Implementation status of transitional care for downward referral of two-way referral patients in China / 中国实用护理杂志

Two-way referral system is an important measure to promote the rational distribution of medical resources and promote the health of patients, but now there is a typical characteristic of"referrals up easy but downward referral difficult". while the transitional care of downward referral patients is one of the important impetus to promote the implementation of downward referral, this paper summarizes the necessity, connotation, main service forms, application effects and problem analysis status of the transitional referral of patients in the two-way referral mode in our country, in order to provide the basis for the establishment of a nursing security system suitable for two-way referral of patients.

Analysis on the gender-specific risk factors of new-onset cerebral hemorrhage / 中华心血管病杂志

Objective@#To explore the gender-specific risk factors of new-onset cerebral hemorrhage.@*Methods@#In this prospective cohort study,a total of 98 961 participants((51.1±12.6)years old), who underwent the 2006 to 2007 physical examination and met the inclusion criteria, were enrolled from the Kailuanstudy cohort. There were 78 908 (79.7%) male,and 20 053 (20.3%) female.The incidence of cerebral hemorrhage was observed once per year until December 31, 2016.The difference on the incidence of cerebral hemorrhage between male and female was compared. Multivariate Cox regression analysis was applied to analyze therisk factors of cerebral hemorrhage events among different genders.@*Results@#The participants were followed up for(10.00±0.73) years,and 860 cerebral hemorrhage events were recorded during follow up. The incidence of cerebral hemorrhage in the population was 86.90/10 million person years (standardized incidence rate of 47.85/10 million person years). The incidence of cerebral hemorrhage was significantly higher in male (49.61/10 million person years) than in female (34.07/10 million person years, P<0.05). Multivariate Cox regression analysis showed that 45-59 years old, ≥ 60 years old, diabetes,and waist-hip ratio were more strongly related to new-onset of cerebral hemorrhage events in female than in male, and the hazard ratios(95%CI) were 2.33 (1.23-4.43) ,2.71 (1.30-5.66) ,2.16 (1.24-3.74) and 8.79 (1.42-54.32) in female versus 1.55 (1.21-1.97) ,2.16 (1.68-2.78) ,1.19 (0.93-1.53) and 3.21 (1.09-9.41) in male, respectively. The risk of male cerebral hemorrhage increased by 29% (HR=1.29, 95%CI 1.19-1.40) in male and 24% (HR=1.24, 95%CI 1.20-1.28) in female,when the systolic blood pressure increased 10 mmHg (1 mmHg=0.133 kPa).@*Conclusions@#The incidence of cerebral hemorrhage is higher in male than in female in this cohort.The association between systolic blood pressure and cerebral hemorrhage is stronger in male than that in female.The associations between age, waist-hip ratio, diabetes and cerebral hemorrhage are stronger in female than in male.@*Trial Registration@#Chinese Clinical Trail Registry, ChiCTR-TNC-11001489.

A survey of the practice status of the new nursing practice standards for intravenous therapy in Shandong province / 中国实用护理杂志

Objective To investigate the practice status of the newNursing practice standards for intravenous therapy in secondary and above hospitals in Shandong province. Methods Self-designed questionnaire was used to investigate 3051 nurses from 129 hospitals in 17 cities in Shandong province. Results Nurses′ awareness rate of the new Nursing practice standards for intravenous therapy was 92.69%(2828/3051);92.13%(2811/3051) nurses reported that their hospitals used the new standard, 65.78%(2007/3051) nurses reported that their hospitals had applied the standard since the second half of 2014; 92.92% (2835/3051) nurses reported that their hospitals had revised their practice rules according to the new standard;93.54%(2854/3051) nurses reported that their hospitals had revised the related nursing process; 50.08% (1528/3051) nurses thought the new standard helpful to clinical practice;22.98%(701/3051) nurses knew well about the new standard;53.85%(1643/3051) nurses thought the standard applicable to clinical practice. Conclusions As nurses do not master the Nursing practice standards for intravenous therapy well, they need strengthened training. Hospitals should fresh their rules, protocolsand supply training program to improve nurses′ knowledge and skill. Meanwhile, Nursing practice standards for intravenous therapyalso needs to be revised and improved according to nurses feedback.

A survey of the video training in the application of the nurse self-directed learning readiness / 中国实用护理杂志

Objective To investigate the nurse self-directed learning readiness in some 3A hospital in Shandong province and discuss the strategies how to improve it. Methods Self-designed questionnaire and The Nurses Self-Directed Learning Readiness Scale were used to investigate 210 nurses from 23 departments in Shandong provincial hospital. Results Before and after the implementation of the video training, a total of 230 and 210 self-directed learning readiness scales were distributed, 210 and 210 questionnaires were returned, the effective recovery rate was 91.30%and 100%respectively. The data of questionnaires were statistically analyzed by the method of paired t test. The results showed that after the implementation of the project, the total score of the after test (156.63±19.48) was higher than the before (137.91 ± 13.71). The difference was statistically significant (t=-9.54, P<0.05). The score in the three dimensions of self-management, self-control, and desire for study (48.03 ± 7.25), (48.71 ± 6.44), (59.89 ± 7.61) points, were higher than (40.11±5.48), (43.40±5.34), (54.40±6.26) pointsbefore implementation. The difference was statistically significant (t=-10.22,-7.67,-6.83,P<0.05). Conclusions The video training would provide the convenient and quick way and could inspire the nurses′ learning motivation even more which is of great significance to improve the nurses ability of autonomic learning.

Investigation of Correlation between Gene Polymorphism of Apolipoprotein E and Mycoplasma Pneumoniae Infection in Children / 现代检验医学杂志

Objective To study the relationship between gene polymorphism of apolipoprotein E (apolipoproteinE,ApoE)of peripheral blood and Mycoplasma pneumoniae infection in children.Methods Collected 236 cases serum of inpatient and outpatient screening in children with Mycoplasma pneumoniae infection and healthy children between March 2011 and March 2014 in the First Affiliated Hospital of Xi’an Medical University and Xi’an Children’s Hospital,at the age of 3~8 years old,divided into two groups:110 cases of control group and 126 cases of Mycoplasma pneumoniae infection in chil-dren.Used multiple allele-specific PCR (multi-AS PCR)to detect gene polymorphism of ApoE in each group.Results ApoE gene was polymorphic and 6 genotypes:3 homozygous (ε2/2,ε3/3,ε4/4)and 3 heterozygote (ε3/2,ε3/4,ε4/2).Theε3/2 had four bands,ε3/3,ε3/4 and 4/2 had three bands,ε2/2 andε4/4 had two bands.ε3/3 of ApoE genotype distribution in two groups was the most common,control group was 66.7%,infection group was 46.4%.Allele frequencies ofε3 and genotype frequencies ofε3/3 inMycoplasmapneumoniae infection of children were lower than those in control group (P<0.05).But allele frequencies ofε4 and genotype frequency ofε4/4 in Mycoplasma pneumoniae infection of children were increased, which were compared with those in control group (P<0.05).Conclusion There were an association between ApoE gene polymorphism and the incidence of Mycoplasma pneumoniae infection in children.Allelesε3 seems to be a protective factor and allelesε4 may contribute to the development of Mycoplasma pneumoniae infection of children.

Analysis of detection of prenatal coagulation four indices,D-dimer and platelet in pregnant women / 国际检验医学杂志

Objective To investigate the clinical significance of the antenatal detection of four indices of coagulation(PT,APTT, TT,FIB),D-dimer(DD)and platelet(PLT)in the judgment of parturient coagulation function and bleeding risk.Methods 795 pregnant women and childbearing age non-pregnant women with physical examination in this hospital from June 2012 to September 2013 were collected and divided into the normal pregnancy group(early pregnancy,middle pregnancy,late pregnancy,parturient pe-riod),obstetric accident group,pregnancy complicating other disease group and healthy control group.At the same time,PT, APTT,TT,FIB,DD and PLT were detected and the related statistical analysis was conducted.Results DD and FIB in the normal pregnancy group were significantly higher than those in the healthy control group(P0.05 );DD and FIB in the obstetric accident group and the pregnancy complicating other disease group were significantly higher than those in the normal pregnancy group(P <0.05),while PT was significantly lower than that in the normal pregnancy group(P <0.05).PLT in the obstetric accident group and the pregnancy complicating other disease group was significantly lower than that in the normal pregnancy group(P <0.05).The sensitivity and specificity of the combined detection of 3 indices in diagnosing the ob-stetrical accidents were greatly superior to those of the single index detection or the combined detection of two indices.Conclusion The prenatal combination detection of four coagulation indices,DD and PLT can preliminarily judge the coagulation status of preg-nancy period in pregnant women,help to treat abnormal bleeding of pregnant women an possess the important guidance significance in formulating the labor scheme and preventing the occurrence of obstetric accidents.