ABSTRACT
Objective:To analyze the related factors affecting the use of autogenous arteriovenous fistula (AVF), and provide a theoretical basis for prolonging the service life of AVF in hemodialysis patients.Methods:This was a retrospective study. The patients undergoing AVF and using it to maintain hemodialysis (MHD) in the First Affiliated Hospital of Nanchang University from October 2004 to June 2017 were selected as study subjects to discuss the relevant factors affecting the service life of AVF. The data of general information, dialysis and laboratory examinations were collected through questionnaire surveys, hospital case system and hemodialysis record sheets. The patients were divided into the patency group and the dysfunction group according to the status of AVF, and the related factors were compared. Multivariate Cox proportional hazard model was used to analyze the influencing factors, and Kaplan-Meier survival curve was used to determine the service life of AVF, respectively.Results:A total of 187 subjects were included in the study. The patency group had 140 cases and the dysfunction group had 47 cases. There were statistically significant differences in the proportion of diabetes, the level of serum albumin, uric acid and parathyroid hormone (PTH) between the two groups (all P<0.05). Multivariate Cox proportional hazard regression analysis showed that diabetes ( HR=9.348, 95% CI 3.507-24.918, P<0.001) and hypoalbuminemia ( HR=12.650, 95% CI 2.925-54.714, P=0.001) were risk factors for the short service life of AVF. The results of Kaplan-Meier analysis showed that the service life of AVF in patients with diabetes was significantly shorter than that in MHD patients without diabetes (Log-rank χ2=13.191, P<0.001); the service life of AVF in patients with hypoalbuminemia was significantly shorter than that without hypoalbuminemia (Log-rank χ2=13.591, P<0.001). Conclusions:Diabetes mellitus and hypoalbuminemia are risk factors for the short service life of AVF. Therefore, intervention programs should be formulated to extend the service life of AVF.
ABSTRACT
Objective To explore the establishment of the coherent health service system for patients undergoing surgery in this region to optimize health care resources.Methods Using the Quantitative-qualitative research to investigate the conditions and needs of the regional network of health service between the third-grade class-A hospital and its collaborative hospitals,and it is about two-way referral,the follow ups after discharge,remote consultation,the conditions and needs of the remote training and the knowledge to the obstacles of carrying out the regional network service.Results The doctors and nurses in the research said,it was difficult to achieve the up referral in two-way referral,and there was financing obstacles for remote consultation and training,furthermore,the effects of the remote training was uncertain.Conclusions The regional network of health service between the third-grade class-A hospital and its collaborative hospitals is still weak,and we need to intensify the development of the regional network service.
ABSTRACT
Objective To investigate the relationship between cancer-related fatigue (CRF) and quality of life (QOL) of the colorectal cancer patients.Methods In this study,patients diagnosed definitely as colorectal cancer were enrolled from November 2010 to January 2011 in this hospital.Piper Fatigue Scale was used to assess the CRF and QLQ-C30 was used to assess the QOL.Results 74 patients were enrolled in this study,and among them 28 patients had CRF(37.84％).Patients with CRF was significantly worse in QOL than patients without CRF.Physical function,role function,emotional function,social function and the general health subscale had a negative correlation with CRF,while pain,fatigue and loss of appetite had a positive correlation with it.Conclusions CRF had an impact on QOL,and this study will provide some reference information when the nurses take measures to intervene CRF and improve QOL of the colorectal cancer patients.
ABSTRACT
Objective To explore the effect of situational clinical probation fourth-step method in Nursing Managementteaching in clinic.Methods We introduced innovative teaching method in clinicsituational clinical probation fourth-step method in Nursing Management.Firstly,it took students to learn the construction of the management structure in clinic (observation),then interview management persons (interview),and playing roles in management activities (role-play),at last interactive discussion (seminar).Results Through the SCP fourth-step learning,the nursing students' learning ability was strengthened,the students' ability to innovate and the learning interest in nursing management were inspired.Conclusions Application of situational clinical probation fourth-step method in Nursing Managementteaching in clinic shows better effect,which should be widely applied in clinic practice.
ABSTRACT
The writer's college cultivated students' scientific research ability through the extracurricular society of undergraduates-matrix clinic quality team(MCQ).The writer's colleges promoted studnets' academic ability and expanded the impact of the school by strengthening scientific research basis and preparation,making students familiar with the process and making students experience and participate in international academic exchanges.
ABSTRACT
Objective To investigate the impact of nutritional risk of preoperative patients with different parts of colorectal cancer. Methods 385 cases of surgical patients diagnosed with colorectal cancer were selected in the retrospective study in April 2008 to March 2009, Gastrointestinal Surgery Center of West China Hospital in Sichuan University. Patients were divided into the right colon cancer group, the left colon cancer group, the rectal cancer group, using internationally recognized NRS- 2002 Scale and serum nutrition indicators to assess their preoperative nutrition. Results NRS-2002 score in the right colon cancer group showed higher than the left colon and rectal cancer group, but no statistical difference between the latter two rates; serum concentrations of HGB, TP, ALB, A/G were lower in the right colon cancer group than the other two groups, but the concentrations of ALT, AST, Ca2+, PO43-showed no statistical difference among three groups. Conclusions The proximal colon (right colon cancer) were more susceptible to the risk of preoperative malnutrition, the patients with different parts of colorectal cancer should be given to the corresponding preoperative nutritional assessment and nutritional support.
ABSTRACT
Objective To study the influence of preoperative nutritional status for postoperative recovery effect of patients with colorectal cancer. Methods Selected 395 patients with colorectal cancer from Feb 2008 to Jan 2009, evaluated their preoperative nutritional status by NRS-2002, and then divided them into three groups according to the NRS-2002 values. Compared the indexes which indicated postoperative recovery effect among the three groups. Results The nutritional risk level were related with the time of postoperative pulled out the catheter and plasma drainage, the time of consumption, exhaust and defecation and the length of hospital stay. There was no significant correlation between the nutrition risk score and the time of pulled out the stomach robe and getting out of bed. Conclusions There were some influence of preoperative nutritional status on postoperative recovery effect of patients with colorectal cancer, nurses should emphases the preoperative nutrition evaluation and then carry out related nutritional support and associated nursing cares.