This study investigated the factors contributing to intravenous admixture preparation errors(IAPEs)within Pharmacy Intravenous Admixture Services(PIVAS).A retrospective analysis was conducted on IAPEs documented in th...This study investigated the factors contributing to intravenous admixture preparation errors(IAPEs)within Pharmacy Intravenous Admixture Services(PIVAS).A retrospective analysis was conducted on IAPEs documented in the PIVAS unit of a large multi-specialty hospital in China,which houses over 2000 beds,covering the period from January 1,2015 to December 31,2022.Drug preparation records were examined using a generalized linear mixed model(GLMM)to identify both univariate and multivariate factors associated with IAPE occurrences.A total of 824 IAPE cases were recorded during the study period,yielding an overall error rate of 0.018%.Univariate analysis identified drug categories(general drugs,anti-infective drugs,and antineoplastic drugs),preparation time(workdays),and years of work experience as significant determinants(P<0.05).Multivariate analysis further confirmed that drug categories(general and antineoplastic drugs),preparation time(workdays),and work experience remained statistically significant predictors of IAPE incidence(P<0.05).IAPEs in PIVAS were influenced by multiple factors,predominantly those related to personnel and drug characteristics.Targeted interventions,informed by multivariate analysis,are essential to mitigating these errors and enhancing medication safety.展开更多
The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic pro...The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic properties,an increasing body of research has uncovered neuroprotective efects of intravenous anesthetics in various animal and cellular models,as well as in clinical studies.However,there also exists conficting evidence pointing to the potential neurotoxic efects of these intravenous anesthetics.The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized.Considering the mentioned above,this work aims to ofer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system(CNS)and the peripheral nerve system(PNS)and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.展开更多
Objective We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral...Objective We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral stones.Methods We retrospectively reviewed 734 patients with ureteral stones treated by fluoroscopy-guided shockwave lithotripsy between March 2014 and March 2021.The primary outcome was a stone-free rate with one session within 30 days,defined as no residual stones without auxiliary treatment.The multivariate analysis was used to examine whether the intravenous urography use predicted treatment success.Furthermore,we compared the outcomes using propensity score matching.Results Ninety-eight patients underwent the intravenous urography use protocol(Group I),and the remaining 636 patients underwent the non-intravenous urography protocol(Group N).Stone-free rates with one session within 30 days were 38%and 32%in groups I and N,respectively(p=0.3).No statistical differences were observed in the conversion rate to ureteroscopy(p=0.3)or complication rate(p=0.7)between Group I and Group N.One patient who developed skin redness was considered a complication of the contrast medium.Propensity score matching examined 88 matched pairs.Treatment success was obtained in 31(35%)patients in Group I and 33(38%)patients in Group N(p=0.9)within 30 days with one session.Conclusion Radiolucent stones can be safely and effectively treated by shockwave lithotripsy with intravenous urography.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)pla...BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised patients.This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.CASE SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations.Postoperatively,he developed COVID-19 pneumonia,severe septic shock,and ARDS.He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse steroids.CONCLUSION IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection.We aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting.With further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.展开更多
BACKGROUND Managing sudden deafness(SD)in patients with diabetes mellitus(DM)is partic-ularly challenging due to the heightened risk of adverse effects associated with systemic drug administration.This study explores ...BACKGROUND Managing sudden deafness(SD)in patients with diabetes mellitus(DM)is partic-ularly challenging due to the heightened risk of adverse effects associated with systemic drug administration.This study explores the potential of retroauricular subperiosteal injection as a localized drug delivery method for a more effective and safe treatment.AIM To compare the efficacy of retroauricular subperiosteal injection vs systemic intravenous glucocorticoid(GC)administration for SD in patients with DM and assess the effects on blood glucose levels.METHODS A total of 128 cases of type 2 DM(T2DM)with SD diagnosed and treated in Zibo Central Hospital from February 2021 to July 2023 were divided into two groups:An observation group(66 cases receiving retroauricular subperiosteal injection of methylprednisolone)and a control group(62 cases receiving systemic intravenous administration of methylprednisolone).The two groups were compared in terms of therapeutic efficacy,hearing recovery,blood glucose level changes,and incidence of adverse reactions.Binary logistic regression was used to analyze the factors affecting therapeutic efficacy.RESULTS The observation group showed a significantly higher total effective rate(90.91%)compared with the control group(75.81%,P<0.05).Additionally,pure-tone hearing threshold,fasting plasma glucose,and 2-hour postprandial blood glucose were significantly lower in the observation group compared with the control group(P<0.05).The incidence of adverse reactions was also lower in the observation group than in the control group(7.58%vs 22.58%,P<0.05).A T2DM course longer than 5 years and systemic intravenous GC administration were identified as independent risk factors for treatment inefficacy(P<0.05).INTRODUCTION Sudden deafness(SD)is a clinical emergency characterized by rapid-onset hearing loss that is often accompanied by clinical symptoms such as tinnitus and vertigo[1].Although its pathogenesis remains unclear,it is supposedly associated with factors,including inner ear microcirculation disorders,autoimmune diseases,and viral infections[2,3].Patients with diabetes are particularly susceptible to microvascular complications due to poor long-term glycemic control,affecting the ear’s microcirculation,subsequently increasing the risk of SD[4].Type 2 diabetes mellitus(T2DM),a chronic metabolic disease,causes multiple microvascular damages throughout the body,complicating SD treatment in patients with diabetes[5,6].Inner ear microcirculation disturbances in patients with diabetes may exacerbate the risk of SD,and its pathological process may be related to vascular endothelial dysfunction,inflammatory reactions,and hemorrhological changes caused by diabetes mellitus(DM)[7].Current SD treatments include glucocorticoids(GCs),vasodilators,and hyperbaric oxygen therapy[8].GCs are widely used due to their anti-inflammatory and immunosuppressive effects[9].However,systemic GCs may cause blood glucose(BG)fluctuations and even increase the risk of complications in patients with DM,limiting their clinical use in this population[10].Therefore,there is a compelling and immediate need for a local alternative solution that minimally affects the metabolic mechanisms.In recent years,retroauricular subperiosteal injection has emerged as a localized administration modality for treating SD[11].This method allows drugs to directly act on the inner ear,avoiding the side effects of systemic administration and having a minor impact on BG levels,providing a potentially effective treatment for patients with diabetes[12].However,there is limited clinical evidence to compare the efficacy and glycaemic effects of retroauricular subperiosteal injection vs systemic intravenous GC administration in patients with SD and diabetes.This study aimed to explore the efficacy of retroauricular subperiosteal injection and systemic intravenous GC administration for treating patients with SD and DM and their effects on BG,providing a safer and more effective clinical treatment approach.展开更多
BACKGROUND Stress hyperglycemia(SH)is a common phenomenon that is present in about 50%of patients with acute ischemic stroke(AIS).It is thought to be a main risk factor for poor functional outcome among patients with ...BACKGROUND Stress hyperglycemia(SH)is a common phenomenon that is present in about 50%of patients with acute ischemic stroke(AIS).It is thought to be a main risk factor for poor functional outcome among patients with AIS undergoing intravenous thrombolysis(IVT).AIM To investigate the predictive value of glycemic indicators for early neurological outcomes(ENOs)in patients with AIS treated with IVT.METHODS We retrospectively reviewed a prospectively collected database of patients with AIS who underwent IVT at the Department of Neurology,Second Affiliated Hospital of Xuzhou Medical University,between January 2017 and June 2022.ENO included early neurological improvement(ENI)and early neurological deterioration(END),defined as a decrease or increase in the National Institutes of Health Stroke Scale(NIHSS)score between baseline and 24 hours after IVT.We analyzed the associations between glycemic indicators[including admission hyperglycemia(AH),fasting blood glucose(FBG),and SH ratio(SHR)]and ENO in all patients and in subgroups stratified by diabetes mellitus(DM).RESULTS A total of 819 patients with AIS treated with IVT were included.Among these,AH was observed in 329 patients(40.2%).Compared with patients without AH,those with AH were more likely to have a higher prevalence of DM(P<0.001)and hypertension(P=0.031)and presented with higher admission NIHSS scores(P<0.001).During the first 24 hours after IVT,END occurred in 208 patients(25.4%)and ENI occurred in 156 patients(19.0%).Multivariate mixed logistic regression analyses indicated that END was independently associated with AH[odds ratio(OR):1.744,95%confidence interval(CI):1.236-2.463;P=0.002].Subjects were classified into four groups representing quartiles.Compared with Q1,patients in the higher quartiles of SHR(Q2:OR:2.306,95%CI:1.342-3.960;P=0.002)(Q3:OR:2.284,95%CI:1.346-3.876;P=0.002)(Q4:OR:3.486,95%CI:2.088-5.820;P=0.001)and FBG(Q3:OR:1.746,95%CI:1.045-2.917;P=0.033)(Q4:OR:2.436,95%CI:1.476-4.022;P=0.001)had a significantly higher risk of END in the overall population.However,none of the glycemic indicators were found to be associated with ENI in patients with or without DM.CONCLUSION Our study demonstrated that glycemic indicators in patients with stroke treated with IVT were associated with the presence of END rather than ENI during the first 24 hours after admission.展开更多
The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitori...The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitoring,complication observation and management,positioning and mobility away from the bed,and quality assurance.These Guidelines encompass all the phases of intravenous thrombolysis care for patients experiencing acute ischemic stroke.This article aims to elucidate the Guidelines by discussing their developmental background,the designation process,usage recommendations,and the interpretation of evolving perspectives,thereby providing valuable insights for clinical practice.展开更多
Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmo...Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmonary complications, such as pneumonia and pneumothorax, significantly contribute to increased morbidity in this population. Case Presentation: We report the case of a 28-year-old female who injects drugs, and presents with fever, bilateral hand edema, and respiratory symptoms. Clinical evaluation revealed erythema and edema of both hands, elevated inflammatory markers, and a left lower lobe infiltration that progressed to pneumothorax. A diagnosis of PHS and left lower lobe pneumonia complicated by pneumothorax was established. Management and Outcomes: The patient was treated with broad-spectrum antibiotics, including ceftriaxone, levofloxacin, dexamethasone, and oxygen supplementation, as well as antipyretics. She demonstrated partial clinical improvement and was referred to another hospital’s thoracic surgery department for specialized care. Conclusions: This case underscores the importance of early recognition and multidisciplinary management of rare but serious complications in IVDU patients. Further research is necessary to elucidate the interplay between lymphatic dysfunction and pulmonary pathophysiology in this demographic.展开更多
This study aimed to explore the specific application effect of specialist nursing intervention in intravenous therapy on elderly patients with peripherally inserted central catheters(PICC).From November 2023 to Novemb...This study aimed to explore the specific application effect of specialist nursing intervention in intravenous therapy on elderly patients with peripherally inserted central catheters(PICC).From November 2023 to November 2024,a total of 60 elderly patients with PICC admitted to Guiqian International General Hospital were selected as research subjects.Using a digital random table method,these patients were randomly divided into a control group and an experimental group,with 30 patients in each.The control group received routine nursing care,while the experimental group received specialized intravenous therapy nursing intervention in addition to routine care.The nursing effects of both groups were comprehensively evaluated,including treatment compliance,psychological state,quality of life,incidence of complications,and satisfaction with nursing care.The results showed that after the intervention,the treatment compliance in the experimental group was significantly higher than that of the control group(P<0.05).Additionally,scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were markedly lower in the experimental group compared to the control group(P<0.05),indicating improved psychological well-being.The experimental group also scored higher in all dimensions of quality of life(P<0.05),and had a lower complication rate and higher satisfaction with nursing care(P<0.05).In conclusion,the application of specialized intravenous therapy nursing intervention in the care of elderly patients with PICC can significantly enhance treatment compliance,improve psychological status,elevate quality of life,and reduce complications,demonstrating strong clinical value and providing important guidance for future treatment and nursing of such patients.展开更多
Intravenous leiomyomatosis(IVL)is a rare,histologically benign uterine smooth muscle tumor with malignant biological behavior due to its propensity for intravascular extension.[1]While gynecological in origin,its most...Intravenous leiomyomatosis(IVL)is a rare,histologically benign uterine smooth muscle tumor with malignant biological behavior due to its propensity for intravascular extension.[1]While gynecological in origin,its most severe manifestations are cardiovascular,arising from tumor propagation through the venous system into the inferior vena cava(IVC),right heart,and pulmonary arteries,mimicking thromboembolic disease.[2,3]This can lead to pulmonary embolism(PE),right heart obstruction,and even sudden cardiac death.[4]Diagnosis is challenging,often delayed by misdiagnosis as conventional PE.We present two cases of IVL initially presenting with PE,highlighting the critical cardiovascular implications and diagnostic pitfalls.展开更多
Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress responses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on bot...Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress responses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on bothμ-andκ-receptors,may provide stable analgesia with less hemodynamic fluctuation compared with the pureμ-agonist sufentanil.This study aimed to compare the efficacy and cardiovascular safety of oxycodone-based versus sufent anil-based intravenous patient-controlled analgesia(IV-PCA)after laparoscopic abdominal surgery.Methods This single-center retrospective comparative study included patients who underwent laparoscopic abdominal surgery between March 2024 and March 2025.According to their postoperative PCA regimen,patients were divided into an oxycodone group and a sufentanil group.The primary endpoint was the incidence of cardiovascular adverse events(CVAE)within 48 h after surgery,including hypotension,bradycardia,and arrhythmia.Logistic regression was used to identify independent predictors of CVAE,and receiver operating characteristic(ROC)analysis assessed discriminative performance.Results A total of 356 patients were analyzed(oxycodone n=197;sufentanil n=159).The incidence of CVAE was significantly lower in the oxycodone group than in the sufentanil group(5.2%vs.12.1%,P=0.021).Oxycodone provided comparable analgesic intensity with fewer PCA bolus attempts(36±15 vs.52±17,P<0.001)and higher patient satisfaction scores(4.3±0.5 vs.4.1±0.5,P=0.002).Multivariate logistic regression identified sufentanil use(OR:2.53,95%CI:1.16-5.84,P=0.018)as independent predictors of CVAE.Conclusions Oxycodone-based IV-PCA provided effective postoperative analgesia with a lower incidence of cardiovascular adverse events compared with sufentanil-based PCA.The results suggested that oxycodone offered a favorable balance between analgesic efficacy and hemodynamic stability,making it a safer alternative for postoperative pain management in patients at cardiovascular risk.展开更多
In the present study, we aimed to analyze the irrational medical orders and evaluate the effect of pharmacy intervention on pharmacy intravenous admixture services of outpatient and emergency departments in our hospit...In the present study, we aimed to analyze the irrational medical orders and evaluate the effect of pharmacy intervention on pharmacy intravenous admixture services of outpatient and emergency departments in our hospital. The irrational medical orders of PIVAS at the outpatient and emergency departments were retrospectively analyzed in Jun. 2015. We strengthened the pharmacy intervention on irrational medical orders since July 2015. All the cases were selected by systematic sampling method. Cased studied in Jun. 2015 served as the control group, whereas those studied in Jan. 2016 served as the intervention group. The irrational rate and the irrational number of daily average were compared between the control group and intervention group. The common type of irrational outpatient and emergency intravenous orders mainly included irrational use of solvents, irrational dosing interval and inappropriate compatibility of drugs. The irrational rate was reduced from 17.4% to 3.3% （P〈0.01）, and the irrational number of daily average was decreased from 5.23 to 1.00 （P〈0.01）. Pharmacy intervention can reduce the irrational rate of medical orders in our hospital, which is of great significance to promote rational drug use and improve medical quality.展开更多
Heparin-induced thrombocytopenia(HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in cl...Heparin-induced thrombocytopenia(HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin(IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.展开更多
The objective of this study was to evaluate the influence of infusion container design on the volume of residual drug solution following use in a clinical setting. 0.9% （w/v） NaCl infusion solution containers （5 ty...The objective of this study was to evaluate the influence of infusion container design on the volume of residual drug solution following use in a clinical setting. 0.9% （w/v） NaCl infusion solution containers （5 types, each of three capacities： 100 mL, 250 mL and 500 mL） following clinical use for in-patients at Peking University Third Hospital were collected during Sept. and Oct. 2007. The volume of residual drug solution was determined. Hospital pharmacy records were used to determine the potential economic implications of discarding residual drug solutions. The mean residual volumes ranged from 0.38 mL to 4.80 mL and, in general, residual volume increased with increasing container capacity. The residual volumes for one type of double-port soft bag were significantly lower than the residual volumes for all other containers of the same capacity （P〈0.05）, including glass and semi-rigid plastic bottles. Highest residual volumes were observed for the single-port soft bag. Estimates of the value of discarded residual drug solution ranged from approximately US $15,000 to US $150,000 per annum in our hospital. Infusion container design has a major influence on residual drug solution volumes following intravenous infusion. Appropriate choice of bag design remains an important consideration for the economics and efficacy of infusion treatment in Chinese hospitals.展开更多
BACKGROUND:A perennial challenge faced by clinicians and made even more relevant with the global obesity epidemic,difficult intravenous access(DIVA)adversely impacts patient outcomes by causing significant downstream ...BACKGROUND:A perennial challenge faced by clinicians and made even more relevant with the global obesity epidemic,difficult intravenous access(DIVA)adversely impacts patient outcomes by causing significant downstream delays with many aspects of diagnoses and therapy.As most published DIVA strategies are limited to various point-of-care ultrasound techniques while other“tricks-of-the-trade”and pearls for overcoming DIVA are mostly relegated to informal nonpublished material,this article seeks to provide a narrative qualitative review of the iterature on DIVA and consolidate these strategies into a practical algorithm.METHODS:We conducted a literature search on PubMed using the keywords“difficult intravenous access”,“peripheral vascular access”and“peripheral venous access”and searched emergency medicine and anaesthesiology resources for relevant material.These strategies were then categorized and incorporated into a DIVA algorithm.RESULTS:We propose a Vortex approach to DIVA that is modelled after the Difficult Airway Vortex concept:starting off with standard peripheral intravenous cannulation(PIVC)techniques,progressing sequentially on to ultrasound-guided cannulation and central venous cannulation and finally escalating to the most invasive intraosseous access should the patient be in extremis or should best efforts with the other lifelines fail.CONCLUSION:DIVA is a perennial problem that healthcare providers across various disciplines will be increasingly challenged with.It is crucial to have a systematic stepwise approach such as the DIVA Vortex when managing such patients and have at hand a wide repertoire of techniques to draw upon.展开更多
Objective: to construct an intravenous therapy team to see whether it can lead nurses of different tiers to have a higher awareness rate in terms of operational norms of techniques involved in intravenous therapy nurs...Objective: to construct an intravenous therapy team to see whether it can lead nurses of different tiers to have a higher awareness rate in terms of operational norms of techniques involved in intravenous therapy nursing and whether it can improve the quality of care. Methods: an intravenous therapy team was constructed in January 2021 in our hospital to carry out relevant knowledge training for nurses at different levels in the whole hospital for 1 year, to summarize the knowledge level of nurses at different levels in the hospital before and after, whether the patients had complications when receiving treatment, the rating of nursing quality, and also to the satisfaction level of nursing care. Results: after 1-year period, in terms of the knowledge rate of operational norms, nurse (75.69 ± 7.18) points, supervisor (81.76 ± 5.95) points and supervisors supervisor and above (88.25 ± 5.99) points were significantly higher compared to (58.12 ± 5.37) points, supervisor (64.21 ± 5.89) points and (76.63 ± 5.78) points before group construction, P 0.05;The complication rate of 3.67% in the study group was significantly lower compared to 10.00% in the reference group, P 0.05;Comparing the quality of nursing care, the basic nursing (84.15 ± 7.33) points, health education (87.25 ± 5.68) points, operational skills (85.36 ± 6.01) points, and nursing records (57.62 ± 6.48) points in the study group were significantly higher compared with the (62.87 ± 6.05) points, (65.69 ± 5.77), basic nursing (67.36 ± 5.56), and (70.36 ± 6.13) points in the reference group, P 0.05;97.67% satisfaction in the study group was significantly higher than 92.33% in the reference group, P 0.05. Conclusions: the construction of the venous therapy team to make nurses at different levels throughout the hospital more aware of venous therapy related operational codes of care, the quality of nursing services has also been improved very well, with fewer related complications and higher patient satisfaction, which is worth promoting.展开更多
AIM: To compare the influence of different transplant sites in bone marrow mesenchymal stem cell (MSC)-based therapy for liver fibrosis. METHODS: MSCs isolated from Sprague Dawley (SD) rats were induced into hepatocyt...AIM: To compare the influence of different transplant sites in bone marrow mesenchymal stem cell (MSC)-based therapy for liver fibrosis. METHODS: MSCs isolated from Sprague Dawley (SD) rats were induced into hepatocyte-like cells. Liver fibrosis in SD rats was induced with carbon tetrachloride. Following hepatocyte induction in vitro, 4',6-diamidino- 2-phenylindole (DAPI)-labeled MSCs were transplanted by intravenous, intrahepatic, and intraperitoneal injection. Histopathological staining, immunohistochemistry, and biochemical analysis were used to compare the morphological and functional liver regeneration among different MSC injection modalities. The expression differences of interleukins, growth factor, extracellular matrix, matrix metalloproteinases, and tissue inhibitor of metalloproteinase were examined by real-time reverse transcription-polymerase chain reaction (RT-PCR) andenzyme linked immunosorbent assay (ELISA). RESULTS: Four days after exposure to hepatocyte differentiation medium, MSCs that did not express hepatocyte markers could express α-fetoprotein, albumin, and cytokeratin 18. The results of histopathological staining, immunohistochemistry, and biochemical analysis indicated that intravenous injection is more effective at rescuing liver failure than other injection modalities. DAPI-labeled cells were found around liver lobules in all three injection site groups, but the intravenous group had the highest number of cells. PCR and ELISA analysis indicated that interleukin-10 (IL-10) was highest in the intravenous group, whereas il1β, il6, tnfα and tgfβ, which can be regulated by IL10 and are promoters of liver fibrosis, were significantly lower than in the other groups. CONCLUSION: MSC administration is able to protect against liver fibrosis. Intravenous injection is the most favorable treatment modality through promotion of IL10 expression.展开更多
Objective:To compare the eflect of zoledronic acid in treatment and prevention of osteoporosis with placebo.Methods:Random control trials regarding zoleilroiiic acid in treatment of osteoporosis were retrieved by sele...Objective:To compare the eflect of zoledronic acid in treatment and prevention of osteoporosis with placebo.Methods:Random control trials regarding zoleilroiiic acid in treatment of osteoporosis were retrieved by selecting Medline.EMbase and Pubmed databases till April 2012. The RevMan software was used for all of the statistical analysis.Results:A total of 9 trials were included in this meta-analysis.The pooled effect shewed that zoledronic acid could increase the bone mineral density by 2.98 times compared with placebo,and reduce the rate of fracture in patients by 32%.The results should the zoledronic acid intervention had significantly less serious adverse events than controls,and the odds ratio was 0.81(0.76-0.87).The longer term intervention, more than 12 months intervention,could gain a better prevention effect for osteoporosis(OR,95% CI for RMD was 3.35.2.77-3.92:for fracture was 0.67.0.54-0.82).Conclusions:This present study shows that zoledronic acid could be effective approach in the prevention of osteoporosis,and could increase the bone mineral density and reduce the risk ol facture.展开更多
In spite of advances in surgical care and rehabilitation, the consequences of spinal cord injury （SCI） are still challenging. Several experimental therapeutic strategies have been studied in the SCI field, and recen...In spite of advances in surgical care and rehabilitation, the consequences of spinal cord injury （SCI） are still challenging. Several experimental therapeutic strategies have been studied in the SCI field, and recent advances have led to the development of therapies that may act on the inhibitory microenvironment. Assorted lineages of stem cells are considered a good treatment for SCI. This study investigated the effect of systemic transplantation of mesenchymal stem cells （MSCs） in a compressive SCI model. Here we present results of the intraperitoneal route, which has not been used previously for MSC administration after compressive SCI. We used adult female C57BL/6 mice that underwent laminectomy at the T9 level, followed by spinal cord compression for 1 minute with a 30-g vascular clip. The animals were divided into five groups： sham （anesthesia and laminectomy but without compression injury induction）, MSC i.p. （intraperitoneal injection of 8×10^5 MSCs in 500 μL of DMEM at 7 days after SCI）, MSC i.v. （intravenous injection of 8 × 10^5 MSCs in 500μL of DMEM at 7 days after SCI）, DMEM i.p. （intraperitoneal injection of 500μL of DMEM at 7 days after SCI）, DMEM i.v. （intravenous injection of 500 μL of DMEM at 7 days after SCI）. The effects of MSCs transplantation in white matter sparing were analyzed by luxol fast blue staining. The number of preserved fibers was counted in semithin sections stained with toluidine blue and the presence of trophic factors was analyzed by immunohistochemistry. In addition, we analyzed the locomotor performance with Basso Mouse Scale and Global Mobility Test. Our results showed white matter preservation and a larger number of preserved fibers in the MSC groups than in the DMEM groups. Furthermore, the MSC groups had higher levels of trophic factors （brain-derived neurotrophic factor, nerve growth factor, neurotrophin-3 and neurotrophin-4） in the spinal cord and improved locomotor performance. Our results indicate that injection of MSCs by either intraperitoneal or intravenous routes results in beneficial outcomes and can be elected as a choice for SCI treatment.展开更多
基金The National Natural Science Foundation of China(Grant No.72474013)the Beijing Health Technology Promotion Project(Grant No.BHTPP2024007)。
文摘This study investigated the factors contributing to intravenous admixture preparation errors(IAPEs)within Pharmacy Intravenous Admixture Services(PIVAS).A retrospective analysis was conducted on IAPEs documented in the PIVAS unit of a large multi-specialty hospital in China,which houses over 2000 beds,covering the period from January 1,2015 to December 31,2022.Drug preparation records were examined using a generalized linear mixed model(GLMM)to identify both univariate and multivariate factors associated with IAPE occurrences.A total of 824 IAPE cases were recorded during the study period,yielding an overall error rate of 0.018%.Univariate analysis identified drug categories(general drugs,anti-infective drugs,and antineoplastic drugs),preparation time(workdays),and years of work experience as significant determinants(P<0.05).Multivariate analysis further confirmed that drug categories(general and antineoplastic drugs),preparation time(workdays),and work experience remained statistically significant predictors of IAPE incidence(P<0.05).IAPEs in PIVAS were influenced by multiple factors,predominantly those related to personnel and drug characteristics.Targeted interventions,informed by multivariate analysis,are essential to mitigating these errors and enhancing medication safety.
基金supported by the National Key Research and Development Program of China(2018YFC2001802)the National Natural Science Foundation of China(82303765 and 82071251)+4 种基金Hubei Province Key Research and Development Program(2021BCA145)Open Foundation of Hubei Key Laboratory of Regenerative Medicine and Multi-disciplinary Translational Research(2022zsyx008)Program of Scientifc and Technological Project in Guizhou Province(Qian Ke He Ji Chu ZK[2022]Yi Ban 516 and Qian Ke He Ji Chu ZK[2021]Yi Ban 559)the Science and Technology Talents Growth Project in Education Department of Guizhou Province(Qian Jiao He KY Zi[2021]4Y211)Research project of Guizhou Administration of Traditional Chinese Medicine(QZYY-2021-082).
文摘The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine(Dex),propofol,ketamine,etomidate,midazolam,and remimazolam.Apart from their established sedative,analgesic,and anxiolytic properties,an increasing body of research has uncovered neuroprotective efects of intravenous anesthetics in various animal and cellular models,as well as in clinical studies.However,there also exists conficting evidence pointing to the potential neurotoxic efects of these intravenous anesthetics.The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized.Considering the mentioned above,this work aims to ofer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system(CNS)and the peripheral nerve system(PNS)and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.
文摘Objective We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral stones.Methods We retrospectively reviewed 734 patients with ureteral stones treated by fluoroscopy-guided shockwave lithotripsy between March 2014 and March 2021.The primary outcome was a stone-free rate with one session within 30 days,defined as no residual stones without auxiliary treatment.The multivariate analysis was used to examine whether the intravenous urography use predicted treatment success.Furthermore,we compared the outcomes using propensity score matching.Results Ninety-eight patients underwent the intravenous urography use protocol(Group I),and the remaining 636 patients underwent the non-intravenous urography protocol(Group N).Stone-free rates with one session within 30 days were 38%and 32%in groups I and N,respectively(p=0.3).No statistical differences were observed in the conversion rate to ureteroscopy(p=0.3)or complication rate(p=0.7)between Group I and Group N.One patient who developed skin redness was considered a complication of the contrast medium.Propensity score matching examined 88 matched pairs.Treatment success was obtained in 31(35%)patients in Group I and 33(38%)patients in Group N(p=0.9)within 30 days with one session.Conclusion Radiolucent stones can be safely and effectively treated by shockwave lithotripsy with intravenous urography.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised patients.This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.CASE SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations.Postoperatively,he developed COVID-19 pneumonia,severe septic shock,and ARDS.He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse steroids.CONCLUSION IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection.We aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting.With further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.
文摘BACKGROUND Managing sudden deafness(SD)in patients with diabetes mellitus(DM)is partic-ularly challenging due to the heightened risk of adverse effects associated with systemic drug administration.This study explores the potential of retroauricular subperiosteal injection as a localized drug delivery method for a more effective and safe treatment.AIM To compare the efficacy of retroauricular subperiosteal injection vs systemic intravenous glucocorticoid(GC)administration for SD in patients with DM and assess the effects on blood glucose levels.METHODS A total of 128 cases of type 2 DM(T2DM)with SD diagnosed and treated in Zibo Central Hospital from February 2021 to July 2023 were divided into two groups:An observation group(66 cases receiving retroauricular subperiosteal injection of methylprednisolone)and a control group(62 cases receiving systemic intravenous administration of methylprednisolone).The two groups were compared in terms of therapeutic efficacy,hearing recovery,blood glucose level changes,and incidence of adverse reactions.Binary logistic regression was used to analyze the factors affecting therapeutic efficacy.RESULTS The observation group showed a significantly higher total effective rate(90.91%)compared with the control group(75.81%,P<0.05).Additionally,pure-tone hearing threshold,fasting plasma glucose,and 2-hour postprandial blood glucose were significantly lower in the observation group compared with the control group(P<0.05).The incidence of adverse reactions was also lower in the observation group than in the control group(7.58%vs 22.58%,P<0.05).A T2DM course longer than 5 years and systemic intravenous GC administration were identified as independent risk factors for treatment inefficacy(P<0.05).INTRODUCTION Sudden deafness(SD)is a clinical emergency characterized by rapid-onset hearing loss that is often accompanied by clinical symptoms such as tinnitus and vertigo[1].Although its pathogenesis remains unclear,it is supposedly associated with factors,including inner ear microcirculation disorders,autoimmune diseases,and viral infections[2,3].Patients with diabetes are particularly susceptible to microvascular complications due to poor long-term glycemic control,affecting the ear’s microcirculation,subsequently increasing the risk of SD[4].Type 2 diabetes mellitus(T2DM),a chronic metabolic disease,causes multiple microvascular damages throughout the body,complicating SD treatment in patients with diabetes[5,6].Inner ear microcirculation disturbances in patients with diabetes may exacerbate the risk of SD,and its pathological process may be related to vascular endothelial dysfunction,inflammatory reactions,and hemorrhological changes caused by diabetes mellitus(DM)[7].Current SD treatments include glucocorticoids(GCs),vasodilators,and hyperbaric oxygen therapy[8].GCs are widely used due to their anti-inflammatory and immunosuppressive effects[9].However,systemic GCs may cause blood glucose(BG)fluctuations and even increase the risk of complications in patients with DM,limiting their clinical use in this population[10].Therefore,there is a compelling and immediate need for a local alternative solution that minimally affects the metabolic mechanisms.In recent years,retroauricular subperiosteal injection has emerged as a localized administration modality for treating SD[11].This method allows drugs to directly act on the inner ear,avoiding the side effects of systemic administration and having a minor impact on BG levels,providing a potentially effective treatment for patients with diabetes[12].However,there is limited clinical evidence to compare the efficacy and glycaemic effects of retroauricular subperiosteal injection vs systemic intravenous GC administration in patients with SD and diabetes.This study aimed to explore the efficacy of retroauricular subperiosteal injection and systemic intravenous GC administration for treating patients with SD and DM and their effects on BG,providing a safer and more effective clinical treatment approach.
基金Supported by the Foundation of Jiangsu Provincial Commission of Health and Family Planning,No.QNRC2016353the Commission of Health and Family Planning Xuzhou,No.KC22206.
文摘BACKGROUND Stress hyperglycemia(SH)is a common phenomenon that is present in about 50%of patients with acute ischemic stroke(AIS).It is thought to be a main risk factor for poor functional outcome among patients with AIS undergoing intravenous thrombolysis(IVT).AIM To investigate the predictive value of glycemic indicators for early neurological outcomes(ENOs)in patients with AIS treated with IVT.METHODS We retrospectively reviewed a prospectively collected database of patients with AIS who underwent IVT at the Department of Neurology,Second Affiliated Hospital of Xuzhou Medical University,between January 2017 and June 2022.ENO included early neurological improvement(ENI)and early neurological deterioration(END),defined as a decrease or increase in the National Institutes of Health Stroke Scale(NIHSS)score between baseline and 24 hours after IVT.We analyzed the associations between glycemic indicators[including admission hyperglycemia(AH),fasting blood glucose(FBG),and SH ratio(SHR)]and ENO in all patients and in subgroups stratified by diabetes mellitus(DM).RESULTS A total of 819 patients with AIS treated with IVT were included.Among these,AH was observed in 329 patients(40.2%).Compared with patients without AH,those with AH were more likely to have a higher prevalence of DM(P<0.001)and hypertension(P=0.031)and presented with higher admission NIHSS scores(P<0.001).During the first 24 hours after IVT,END occurred in 208 patients(25.4%)and ENI occurred in 156 patients(19.0%).Multivariate mixed logistic regression analyses indicated that END was independently associated with AH[odds ratio(OR):1.744,95%confidence interval(CI):1.236-2.463;P=0.002].Subjects were classified into four groups representing quartiles.Compared with Q1,patients in the higher quartiles of SHR(Q2:OR:2.306,95%CI:1.342-3.960;P=0.002)(Q3:OR:2.284,95%CI:1.346-3.876;P=0.002)(Q4:OR:3.486,95%CI:2.088-5.820;P=0.001)and FBG(Q3:OR:1.746,95%CI:1.045-2.917;P=0.033)(Q4:OR:2.436,95%CI:1.476-4.022;P=0.001)had a significantly higher risk of END in the overall population.However,none of the glycemic indicators were found to be associated with ENI in patients with or without DM.CONCLUSION Our study demonstrated that glycemic indicators in patients with stroke treated with IVT were associated with the presence of END rather than ENI during the first 24 hours after admission.
文摘The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitoring,complication observation and management,positioning and mobility away from the bed,and quality assurance.These Guidelines encompass all the phases of intravenous thrombolysis care for patients experiencing acute ischemic stroke.This article aims to elucidate the Guidelines by discussing their developmental background,the designation process,usage recommendations,and the interpretation of evolving perspectives,thereby providing valuable insights for clinical practice.
文摘Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmonary complications, such as pneumonia and pneumothorax, significantly contribute to increased morbidity in this population. Case Presentation: We report the case of a 28-year-old female who injects drugs, and presents with fever, bilateral hand edema, and respiratory symptoms. Clinical evaluation revealed erythema and edema of both hands, elevated inflammatory markers, and a left lower lobe infiltration that progressed to pneumothorax. A diagnosis of PHS and left lower lobe pneumonia complicated by pneumothorax was established. Management and Outcomes: The patient was treated with broad-spectrum antibiotics, including ceftriaxone, levofloxacin, dexamethasone, and oxygen supplementation, as well as antipyretics. She demonstrated partial clinical improvement and was referred to another hospital’s thoracic surgery department for specialized care. Conclusions: This case underscores the importance of early recognition and multidisciplinary management of rare but serious complications in IVDU patients. Further research is necessary to elucidate the interplay between lymphatic dysfunction and pulmonary pathophysiology in this demographic.
文摘This study aimed to explore the specific application effect of specialist nursing intervention in intravenous therapy on elderly patients with peripherally inserted central catheters(PICC).From November 2023 to November 2024,a total of 60 elderly patients with PICC admitted to Guiqian International General Hospital were selected as research subjects.Using a digital random table method,these patients were randomly divided into a control group and an experimental group,with 30 patients in each.The control group received routine nursing care,while the experimental group received specialized intravenous therapy nursing intervention in addition to routine care.The nursing effects of both groups were comprehensively evaluated,including treatment compliance,psychological state,quality of life,incidence of complications,and satisfaction with nursing care.The results showed that after the intervention,the treatment compliance in the experimental group was significantly higher than that of the control group(P<0.05).Additionally,scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were markedly lower in the experimental group compared to the control group(P<0.05),indicating improved psychological well-being.The experimental group also scored higher in all dimensions of quality of life(P<0.05),and had a lower complication rate and higher satisfaction with nursing care(P<0.05).In conclusion,the application of specialized intravenous therapy nursing intervention in the care of elderly patients with PICC can significantly enhance treatment compliance,improve psychological status,elevate quality of life,and reduce complications,demonstrating strong clinical value and providing important guidance for future treatment and nursing of such patients.
基金supported by the Capital Medical University Undergraduate Innovation Project 2025(XSKY20-25251).
文摘Intravenous leiomyomatosis(IVL)is a rare,histologically benign uterine smooth muscle tumor with malignant biological behavior due to its propensity for intravascular extension.[1]While gynecological in origin,its most severe manifestations are cardiovascular,arising from tumor propagation through the venous system into the inferior vena cava(IVC),right heart,and pulmonary arteries,mimicking thromboembolic disease.[2,3]This can lead to pulmonary embolism(PE),right heart obstruction,and even sudden cardiac death.[4]Diagnosis is challenging,often delayed by misdiagnosis as conventional PE.We present two cases of IVL initially presenting with PE,highlighting the critical cardiovascular implications and diagnostic pitfalls.
基金supported by the Health and Health Development Promotion Project-Anesthesia and Critical Care Research Project(No.KM-20240219-01)。
文摘Background Postoperative pain,if not effectively controlled,can trigger sympathetic activation and stress responses that increase the risk of cardiovascular complications.Oxycodone,a semisynthetic opioid acting on bothμ-andκ-receptors,may provide stable analgesia with less hemodynamic fluctuation compared with the pureμ-agonist sufentanil.This study aimed to compare the efficacy and cardiovascular safety of oxycodone-based versus sufent anil-based intravenous patient-controlled analgesia(IV-PCA)after laparoscopic abdominal surgery.Methods This single-center retrospective comparative study included patients who underwent laparoscopic abdominal surgery between March 2024 and March 2025.According to their postoperative PCA regimen,patients were divided into an oxycodone group and a sufentanil group.The primary endpoint was the incidence of cardiovascular adverse events(CVAE)within 48 h after surgery,including hypotension,bradycardia,and arrhythmia.Logistic regression was used to identify independent predictors of CVAE,and receiver operating characteristic(ROC)analysis assessed discriminative performance.Results A total of 356 patients were analyzed(oxycodone n=197;sufentanil n=159).The incidence of CVAE was significantly lower in the oxycodone group than in the sufentanil group(5.2%vs.12.1%,P=0.021).Oxycodone provided comparable analgesic intensity with fewer PCA bolus attempts(36±15 vs.52±17,P<0.001)and higher patient satisfaction scores(4.3±0.5 vs.4.1±0.5,P=0.002).Multivariate logistic regression identified sufentanil use(OR:2.53,95%CI:1.16-5.84,P=0.018)as independent predictors of CVAE.Conclusions Oxycodone-based IV-PCA provided effective postoperative analgesia with a lower incidence of cardiovascular adverse events compared with sufentanil-based PCA.The results suggested that oxycodone offered a favorable balance between analgesic efficacy and hemodynamic stability,making it a safer alternative for postoperative pain management in patients at cardiovascular risk.
文摘In the present study, we aimed to analyze the irrational medical orders and evaluate the effect of pharmacy intervention on pharmacy intravenous admixture services of outpatient and emergency departments in our hospital. The irrational medical orders of PIVAS at the outpatient and emergency departments were retrospectively analyzed in Jun. 2015. We strengthened the pharmacy intervention on irrational medical orders since July 2015. All the cases were selected by systematic sampling method. Cased studied in Jun. 2015 served as the control group, whereas those studied in Jan. 2016 served as the intervention group. The irrational rate and the irrational number of daily average were compared between the control group and intervention group. The common type of irrational outpatient and emergency intravenous orders mainly included irrational use of solvents, irrational dosing interval and inappropriate compatibility of drugs. The irrational rate was reduced from 17.4% to 3.3% （P〈0.01）, and the irrational number of daily average was decreased from 5.23 to 1.00 （P〈0.01）. Pharmacy intervention can reduce the irrational rate of medical orders in our hospital, which is of great significance to promote rational drug use and improve medical quality.
文摘Heparin-induced thrombocytopenia(HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin(IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.
文摘The objective of this study was to evaluate the influence of infusion container design on the volume of residual drug solution following use in a clinical setting. 0.9% （w/v） NaCl infusion solution containers （5 types, each of three capacities： 100 mL, 250 mL and 500 mL） following clinical use for in-patients at Peking University Third Hospital were collected during Sept. and Oct. 2007. The volume of residual drug solution was determined. Hospital pharmacy records were used to determine the potential economic implications of discarding residual drug solutions. The mean residual volumes ranged from 0.38 mL to 4.80 mL and, in general, residual volume increased with increasing container capacity. The residual volumes for one type of double-port soft bag were significantly lower than the residual volumes for all other containers of the same capacity （P〈0.05）, including glass and semi-rigid plastic bottles. Highest residual volumes were observed for the single-port soft bag. Estimates of the value of discarded residual drug solution ranged from approximately US $15,000 to US $150,000 per annum in our hospital. Infusion container design has a major influence on residual drug solution volumes following intravenous infusion. Appropriate choice of bag design remains an important consideration for the economics and efficacy of infusion treatment in Chinese hospitals.
文摘BACKGROUND:A perennial challenge faced by clinicians and made even more relevant with the global obesity epidemic,difficult intravenous access(DIVA)adversely impacts patient outcomes by causing significant downstream delays with many aspects of diagnoses and therapy.As most published DIVA strategies are limited to various point-of-care ultrasound techniques while other“tricks-of-the-trade”and pearls for overcoming DIVA are mostly relegated to informal nonpublished material,this article seeks to provide a narrative qualitative review of the iterature on DIVA and consolidate these strategies into a practical algorithm.METHODS:We conducted a literature search on PubMed using the keywords“difficult intravenous access”,“peripheral vascular access”and“peripheral venous access”and searched emergency medicine and anaesthesiology resources for relevant material.These strategies were then categorized and incorporated into a DIVA algorithm.RESULTS:We propose a Vortex approach to DIVA that is modelled after the Difficult Airway Vortex concept:starting off with standard peripheral intravenous cannulation(PIVC)techniques,progressing sequentially on to ultrasound-guided cannulation and central venous cannulation and finally escalating to the most invasive intraosseous access should the patient be in extremis or should best efforts with the other lifelines fail.CONCLUSION:DIVA is a perennial problem that healthcare providers across various disciplines will be increasingly challenged with.It is crucial to have a systematic stepwise approach such as the DIVA Vortex when managing such patients and have at hand a wide repertoire of techniques to draw upon.
文摘Objective: to construct an intravenous therapy team to see whether it can lead nurses of different tiers to have a higher awareness rate in terms of operational norms of techniques involved in intravenous therapy nursing and whether it can improve the quality of care. Methods: an intravenous therapy team was constructed in January 2021 in our hospital to carry out relevant knowledge training for nurses at different levels in the whole hospital for 1 year, to summarize the knowledge level of nurses at different levels in the hospital before and after, whether the patients had complications when receiving treatment, the rating of nursing quality, and also to the satisfaction level of nursing care. Results: after 1-year period, in terms of the knowledge rate of operational norms, nurse (75.69 ± 7.18) points, supervisor (81.76 ± 5.95) points and supervisors supervisor and above (88.25 ± 5.99) points were significantly higher compared to (58.12 ± 5.37) points, supervisor (64.21 ± 5.89) points and (76.63 ± 5.78) points before group construction, P 0.05;The complication rate of 3.67% in the study group was significantly lower compared to 10.00% in the reference group, P 0.05;Comparing the quality of nursing care, the basic nursing (84.15 ± 7.33) points, health education (87.25 ± 5.68) points, operational skills (85.36 ± 6.01) points, and nursing records (57.62 ± 6.48) points in the study group were significantly higher compared with the (62.87 ± 6.05) points, (65.69 ± 5.77), basic nursing (67.36 ± 5.56), and (70.36 ± 6.13) points in the reference group, P 0.05;97.67% satisfaction in the study group was significantly higher than 92.33% in the reference group, P 0.05. Conclusions: the construction of the venous therapy team to make nurses at different levels throughout the hospital more aware of venous therapy related operational codes of care, the quality of nursing services has also been improved very well, with fewer related complications and higher patient satisfaction, which is worth promoting.
基金Supported by Millitary Medicine and Health Foundation of China, No. 08Z030
文摘AIM: To compare the influence of different transplant sites in bone marrow mesenchymal stem cell (MSC)-based therapy for liver fibrosis. METHODS: MSCs isolated from Sprague Dawley (SD) rats were induced into hepatocyte-like cells. Liver fibrosis in SD rats was induced with carbon tetrachloride. Following hepatocyte induction in vitro, 4',6-diamidino- 2-phenylindole (DAPI)-labeled MSCs were transplanted by intravenous, intrahepatic, and intraperitoneal injection. Histopathological staining, immunohistochemistry, and biochemical analysis were used to compare the morphological and functional liver regeneration among different MSC injection modalities. The expression differences of interleukins, growth factor, extracellular matrix, matrix metalloproteinases, and tissue inhibitor of metalloproteinase were examined by real-time reverse transcription-polymerase chain reaction (RT-PCR) andenzyme linked immunosorbent assay (ELISA). RESULTS: Four days after exposure to hepatocyte differentiation medium, MSCs that did not express hepatocyte markers could express α-fetoprotein, albumin, and cytokeratin 18. The results of histopathological staining, immunohistochemistry, and biochemical analysis indicated that intravenous injection is more effective at rescuing liver failure than other injection modalities. DAPI-labeled cells were found around liver lobules in all three injection site groups, but the intravenous group had the highest number of cells. PCR and ELISA analysis indicated that interleukin-10 (IL-10) was highest in the intravenous group, whereas il1β, il6, tnfα and tgfβ, which can be regulated by IL10 and are promoters of liver fibrosis, were significantly lower than in the other groups. CONCLUSION: MSC administration is able to protect against liver fibrosis. Intravenous injection is the most favorable treatment modality through promotion of IL10 expression.
文摘Objective:To compare the eflect of zoledronic acid in treatment and prevention of osteoporosis with placebo.Methods:Random control trials regarding zoleilroiiic acid in treatment of osteoporosis were retrieved by selecting Medline.EMbase and Pubmed databases till April 2012. The RevMan software was used for all of the statistical analysis.Results:A total of 9 trials were included in this meta-analysis.The pooled effect shewed that zoledronic acid could increase the bone mineral density by 2.98 times compared with placebo,and reduce the rate of fracture in patients by 32%.The results should the zoledronic acid intervention had significantly less serious adverse events than controls,and the odds ratio was 0.81(0.76-0.87).The longer term intervention, more than 12 months intervention,could gain a better prevention effect for osteoporosis(OR,95% CI for RMD was 3.35.2.77-3.92:for fracture was 0.67.0.54-0.82).Conclusions:This present study shows that zoledronic acid could be effective approach in the prevention of osteoporosis,and could increase the bone mineral density and reduce the risk ol facture.
文摘In spite of advances in surgical care and rehabilitation, the consequences of spinal cord injury （SCI） are still challenging. Several experimental therapeutic strategies have been studied in the SCI field, and recent advances have led to the development of therapies that may act on the inhibitory microenvironment. Assorted lineages of stem cells are considered a good treatment for SCI. This study investigated the effect of systemic transplantation of mesenchymal stem cells （MSCs） in a compressive SCI model. Here we present results of the intraperitoneal route, which has not been used previously for MSC administration after compressive SCI. We used adult female C57BL/6 mice that underwent laminectomy at the T9 level, followed by spinal cord compression for 1 minute with a 30-g vascular clip. The animals were divided into five groups： sham （anesthesia and laminectomy but without compression injury induction）, MSC i.p. （intraperitoneal injection of 8×10^5 MSCs in 500 μL of DMEM at 7 days after SCI）, MSC i.v. （intravenous injection of 8 × 10^5 MSCs in 500μL of DMEM at 7 days after SCI）, DMEM i.p. （intraperitoneal injection of 500μL of DMEM at 7 days after SCI）, DMEM i.v. （intravenous injection of 500 μL of DMEM at 7 days after SCI）. The effects of MSCs transplantation in white matter sparing were analyzed by luxol fast blue staining. The number of preserved fibers was counted in semithin sections stained with toluidine blue and the presence of trophic factors was analyzed by immunohistochemistry. In addition, we analyzed the locomotor performance with Basso Mouse Scale and Global Mobility Test. Our results showed white matter preservation and a larger number of preserved fibers in the MSC groups than in the DMEM groups. Furthermore, the MSC groups had higher levels of trophic factors （brain-derived neurotrophic factor, nerve growth factor, neurotrophin-3 and neurotrophin-4） in the spinal cord and improved locomotor performance. Our results indicate that injection of MSCs by either intraperitoneal or intravenous routes results in beneficial outcomes and can be elected as a choice for SCI treatment.
