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Objective:To analyze the application of path quality inspection combined with "zero defect" service management in nursing quality management of orthopedic ward.Methods:From January 2018 to December 2019,196 patients admitted to the Department of Orthopaedics of Panzhihua Central Hospital, Sichuan Province. Ninety-eight patients from January to December 2018 were as control group, 98 patients from January to September 2019 were as observation group. The control group adopted the routine nursing management mode, while the observation group adopted the path type quality inspection combined with the "zero defect" service management mode. The differences in the incidence of nursing adverse events, quality of life scores and nursing satisfaction were compared between the two groups.Results:The incidence of nursing adverse events during hospitalization in observation group and control group was 6.12% (6/98) and 15.31% (15/98), the difference was statistically significant ( χ 2 value was 4.320, P<0.05). Mental score, sleep score, diet score, mental health score, total score were (94.38±8.36), (93.28±8.33), (95.37±8.43), (91.89±10.48), (377.12±20.08) points in observation group, significantly higher than (85.65±10.74), (81.01±9.48), (87.69±7.97), (85.47±12.02), (331.09±13.39) points in the control group, the difference between the two groups was statistically significant ( t value was 3.118-18.880, P<0.01). The nursing satisfaction of observation group and control group was 92.86% (91/98), 82.65% (81/98), the difference was statistically significant ( χ 2 value was 4.749, P<0.05). Conclusion:The application of path quality inspection combined with "zero defect" service management in the nursing quality management of orthopedic ward is conducive to reducing the incidence of nursing adverse events, improving the quality of life of patients after surgery, and improving patients' satisfaction with nursing services.
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Objective:To explore the effect of multi disciplinary team (MDT) combined with call-out nursing on postoperative recovery time and complications of patients with multiple injuries during perioperative period.Methods:A total of 87 patients with multiple injuries admitted to our hospital from April 2018 to April 2020 were selected as the research objects. The patients were randomly divided into the control group (43 cases) and the observation group (44 cases) using a random number table method. The control group received routine care, and the observation group used MDT mode combined with call-out nursing based on routine care. The surgical awake rate and recovery time of the two groups were compared, and the scores of Glasgow Coma Scale(GCS), Disability Rating Scale(DRS) and the incidence of postoperative complications of the two groups were analyzed.Results:A total of 36 cases (81.82%) in the observation group were awake, which was significantly more than 22 cases (51.16%) in the control group. There was a statistical difference between the two groups ( χ2 value was 9.197, P<0.05). The recovery time of the observation group was (15.52±8.48) days, shorter than (27.13±10.35) days of the control group with significant difference ( t value was 5.729, P<0.01). Seven cases (15.91%) of complications occurred in the observation group after nursing, which was significantly less than 15 cases (34.88%) of the control group. There was a statistical difference between the two groups ( χ2 value was 4.144, P<0.05). After 1, 3, and 6 months of intervention, the GCS and DRS scores of the two groups of patients were lower than the previous point in time, and the observation group was lower than those of the control group, the difference was statistically significant ( t value was 2.003-11.039, P<0.05). Conclusions:The use of MDT combined with call-out nursing for patients with multiple injuries during the perioperative period can increase the postoperative wakefulness rate, reduce the patients' wakefulness time and the probability of complications, and also effectively reduce the patient's coma during nursing and improve their physiological state. It is worthwhile being promoted in related nursing work.
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Objective: To observe the changes of Notch signaling pathway related molecule expression in hippocampus of rats with stagnation of liver qi and spleen deficiency syndrome and to explore the regulatory effect of Xiaoyaosan. Methods: Male SD rats were randomly divided into four groups: normal group, model group, model+xiayaosan group and model+fluoxetine group, each group had 12 rats. The stagnation of liver qi and spleen deficiency model was established by chronic immobilization stress for 21 days. Detection of Nissl bodies by Nissl staining, expression of NICD, Hes1, Hes5 and Jad1 were detected by Fluorescent quantitative PCR and Western-blot method. Results: Compared with the normal group, the number of Nissl bodies in the model group decreased significantly (P ＜ 0.01), which showed that Xiaoyaosan and fluoxetine could reverse it (P ＜ 0.01). The expression of Notch signaling pathway-related protein in model group was significantly lower than that in normal group (P ＜ 0.01), which showed that Xiaoyaosan and fluoxetine could reverse the expression of NICD, Hes5 and Jag1 protein (P ＜ 0.05, P ＜ 0.01). Compared with the normal group, the expression of each gene in the model group decreased (P ＜ 0.01), which showed that Xiaoyaosan and fluoxetine could reverse the expression of NICD, Hes1 and Hes5 mRNA (P ＜ 0.05, P ＜ 0.01). Conclusion: The hippocampal neurons of rats with stagnation of liver qi and spleen deficiency syndrome were damaged and the Nissl bodies were reduced, the expression of each protein and gene in Notch signaling pathway decreased. Xiaoyaosan may play a therapeutic role by regulating the expression level of hippocampal related molecules to protect neurons.
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This paper is based on the theory of"internal diseases will be presented externally"in Traditional Chinese Medicine, combined with the idea of syndrome differentiation and grasping the main symptoms, and proposes the concept of"virtual special disease". It is extracted from ancient books and expert experience, and it is believed that it is widespread and can be tested by clinical practice. The application of virtual syndrome to diagnosis can achieve the purpose of simplifying the complexity TCM syndrome differentiation. On the one hand, it provides a new exploration for enriching the TCM syndrome differentiation system; on the other hand, it provides new ideas for supplementing the biological research of syndromes and developing the diagnosis of integrated traditional Chinese and Western medicine.