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Objective:To summarize the best evidence of intracranial hypertension nursing for adult patients with severe brain injury, and to provide reference for clinical nursing practice.Methods:According to the evidence-based methodology, a systematic search of Chinese and English literature on intracranial hypertension nursing of adult patients with severe brain injury was conducted in domestic and foreign databases such as CNKI, Wanfang, PubMed, Cochrane Library and Cinahl Plus and so on, as well as related guide websites and professional association websites from the establishment of database to August 2022. Two researchers independently evaluated literature quality and screened evidence, and then the project team summarized and concluded the evidence.Results:A total of 6 009 articles were obtained through preliminary search, and 33 articles were included after screening, including 13 guidelines, 1 systematic review, 17 expert consensus, 1 evidence summary, and 1 meta-analysis. In total, 33 pieces of best evidence were obtained from 8 dimensions, including intracranial pressure related threshold, assessment and monitoring, respiratory care, circulation care, analgesic and sedative care, temperature care, nutrition care and cerebrospinal fluid care.Conclusions:This study summarizes the evidence-based basis of intracranial hypertension nursing in adult patients with severe brain injury, which provides a basis for the standardized construction of clinical nursing strategies and empirical research.
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Objective To screen Oxalobacter formigenes (OxF) from fresh feces of healthy adults,and study its effect on the the prevention of calcium oxalate kidney stones.Methods OxF was screened and cultured from fresh feces of healthy adults.The rat model of calcium oxalate stone was established by esophageal gavage of 0.8％ of ethylene glycol.Rats were divided into a control group and four groups of rats with ethylene glycol-induced calcium oxalate kidney stones according to random number table.Three groups were treated with 106 CFU,107 CFU,108 CFU viable OxF every day,respectively,for 4 weeks.The blood and 24-hour urine samples were collected to detect the serum creatinine,urea nitrogen,serum and urine calcium,phosphorus,magnesium and urine oxalate every week.At the end of the 4th week,the rats were sacrificed and the kidney tissues were stained with HE and Yasue.The deposition and content of calcium oxalate crystals were observed under a light microscope.Results The bacteria strain isolated from fresh feces of healthy adults was 100％ as same as the known ATCC35274 bacteria strain,which means the strain screened is OxF.Among the 5 groups,there were no significant differences in body weight,Scr,BUN,serum calcium,blood magnesium,blood phosphorus,urinary magnesium and urinary phosphorus.The 24-hour urinary calcium excretion in the model group was significantly lower than that of the control group (P ＜ 0.05).After intervention with OxF solution,the 24-hour urinary calcium excretion in the 108 CFU OxF group was significantly higher than that in the model group (P ＜ 0.05),while there was no significant difference between the other intervention groups and the model.The oxalic acid excretion of 106 CFU OxF group and 107 CFU OxF group was lower than that of the model,but the difference did not reach statistical significance (P＞ 0.05).The 24 h oxalic acid excretion in the 108 CFU OxF group was significantly lower than that of the model at the end of first week (P ＜ 0.05),and continued to decrease for the next 3 weeks.After 4 weeks of intervention,no crystal formation was observed in the control group under the deflection microscope,but a large amount of calcium oxalate crystals were formed in the renal cortex and renal medulla.The crystals were piled up and connected to each other.Yasue staining coincided with the calcium oxalate crystal in the same part of the kidneys.Compared with the model,there was no significant change in the score of calcium oxalate crystal in the kidneys of 106 CFU OxF group and 107 CFU OxF group,while the score of calcium oxalate crystal in the kidneys of 108 CFU OxF group was significantly lower (P ＜ 0.05).Conclusions OxF are successively screened from healthy adults.Daily administration of 108 CFU OxF can safely and effectively reduce the urinary oxalic acid excretion,prevent the formation of calcium oxalate crystals and inhibit the formation of stones in kidneys of rats.
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Objective To improve the efficiency of blood collection in hemodialysis patients by inventing and applying new blood collection needles.Methods One hundred and eighty cases of hemodialysis patients were randomly divided into control group 1(CG1),control group 2(CG2),experimental group(EG). Comparison of the three groups in time of blood collection,the number of operation that had the risk of acupuncture injury and the number of the blood samples that had been contaminated. Results There were statistically significant difference (P<0.05)in three groups.The number of times of blood collection in the number of operations that had the risk of acupuncture injury,and the number of the blood sample that had been contaminated. CG1 had the longest blood collection time(12.55 min),EG had the shortest blood collection time(5.09 min);the risk of acupuncture injury was the highest in CG2 and the lowest in the EG.The number of contamination of blood samples and the amount of inaccurate sample in CG1 were the highest,and the lowest in the EG. Conclusions The working efficiency of transfer type anti-acupuncture needle(TTAN)during blood sample collection in hemodialysis patients is signifi-cantly better than that of traditional blood collection method,and it is helpful to reduce the risk of acupuncture injury and the risk of contamination in blood samples,which is worthy of promotion.
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Objective To establish a platinum resistance nude mice model of epithelial ovarian cancer (EOC) and investigate its resistance to cisplatin (DDP) biological characteristics, so as to provide evidences for exploring chemoresistence mechanisms and screening for reversal targets in vivo micro-environment. Methods The resistance model was produced by repeating a crossover subcutaneous injection of human ovarian cancer SKOV3 cells labelled green fluorescent protein(GFP) and transplatation of tumor fragment into nude mice. Two kinds of cancer cell lines of SKOV3/DDPⅠand SKOV3/DDPⅡwere induced with acquired resistence to DDP. The chemosensitivities of EOC cells to DDP were tested and half maximal inhibitory concentration(IC50) was measured by methyl thiazolyl tetrazolium (MTT) and flow cytometry (FCS). Dynamic analysis among the concentration of DDP treatment and cell apoptosis, cell cycle phase distribution and intracellular DDP concentration. The expression of PTEN, STAT5, XIAP, BRCA1 and MDR1 were examined by real time quantitative reverser transcription PCR (qRT-PCR) in vivo. Results IC50 value of cisplatin for SKOV3/DDPⅡ were 2.83 ± 0.12 and 3.82 ± 0.19 folds than those for SKOV3/GFP by MTT and flow cytometry, separately. SKOV3/DDPⅠwere 2.20±0.16 and 3.40±0.20 folds. The apoptosis rate of SKOV3/DDPⅡ and SKOV3/DDPⅠ were decreased significantly at 29.7 and 39.6μmol/L DDP when treatment for 36 hours,which were lower than that of SKOV3/GFP cells [(57.0±1.4)%vs (37.6 ± 4.36)%vs (83.1 ± 2.71)%,P=0.024;(74.4 ± 2.3)%vs (50.5 ± 3.4)%vs (87.4 ± 4.0)%,P=0.001]. SKOV3/DDPⅠ and SKOV3/DDPⅡ was positively related with cisplatin processing time. Intracellular DDP accumulation of SKOV3/DDPⅡand SKOV3/DDPⅠwere lower than SKOV3-GFP in dynamic processes(P<0.05). Besides intracellular DDP accumulation of SKOV3/DDPⅡ also lower than SKOV3/DDPⅠin dynamic processes (P<0.05). Transplanted tumor of SKOV3/GFP appeared organelle degradation and nuclear membrane imcompleted after five times DDP injection with concentration of 4 mg/kg. SKOV3/DDPⅡand SKOV3/DDPⅠdid not generate these phenomenon untill eighth DDP injections with concentration of 4 mg/kg. STAT5 and BRCA1 of SKOV3/DDPⅡwere increased with DDP treatment at concentration of 4 mg/kg. Expression of XIAP from SKOV3/DDPⅡwas positive correlated with injection times. STAT5,XIAP and BRCA1 of SKOV3/DDPⅡwere up-regulated 3.86,28.1 and 14.6 folds than those in SKOV3/GFP cells after eighth DDP treatment, separately. While PTEN of SKOV3/DDP Ⅱ was decreased 3.77 folds. Conclusions We have successfully established platinum-resistent EOC mice model,which provides a new platform for further study on chemoresistant reversal and individualized clinical treatment. The results shown that potential mechanisms of SKOV3/DDPⅡDDP-resistance included over-expressed BRCA1 gene may be promote DNA damage repair, elevate XIAP gene to decrease cell apoptosis,up-regulated STAT5 gene and decrease PTEN gene to stimulate proliferation.
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Objective To study the effect of 3+1 rehabilitation nursing mode on treatment effect and cognitive function of dementia patients. Methods Two hundreds and forty cases of dementia patients were randomly divided into the observation group and the control group with 120 cases in each group. The observation group were treated with routing therapy and 3+1 nursing mode and the control group with routine therapy and nursing. Mini-mental state examination(MMSE), and main symptoms (MS) scales,activity of daily living (ADL) scale were used for assessment of symptoms and signs before and after nursing. Results Changes of scores for MMSE, MS and ADL before and after rehabilitation nursing had statistical differences in the two groups. Conclusions The 3+1 nursing mode can improve the effect on cognitive function of dementia patients.