ABSTRACT
Objective To explore the effectiveness of Team Strategies & Tools to Enhance Performance and Patient Safety (TeamSTEPPS) in reducing hyperphosphatemia of outpatients on maintenance hemodialysis.Methods A total of 56 outpatients on hemodialysis received traditional dietary management from April to June,2016 were as control group,and 60 patients from October to December,2016 with TeamSTEPPS implemented in hyperphosphatemic dietary management were as observation group.The difference of the incidence rate of hyperphosphatemia and hypoproteinemia,grasp of knowledge of hyperphosphatemic dietary management were compared between two groups and medical staffs.Results The incidence rate of hyperphosphatemia were dropped from 60.7％(34/56) in control group to 41.7％(25/60) in observation group,difference between two groups had statistical significance(x2=4.20,P=0.036).The hypoproteinemia had no statistical difference between two group(x2=2.72,P=0.102),but still dropped from 39.3％ (22/56) in control group to 25.0％ (15/60) in observation group.Grasp of knowledge of hyperphosphatemic dietary management were rised from (75.1±5.1) points and (69.7 ±6.4)points in control group and medical staffs to (88.4±2.6) points and (80.1±6.5) points in observation group and medical staffs respectively,and there were significant differences(t=15.82,-8.84,P=0.00).Conclusions The application of TeamSTEPPS for hyperphosphatemic dietary management in outpatients on maintenance hemodialysis can effectively decrease the incidence of the hyperphosphatemia.
ABSTRACT
Objective To investigate the therapeutic effect of ambroxol hydrochloride on severe pneumonia, and the influence on the inflammatory cytokines of TNF-alpha and hs-CRP etc.MethodsThe clinical data of severe pneumonia patients treated in ningbo city medical treatment center Lihuili hospital from December 2014 to August 2016 were retrospectively analyzed.According to the treatment methods are divided into control group and observation group, the control group was given routine treatment, the observation group in the conventional treatment based on the given of ambroxol hydrochloride.To observe the therapeutic effect of two groups, the differences of serum levels of inflammatory cytokines, pulmonary function, cough and expectoration symptom scores of the two groups were compared before and after treatment.ResultsThe effective rate of the observation group was 97.50%, which was significantly higher than that of the control group;Two groups of patients before treatment serum inflammatory cytokines level no difference, after treatment, the observation group IL-6, IL-8, hs-CRP and TNF-alpha water average lower than the control group;Two groups of patients before treatment pulmonary function index no difference, after treatment, the observation group FVC, FEV1 and FEV1/FVC levels were higher than the control group;Two groups of patients with symptoms of no difference before treatment after treatment, observation group cough, sputum volume, cough ease and wheezing scores were lower than the control group.ConclusionAmbroxol hydrochloride has a good therapeutic effect on severe pneumonia can be significantly reduced in patients with TNF-hs-CRP alpha, inflammatory cytokine levels, improve the symptoms and signs, has good application value.
ABSTRACT
Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. The paper reviewed the concept, construct, training model, measures and implementation in healthcare of team strategies and tools to enhance performance and patient safety (TeamSTEPPS) which was the most widely applied team training strategy, in order to provide reference for the healthcare in China.
ABSTRACT
Objective To investigate the effects of serum isoenzyme and inflammatory factors by large doses of methyl prednisolone shocktherapy in the treatment of patients with acute hundred withered grass poisoned.Methods 46 cases of patients with acute hundred withered grass poisoned from June 2014 to October 2015 in ningbo medical center lihuili hospital were collected and randomly divided into two groups,23 cases in each group.On the base of the conventional treatment,patients in the control group were treated by blood perfusion therapy,patients in the experiment group were treated with large dose of methyl prednisolone shock therapy on the base of the control group,tested and compared the levels of serum enzyme and inflammatory factors before and after treatment,observed the clinical symptoms,clinical efficacy and adverse reactions.Results Compared with before treatment,the levels of IL-1,IL-10,TNF-αand CRP in two groups were decreased (P<0.05),levels of CK, CK-MB, TGF-β1 and HIF-1αdecreased (P<0.05);Compared with the control group,the levels of IL-1,IL-10, TNF-αand CRP in the experiment group were lower (P<0.05);CK,CK-MB,TGF-β1 and HIF-1αlevels were lower (P<0.05),after treatment from the last row of green time,the plasma PQ clearance time and length of hospital stay were shorter (P<0.05),total effective rate was higher (P<0.05).Conclusion Large doses of methyl prednisolone shock therapy in the treatment of patients with acute hundred withered grass poisone has definite clinical efficacy , can reduce the patients’serum CK,CK-MB,TGF-β1,HIF-1αand inflammatory factors levels, with higher security.
ABSTRACT
As many naturally-derived proteins,keratins have intrinsic biological activity,good biocompatibility and are biodegradable.Human hair keratins,as one type of the autogenous proteins,also have low immune rejection.Compared to other autogenous materials,human hair keratins come from a variety of sources and show attraction in field of regenerative medicine.The human hair keratins applied in neural implant materials,wound dressing,cell culture substrates,drug delivery system and soft tissue reconstructions,which are based on hydrogels,scaffolds coating,films and composite materials present huge development potential in regenerative medicine.