Effects of PDCA method on improving the accuracy of the Autar Deep Venous Thrombosis Scale / 中国实用护理杂志

Objective:To investigate the effects of PDCA method on improving the accuracy of the Autar Deep Venous Thrombosis (DVT) Scale used by nurses to assess the risk of deep venous thrombosis in surgical patients.Methods:Applied the way of PDCA, namely, raising questions, analyzing reasons, implementing measures, feeding back effects to professional explanate the difficulty in using the scale, moreover, training the nurses used level education method between August 2017 and December2018.The accuracy and consistency of the scale were compared before and after interventions.Results:A total 396 patients were evaluated in the study. There were significant differences in the consistency of evaluation among hospitalized, post-operative and discharged patients after intervention compared with before intervention ( P< 0.0167).The consistency of assessment of team members and responsible nurses increased from 68 to 120 cases, and the consistency of assessment reached 90.91%. The Kappa consistency of assessment of responsible nurses and team members increased from 0.354 before intervention to 0.879 after intervention. The effect was remarkable. Conclusions:PDCA cycle method is based on the problems found in clinical practice. It clarifies the professional terms and rules used in the scale, improves the accuracy and consistency of the Autar DVT scale used by nurses, correctly reflects the risk of thrombosis, ensures the safety of patients, and is worthy of promotion and reference.

Effect of multidisciplinary collaboration management on the self?management efficacy of patients with ileostomy irritant dermatitis / 中华健康管理学杂志

Objective To investigate the effects of the multidisciplinary cooperative management intervention model on the self‐management efficacy of patients with ileostomy irritant dermatitis. Methods Among the patients with irritative dermatitis in the ileostomy section of the Anorectal Surgery and Ostomy Clinic of Hwamei Hospital, the Chinese Academy of Sciences, 72 patients, who visited the clinic from August 2016 to August 2018, met the inclusion criteria and were finally included in the study. According to the random number table method, 36 patients each were assigned to the control and observation groups respectively. There were no significant differences in age, sex and education between the two cohorts. The control groups were compared. The control group was treated with routine nursing methods. The observation group underwent multidisciplinary nursing intervention that was based on the routine measures of the control group. The Chinese version of the cancer self‐management efficacy was used as the questionnaire survey that was administered before and after treatment. The results were compared and analyzed between the patient groups. The independent sample t‐test was used to compare the results between the groups, and the paired sample t‐test was used for intra‐group comparisons. Results After intervention, the total scores of self‐management efficacy and positive attitude, self‐decompression and self‐decision scores were higher in the observation group than in the control group (t=4.192, 3.095, 4.123, 2.267, P<0.05). The scores of self‐administration efficacy and each dimension of the two groups were higher than those before intervention, and the difference was statistically significant (P<0.01). After the intervention, 3 patients (10.0%) in the observation group with recurrent dermatitis and 13 patients (43.3%) in the control group. The recurrence rate of the observation group was significantly lower than that of the control group (χ2= 8.357, P<0.05). Conclusion Multidisciplinary cooperative management can improve the self‐management efficacy of patients with irritating dermatitis and reduce the incidence of this condition.

A study of prospect and review on risk assessment tools for deep vein thrombosis / 中国实用护理杂志

Deep venous thrombosis (DVT) is an acute critical disease with high clinical incidence and easy to be misdiagnosed and missed. Not early assessment and effective prevention, it is very easy to lead to the occurrence of post thrombotic syndrome and pulmonary embolism, with high mortality and a serious threat to the life safety of the patients. The early and effective individual assessment of the DVT risk assessment tool is the basis for risk stratification and appropriate preventive measures. It is the key to reduce the incidence of DVT, misdiagnosis rate, missed diagnosis rate, incidence of complications and mortality. This paper is to review the research progress of individual DVT risk assessment tools at home and abroad, with a view to the same kind. The development of the research can be used for reference.

Research progress of time perspective therapy and the enlightenment of time perspective therapy to nurse post-traumatic stress disorder in our country / 中国实用护理杂志

Time perspective therapy (TPT) which belongs to positive psychology is a new psychological intervention to post-traumatic stress disorder (PTSD).A large number of studies abroad have testified that TPT is very long-term effective,what′s more, TPT has been popularized and improved by foreign scholars but not been applied in China.TPT has been a study issue in mental and psychological fields,but that how to apply TPT rightly in China needs to explore.Therefore, this paper systematically introduced and analyzed TPT theory, the problems of applying TPT and the enlightenment of nursing PTSD,so as to help Chinese scholars apply TPT to solve problems and status of nursing PTSD in China.

EsxA might as a virulence factor induce antibodies in patients with Staphylococcus aureus infection

Staphylococcus aureus (S. aureus) is an important human pathogen, which commonly causes the acquired infectious diseases in the hospital and community. Effective and simple antibiotic treatment against S. aureus-related disease becomes increasingly difficult. Developing a safe and effective vaccine against S. aureus has become one of the world's hot spots once again. The key issue of developing the vaccine of S. aureus is how to find an ideal key pathogenic gene of S. aureus. It was previously suggested that EsxA might be a very important factor in S. aureus abscess formation in mice, but clinical experimental evidence was lacking. We therefore expressed EsxA protein through prokaryotic expression system and purified EsxA protein by Ni-affinity chromatography. ELISA was used to detect the anti-EsxA antibodies in sera of 78 patients with S. aureus infection and results showed that the anti-EsxA antibodies were positive in the sera of 19 patients. We further analyzed the EsxA positive antibodies related strains by antimicrobial susceptibility assay and found that all of the corresponding strains were multi-drug resistant. Among those multi-drug resistant strains, 73.7% were resistant to MRSA. The results indicated EsxA is very important in the pathogenesis of S. aureus. We suggested that the EsxA is very valuable as vaccine candidate target antigens for prevention and control of S. aureus infection.

Expression of fljB: z66 on a linear plasmid of Salmonella enterica serovar typhi is dependent on FliA and FlhDC and regulated by OmpR

Salmonella enterica serovar Typhi z66-positive strains have two different flagellin genes, fliC:d/j and fljB:z66, located on the chromosome and on a linear plasmid, respectively. To investigate the mechanism underlying the expressional regulation of fljB:z66, gene deletion mutants of the regulators FliA, FlhDC, and OmpR were constructed in this study. The expression levels of fliC and fljB:z66 were analyzed by qRT-PCR in the wild-type strain and mutants at high and low osmolarity. The results show that the expression levels of both fljB:z66 and fliC were greatly reduced in fliA and flhDC mutants under both high and low osmotic conditions. In the ompR mutant, the expression levels of fljB:z66, fliC, fliA, and flhD were increased at low osmotic conditions. SDS-PAGE and western blotting analysis of the secreted proteins revealed that the FljB:z66 was almost absent in the fliA and flhDC mutants at both high and low osmolarity. In the wild-type strain, the fljB:z66 was more highly expressed under high-osmolarity conditions than under low-osmolarity conditions. However, this difference in expression disappeared in the ompR mutant. Translational expression assay of FljB:z66 showed that the FljB:z66 expression was decreased in ompR mutant at both low and high osmolarity. These results suggest that the expression of fljB:z66 in S. enterica serovar Typhi is dependent on FliA and FlihDC, and OmpR can regulate the expression and secretion of FljB:z66 in different osmolarity.

Short and long-term efficacy of focused ultrasound therapy for vulva dystrophy / 中华妇产科杂志

0.05).However,the shorter the history of the disease,the better the efficacy of the treatment.The younger the patient was,the better the efficacy of the treatment.Conclusions Vulva dystrophy can be treated with focused ultrasound effectively and safely.This approach appears to be a new promising treatment method.

Anabolic Effects of Recombinant Human Parathyroid Hormone (1-84) on Bone Histomorphometry in Overiectomized Rats / 대한내분비학회지

To evaluate the anabolic effects of human recombinant parathyroid hormone [hrPTH(1-84)], we examined effect of low-dose and high-dose of [hrPTH(1-84)] and estradiol on bone histomorphometry in ovariectomized rats. Sixty Sprague-Dawley female rats aged 8~10 weeks were used. Eight weeks after ovariectomy, or sham operation, rats were given daily sc injection of hrPTH (1-84), 30 pg/kg (OVX+L group), 150 pg/kg (OVX+H group), 17-estradiol (30 pg/kg, OVX+E group) or vehicle (OVX+V group) for 4 weeks. After double tetracycline labeling, all rats were killed at day 84. We completed the histomorphometric analysis of distal femoral metaphyseal cancellous bone for trabecular bone volume (TBV), mean trabecular plate thickness (MTPT), mean trabecular plate density (MTPD), mean trabecular plate separation (MTPS), mean osteoid seam width (OSW) and appositional rate (AR). The histomorphometric parameters (TBV, MTPT, OSW and AR) of trabecular bone mass in (OVX+E) group were higher than those in (OVX+V) group. The TBV of trabecular bone in PTH treated groups were higher than that in sham operated, (OVX+V) and (OVX+E) group. The histomorphometric parameters (TBV, MTPD, OSW and AR) of trabecular bone mass in (OVX+H) group showed a tendency to be higher than those in (OVX+L) group, but statistically not significant. In conclusion, Low dose (30 mg/kg) hrPTH (1-84) also shows a sufficient anabolic effect on trabecular bone.

Intermittent parathyroid hormone treatment can promote linear growth in the ovariectomized growing rat

To compare the effect of intermittent parathyroid hormone (PTH) treatment with that of estrogen treatment on epiphyseal growth in ovariectomized rats, 46 Sprague-Dawley female rats aged 9-10 weeks (about 200-220 g) were either ovariectomized or sham operated. From 6 weeks after ovariectomy (ovx), rats were daily injected with subcutaneous human recombinant PTH (1-84)-dosed 30 micrograms/kg (the low dose PTH-treated group) or 300 micrograms/kg (the high dose PTH-treated group), 17 beta-estradiol (the 17 beta-estradiol-treated group, 30 micrograms/kg) or vehicle (the ovx-alone group), 5 times a week for 4 weeks. The decalcified sections of the distal femoral epiphyseal plate were analyzed on light microscopy after H&E stain, and the lengths of the zones of proliferation, maturing and hypertrophic chondrocytes were measured. The length of the growth plate, the zone of proliferation and the zone of hypertrophic chondrocyte in the ovx-alone group were significantly shorter than those of the sham-operated group. The treatment of 17 beta-estradiol speeded up the differentiation of cells from proliferating chondrocytes to maturing and hypertrophic chondrocytes even though the length of the growth plate was comparable to that of the sham-operated group. Both low and high dose PTH treatments increased the length of the growth plate, and those lengths were comparable to that of the sham-operated group. The fractions of proliferating, maturing and hypertrophic zone in the low dose PTH-treated group were also comparable to those of the sham-operated group. However, high dose PTH treatment slowed down the differentiation of cells from proliferating chondrocytes to maturing and hypertrophic chondrocytes to a greater extent, and therefore the fraction of proliferating chondrocytes of the high dose PTH-treated group was larger than that of the low dose PTH-treated group (73.8 +/- 1.8 Vs 63.3 +/- 1.3%, p < 0.005). From these results, we showed that intermittent PTH treatment could promote linear growth in the ovariectomized growing rat. We propose that PTH may be an alternative drug candidate for promoting linear growth of long bones without the risk for early closure of the growth plate.