ABSTRACT
In pediatric nursing, the conflict between the principle of beneficial and non-maleficence is a major challenge for nurses. To systematically understand the current situation of the conflict in the nursing practice of pediatric nurses at home and abroad, this paper reviewed four clinical situations where conflict occurs frequently: end-of-life decision-making of critically ill children, physical restraint, the child abuse case report, and new pediatric clinical therapies, and analyzed the factors influencing the conflict of pediatric nurses in China, so as to provide reference for pediatric nurses to cope with the conflict between the principle of beneficial and non-maleficence.
ABSTRACT
The moral distress of nurses is an important ethical issue in nursing practice, especially in pediatric nursing, which is unique and specialized. It can lead to burnout and compassion fatigue, resulting in lower job engagement and job satisfaction, and higher turnover rates. In order to provide a comprehensive and timely understanding of the current state of moral distress of pediatric nurses and their influencing factors, this article reviews the current state of domestic and international research on the moral distress of pediatric nurses and the influencing factors. It showed that overseas research on the moral distress of pediatric nurses is more in-depth, while there was less research in China at present, and the research and attention on the moral distress of pediatric nurses in China was insufficient. The influencing factors mainly include three aspects: personal factors, organizational factors and external environment. The review provided a theoretical basis for implementing targeted interventions to prevent and mitigate moral distress among pediatric nurses and calls for nursing researchers, nursing educators, nursing managers and individuals in China to pay more attention to moral distress.
ABSTRACT
Objective Investigate the effect of valsartan combined with statins on coronary heart disease and its effect on BNP and CRP.Methods 92cases of patients with coronary heart disease were selected, which were treated in hospital from March 2015to March 2017, and were divided into the study group (46cases) and control group (46cases) .The patients of all two groups were treated with conventional treatment.The patients of control group were treated with valsartan (40mg/d, oral;if no hypotension after 3days of treatment, the dose increased to 80mg/d) , and on the basis of control group, the patients of study group were treated with atorvastatin calcium capsules (20mg/d, in 0.5hafter dinner) .The patients of two groups were all treated for 6months in a row.Compare the adverse reactions and changes of the levels of blood lipids, coronary plaques, BNP, CRP and LVEF of two groups.Results After the appropriate treatment, the TG, TC, LDL-C levels of the study group were significantly lower than those of the control group, and the HDL-C, LVEF levels of the study group were significantly higher than those of the control group (P<0.05);the lipid plaque, fibrous plaque, calcified plaque, mixed plaque levels of the study group were significantly lower than those of the control group (P<0.05);The BNP, CRP levels of the study group were significantly lower than those of the control group (P<0.05);There were acute myocardial infarction, unstable angina, heart failure and other adverse events occurred in both two groups, and the difference was statistically significant between the two groups (P<0.05) .Conclusion Valsartan combined with statins in the treatment of patients with coronary heart disease can improve blood lipid levels, reduce coronal plaque area, inhibit inflammatory response, which makes it worthy of clinical promotion.
ABSTRACT
Objective To investigate the clinical and pathological characteristics, diagnosis and treatment of gastric cancer with ovarian metastasis. Methods The clinical data of 17 cases of gastric cancer with ovarian metastasis, confirmed by surgery and pathology, were analyzed retrospectively. Results The average age of the patients was 48.41 years, and the first appearance of symptoms and signs often were of metastatic ovarian cancer. The main ultrasonographic findings were either a complex type of mass with both solid and cystic characteristics or only solid, and most of them were accompanied by intraperitoneal fluid accumulation. Bilateral metastatic ovarian cancer was more common(13 cases). The preoperative accurate diagnosis of this disease was difficult, so that the misdiagnostic rate was 64.7% in this series. Operation was done in all the patients, but prognosis was poor. The median survival time was only 11.6 months. Conclusions The prognosis of gastric cancer with ovarian metastasis is poor. It is of importance to inspect the stomach in cases of bilateral ovarian cancer. Radical resection of the primary disease focus together with hysterectomy and bilateral adnexectomy should be performed. Postoperative comprehensive therapy is conducive to improve the prognosis of gastric cancer with ovarian metastasis.