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Objective:To investigate the application and effects of WeChat official account in improving the nursing trainees' core post competency.Methods:The study included in 105 nursing trainees of Batch 2015 as experimental group, taking the nursing practice WeChat official account based on the routine clinical teaching pattern, and 95 nursing trainees of Batch 2014 as control group, taking traditional teaching mode. At the end of the internship, the scores of special examinations for nursing students and the national examination for nursing qualifications ("nursing qualification examination" for short) of the two group were compared, and the critical thinking ability, ability to acquire information lifelong learning ability, nurse-patient clinical communication ability and teaching satisfaction of the two groups of students were analyzed. SPSS 23.0 software was used for t test. Results:The scores of special examinations, nursing qualification examination and each module at main dimensions of the core post competency of nursing students in the experimental group were higher than those in the control group ( P<0.05). The nursing trainees in the experimental group were satisfied with the teaching effects of the WeChat official account. Conclusion:The WeChat official account in clinical nursing practice helps improve the quality of clinical practice teaching and assist in enhancing core post competency of nursing trainees.
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Objective:To establish a set of scientific and reasonable indicator system of common prosperity in the field of health, so as to promote the construction and evaluation of the demonstration area of common prosperity with high quality of health.Methods:According to the requirements of promoting common prosperity demonstration area with high quality of health in Zhejiang province, the initial indicator pool was established through literature research and theoretical analysis in July 2021, and experts were convened to carry out expert brainstorming to determine indicator system in the form of meetings. Delphi method was used to conduct two rounds of expert consultation on the indicator system.Finally, the analytic hierarchy process and percentage weight method were used to calculate the indicator weight value.Results:The final indicator system included 4 first-level indicators and 30 second-level indicators. Among the first-level indicators, the weight values of the development, equilibrium, inclusiveness, and sustainability were 0.326 4, 0.242 8, 0.245 8, and 0.185 0. There were 8 second-level indicators in developmental indicator dimension, of which the indicator with the highest weight was the per capita health expectancy. The balance indicator dimension included 6 second-level indicators, of which the indicator with the highest weight was the per capita financing difference of basic medical insurance between the urban workers with the urban-rural residents. The inclusive indicator dimension included 6 second-level indicators, and the proportion of personal health expenditure to total health expenditure had the highest weight. The sustainability indicator dimension included 10 second-level indicators, and the proportion of government health expenditure in fiscal expenditure had the highest weight.Conclusions:The indicator system constructed in this research could provide certain guidance and reference for promoting the construction of common prosperity in health, and provide some reference for follow-up research in this field.
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Objective:To investigate the clinical effect of cluster nursing on the prevention of perioperative urinary catheter associated urinary tract infection (CAUTI) in patients with spinal fracture.Methods:A retrospective case-control method was used to select 160 patients with spinal fracture admitted to the department of spinal cord injury in emergency care from January 2018 to March 2020 in the Department of Orthopaedics General Hospital of Chinese People′s Liberation Army as study subjects, 80 patients admitted to the department of spinal cord injury from January to December 2018 were set as the control group, and 80 patients admitted from January 2019 to March 2020 as the observation group. The control group was given standardized clinical nursing measures during the perioperative period, while the observation group was given cluster nursing measures. The duration of indwelling of catheters, the incidence of catheter reinsertion and the incidence of CAUTI were compared between the two groups.Results:The catheter indwelling time in the observation group was (3.37±0.64) days, lower than that in the control group (6.35±1.52) days. The incidence of catheter insertion and CAUTI was 5.00%(4/80), 3.80%(3/80) in the observation group, lower than 11.30%(9/80), 11.60%(13/80) in the control group. The differences were statistically significant ( χ2 values were -2.927, -2.654, all P<0.05). Conclusions:Cluster nursing intervention for patients with spinal fracture in the perioperative period can effectively shorten the catheter indwelling time, reduce the incidence of catheter re-insertion and the incidence of patients with CAUTI, significantly improve the quality of clinical care in the department, and have positive significance for the treatment and rehabilitation of patients.
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Objective To investigate the efficacy and feasibility of ultrasound-guided percutaneous catheter drainage for cervical abscess.Methods The clinical data of 18 patients with cervical abscess treated by percutaneous puncture and catheterization under ultrasound guidance were analyzed retrospectively.Results All of the 18 patients were successfully treated on one round.None of the 18 patients was nerve injury,main vessels injury or dead during the operation.Conclusions Ultrasound-guided percutaneous catheter drainage of neck abscess is safe and effective,and has high clinical application value.
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Objective To evaluate the efficacy of pivot-regulating manipulations applied in traditional Chinese medicine (TCM) clinical nursing for infantile anorexia based on the meridian and acupoint theory. Methods One hundred and twenty children with anorexia were randomly divided into trial group and control group , 60 cases in each group. The control group was given spine-pinching therapy based on the conventional nursing care. The trial group was given pivot-regulating manipulations based on the conventional nursing care , and the pivot-regulating manipulations covered manipulating spleen -stomach meridian , regulating Neibagua, kneading Banmen, kneading abdomen, manipulating acupoints of Zhongwan, Tianshu and Zusanli, and pinching spine according to the deficiency-excess differentiation, once every other day and 3 times constituting one course of treatment. After treatment for 2 courses, the clinical efficacy of the two groups was evaluated. The changes in TCM symptom scores and physical examination indexes of body height, body mass, head circumference, chest circumference, height-for-age (HT/A), weight-for-age (WT/A) in the two groups were observed before and after treatment. Results(1) Five cases(3 differentiated into excess syndrome and 2 into deficiency syndrome) of the trial group dropped out and quitted from the trial, and 6 cases of the control group dropped out and quitted from the trial. (2) After two courses of treatment, the total effective rate of the trial group was 94.55％, and that of the control group was 87.04％, the difference being significant (P < 0.05). (3) After treatment, the scores of appetite and food-intake amount, complexion and lip color, water intake, restlessness, and urination as well as TCM symptom scores in both groups were improved; the WT/A of the trial group was also improved (P < 0.05 compared with those before treatment). The trial group had better effect on improving the scores of appetite and food-intake amount, complexion and lip color, and restlessness as well as TCM symptom scores than the control group (P < 0.05 or P < 0.001). The trial group also showed better effect on improving body mass, body height, head circumference, and HT/A than the control group(P<0.05). Conclusion As a nursing method based on the meridian and acupoint theory as well as syndrome differentiation and treatment, pivot-regulating manipulations are effective for the treatment of infantile anorexia by quickly starting an effect and obviously relieving the symptoms.
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Objective To investigate the effect of transitional care of physical and mental health of the thoracic spinal cord injury and paraplegic patients discharged on its recovery. Methods Randomized controlled analysis of patients in Spine and Spinal Cord Injury Surgery between June 2014 to October 2015, a total of 65 patients with thoracic spinal cord injury and paraplegic were studied, according to hospital mantissa odd and even numbers divided into observation group (35 cases) and control group (30 cases). The observation group was instituted to extending posthospital care, not the control group. The self-care ability and psychological state were evaluated by Function Independent Measure (FIM), Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale (HAMD)within discharge and in 3 months. And the incidence of complications between the two groups were compared. Results At discharge, the difference of FIM, HAMA, HAMD score between the observation group and the control group was not statistically significant (P>0.05). Discharged after 3 months, the score of FIM, HAMA, HAMD in observation group was(72.35 ± 4.35),(4.80 ± 4.50),(12.13 ± 7.25)points, (63.95 ± 5.02),(10.15 ± 4.91), (19.48 ± 8.31)points in control group. The difference between the two groups was statistically significant (t=-4.798, 3.524, 3.110, P 0.05); The incidence of urinary tract infection, pressure ulcers, constipation were 8.57% (3/35), 5.71% (2/35), 17.14% (6/35) in observation group, 40.00% (12/30), 33.33%(10/30), 63.33%(19/30) in control group, there were significant differences between, two groups (χ2= 4.324, 4.219, 5.337, P < 0.05). Conclusions Transitional care can significantly improve the psychological state of patients with thoracic spinal cord injury and paraplegia discharged, reduce the incidence of complications and improve quality of life.
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<p><b>OBJECTIVE</b>To discuss the clinical effect on swelling and pain after total knee arthroplasty treated with acupoint massage, mild moxibustion and routine detumescence.</p><p><b>METHODS</b>One hundred and twenty patients of knee osteoarthritis (KOA) after total knee arthroplasty (TKA), were randomized into an observation group and a control group, 60 cases in each one. In the control group, after TKA, the routine detumescence was applied, including elastic bandage compression, the operated limb raising exercise, knee joint braking, local ice compress, intermittent pneumatic compression, active ankle pumping and quadriceps contraction exercise, continuous passive mechanical exercise, using stretch socks, oral administration of rivaroxaban tablets, 10 mg, once a day, continuously for 21 to 24 days. In the observation group, on the basis of the routine detumescence as the control group, 1 h after operation, acupoint massage was done at Zusanli (ST 36) and Sanyinjiao (SP 6) till soreness and distension presented, twice a day; 48 h after operation, mild moxibustion was intervened at Zusanli (ST 36) and Sanyinjiao (SP 6), avoiding burning pain, once a day, continuously till the 7th day after operation. Before and after operation, the limb swelling condition and the scores of visual analogue scale (VAS) and HSS (hospital for special surgery) knee joint function were observed in the patients of the two groups.</p><p><b>RESULTS</b>On the 1st, 3rd, 5th, 7th and 14th days after operation, the swelling incidence in the observation group was apparently lower than that in the control group (P < 0.05, P < 0.01). On the 1st, 3rd, 5th and 7th days after operation, the scores of VAS in the observation group were lower than those in the control group (all P < 0.05). On the 7th and 14th days after operation, the scores of HSS in the observation group were better than those in the control group (all P < 0.05).</p><p><b>CONCLUSION</b>The combined intervention of acupoint massage and mild moxibustion reduces the incidence of lower limb swelling, alleviates pain and promotes knee joint function recovery of TKA and the effects are better than those achieved by the simple routine detumescence therapy.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Acupuncture Points , Arthroplasty, Replacement, Knee , Combined Modality Therapy , Knee Joint , General Surgery , Massage , Moxibustion , Osteoarthritis, Knee , General Surgery , Therapeutics , Treatment OutcomeABSTRACT
Objective To explore the effects of music therapy and massage on the quality of newborn hearing screening. Methods One hundred and twenty neonates were equally divided according to their registration number: those with even numbers in the experiment group and those with odd number in the control one. Both groups were treated with music therapy. In the experiment group, massage was added by specially trained nurses on the basis of music therapy. The two groups were compared in terms of neonatal hearing test and screening results. Result In the experiment group, the excellence rate of neonatal hearing test and the success rate of screening were significantly higher than those of the control group ( P<0 . 05 ) . Conclusion The music therapy and massage in the neonatal hearing screening can improve the quality of newborn hearing screening.
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Objective To observe the effect of hot compress with medicinal salt pack in preventing PICC-associated mechanical phlebitis.Method Totally 200 inpatients undergone PICC intubation were randomized into a treatment group and a control group, 100 cases in each group. After PICC intubation, the treatment group was intervened by hot compress with medicinal salt pack, while the control group was by hot compress with warm wet towel. The occurrence of mechanical phlebitis was observed at different time points and compared between the two groups. Result The occurrence rate of mechanical phlebitis was 9.0% in the treatment group versus 26.0% in the control group, and the difference was statistically significant (P72 h, versus 16.0% and 10.0% in the control group, and the differences were statistically significant (P<0.05). Conclusion Hot compress with medicinal salt pack can effectively reduce the occurrence of PICC-associated mechanical phlebitis.
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ObjectiveTo investigate the therapeutic effect of acupoint pressing plus gentle moxibustion on lower limb swelling after total knee arthroplasty.MethodOne hundred and twenty patients diagnosed with knee osteoarthritis who required unilateral total knee arthroplasty were allocated, in order of operations, to observation and control groups, 60 cases each. After the operation, all the patients received routine nursing care including elastic bandage pressure dressing, operated-on limb elevation, early knee immobilization, local ice compress, intermittent pneumatic compression, active ankle pump and quadriceps contracting-relaxing exercise, CPM mechanical exercise, use of elastic stockings and oral administration of rivaroxaban. The observation group received postoperative acupoint pressing plus gentle moxibustion additionally. Limb circumferences 10 cm superior and inferior to thepatella were measured and operated-on limb pains were scored (using the VAS) in the two groups of patients before, on the day of and at one, three, five, seven and fourteen days after the operation. Knee joint range of motion (ROM) was measured before and at three,seven and fourteen days after the operation.ResultThe incidence of swelling was 47.46% in the observation group and 67.24% in the control group. The duration of swelling was (7.31±3.19) days in the observation group and (10.92±3.12)days in the control group. There were statistically significant differences in the VAS score and operated-on knee joint range of motion between the two groups of patients at the same time points after the operation (P<0.05).ConclusionAcupoint pressing plus gentle moxibustion can effectively intervene in lower limb swelling and promote the recovery of knee joint function after total knee arthroplasty.
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Objective To evaluate the role of different opioid receptors in sufentanil postconditioning-induced attenuation of myocardial ischemia-reperfusion (I/R) injury in rats.Methods Fifty adult male Sprague-Dawley rats,aged 4-6 months,weighing 200-330 g,were randomly divided into 9 groups:I/R group (n =7),ischemic postconditioning (IPC) group (n =7),sufentanil postconditiong (SP) group (n =6),κ-opioid receptor antagonist nor-binaltorphimine (nor-BNI) + SP group (group BNI + SP,n =5),δ-opioid receptor antagonist naltrindole + SP group (group NTD + SP,n =5) and μ-opioid receptor antagonist CTOP + SP group (group CTOP +SP,n =5).Myocardial I/R was produced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion.IPC was induced by 3 episodes of 10 s reperfusion followed by 10 s ischemia at the end of 30 min myocardial ischemia.Sufentanil 1 μg/kg was injected intravenously at 5 min before reperfusion in SP group.In groups BNI + SP,NTD + SP and CTOP + SP,nor-BNI 5 mg/kg,naltrindole 5 mg/kg and CTOP 1 mg/kg were injected intravenously,respectively,before SP and the corresponding doses of nor-BNI,naltrindole and CTOP were injected intravenously,respectively,at 5 min before reperfusion.Arterial blood samples were collected at 120 min of reperfusion for measurement of the plasma cardiac tropnin I (cTnI) concentration.The rats were then sacrificed and hearts removed for determination of myocardial infarct size (IS) and area at risk (AAR).IS/AAR was calculated.Results Compared with I/R group,the plasma cTnI concentration and IS/AAR were significantly decreased in groups IPC,SP,BNI + SP and NTD + SP (P ＜ 0.05),and no significant change was found in the plasma cTnI concentration and IS/AAR in groups CTOP + SP,NTD,BNI and CTOP (P ＞ 0.05).Compared with SP group,IS/AAR was increased in NTD + SP and BNI + SP groups and the plasma cTnI concentration and IS/AAR were significantly increased in CTOP + SP group (P ＜ 0.05).Conclusion The μ-,κ-and δ-opioid receptors mediate sufentanil postconditioning-induced attenuation of myocardial I/R injury in rats.
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Objective To investigate the effect of type 2 diabetes mellitus (DM) on the attenuation of myocardial ischemia-reperfusion (I/R) injury by sufentanil postconditioning in rats.Methods Male pathogen-free Sprague-Dawley rats,weighing 160-180 g,were used in the study.A model for type 2 DM was established by the feeding of high-fat diet-induced insulin resistance and intraperitoneal streptozocin 35 mg/kg.DM was confirmed by blood glucose level ≥ 16.7 mmol/L one week after injection.Eighteen type 2 diabetic rats were randomly divided into 3 groups (n =6 each):DM sham operation group (DM-S group) ; DM-I/R group; DM sufentanil postconditioning group (DM-SP group).Another 18 healthy nondiabetic rats were chosen and randomly divided into 3 groups (n =6 each):nondiabetes mellitus sham operation group (NDM-S group) ; nondiabetes mellitus I/R group (NDM-I/R group) ; nondiabetes mellitus sufentanil postconditioning group (NDM-SP group).Myocardial I/R was induced by 30 min occlusion of the left anterior descending branch of coronary artery (after 30 min of equilibration) followed by 120 min of reperfusion.Sufentanil 1.0 μg/kg was injected via the right jugular vein 5 min before reperfusion in NDM-SP and DM-SP groups.MAP,SP and HR were recorded immediately before ischemia,at 30 min of ischemia and at 120 min of reperfusion and rate-pressure product (RPP) was calculated.Arterial blood samples were collected at 120 min of reperfusion for measurement of plasma cardiac troponin Ⅰ (cTnⅠ) concentration.The rats were then sacrificed for determination of the myocardial infract size.Results MAP and RPP were decreased,while the plasma cTnl concentration was increased during reperfusion in diabetic and nondiabetic rats.Sufentanil postconditioning decreased the myocardial infract size and plasma concentrations of cTnⅠ,and increased MAP and RPP during reperfusion in nondiabetic rats,but had no effect on the parameters in diabetic rats.Conclusion Type 2 DM interferes with sufentanil postconditioning-induced myocardial protection in rats.
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The paper described the practice of contingency nursing management for ICU wards in case of power breakdown in the hospital The SICU wards have developed their power failure contingency plan in which the nurses on duty are divided into Group A,B and C according to their positions and qualifications.Respectively,they take charge of patient safety,coordination and command,and medical aid.We also established the procedure of emergency response for these duties.Training and examination familiarize the medical personnel with the procedure and their duties.Four practices proved that the implementation of the plan reduces risks exposure and improves the satisfaction.With the contingency plan,the nurses in ICU can now take care of critical incidents and avoid nursing risks in ICU efficiently.
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Objective To evaluate the role of mitochondrial permeability transition pore (mPTP) in attenuation of myocardial ischemia-reperfusion (I/R) injury by sufentanil postconditioning in rats.Methods Sixty male Sprague-Dawley rats,aged 14-15 weeks,weighing 350-420 g,were randomly divided into 4 groups (n =15 each):sham operation group (group S),group I/R,cyclosporin A group (group CP) and sufentanil postconditioning group (group SP).Myocardial I/R was produced by occlusion of left anterior descending branch of coronary artcry for 30 min followed by reperfusion.In groups CP and SP,cyclosporin A 5 mg/kg and sufentanil 1 μg/kg were injected via the jugular vein at 5 min before reperfusion respectively,while the equal volume of normal saline was injected in group I/R.At 10 min of reperfusion,hearts were excised,the myocardial mitochondria were immediately isolated and the activity of mPTP was measured by spectrophotometry.MAP and HR were recorded at 30 min of equilibration,at 30 min of ischemia and at 120 min of reperfusion and rate-pressure product (RPP) was calculated.Arterial blood samples were obtained at 120 min of reperfusion for determination of the plasma cardiac troponin Ⅰ (cTnⅠ) concentration.The animals were then sacrificed for determination of infarct size (IS) and area at risk (AAR),and IS/AAR was calculated.The mitochondrial ultra-structure was examined with electron microscope.Results Compared with group S,the mPTP activity and plasma cTnI concentration were significantly increased,and MAP and RPP were significantly decreased in the other three groups (P ＜ 0.05).Compared with group I/R,the mPTP activity,plasma cTnI concentration and IS/ARR were significantly decreased in groups CP and SP,and MAP was significantly increased in group CP (P ＜ 0.05).Compared with group CP,MAP was significantly decreased (P ＜ 0.05),while no significant change was found in the other indexes in group SP (P ＞0.05).Significant mitochondrial swelling,and disruption and disappearance of cristae were showed in I/R group.The mitochondrial structure was more complete in CP and SP groups than that in group I/R,and the disrupted cristae were found in a small number of mitochondria in CP and SP groups.Conclusion The mechanism by which sufentanil postconditioning reduces myocardial I/R injury is related to inhibition of mPTP opening in rats.
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Objective To investigate effect of diabetes mellitus factor on attenuation of myocardial ischemia-reperfusion injury by sufentanil postconditioning in rats.Methods Diabetes mellitus was established by intraperitoneal streptozotocin 50 mg/kg and was confirmed by blood glucose ≥ 16.7 mmol/L.Thirty healthy adult male SD rats,weighing 250-300 g which diabetes mellitus model was successfully established were randomly divided into 3 groups ( n =10 each):diabetic mellitus sham operation group (group DM-S),diabetic mellitus ischemia-reperfusion group (group DM-IR) and diabetic meltitus sufentanil postconditioning group (group DM-SP).Another 30nondiabetic mellitus rats were also randomly divided into 3 group ( n =10 each):nondiabetic mellitus sham operation group (group NDM-S),nondiabetic mellitus ischemia-reperfusion group (group NDM-IR) and nondiabetic mellitus sufentanil postconditioning group (group NDM-SP).Myocardial ischemia-reperfusion was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by reperfusion.Sufentanil postconditioning was induced by iv injection of sufentanil 1.0 μg/kg at 5 min before reperfusion.MAP,SBP,HR and RPP (HR × SBP) were recorded before ischemia,30 min of ischemia and 120 min of reperfusion.Arterial blood samples were collected at 120 min of reperfusion for measurement of plasma cardiac troponin 1 (cTnI) concentration.The animals were then sacrificed for determination of total areas of right and left ventricles ( LV + RV),infarct area (IS),area at risk (AAR) and IS/AAR.Results MAP and RPP were significantly lower,while plasma cTnI concentration was higher during myocardial ischemia reperfusion in diabetic and nondiabetic rats.Sufentanil postconditioning significantly decreased IS,IS/AAR and plasma cTnI concentration in nondiabetic rats during myocardial ischemia reperfusion but had no effect on IS,IS/AAR and plasma cTnI concentration in diabetic rats.The IS,IS/AAR and plasma cTnI concentration were significantly higher in DM-SP group than in NDM-SP gnoup ( P ＜ 0.05).Conclusion Diabetes mellitus factor can negate sufentanil postconditioning induced protection against myocardial ischemia-reperfusion injury in rats.
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OBJECTIVE@#To explore the treatment effect of selective neurotomy of anterior ethmoid nerve and squeezing operation of inferior turbinate in the treatment of perennial allergic rhinitis (PAR).@*METHOD@#Seventy cases of perennial allergic rhinitis were selected and subjected to selective neurotomy of anterior ethmoid nerve and squeezing operation of inferior turbinate,and the treatment effect was observed by analysis of the the symptoms and signs score of all cases preoperatively and postoperatively.@*RESULT@#The total effective rate were 90.0% at 1 year follow-up.@*CONCLUSION@#Selective neurotomy of anterior ethmoid nerve and squeezing operation of inferior turbinate were effective for the patients with PAR. It is worthy to be popularized for its convent and rare complications.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Denervation , Methods , Ethmoid Bone , Rhinitis, Allergic, Perennial , General Surgery , Turbinates , General SurgeryABSTRACT
Objective: To evaluate the effects of the modified fixed r everse Twin-block appliance(TBA) combined with maxillary protraction appliance( MPA) in the treatment of early Angle Ⅲ skeletal anterior crossbite. Met hods:TBA combined with MPA was used in 15 growing subjects with early An gle Ⅲskeletal malocclusion (group TBA-MPA). Another 15 subjects with the same type of malocclusion were treated by MPA(group MPA). The effects of treatment we re studied by cephalometric measurments.Results:3-5 months afte r treatment SNB, B-Vert T, Po-Vert T,NPo-FH,Co-Po and 1-NB in group 1 were decreased more than those in group 2 (P0.05).Conclusion:Angle Ⅲ skeletal ante rior crossbite can be corrected successfully with reverse TBA combined with maxi llary protraction appliance by mandible retrusion and maxilla forward growth.