April 2019, Volume 22，No.11 Abstracts(B)
Author：尹鹏 Source：CGP Published： [04-30] views： 256
Pelvic Floor Biofeedback Therapy for Postoperative Dysuresia among Middle-aged and Elderly People with Cervical Spinal Cord Injury LIU Liangle，DAI Minghai，YE Xiuzhi，ZHONG Xiqiang，WANG Juncheng，TANG Chengxuan*
The Third Affiliated Hospital of Wenzhou Medical University，Wenzhou 325200，China
*Corresponding author：TANG Chengxuan，Professor，Chief physician；E-mail：email@example.com
【Abstract】 Background Cervical hyperextension injury is a common disease in middle-aged and elderly patients，and dysuria is one of the main complications. In recent years，pelvic floor electrobiofeedback method has been used to treat dysuria，and has been gradually promoted in clinical practice. However，the effect of using only a single physical or pharmaceutical method to treat dysuria in middle-aged and elderly patients is often unsatisfactory. Objective To evaluate the effect of pelvic floor biofeedback therapy （PFBT） on postoperative dysuresia in middle-aged and elderly people with cervical spinal cord injury （CSCI）．Methods We enrolled 82 middle-aged and elderly patients with postoperative dysuresia following CSCI surgery from the Third Affiliated Hospital of Wenzhou Medical University from May 2012 to May 2015.We divided them into control group （n=42） and treatment group （n=40） by random number table，receiving bladder training，bladder training combined with PFBT，respectively.The treatment effect was evaluated by the duration of indwelling urethral catheter and the rate of successful spontaneous voiding measured during the active voiding trial，and urodynamic parameters （including the residual urine volume，maximum capacity of the bladder，maximum urinary flow rate，average urinary flow rate，detrusor pressure at the end of filling） measured after treatment.Results All patients were followed up for an average of 4.5 months.The average duration of indwelling urethral catheter in the treatment group was significant less than that of the control group〔（24.5±3.9） d vs （45.6±5.5） d，t=19.950，P<0.001〕.Spontaneous voiding recovery was achieved in 37 （92.5%） in the treatment group，and 28 （66.7%）in the control group including 13 demonstrated different degrees of dysuresia after the removal of the urethral catheter，indicating that the treatment group had a higher rate of successful spontaneous voiding （χ2=8.329，P=0.004）．After treatment，the maximum capacity of the bladder，maximun arinary flow rate，and the average urinary flow rate significantly increased while the residual urine volume decreased，and the detrusor pressure at the end of filling dropped obviously in both groups compared to the baseline （P<0.05）；the treatment group demonstrated substantially less residual urine volume and detrusor pressure at the end of filling and significantly increased maximum capacity of the bladder and average urinary flow rate compared with the control group （P<0.05）．Conclusion PFBT can effectively improve the postoperative voiding function and shorten the duration of indwelling urethral catheter in middle-aged and elderly patients with CSCI，which is worthy of clinical application.
【Key words】 Urination disorders；Urinary bladder，overactive；Electric biofeedback therapy；Bladder training therapy；Spinal cord injuries；Middle aged；Aged
Application Effect of Otago Exercise Program and Xiao's Double C Nursing in Elderly Patients with Hemiplegia Following Cerebral Infarction XIE Jing
Social Work Department，Henan Provincial Chest Hospital，Zhengzhou 450000，China
【Abstract】 Background The incidence of hemiplegia following cerebral infarction is increasing，which has a great impact on the quality of life and physical and mental health of the population in the world.In the past，Otago exercise program was often used to intervene such patients，which can achieve certain effects，but the overall effect is not satisfactory.Xiao's double C nursing is an intervention of important clinical significance，which can make patients reach various comfort levels，improve the quality of comprehensive care，and promote the patients' recovery as early as possible.Objective To investigate the effect of Otago exercise program and Xiao's double C nursing in patients with hemiplegia induced by cerebral infarction.Methods Eighty four cases of cerebral infarction following hemiplegia were recruited from Henan Provincial Chest Hospital from November 2015 to May 2017，and were equally randomized into the control group （n=42） and study group （n=42），receiving 2-month conventional nursing and Otago exercise program，2-month conventional nursing，Otago exercise program and Xiao's double C nursing，respectively.At baseline，and the end of the 1st，and 2nd months of intervention，sensorimotor recovery was assessed by Fugl-Meyer Assessment （FMA） scale，level of activities of daily living was assessed by Barthel index，and quality of life was assessed by 30-item QOL scale，respectively.Adherence to rehabilitation training and satisfaction with nursing were also measured at the end of intervention.Results Intervention methods and duration had significant interactive effect on FMA score，Barthel index and 30-item QOL score （P<0.05）．And they produced obvious main effect on FMA score，Barthel index and 30-item QOL score （P<0.05）．Compared with baseline，FMA score，Barthel index and 30-item QOL score increased significantly in both groups at the end of the 1st and 2nd months of intervention （P<0.05）．Intergroup comparisons found that although FMA score，Barthel index and 30-item QOL score were similar in both groups at baseline （P>0.05），and FMA score，Barthel index and 30-item QOL score increased significantly in the study group at the end of the 1st and 2nd months of intervention （P<0.05）．Moreover，the adherence to rehabilitation training and satisfaction with nursing in the study group were all better than those of the control group （P<0.05）．Conclusion Conventional nursing in combination with Otago exercise program and Xiao's double C nursing，can effectively recover the level of activities of daily living，improve the sensorimotor recovery and quality of life，adherence to rehabilitation training，and enhance satisfaction with nursing in elderly patients with hemiplegia following cerebral infarction.
【Key words】 Brain infarction；Hemiplegia；Otago exercise training；Xiao double C nursing mode
Panicked Patient and Family Members：a RICE Skills-based Consultation Case Study in Primary Care Practice JIN Feng1*，WEI Xiao-lin2
1.Dongguang Machong Community Health Center，Dongguang 523000，China
2.Emergency Department，Dongguan People's Hospital，Dongguan 523059，China
*Corresponding author：JIN Feng，Associate chief physician；E-mail：firstname.lastname@example.org
【Abstract】 When encountering a panicked patient with metoclopramide-induced extrapyramidal reactions accompanied with family members，we used RICE （Reason-Idea-Concern-Expectation） skills，namely，detailedly analyzing the reasons for healthcare seeking，thoughts of the patient，concerns and expectations of the patient and her family members.By treatment based on this type of consultation，the anxieties and symptoms of the patient were relieved in a short period of time.Limited by the conditions of community health organizations （CHOs），general practitioners shall learn to solve problems in practice with simple methods，and improve the level of people's trust in the care delivered by CHOs with knowledge，technology and moral quality.
【Key words】 RICE inquiring；Metoclopramide；Extrapyramidal reaction；General practitioners
Multiple Myeloma with Hyperamylasaemia：a Case Report and Literature Review GUO Maodong1，DING Jin1，CHEN Yanping1，WANG Qunying1，WENG Xiang2，YE Xiaohua1*
1.Department of Gastroenterology，Jinhua Hospital of Zhejiang University/Jinhua Municipal Central Hospital，Jinhua 321000，China
2.Department of Hematology，Jinhua Hospital of Zhejiang University /Jinhua Municipal Central Hospital，Jinhua 321000，China
*Corresponding author：YE Xiaohua，Attending physician；E-mail：email@example.com
【Abstract】 Multiple myeloma （MM） is a terminally differentiated B-cell malignancy with clinical presentations of osteolytic bone lesions，impaired renal function，and pathological secretion of monoclonal immunoglobulin.Hyperamylasemia is a presentation mostly found in acute pancreatitis.Hyperamylasaemia associated with MM appears to be a fairly unusual phenomenon.We reported a case of MM with hyperamylasemia with a detailed description of the diagnosis and treatment process.Moreover，we investigated the clinical manifestations，treatments，prognosis and pathological mechanisms of this disease on the basis of the review of the related studies.The study can deepen clinicians' understanding of this disease.
【Key words】 Multiple myeloma；Hyperamylasemia；Case reports