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【Objective:】 To study the application and effect of peer education mode in the nursing of patients with urinary tumor, and explore the ways to improve the quality of clinical care and the humanistic significance of this mode in clinical nursing. 【Methods:】 84 patients with urological tumors who received surgical treatment in urology department of a third-class hospital from March 2021 to December 2021 were randomly divided into the control group and the experimental group, with 42 patients in each group. The subjects in control group adopted routine intervention mode.The subjects in experimental group integrated the peer education program into the routine nursing mode.SAS and SDS scales were used to evaluate patients’ state of anxiety and depression, and the degree of nursing satisfaction. 【Results:】 The scores of SAS and SDS in the experimental group were significantly lower than that of the experimental group before intervention and the control group after intervention (P<0.05).The number of very satisfied, moderately satisfied and dissatisfied cases in the control group was 12, 29 and 1 respectively, and in the experimental group was 19, 23 and 0 respectively. The difference was statistically significant (P<0.05). 【Conclusion:】 Adopting peer education with humanistic care significance can effectively alleviate patients’ preoperative anxiety, depression and other adverse mental state, reduce preoperative stress, and provide a new way for nursing quality.
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Objective To estimate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) level for early diagnosis of acute kidney injury (AKI) in patients with sepsis.Methods One hundred and twenty-six sepsis patients admitted to intensive care unit (ICU) in Baoshan Branch Hospital of Shuguang Hospital Affiliated to Shanghai University ofTraditional Chinese Medicine from June 2014 to December 2015 were enrolled, and they were divided into two groups according to whether complication of AKI was present. The levels of urinary NGAL in the two groups of septic patients were evaluated immediately and at 12, 24 and 48 hours after the definite diagnosis, and the levels were compared between the two groups; the receiver operating characteristic curve (ROC curve) was performed and the value of urinary NGAL level in early diagnosis of sepsis AKI was evaluated.Results There were 60 septic cases complicated with AKI (AKI group), with the prolongation of time after definite diagnosis, the urinary NGAL (g/L) levels were gradually increased at 12, 24 and 48 hours, the levels were significantly higher than those at the corresponding time points in the group without AKI [non AKI group (66 cases), 12 hours: 178.2±32.8 vs. 53.8±10.4, 24 hours: 228.4±24.6 vs. 54.1±9.0, 48 hours: 186.1±43.6 vs. 52.5±9.4, allP < 0.05]. The area under ROC curve (AUC) of urinary NGAL level at 24 hours after definite diagnosis and 95% confidence interval (CI) were 0.863 (0.766-0.929) and 0.686 (0.466-0.696), respectively, when the cutoff value of urinary NGAL was 65.9μg/L, the sensitivity was 81.9% and specificity 76.1%; when the cutoff value of urinary NGAL was 57.9μg/L, the sensitivity was 70.2% and the specificity 57.2%.Conclusion Urinary NGAL level can be used as a reference marker for the early diagnosis of sepsis concomitant AKI.
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Objective To investigate the effect of renal dysfunction on the prognosis of hospitalized patients with decompensated heart failure (DHF).Methods 191 patients with DHF hospitalized between June 2011 and June 2013 in Baoshan Branch of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled. These patients were divided into three groups according to the glomerular filtration rate (eGFR): normal renal function group (eGFR ≥ 90 mL·min-1·1.73 m-2, 63 cases), mild renal function descend group (eGFR 60 - 89 mL·min-1·1.73 m-2, 80 cases) and moderate or severe renal function descend group (eGFR 0.05). The complication incidence of AMI [25.0% (12/48) vs. 10.0% (8/80)] and old myocardial infarction [31.3% (15/48) vs. 11.3% (9/80)] in moderate or severe renal function descend group was obviously higher than that in mild renal function descend group (bothP 0.05). Compared with normal renal function group, the levels of inflammatory cytokines in serum TNF-α, IL-1, IL-6, IL-8, IL-10, IL-13, and the mortality, the re-admission rates due to heart failure, rates of malignant arrhythmia in the two renal function descend groups were increased significantly, the increment being more remarkable in moderate or severe renal function descend group [TNF-α (ng/L): 235.8±20.9 vs. 121.6±10.7, IL-1 (ng/L): 345.9±40.8 vs. 203.5±34.7, IL-6 (ng/L): 502.8±64.2 vs. 321.9±53.8, IL-8 (ng/L): 723.9±210.3 vs. 431.5±110.5, IL-10 (ng/L): 155.4±23.5 vs. 103.1±13.2, IL-13 (ng/L): 184.5±27.3 vs. 136.8±20.2, the rate of mortality in the first time of hospitalization: 14.6% (7/48) vs. 5.0% (4/80), mortality within one year after discharge: 25.0% (12/48) vs. 18.0% (9/80), readmission rate due to heart failure: 47.9% (23/48) vs. 30.0% (24/80), rate of relapse of coronary events: 72.9% (35/48) vs. 37.5% (30/80), malignant arrhythmia rate: 39.6% (19/48) vs. 20.0% (16/80), allP 0.05].Conclusions The incidence of renal dysfunction in patients with DHF is relatively high, and their mortality, re-admission rate and their levels of inflammatory cytokines are high obviously. Thus, the intervention of renal dysfunction may have important significance in the improvement of their prognoses.
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Objective To estimate the predictive value of neutrophil gelatinase-associated lipocalin in urine (uNGAL) for detection of acute kidney injury (AKI) in the intensive care unit (ICU) critically ill patients.Methods A total of 110 patients from the ICU of three general hospitals were enrolled in the study.The patients were adults more than 18 years of age.After admitted to ICU,the patients were continuously observed for 72 hours.According to the RIFLE criteria for diagnosis of AKI,the patients were classified as AKI group (33 cases) or non-AKI (77 cases).According to the sepsis diagnostic criteria,the patients were classified as sepsis (79 cases) or non-sepsis (31 cases).Exclusion criteria of patients were chronic renal insufficiency,malignant tumor,death after admitted to ICU 24 hours.Serum creatinine and uNGAL of the patients were analyzed daily.The difference of uNGAL between sepsis and non-sepsis patients,AKI and non-AKI patients,sepsis non-AKI and sepsis AKI patients was compared.Moreover,the difference of serum creatinine and uNGAL between AKI and non-AKI patients into ICU 24 h was compared,and the sensitivity and specificity of uNGAL and serum creatinine for diagnosis of AKI in the ICU patients were evaluated using ROC curve.Results The uNGAL levels were all significantly different between sepsis and non-septis patients,AKI and non-AKI patients,sepsis concomitant AKI and sepsis without AKI patients.The uNGAL levels were significantly different between AKI and non-AKI patients in ICU for the first 24 h,while the difference of serum creatinine were not significant.The area under receiver operating characteristic (ROC) curve of uNGAL and serum creatinine of patients in ICU for the first 24 h were 0.828 (95％ CI:O.742-0.914) and 0.583 (95％ CI:0.471-0.695),respectively.The cutoff value of uNGAL was 170 ng/ml,and the sensitivity and specificity were 0.778 and 0.784,respectively.The sensitivity was superior to serum creatinine.Conclusions uNGAL was superior to serum creatinine in the diagnosis of AKI,and could be used as a marker of the early diagnosis of AKI.