ABSTRACT
Objective:To analyze the causes of puncture wound infections induced by the high pressure resistant injectable PICC catheter in patients undergoing hematopoietic stem cell transplantation and management measures.Methods:linical data of 75 patients undergoing hematopoietic stem cell transplantation who were treated with the high pressure resistant injectable PICC catheter in our hospital from Nov.2017 to Nov.2019 were retrospectively analyzed.According to whether there were puncture wound infections, patients were divided into the infection group(n=26)and the non-infection group(n=49). Bacterial culture results of the infection group were recorded, and the related factors for puncture wound infections caused by the injectable PICC catheter were analyzed.Effective strategies to prevent high-risk factors, treatment frequency, treatment effect and healing time for patients with different degrees of puncture wound infections were discussed.Results:There were 26 patients in the infection group.The proportions of bacteria types associated with PICC catheter-related infections, in descending order, were as follows: Staphylococcus aureus(46.51%), Klebsiella pneumoniae(30.77%), Corynebacterium(15.38%)and others(7.69%). Significant differences were found in materials used, season of tube placement, timing of dressing changes, duration of catheterization, success rate of first tube placement and condition of dressing films between the non-infection and infection groups( t=5.5, 4.9, 5.0, 13.6, 9.4 and 6.2, all P<0.05). Logistic multi-factor analysis showed that non-U-shaped fixation, delay in dressing changes, long duration of tube placement, low success rate of first tube placement, and loose dressing films were the high-risk factors for PICC catheter-related infections( OR=2.78, 2.42, 3.16, 2.66 and 2.32, all P<0.05). Compared with patients with moderate and mild infections, patients with severe infections had a higher frequency of treatment, a lower total effectiveness rate and a longer healing time( F=10.353, 8.775 and 12.341, all P<0.05). Conclusions:Materials, timing of dressing changes, catheterization time, success rate of first tube placement and condition of dressing films are the high-risk factors for puncture wound infections caused by high pressure resistant injectable PICC catheters in patients undergoing hematopoietic stem cell transplantation.Developing effective intervention strategies can help control the incidence of wound infections.
ABSTRACT
Objective:To explore the effect of nursing intervention based on the integration theory of health behavior change in pelvic floor muscle exercise of patients with pelvic floor dysfunction (PFD) after early cervical cancer surgery.Methods:A total of 134 patients with pelvic floor dysfunction after early cervical cancer surgery were selected and divided into test group ( n=67) and control group ( n=67) by random digits table method. The test group received three months of pelvic floor muscle exercise based on the theory of healthy behavior change. The control group received conventional pelvic floor rehabilitation care. The Pelvic Floor Distress Inventory-Short Form 20(PFDI-20), Pelvic Floor Impact Questionnaire-7(PFIQ-7), General Self-Efficacy Scale (GSES) and Social Support Rating Scale (SSRS) were evaluated before the intervention (T0), After one month of intervention (T1) and at the end of the intervention (T2). Results:The results of repeated measurement analysis of variance showed significant group/time interaction between PFDI-20 and PFIQ-7 scores ( Finteraction=29.196,13.213, both P<0.05); significant group/time interaction between GSES and SSRS scores ( Finteraction value was 25.664,70.240, both P<0.05). At the end of the intervention, the scores of PFDI-20 and PFIQ-7 in the test group were 66.54±14.04 and 73.20±7.41, which were lower than 77.47±15.91 and 78.39±8.51 in the control group over the same period. The difference was statistically significant ( t value was -4.216, -3.765, both P<0.01); the GSES and SSRS scores of the test group were 2.86±0.30 and 50.37±2.45, which were higher than the control group (2.51±0.34 and 46.42±2.82), the differences between the groups were statistically significant ( t value was 6.447, 8.662, both P<0.01). Conclusion:The nursing intervention plan based on the integration theory of health behavior change can significantly improve the self-efficacy, social support level and quality of life of patients with PFD after early cervical cancer surgery, and enhance the short-term and long-term pelvic floor rehabilitation effect of patients.
ABSTRACT
Objective To investigate the effect of comprehensive geriatric assessment on health management outcomes and quality of life in elderly patients with coronary heart disease.Methods A total of 100 elderly patients with coronary heart disease admitted into our hospital from April 2017 to April 2018 were enrolled in this study and randomly divided into a control group(n=50)receiving routine nursing intervention and an observation group (n =50)undergoing individualized health management after comprehensive geriatric assessment.Length of hospital stay,incidence of adverse events and quality of life were compared between the groups.Results The length of hospital stay was shorter in the observation group than in the control group[(10.6 ± 1.4) d vs.(15.5 ± 1.5) d,t =16.7,P＜0.05].Patients in the observation group had higher satisfaction than those in the control group[(55.6±1.4)vs.(45.5±1.5),t =34.2,P＜0.05],The incidence of cardiac adverse events was lower in the observation group than in the control group(20.0％ vs.52.0％％,x2 =5.0,P＜0.05).The scores for quality of life were higher in the observation group than in the control group(P＜0.05).Conclusions Comprehensive geriatric assessment can effectively shorten the length of hospital stay,reducethe incidence of cardiac adverse events,and improve the satisfaction and quality of life in elderly coronary heart disease patients,and should be recommended in clinical practice.
ABSTRACT
Objective To explore the association of suprapatellar pouch effusion with knee pain and serum levels of interleukin (IL)-6,IL-17,IL-23 in patients with knee osteoarthritis measured by magnetic resonance imaging (MRI).Methods 204 patients with knee osteoarthritis were enrolled into the study.Suprapatellar pouch effusion was measured by OSIRIS in both grade (0-3) and maximum area (cm2).Serum IL-6,IL-17,IL-23 were measured.Knee pain was assessed by Western Ontario and McMasters osteoarthritis index (WOMAC) questionnaire and Lequesne index.Characteristics of patients were recorded and body mass index (BMI) was calculated.Student t test or Chi-square test was used to compare means or proportions.Multivariable linear regression or logistic regression was used to determine risk factors (α=0.05).Results ① In the 204 patients [mean age (55±8) years,86.3％ were females],the prevalence of physiologic effusion (≤ 1) was 47.9％ while moderate or larger (≥2) effusion was 52.1％.② The age,labour intensity,serum levels of uric acid (sUA) and Lequesne index of higher grade effusion group were higher (P＜0.05) compared with lower grade effusion group.③ Suprapatellar pouch effusion maximum area was positively correlated with age (r=0.208,P=0.006),BMI (r=0.171,P=0.027) and labour intensity (r=0.189,P=0.013).④ Adjusted for age,gender and BMI,the results of Logistic regression analysis showed that:suprapatellar pouch effusion grades were positively correlated with Lequesne index [OR=1.120,95％CI(1.011,1.241),P=0.029] and negatively correlated with IL-23 [OR=0.768,95％CI (0.598,0.986),P=0.038].Suprapatellar pouch effusion was not independently associated with WOMAC index,IL-6 and IL-17.Conclusion The prevalence of suprapatellar pouch pathological effusion is 52.1％ in knee osteoarthritis.Suprapatellar pouch effusions is positively correlated with knee pain (Lequesne index) and negatively conrelated with IL-23.
ABSTRACT
Objective To explore undergraduate nursing students’psychological feelings during the internship, and provide a theoretical basis for the development of clinical nursing teaching measures. Methods The phenomenological research methods in qualitative study were adopted in this paper and 15 undergraduate nursing students were done with unstructured interview. In order to extract the theme, the obtained information were analyzed and organized with phenomenological analysis. Results Using the generic analytical method we got four topics about psychological feeling that influenced undergraduate nursing students. The low professional identity, mental depression, limited capacity cannot meet the needs of patients and the teacher was too busy to care of undergraduate nursing students that influence the practice enthusiasm. Conclusion The care managers and teachers should take various measures to improve the quality of nursing students and their theoretical and technical skills, develop a reasonable plan to improve the mental health status of undergraduate nursing students and the quality of clinical nursing practice can be improved.
ABSTRACT
Objective To investigate the expression of matrixmetalloprotein -9(MMP-9)and E-cad-herin in triple negative breast cancer ( TNBC) and its relationship with the clinicopathologic features of TNBC .To analyze the function of MMP -9 and E-cadherin in TNBC .Methods Immunohistochemical method was used to detect the expression of MMP -9 and E-cadherin in 127 cases of TNBC.Results The MMP-9 positive rate was 53.54%and E-cadherin positive grade was 32.28%in TNBC.Expression of MMP-9 was correlated with tumor size(P=0.007),histological grade(P=0.006),TNM stage(P=0.003),lymph node metastasis(P=0.000)and lymph duct invasive(P=0.000).Expression of E-cadherin was correlated with lymph node metasta-sis(P=0.016)and lymph duct invasive(P=0.015).However,they were not correlated with other factors .Con-clusion The expression of MMP -9 and E -cadherin was correlated with invasion and metastasis in TNBC , which could be an important research topic in the future studies .