Objective  To investigate the effect of norepinephrine combined with esmolol on myocardial function and lactate clearance rate in patients with septic shock.

  Methods  Totally 100 septic shock patients were divided into control group (n=48) and observation group (n=52) according to the order of hospital admission. All the patients were treated with standard anti-infection and fluid resuscitation. The control group was treated with norepinephrine on this basis, while the observation group was treated with esmolol on the basis of the control group. The mechanical ventilation time, hospital stay in intensive care unit (ICU), recovery success rate within 6 hours, myocardial function, blood lactate concentration and lactate clearance rate, tissue perfusion, sequential organ failure estimation (SOFA) score, acute physiology and chronic health (APACHE Ⅱ) score were compared between the two groups.

  Results  The duration of mechanical ventilation and hospital stay in ICU in the observation group were significantly shorter than those in the control group, while the success rate of resuscitation within 6 hours and lactate clearance rate after 7 days of treatment were significantly higher than those in the control group (P < 0.05). Before treatment, there were no significant differences in B-type natriuretic peptide (BNP), troponin T (cTnT), creatine phosphate isoenzyme (CK-MB), urine volume, central venous oxygen saturation (ScvO₂), SOFA score and APACHE Ⅱ score between the two groups (P>0.05). After treatment, BNP, cTnT and CK-MB, SOFA score and APACHE II score in both groups decreased significantly (P < 0.05), and the above indexes in the observation group were significantly lower than those in the control group (P < 0.05), while urine volume and ScvO₂ were significantly higher than those before treatment (P < 0.05), and urine volume and ScvO₂ in the observation group were significantly higher than those in the control group (P < 0.05).

  Conclusion  Norepinephrine combined with esmolol can improve the curative effect of patients with septic shock, protect myocardial function, improve lactate clearance rate and reduce the degree of hypoxia in patients′ tissues.

  Objective  To explore the early fluid resuscitation strategy based on base excess (BE) condition for patients with traumatic hemorrhagic shock.

  Methods  Sixty patients with traumatic hemorrhagic shock were selected, including 6 cases without metabolic acidosis after emergency operation, 13 cases with metabolic acidosis without correction within 48 hours and 41 cases with metabolic acidosis within 48 hours. For 41 cases, they were divided into severe metabolic acidosis group (group A, n=29) and mild metabolic acidosis group (group B, n=12) according to BE≤ -6 mmol/L and BE>6 mmol/L. The severity of trauma (ISS) score, visiting time, platelet count, actual correction time of metabolic acidosis, proportion of blood transfusion and fluid input rate in both groups were retrospectively analyzed.

  Results  There were significant differences in fluid replacement rate and BE between group A and group B (P < 0.05).

  Conclusion  For patients with traumatic hemorrhagic shock, rapid selection of rehydration rate based on BE value can correct metabolic acidosis as soon as possible and improve the success rate of rescue under the condition of injury and hemorrhage control.

  Objective  To analyze the clinical features of patients with multiple organ dysfunction syndrome (MODS) caused by severe heat stroke.

  Methods  Clinical data and measures for cluster therapy of 18 patients with MODS caused by severe heat stroke were retrospectively analyzed, and clinical efficacy was observed.

  Results  All the patients were characterized by high fever, the average temperature was (40.5±1.8) ℃, and inflammatory indicators such as white blood cell count (WBC), C reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) significantly increased with an abnormal rate over 65%. Fifteen patients met the criteria of systemic inflammatory response syndrome (SIRS), prothrombin time (PT) and activated partial thromboplastin time (APTT) significantly prolonged, D-Dimer level significantly increased, and the abnormal rate was more than 80%. A total of 70 injured organs were involved, and the circulatory system, kidney and coagulation system ranked the top three. After implementation of cluster therapy, the patients′organ dysfunction can be reversed in time and recovered quickly.

  Conclusion  Several mechanisms, such as heat injury, SIRS and coagulation dysfunction, are involved in the pathophysiological process of severe heat stroke. Cluster therapy is effective.

  Objective  To observe the correlation between platelet count and severity of agkistrodon bite, and its effect on the prognosis of the disease.

  Methods  All patients with agkistrodon bite were divided into normal platelet group and thrombocytopenia group. The clinical indexes such as glutamic-pyruvic transaminase(ALT), serum creatinine(Cr), creatine kinase(CK), oxygenation index and C reactive protein(CRP) and erythrocyte sedimentation(ESR) were compared between the two groups. Meanwhile, the incidence of systemic inflammatory response syndrome(SIRS) and multiple organ dysfunction syndrome(MODS)in both groups were compared. The prognosis of the two groups was observed after treatment.

  Results  There were significant differences in ALT and CK levels in two groups (P < 0.05). The incidence of SIRS, MODS in the thrombocytopenia group were higher than that of normal platelet group (P < 0.05). Patients in thrombocytopenia group had a poor prognosis, the between-group difference was statistically significant(P < 0.05).

  Conclusion  Being prone to occurring SIRS and MODS, agkistrodon bite patients with thrombocytopenia are usually in more serious condition, and have poor prognosis.

  Objective  To explore the influence of multidisciplinary enteral nutrition nursing group on enteral nutrition support in patients with severe diseases.

  Methods  A total of 104 hospitalized patients with severe diseases were selected and randomly divided into observation group and control group, with 52 cases in each group. Patients in the control group received routine nursing services, and those in the observation group received nursing services provided by multidisciplinary enteral nutrition nursing group. Nutritional biochemical indicators, incidence rate of complications and adverse reactions were compared between the two groups.

  Results  Before nursing, there were no significant differences in contents of albumin, transferrin and hemoglobin between the two groups (P>0.05). After nursing, the above three indexes in the observation group were significantly higher than those in the control group (P < 0.05). The incidence rate of complications in the observation group was 5.77%, which was significantly lower than 17.31% in the control group (P < 0.05). The incidence rate of adverse reactions in the observation group was 7.69%, which was significantly lower than 23.08% in the control group (P < 0.05).

  Conclusion  For severe patients with support enteral nutrition, the implementation of the in-hospital multidisciplinary nutrition nursing group can effectively increase the efficacy and reduce the incidence rate of adverse reactions and complications.

  Objective  To investigate the effect of carotid ultrasound combined with detections of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9) and hypersensitive C-reactive protein (hs-CRP) in the stability of atherosclerotic plaque.

  Methods  Totally 98 patients with atherosclerosis were conducted with carotid ultrasound and detections of VEGF, MMP-9 and hs-CRP. Taking the results of follow-up and magnetic resonance imaging as controls, the results of carotid ultrasound and carotid ultrasound combined with VEGF, MMP-9, hs-CRP were compared, and the serum levels of VEGF, MMP-9 and hs-CRP in patients with different plaque types were compared as well.

  Results  Follow-up and histopathological findings showed that among 98 patients with atherosclerosis, 33 cases had no plaque, 32 cases had stable plaque and 33 cases had vulnerable plaque. The accuracy of carotid ultrasound combined with VEGF, MMP-9 and hs-CRP in detecting non-plaque, stable plaque and vulnerable plaque was significantly higher than that of carotid ultrasound (P < 0.05). The serum levels of VEGF, MMP-9 and hs-CRP in patients with stable plaque were significantly higher than those without plaque, and was significantly lower than those with vulnerable plaque (P < 0.05).

  Conclusion  Carotid ultrasound combined with detection of VEGF, MMP-9 and hs-CRP can accurately determine the nature of atherosclerotic plaque and reflect the stability and degree of atherosclerotic plaque.

  Objective  To investigate the efficacy and safety of clopidogrel and tigrillo in treating elderly acute coronary syndrome (ACS) patients with hepatic injury caused by statins.

  Methods  Totally 160 elderly patients with ACS were randomly divided into control group and observation group, with 80 cases in each group. The control group was treated with clopidogrel, while the observation group was treated with tigrillo. The platelet aggregation rates at 3, 7 and 30 days after medication, the occurrence of cardiovascular and cerebrovascular adverse events (recurrent angina pectoris, heart failure, myocardial infarction, stroke) and the safety of medication (major bleeding events, minor bleeding events, dyspnea and creatinine elevation) were observed in both groups.

  Results  The platelet aggregation rates at 3, 7 and 30 days after medication in the observation group were significantly lower than those in the control group (P < 0.05). The incidence rate of cardiovascular and cerebrovascular events in the control group was significantly higher than that in the observation group (P < 0.05). There were no major bleeding events in both groups. The number of patients with secondary bleeding events in the observation group was more than that in the control group, but there was no significant difference (P>0.05). The incidence rate of dyspnea in the observation group was higher than that in the control group at 2 months of follow-up, but then decreased significantly. There was no increase of creatinine in both groups.

  Conclusion  Tigrillo is safe in the treatment of elderly ACS patients with statin-induced liver dysfunction. No major bleeding events and dyspnea symptoms occur in the patients, and theincidence rate of cardiovascular and cerebrovascular events is low.

  Objective  To investigate the effect of Yiqi Yangxin Huoxue Recipe on blood lipid and hemorheological level in patients with angina pectoris differentiated as type of deficiency of Qi and Yin complicated with blood stasis.

  Methods  A total of 126 patients with angina pectoris differentiated as type of deficiency of Qi and Yin complicated with blood stasis were selected and randomly divided into experimental group (n=63) and control group (n=63). The control group was treated with conventional western medicine, while the experimental group was treated with Yiqi Yangxin Huoxue Decoction on the basis of control group. The clinical efficacy, electrocardiogram efficacy and adverse reactions of the two groups were compared. The scores of TCM symptoms, blood lipid indexes [high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC)], hemorheological indexes [plasma viscosity, hematocrit (HCT), erythrocyte aggregation index (EAI)] were compared before treatment and 1 month after treatment in both groups.

  Results  The clinical effect and electrocardiogram effect of the experimental group were significantly better than those of the control group (P < 0.05). After one month of treatment, the scores ofTCM symptoms in both groups were significantly lower than those before treatment, and the scores in the experimental group were significantly lower than those in the control group (P < 0.05). One month after treatment, the levels of HDL-C in both groups were significantly higher than those before treatment, while the levels of LDL-C, TG and TC were significantly lower than those before treatment, and the indexes in experimental group were significantly better than those in the control group (P < 0.05). One month after treatment, plasma viscosity, HCT and EAI levels in both groups were significantly lower than those before treatment, and the indexes in experimental group were significantly lower than those in the control group (P < 0.05). The incidence rate of adverse reactions in the experimental group was 9.52%, which showed no significant difference when compared to 7.94% in the control group (P>0.05).

  Conclusion  Yiqi Yangxin Huoxue Recipe can effectively relieve the clinical symptoms of patients with angina pectoris differentiated as type of deficiency of Qi and Yin complicated with blood stasis, which can improve blood lipid metabolism and hemorheology.

  Objective  To investigate the effect of oral administration of aspirin and lipitor in combination for patients with different types of carotid plaques.

  Methods  A total of 80 patients with carotid artery plaques in our hospital were divided into soft plaque group (n=45), mixed type plaque group(n=16)and hard plaque group (n=19). Patients of three groups were given oral administration of aspirin and lipitor in combination. The plaque size, serum inflammatory index and blood lipid of the three group before treatment and 6, 12 months after treatment were compared.

  Results  Compared with before treatment, soft plaque group and mixed plaque group were significantly smaller at 6 and 12 months after treatment (P < 0.05), and the outcomes at 12 months was better than at 6 months, but the size of hard plaque group has no obvious change(P>0.05). Compared with before treatment, the serum hypersensitive C reactive protein (hs-CRP), plasma total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) at 6 and 12 months after treatment of three groups were significantly decreased, but high-density lipoprotein (HDL-C) was increased(P < 0.05), and the results of at 12 months after treatment was better than that at 6 months after treatment.

  Conclusion  Combined oral administration of aspirin and lipitor can significantly reduce the soft and mixed type of carotid artery plaques, and it can improve patients′serum inflammatory reaction and lipid levels, but the effect of hard plaques treatment is not obvious.

  Objective  To investigate the diagnostic value of coronary CT angiography (CTA) in plaque characteristics of patients with acute coronary syndrome (ACS).

  Methods  A total of 100 patients with ACS were selected as study group, and 50 patients with stable angina pectoris during the same period were selected as control group. All patients were diagnosed by CTA. Taking coronary angiography as the gold standard, the diagnostic accuracy, specificity and sensitivity of CTA for plaque characteristics of ACS patients were evaluated.

  Results  The diagnostic accuracy, specificity and sensitivity of CTA were 96.00% (96/100), 90.00% (27/30) and 98.57% (69/70), respectively. The load and resistance index(RI) of non-calcified plaques in the study group were higher than those in the control group, while the minimum density of plaques was lower than those in the control group(P < 0.05).

  Conclusion  CTA has high accuracy, specificity and sensitivity in the diagnosis of plaque characteristics in ACS patients, and can accurately differentiate plaque load between ACS patients and stable angina patients.

  Objective  To evaluate the efficacy of butylphthalide injection combined with rosuvastatin calcium tablets for patients with acute progressive cerebral infarction and its impact on high sensitivity C reactive protein (hs-CRP) and neurological function.

  Methods  A total of 120 patients with acute progressive cerebral infarction were divided into two groups according to random number table method. The control group was given rosuvastatin calcium tablets, while the study group received butylphthalide injection and rosuvastatin calcium tablets. Clinical effects, hs-CRP level, National Institutes of Health Stroke Scale(NIHSS)score, modified mental state scale(MMSR)score, homocysteine(Hcy), tumor necrosis factor-α(TNF-α), low density lipoprotein cholesterol(LDL-C).

  Results  After treatment, the total effective rate of the study group was higher than that of the control group(P < 0.05). The NIHSS score of the study group was lower, and MMSR score was higher than that of the control group, and Hcy, hs-CRP, TNF-α and LDL-C levels in the study group were lower than that of the control group(P < 0.05).

  Conclusion  Butylphthalide injection combined with rosuvastatin for patients with acute progressive cerebral infarction can improve clinical outcomes, improve neurological and cognitive function, reduce Hcy, hs-CRP, TNF-α and LDL-C levels.

  Objective  To investigate the effects of butylphthalide combined with alteplase on neurological function, fibrinolytic activity and inflammation factors in patients with ischemic cerebral infarction.

  Methods  A total of 84 patients with ischemic cerebral infarction admitted to our hospital were randomly divided into two groups. The control group was treated with ateplase and the research group was treated with butylphthalide on the basis of the control group. The therapeutic effect, life ability, infarction size, National Institute of Health Stoke Scale(NIHSS) score, inflammatory factor level, renal function and incidence of adverse reactions were compared between the two groups.

  Results  The therapeutic effect of the study group was better than that of the control group (P < 0.05). After treatment, the living ability of the study group was higher, and the infarct size was less and NIHSS score was lower than the control group, the difference was statistically significant (P < 0.05). The inflammatory factor level of the study group was lower than that of the control group (P < 0.05). There was no significant difference in renal function between the two groups before treatment (P>0.05). After treatment, the creatinine clearance rate of the study group was higher than that of the control group, 24 h urine protein quantitation. The serum creatinine(Scr) level was lower than that of the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

  Conclusion  For patientswith ischemic cerebral infarction, butylphthalide combined with alteplase is effective, which can effectively improve clinical symptoms, reduce inflammatory response, improve living ability, and reduce infarct size and NIHSS score. In addition, the treatments in combination can reduce the incidence of adverse reactions, and has higher safety, and can improve the prognosis of patients.

  Objective  To investigate the effect of nimodipine combined with edaravone in the treatment of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH).

  Methods  A total of 80 patients with CVS after SAH were randomly divided into observation group and control group, with 40 cases in each group. Both groups were given routine treatment, the control group was treated with edaravone by intravenous drip, while the observation group was treated with edaravone combined with nimodipine by intravenous drip. The total effective rate, levels of inflammatory factors, serum S100β protein, endothelin-1 (ET-1), blood flow velocity of middle cerebral artery (MCA), Glasgow coma score (GCS), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI) before and after treatment and adverse reactions were compared between the two groups.

  Results  The total effective rate of the observation group was 97.50%, which was significantly higher than 85.00% of the control group (P < 0.05). After treatment, the levels of inflammatory factors, serum S100β protein, ET-1 and MCA blood flow velocity of the observation group were significantly lower than those of the control group (P < 0.05). After treatment, the GCS score and BI of the observation group were significantly higher than those of the control group, and the NIHSS score was significantly lower than that of the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

  Conclusion  The combination of nimodipine and edaravone is effective in the treatment of CVS after SAH, which can effectively inhibit inflammatory response and reduce the severity of CVS.

  Objective  To explore the influence of transcatheter arterial chemoembolization (TACE) combined with radioactive partial implantation on CT perfusion imaging parameters in patients with primary liver cancer (PLC).

  Methods  Totally 104 patients with PLC were randomly divided into control group and experimental group, with 52 cases in each group. The control group was treated with TACE, while the observation group was treated with TACE combined with radioactive seed implantation. The objective remission rate, alpha fetoprotein (AFP) and carcinoembryonic antigen (CEA), the levels of peripheral blood T lymphocyte subsets and natural killer cells (NK) after treatment were compared between two groups. Changes of CT perfusion parameters and incidence of adverse reactions before and after treatment were compared between two groups.

  Results  One month after treatment, the objective remission rate of the observation group was significantly higher than that of the control group (P < 0.05). The serum CEA and AFP levels of the two groups were significantly lower than those before treatment (P < 0.05), and the serum CEA and AFP levels of the observation group were significantly lower than those of the control group (P < 0.05). The levels of CD4⁺, CD3⁺, CD4⁺/CD8⁺ and NK cells of the observation group were significantly higher than those of the control group (P < 0.05), while the level of CD8⁺ in the observation group was significantly lower than that in the control group (P < 0.05). The blood volume (BV), surface permeability (PS), blood flow (BF), hepatic artery fraction (HAF) and mean transit time (MTT) in both groups were significantly lower than those before treatment (P < 0.05), and the above indexes in the observation group were significantly lower than those in the control group (P < 0.05). During treatment, there was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05), and no severe adverse reactions occurred.

  Conclusion  TACE interventional therapy combined with radioactive particles can improve the objective remission rate of patients with PLC, reduce the levels of AFP and CEA, increase the levels of T lymphocyte and NK cell, improve the immune ability, enhance the inhibition of angiogenesis of tumor tissue, and reduce CT perfusion parameters.

  Objective  To explore the expression levels and significance of peripheral blood natural killer cells (NK), CD3⁺, CD4⁺, CD8⁺, CD8⁺CD28^- and the immune related factors such as tumor necrosis factor-α (TNF-α), interleukin (IL)-2, interferon-γ (IFN-γ), IL-22, IL-8 in patients with colorectal cancer (CRC).

  Methods  Totally 80 CRC patients, 54 patients with chronic enteritis and 36 healthy volunteers were selected as intestinal cancer group, benign group and healthy group. Serum levels of TNF-α, IL-2, IFN-γ, IL-22, IL-8 and peripheral blood NK, CD3^+, CD4⁺, CD8⁺, CD8⁺CD28^- were detected in all the groups. One-way ANOVA method was used to analyze the immune-related indexes. At the same time, the non-parametric Kruskal Wallis rank sum test was used to analyze the correlation between the expression of immune-related factors and pathological time in CRC patients.

  Results  There were significant differences in peripheral blood NK, CD3⁺, CD4⁺, CD8⁺, CD8⁺CD28^- levels and serum TNF-α, IL-2, IFN-γ, IL-22, IL-8 among the three groups (P < 0.05). Compared with the healthy group, the peripheral blood CD8⁺, CD8⁺CD28^- contents and serum TNF-α, IL-22, IL-8 levels significantly increased in the benign group and the intestinal cancer group, while the peripheral blood NK, CD3⁺, CD4⁺ and serum IL-2, IFN-γ levels significantly decreased (P < 0.05). Compared with benign group, the TNF-α, IL-22, IL-8 levels and peripheral blood CD8⁺, CD8⁺CD28ˉ contents increased significantly in the intestinal cancer group, while serum IL-2, IFN-γ levels and peripheral blood NK, CD3⁺, CD4⁺ levels significantly decreased (P < 0.05). There were significant differences in serum TNF-α, IL-2, IFN-γ, IL-22, IL-8 and peripheral blood NK, CD3⁺, CD4⁺, CD8⁺ and CD8⁺CD28^- levels in patients with different clinical stages of CRC (P < 0.05). From stage Ⅰ to Ⅳ of TNM, serum TNF-α, IL-22, IL-8 levels and peripheral blood CD8⁺, CD8⁺CD28^- levels significantly increased, while IL-2, IFN-γ levels and the contents of NK, CD3⁺ and CD4⁺ significantly reduced (P < 0.05).

  Conclusion  The immune-related factors such as TNF-α, IL-2, IFN-γ, IL-22, IL-8 and peripheral blood immune cells play important roles in the development of CRC, which can be used as important factors to reflect the progress of CRC and evaluate the clinical therapeutic effect of patients.

  Objective  To investigate the effect of dezocine injection combined with dexmedetomidine on the postoperative pain and quality of life in patients with advanced liver cancer.

  Methods  A total of 64 patients with advanced liver cancer were selected and randomly divided into experimental group and control group, with 32 cases in each group. The control group was anesthetized with remifentanil during operation, while the experimental group was anesthetized with dzocine combined with dexmedetomidine on the basis of the control group. The extubation time, recovery time, orientation recovery time and pain degrees at 2, 6 and 24 hours after operation were compared between two groups. The scores of dimensions of SF-36 before operation and 7 days after operation were compared between two groups. The incidence rate of adverse reactions within 24 hours after operation was compared between the two groups.

  Results  The Visual Analogue Scale (VAS) scores of the experimental group at 2, 6 and 24 hours after operation were significantly lower than those of the control group (P < 0.05). The extubation time, recovery time and orientation recovery time of the experimental group were significantly shorter than those of the control group (P < 0.05). Before operation, there were no significant differences in the scores of dimensions of SF-36 between the two groups (P>0.05). After operation, the scores of physical function, psychological function and life function increased significantly in both groups (P < 0.05), and the scores of dimensions of SF-36 in the experimental group were significantly higher than those in the control group (P < 0.05). The incidence of postoperative adverse reactions in the experimental group was significantly lower than that in the control group (P < 0.05).

  Conclusion  Dezocine injection combined with dexmedetomidine can significantly alleviate postoperative pain in patients with advanced liver cancer, shorten the recovery time and improve the quality of life.

  Objective  To investigate the magnetic resonance imaging (MRI) characteristics and pathological basis of atypical meningiomas.

  Methods  The MRI materials of 20 patients with atypical meningioma confirmed by surgery and pathology were retrospectively analyzed, including imaging features (cystic degeneration, lobulation, enhancement mode and degree, tumor-brain interface, adjacent skull signs) and pathological basis.

  Results  The tumors were located on convex surface in 12 cases, beside falciform surface in 6 cases, and beside sigmoid sinus in 2 cases. Typical MRI findings showed clear boundary soft tissue masses. The lesion showed iso-signal or hypo-signal on T₁WI, and hyper-signal on T₂WI. The space-occupying effect was more significant than edema. Cystic degeneration and necrosis were found in the tumors. Enhanced scan showed heterogeneous enhancement.

  Conclusion  The incidence rate of atypical meningioma is low, and its MRI manifestations has certain characteristics. Preoperative localization and qualitative diagnosis of tumors can be achieved by plain and enhanced MRI scans.

  Objective  To observe the effect of closed sputum suction combined with mechanical ventilation in the treatment of neonatal ventilator-associated pneumonia.

  Methods  A total of 80 neonates with mechanical ventilation in neonatal intensive care unit in our hospital were selected as research objects, and were divided into two groups by random number table method, with 40 cases in each group. The patients of two groups were treated with mechanical ventilation, the control group was treated with conventional sputum suction, while the observation group was treated with closed sputum suction. The arterial blood gas index, occurrence of complications, mortality, length of hospital stay, hospitalization expenses and bacterial flora were compared between the two groups.

  Results  Before treatment, there were no significant differences in the levels of arterial partial pressure of oxygen [p(O₂)] and nitrogen dioxide [p(CO₂)] between the two groups (P>0.05). After treatment, the levels of p(O₂) and p(CO₂) in the two groups were significantly improved, and the level of p(O₂) in the observation group was significantly higher, while the level of p(CO₂) was significantly lower than that in the control group (P < 0.05). There were no significant differences in intracranial hemorrhage, airway injury, air leakage and mortality between the two groups (P>0.05); the incidence of ventilator-associated pneumonia in the observation group was significantly lower, and the hospitalization time was significantly shorter, the cost of hospitalization was significantly lower, and the number of bacteria was significantly less than that in the control group (P < 0.05); there was no significant difference in mortality between the two groups (P>0.05).

  Conclusion  Closed sputum aspiration combined with mechanical ventilation can effectively reduce the incidence of neonatal ventilator-associated pneumonia, shorten the duration of mechanical ventilation and hospitalization stay.

  Objective  To investigate the efficiency of glucocorticoids (GCs) combined with azithromycin in treatment of children with lobar pneumonia and its influence on levels of serum inflammatory factors.

  Methods  Totally 118 children with lobar pneumonia were randomly divided into control group and observation group, with 59 cases in each group. The control group was treated with azithromycin, and the observation group was treated with methylprednisolone plus azithromycin. The therapeutic effect, symptoms, signs and changes of serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), procalcitonin (PCT) and other inflammatory factors were compared between the two groups.

  Results  The fever regression time, cough and rale disappearance time, lung shadow absorption time, hospitalization time, and levels of serum CRP, TNF-α, IL-6 and PCT in the observation group were significantly better than those in the control group (P < 0.05), and the total effective rate was significantly higher than that in the control group (P < 0.05).

  Conclusion  GCs combined with azithromycin is effective in the treatment of children with lobar pneumonia, which can quickly alleviate clinical symptoms and signs, shorten the course of disease, and the safety isgood.

  Objective  To explore the effects of different doses of recombinant human interferon alpha α-1b on central nervous system of severe hand, foot and mouth disease.

  Methods  A total of 264 children with severe hand, foot and mouth disease treated in our hospital were selected as research objects. According to the random number table method, the children were divided into three groups, the control group was treated with ribavirin, the low dose group was treated with 2 μg/kg recombinant human interferon α-1b on the basis of ribavirin, and high dose group was treated with 4 μg/kg recombinant human interferon α-1b. Serological parameters, blood routine results and improvement of clinical symptoms were observed and compared.

  Results  There was no significant difference in C Reactive Protein (CRP) among the three groups (P>0.05). The levels of nervous specific enolase and S-100 protein in the control group were significantly higher than those in the low-dose group and the high-dose group (P < 0.05), and were significantly higher in the low-dose group than those in the high-dose group (P < 0.05). There was no significant difference in platelet count among the three groups (P>0.05). The neutrophils count in the control group was significantly higher than that in the low-dose group and the high-dose group (P < 0.05). The subsidence time of fever and skin rash of the control group were significantly longer than those of the low-dose group and the high-dose group (P < 0.05), and were significantly higher in the low-dose group than those of the high-dose group (P < 0.05).

  Conclusion  Recombinant human interferon α-1b has significant effect in the treatment of severe hand, foot and mouth disease. It can significantly improve the clinical symptoms of children, and has a significant protective effect on the central nervous system for atomization inhalation of high-dose recombinant human interferon α-1b. Therefore, the dosage should be selected according to the tolerance of children.

  Objective  To investigate the clinical characteristics and prognostic factors of very low birth weight (VLBW) in our hospital.

  Methods  The clinical data of 120 VLBW neonates admitted to our hospital were reviewed. The clinical characteristics of neonates with VLBW, maternal perioperative basic information, and the incidence of complications of neonates were analyzed, the prognostic factors of the VLBW neonates were summarized.

  Results  The gestational age and birth weight of neonates in the unhealed group were significantly lower than those in the cured group(P < 0.05), and the length of hospital stay was shorter than that in the cured group(P < 0.05). There were no significant differences in dilivery age, and the ratios of gestational diabetes mellitus and habitual abortion(P>0.05). The proportion of mothers with higher child-bearing age in the unhealed group was significantly higher than that in the cured group(P < 0.05), and there was significant difference in ratio of gestational diabetes between two groups(P < 0.05). The incidences of complications such as respiratory failure, hyperlactacidemia and hypoglycemia in the cured group was significantly lower than that in the unhealed group(P < 0.05).

  Conclusion  The VLBW infants affecting by many factors have higher mortality. Therefore, reasonable management and treatment programs should be developed according to these factors in clinical practice, so as to improve the survival rate and quality of life of VLBW infants.

  Objective  To investigate the effect of mucopolysaccharide polysulfate cream combined with zinc oxide ointment on the levels of interferon-γ (IFN-γ), interleukin-4 (IL-4) and interleukin-10 (IL-10) in eczema infants.

  Methods  A total of 80 infants with eczema admitted to our hospital were randomly divided into control group (n=40) and observation group (n=40). The control group was treated with mucopolysaccharide polysulfate cream, while the observation group was treated with mucopolysaccharide polysulfate cream combined with zinc oxide ointment. The levels of IFN-γ, IL-4 and IL-10 before and after treatment were compared between the two groups. The clinical efficacy and the score of clinical symptoms were compared between the two groups.

  Results  There was no significant difference in the levels of IFN-γ, IL-4 and IL-10 between the two groups before treatment (P>0.05). After treatment, the level of IFN-γ in the observation group was higher and levels of IL-4 and IL-10 in the observation group were significantly lower than those in the control group (P < 0.05). The total effective rate in the observation group was higher, and clinical symptom scores in the observation group was better than that in the control group (P < 0.05).

  Conclusion  The therapeutic effect of two ointments for infants with eczema is ideal, which can effectively improve the level of cytokines and the clinical symptoms of children.

  Objective  To investigate the effect of cluster nursing intervention in inhalation treatment of respiratory diseases in children.

  Methods  A total of 60 children with respiratory diseases admitted to our hospital were randomly divided into control group (conventional nursing) and observation group (cluster nursing), with 30 cases in each group. Nursing results of two groups were analyzed.

  Results  After cluster nursing, the total effective rate was 93.33% in observation group, which was significantly higher than 73.33% in the control group(P < 0.05). The remission time of clinical symptoms in observation group was significantly better than that in the control group(P < 0.05); the average hospital stay in the observation group was significantly shorter than that in the control group(P < 0.05); the satisfaction of parents in observation group was significantly higher than that of the control group (100.00% vs. 83.33%, P < 0.05).

  Conclusion  Cluster nursing can promote the recovery of children and improve parents′satisfaction.

  Objective  To investigate the effects of health belief mode on nebulization treatment compliance and disease control in bronchopneumonia children.

  Methods  A total of 80 bronchopneumonia children who underwent nebulization treatment were randomly divided into observation group and control group, with 40 cases in each group. The control group was given routine nursing, while observation group was given health belief mode on the basis of routine nursing. The disease cognition level of children′s family members and treatment compliance of children before and after intervention were compared between the two groups. The curative effect and occurrence of complications after intervention in both groups were observed.

  Results  After intervention, medication compliance, dietary compliance and exercise compliance of both groups were increased (P < 0.05), and scores of disease knowledge of children′s family members, dietary contraindications and knowledge of doctor-visiting persistence were increased (P < 0.05). Compared with control group, medication compliance, diet compliance and exercise compliance in observation group were increased (P < 0.05), and scores of disease knowledge of children′s family members, dietary contraindications and knowledge of doctor-visiting persistence were increased (P < 0.05). The effective rate of clinical treatment in observation group was higher than that in control group (90.00% vs. 85.00%, P < 0.05).

  Conclusion  The health belief mode can improve disease cognition level of children′s family members, and increase treatment compliance of bronchopneumonia children.

  Objective  To study the clinical significance of blood lipid level in patients with gestational diabetes mellitus (GDM) in late pregnancy and its impact on neonates.

  Methods  A total of 101 GDM patients were selected as GDM group, and 103 pregnant women with normal glucose tolerance in the same period were as control group. The neonatal weight, incidence of fetal macrosomia and weight gaining of puerperas in both groups were evaluated.

  Results  Patients in GDM group was older than those in control group, and the total cholesterol (TC) level in GDM group was higher than that in control group (P < 0.05). A higher neonatal weight and incidence of macrosomia was found in GDM group compared with control group (P < 0.05). However, there were no significant differences in weight of fetal macrosomia, and Apgar scores at birth and 5 min after birth in two groups (P>0.05).

  Conclusion  GDM is mostly accompanied with abnormal lipid metabolism during abnormal glucose metabolism process. Therefore, attention should be paid not only to diet control, proper exercise, and rational use of insulin, but also to monitoring of blood lipid, insulin resistance reduction, and improvement of pregnancy outcomes, thus ensuring the maternal and child health.

  Objective  To explore the effect of low molecular weight heparin combined with aspirin on efficacy and maternal and infant outcomes in patients with preeclampsia.

  Methods  Totally 200 patients with preeclampsia were selected and randomly divided into heparin plus aspirin group and aspirin group, with 100 cases in each group. The aspirin group was given aspirin and symptomatic treatment, while the heparin plus aspirin group was given low molecular weight heparin treatment on the basis of the aspirin group. The coagulation function indexes [D-dimer (D-D), plasma fibrinogen (FIB)], blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], the ratio of maximum systolic blood flow velocity of uterus and umbilical artery to end-diastolic blood flow velocity (S/D), maternal and infant outcomes and adverse reactions were compared between the two groups.

  Results  After treatment, D-D, FIB, SBP, DBP, S/D values of uterus and umbilical artery in both groups were significantly lower than those before treatment, while D-D, FIB, SBP, DBP, S/D values of uterus and umbilical artery in the heparin plus aspirin group were lower than those in the aspirin group (P < 0.05), and the incidence rate of adverse maternal and infant outcomes in the heparin plus aspirin group was significantly lower than that in the aspirin group (P < 0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05).

  Conclusion  Low molecular weight heparin combined with aspirin can effectively improve the blood coagulation function, blood pressure, blood flow status of uterine and umbilical artery in patients with preeclampsia.

  Objective  To investigate the clinical value of early diagnosis in elderly patients with pulmonary embolism.

  Methods  A total of 115 elderly patients with pulmonary embolism who were examined in our hospital were selected as group A, and another 115 non-elderly patients with pulmonary embolism who were examined at the same period were selected as group B. Among them, there were 56 males and 59 females in group A, aged 60 years and above, 57 males and 58 females in group B, aged below 60 years.

  Results  There was no significant difference in the ratio of male to female in group A(48.70%vs. 51.30%) and group B(49.57%vs. 50.43%) (P>0.05). The age, mortality within 30 days, mortality after 30 days, and rate of thrombolytic therapy were (74.31±1.23) years, 21.74%, 42.61%, 9.57%, respectively, in group A, which were significantly higher than (50.38±1.08) years, 10.43%, 13.91%and 3.49%, respectively, in the group B(P < 0.05). There was no significant difference in the incidence of complicating with tumors between group A (11.30%) and group B (12.17%) (P>0.05). The incidences of arrhythmia, pneumonia, cardiac insufficiency, chronic obstructive pulmonary disease, renal insufficiency, hypertension, hypoproteinemia, diabetes and hyperlipidemiain were 31.30%, 33.91%, 36.52%, 26.96%, 37.39%, 65.21%, 18.26%, 32.17%, 16.52%, respectively, in the group A, which were higher than 17.39%, 1.74%, 5.22%, 1.74%, 0.87%, 27.83%, 1.74%, 5.22%, 2.61%, respectively, in group B(P < 0.05)The blood pressure, pulse wave, cardiac troponin I and serum uric acid in group A were significantly higher, and arterial oxygen saturation was significantly lower than that in the control group (P < 0.05). The levels of D-dimer, and serum albumin were (5.89±1.23) mg/L, (24.13±0.23) g/L, respectively, in group A, and were (4.03±0.41) mg/L and (24.09±0.01) g/L, respectively, in group B, which showed no significant differences between two groups.

  Conclusion  Early diagnosis is of high clinical value for elderly patients with pulmonary embolism. The high-risk indicators of early diagnosis can be reference for timely treatment.

  Objective  To explore the effect of argon plasma coagulation (APC) under digestive endoscope in treatment of gastroduodenal hemorrhage.

  Methods  Totally 70 patients with gastroduodenal hemorrhage were selected. According to surgical methods, the patients were divided into control group and observation group, with 35 cases in each group. The control group was treated by injection under digestive endoscope, while the observation group was treated by APC under digestive endoscope. The curative effect, hospitalization time, blood transfusion volume, bleeding volume, hemostasis time and the incidence rate of complications were compared between two groups.

  Results  The total effective rate of the observation group was 97.14%, which was significantly higher than 80.00% of the control group (P < 0.05). The hospitalization time and hemostasis time of the observation group were (5.45±0.64) days and (1.77±0.20) days, which were significantly shorter than (8.95±0.82) days and (3.20±0.46) days of the control group (P < 0.05). The blood transfusion volume and the amount of blood transfusion in the observation group were (423.16±45.61) mL and (388.68±42.44) mL, which were significantly less than (804.28±86.90) mL and (521.52±57.14) mL in the control group (P < 0.05). The incidence rate of complications in the observation group was 5.71%, which was significantly lower than 25.71% in the control group (P < 0.05).

  Conclusion  APC under digestive endoscopy is effective in treatment of gastroduodenal hemorrhage, which can stop bleeding quickly and reduce incidence of complications.

  Objective  To compare the clinical effect of traditional excision and laser excision in the operation for mucous gland cyst of lower lip.

  Methods  Totally 50 patients with mucous gland cyst of lower lip were randomly divided into observation group and control group, with 25 cases in each group. The patients in the observation group were treated with laser, while the patients in the control group were treated with traditional excision. The operation condition, clinical effect and pain degree were compared between the two groups.

  Results  The number of patients with intraoperative bleeding, operation time and wound healing time in the observation group were significantly better than those in the control group (P < 0.05). The degree of pain in the observation group was significantly lower than that in the control group (P < 0.05). The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05). The incidence rate of complications in the observation group was significantly lower than that in the control group (P < 0.05).

  Conclusion  Compared with traditional excision, laser excision has the advantages of simple manipulation and less bleeding in the operation for mucous gland cyst of lower lip, which can improve the total effective rate of treatment.

  Objective  To evaluate the value of delivery ball and free position in promoting delivery of primiparas.

  Methods  A total of 84 delivery primiparas in obstetrics department were divided into control group (n=42, traditional delivery intervention) and observation group (n=42, delivery ball and free position) according to random number table method. The delivery results of the two groups were compared.

  Results  The rate of vaginal delivery in the observation group was higher, the rate of forceps assisted delivery was lower, and the incidence of complications during delivery was lower than that in the control group(P < 0.05). The observation group had shorter first stage of labor, second stage of labor and third stage of labor, and higher sense of labor control than the control group (P < 0.05).

  Conclusion  The delivery ball and free position can shorten the delivery time and reduce the rate of cesarean section.

  Objective  To explore the efficiency of physiological anchorage control technology in patients with tooth extraction for orthodontics.

  Methods  Totally 70 patients with tooth extraction were randomly divided into control group (n=35) and experimental group (n=35). The control group was treated with bracket correction and auxiliary anchorage device, while the experimental group was treated with physiological anchorage control technology. Therapeutic time and therapeutic effect of the two groups were compared.

  Results  The therapeutic time of the experimental group was (3.62±0.87) months, which was significantly shorter than (4.78±1.54) months of the control group (P < 0.05). There were significant differences in U1-NA angle and U1-NA before and after treatment in the experimental group (P < 0.05). There were significant differences in U1-SN, U1-NA, NLA and U1-L1 before and after treatment in the control group (P < 0.05).

  Conclusion  Application of physiological anchorage control technology in tooth extraction can effectively enhance the anchorage of molars, reduce the use of additional anchorage and shorten the alignment time.

  Objective  To explore the clinical efficacy of traditional Chinese medicine decoction combined with aripiprazole in the treatment of chronic schizophrenia.

  Methods  Sixty patients with chronic schizophrenia were randomly divided into combined treatment group (traditional Chinese medicine decoction combined with aripiprazole) and single treatment group (aripiprazole only), with 30 cases in each group. The score of positive and negative syndrome scale (PANSS), quality of life, incidence of adverse reactions and clinical efficacy were compared between the two groups.

  Results  The scores of psychopathology, positive symptoms, negative symptoms and PANSS in both groups after treatment were significantly lower than those before treatment (P < 0.05), and the scores of items mentioned above in the combined treatment group were significantly lower than those in the single treatment group (P < 0.05). The scores of symptoms/side effects, energy/motivation, psychological/social and total score of Schizophrenia Quality of Life Scale (SQLS) in both groups after treatment were significantly lower than those before treatment (P < 0.05), and the scores of items mentioned above in the combined treatment group were significantly lower than those in the single treatment group (P < 0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). The total effective rate of the combined treatment group was 96.7%, which was significantly higher than 80.0% of the single treatment group (P < 0.05).

  Conclusion  Traditional Chinese medicine decoction combined with aripiprazole is effective in the treatment of chronic schizophrenia.

  Objective  To investigate the effect of Morita therapy combined with Orem self-care intervention on prognosis of acute traumatic fracture patients with depression.

  Methods  Totally 86 acute traumatic fracture patients with depression were selected and randomly divided into control group (routine nursing intervention) and observation group (Morita therapy combined with Orem self-care intervention) according to admission order, with 43 cases in each group. Hamilton Depression Scale (HAMD) was used to evaluate depression in both groups. Generic Quality of Life Inventor-74 (GQOLI-74) was used to assess quality of life in both groups. The awareness rate of health knowledge, nursing satisfaction degree and incidence of complications were compared between the two groups.

  Results  After intervention, the HAMD scores in both groups were significantly lower than those before treatment, and the HAMD score of the observation group was significantly lower than that of the control group (P < 0.05). After intervention, the awareness rate of health knowledge and nursing satisfaction score of the observation group were significantly higher than those of the control group (P < 0.05). After intervention, the scores of physical function, psychological function, social function and material function in both groups were significantly higher than those before intervention, and the scores of physical function and psychological function in the observation group were significantly higher than those in the control group (P < 0.05). The incidence rate of complications in the observation group was significantly lower than that in the control group (P < 0.05).

  Conclusion  For acute traumatic fracture patients with depression, the Morita therapy combined with Orem self-care intervention can alleviate depression, improve prognosis and quality of life, and improve self-care ability.

  Objective  To explore the effect of cognitive behavioral intervention on psychological stress indicators and treatment compliance of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).

  Methods  A total of 80 patients who underwent endoscopic retrograde cholangiopancreatography in our hospital were selected as study subjects, and were randomly divided into control group and observation group according to the order of admission, with 40 cases per group. The control group received routine nursing, while the observation group received cognitive behavioral intervention on the basis of routine nursing. The anxiety, depression score, nursing satisfaction and treatment compliance of the two groups were compared.

  Results  The scores of Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale (SDS) after nursing in the observation group were lower than those in the control group(P < 0.05). The treatment compliance and nursing satisfaction of the patients in the observation group were higher than those in the control group(P < 0.05).

  Conclusion  The cognitive behavioral intervention for patients undergoing endoscopic retrograde cholangiopancreatography can improve their treatment compliance and prognosis.