ABSTRACT
Objective To evaluate the safety of heparin used in plasma exchange (PE) and molecular absorbent recirculating system (MARS) for hepatic failure. Methods 8 databases were electronically searched including CNKI,CBM,WANFANG,VIP,PubMed,Web of Science,Cochrane and EMBASE.Two researchers individually performed the literature screening,data extraction and evaluation of risk of bias.Random or fixed effect model based on the result of the test of heterogeneity were chosento synthesize the datausing RevMan 5.3 software. Results 6 eligible studies with 863 patientswere included. Compared to omitting of heparin, the heparin PE could increase the probability of circuit clotting, hemorrhage in puncture point, puncture hematoma (RR = 6.05, 95% CI:2.00-18.30, P=0.001;RR=10.80,95% CI:4.78-24.37,P<0.05;RR=6.34,95% CI:1.13-35.53,P=0.04),but the probability of circuit blocking and other adverse reactions are not influenced(RR=5.61,95% CI:0.99-31.89,P=0.05;RR = 1.17,95% CI: 0.73-1.86, P=0.51). As for the treatment with MARS, heparin could increase the chance bleeding death (RR =12.04, 95% CI:1.69-85.66, P=0.01), but had no obvious effect on circuit clotting. Conclusion When curing the hepatic failure,heparin PE can increase the probability of circuit clotting, hemorrhage in puncture point and puncture hematoma, and heparin MARSE can increase the probability of bleeding death. On the contrary, no-heparin PE and MARSE will be safer in treatment of hepatic failure.
ABSTRACT
Objective To study the correlation of nurse -perceived organizational atmosphere climate and their job involvement. Method About 465 clinical nurses were involved in the investigation by nursing organizational climate scale and work engagement scale. Results The total score on the organizational climate and job involvement were (149.24 ± 21.36) and (52.80 ± 6.31), respectively. The nurse -perceived organizational climate was positively correlated with job involvement ( P <0.01). Conclusions The nurse-perceived organizational climate and job involvement are at a medium level. Nursing managers should create a good organizational climate and promote their positive status into nursing, thereby improving the quality of care.