摘要:目的:了解老年住院患者發生尿路感染的病因,為臨床治療提供依據。方法:回顧性分析我院2007年1月至2007年12月發生尿路感染的老年住院患者臨床資料,分別統計各種病因。結果:共收集52例臨床資料,發生上尿路感染17例,下尿路感染35例。前列腺增生或前列腺炎6例,尿路結石7例,單純尿路感染10例。結論:老年人由于器官衰老萎縮和免疫功能減退,抗病毒能力下降,尿路感染是老年人常見的疾病之一,應引起重視,注意根據尿細菌培養結果與尿藥物敏感結果使用敏感抗生素,并注意保護腎功能。
目的:討論規范急診科儀器設備的管理,提高護士搶救患者的質量和效率。方法:對監護室的急救儀器設備定點定位放置,規范管理;設計操作保養維修流程圖,規范護士的行為;加強培訓考核力度,使護士熟練掌握急救技能。結果:急救儀器設備地完好率、患者搶救的成功率、醫生對護士的滿意度均有所提高。結論:規范了急救設備的管理,有效的提高了護理質量,及時杜絕了護理隱患的發生。
As a new discipline, the cardiac surgery has a great development in the modern age, but still faces many problems and disputes. The emergence of the evidence-based medicine(EBM),which emphasizes the best evidence, and combines the doctor’s clinical experience to make the best judgment, gives the development of the cardiac surgery a new thinking . Four systematic reviews published in The Cochrane Library (Issue 3, 2004) have interprated the importance of EBM on how to resolve the actual problems in different field of the cardiac surgery.
Early endovascular interventional therapy can effectively improve the prognosis of patients with acute ischemic stroke. Dual-source CT dual-energy scanning, as a new CT imaging technology developed rapidly in recent years, with its unique technical characteristics and advantages, shows potential and application prospects in early endovascular interventional therapy of acute ischemic stroke. This article discusses the value of dual-source CT dual-energy scanning in the early screening and evaluation, the identification of postoperative iodine contrast agent extravasation and secondary cerebral hemorrhage, and the prediction of prognosis of patients with early endovascular interventional treatment of acute ischemic stroke. The purpose is to provide a theoretical basis for better application of dual-source CT dual-energy scanning in early endovascular interventional treatment of acute ischemic stroke.
Parkinson’s disease is a common chronic progressive neurodegenerative disease, and its main pathological change is the degeneration and loss of dopaminergic neurons in substantia nigra striatum. Vitamin D receptors are widely distributed in neurons and glial cells, and the normal function of substantia nigra striatum system depends on the level of vitamin D and the normal expression of vitamin D receptors. In recent years, from basic to clinical research, there are some differences in the conclusion of the correlation of vitamin D and its receptor gene polymorphism with Parkinson’s disease. This paper aims to review the research on the correlation of vitamin D and vitamin D receptor gene polymorphism with Parkinson’s disease, and discuss the future research direction in this field.
Acute cerebral infarction is characterized by high incidence rate, high recurrence rate, high disability rate and multiple complications. Early evaluation and treatment of acute cerebral infarction is particularly important to improve the survival rate and prognosis of patients. As an easily available clinical laboratory indicator, blood routine test can reflect the pathological changes in the body to a certain extent. In recent years, many studies have shown that the indicators such as red cell volume distribution width, mean platelet volume, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in blood routine examination have important values in the onset, severity and prognosis of acute cerebral infarction. This article reviews the correlations of the above parameters and ratio parameters with acute cerebral infarction, in order to provide some reference and basis for clinical diagnosis, treatment and prognosis evaluation of acute cerebral infarction.
ObjectiveTo investigate the role of Peptidase domain containing associated with muscle regeneration 1 (PAMR1) in the proliferation, migration, and prognosis of hepatocellular carcinoma (HCC) through cellular experiments and clinical sample validation. Methods① Bioinformatics analysis was performed on datasets from the GEO public database to identify and screen for key genes, ultimately selecting PAMR1 for further study. Findings were validated using data from the TCGA database and six primary HCC surgical specimens prospectively obtained from the Army Characteristic Medical Center of Army Medical University from February 2024 to June 2024. ② PAMR1-overexpressing cell lines were established using HCC cell lines Huh7 and Lm3. Cells were transfected with either the recombinant plasmid pcDNA3.1(+)-PAMR1 as overexpression group or the empty vector pcDNA3.1(+) as negative control group. The effects of PAMR1 on HCC cell proliferation and migration were assessed using the Cell Counting Kit-8 (CCK-8) assay and wound healing assay, respectively. ③ Pathological specimens and clinical data were retrospectively collected from 61 patients with primary HCC who underwent surgical resection at the Army Characteristic Medical Center of Army Medical University between May 2019 and April 2020. The impact of PAMR1 expression on disease-free survival was evaluated. Results① PAMR1 was identified as a candidate gene through GEO database screening and was found to be downregulated in HCC tissues based on both TCGA data and the six HCC surgical specimens. ② The CCK-8 assay revealed that cell proliferation was significantly inhibited in the PAMR1 overexpression group compared to the negative control group (P<0.05). Similarly, the wound healing assay demonstrated reduced migratory capability in PAMR1 overexpression group (P<0.05). ③ Multivariate cox proportional hazards regression analysis of patient data indicated that high PAMR1 expression serves as an independent protective factor for disease-free survival in HCC (HR= 0.335, P=0.026). ConclusionPAMR1 serves as a crucial gene in HCC, high PAMR1 expression can significantly suppressing tumor cell proliferation and migration and indicates a favorable prognosis.
Objective To investigate the correlation between grip strength and subjective cognitive decline (SCD) in maintenance hemodialysis (MHD) patients of different genders. Methods Patients who underwent outpatient MHD in the Wenjiang Hemodialysis Unit, Department of Nephrology, West China Hospital, Sichuan University between March and June 2024 were selected as the research subjects. Multiple linear regression analysis was used to explore the relationship between grip strength and SCD in MHD patients of different genders. Results A total of 171 patients were investigated, with 76 in the non-SCD group and 95 in the SCD group. The results of multiple linear regression analysis showed that educational level (P=0.039), nutritional status (P=0.026), and grip strength (P=0.042) were the influencing factors of SCD in male MHD patients. Work status (P=0.001) and nutritional status (P=0.011) were the influencing factors of SCD in female MHD patients. Conclusions Educational level, nutritional status, and grip strength are influencing factors of SCD in male MHD patients. Work status and nutritional status are influencing factors of SCD in female MHD patients. Grip strength may serve as an indicator for evaluating SCD in male MHD patients.
Objective To systematically evaluate the effectiveness and safety of Resina Draconis for pressure ulcer. Methods Such databases as The Cochrane Library (Issue 4, 2013), PubMed, Elsevier SDOL, Web of Knowledge, CBM, CNKI, VIP and WanFang Data were searched from inception to May 2013 to collect randomized controlled trials (RCTs) about Resina Draconis for pressure ulcer. Two reviewers were assigned to independently screen the literature according to inclusion and exclusion criteria, extract data, and appraise the methodological quality. Then, meta-analysis was conducted using RevMan 5.2.4 software. Results A total of 14 RCTs were included, involving 610 patients. The results of meta-analysis showed that, Resina Draconis treatment were associated with a higher effective rate for pressure ulcer (RR=1.17, 95%CI 1.08 to 1.26, Plt;0.000 1). The results of descriptive analysis showed that, compared with the control group, Resina Draconis treatment shortened healing time. As for safety, adverse reactions had not been reported. Conclusion Resina Draconis can improve the effective rate for pressure ulcer and shorten the healing time, compared with other drug treatments. However, due to limited quality and quantity of the included studies, this conclusion needs to be proved by more high quality studies.
Transcatheter aortic valve replacement (TAVR) has become an increasingly important therapy option for patients with severe aortic stenosis who are not suitable for traditional aortic valve surgery. Transfemoral access remains the most utilized and preferred route for TAVR. Several alternative routes exist, including transapical, direct aortic, axillary-subclavian, transcarotid, and transcaval accesses. Many factors will be taken into account when operators determine the best vascular access, such as diameters of the access and sheater, valve size, calcification, and tortuosity. Vascular complications are the most common complications of TAVR, which are closely related to the adverse outcome and prognosis, and their occurrences are related to many factors, including the surgeon’s experience, the patient-associated factors, and the device-associated factors. The risk of vascular complications can be reduced through the choice of valve type and vascular approach, detailed preoperative imaging evaluation, and improvement of the patient’s baseline disease. It is suitable to determine whether conservative treatment or reintervention will be chosen according to the severity of the complications.