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Objective:Health education program based on information-motivation-behavioral skills model (IMB model) was developed, and its application effect in functional exercise after autogenous arteriovenous fistula (AVF) in hemodialysis patients was explored.Methods:Using the convenient sampling method, 100 patients undergoing AVF surgery in hemodialysis center of Qingdao Municipal Hospital from June 2020 to June 2021 were selected as the study objects. The patients were numbered according to the order of visit. The single number was the observation group, and the double number was the control group. There were 50 patients in each group. The control group was given routine AVF function exercise education, and the observation group was given AVF function exercise education based on the IMB model. Patients′ compliance with functional exercise, cephalic vein diameter, fistula maturation time, and the incidence of complications were compared between the two groups.Results:Finally, 49 cases in the control group and 50 cases in the observation group finished the research. The compliance of function exercise of the observation group was 94.0%(47/50), which was higher than 73.5%(36/49) in the control group, and the difference was statistically significant ( χ2=7.70, P<0.05). The maturation time of plasty in the observation group was (5.18 ± 1.14) weeks, shorter than that in the control group (5.94 ± 1.39) weeks, and the difference was statistically significant ( t=2.98, P<0.05). The cephalic vein diameter and blood flow controlled by hemodialysis pump in the observation group were (5.19 ± 0.28) mm and (218.40 ± 24.19) ml/min, respectively, higher than those in the control group (4.99 ± 0.34) mm and (200.41 ± 23.89) ml/min, the differences were statistically significant ( t=-3.21, -3.72, both P<0.05). The incidence of fistula complications in the observation group was 6.0%(3/50), lower than 22.4%(11/49) in the control group, and the difference was statistically significant ( χ2=5.52, P<0.05). Conclusions:The application of IMB model in hemodialysis patients with functional exercise after AVF plasty can effectively improve patients′ compliance, increase the diameter of cephalic vein and the blood flow controlled by dialysis pump, shorten the maturation time of internal fistula, and reduce the incidence of complications of AVF.
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Objective:To construct a palliative care quality evaluation index system in ICU, and to provide guidance for implementing high-quality palliative care in ICU.Methods:The questionnaire was designed by literature review, qualitative interview and questionnaire survey, and 20 experts were inquired in two rounds by Delphi method from September to November 2020.Results:After two rounds of letter consultation, experts′ response rates were 80% and 100% respectively, experts′ authority coefficient was 0.873, and coordination coefficient of experts′ opinion were 0.198 and 0.176 respectively. The quality evaluation index system for palliative care in ICU included 6 first-level indicators, 22 second-level indicators and 95 third-level indicators.Conclution:The constructed evaluation system for palliative care is scientific and reliable,which can provide guidance for the implementation and development of ICU high-quality palliative care in China.
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Objective@#To evaluate the safety of clinically-indicated replacement of peripheral intravenous catheters (PIVCs) in old adults.@*Methods@#Total of 1 627 patients with peripheral intravenous catheters in emergency wards at a tertiary hospital in shanghai were recruited. Patients were randomly divided into an experimental group (817 cases) and control group (810 cases) by random digits tale method. PIVCs in the experiment were replaced only when clinical indications appeared, while PIVCs in the control group were routinely changed every 72-96 hours. Indwelling time, complications associated with PIVCs and nurse compliance were compared after indwelling peripheral intravenous catheters.@*Results@#PIVC indwelling time was (3.43±1.36) days in the experimental group, and (3.18±1.16) days in the control group ,there was significant difference between two groups (t value was 4.07, P<0.05). The incidence of phlebitis, occlusion, infiltration, and accidental removal in experimental group was 11.26% (92/817), 17.97% (146/817), 10.77% (88/817), 3.91% (32/817), while in the control group 9.88% (80/810), 15.06% (122/810), 11.23% (91/810), 3.70% (30/810). The two groups showed no statistically difference in catheter phlebitis, occlusion, infiltration, and accidental removal (χ2 values were 0.82, 2.33, 0.09, 0.05, P>0.05). The severity of phlebitis in the experiment group was higher than that in the control group, and there was significant difference between two groups (χ2 value was 20.99, P<0.05). Nurse compliance achieved in the experimental group 100.00% (817/817) was higher than that in the control group 87.65% (710/810), which showed statistically difference (χ2 value was 107.47, P<0.05).@*Conclusion@#Indwelling time in the clinically- indicated replacement group was longer than that of the routine replacement group. Peripheral intravenous catheters in old adults can be remove as clinically-indicated with a close monitoring of complications.
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Objective:To evaluate the safety of clinically-indicated replacement of peripheral intravenous catheters (PIVCs) in old adults.Methods:Total of 1 627 patients with peripheral intravenous catheters in emergency wards at a tertiary hospital in shanghai were recruited. Patients were randomly divided into an experimental group (817 cases) and control group (810 cases) by random digits tale method. PIVCs in the experiment were replaced only when clinical indications appeared, while PIVCs in the control group were routinely changed every 72-96 hours. Indwelling time, complications associated with PIVCs and nurse compliance were compared after indwelling peripheral intravenous catheters.Results:PIVC indwelling time was (3.43±1.36) days in the experimental group, and (3.18±1.16) days in the control group ,there was significant difference between two groups ( t value was 4.07, P<0.05). The incidence of phlebitis, occlusion, infiltration, and accidental removal in experimental group was 11.26% (92/817), 17.97% (146/817), 10.77% (88/817), 3.91% (32/817), while in the control group 9.88% (80/810), 15.06% (122/810), 11.23% (91/810), 3.70% (30/810). The two groups showed no statistically difference in catheter phlebitis, occlusion, infiltration, and accidental removal ( χ2 values were 0.82, 2.33, 0.09, 0.05, P>0.05). The severity of phlebitis in the experiment group was higher than that in the control group, and there was significant difference between two groups ( χ2 value was 20.99, P<0.05). Nurse compliance achieved in the experimental group 100.00% (817/817) was higher than that in the control group 87.65% (710/810), which showed statistically difference ( χ2 value was 107.47, P<0.05). Conclusion:Indwelling time in the clinically- indicated replacement group was longer than that of the routine replacement group. Peripheral intravenous catheters in old adults can be remove as clinically-indicated with a close monitoring of complications.
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Objective To investigate the influences of IL-17 on regulatory T ( Treg) cells during Chlamydia trachomatis infection. Methods Wild-type ( WT) C57BL/6 mice and IL-17-/- mice were in-tranasally injected with 1×103inclusion forming units (IFU) of Chlamydia muridarum (Cm) to establish the mouse model of Chlamydia trachomatis respiratory tract infection. Mouse spleen and lung single cells were prepared. The percentages of CD4+CD25+T and CD4+CD25+Foxp3+T cells were detected by flow cytome-try. Expression of Foxp3 and TGF-β at mRNA level in lung was detected by RT-PCR. The levels of IL-10 in bronchoalveolar lavage fluid samples were detected by ELISA. Results Compared with the WT mice, the IL-17-/- mice had higher percentages of CD4+CD25+T and CD4+CD25+Foxp3+T cells in spleen and lung on the third day of Cm infection. Both of the expression of Foxp3 at mRNA level in lung and the secretion of IL-10 in bronchoalveolar lavage fluid were increased in IL-17-/- mice as compared with those in WT mice. No significant difference in the expression of TGF-β at mRNA level in lung tissues was found between the two groups. Conclusion IL-17 might inhibit the proliferation of Treg cells and the secretion of IL-10 in the very early stage of Cm respiratory tract infection.
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Objective To analyze the clinical characteristics of patients with presbycusis by using disyllabic mandarin speech test materials (MSTMs).Methods A total of 59 subjects (23 men and 36 women) with presbycusis,from 61 to 84 years old with the average as 71.3±6.7.They were divided into three groups:the mild group (10 subjects),the moderate group (35 subjects)and the severe group (14 subjects)according to the pure tone average (PTA) thresholds at 0.5,1,2 and 4 kHz from the better ear.In addition,11 subjects of elderly persons with normal hearing were used as the control group.All the subjects enrolled in this study could speak Mandarin well in their daily lives.Nine lists of disyllabic mandarin speech test materials were utilized to test speech recognition threshold (SRT) and P-I function for these groups respectively.Results The PTA(51.65±11.98)and SRT (50.98±16.05)from presbycusis group were much higher than the control group(PTA 19.55± 4.55,SRT 18.79± 7.45),while the average slope of the P-I function 2.63％/dB from the presbycusis group was lower than the control group 4.65％/dB (P＜0.01).The SRT of male patients (56.54±17.23) was higher than the females(47.99± 15.63) (P＜0.05).The PTA and SRT in these three groups divided by degrees of hearing loss were higher than the control group obviously.The PTA and SRT had significantly increased as the degree of hearing loss increased.The differences among these groups were significant (P＜0.01).The average slope of P-I function of these three groups divided by degrees of hearing loss (mild group:2.47％/dB,moderate group:2.76％/dB,severe group:2.42％/dB) was smaller than the slopes in the control group which was 4.65 ％/dB (P＜0.01).The average slope of P-I function among these groups had no significant difference (P＞0.05).Conclusion The SRT of patients with presbycusis increased and the SRT of male was higher than the females.The average slope of P-I function decreased and the curve moved to right side and became a gradual curve.As hearing loss became more severe,the SRT rose more apparently.
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Objective To explore nursing care of the ex-utero intrapartum treatment (EXIT) in fetal neck mass oppressing airway. Methods A case of EXIT in which a fetal neck mass was diagnosed on ultrasound was fully prepared supplies and carried out. Nursing care was well implemented and vital signs of the puerpera and fetus were observed in preoperative and intraoperative surgery. Results The EXIT procedure was successful performed and vital signs of the puerpera and fetus were steadied. The score of Apgar was seven to eight. Conclusions Adequate equipment, multi-department collaboration, preoperative exercise and close cooperation are the important guarantee for the success of ex-utero intrapartum treatment.
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Objective:To investigate the effect of IL-17A on the differentiation and maturation of murine bone marrow-derived dendritic cells( BMDCs ) . Methods: Murine bone marrow cells were isolated and cultured in RPMI1640 complete medium in the presence of GM-CSF(20 ng/ml) for 8 days to induce differentiation of murine bone marrow cells to DC progenitors. Then these cells were treated with LPS(1 μg/ml) for 36 h which polarized immature DCs into mature DCs. Different concentrations of rmIL-17A(10 or 100 ng/ml) was added to the culture medium at different stages of BMDC differentiation and maturation. Co-stimulatory molecules expression on BMDC were analyzed by flow cytometry,and the culture supernatants were analyzed for IL-12p40 and IL-10 level by ELISA. Results:rmIL-17 could promote co-stimulatory molecules( CD40,CD80,CD86 and MHCⅡ) expression on BMDCs in a does-dependent manner,especially,the expression of CD40 and MHCⅡhad a significant increase in high concentration of rmIL-17A group;rmIL-17A was added while LPS induced maturation of BMDCs. CD40,CD80,CD86 and MHCⅡexpression on BMDC increased sharply in LPS plus rmIL-17A stimulation group,besides,CD86,MHCⅡ showed a higher level expression on BMDC with the increase of con-centration of rmIL-17A. Furthermore,secretion of IL-12p40 and IL-10 increased significantly in the group of DCs treated with LPS plus low concentration of rmIL-17 compared with the group without rmIL-17(P<0. 001). However,high concentration of rmIL-17A group showed significantly higher levels of IL-12p40(P<0. 001),but there was no difference in IL-10. Conclusion:IL-17A promotes the phe-notypic development of BMDC progenitors propagated in GM-CSF and cooperate with LPS to induce BMDC differentiation and matura-tion.
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Objective:Explore the education content and method for the accompanying persons to enhance the capacity of taking care of patient .Methods:Life satisfaction index ( LSR-A) Scale and accompanying persons chaperone capability questionnaire are the tools of this research .This research trained the 45 accompanying persons care ability, and used before and after comparison .Results:Before the intervention , Most of the persons′life satis-faction levels was at a low level (41 persons′≤13), only 4 (8.9%) at a medium level.After the intervention, life satisfaction levels was improved (27 persons′≥14).Life sat!sfaction was improved (P<0.05).Chaperone capability situation was improved , for the P values in all the examination were <0 .05 .Conclusion:The manage-ment could strengthen the support for accompanying persons , could effectively improve their life satisfaction and im-prove their ability to accompany , thus improving the quality of patient care .The hospital should also consider the nursing ethical problems in accompanying persons education .
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This study was aimed to establish an analysis method of amentotaxus biflavone distribution in rats' tissues, including the heart, liver, spleen, lungs, kidney, brain, stomach, large intestine and small intestine, in order to investigate its distribution characteristics in tissues after rats gavaged with amentotaxus biflavone. HPLC-UV was employed to determine contents of amentotaxus biflavone in rats' tissues. The intragastric administration dose of amentotaxus biflavone was 500 mg·kg-1. Rats were sacrificed by cervical dislocation 10 min, 0.5, 1, 2, 4, 8, 12 h after intragastric administration. Tissues of the heart, liver, spleen, lungs, kidney, stomach, large intestine, small intestine and brain were removed and dissected immediately. Distribution of amentotaxus biflavone in each tissue was determined after processing. The results showed that tissue in different range had a good linear range. The lowest detection limit was 0.125 ng. The RSD of intra and inter-day was less than 10%. The absolute recovery rate of amentotaxus biflavone in each tissue was between 75.07% and 89.80%. The relative recovery rate was between 92.00% and 107.00%. Amentotaxus biflavone in each tissue was stable in different tissues in refrigerator of -20° C for 15 days. It was concluded that there were relatively large concentration differences of amentotaxus biflavone in different tissues. After intragastric administration, amentotaxus biflavone was mainly distributed in the stomach, large intestine, small intestine, liver and kidney, and then the heart, lungs and spleen. It also distributed in brain tissues through the blood-brain barrier.
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Objective To investigate the possible mechanism of aggregation and activation of neu-trophils(polymorphonuclear neutrophils,PMN)in mice with chlamydial pneumonitis. Methods C57BL/ 6 mice were inoculated intranasally with 3×103 inclusion-forming units(IFU)of Chlamydia muridarum(Cm) to induce the murine model of chlamydial pneumonitis. Samples of lung tissues collected at different time points after infection were stained by hematoxylin and eosin for histopathological assessment of inflammation. The levels of myelo-peroxidase(MPO)were detected for the evaluation of PMN aggregation. The mononu-clear cells were isolated from lung tissues. The inflammatory cells were counted with Giemsaˊs staining. CD11b+Gr1+ cell population and CD11b expression in lung mononuclear cells were analyzed by flow cytome-try. The expression of chemokines(MIP-2,LIX,KC and MCP-1)in lung tissues at mRNA level was meas-ured by RT-PCR. Results Chlamydial pneumonitis was induced in mice by intranasal inoculation of 3×103 IFU of Cm. Compared with the mice from control group,large amounts of inflammatory cells including PMN, monocytes and lymphocytes were induced in lung tissues of mice with Cm infection. PMN responded earlier than monocytes to the infection. The levels of MPO were significantly increased in mice with Cm infection and reached the highest level on the 7th day after infection. A decline in MPO levels was observed on the 14th day but the levels were still higher than those on day 0. The percentages and total numbers of CD11b+Gr1+ cells were significantly increased after Cm infection. Moreover,an increased expression of PMN CD11b was also detected by flow cytometry. The expression of chemokines(MIP-2,LIX,KC and MCP-1)was in-creased in lung tissues of mice after Cm infection. The results of the study indicated that Cm infection in-duced the expression of PMN chemoattractants,resulting in the recruitment of PMN. Conclusion The infil-tration and activation of PMN in lung tissues of mice were induced by Cm infection through increasing the ex-pression of chemokines. PMN played an important role in immune responses against Cm infection.
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Objective To explore the expression and significance of Kiss-1, Ki-67 and VEGF-C in papillary thyroid carcinoma(PTC) and thyroid follicular adenoma (FA).Methods Forty-four cases of PTC and twelve cases of FA paraffin-embedded tissues were used .Immunohistochemical staining and microscopic image analysis technique were used to analyze the expression of Kiss-1, Ki-67 and VEGF-C.Results The integrated optical density (IOD) of Kiss-1, and VEGF-C in the PTC groups was 475.56 ±126.02 and 805.29 ±226.05,respectively.The proliferation index of Ki-67 protein was (3.36 ±1.11) %and the difference between the PTC and FA groups was statistically significant (P<0.05).The IOD of the above two indices was 408.12 ±124.05 and 912.63 ±108.12 in the PTC with lymph node metastasis group , respectively, while the proliferation index of Ki -67 protein was (3.93 ±0.92) % and the difference vs the group without lymph node metastasis was significant ( P <0.05 ) .In the PTC with capsular infiltration group the IOD of above two was 425.58 ±87.38 and 891.37 ±149.36, the proliferation index of Ki -67 protein was (3.79 ±1.09) %and the difference with PTC group without capsular infiltrtion was statistically significant (P<0.05).Linear correlation analysis showed that Ki-67 and VEGF-C were with positively correlated in PTC and FA tissues (P<0.05),while Kiss-1 and Ki-67, VEGF-C were with negatively correlated in PTC and FA tissues (P<0.05).Conclusion Kiss-1, Ki-67 and VEGF-C can facilitate the differential diagnosis of PTC and FA , serving as prognostic indicators in patients with PTC .