factors for NCPAP stability. NCPAP≥72(OR=2.159,95%CI:1.212~8.874), stuffy nose off(OR=3.283,95%CI: 1.643~6.558), nasal mucosa damage (OR=2.724,95%CI:1.506~1.930), fetus restless(OR=1.873,95%CI:1.066~3.291), secreta block (OR=2.419,95%CI:1.231~4.755)and excessive condensate water (OR=2.253, 95%CI:1.095~4.637)were also risk factors for NCPAP pressure anomaly. Conclusion Necessary precautions should be taken according to the risk factors of NCPAP pressure anomaly, and timely troubleshooting is the effective measure for improving NCPAP quality.
     
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  Risk factor analysis of diarrhea after enteral tube feeding in patients with acute cerebral infarction

  Xiang Guoye

  journal1. 2018, 25(1): 23-25. https://doi.org/10.3969/j.issn.1006-5253.2018.01.007

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  Objective To explore the risk factors of diarrhea after enteral tube feeding in patients with acute cerebral infarction, in order to provide a basis for clinical improvement of prognosis. Methods Totally 112 patients with acute cerebral infarction who underwent enteral tube feeding were selected as research objects. All patients were divided into diarrhea group (47 cases) and non-diarrhea group (65 cases) according to diarrhea or not. Single factor analysis and binary logistic analysis were used to analyze the relationship between the diarrhea and 9 factors (sex, age, hypertensive, heart disease history, diabetes, infarction location, probiotics, antibiotics and nutrition), in order to identify risk factors. Results The differences in probiotics, antibiotics and nutrition between diarrhea group and non-diarrhea group had statistically significance (P<0.05). However, the differences in sex, age, hypertensive, heart disease history, diabetes and infarction location had not statistically significance (P>0.05). The binary logistic analysis found that antibiotics (OR:7.800,95%CI:3.139~19.381) was the risk factors of diarrhea (P<0.001), while probiotics (OR:0.380,95%CI:0.162~0.895) and the hole-protein nutrient solution containing cellulose (OR:0.268,95%CI:0.110~0.653) were the protective factors of diarrhea (P<0.05). Conclusion The risk factors of diarrhea after enteral tube feeding in patients with acute cerebral infarction indicated that proper use of antibiotics, improving probiotics, and selection of nutrient solution containing cellulose can valid reduce?the incidence of diarrhea.
     
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  Research on the mode of integrated treatment and convalesce based on aging society

  Li Xuehui, Cao Mingyang, Xiang Jing

  journal1. 2018, 25(1): 26-28. https://doi.org/10.3969/j.issn.1006-5253.2018.01.008

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  Objective To explore the current situation of the mode of integrated treatment and convalesce in Zibo City. Methods Literature review, logical analysis, questionnaire, interview and statistical analysis were used to investigate the implementation in Zibo. Results In 588 subjects, there are 62.59% of the old men willing to choose d a combination . According to the results of the survey, urban and rural residents pay attention to four important factors, such as medical care(OR=1.035), nursing services(OR=1.008), live with the old man′s kindness(OR=1.025), attention of the medical insurance system(OR=1.012). Conclusion Is expected to improve the professional level and service attitude of nursing workers. We should pay attention to the mental health care and improve living resources of the elderly.Combination of medical treatment and endowment is the only way for the aging society to develop, which will be the important direction for the development of the old-age service industry.
     
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  Risk factors of nosocomial infections in patients with chronic renal failure undergoing hemodialysis

  Zhong Hongxia

  journal1. 2018, 25(1): 29-32. https://doi.org/10.3969/j.issn.1006-5253.2018.01.009

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  Objective To explore the risk factors of nosocomial infections in patients with chronic renal failure (CRF) undergoing hemodialysis, in order to provide reference basis for reducing hospital infection rate. Methods Totally 142 hospitalized CRF patients undergoing hemodialysis were selected as research objects. Thirty-six cases were with hospital infection and belonged to the infection group, and 106 cases were not with hospital infection and belonged to the non-infection group. The common part of infection was numbered. Single factor analysis and logistic analysis were used to analyze relations of hospital infection with 9 factors (sex, age, primary disease, heart failure, length of stay, dialysis age, venous catheter, hemoglobin and blood albumin), in order to identify risk factors. Results The total of infection rate was 25.35%, including 12 cases in respiratory system (33.33%), 9 cases in urinary system (25.00%), 6 cases in vascular access (16.67%), 4 cases in digestive system (11.11%), 3 cases in cyclic system (8.33%) and 2 case in others (5.56%). The differences in age, primary disease (diabetic nephropathy, chronic glomerulonephritis, chronic pyelonephritis, obstructive nephropathy, gouty nephropathy and others), heart failure, length of stay, dialysis age, venous catheter, hemoglobin and blood albumin between the diarrhea group and the non-diarrhea group were statistically significant (P<0.05). The logistic analysis showed that age>60 years (OR:2.746), diabetic nephropathy (OR:2.592), chronic glomerulonephritis (OR:2.527), heart failure (OR:2.578), venous catheter (OR:3.188) and the level of blood albumin<30 g/L (OR:4.744) were the risk factors of nosocomial infections in CRF patients undergoing hemodialysis (P<0.05). Conclusion The risk factors of nosocomial infections in CRF patiets undergoing hemodialysis indicated that active preventive treatment of high-risk groups, strict hemodialysis operation and the strengthening of nutritional support can effectively reduce the ratio of hospital infection.
     
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  Analysis of knowledge and influencing factors of ICU patients′ knowledge about early activities

  Fang Lingyan

  journal1. 2018, 25(1): 33-35. https://doi.org/10.3969/j.issn.1006-5253.2018.01.010

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  Objective To understand the status of ICU patients′ knowledge about early activities and to explore their influencing factors. Methods Questionnaires were used to investigate 200 ICU patients with stable disease situation. Results Male patients accounted for 55.50% (111/200), and female patients accounted for 45.50% (89/200), with the average age (56.65±4.85)years old. Early activity-related knowledge of the patents was not high, and the knowledge of grades of early activity program was the lowest level of knowledge, accounting for 14.00% (28/200). There were statistically significant differences in the scores of patients with different educational levels, payment methods, working status, ICU stay, SAPS Ⅱ score, mechanical ventilation, and sedative analgesia in early activity-related knowledge scores (P<0.05). The score of knowledge of patients with working status for the job, pay for medical insurance, mechanical ventilation for oxygen, and non-sedative analgesic was higher than that of other patients. Multivariate logistic regression analysis showed that the level of culture (OR=3.768, OR 95%CI=1.189-10.676) and the time during the stay in the ICU (OR=3.053, OR 95% CI=1.178-7.867), the SAPS Ⅱscore(OR=0.062, OR 95%CI=0.010-0.408) were important factors influencing the knowledge of patients with intensive care in the intensive care unit. Conclusion Early activity-related knowledge of ICU patients is not high. The higher the level of culture, the longer the ICU stay, the higher the acute physiological score of patients with early activity. There is a need to improve the awareness of ICU patients and their families on early activity-related knowledge.
     
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  Analysis of infection control in patients with class I cleansing surgery of operating room by PDCA circulation management

  Chen Huiying

  journal1. 2018, 25(1): 36-39. https://doi.org/10.3969/j.issn.1006-5253.2018.01.011

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  Objective To investigate the infection control of PDCA cycle management measures in patients with type I clean incision surgery. Methods Totally 253 patients were selected from August 2015 to April 2017 in our hospital as the research objects, and according to the random number table method, they were randomly divided into the observation group of 127 patients and the control group of 126 patients. The control group was intervened with conventional infection control measures, and the observation group adopted PDCA circulation management measures. The infection and the use of antibiotics of the two groups were observed and recorded, the qualified rates of disinfection of the surfaces of objects, air, thermostat and medical staff were recorded and compared. Results The qualified rate of non-sterile surface disinfection in the observation group was about 91.34%, the qualified rate of hand disinfection in the observation group was about 98.43%, the qualified rates of indoor air and incubator in the observation group was significantly higher than those of the control group, and the difference between the two groups was statistically significant (P<0.05). The total infection rate of the observation group was about 3.15%, and the total infection rate in the control group was about 9.52%. There was significant difference between the two groups (P<0.05). The use rate of antimicrobial agents in the patients with different surgical types was significantly lower than that in the control group (P<0.05). Conclusion PDCA cycle management measures are ideal for infection control in patients with type I clean incision surgery. There is a high rate of disinfection in the operating room, air and medical staff and the usage rate of antibiotics decreases. The infection reduces and the quality of infection control is high.
     
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  Incidence and influencing factors of venous thromboembolism in elderly patients with acute exacerbation of COPD

  Wang Wei

  journal1. 2018, 25(1): 40-41. https://doi.org/10.3969/j.issn.1006-5253.2018.01.012

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  Objective To investigate the morbidity and influencing factors of venous thromboembolism in elderly patients with acute exacerbation of COPD. Methods Totally 160 elderly patients aged over 50 who were hospitalized for COPD were collected for statistical analysis. Results There were 41 cases in the VTE group, with the average age 70.31 ± 6.84 years old, and there were 119 cases in the non-VTE group, with the average age 58.74 ± 6.02 years old. There were significant differences between the two groups in age, smoking history, history of cardiovascular and cerebrovascular disease, diabetes mellitus, COPD grade (grade III and above), deep vein catheterization (>2 weeks), D-dimer, and levels of h-CRP, PaO₂, PaCO₂ (P<0.05). Multivariate results showed that D-dimer level (OR=3.53) and PaO₂ level (OR=2.67) were important factors influencing venous thrombosis in elderly patients with AECOPD. Conclusion The proportion of age and smoking history of VTE group is higher than that of non-VTE group, high levels of D-dimer and PaO₂ are risk factors for venous thrombosis in elderly patients with AECOPD .