Objective: To explore and analyze the effect of acupoint application combined with microwave treatment on the intestinal barrier dysfunction with moderately severe acute pancreatitis. Methods: A convenient sample of 9...Objective: To explore and analyze the effect of acupoint application combined with microwave treatment on the intestinal barrier dysfunction with moderately severe acute pancreatitis. Methods: A convenient sample of 90 moderately severe acute pancreatitis was selected from March 2017 to December 2017 in the comprehensive hospital with third grade in Tianjin. The patients were divided into group A (acupoint application combined with microwave treatment), group B (acupoint application) and group C (routine nursing). Thirty patients were included in each group. This study need to get the informed consent of the patients. Acupoint application combined with microwave treatment was used, basing on routine nursing measures in group A. Acupoint application was used by the same way and the same traditional Chinese medicine ,basing on routine nursing measures in group B. Routine nursing used in group C. C-reactive protein and the score of intestinal function were measured on 3 th day, 7 th day and 10 th day, after intervention. To record the effective ratio of the treatment after 10 days of intervention. Results: There are significant statistical difference among the three group after intervention (P < 0.05). Conclusion: In some way, acupoint application combined with microwave treatment are able to decrease the time about the recovery of intestinal barrier dysfunction in moderately severe acute pancreatitis and to alleviate the suffering of patients.展开更多
Objective:Lung cancer has the highest incidence and mortality of all malignant tumors in China.Cancer pain dramatically affects patients’comfort level,causing insomnia,anorexia,anxiety,fear,depression,and a decline i...Objective:Lung cancer has the highest incidence and mortality of all malignant tumors in China.Cancer pain dramatically affects patients’comfort level,causing insomnia,anorexia,anxiety,fear,depression,and a decline in the quality of life(QOL).The literature suggests a shortage of adequate cancer pain management for 59.1% of patients in China.The quality control circle(QCC)activity reflects the people-oriented core idea of management.This study aimed to assess the efficacy of QCC in enhancing the effectiveness of drug interventions in lung cancer patients with moderate to severe pain.Methods:From January 2019 to July 2019,lung cancer patients with moderate to severe pain were treated with drugs.The total number of drug interventions was 3072.A QCC activity was performed following the ten steps of the plan-do-check-act(PDCA)model.The reasons for the poor effectiveness of drug intervention in lung cancer patients with moderate to severe pain were analyzed.Countermeasures were designed to improve the effectiveness of drug intervention,including setting up a pain college,writing a medication education manual,and formulating operational rules for the administration of narcotic drugs.The effectiveness of drug intervention in lung cancer patients with moderate to severe pain and activity ability scores of QCC members were analyzed statistically before and after QCC activity.The effectiveness of drug intervention was investigated and compared before and after establishing the QCC.Results:After establishing the PDCA model,the effectiveness of drug intervention for moderate to severe pain in lung cancer patients increased from 56.28% to 85.29%.Members had significant improvement in problem-solving ability,responsibility,communication,coordination,self-confidence,team cohesion,enthusiasm,QCC skills,and harmony.Conclusion:QCC activity can significantly improve the efficiency of drug intervention in lung cancer patients with moderate to severe pain and their quality of life.展开更多
Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR gr...Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR group and 62 in the control group)were recruited in this study.The patients in the PR group received 12 weeks of conventional treatment,nursing,and modified pulmonary rehabilitation,while the patients in the control group underwent 12 weeks of conventional treatment,nursing,pursed-lip breathing training,and abdominal breathing training.Baseline characteristics,St.George's Respiratory Questionnaire(SGRQ),the six-minute walk test(6MWT),modified medical research council(MMRC)dyspnea scale,and lung function were compared between the two groups.Results:A total of 112 patients(58 patients in the PR group and 54 patients in the control group)completed the 12-week monitoring and follow-up.The SGRQ scores,symptoms(54.933±11.900),activity(52.644±14.334),impact(55.400±9.905),and total score(54.655±10.681)of the PR group did not significantly differ in pre-and post-treatments(P<0.05).No significant change was also observed in the control group(P>0.05).6MWT[(372.089±67.149)m]was significantly improved in the PR group(P<0.05)but was not significantly different in the control group(P>0.05).MMRC(actual rank sum 1719,rank sum 2047.5)was significantly reduced in the PR group(P<0.05)but not in the control group(P>0.05).The lung function(FVC,FEV1,FEV1/FVC,FEV1%and PEF)of the patients in both groups did not significantly change(P>0.05).Conclusion:Modified PR reduces the symptoms of dyspnea,increases exercise capacity,and improves the quality of life of patients with moderate to severe COPD.展开更多
Objective:To describe the clinical,laboratory and radiological characteristics and outcomes of moderate-to-severe coronvirus disease 2019(COVID-19)patients.Methods:We retrospectively analyzed 43 RT-PCR confirmed moder...Objective:To describe the clinical,laboratory and radiological characteristics and outcomes of moderate-to-severe coronvirus disease 2019(COVID-19)patients.Methods:We retrospectively analyzed 43 RT-PCR confirmed moderate-to-severe COVID-19 patients who were admitted to a tertiary care center.The primary composite outcomes were admission to intensive care unit,requirement of mechanical ventilation,and death.Results:The median age of the patients was 50 years,and 62.8%of the patients were male.Out of 43 patients,15(34.88%)were categorized as severe.A total of 26(60.47%)patients had 1 or more comorbidities[diabetes(34.88%)and hypertension(30.23%)].The median duration from the onset of symptoms to admission was 3 days,and the most common symptoms were dyspnoea(90.7%),cough(79.07%),fever(69.77%),and body ache(46.51%).Leucopenia was presented in 14(32.56%)patients,lymphopenia in 26(60.47%)patients,and monocytosis in 7(16.28%)patients.Besides,40(93.02%)patients had bilateral patchy nodular or interstitial infiltration on chest X-ray.The primary outcomes occurred in 20 patients(46.5%),among whom 8 required mechanical ventilation.The patients who had met the primary outcomes were older.They were prone to have at least 1 comorbidity(P=0.004),diabetes(P=0.01),hypertension,higher sequential organ failure assessment score,more tachycardia,lower SpO2,lower PaO2/FiO2,more thrombocytopenia,and more pancytopenia.Conclusions:This retrospective study identified several risk factors for poor outcomes in adults with COVID-19.In particular,older age,tachycardia,high SOFA score,low SpO2,low PaO2/FiO2,presence of comorbidities in form of diabetes and hypertension,thrombocytopenia,and pancytopenia at admission were associated with higher odds of ICU admission,a requirement of mechanical ventilation and in-hospital death.展开更多
Objective: to analyze the clinical efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis. Methods: a total of 60 patients with moderate to severe atopic dermatitis treated in Beijing Jingcheng...Objective: to analyze the clinical efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis. Methods: a total of 60 patients with moderate to severe atopic dermatitis treated in Beijing Jingcheng Skin Hospital (2021.1-2021.12) were divided into observation group (dupilumab) and control group (conventional treatment). The clinical efficacy (excellent + effective), the improvement time of clinical symptoms (eczema like skin lesions, dry skin, pruritus), EASI (total score of 6, the lower the better) and NRS (total score of 10, the lower the better) were compared after treatment. Results: there were significant differences in clinical efficacy between the observation group (dupilumab) and the control group (conventional treatment) after treatment (P 0.05). There was a significant difference in the improvement time of clinical symptoms between the observation group (dupilumab) and the control group (conventional treatment) after treatment (P 0.05). Before treatment, there were no differences in EASI and NRS scores between the observation group (dupilumab) and the control group (conventional treatment) (P > 0.05), but after treatment, there were differences in EASI and NRS scores between the observation group (dupilumab) and the control group (conventional treatment) (P 0.05). Conclusion: in the treatment of patients, the use of dupilumab can improve the treatment effect, the treatment is obvious, and the symptoms of patients are more obvious, the score of pruritus is more obvious, which is conducive to improve the quality of life of patients, and is worthy of being widely used in clinical practice.展开更多
Objective:This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and inter...Objective:This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and intervention strategies.Methods:The clinical data of 150 elderly lung cancer patients who received chemotherapy were retrospectively analyzed.Demographic data,clinical characteristics,laboratory indicators,treatment plans,and other relevant information were collected.Independent risk factors for moderate to severe malnutrition during chemotherapy were identified.Results:During chemotherapy,50 patients(33.33%)developed moderate to severe malnutrition.The BMI of patients with moderate to severe malnutrition was significantly lower than that of patients with no or mild malnutrition(21.20±1.60 vs.26.14±2.31,P<0.001),and the proportion of patients with stage IV tumors was significantly higher(60.00%vs.27.00%,P<0.001).Serum pre-albumin(pre-ALB)and hemoglobin(Hb)levels in patients with moderate to severe malnutrition were significantly lower than those in patients with no or mild malnutrition(152.67±30.41 g/L vs.252.47±51.24 g/L and 102.44±10.09 g/L vs.154.21±15.18 g/L,respectively,P<0.001 for all).Conclusion:Low BMI,decreased serum pre-ALB levels,and decreased serum Hb levels before chemotherapy are independent risk factors for moderate to severe malnutrition in elderly lung cancer patients during chemotherapy.Close clinical attention should be given to these patients,with early intervention measures such as nutritional support to reduce the incidence of malnutrition and improve patients’quality of life and prognosis.展开更多
Objective To study difference between intravascular cooling system and traditional moderate hypothermia in patients with severe traumatic brain injury. Methods Eighty sTBI patients were randomly divided into intravasc...Objective To study difference between intravascular cooling system and traditional moderate hypothermia in patients with severe traumatic brain injury. Methods Eighty sTBI patients were randomly divided into intravascular hypothermic groups (IVT) and traditional moderate hypothermia groups(HT) . Inclusion criteria included a Glasgow Coma Scale(GCS) score ≤8 and time from injury to admission must be within 12 hours.展开更多
Blindness affected 45 million people globally in 2021,and moderate to severe vision loss a further 295 million.[1]The most common causes,cataract and uncorrected refractive error,are generally the easiest to treat,and...Blindness affected 45 million people globally in 2021,and moderate to severe vision loss a further 295 million.[1]The most common causes,cataract and uncorrected refractive error,are generally the easiest to treat,and are among the most cost-effective procedures in all of medicine and international development.[1-2]Thus,vision impairment is both extremely common and,in principle,readily manageable.展开更多
Purpose： This study investigates how online user intention in searching health information is affected by problematic situations.Design/methodology/approach： Based on the Theory of Reasoned Action, the Technology Ac...Purpose： This study investigates how online user intention in searching health information is affected by problematic situations.Design/methodology/approach： Based on the Theory of Reasoned Action, the Technology Acceptance Model, and Sense-making theory, we propose two dimensions of problematic situations： urgency and severity of health issues being searched online. Data were collected through a questionnaire survey among 214 Wuhan University students and analyzed using hierarchical regression analysis.Findings： Perceived usefulness, perceived ease of use, and subjective norm can influence user intention to seek health information online. The urgency of problematic situations has a negative moderating effect on the relationship between perceived ease of use and user intention and the relationship between subjective norm and user intention. The severity of problematic situations has a negative moderating effect on the relationship between subjective norm and user intention.Research limitations： The respondents of the survey are limited to students in one Chinese university, so whether this study＇s results can be applied to another population or not remains to be verified. In addition, only two dimensions of problematic situations are considered in this study. Practical implications： The paper puts forward the moderating effect of problematic situations and verifies it, which is the compensation for online health information-seeking behavior research. Besides, our analyses have implications for professional design of health care systems and related consumer information searches, and improve their performance. Originality/value： Previous work has reported the effects of problematic situation on user intention to seek health information online, ignoring its influence on other factors. This empirical study extends that work to identify the influence of problematic situation when seeking intention-behavior data in two dimensions, urgency and severity.展开更多
Background Inflammation and blood-brain barrier disruption may contribute to the pathogenesis of ischaemic stroke.Minocycline was shown to exert anti-inflammatory effects by attenuating microglial activation and prote...Background Inflammation and blood-brain barrier disruption may contribute to the pathogenesis of ischaemic stroke.Minocycline was shown to exert anti-inflammatory effects by attenuating microglial activation and protecting blood-brain barrier in preclinical studies.Previous small-scale clinical studies have suggested that minocycline may have a potential beneficial effect on prognosis in acute ischaemic stroke.However,the efficacy and safety of minocycline in patients with acute ischaemic stroke need to be further confirmed.Study aims We designed the study,Efficacy and Safety of Minocycline in Patients with Moderate to Severe Acute Ischaemic Stroke(EMPHASIS),to evaluate the effect of minocycline in improving the functional outcome and the drug safety in patients with acute ischaemic stroke.Methods The EMPHASIS study is a multicentre,randomised,double-blind,placebo-controlled trial aiming to recruit patients with acute ischaemic stroke.Patients who had ischaemic stroke within 72 hours of onset,a National Institutes of Health Stroke Scale score between 4 and 25 and Ia≤1(moderate-to severe)will be randomly allocated to either minocycline or placebo groups in a 1:1 ratio.Patients will receive minocycline(or placebo)with a loading dose of 200 mg,and subsequent 100 mg every 12 hours for 4 days.All patients will receive routine guideline-based treatment.The primary efficacy outcome is an excellent functional outcome assessed by the proportion of modified Rankin Scale score of 0-1 at 90±7 days.The main safety outcomes include the number of symptomatic intracranial haemorrhage at 24±2 hours and 6±1 days.Discussion The EMPHASIS trial is the first phase III trial to investigate whether minocycline is effective and safe in improving functional outcome at 90 days in patients with moderate-to severe acute ischaemic stroke.The data generated may provide valuable evidence of a potential anti-inflammation treatment for ischaemic stroke.展开更多
To the editor:Type 2 inflammation is a major driving factor in pediatric moderate-to-severe asthma,which may lead to the activation of downstream eosinophils,immunoglobulin E(IgE)production,increased fractional exhale...To the editor:Type 2 inflammation is a major driving factor in pediatric moderate-to-severe asthma,which may lead to the activation of downstream eosinophils,immunoglobulin E(IgE)production,increased fractional exhaled nitric oxide(FeNO),and airway mucus production.[1]Despite adequate treatment with medium-high dose inhaled corticosteroids combined with long-acting β2-receptor agonists(ICS–LABAs)for pediatric moderate-to-severe asthma,symptoms persist or frequently worsen.[2]Studies have shown that approximately 70–89%of children with moderate-to-severe asthma have type 2 inflammation,and a major endotype is type 2 asthma,characterized by the presence of elevated type 2 biomarkers,including blood or sputum eosinophils,total IgE with allergic sensitization,and FeNO.展开更多
Objective To analyze the factors influencing the time-dependent effect and prognosis of recruitment-toinflation ratio (R/I) and elastic power in the prone position in patients with moderate-to-severe acute respiratory...Objective To analyze the factors influencing the time-dependent effect and prognosis of recruitment-toinflation ratio (R/I) and elastic power in the prone position in patients with moderate-to-severe acute respiratory distress syndrome (ARDS).展开更多
Objective To observe the clinical efficacy of Daoqi(directing qi flowing) acupuncture technique in Huangdi Neijing(Yellow Emperor's Inner Classic) for moderate-tosevere obstructive sleep apnea-hypopnea syndrome(OS...Objective To observe the clinical efficacy of Daoqi(directing qi flowing) acupuncture technique in Huangdi Neijing(Yellow Emperor's Inner Classic) for moderate-tosevere obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Sixty patients with moderate-tosevere OSAHS were randomly divided into a Daoqi acupuncture group (30 cases) and a conventional acupuncture group(30 cases,1 case dropped out).展开更多
Objective To investigate the specific method,efficacy and safety of intrathecal baclofen(ITB)in the treatment of moderate and severe spasticity.Methods The clinical features,response to ITB trial,clinical outcomes and...Objective To investigate the specific method,efficacy and safety of intrathecal baclofen(ITB)in the treatment of moderate and severe spasticity.Methods The clinical features,response to ITB trial,clinical outcomes andtreatment-related complicationsafter baclofen pump implantation surgery were retrospectively analyzed in patients with moderate to severe spasticity who received ITB treatment in Hong Kong University Shenzhen Hospital from August 2022 to August 2023.Results The study included 22 patients with moderate to severe spasticity,of whom 18 patients(81.8%)were effective in ITB trial.For these patients with effective trial,the lowest mean Modified Ashworth Scale(MAS)score of lower extremity muscle groups after ITB bolus injection was decreased significantly compared with the baseline mean value before injection(1.29±0.81 vs 3.31±1.18,t=11.364,P<0.001),and the M/H amplitude ratio of soleus H-reflex at 4 hours after ITB bolus injection was significantly higher than the baseline value(9.61±4.66 s 3.83±2.69,t=7.780,P<0.001).Among the 18 patients with effective ITB trial,10 patients received baclofen pump implantation surgery with the informed consent of the patients or their guardians.Compared with the 8 patients without surgery,the baseline mean MAS score of lower extremity muscle groups of the 10 patients who received surgery was higher(3.71±1.06vs 2.83±1.16,F=5.645,P<0.05),the maximum reduction of mean MAS score of lower extremity muscle groups of the 10 patients who received surgery was greater(2.61±0.99 vs 1.30±0.64,F=20.696,P<0.001).In 10 patients who received baclofen pump implantation surgery,the mean MAS score of lower limb muscle groups was significantly decreased in the first and sixth months after surgery compared with the baseline mean value before surgery(1.64±0.91,1.16±0.89 and 3.71±1.06,F=39.946,P<0.001).Among them,2 patients were followed up to 12 months after surgery,2 patients were followed up to 18 months after surgery,and the mean MAS score of their lower limb muscle groups showed continuous improvement,and 1 patient with cerebral palsy combined with lower urinary tract hyperactive syndrome also showed significant improvement of urgent urinary incontinence after surgery.Up to the last followup,the daily dose of baclofen in 10 patients receiving baclofen pump implantation was(143.60±96.24)μg,and notreatment-related1complications occurred.ConclusionITB3 can effectively relieve spasticity symptoms and other related neurological dysfunction in patients with moderate and severe spasticity,and the efficacy can be maintained for a long time,and treatment-related complications are rare.Preoperative ITB trial is helpful to screen out patients more suitable for baclofen pump implantation.Patients with higher grade of spasticity at baseline and better efficacy of ITB trial are more suitable for baclofen pump implantation.The soleus H reflex can effectively reflect the change of stretch reflex of lower limb muscle groups in patients with spasticity treated by ITB,and can be used to evaluate the treatment effect of ITB.展开更多
Vision health is crucial for overall well-being,affecting physical health,livelihoods,and social sustainability.Visual impairment limits mobility,increases risks of dementia,falls,and accidents,and burdens social care...Vision health is crucial for overall well-being,affecting physical health,livelihoods,and social sustainability.Visual impairment limits mobility,increases risks of dementia,falls,and accidents,and burdens social care systems[1].The International Agency for the Prevention of Blindness(IAPB)reported that in 2020,1.1 billion people worldwide were visually impaired,including 43 million with blindness and 295 million with moderate to severe visual impairment[2].This burden is unevenly distributed,with low-and middle-income countries/regions bearing the brunt.Visual health is essential for good health and well-being,and promoting eye health is a key topic for social development guided by the United Nations Sustainable Development Goals(SDGs).Despite significant progress in preventing and treating blindness,China now faces a shift in its main eye health challenge from infectious to non-infectious eye diseases due to an aging population and persistent unhealthy lifestyles.展开更多
文摘Objective: To explore and analyze the effect of acupoint application combined with microwave treatment on the intestinal barrier dysfunction with moderately severe acute pancreatitis. Methods: A convenient sample of 90 moderately severe acute pancreatitis was selected from March 2017 to December 2017 in the comprehensive hospital with third grade in Tianjin. The patients were divided into group A (acupoint application combined with microwave treatment), group B (acupoint application) and group C (routine nursing). Thirty patients were included in each group. This study need to get the informed consent of the patients. Acupoint application combined with microwave treatment was used, basing on routine nursing measures in group A. Acupoint application was used by the same way and the same traditional Chinese medicine ,basing on routine nursing measures in group B. Routine nursing used in group C. C-reactive protein and the score of intestinal function were measured on 3 th day, 7 th day and 10 th day, after intervention. To record the effective ratio of the treatment after 10 days of intervention. Results: There are significant statistical difference among the three group after intervention (P < 0.05). Conclusion: In some way, acupoint application combined with microwave treatment are able to decrease the time about the recovery of intestinal barrier dysfunction in moderately severe acute pancreatitis and to alleviate the suffering of patients.
基金supported by the National Key Research and Development Plan of China(No.2017YFC0909900).
文摘Objective:Lung cancer has the highest incidence and mortality of all malignant tumors in China.Cancer pain dramatically affects patients’comfort level,causing insomnia,anorexia,anxiety,fear,depression,and a decline in the quality of life(QOL).The literature suggests a shortage of adequate cancer pain management for 59.1% of patients in China.The quality control circle(QCC)activity reflects the people-oriented core idea of management.This study aimed to assess the efficacy of QCC in enhancing the effectiveness of drug interventions in lung cancer patients with moderate to severe pain.Methods:From January 2019 to July 2019,lung cancer patients with moderate to severe pain were treated with drugs.The total number of drug interventions was 3072.A QCC activity was performed following the ten steps of the plan-do-check-act(PDCA)model.The reasons for the poor effectiveness of drug intervention in lung cancer patients with moderate to severe pain were analyzed.Countermeasures were designed to improve the effectiveness of drug intervention,including setting up a pain college,writing a medication education manual,and formulating operational rules for the administration of narcotic drugs.The effectiveness of drug intervention in lung cancer patients with moderate to severe pain and activity ability scores of QCC members were analyzed statistically before and after QCC activity.The effectiveness of drug intervention was investigated and compared before and after establishing the QCC.Results:After establishing the PDCA model,the effectiveness of drug intervention for moderate to severe pain in lung cancer patients increased from 56.28% to 85.29%.Members had significant improvement in problem-solving ability,responsibility,communication,coordination,self-confidence,team cohesion,enthusiasm,QCC skills,and harmony.Conclusion:QCC activity can significantly improve the efficiency of drug intervention in lung cancer patients with moderate to severe pain and their quality of life.
基金This work was financially supported by the Instructive Research Program of Changzhou Municipal Commission of Health and Family Planning(WZ201417)
文摘Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR group and 62 in the control group)were recruited in this study.The patients in the PR group received 12 weeks of conventional treatment,nursing,and modified pulmonary rehabilitation,while the patients in the control group underwent 12 weeks of conventional treatment,nursing,pursed-lip breathing training,and abdominal breathing training.Baseline characteristics,St.George's Respiratory Questionnaire(SGRQ),the six-minute walk test(6MWT),modified medical research council(MMRC)dyspnea scale,and lung function were compared between the two groups.Results:A total of 112 patients(58 patients in the PR group and 54 patients in the control group)completed the 12-week monitoring and follow-up.The SGRQ scores,symptoms(54.933±11.900),activity(52.644±14.334),impact(55.400±9.905),and total score(54.655±10.681)of the PR group did not significantly differ in pre-and post-treatments(P<0.05).No significant change was also observed in the control group(P>0.05).6MWT[(372.089±67.149)m]was significantly improved in the PR group(P<0.05)but was not significantly different in the control group(P>0.05).MMRC(actual rank sum 1719,rank sum 2047.5)was significantly reduced in the PR group(P<0.05)but not in the control group(P>0.05).The lung function(FVC,FEV1,FEV1/FVC,FEV1%and PEF)of the patients in both groups did not significantly change(P>0.05).Conclusion:Modified PR reduces the symptoms of dyspnea,increases exercise capacity,and improves the quality of life of patients with moderate to severe COPD.
文摘Objective:To describe the clinical,laboratory and radiological characteristics and outcomes of moderate-to-severe coronvirus disease 2019(COVID-19)patients.Methods:We retrospectively analyzed 43 RT-PCR confirmed moderate-to-severe COVID-19 patients who were admitted to a tertiary care center.The primary composite outcomes were admission to intensive care unit,requirement of mechanical ventilation,and death.Results:The median age of the patients was 50 years,and 62.8%of the patients were male.Out of 43 patients,15(34.88%)were categorized as severe.A total of 26(60.47%)patients had 1 or more comorbidities[diabetes(34.88%)and hypertension(30.23%)].The median duration from the onset of symptoms to admission was 3 days,and the most common symptoms were dyspnoea(90.7%),cough(79.07%),fever(69.77%),and body ache(46.51%).Leucopenia was presented in 14(32.56%)patients,lymphopenia in 26(60.47%)patients,and monocytosis in 7(16.28%)patients.Besides,40(93.02%)patients had bilateral patchy nodular or interstitial infiltration on chest X-ray.The primary outcomes occurred in 20 patients(46.5%),among whom 8 required mechanical ventilation.The patients who had met the primary outcomes were older.They were prone to have at least 1 comorbidity(P=0.004),diabetes(P=0.01),hypertension,higher sequential organ failure assessment score,more tachycardia,lower SpO2,lower PaO2/FiO2,more thrombocytopenia,and more pancytopenia.Conclusions:This retrospective study identified several risk factors for poor outcomes in adults with COVID-19.In particular,older age,tachycardia,high SOFA score,low SpO2,low PaO2/FiO2,presence of comorbidities in form of diabetes and hypertension,thrombocytopenia,and pancytopenia at admission were associated with higher odds of ICU admission,a requirement of mechanical ventilation and in-hospital death.
文摘Objective: to analyze the clinical efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis. Methods: a total of 60 patients with moderate to severe atopic dermatitis treated in Beijing Jingcheng Skin Hospital (2021.1-2021.12) were divided into observation group (dupilumab) and control group (conventional treatment). The clinical efficacy (excellent + effective), the improvement time of clinical symptoms (eczema like skin lesions, dry skin, pruritus), EASI (total score of 6, the lower the better) and NRS (total score of 10, the lower the better) were compared after treatment. Results: there were significant differences in clinical efficacy between the observation group (dupilumab) and the control group (conventional treatment) after treatment (P 0.05). There was a significant difference in the improvement time of clinical symptoms between the observation group (dupilumab) and the control group (conventional treatment) after treatment (P 0.05). Before treatment, there were no differences in EASI and NRS scores between the observation group (dupilumab) and the control group (conventional treatment) (P > 0.05), but after treatment, there were differences in EASI and NRS scores between the observation group (dupilumab) and the control group (conventional treatment) (P 0.05). Conclusion: in the treatment of patients, the use of dupilumab can improve the treatment effect, the treatment is obvious, and the symptoms of patients are more obvious, the score of pruritus is more obvious, which is conducive to improve the quality of life of patients, and is worthy of being widely used in clinical practice.
基金Shaanxi Provincial People’s Hospital Grant“Construction and Verification of Malnutrition Risk Prediction Model in Elderly Patients with Lung Cancer Undergoing Chemotherapy”(Grant No.2023HL-14)。
文摘Objective:This study aims to identify the factors influencing moderate to severe malnutrition in elderly lung cancer patients undergoing chemotherapy and to provide a basis for developing clinical prevention and intervention strategies.Methods:The clinical data of 150 elderly lung cancer patients who received chemotherapy were retrospectively analyzed.Demographic data,clinical characteristics,laboratory indicators,treatment plans,and other relevant information were collected.Independent risk factors for moderate to severe malnutrition during chemotherapy were identified.Results:During chemotherapy,50 patients(33.33%)developed moderate to severe malnutrition.The BMI of patients with moderate to severe malnutrition was significantly lower than that of patients with no or mild malnutrition(21.20±1.60 vs.26.14±2.31,P<0.001),and the proportion of patients with stage IV tumors was significantly higher(60.00%vs.27.00%,P<0.001).Serum pre-albumin(pre-ALB)and hemoglobin(Hb)levels in patients with moderate to severe malnutrition were significantly lower than those in patients with no or mild malnutrition(152.67±30.41 g/L vs.252.47±51.24 g/L and 102.44±10.09 g/L vs.154.21±15.18 g/L,respectively,P<0.001 for all).Conclusion:Low BMI,decreased serum pre-ALB levels,and decreased serum Hb levels before chemotherapy are independent risk factors for moderate to severe malnutrition in elderly lung cancer patients during chemotherapy.Close clinical attention should be given to these patients,with early intervention measures such as nutritional support to reduce the incidence of malnutrition and improve patients’quality of life and prognosis.
文摘Objective To study difference between intravascular cooling system and traditional moderate hypothermia in patients with severe traumatic brain injury. Methods Eighty sTBI patients were randomly divided into intravascular hypothermic groups (IVT) and traditional moderate hypothermia groups(HT) . Inclusion criteria included a Glasgow Coma Scale(GCS) score ≤8 and time from injury to admission must be within 12 hours.
文摘Blindness affected 45 million people globally in 2021,and moderate to severe vision loss a further 295 million.[1]The most common causes,cataract and uncorrected refractive error,are generally the easiest to treat,and are among the most cost-effective procedures in all of medicine and international development.[1-2]Thus,vision impairment is both extremely common and,in principle,readily manageable.
基金supported in part by the Key Projects of Philosophy and Social Sciences Research supported by the Ministry of Education of the People’s Republic of China(Grant No.:15JJD870001)Luo Jia Youth Scholar of Wuhan University
文摘Purpose： This study investigates how online user intention in searching health information is affected by problematic situations.Design/methodology/approach： Based on the Theory of Reasoned Action, the Technology Acceptance Model, and Sense-making theory, we propose two dimensions of problematic situations： urgency and severity of health issues being searched online. Data were collected through a questionnaire survey among 214 Wuhan University students and analyzed using hierarchical regression analysis.Findings： Perceived usefulness, perceived ease of use, and subjective norm can influence user intention to seek health information online. The urgency of problematic situations has a negative moderating effect on the relationship between perceived ease of use and user intention and the relationship between subjective norm and user intention. The severity of problematic situations has a negative moderating effect on the relationship between subjective norm and user intention.Research limitations： The respondents of the survey are limited to students in one Chinese university, so whether this study＇s results can be applied to another population or not remains to be verified. In addition, only two dimensions of problematic situations are considered in this study. Practical implications： The paper puts forward the moderating effect of problematic situations and verifies it, which is the compensation for online health information-seeking behavior research. Besides, our analyses have implications for professional design of health care systems and related consumer information searches, and improve their performance. Originality/value： Previous work has reported the effects of problematic situation on user intention to seek health information online, ignoring its influence on other factors. This empirical study extends that work to identify the influence of problematic situation when seeking intention-behavior data in two dimensions, urgency and severity.
基金National Natural Science Foundation of China(No.81825007,82271516)Beijing Healthunion Cardio-cerebrovascular Disease Prevention and Treatment Foundation(No.20230418-J E 010).
文摘Background Inflammation and blood-brain barrier disruption may contribute to the pathogenesis of ischaemic stroke.Minocycline was shown to exert anti-inflammatory effects by attenuating microglial activation and protecting blood-brain barrier in preclinical studies.Previous small-scale clinical studies have suggested that minocycline may have a potential beneficial effect on prognosis in acute ischaemic stroke.However,the efficacy and safety of minocycline in patients with acute ischaemic stroke need to be further confirmed.Study aims We designed the study,Efficacy and Safety of Minocycline in Patients with Moderate to Severe Acute Ischaemic Stroke(EMPHASIS),to evaluate the effect of minocycline in improving the functional outcome and the drug safety in patients with acute ischaemic stroke.Methods The EMPHASIS study is a multicentre,randomised,double-blind,placebo-controlled trial aiming to recruit patients with acute ischaemic stroke.Patients who had ischaemic stroke within 72 hours of onset,a National Institutes of Health Stroke Scale score between 4 and 25 and Ia≤1(moderate-to severe)will be randomly allocated to either minocycline or placebo groups in a 1:1 ratio.Patients will receive minocycline(or placebo)with a loading dose of 200 mg,and subsequent 100 mg every 12 hours for 4 days.All patients will receive routine guideline-based treatment.The primary efficacy outcome is an excellent functional outcome assessed by the proportion of modified Rankin Scale score of 0-1 at 90±7 days.The main safety outcomes include the number of symptomatic intracranial haemorrhage at 24±2 hours and 6±1 days.Discussion The EMPHASIS trial is the first phase III trial to investigate whether minocycline is effective and safe in improving functional outcome at 90 days in patients with moderate-to severe acute ischaemic stroke.The data generated may provide valuable evidence of a potential anti-inflammation treatment for ischaemic stroke.
基金sponsored by the Guangzhou Municipal Health Science and Technology Project(No.20231A011084).
文摘To the editor:Type 2 inflammation is a major driving factor in pediatric moderate-to-severe asthma,which may lead to the activation of downstream eosinophils,immunoglobulin E(IgE)production,increased fractional exhaled nitric oxide(FeNO),and airway mucus production.[1]Despite adequate treatment with medium-high dose inhaled corticosteroids combined with long-acting β2-receptor agonists(ICS–LABAs)for pediatric moderate-to-severe asthma,symptoms persist or frequently worsen.[2]Studies have shown that approximately 70–89%of children with moderate-to-severe asthma have type 2 inflammation,and a major endotype is type 2 asthma,characterized by the presence of elevated type 2 biomarkers,including blood or sputum eosinophils,total IgE with allergic sensitization,and FeNO.
文摘Objective To analyze the factors influencing the time-dependent effect and prognosis of recruitment-toinflation ratio (R/I) and elastic power in the prone position in patients with moderate-to-severe acute respiratory distress syndrome (ARDS).
文摘Objective To observe the clinical efficacy of Daoqi(directing qi flowing) acupuncture technique in Huangdi Neijing(Yellow Emperor's Inner Classic) for moderate-tosevere obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Sixty patients with moderate-tosevere OSAHS were randomly divided into a Daoqi acupuncture group (30 cases) and a conventional acupuncture group(30 cases,1 case dropped out).
文摘Objective To investigate the specific method,efficacy and safety of intrathecal baclofen(ITB)in the treatment of moderate and severe spasticity.Methods The clinical features,response to ITB trial,clinical outcomes andtreatment-related complicationsafter baclofen pump implantation surgery were retrospectively analyzed in patients with moderate to severe spasticity who received ITB treatment in Hong Kong University Shenzhen Hospital from August 2022 to August 2023.Results The study included 22 patients with moderate to severe spasticity,of whom 18 patients(81.8%)were effective in ITB trial.For these patients with effective trial,the lowest mean Modified Ashworth Scale(MAS)score of lower extremity muscle groups after ITB bolus injection was decreased significantly compared with the baseline mean value before injection(1.29±0.81 vs 3.31±1.18,t=11.364,P<0.001),and the M/H amplitude ratio of soleus H-reflex at 4 hours after ITB bolus injection was significantly higher than the baseline value(9.61±4.66 s 3.83±2.69,t=7.780,P<0.001).Among the 18 patients with effective ITB trial,10 patients received baclofen pump implantation surgery with the informed consent of the patients or their guardians.Compared with the 8 patients without surgery,the baseline mean MAS score of lower extremity muscle groups of the 10 patients who received surgery was higher(3.71±1.06vs 2.83±1.16,F=5.645,P<0.05),the maximum reduction of mean MAS score of lower extremity muscle groups of the 10 patients who received surgery was greater(2.61±0.99 vs 1.30±0.64,F=20.696,P<0.001).In 10 patients who received baclofen pump implantation surgery,the mean MAS score of lower limb muscle groups was significantly decreased in the first and sixth months after surgery compared with the baseline mean value before surgery(1.64±0.91,1.16±0.89 and 3.71±1.06,F=39.946,P<0.001).Among them,2 patients were followed up to 12 months after surgery,2 patients were followed up to 18 months after surgery,and the mean MAS score of their lower limb muscle groups showed continuous improvement,and 1 patient with cerebral palsy combined with lower urinary tract hyperactive syndrome also showed significant improvement of urgent urinary incontinence after surgery.Up to the last followup,the daily dose of baclofen in 10 patients receiving baclofen pump implantation was(143.60±96.24)μg,and notreatment-related1complications occurred.ConclusionITB3 can effectively relieve spasticity symptoms and other related neurological dysfunction in patients with moderate and severe spasticity,and the efficacy can be maintained for a long time,and treatment-related complications are rare.Preoperative ITB trial is helpful to screen out patients more suitable for baclofen pump implantation.Patients with higher grade of spasticity at baseline and better efficacy of ITB trial are more suitable for baclofen pump implantation.The soleus H reflex can effectively reflect the change of stretch reflex of lower limb muscle groups in patients with spasticity treated by ITB,and can be used to evaluate the treatment effect of ITB.
基金supported by the National Natural Science Foundation of China(82330031).
文摘Vision health is crucial for overall well-being,affecting physical health,livelihoods,and social sustainability.Visual impairment limits mobility,increases risks of dementia,falls,and accidents,and burdens social care systems[1].The International Agency for the Prevention of Blindness(IAPB)reported that in 2020,1.1 billion people worldwide were visually impaired,including 43 million with blindness and 295 million with moderate to severe visual impairment[2].This burden is unevenly distributed,with low-and middle-income countries/regions bearing the brunt.Visual health is essential for good health and well-being,and promoting eye health is a key topic for social development guided by the United Nations Sustainable Development Goals(SDGs).Despite significant progress in preventing and treating blindness,China now faces a shift in its main eye health challenge from infectious to non-infectious eye diseases due to an aging population and persistent unhealthy lifestyles.
