The Effect of Combination Use of Hemodialysis and Hemoperfusion on Microinflammation in Elderly Patients with Maintenance Hemodialysis

Objective: To investigate the clinical efficacy of insulin glargine combined with acarbose in the treatment of elderly patients with diabetes. Methods: One hundred and forty-four elderly patients with diabetes who received treatment between December 2016 and December 2017 in Binzhou People’s Hospital, China, were selected and divided into a control group and an observation group, 72 each, using random number table. The control group was treated with insulin glargine, while the observation group was treated with insulin glargine combined with acarbose. The therapeutic effect, improvement of quality of life and adverse reactions were compared between the two groups. Results: After treatment, fasting blood glucose (FBG), 2h postprandial blood glucose (PBG) and glycosylated hemoglobin (Hb Alc) of the two groups were lower than those before treatment, and the decrease degree of the observation group was significantly larger than that of the control group (P<0.05). The time needed for blood glucose reaching the standard level and daily insulin dosage of the observation group were significantly lower than that of the control group, and the differences were statistically significant (P<0.05). SF-36 scale score of the observation group was significantly better than the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The combination of insulin Glargine and Acarbose can significantly control the blood glucose level of elderly patients with diabetes, improve the biochemical indicators, and enhance the quality of life. It is worth promotion in clinical practice. doi: https://doi.org/10.12669/pjms.35.3.86 How to cite this:Li J, Ji J, Liu F, Wang L. Insulin Glargine and Acarbose in the treatment of elderly patients with diabetes. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.86 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

UNSTRUCTURED The purpose of this study is to explore the effect of continuous nursing system of artificial intelligence (AI) on patients discharged from hospital after heart valve replacement (HVR) and the application value of Omaha system. The patients undergoing HVR were taken as the research objects and divided into control group (routine nursing) and observation group (continuous nursing). Through the continuous nursing system of AI, the patients discharged from the hospital were monitored remotely, and the vital signs of patients were analyzed by AI. Different nursing methods were used to intervene the patients. Nursing evaluation data were used for nursing evaluation of patients undergoing HVR. Activity of Daily Life Scale (ADL) was used to evaluate patients' daily living ability, health status questionnaire was used to evaluate patients' health status, and World Health Organization Quality of Life-Brief version (WHOQOL-BREF) was used to evaluate patients' quality of life. The results showed that, before intervention, there was no significant difference in the scores of ADL between the control group and the observation group, with no statistical significance (P > 0.05). After intervention, the scores of ADL in the observation group were higher than those in the control group (P < 0.05), and the differences were statistically significant (P < 0.05); before intervention, the scores of ADL in the control group were higher than those in the control group, with statistical significance (P < 0.05). Before intervention, there was no significant difference in the health status questionnaire score between the control group and the observation group, without statistical significance (P > 0.05). After intervention, the health status questionnaire score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). Before intervention, there was no significant difference in WHO quality of life evaluation score between the control group and the observation group, without statistical significance (P > 0.05). After intervention, the WHO quality of life evaluation score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). After intervention, the KBS evaluation of nursing problem outcomes in the observation group was higher than that before intervention, and the difference was statistically significant (P < 0.05). In conclusion, the continuous nursing system of AI based on Omaha system can effectively evaluate the nursing problems of patients after discharge and improve the quality of life of patients, which has important application value.

Abstract The assessment of the six-week influence of Kinesio Taping combined with a rehabilitation on selected ultrasonography measurements, the level of disability, and the quality of life in patients with rotator cuff lesions. 60 participants were randomly assigned into a taping group (KT combined with a six-week rehabilitating protocol) and a control group (only rehabilitation protocol). In all patients the following assessments were performed twice: USG, UEFI and NHP questionnaires. In the examination of the subacromial space and the subacromial bursa in the taping group, no statistical significance was observed. A statistically significant change in the thickness of the muscles was obtained only for the thickness of the infraspinatus in the taping group. A statistically significant change was obtained in the assessment of tendinopathy only for the supraspinatus muscle in both groups. Within both groups a statistically significant difference was observed in the average UEFI and NHP scores; however, the differences in the scores obtained between the groups were not statistically significant. The use of KT with a rehabilitation program did not yield statistically significantly better results in the improvement of selected shoulder region indicators, the function of the upper limb and the quality of life.

Abstract Background and purpose Although participation in cardiac rehabilitation (CR) improves quality of life (QoL), participation in CR, especially among elderly, is limited. We conducted this study to assess whether mobile home-based CR (mCR) increases QoL in elderly (≥65 years old) patients with coronary artery disease (CAD) or a valvular intervention who decline participation in conventional CR. Methods It is designed as a randomised multi-centre study with two parallel arms. Randomisation assigned patients either to mCR or a control group. mCR Consisted of six months of home-based CR with telemonitoring and coaching. Control-group patients did not receive any form of CR throughout the study period. Quality of life was measured with the SF-36v2 questionnaire at 0, 6 and 12 months. Results A total of 179 patients were included in this study (90 control, 89 mCR). A flowchart of the trial is presented in Figure 1. Patients were predominantly male (81.1%). Baseline characteristics can be found in Table 1. Patients using mCR improved on physical QoL after 6 (p=0.026) and 12 (p=0.008) months. There was no difference on mental QoL for both groups (mCR 6 months p=0.563, 12 months p=0.945; control 6 months p=0.589, 12 months p=0.542). No difference existed in QoL between the mCR and control group (physical: 6 months p=0.070, 12 months p=0.150; mental: 6 months p=0.355, 12 months p=0.625). Conclusion Although there is no significant difference in QoL between the control and mCR group, mCR increases physical QoL after 6 and 12 months in elderly patients who decline participation in conventional CR. Therefore E-Health tools should be considered as an alternative for conventional CR when (elderly) patients decline to participate in conventional CR. Figure 1. Flow chart of all eligible patients Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020 research and innovation programme

Abstract Context Pain is one of the most common and intolerable symptoms in cancer patients. But cancer pain control is still negative in China. Objectives This paper explores the application of quality control circle in the treatment of cancer pain in inpatients to improve the quality of life of patients with cancer pain. Method Established a quality control circle group to analyze the current status of cancer pain control in inpatients with moderate cancer pain, set goals, formulate corresponding countermeasures and implement and review them in stages. The plan-do-check-act method was cyclically applied. The Brief Pain Inventory was used to evaluate the cancer pain status of patients with cancer pain hospitalized before (January to April 2016) and after (September to December 2016) the implementation of quality control circle activities. Results The pain control effect of the observation group was significantly better than that of the control group. The mean (standard deviation) of pain severity and pain interference in the observation group were significantly lower than those in the control group (6.21 [2.86] vs 4.31 [2.25], 10.54 [4.10] vs 7.25 [3.77]). There was significant difference after the implementation of quality control circle (P &lt; 0.01). Conclusion Quality control circle activities are used to manage patients with cancer pain, to improve the situation of pain control and to improve the quality of life of patients. This management tool and method is worthy of clinical promotion and application.

Abstract Objective：The purpose of this study is to retrospectively observe the clinical efficacy and adverse reactions of docetaxel hyperthermic intraperitoneal chemotherapy (HIPEC) combined with endostar in treatment of malignant ascites. Methods：56 cases of malignant ascites admitted to Zhejiang Hospital from July 2019 and October 2020 had received no less than second-line chemotherapy. The observation group (n = 29) was treated with endostar 60mg d1,4,7 Q3W intraperitoneal injection combined with docetaxel 60mg/m2 d4 HIPEC Q3W for 2 cycles. The control group (n = 27) was just treated with docetaxel 60mg/m2 d1 HIPEC Q3W for 2 cycles. The general clinical data and qualitative data of the treatment results were processed by SPSS26.0 using χ2 test, and quantitative data were processed by t test. When P < 0.05, statistical data can be considered statistically significant.Results：There were significant differences between the observation group and the control group in objective response rate (ORR) (65.5% vs 37.0%，P=0.033)，in the improvement rate of KPS (48.3% vs 22.2%, P=0.042)，also in the median control time (57dvs 45d，P=0.027). The incidence of III to IV adverse reactions was low, and no treatment-related death was observed. There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion：Endostar combined with docetaxel HIPEC has good clinical effect on malignant ascites and can improve patients’ quality of life, and the adverse reactions can be tolerated.

<p>With the development of science and technology, occupational accidents, as one of the most important problems in the world, result in negative effects on physical and psychological health, and also the quality of life of workers. The aim of this study was to compare the quality of life among workers with and without accident. In a cross-sectional study, 93 workers were selected, 31 who experienced accident and 62 as control group. To gather the data, a researcher-made questionnaire for demographic characteristics and the quality of life questionnaire (SF-36) were used. Mann-Whitney and Chi-square tests were used for data analysis. The mean and standard deviation of age was 30.81±7.29 and 30.56±7.19 in workers with accident (case group) and control group, respectively. Homogeneity was ensured in terms of age and work experience and the two groups had no significant difference in this regard (p&gt;0.05). Most of the participants were high school graduates (67.7%). The majority of accidents (68.8%) had occurred in the manufacturing sections. The most common accident type was sprayed chemical substances (19.4%) and the less frequent was electrocution (3.2%). The mean total score for the quality of life was 37.61±14.29 and 74.92±12.95 in the case and control groups with a statistical significance difference (p&lt;0.001). The results of this study indicate that the incident could affect the quality of life of workers. Therefore, promoting the safety culture can help to reduce the occupational accidents.</p>

Aims:Objective to explore the influence of family enteral nutrition support on nutritional status, lung function, activity tolerance and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD) in stable stage and malnutrition. Methods: a total of 165 elderly patients with COPD and malnutrition discharged from the geriatric department of our hospital were randomly divided into two groups: control group (82 cases) and observation group (83 cases). The control group was treated with conventional diet, and the observation group was treated with conventional diet + enteral nutrition suspension (nengjin, 500kcal / bottle, newdisia Pharmaceutical Co., Ltd.) for support. One month later, they were observed The body mass index (BMI), serum albumin (ALB), total protein (TP), hemoglobin (HB), pulmonary function of the two groups were observed: forced vital capacity (FVC), forced expiratory volume (FEV1) in the first second, FEV1 / FVC, FEV1% of the predicted value (FEV1%), exercise tolerance and quality of life.Results (1) compared with the control group, BMI and ALB in the observation group increased significantly (t = 10.465, 6.189, P < 0.05), TP and Hb had no significant change, and the difference was not statistically significant (t = 1.310, 1.302, P > 0.05). (2) compared with the control group, FVC, FEV1, FEV1 / FVC, FEV1% in the observation group increased, with statistical differences (t = 11.999, 19.654, 13.418, 16.924, P < 0.05). (3) compared with the control group, the quality of life symptom score, activity score, influence score and total score of the observation group decreased significantly (t = 15.303, 6.773, 23.600, 14.766, P < 0.05), and 6MWT increased significantly (t = 111.962, P < 0.05).Conclusion enteral nutrition support can improve the nutritional status, lung function, activity tolerance and quality of life of elderly patients with COPD in stable stage and malnutrition.

AbstractObjectiveThis paper aims to explore specific effects of out-of-hospital continuing nursing on schizophrenia patients’ health rehabilitation and quality of life, and further improve application and popularization of out-of-hospital continuing nursing.MethodsThe 180 schizophrenia patients discharged from our hospital from March 2014 to March 2016 were selected as the subjects. The patients were divided into two groups according to the randomized double-blind method. Both groups received routine discharge guidance, and the observation group received out-of-hospital continuing nursing on this basis. Questionnaires and scales were used to compare differences of the two groups after discharge from hospital, such as medication compliance, recurrence rate of schizophrenia, awareness of health knowledge and quality of life.ResultsAfter 6 months of nursing for the observation group, complete medication compliance rate was 71.11% (64/90), awareness rate of schizophrenia-related health knowledge was 96.67% (87/90), and recurrence rate was 8.89% (8/90). For the control group, complete medication compliance rate was 45.56% (41/90), awareness rate of schizophrenia-related knowledge was 46.67% (42/90) and the recurrence rate of disease was 26.67% (24/90). Hence, the observation group enjoys significant advantages compared with the control group. Statistical analysis (P <0.05) showed statistical significance; In addition, life quality scores showed that the quality of life of the observation group was obviously better than the control group; the difference was statistically significant (P <0.05).ConclusionOut-of-hospital continuing nursing for schizophrenia patients after discharge can effectively improve medication compliance, awareness rate of health knowledge, effectively reduce incidence of schizophrenia and improve the quality of life of patients. Thus, the nursing concept and related methods are worthy of publicity and application in a wider range.

To explore the application of natural convalescent factors combined with exercise intelligence management in blood pressure control of patients with hypertension, 102 patients with hypertension who were admitted from January 2017 to August 2019 were selected as the research subjects. According to the odd-even number method, they were divided into two groups with 51 cases in each group. The control group was treated with natural convalescent factor therapy alone, and the observation group was treated with natural convalescent factor combined with motor intelligence management. The application effects of the two groups were compared. Before sports intelligence management, the levels of systolic blood pressure (SBP) in control group and observation group were (145.45 ± 8.44) mmHg (1 mmHg = 0.133 kPa) and (146.55 ± 8.37) mmHg, respectively; the diastolic blood pressure (DBP) levels of the control group and the observation group were (98.47 ± 3.48) mmHg and (98.94 ± 3.48) mmHg, respectively, with no statistical significance ( P > 0.05 ). After the exercise intelligence management, the SBP levels of the control group and the observation group were (132.76 ± 4.48) mmHg and (130.06 ± 2.48) mmHg, respectively. The DBP levels of the control group and the observation group were (85.48 ± 5.38) mmHg and (83.47 ± 3.35) mmHg, respectively. The difference was statistically significant ( P < 0.05 ). The scores of each index of quality of life in the observation group were higher than those in the control group, and the differences of physical function and psychological/mental scores were significant. The scores of physical function in the two groups before administration were (48.36 ± 1.69) and (48.74 ± 1.62), and the differences were not statistically significant ( P > 0.05 ). After management, the physiological function scores of the two groups were (40.32 ± 1.33) and (32.15 ± 1.54) and the difference was statistically significant ( P < 0.05 ). There were no significant differences in the psychological (30.75 ± 1.26)/mental scores (30.26 ± 1.48) between the two groups before management ( P > 0.05 ), but there were significant differences in the psychological (25.30 ± 1.02)/mental scores (18.76 ± 1.36) between the two groups after management ( P < 0.05 ). The combination of natural convalescent factors and intelligent exercise management can effectively control the blood pressure level and improve the quality of life of patients with hypertension, and the clinical application effect is good.