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Objective:To explore the impact of empathy training programs on operating room nurses.Methods:A total of 100 internship nurses from the first phase and the second phase of clinical practice in the operation room of Liaocheng People′s Hospital from December 2016 to December 2018 were randomly selected. They were divided into the control group and the experimental group by randomized picking method. The experimental group was given empathy training intervention, and the control group students did not have the above training. The demographics of each intern student were recorded. The control group did not have the above training; the experimental group did three epistemological questionnaires immediately before the training, three weeks after the training and one month after the training, and the control group did not know the experimental group empathy training, at the same time as the experimental group, did three empathy questionnaire scores. Comparing the experimental group and the control group, the scores of the questionnaires in each stage of the experimental group were statistically different.Results:There were 48 nursing students in the control group and 45 nursing students in the experimental group. Before the training and immediately after the training, the median score of the empathy questionnaire was 107 points and 120 points. There was statistical difference ( U value was 6.53, P < 0.05). The median score of the empathy questionnaire for the 1 month after the training in the experimental group was 122 points, which was statistically different from that before the training ( U value was 7.53, P <0.05). There were statistically significant differences in the scores of the questionnaires in the immediately after the training and 1 month after the training between the control group and the experimental group ( U values were 6.34, 6.67, P<0.05). Conclusions:Through the empathy training program, the scores of empathy nurses in the operating room can be effectively improved.
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Objective To investigate the relationship between nutritional risk status and implementation of nutrition therapy in mechanical ventilated (MV) chronic obstructive pulmonary disease (COPD) patients, so as to provide evidence for individualized nutrition therapy. Methods A prospective multicenter observational study was conducted. MV COPD patients admitted to Department of Intensive Care Units (ICU) of 10 County Hospitals in Zhejiang Province from January 2015 to January 2016 were enrolled, and according to nutrition risk screening 2002 (NRS2002) score, they were divided into nutritional high risk group (NRS2002 3-5) and nutritional extremely high risk group (NRS2002 6-7). Nutrition therapy situation and hospital mortality were compared between the two groups; multivariate Cox regression analysis was used to analyze the risk factors affecting the prognosis of patients with COPD under mechanical ventilation. Kaplan-Meier curve was used to analyze the prognosis at 30 days; receiver operating characteristic (ROC) curve was used to test the robustness of multivariable regression analysis. Results ① One hundred and six COPD patients with MV were analyzed; among them, 90 patients were in the nutritional high risk group, and 16 were in the nutritional extremely high risk group. There were no significant differences in age, gender and body mass index (BMI) between the two groups (all P > 0.05); the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, NRS2002 score in patients of nutrition risk extremely high group were obviously higher than that in patients with nutrition high risk group (APACHEⅡ: 24.9±6.1 vs. 20.3±5.8, NRS2002 score: 6.3±0.5 vs. 4.2±0.8, both P < 0.05). ② Patients in both groups received early enteral nutrition (EN) therapy, the proportion of patients in nutritional extremely high risk group received early EN was lower than that of patients in the nutritional high risk group [12.5% (2/16) vs. 17.7% (16/90)], along with the prolongation of hospital stay, the proportions of patients beginning to receive the EN were gradually increased in the nutrition extremely high risk group and high risk group, after 2 days the EN increased significantly, and reached the highest value on day 6 after entering ICU [100.0% (16/16), 98.9% (89/90), respectively]; within 3 days after admission into ICU, the proportion of EN in nutrition extremely high risk group was obviously lower than that in nutrition high risk group, and from day 4, there was no statistical significant difference in proportion of EN between the two groups (all P > 0.05). The time to start parenteral nutrition (PN) treatment was relatively early admission to the ICU on day 1 and the proportion of this therapy was high in the two groups [56.2% (9/16), 27.7% (25/90), respectively], the PN proportion did not decrease with the length of hospitalization and the increase of EN. The proportion of patients in the nutrition extremely high risk group who started PN treatment was higher, which reached 56.2% admission to the ICU on day 1.③ With extension of hospital stay, the calories of EN were gradually increased in the nutritional high risk group, the highest calories in nutritional high risk groups was 4 318 (3 912, 4 812) kJ/d at day 7; while the highest calories in nutritional extremely high risk groups was 3 602 (2 167, 4 615) kJ/d at day 6 and a slight decreased at day 7; the difference of calories within the first week between the two groups had no significance (all P > 0.05). The calorific value of PN therapy remained at a constant level during hospitalization within 7 days, and after admission into ICU for 4-5 days, the target range of calories was achieved. ④ Kaplan-Meier survival curve analysis showed that the mortality at 30 days in the extremely high risk group was significantly higher than that in the high risk group [62.5% (10/16) vs. 11.1% (10/90), χ2 = 15.4, P < 0.01]. ⑤ Multiple cox-regression analysis showed that NRS2002 scoring was the independent risk factor affecting the mortality of patients in hospital [odds ratio (OR) = 2.08, 95% confidence interval (95%CI) = 1.39-3.12, P = 0.005]. ⑥ ROC curve analysis: according to ROC curve analysis of the effectiveness of multi-factor regression model, area under ROC curve (AUC) was 0.79, sensitivity was 70.00%, specificity was 74.42%, positive likelihood ratio was 2.74, negative likelihood ratio was 0.40, 95% confidence interval (95%CI) was 0.702-0.864, P = 0.001, and it showed that the regression model had a good prediction effect. Conclusions MV COPD patients have significant nutritional risk and all receive early EN therapy. The proportion of beginning to use PN treatment in patients with nutritional extremely high risk is relatively high. Initial nutritional status is the independent risk factor of poor prognosis in MV patients with COPD.
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Objective:To compare the clinical efficacy and safety between spleen total resection splenectomy and spleen partial splenectomy in the treatment of patients with traumatic spleen rupture.Methods:84 cases of patients with traumatic spleen rupture from March 2013 to March 2016 were selected and divided into two groups.42 cases in the spleen total resection group were treated with spleen total resection,while the other 42 cases in the spleen partial nephrectomy group were treated with spleen partial splenectomy.The operative effect,the levels of platelet count,serum IgA,IgG,IgM,CD3 +,CD4 +,CD8 +,CD4 + / CD8 + levels before and after treatment,the incidence of complications were compared between two groups.Results:The intraoperative blood loss,exhaust time,length of hospital stay of spleen partial nephrectomy group were shorter than those of the spleen total resection group,but the operation time of research group was longer than that of the spleen total resection group (P＜0.05).The platelet count,CD8+ of spleen partial nephrectomy group were lower than those of the spleen total resection group (P＜0.05).The IgA,IgG,IgM,CD3+,CD4+,CD8+,CD4+/CD8+ of spleen partial nephrectomy group were significantly higher than those of the spleen total resection group (P＜0.05).The incidence rate of complications in the spleen partial nephrectomy group was lower than that of the spleen total resection group (P＜0.05).Conclusion:Spleen partial splenectomy was more effective than spleen total resection in the treatment of traumatic splenic rupture,which had little effect on the platelet and immune function.
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Objective To prepare patent-blue-lipesomes(PB-LPS),a lymph-mapping developer.Methods PB was encapsulated in the liposomes using the passive loading method.The female Wistar rats were injected subcutaneously with the PB-LPS,PB,blank liposomes or isotonic rmtrium chloride at the heel solos,to study the stained situation of the lymph nodes and chemical analysis oftheir ALT,AST,BUN,Cr.Results The lymph nodes were obviously blue staining after injected PB-LPS or PB,the blue smimng ratios were 40%,20%(P<0.05),and the effect of PB-LPS on tracing of lymphy nodes was better than PB.No significant difference was found in ALT,AST,BUN and Cr.Conclusion The PB-LPS can be successfully prefabricated with such advantage as avirulence and high entrapment efficiency by passive loading method.
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Objective To evaluate the different effeotions among laparoseopic choleeysteotomy (LC)combined with bile duct exploration (LCBDE)and stone removal,LC with endoacopic sphincterotomy (EST),and open-choleeysteetomy (OC)with exploration of common bile duct (ECBD)for treating choleeys-tolithiasis with choledocholithiasis.Methods Among 289 cases of choleeystolithiasis and choledocholithla-sis,132 patients were treated by OC with ECBD,36 cases by LC with LCBDE,121 cases by EST combined with LC.The stone residual rate and leakage of bile rate,operation time,the loss of blood in operation,re-covery time of gastrointestinal function,length of hospital stay of the three groups were compared.Results There was no statistical difference in the stone residual rate and leakage of bile rate among the three groups,but OC with ECBD group had significantly longer operation time,more loss of blood in operation,later re-covery time of gastrointestinal function and longer hospital stay than the other groups.Conclusions There are respective indications,advantages and disadvantages in the three groups.We found that the operation of LC with LCBDE is the better choice for the patients of cholecystolithiasis with choledocholithiasis,single choledocholithiasis;However,the patients with obviously infection of biliary tract or acute pancreatitis is not suitable for this method.
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Objective To study the epidemiological patterns of HIV infection prevalent in HongKong.Method The epidemiological patterns of HIV infection in HongKong were analyzed with a mathematic model SI by changing its initial condition,which was used to test the related data.Results The changeable patterns of susceptible accumulative numbers of HIV infection in HongKong and the epidemiological curves and the curve of infection velocity were obtained.Conclusion The epidemic pattern of HIV infection in Hongkong and local infection velocity from 1987 to 2004 were well described using the epidemic model SI.An accumulation of 2 733 cases of HIV infection will be predicted in the year of 2005.The epidemic peak occurred in 2002 to 2004 and the overall HIV epidemic will last for 50 years approximately.
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Objective To investigate the effect of enteral nutrition on patients with COPD during acute exacerbation stage. Methods Subjects hospitalized for an acute exacerbation of COPD (n=58) were assigned into two groups: enteral nutrition group (n=33) or parenteral nutrition group (n=25). The blood indexes of nutrition at day 5 and day 10,the incidence of complication and the mortality were observed. Results Less decrease of serum proteins was detected in the enteral nutrition group as compared with that in the parenteral alimentation group (day 5 P