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Objective:To explore the application effect of dyadic intervention scheme based on dyadic disease management theory and Information, Knowledge, Attitude, and Practice model in the discharge preparation of elderly stroke patients and family caregivers.Methods:The 92 pairs of elderly stroke patients and their caregivers hospitalized in the Department of Neurology in People′s Hospital of Zhengzhou University were conveniently selected. The non synchronous control method quasi experimental research was adopted. Totally 46 pairs of subjects who met the criteria for admission and discharge from May to July 2022 were set as the control group, and routine nursing was carried out; from August to October 2022, 46 pairs of subjects who met the criteria for admission and emission were set as the observation group to implement the dyadic intervention program. The scores of discharge readiness, self-efficacy and unplanned readmission rate of patients between the two groups were compared, and the scores of caregiver readiness, self-efficacy and caregiver stress between the two groups were compared.Results:Finally, 85 pairs of subjects completed the study, with 42 pairs in the control group and 43 pairs in the observation group. On discharge day, the total scores of discharge readiness and caregiver readiness in the observation group were (95.19 ± 4.47), (23.02 ± 2.20) points, respectively, which were higher than those in the control group (85.71 ± 5.31), (19.57 ± 1.65) points, with statistically significant differences ( t=8.91,8.16, both P<0.01); the self-efficacy levels of patients in the observation group at discharge and one month after discharge, as well as those of caregivers at discharge and one month after discharge were (73.86 ± 4.87), (75.91 ± 4.51), (75.67 ± 4.99), (79.21 ± 4.90) points, respectively, higher than those in the control group (71.62 ± 5.19), (73.33 ± 4.91), (73.48 ± 4.24), (75.48 ± 4.24) points, with statistically significant differences ( t values were from 2.05 to 3.75, all P<0.05); the pressure levels of caregivers in the observation group at discharge and one month after discharge were (7.51 ± 2.48), (6.28 ± 1.99) points, respectively, lower than those in the control group (8.76 ± 2.55), (7.45 ± 2.36) points, with statistically significant differences ( t=-2.29, -2.48, both P<0.05); the unplanned readmission rate of patients in the observation group one month after discharge was 7.0% (3/43), lower than the control group′s 23.8% (10/42), with statistically significant difference ( χ2=4.65, P<0.05). Conclusions:The implementation of dyadic intervention on elderly stroke patients and caregivers can make their discharge preparation process more adequate, thus reducing the caregiver′s care pressure, reducing the unplanned readmission rate of patients, and improving their health outcomes.
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Objective To investigate the effects of hyperglycemia on ubiquitination and endoplasmic reticulum stress in renal intrinsic cells (podocytes and proximal tubular epithelial cells)and its role in pathogenesis of diabetic nephropathy.Methods Diabetic mice were induced by streptozotocin injection.After 16 weeks of hyperglycemia,immunofluorescence was used to detect the expressions of ubiquitination and glucose-regulating protein 94 (GRP94) in renal cortex and medulla area of kidney sections.Primary mouse podocyte and proximal tubular epithelial cells were isolated by flow cytometry,and exposed to 30 mmol/L glucose for indicated time (1 d,3 d and 7 d).Their ubiquitination and GRP94 expressions were evaluated by Western blotting.Results Diabetic mice presented microalbuminuria and slightly widened mesangium was found in glomerular area.Ubiquitinated proteins,mainly localized in podocytes and tubular epithelial cells,exhibited an apparently higher expression in diabetic mice than control mice (all P ＜ 0.05).Hyperglycemia promoted the ubiquitination in a time-dependent manner.Compared with their normal cells,primary mouse podocyte and primary tubular epithilial cells treated with high glucose for 3 d and 7 d showed increased ubiquitinated protein (all P ＜ 0.05).GRP94 was interspersed in podocytes and proximal tubular epithelial cells.Expression of GRP94 was significantly increased in glomerular area of diabetic mice and podocyte with 3 and 7 day-high glucose as compared with those in their control groups (all P ＜ 0.05).GRP94 expression had no significant change in tubular area and tubular epithilial cells treated with high glucose.Conclusions Hyperglycemia may lead to accumulation of ubiquitinated proteins in intrinsic kidney cells.The imbalance of protein homeostasis in podocyte may contribute to podocyte injury during the onset of diabetic nephropathy.
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OBJECTIVE To investigate the ESBLs ′ genotypes and the resistance of Escherichia coli and Klebsiella pneumoniae in Taizhou Hospital of Zhejiang Province.METHODS We collected 30 strains of E.coli and K.pneumoniae expressing ESBLs,then analyzed their encoding genotypes of TEM,SHV,PER,VEB and CTX genes by PCR and DNA sequencing technology separately.RESULTS There were 26 strains expressing blaCTS-M gene among 30 strains,in which 16 strains belonged to blaCTS-M-9 subgroup genotype,8 strains to blaCTX-M-1,7 strains to blaCTX-M-2,4 strains to blaCTX-M-1 as well as blaCTX-M-2,1 strain to blaCTX-M-2 as well as blaCTX-M-9 and 1 strain belonged to blaCTX-M-1 as well as blaCTX-M-9.CONCLUSIONS The prevalent clinical genotype of E.coli and K.pneumoniae is blaCTX-M-9.