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Objective:To evaluate the correlation between elevated cTnI level and 28-day mortality after liver transplantation.Methods:A retrospective study was conducted in adult patients admitted to ICU after liver transplantation from Jun 2015 to March 2019 at Beijing Chao-Yang Hospital. The cardiac troponin Ⅰ levels within 48 h after surgery were examined. Patients outcome was followed up,the primary end point was mortality within 28-day. Univariate and multivariate logistic regression models were used to look for predictors of 28-day mortality.Results:Three hundred and eighteen patients were included in our analyses. Twenty-six patients died and 292 survived within 28 days after LT. Two hundred and forty-three of 318 (76.4%) cases presented elevated cTnI in the early stage after LT. Thirty-seven of 318 (11.6%) patients presented a moderate elevation of cTnI level (5-10 times over normal upper limit), 75 (23.6%) of them presented severe cTnI elevation (10 times over normal upper limit). Univariate and multivariate logistic regression model shows severe cTnI elevation was the independent prognostic factors associated with 28-day mortality [Odds Ratio (95% confidence interval)=3.151(1.218-8.150), P=0.018]. Conclusion:Early cTnI elevation is common after liver transplantation, and severe cTnI elevation is significantly associated with 28-day mortality.
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Objective To explore the quality control circle (QCC) in midwife practice teaching activities for improving the quality of teaching effect, innovate the method for obstetric practice teaching and provide reference for other practice teaching methods. Methods Take the 84 midwifery interns as research object who entered the maternity ward within two years after the implementation of the QCC activities, and randomly divided into the experimental group and the control group and each group included 42 people. The experimental group adopted the teaching mode of integrating daily teaching into the QCC. The control group adopted the traditional one-on-one teaching mode based on teaching, and compared the learning effects of the two groups of interns. Results After the internship, the three levels of the Koch′s four-level training evaluation model method were used to evaluate the teaching effect. The reaction layer was evaluated through five aspects: teaching plan, teacher resources, internship environment, teaching form and content, and appraisal evaluation. It was found that the satisfaction of the teaching plan and teaching form evaluation of the experimental group was significantly higher than that of the control group; the learning level passed the theoretical test. The results of the scores, skills test scores and overall care were evaluated. It was found that the three results of the internship group were significantly higher than those of the control group. The behavioral level was evaluated by the satisfaction of the client and the maternal was proficient in the operation of the experimental group. The satisfaction evaluation of the mission and the mission was significantly higher than the control group. The difference in the above evaluation results was statistically significant (P<0.05). Conclusions The quality control circle teaching mode is feasible in the midwife internship teaching in the delivery room, which transforms the traditional passive teaching mode into a common and active participation teaching mode for teachers and students, enhances the level and enthusiasm of teachers to teach, and enhances service awareness and quality of care. It also plays a role in cultivating management talents and is worthy of further exploration and promotion.
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Objective@#To explore the quality control circle (QCC) in midwife practice teaching activities for improving the quality of teaching effect, innovate the method for obstetric practice teaching and provide reference for other practice teaching methods.@*Methods@#Take the 84 midwifery interns as research object who entered the maternity ward within two years after the implementation of the QCC activities, and randomly divided into the experimental group and the control group and each group included 42 people. The experimental group adopted the teaching mode of integrating daily teaching into the QCC. The control group adopted the traditional one-on-one teaching mode based on teaching, and compared the learning effects of the two groups of interns.@*Results@#After the internship, the three levels of the Koch′s four-level training evaluation model method were used to evaluate the teaching effect. The reaction layer was evaluated through five aspects: teaching plan, teacher resources, internship environment, teaching form and content, and appraisal evaluation. It was found that the satisfaction of the teaching plan and teaching form evaluation of the experimental group was significantly higher than that of the control group; the learning level passed the theoretical test. The results of the scores, skills test scores and overall care were evaluated. It was found that the three results of the internship group were significantly higher than those of the control group. The behavioral level was evaluated by the satisfaction of the client and the maternal was proficient in the operation of the experimental group. The satisfaction evaluation of the mission and the mission was significantly higher than the control group. The difference in the above evaluation results was statistically significant (P<0.05).@*Conclusions@#The quality control circle teaching mode is feasible in the midwife internship teaching in the delivery room, which transforms the traditional passive teaching mode into a common and active participation teaching mode for teachers and students, enhances the level and enthusiasm of teachers to teach, and enhances service awareness and quality of care. It also plays a role in cultivating management talents and is worthy of further exploration and promotion.
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Objective To analyze the effect of mechanical press and manual press in cardiopulmonary resuscitation.Methods A prospective randomized controlled study was performed.A total of 95 cases who needed cardiopulmonary resuscitation were collected,according to the inclusion criteria,which including mechanical compression group (n =48),and the manual compression group (n =47).Demographic,clinical course of two groups were collected.Arterial and venous blood gas analysis in the recovery after the start of 5 minutes,15 minutes,30 minutes,the end of recovery were also collected and the pH value,partial pressure of oxygen,extracellular base remaining,actual bicarbonate,lactic acid,calcium and central venous oxygen saturation (ScvO2) and other data were mainly analyzed.All data collation and statistical analysis were used Microsoft excel,SAS 9.4.The enumeration data were expressed by the frequency and percentage,and chi square test was used.The measurement data were expressed by mean and standard deviation,and t test was used.Multiple Logistic regression analysis was performed to analysis of the effect of various factors.Results There were no statistically differences in age and pathogenic factors between the mechanical compression group and manual compression group (P ＞ 0.05).The press time,success rate of resuscitation and hospitalization days were respectively (22 ±14) minutes,81％,(37 ± 16) days in the mechanical compression group and (27 ± 19) minutes,54％,(41 ±20) days in the manual compression group,with no statistically significant differences (all P ＞ 0.05).Mechanical compression group and manual compression group were cured in 17 cases,10 cases,survived in 21 cases,9 cases,deaded in 10 cases,28 cases,with statistically significant differences between 2 groups (P ＜0.05).The troponin Ⅰ and creatine kinase MB were respectively (4.1 ± 2.0) ng/ml,(31 ± 15) U/L in the manual compression group and (5.6 ± 1.9) ng/ml,(43 ± 22) U/L in the mechanical compression group,with statistically significant differences between 2 groups (P ＜ 0.05).The defibrillation energy and defibrillation times in manual group were significantly higher than that of mechanical compression group (P ＜ 0.05).Multivariate logistic regression analysis showed that the central venous oxygen saturation at the first 5 minutes after the start of compression (x2 =65.0538,P ＜ 0.0001),the arterial blood pH at the end of compression (x2 =21.5779,P ＜ 0.0001),and the 5％ sodium bicarbonate was significantly correlated with the prognosis of survival after resuscitation,mechanical compression group was better than the manual compression group (x2 =3.1421,P =0.0463).Conclusions The effect of cardiopulmonary resuscitation machine is better than that of manual compression,which can effectively improve the clinical treatment effect.The result recommends the use of cardiopulmonary resuscitation machine for patients with cardiac arrest.
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@#Objective To detect the effect of the operative and non-operative therapy on acute mesenteric venous thrombosis (AMVT).Methods The documents of 18 AMVT patients from Jan 1990 to May 2006 were reviewed retrospectively.Results In 18 patients, 12 cases with intestinal necrosis received operation, among them, 2 cases received the operation only and 10 cases added with anti-coagulation therapy further. The rest 6 patients received non-operative therapy. All of 18 patients recovered well.Conclusion Non-operative therapy is safe and effective for the patients without intestinal necrosis. Post-operative anti-coagulation therapy is very important for the patients received the operative therapy.
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Objective To observe the action of penehyclidine hydrochloride on the treatment for septic shock. Methods Total 40 admitted patients for septic shock,were randomly divided into four groups,Group A:654-2 30 mg, Q 30 min;Group B:penehvclidine hydrochloride 2 mg,Q 1 h;Group C:penehyclidine hydrochloride 2 mg,Q 6 h; Group D:penehyclidine hydrochloride 6 mg,Q 6 h,The medication dosage was not abated until twig were improved.The heart rate (HR),mean arterial pressure (MAP),diameter of the pupil,the time and duration of the twig improvement, saturation of pulse oxygen (SpO_2),consciousness,intestinal sound and the level of lactolose in blood were observed. Results penehyclidine hydrochloride could improve the microcirculation in patients with septic shock.The administration time was few.It didn't make the heart rate increase and inhibit the intestinal motion.Conclusion Penehyclidine hydrochloride would be one of the ideal vasoactive drugs in treatment for septic shock.