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Objective To explore the teaching efficacy of applying scene simulation in enteral nutrition nursing skills training.Methods Totally 126 nursing students were randomly divided into 2 groups:experiment group with scene simulation teaching method and control group with traditional teaching method.Comparison of teaching efficacy between the two methods was made.Results The students in experiment group can skillfully complete nutritional care and get the praise of teachers.The satisfied patients made by students in experiment group were higher than those in control group 14.28％ - 19.05 ％ ( P＜0.05 ).The assessment scores of theoretic knowledge test and enteral nutrition nursing manipulation examination and comprehensive nursing skill test were higher in experimental group than in control group 6.69 - 11.94 ( P＜0.005 ).Conclusion Scene simulation teaching method is suitable for enteral nutrition nursing skill training and is favored by nursing students.
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Objective To investigate the risk factors for intracranial atherosclerosis in patients with ischemic stroke.Methods The demographic data and vascular risk factors in patients with ischemic stroke who performed digital subtraction angiography were analyzed retrospectively.According to the lesion locations,the patients with moderate to severe intracranial arterial stenosis were divided into intracranial internal carotid artery,middle cerebral artery,intracranial vertebral artery,and basilar artery.The démographic data and vascular risk factors among all groups were compared.Results A total of 344 patients with ischemic stroke were recruited,147 (42.7％ ) of them were moderate to severe intracranial arterial stenosis and 197 (57.3％ ) were mild intracranial arterial stenosis.Univariate analysis showed that the proportion of diabetes (34.0％ vs.20.8％,x2 =7.541,P=0.006) or hyperlipidemia (78.9％ vs.66.0％,x2 =6.900,P=0.009) in the moderate to severe intracranial arterial stenosis groups was significantly higher than that in the mild intracranial arterial stenosis group.The levels of total cholesterol (4.656 ±0.955 mmol/L vs.4.401 ±0.882 mmol/L,t =-2.543,P =0.011),low-density lipoprotein cholesterol (3.015 ± 0.817 mmol/L vs.2.741 ± 0.786 mmol/L,t =-3.113,P =0.002),fasting blood glucose (FBG) (6.184 ± 2.127 mmol/L vs.5.568 ±1.772 mmol/L,t =-2.869,P =0.004),and the National Institutes of Health Stroke Scale score (5.48 ± 4.980 vs.4.33 ± 4.094,t =-2.332,P =0.020) were significantly higher.Multivariable logistic regression analysis showed that diabetes (odds ratio [ OR ] 1.907,95％confidence interval [ CI] 1.164-3.124; P =0.010) and low-density lipoprotein cholesterol (OR 1.500,95％ CI 1.133-1.986; P =0.005) were the independent risk factors for moderate to severe intracranial arterial stenosis.Among the patients with different locations of intracranial arteries,there were significant differences in the distribution of the risk factors,such as male (P =0.017),coronary artery disease (P =0.002),and smoking (P =0.026).Conclusion Diabetes and the increased level of low-density lipoprotein cholesterol were the independent risk factors for moderate to severe stenosis of intracranial arteries.The distribution of risk factors for intracranial atherosderosis had location specificity.
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Objective To investigate risk factors and prognosis of hemorrhagic transformation(HT)in acute cerebral infarction patients treated by intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA).Methods All 128 patients with acute cerebral infarction were treated with intravenous rtPA within 6 hours from stroke onset.The clinic records and laboratory datas of pre-and post-treatment were statistically analyzed between HT group and non-HT group to find potential risk factors to HT and contributors of prognosis.Results HT occurred in 29 patients(22.66％),including 16 patients with symptomatic ICH(12.50％)and 2 patients died(6.90％ of HT).Logistic regression analysis showed that history of atrial fibrillation(OR =1.293,95％ CI 1.224-1.589,P =0.001),CT density changes with mass effect or edema(OR =2.452,95％ CI 1.132-3.309,P =0.034),diastolic blood pressure ≥ 100 mm Hg before thrombolytic therapy(1 mm Hg =0.133 kPa,OR =9.265,95％ CI 1.435-59.836,P =0.019),blood glucose ≥ 11.1 mmol/L(OR =3.037,95％ CI 0.252-57.593,P =0.047),NIHSS score ＞ 15 points (OR =8.752,95％ CI 1.035-30.285,P =0.023)and thrombolysis time ＞ 3 h(OR =98.74,95％ CI 5.067-186.120,P =0.002)are independent risk factors for HT; among these factors,baseline blood glucose(OR =3.265,95 ％ CI 0.435-59.863,P =0.045),NIHSS score(OR =10.453,95 ％ CI 5.647-38.185,P =0.003)and thrombolysis time(OR =2.541,95％ CI 1.098-51.086,P =0.017)also are prediction factors of the prognosis of HT.Conclusion Risk factors associated with HT are diastolic blood pressure before thrombolysis,glucose level,degree of neurological deficits,CT early changes,atrial fibrillation and thrombolytic time.Glucose level,neurological deficits and thrombolysis time affects the prognosis of patients.