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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.
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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.
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Objective: To evaluate the risk factors for contrast-induced nephropathy (CIN) in patients of acute coronary syndrome (ACS) with normal or slightly impaired renal function after percutaneous coronary intervention (PCI). Methods: A total of 254 consecutive ACS patients with normal or slightly impaired renal function received PCI in the Second Artillery General Hospital from 2013-06 to 2015-06 were retrospectively studied. All patients had eGRF≥60 ml (min?1.73 m2) and they were divided into 2 groups:CIN group, the patients with serum creatinine increased by 0.5mg/dl (44.2μmol/L) or elevated to 25%higher than the baseline, n=23;Non-CIN group, n=231. The basic condition with laboratory tests, operative indexes were recorded and eGRF value were calculated in all patients. Results: There were 9%(23/254) patients suffered from CIN after PCI. Multivariate regression analysis indicated that emergent PCI (OR=0.370, 95%CI 0.060-2.297), increased plasma level of NT-proBNP (OR=4.209, 95%CI 1.202-14.742) and without pre-operative aspirin administration (OR=7.950, 95%CI 1.108-57.034) were the clinical risk factors for post-operative CIN occurrence. Conclusion: Emergent PCI, higher plasma level of NT-proBNP and no pre-operative aspirin administration were the risk factors for CIN occurrence in ACS patients with normal or slightly impaired renal function after PCI.
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Objective: To explore the relationship between the ratio of neutrophil/lymphocyte (NLR) and in-hospital major adverse cardiac events (MACE) in patients with acute ST-elevation myocardial infarction (STEMI) at early admission. Methods: A total of 420 acute STEMI patients admitted and received primary PCI in our hospital from 2010-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups:In-hospital MACE group, n=47 and Normal discharged group, n=373. Uni-and multivariate analyses were conducted to assess whether high NLR is the independent predictor for in-hospital MACE occurrence. Results: Univariate regression analysis indicated that the occurrence rate of in-hospital MACE in high NLR patients were higher than those in low NLR patients (OR=3.19, 95%CI 1.55-2.65, P=0.012). Multivariate regression analysis showed that high NLR was the independent risk factor for in-hospital MACE occurrence in STEMI patients (OR=3.05, 95%CI 1.59-10.54, P=0.015). Conclusion: High NLR is the independent risk factor for in-hospital MACE occurrence in STEMI patients at the early admission.
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Objective To analyze the risk factors of paroxysmal atrial fibrillation (PAF) in very olderly hypertensive patients. Methods According to the electrocardiograph (ECG) and history data, two hundred and six older old-hypertensive patients were divided into PAF group (n=66) and sinus rhythm (SR) group (n=140). Data of age, gender, body mass index (BMI), the use of angiotension-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs) and statin drug history, 24-hour ambulatory blood pressure monitoring (ABPM), echocardiography, pulse wave velocity (PWV), blood lipid profile and renal function were recorded in two groups. Logistic regression analyses of the relevant factors were compared between groups. Results Data of age, the diameter of the left atrium (LAD), the 1eft ventricular mass index (LVMI) and the PWV were significantly higher in PAF group than those of SR group [(88.92±3.42) years old vs. (86.36±4.67) years old, (39.00±6.66) mm vs. (33.54±7.77) mm, (132.49±14.83) g vs. (119.00±11.35) g, (13.45±4.85) m/s vs. (9.89±2.74) m/s, respectively]. Values of three acyl glycerin (TG), blood pressure smoothing index (SI) were lower in PAF group than those of SR group [(1.33±0.91) mmol/L vs. (1.95±1.29) mmol/L, 0.75±0.06 vs. 0.79±0.04, respectively]. Results of two classification Logistic regression analyses showed that the reduced SI, the enlarged LAD and LVMI and the increased PWV were the risk factors of PAF in very olderly hypertensive patients. Conclusion Unstable blood pressure, left atrial enlargement, left ventricular hypertrophy and arterial stiffness are the risk factors of PAF in very olderly hypertensive patients.
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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.
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Objective To know the cognition of residents of middle or small cities of China on adverse effects of indoor air pollution on human health.Methods 208 pupils of grade 2 to 4 were randomly selected in 2 primary schools in Taian city,and their parents were asked to fill in the questionnaires in May,2008.Results 72% of the total investigated families moved into their new houses within 3 months after the interior decoration was finished,and only 2% of the investigated families monitored the pollutants concentration after the decoration was finished.Most families hadn't the correct concepts on decoration pollution.52.88% of the investigated families considered that the newly decorated house should be safe if the green materials were used in the decoration.47.12% considered it was safe if no abnormal odor.39.42% said that indoor pollution could be eliminated by air refresher.55.76% to 62.5% of the investigated families hadn't the knowledge that furniture and fibrous materials may cause the indoor air pollution.As for the harm of decoration pollution,most families(above 50%) knew,but a few,such as cancer,leukemia and respiratory diseases.63.46% of the families did not really know China's policies and regulations on interior environment inspection.Conclusion In our country,it is very important for the prevention and control of the air pollution related diseases that the whole society should pay more attention to indoor air pollution and human health.