ObjectiveTo analyze the impact of high-quality nursing care on adult patients with asthma and asthma control.
MethodsWe randomly chose 100 patients with asthma from June 2012 to July 2013, and the patients were randomly divided into experimental group (n=50) and control group (n=50). Patients in both the two groups received treatments based on the characteristics of the patients' condition. The control group received conventional care, while the experimental group received high-quality nursing care aimed to help them establish the concept of Asthma Prevention on the basis of the conventional care. Then, we analyzed the effect of nursing intervention in both groups.
ResultsBefore the treatment, the forced expiratory volume in 1 second (%) and peak expiratory flow were not significantly different between the two groups (P>0.05). After treatment, both groups had improvement in their lung function. However, improvement in lung function of the experimental group was significantly better than the control group (P<0.05). The disease remission level in the experiment group and the control group was respectively 86.0% (43/50) and 64.0% (32/50) (χ2=6.453, P=0.011). According to the Asthma Control Questionnare (5-item version), in the experimental group, 46 patients completed the assessment and the total control of asthma accounted for 34.8% (16/46), well-controlled asthma accounted for 50.0% (23/46), and uncontrolled asthma accounted for 15.2% (7/46); while in the control group, 48 patients completed the assessment and the total control of asthma accounted for 18.8% (9/48), well-controlled asthma accounted for 43.8% (21/48), and uncontrolled asthma accounted for 37.5% (18/48) (Z=-2.533, P=0.011). The average hospital stay for the experimental group and the control group was respectively 11.24 days and 12.16 days.
ConclusionHigh-quality nursing care can improve the quality of life of adult asthma patients, improve the patients' lung function, and enhance the control of asthma.
Erythemato-squamous diseases are a general designation of six common skin diseases, of which the differential diagnosis is a difficult problem in dermatology. This paper presents a new method based on virtual coding for qualitative variables and multinomial logistic regression penalized via elastic net. Considering the attributes of variables, a virtual coding is applied and contributes to avoid the irrationality of calculating nominal values directly. Multinomial logistic regression model penalized via elastic net is thence used to fit the correlation between the features and classification of diseases. At last, parameter estimations can be attained through coordinate descent. This method reached accuracy rate of 98.34%±0.0027% using 10-fold cross validation in the experiments. Our method attained equivalent accuracy rate compared to the results of other methods, but steps are simpler and stability is higher.
Objective To evaluate the efficacy of asarone injection in treating respiratory disease. Methods All the randomized controlled trials (RCTs) about treating respiratory disease with asarone injection were collected by searching MEDLINE (1990 to 2010), EMbase (1990 to 2010), CSJD (1989 to January 2010) and CNKI (1979 to December 2009). The assessment of methodological quality and data extraction of the included studies were performed independently by two reviewers, and Meta-analysis was conducted with RevMan 5.0 software. Results A total of 29 studies involving 3 931 patients met the inclusion criteria. The results of Meta-analysis showed that: a) Asarone injection was effective in treating respiratory diseases including bronchiolitis, chronic obstructive pulmonary diseases (COPD) and AECOPD, bronchitis and pneumonia; b) In treating bronchiolitis, asarone injection was superior to aminophylline, heartleaf houttuynia herb and virazole in total effective rate, and was similar to andrographolide in curative effect; c) In treating COPD and AECOPD, asarone injection was superior to symptomatic treatment and bromhexine in total effective rate, was similar to benzylpenicillin sodium and tablete glycyrrhiza in curative effect, and was inferior to aminophylline in total effective rate without significant difference; d) In treating bronchitis, asarone injection was superior to aminophylline and symptomatic treatment in total effective rate, and was similar to mucosolvin in curative effect; and e) In treating pneumonia, asarone injection was superior to antibiotic, ribavirin and aminophylline in total effective rate. Conclusion Asarone injection is effective in treating respiratory disease. Because of the lower methodological quality and publication bias of the included trials, it is necessary to perform more high-quality and large-scale randomized controlled trials to make the conclusion more reliable.
ObjectiveTo investigate the predictive value of preoperative plasma fibrinogen and serum albumin score (FA score) for postoperative survival of hepatocellular carcinoma (HCC) after hepatectomy.MethodWe retrospectively analyzed the clinicopathological data and follow-up information of 275 patients with HCC who underwent hepatectomy in West China Hospital of Sichuan University from March 2009 to December 2013.ResultsThere’s no statistically significant difference in gender, ALT, total bilirubin, hepatitis B virus surface antigens, AFP, cirrhosis, macrovascular invasion, tumor differentiation, TNM stage, and postoperative adjuvant transarterial chemoembolization of HCC patients between FA score of 0 group and FA score of 1 and 2 group (P>0.05). There’s statistically significant difference in age, AST, tumor size, tumor number, microvascular invasion, and BCLC stage (P<0.05). Multivariate Cox proportional hazard regression analyses revealed that FA score (1 and 2) was an independent risk factor for HCC patients’ overall survival rate [HR=1.632, 95%CI was (1.141, 2.335), P=0.007] and early recurrence-free survival rate [HR=1.678, 95%CI was (1.083, 2.598), P=0.021], the overall survival rate and early recurrence free survival rate of HCC patients with FA score of 0 group were better than those of patients with FA score of 1 and2 group.ConclusionsThe preoperative FA score has a good prognostic value for survival of HCC patients who underwent hepatectomy. Preoperative FA score of 1 and 2 is an independent risk factor for overall survival rate and early recurrence free survival rate of HCC patients after hepatectomy.
【摘要】 目的 觀察腹腔鏡手術聯合孕三烯酮治療子宮內膜異位癥合并不孕的療效及不同評分系統對妊娠結局的預測價值。 方法 回顧性分析2004年1月-2006年12月收治的97例子宮內膜異位癥合并不孕患者的臨床病理資料，統計其術后妊娠率及活產率。 結果 術后1年內與1~2年的妊娠率與活產率比較，差異均無統計學意義（Pgt;0.05）。根據美國生育協會1985年修訂的子宮內膜異位癥分期標準（r-AFS）進行分期，各期患者術后妊娠率差異無統計學意義（Pgt;0.05）；但隨著分期升高，活產率逐漸下降（Plt;0.05）。子宮內膜異位癥生育指數（EFI）評分越高，其妊娠率和活產率也越高（Plt;0.05）。 結論 子宮內膜異位癥患者腹腔鏡手術后聯用孕三烯酮可能會提高遠期妊娠率。r-AFS分期對妊娠結局的預測有一定局限性，而EFI具有較好的預測性。【Abstract】 Objective To evaluate the therapeutic effectiveness of laparoscopic surgery combined with gestrinone treatment in the infertile women with endometriosis (EM), and the value of different score systems to predict gestational outcome. Methods We retrospectively analyzed the clinical data of 97 infertile women with EM who were treated in our hospital from January 2004 to December 2006, and collected their pregnancy rate (PR) and live birth rate (LBR) after operation. Results There was no significant difference of PR and LBR within the 1st year and between the 1st and the 2nd year (Pgt;0.05). There was no significant difference of PR among women of various stages of EM based on the 1985 edition of risk stratification for patients with EM put forward by American Fertility Society (r-AFS) (Pgt;0.05), but the LBR decreased with the raising of the stages (Plt;0.05). The endometriosis fertility index (EFI) was positively correlated with PR and LBR (Plt;0.05). Conclusion Laparoscopic surgery combined with gestrinone may increase the long-term pregnancy rate of women with EM. R-AFS classification is limited in predicting the gestational outcome of women with EM, while EFI achieves a better result.
ObjectiveTo systematically review the risk factors in elderly patients with primary hypertension with morning blood pressure surge in China, so asto provide references for clinical treatment and prevention of complications.
MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 11, 2013), CNKI, VIP and WanFang Data were electronically searched for the case-control studies about morning blood pressure surge (MBPS) among elderly patients with primary hypertension in China from January 2006 to June 2014 were collected. Literature was screened according to inclusion and exclusion criteria, data were extracted and the methodological quality of the included studies was assessed, and then meta-analysis was conducted using RevMan 5.2 software.
ResultsA total of 16 studies involving 2 007 cases were finally included, of which 956 cases were detected with MBPS. The results of meta-analysis showed that significant differences were found in glucose levels (MD=0.42, 95%CI 0.04 to 0.81, P=0.03), urinary microalbumin levels (MD=23.85, 95%CI 6.64 to 41.07, P=0.007), incidences of cerebrovascular events (OR=1.96, 95%CI 1.25 to 3.08, P=0.004), carotid atherosclerosis (OR=5.13, 95%CI 1.70 to 15.45, P=0.004) and left ventricular hypertrophy (OR=2.49, 95%CI 1.70 to 3.64, P < 0.000 01), left ventricular mass (MD=12.89, 95%CI 3.94 to 21.84, P=0.005), and carotid artery intima-media thickness (MD=0.08, 95%CI 0.02 to 0.14, P=0.009); while no significant difference was found in gender (OR=1.12, 95%CI 0.84 to 1.49, P=0.44), total cholesterol levels (MD=0.01, 95%CI-0.11 to 0.12, P=0.92), and creatinine levels (MD=1.77, 95%CI-1.16 to 4.70, P=0.24) between patients with or without MBPS.
ConclusionCurrent evidence shows that glucose levels, early kidney damage, emergent cerebrovascular events and the reconstruction of the artery and the left ventricle are risk factors of abnormal MBPS in China. However, the above conclusion needs to be verified by further conducting high quality prospective studies.
Objective To evaluate the effectiveness and safety of chemotherapy regimens represented by pirarubicin (THP) vs. adriamycin hydrochloride (ADM) for non-Hodgkin lymphoma (NHL) in mainland China. Methods The randomized controlled trials (RCTs) about THP vs. ADM for treating NHL were collected in the databases such as CNKI, CBM, VIP and WanFang Data, and the references of the included studies were also retrieved manually, with the retrieval time from January 1989 to September 2012. According to the inclusion and exclusion criteria, two reviewers independently screened articles, extracted data, and assessed the methodological quality of the included studies. Then meta-analysis was performed using RevMan 5.0 software. Results A total of 15 RCTs involving 1 659 patients were included. The results of meta-analysis showed that: a) As for the total effective rate, the CTOP (C: cyclophosphamide, T: pirarubicin, O: vincristine, P: prednison) regimen was superior to the CHOP (C: cyclophosphamide H: adriamycin hydrochloride, O: vincristine, P: prednison) regimen with a significant difference (OR=1.07, 95%CI 1.02 to 1.12, P=0.006); and b) As for the safety, there were significant differences between the two groups in the incidence of cardiac toxicity (OR=0.42, 95%CI 0.30 to 0.57, Plt;0.000 01), gastrointestinal tract response (OR=0.69, 95%CI 0.56 to 0.85, P=0.000 5) and liver damage (OR=0.69, 95%CI 0.48 to 1.00, P=0.05). But no significant differences were found between the two groups in the incidence of mye1osuppression: the decreased hemoglobin (OR=0.83, 95%CI 0.61 to 1.14, P=0.25), leucopenia (OR=0.85, 95%CI 0.68 to 1.07, P=0.17), and thrombocytopenia (OR=0.99, 95%CI 0.70 to 1.39, P=0.95). Conclusion Based on the domestic evidences at current and compared with CHOP regimen represented by ADM, CTOP regimen represented by THP for treating NHL shows a higher total effective rate and less side effects. However, more high quality, large sample and double blind RCTs are required to prove this conclusion for the quality and quantity limitation of the included studies.
