Effect of the Active Cycle of Breathing Technique on Perioperative Outcome in Individuals With Esophagectomy: A Quasi-Experimental Study

Background: The effect of active cycle of breathing technique (ACBT) on EC patients has not been well elucidated. In this research, we aim to explore the effect of ACBT on the perioperative outcomes in patients with esophageal carcinoma who underwent esophagectomy.Methods: Patients who underwent esophagectomy in an academic institution from December 2017 to July 2019 were included in this study. In a quasi-experimental study, participants were randomly divided into an experimental group (active cycle of breathing technique, n = 107) and an observational group (n = 106) by drawing lots. The chi-squared test, Cochran–Mantel–Haenszel test, Logistic regression analysis, and Kruskal–Wallis test were used to analyze data. A two-sided P value <0.05 was considered statistically significant. The primary observational endpoint was the mean weight of the sputum. Other outcomes included the six-min-walk test (6MWT), Borg scale, anastomotic leakage, and the length of hospital stay.Results: 95 patients underwent minimally invasive surgery, and 118 patients received open surgery. There were 16 patients with anastomotic leakage in the present study, and we found that patients in the observational group had higher odds of anastomotic leakage. The results showed that the mean weight of the sputum in the observation group was lighter than that of the experimental group. After esophagectomy, the experimental group had better outcomes than the observation group (Borg scale: 2.448 vs. 1.547; 6-MWT: 372.811 vs. 425.355m, all P < 0.05). The mean length of hospital stay was longer in the observation group (17.953 days) than that in the experimental group (12.037 days, P = 0.01). We also found that the observational group had a higher discharge ratio over 2 weeks in all cohort (adjusted OR 2.487, 95% confidence intervals 1.147–5.392, P = 0.021).Conclusion: Active cycle of breathing technique may improve the perioperative outcomes and decrease the length of hospital stay after surgery in patients with esophageal cancer. However, we need more researches to validate these findings.

Retrospective Analysis of Fondaparinux and Low-Molecular-Weight Heparin in the Treatment of Women With Recurrent Spontaneous Abortion

BackgroundTo compare the clinical efficacy of fondaparinux and LMWH and provide clinical evidence for the effectiveness of fondaparinux in the treatment of recurrent spontaneous abortion caused by PTS.MethodsA retrospective analysis was conducted for 120 patients diagnosed with a recurrent spontaneous abortion caused by PTS in Qingdao Jinhua Women’s Hospital from March 2019 to April 2020. The patients were divided into two groups: 68 cases in the control group, treated with LMWH, 52 cases in the observational group, treated with fondaparinux. The pregnancy outcomes and adverse reactions between the two groups of recurrent miscarriage patients were compared.ResultsNo significant difference was detected in the general data between the two groups of patients before treatment (P>0.05). In the observational group, the R value was increased, and the α and MA values were decreased after three months of treatment compared to those before treatment (P<0.05). In the control group, the R value was increased, and the MA value was decreased after three months of treatment compared to those before treatment (P<0.05). After treatment, no significant difference was observed in the pregnancy outcome between the two groups (P>0.05). The total adverse reaction rate of the fondaparinux group was lower than that of the LMWH group (P<0.05).ConclusionsIn this study, no significant difference was detected in the pregnancy outcome between fondaparinux and LMWH in the treatment of recurrent spontaneous abortion caused by PTS, but fondaparinux had a low occurrence rate of adverse reactions and high safety.

Therapeutic Effect of Micro-Ecologics Combined with Blue Light Irradiation on Neonatal Jaundice: Randomized Control Trial

Abnormal bilirubin metabolism results in abnormally raised serum bilirubin level thus presenting as yellowing of face, skin and mucosa to varying degrees. Purpose: To observe clinical effects on neonatal jaundice of micro-ecological preparation combined with blue light irradiation. Study Design: Randomized control trial. Methodology: Enrolled 100 neonatal jaundiced children (50 each group). Control group received blue light irradiation while observation group was given probiotics on the basis of blue light irradiation. Percutaneous bilirubin levels, clinical efficacy and the incidence of side effects were compared between pre and post-treatment groups. Statistical analysis: Data analyzed by SPSS 20.0v. Results: Post-treatment, levels of percutaneous bilirubin were significantly lower than pre-treatment. Observational group had significantly lower levels than the control group, having significant p-value (P<0.05). However, total effective rate of the observational group was significantly higher than control group with statistically significant p-value (P<0.05).The difference in incidence of ADR was significant (P<0.05). Conclusion: This study concluded that microecological preparation combined with blue light irradiation had a definite effect on the treatment of neonatal jaundice, not only effectively reduced the bilirubin level of children, but also reduced adverse reactions hence the safety was high. Therefore, it was worthy of application and promotion. Key Words: Neonatal Jaundice, Micro-ecological Preparations, Blue Light Exposure

Application of comprehensive u nit-based safety program model in the inter-hospital transfer of patients with critical diseases: a retrospective controlled study

Background To explore the effect of applying a comprehensive unit-based safety program (CUSP) in the intrahospital transfer of patients with critical diseases. Methods A total of 426 critically ill patients in the first affiliated Hospital of Anhui Medical University from August 2018 to February 2019 were divided into two groups according to the time of admission. Overall, 202 patients in the control group were treated with the routine transfer method, and 224 patients in the observational group were treated with the transfer method based on the CUSP model. The safety culture assessment data of medical staff, the occurrence rate of adverse events and related causes, the time of transfer, and the satisfaction of patients’ relatives to the transfer process were compared before and after implementation of the transfer model between the two groups. Results Before and after the implementation of the CUSP mode transfer program, there were significant differences in the scores of all dimensions of the safety culture assessment of medical staff (P < 0.05), and the occurrence rate of adverse events and the causes in the observational group were significantly lower than those in the control group (disease-related, staff-related, equipment-related, environment-related) (P < 0.05). The transfer time for Computed Tomography (CT), Magnetic Resonance Imaging (MRI), operating room, and the interventional room was significantly shorter in the observational group than that in the control group (P < 0.05), while the satisfaction of relatives to the transfer process was significantly higher than those in the control group (P < 0.05). Conclusion The implementation of CUSP model for the intrahospital transfer of critically ill patients can significantly shorten the in-hospital transfer time, improve the attitude of medical staff towards safety, reduce the occurrence rate of adverse events, and improve the satisfaction of patients’ relatives to the transfer process.

Clinico-histopathological and ultrasonographic correlation of abnormal uterine bleeding in perimenopausal and postmenopausal women

Background: Abnormal uterine bleeding (AUB) accounts for one of the most common gynaecological problem, almost one third of total cases. The study was a prospective study done from December 2017 to November 2019. The histopathological reports of endometrial pattern as well as that of hysterectomy specimens were correlated with clinical diagnosis and ultrasonographic findings. The main objective was to study the correlation between clinical, ultrasonographic and histopathological correlation of AUB in perimenopausal, menopausal and postmenopausal women.Methods: Formal Permission was obtained from the administrator of St. Philomena’s hospital. Ethical clearance was obtained from institutional ethical review board of St. Philomena’s hospital. Informed consent was obtained from observational group and confidentiality was assured. Data entry and analyses was done using the Statistical Package for Social Sciences (SPSS) for Windows software (version 20.0; SPSS Inc, Chicago).Results: A total number of 165 cases were studied. Maximum women were in the age group of 40-55 years 87.27%. Most common presentation of abnormal uterine bleeding is menorrhagia which accounts for 72.7% of women (120 women). The most common finding noted in USG was fibroid uterus which accounts for 44.2% of women (73 women). Most commonly observed histological pattern noted were proliferative (62.4%) followed by secretory endometrium (8.5%) and simple endometrial hyperplasia with atypia (8.5%).Conclusions: In conclusion, AUB is one of the most common condition for which patients seek advice in the gynaecological outpatient department. Analysis of histopathology of endometrium in abnormal uterine bleeding helps in management of patients and to know the pathological incidence of structural causes in AUB prior to surgery.

How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer?

3D printed surgical guides are used for prosthetically-driven oral implant placement. When manufacturing these guides, information regarding suitable printing techniques and materials as well as the necessity for additional, non-printed stock parts such as metal sleeves is scarce. The aim of the investigation was to determine the accuracy of a surgical workflow for oral implant placement using guides manufactured by means of fused deposition modeling (FDM) from a biodegradable and sterilizable biopolymer filament. Furthermore, the potential benefit of metal sleeve inserts should be assessed. A surgical guide was designed for the installation of two implants in the region of the second premolar (SP) and second molar (SM) in a mandibular typodont model. For two additive manufacturing techniques (stereolithography [SLA]: reference group, FDM: observational group) n = 10 surgical guides, with (S) and without (NS) metal sleeves, were used. This resulted in 4 groups of 10 samples each (SLA-S/NS, FDM-S/NS). Target and real implant positions were superimposed and compared using a dedicated software. Sagittal, transversal, and vertical discrepancies at the level of the implant shoulder, apex and regarding the main axis were determined. MANOVA with posthoc Tukey tests were performed for statistical analyses. Placed implants showed sagittal and transversal discrepancies of <1 mm, vertical discrepancies of <0.6 mm, and axial deviations of ≤3°. In the vertical dimension, no differences between the four groups were measured (p ≤ 0.054). In the sagittal dimension, SLA groups showed decreased deviations in the implant shoulder region compared to FDM (p ≤ 0.033), whereas no differences in the transversal dimension between the groups were measured (p ≤ 0.054). The use of metal sleeves did not affect axial, vertical, and sagittal accuracy, but resulted in increased transversal deviations (p = 0.001). Regarding accuracy, biopolymer-based surgical guides manufactured by means of FDM present similar accuracy than SLA. Cytotoxicity tests are necessary to confirm their biocompatibility in the oral environment.

Application of Standardized Measures in Clinical Teaching of Medical Imaging Department

Objective: To explore the application of standardized measures in clinical teaching of medical imaging department. Methods: Forty-eight medical interns in Department of Medical Imaging of our hospital from February 2018 to May 2019 were selected as research objects. They were divided into 2 groups according to random number table method, with 24 cases in each group. Routine education management was performed in clinical teaching for control group, standardized measure management was performed in clinical teaching for observational group. Performance assessment before and after intervention was compared between two groups of medical students. Results: Before intervention, there was no significant difference in assessment result between two groups of medical students (P>0.05). Assessment result after intervention was higher than before intervention in two groups of medical students. Observational group was higher than control group, the difference was statistically significant (P<0.05). Conclusions: Implementation of standardized measures in clinical teaching of medical imaging department could significantly improve assessment result of medical students, and its application can be considered in clinical teaching.

Patient’s anxiety at the different stages of genesis of myocardial infarction

The subject of this research is the anxiety of patients at different stages of genesis of myocardial infarction (MI). It is a proven fact that the high level of anxiety leads to reoccurrence and unfavorable course of disease both, in combination with other factors or regardless of them. However, the influence of separate aspects of anxiety into reoccurrence of MI remains insufficiently studied, which actualizes determination of the components of anxiety at different staged of emergence of this disease. The article presents a comparative analysis and description of the level of manifestation of various components of anxiety among the following empirical groups: 33 persons without myocardial infarction in past medical history, but in the group of risk by its genesis; 29 patients undergoing 2 to 5 days of hospital treatment for recovering after MI; 27 patients that have already received post-hospital therapy after MI. The observational group included 30 technically healthy persons. The following conclusions are formulated: 1) Anxiety components, such as asthenic, phobic, emotional discomfort are vivid among the patients who have survived MI, as well as persons in the risk group. However, an additional longitude research is required for proving the influence of anxiety into the genesis of myocardial infarction. 2) The currently conducted rehabilitation of MI patients reduces the overall level of situational anxiety, practically avoiding such its components that in the future can prompt recurrence of MI. 3) High level of anxiety is characteristic to all IM patients. The recommended programs for prevention and rehabilitation should be focused on long-term reduction of the level of personal anxiety, such as cognitive-behavioral psychotherapy.

Physiological Responses of Dogs to Different Housing Systems

Background: The hypothalamic-pituitary-adrenal (HPA) axis undergoes adaptations throughout housing system that might contribute to the avoidance of adverse effects of welfare status in dogs housed in a shelter. Nevertheless, the influence of housing systems and stabling time on glucose and PCV changes is little known. The purpose of the present study was to evaluate the patterns of cortisol, glucose and PCV in dogs housed in a kennel and normal environments, evaluating the differences between housing systems, by taking account the different stabling time and sex. Materials, Methods & Results: The study comprised 98 cross-breed dogs, aged 4 ± 1.5 years, lodged in a kennel (observational group I: N= 61, 29 females and 27 males), in paired household dogs (control group II: N= 25, 13 females and 12 males) and in unpaired household dogs (control group III: N= 12, 6 females and 6 males). Females of both groups were spayed. The subjects were studied on the basis of different stabling times, ranged among <1 year, 2 years and 4 years, and different sex.Discussion: This observational study showed that kennelled males lodged for 2 (P < 0.01) and 4 (P < 0.001) years showed lower cortisol concentrations than males lodged <1 year, males lodged for <1 year (P < 0.001) showed higher cortisol concentrations than females; males lodged for 4 year showed lower cortisol concentrations (P < 0.01) than females. Kennelled females lodged for 4 year showed higher PCV values (P < 0.001) than females lodged for <1 year. Paired and unpaired household females and males lodged for 4 years showed lower cortisol concentrations (P < 0.01) than 2 years and <1 year. Paired and unpaired household females and males lodged for short-, medium- and long-term times showed higher glucose concentrations (P < 0.001) than kennelled dogs. This study showed significant changes of circulating cortisol, glucose and PCV values inter- and intra-groups, according to different housing systems, stabling time and sex. The magnitude of cortisol decreases after 2 and 4 years of stabling time in kennelled male dogs could suggest a stimulus-response relationship, probably due to adaptive responses. Interestingly enough in this observational study was that the exact consummatory event could be represented by the long stabling time itself, observed only in males. Moreover, the significant differences of cortisol concentrations between males and females in group I after a stabling time of <1 and 4 years confirm the wide variability of HPA activity independent of the different sex of dogs. The physiological higher glucose concentrations in household dogs than kennel dogs showed that the normal home environment offers probably more rich stimuli than kennel, independent of stabling times and sex. It is possible to suppose that the housing system of dogs also results in significant rise of organ reserve and adaptability, presumably due at early greatest in functional changes in the catecholaminergic system and related increased hepatic glycogenolysis and gluconeogenesis. Concerning the PCV changes, data obtained confirmed the disagreement among authors about sex differences in the circulating mass of erythrocytes according to different age and sex. In conclusion, this is an observational study on the adaptive responses of circulating cortisol, glucose and PCV patterns to different housing systems in both kennel and household, leading to the question of physiological relevance concerning the effects of different stabling, according to the quality of dogs’ life.

Clinical Study on Treatment of Vascular Aging in Patients with Type 2 Diabetes Complicated by Hypertension with Combination of Traditional Chinese Medicine and Western Medicine

Objective: To explore the clinical effect of combination of traditional Chinese medicine and western medicine in treatment of vascular aging in patients with type 2 diabetes complicated by hypertension. Methods: Ninety patients with type 2 diabetes complicated by hypertension admitted to our hospital from May 2016 to August 2019 were selected as research objects. They were randomly divided into control group and observational group, with 45 cases each. Control group was given amlodipine besylate combined with metformin hydrochloride. On the basis of control group, observational group was given combination of TCM syndrome differentiation. Blood glucose, blood pressure and blood lipids before and after 14 days of treatment were compared between two groups. Results: Blood glucose, blood pressure and lipid indexes after treatment were lower than before treatment in both groups; observational group was lower than control group and the difference was statistically significant (P<0.05). Conclusion: Combination of traditional Chinese medicine and Western medicine could lower blood glucose and blood pressure indexes, control blood lipids and delay blood vessel aging in patients with type 2 diabetes complicated by hypertension, it is worthy of clinical popularization.