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Objective:In order to analyze the current research status of handover shift in nursing management, summarize, analyze and judge the existing literature, in order to provide reference for clinical nursing practice.Methods:Through literature review, it is planned to review the current situation, shortcomings and future development of nursing handover classes.Results:The handover process was generally divided into four stages, of which SBAR was the best practice tool for handing over key information. For the performance of handover shifts, NASR, PVNC-BR, HES and Handoff CEX were often used to evaluate the performance of shifts, and for the results of shifts, evaluations were mostly conducted at the levels of patient safety, process elements, and organizational management. At present, the use of electronic information systems, benign organizational culture and patient and family-centered clinical practice could effectively improve the efficiency and effectiveness of handover.Conclusions:The process and elements of the current shift mode are relatively complete, and the communication strategy is reasonable, but there are still many shortcomings and defects. This suggests that nursing managers should adopt scientific intervention methods and evaluation tools when paying attention to and reforming nursing handover in the future to continuously improve the quality of handover.
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Objective To evaluate the development of cerebral anoxia during controlled hypoten-sion with nicardipine or urapidil after carotid endarterectomy in patients. Methods Forty-four patients of either sex, aged 48-64 yr, scheduled for elective carotid endarterectomy under general anesthesia, requi-ring controlled hypotension after operation, were divided into nicardipine group ( group N ) and urapidil group ( group U) using a random number table method, with 22 patients in each group. Nicardipine at 2. 5μg·kg-1 ·min-1 was intravenously infused in group N, and urapidil 2μg·kg-1 ·min-1 was intravenously infused in group U. After systolic blood pressure was decreased to 130-140 mmHg, the consumption of nicardipine was adjusted to 0. 2 - 0. 5 μg·kg-1 ·min-1 and the consumption of urapidil to 1-2μg·kg-1 ·min-1 in group N and group U, respectively, to maintain systolic pressure at 130-140 mmHg. Heart rate ( HR) , cardiac index ( CI) , bispectral index ( BIS) value, regional cerebral oxygen saturation (rSO2) and end-tidal pressure of carbon dioxide (PETCO2) were recorded after entering the operating room ( baseline) , at the beginning of controlled hypotension ( T1 ) , and at 5, 10, 20, 30, 60 and 120 min af-ter systolic blood pressure was decreased to the target hypotension ( T2-7 ) . Development of cerebral anoxia( the relative decrease in rSO2>12％ of the baseline value) was recorded in controlled hypotension period. Results Compared with the value at T1 , the HR at T2,3 and CI at T3-7 were significantly increased ( P<0. 05), and no significant change was found in rSO2, PETCO2 or BIS value at the other time points in group N (P>0. 05), and rSO2 was significantly decreased at T3-7 (P<0. 05), and no significant change was found in HR, CI, PETCO2 or BIS value at the other time points in group U (P>0. 05). Compared with group N, the HR at T2,3, CI at T3-7 and rSO2 at T3-7 were significantly decreased in group U (P<0. 05). The incidence of cerebral anoxia was significantly higher in group U than in group N ( P<0. 05) . Conclu-sion Controlled hypotension with nicardipine is recommended after carotid endarterectomy in order to avoid the development of cerebral anoxia in the patients.
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ObjectiveTo investigate the effect of improvement in internal environment after plasma exchange on the bioactivity of peripheral blood CD34+ cells in patients with acute-on-chronic (subacute) liver failure. MethodsThe peripheral blood CD34+ cells from patients with acute-on-chronic (subacute) liver failure were cultured in vitro using the medium containing with the serum collected before or after plasma exchange. The growth curves of the two groups of cells were recorded and compared. RT-PCR was used to detect the expression of the cell surface markers PK-M2, Integrin-β1, and L-PK, and immunofluorescence was used to detect the expression of Integrin-β1. A repeated measures analysis of variance was used for comparison of continuous data between groups. ResultsThe CD34+ cells in the medium containing the serum collected after plasma exchange grew better than those in the medium containing the serum collected before plasma exchange (P＜0.05). PK-M2 and Integrin-β1 were detected in the CD34+ cells of both groups, but L-PK was not detected in either group. ConclusionFor patients with liver failure, the improvement in internal environment after plasma exchange helps to maintain the bioactivity of peripheral blood CD34+ cells, thus improving the efficacy of stem cell transplantation for liver failure.
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Objective To analyze the clinical characteristics and related factors associated with impulse compulsive behaviors (ICBs) in Parkinson's disease (PD).Methods Two hundred and thirty-one PD outpatients were recruited from Beijing Hospital and Chinese Medicine Hospital of Pinggu District of Beijing from November 2012 to November 2015.Questionnaire for Impulse Compulsive Disorders in Parkinson's Disease (QUIP) was used to assess all subjects if they have ICBs or not.The general materials, medication utilized were recorded , and the related scales were used to evaluate PD patients.Intergroup analysis was made according to with or without ICBs.The Logistic regression analysis was adopted to analyze the relevance between incidence of ICBs and on-set age of PD, drinking tea or not, the 39-item Parkinson's Disease Questionnaire score, dosage of amantadine and dopamine agonist levodopa equivalent daily doses (DA-LEDD).Results Twenty-four cases of 231 outpatients were QUIP screening positive , and only 13 cases ( 5.63%) were diagnosed with ICBs as follows : hypersexuality in four ( 1.73%), compulsive shopping in two (0.87%), pathological gambling in one (0.43%), punding in eight(3.46%), dopamine dysregulation syndrome in two (0.87%) and with two or more ICBs in three (1.30%).Compared with non-ICBs group, ICBs group took more dopamine agonists (137.5(37.5, 175.0) mg/d vs 50.0(0, 125.0) mg/d, Z＝-2.175,P＝0.030), and had higher percentage of drinking tea (2/13 vs 3/218(1.4%),χ2＝11.369,P＝0.027).Logistic regression showed that higher dosage of dopamine agonist ( DA-LEDD≥100 mg/d,OR＝4.404, 95%CI 1.191-16.284,P＝0.026) was a risk factor for ICBs.Conclusions ICBs are not rare in Parkinson's disease, and punding is more common among the clinical phenotypes of ICBs. More dopamine agonists in PD (more than 100 mg/d) may be associated with about 4-fold increased odds of having ICBs.
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Objective To investigate the clinicopathological features,treatment and prognosis of leiomyomatosis peritonealis disseminata (LPD).Methods A total of 10 patients suffered from LPD after laparoscopic uterine myomectomy were collected in the First Affiliated Hospital of Zhengzhou University from September 2012 to September 2016,and all clinical database were retrospectively analyzed.Results (1)Clinical features:the age of 10 cases was 25-50 years old,and 8 cases of them were in child-bearing age,while 2 cases were in perimenopausal period.Of 10 cases,2 cases manifested as discontinuous lower abdominal pain,and the other cases were seen the doctor for the examinations found tumors of pelvis or abdomen.All 10 cases had a history of laparoscopic uterine myomectomy under went power morcellation with an average of (4.0±2.2) years (range 1.3 to 8.1 years),2 cases of them had a history of oral hormone treatment after the first myoma morcellation.(2) Treatment methods and postoperative pathologic diagnosis:during intraoperative exploration,LPD nodules were most distributed in Douglas pouch (10 cases),and next in mesentery (7 cases),abdominal peritoneum (6 cases) and omentum majus (4 cases),etc.Seven of the 8 cases of child-bearing age were performed laparoscopic LPD nodules removal,1 case gone combined with laparotomy and resecting LPD nodules;2 cases in perimenopausal period done laparotomy oophorotomy and resected all LPD nodules and omentum.(3) Postoperative relapse and reproductive outcomes:the follow-up time of all cases was 2.8 years,and no recurrence was found during the follow-up period;2 cases had natural conception and term vaginal birth during the follow-up period.Conclusions LPD is mainly related to iatrogenic planting and spreading,which is a benign disease and characterized by multiple smooth muscle nodules throughout abdominopelvic cavity,and the nodules of LPD is commonly located in Douglas pouch,mesenteric and omentaum majus,etc.The preferred method of LPD should be individual operative treatment according to different situations,and in which patients may be have better prognosis.
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Objective To study the PFGE type of Salmonella (S.) strains isolated from poultry production chains (hatching,breeding,slaughter,distribution and retail) of four cities in Heilongjiang province.Methods DNA collected from S.strains in 2012 was digested by Xba Ⅰ according to the standard PFGE protocol of US CDC.The PFGE patterns were then analyzed by BioNumerics software.Results The contamination of S.appeared most serious during the process of slaughtering (13.84％).PFGE was used to determine the genetic relationships between these isolates from poultry production chains,89 pulsotypes from 150 S.enteritidis isolates and 55 pulsotypes from 65 S.indiana isolates showed considerable diversity.The same pulsotypes ofS.enteritidis can be found between different food chains and cities.In contrast,no identical pulsotypes of S.indiana were found between different food chain and cities.In these four cities,the above said two kinds of S.were from different sources.The source of S.contamination in HLJ2 city had been traced back to the chain of poultry hatching.Conclusions The distribution of pulsetypes of the S.enteritidis and S.indiana isolates was from different regions and the dominant bands were also different between the chains of poultry production.Cross contamination existed in slaughterhouses and contamination can be traced back to the poultry hatching.
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Objective To study the PFGE type of Salmonella (S.) strains isolated from poultry production chains (hatching,breeding,slaughter,distribution and retail) of four cities in Heilongjiang province.Methods DNA collected from S.strains in 2012 was digested by Xba Ⅰ according to the standard PFGE protocol of US CDC.The PFGE patterns were then analyzed by BioNumerics software.Results The contamination of S.appeared most serious during the process of slaughtering (13.84％).PFGE was used to determine the genetic relationships between these isolates from poultry production chains,89 pulsotypes from 150 S.enteritidis isolates and 55 pulsotypes from 65 S.indiana isolates showed considerable diversity.The same pulsotypes ofS.enteritidis can be found between different food chains and cities.In contrast,no identical pulsotypes of S.indiana were found between different food chain and cities.In these four cities,the above said two kinds of S.were from different sources.The source of S.contamination in HLJ2 city had been traced back to the chain of poultry hatching.Conclusions The distribution of pulsetypes of the S.enteritidis and S.indiana isolates was from different regions and the dominant bands were also different between the chains of poultry production.Cross contamination existed in slaughterhouses and contamination can be traced back to the poultry hatching.
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Calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial tumor of odontogenic origin. CEOT is a benign but a locally infiltrative tumor. CEOT has two clinical variants: intraosseous (central) CEOT and extraosseous (peripheral) CEOT. The peripheral type is rare. In this paper, we report two cases of CEOT. The diagnoses of the cases were verified by histopathology. This study aims to explore the clinical and imaging appearances of CEOT and improve the understanding of the disease.
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Humans , Odontogenic Tumors , Skin NeoplasmsABSTRACT
Objective To estimate the incidence of human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) and its related factors in Harbin,Heilongjiang province.Methods A total of 661 MSM were recruited at baseline study from April to June 2013,and followed at 6 months,12 months,and 18 months periods,respectively.Face to face questionnaire interviews were conducted and venous blood was collected for HIV testing among these people.Univariate logistic regression model was used to identify the factors associated with lost-to-follow-up in the cohort.Results At the end of 18-month follow-up period,the HIV incidence density in the cohort was 4.23/100 person year (95％ CI:2.91/100 person year-5.93/100 person year),with the follow-up rate of loss as 15.4％.Factors as failed to receiving the intervention programs,being at older age,with higher education level and receiving no HIV testing in this MSM community,were related to the loss of follow-up.Conclusion The HIV incidence rate was high among the MSM in Harbin.MSM community based cohort study could improve the efficiency on the study for the problems of follow-up.
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<p><b>OBJECTIVE</b>To identity the clinical characteristics and severe case risk factors for the adult inpatient cases confirmed of influenza monitored by the sentinel surveillance system for severe acute respiratory infection (SARI) inpatient cases in ten provinces in China.</p><p><b>METHODS</b>Epidemiology and clinical information surveys were conducted for adult cases (≥ 15 year old) consistent with SARI case definition, who were monitored by SARI sentinel hospitals in ten cities in China from December 2009 to June 2014, with their respiratory tract specimens collected for influenza RNA detection. Adult SARI cases were classified into influenza inpatient group and outpatient group by the detection outcomes, analyzing their demographic information, clinical and epidemiology characteristics respectively, in addition to risk factors for severe inpatient cases.</p><p><b>RESULTS</b>3 071 adult SARI cases were recruited from ten hospitals, including 240 (7.8%) cases of laboratory-confirmed influenza, most of them being A (H1N1) pdm2009 and A (H3N2) sub-types. Age M of the included influenza cases was 63 year old, 47.1% of them being ≥ 65 seniors. 144 (60.0%) cases of the influenza inpatients suffered from at least one chronic underlying condition, and the proportion of emphysema (7.9%) was higher than non-influenza inpatient cases (3.8%), being statistically significant (χ(2) = 3.963, P = 0.047). 19.4% of the women of childbearing age infected of influenza were in pregnancy, and only 1.1% of the 240 influenza cases had been vaccinated against influenza. The proportion of sore throat and dyspnea found among influenza inpatients was higher than inpatients without influenza. 17.4% of the influenza cases were accepted into ICU for treatment, with no statistical significance with non-influenza inpatient cases (P = 0.160). 23.1% of the influenza inpatients received an antiviral drug therapy, a figure higher than the non-influenza inpatient cases (4.8%) (P < 0.001). 41.5% of the inpatients developed complications, with the proportion of viral pneumonia significantly higher than the non-influenza inpatient cases (P < 0.001). Asthma (RR = 15.200, 95% CI: 1.157-199.633), immunosuppressive diseases (RR = 5.250, 95% CI: 1.255-21.960), pregnancy (RR = 21.000, 95% CI: 1.734-254.275), time interval from onset to admission less 7 days (RR = 1.673, 95% CI: 1.071-2.614) were identified as risk factors of severely-ill influenza cases.</p><p><b>CONCLUSION</b>It was found that adult influenza inpatients were mostly ≥ 65 year old seniors. The influenza vaccination rate among the influenza cases was very low, and antivirus drugs were used less than necessary. In this regard, influenza vaccination was recommended for high risk groups of pregnant women, seniors and chronic disease patients on annual basis, while influenza inpatients were advised to use antiviral drugs as early as possible.</p>
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Adult , Aged , Female , Humans , Pregnancy , Antiviral Agents , China , Epidemiology , Hospitalization , Influenza A Virus, H1N1 Subtype , Influenza A Virus, H3N2 Subtype , Influenza, Human , Epidemiology , Inpatients , Outpatients , Pneumonia, Viral , Respiratory Tract Infections , Risk Factors , Sentinel Surveillance , VaccinationABSTRACT
Objective:To investigate the prevalence and significance of IgG-anti-cyclic citrullinated pep-tides (CCP) antibody in PSS patients .Methods:A total of 120 patients diagnosed with PSS were investi-gated in the first affiliated hospital of Baotou Medical College from March 2006 to December 2009.IgG-anti-CCP antibody was assayed by enzyme-linked immunosorbent assay (ELISA), also anti-Sj?gren’s syn-drome type A ( SSA) and Sj?gren’ s syndrome type B ( SSB) antibody were assayed by immunoblotting . Erythrocyte sedimentation rate ( ESR ) was assayed by westergren in serum , and C reactive protein (CRP), IgA, IgM, IgG and IgM-RF were detected by immune turbidimetric .At the same time, clinical symptoms and involvement of important organs were observed .Following up the patients above 3 years, the primary Sj?gren’ s syndrome ( PSS) patients who had progressed to rheumatoid arthritis ( RA) were evaluated .Results:The positive rate of anti-CCP antibody in the PSS patients was 19 .17%; After 3 years, more patients who were positive for anti-CCP antibody had progressed to RA (χ2 =5.015,P=0.022) than the patients in negative group;The patients in anti-CCP antibody positive group were more prone to joint involvement (χ2 =8.058,P0.05); The positive rate of anti-SSA and SSB antibody in anti-CCP antibody positive group and negative group had no significant difference (χ2 =0.008 and 0.56,P>0.05);Multiple linear regression showed that the level of anti-CCP antibody was positively correlated with IgM-RF levels in the PSS patients (B=0.61, 95%CI =0.36 -0.86, P0.05).There were no significant differences in the level of ESR, CRP, IgA, IgM and IgG between anti-CCP antibody positive group and negative group ( P >0.05), but the level of IgM-RF in anti-CCP antibody positive group was significantly higher than that in the negative group (U=623.50, P<0.05).Conclusion:Positive rate of IgG-anti-CCP antibody in PSS is 19 .17%, also it is associated with joint involvement and more prone to progressing to RA .
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Objective To investigate the detection rate of anti-SSA60 and SSB antibodies in sera of patients with systemic lupus erythematosus (SLE).The correlation of anti-SSA and SSB antibodies with SLE clinical outcome was also investigated.Methods This study included 251 cases of SLE diagnosed in our hospital between 2007 and 2010.ELISA and double immunodiffusion method was used to detect the sera antiSSA60 and SSB antibodies.The patients were closely monitored for three years in terms of clinical and laboratory parameters and the presence of associated Sj(o)gren' s syndrome (SS).Statistical analysis were performed using student t test or x2 test.Results ① The detection rate of anti-SSA60 antibody in serum of patients with SLE was 65.3％.The detection rate of anti-SSB antibody in serum of patients with SLE was 28.3％; ② During the three-year follow up,patients with anti-SSA60 (29.3％,48 cases) or SSB antibodies (35.2％,25 cases) were more likely to have dry mouth and eyes and later developed SS (P＜0.05); ③ Patients with anti-SSA60 antibody were more likely to develop serositis (20.7％ vs 8.0％),neuropsychiatric lupus erythematosus (NPLE)(18.9％ vs 8.0％),and hematuria (35.4％ vs 21.8％)(P＜0.05).Patients with negative anti-SSB antibody were more likely to have fever (43.7％ vs 57.8％,x2=4.082,P＜0.05); ④ Patients positive for anti-SSB antibody were also positive for anti-Sm antibody (50.7％ vs 32.8％,x2=6.956,P＜0.05);⑤ Younger patients were more likely to have anti-SSA60 and SSB antibodies in their sera (P＜0.05); ⑥Patients positive for anti-SSA60 antibody had higher SLE disease activity index (SLEDAI) than patients with negative anti-SSA60 antibody [(17±9) vs (15±7),t=2.389,P＜0.05].Patients positive for anti-SSB antibody had higher level of IgG [(18±7) vs (16±6) g/L,t=2.304,P=0.023],and lower level of CRP than patients negative for anti-SSB antibody [(14±20) vs (21±33) mg/L,t=-2.173,P=0.031].Conclusion Patients positive for anti-SSA60 antibody have higher SLEDAI and more severe clinical outcomes.Patients with antiSSA or anti-SSB antibody are more likely to develop dry mouth and eyes which eventually leads to SS.
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To explore the protective effects of Huqi extractum, a compound Chinese herbal medicine, on salivary glands against radiation in Wistar rats.