ABSTRACT
Objective:To explore the effect of Iowa evidence practice mode-based management program on the swallowing function in stroke patients.Methods:A total of 88 stroke patients in affiliated hospital of North Sichuan Medical College from April 2017 to April 2018 were recruited in the present study. Patients were randomly divided into experimental group (44 cases) and control group (44 cases) according to the random number table. The control group received routine nursing, while the Iowa evidence practice mode-based management program was carried our in the experimental group. After 30 days of intervention, the swallowing function was assessed by water swallow test, quality of life was evaluated by Short form of 36, the incidence of aspiration pneumonia was also compared between groups.Results:After intervention, the grade 1 patients in water swallow test were up to 29.3%(12/41) in the experimental group, and 18.6%(8/43) in the control group, the water swallow test was better in the experimental group compared to the control group ( Z value was 2.332, P<0.05). After intervention, the scores of vitality, social functioning, role-emotional, mental health were significantly increased in the experimental group compared to the control group (61.39±13.07, 60.44±10.89, 62.07±14.82, 64.78±15.24, 446.15±42.06 vs. 53.19±14.77, 50.09±13.15, 53.91±16.72, 57.81±16.34, 410.98±35.81), the difference was statistically significant ( t value was 2.018-4.133, P<0.01 or 0.05). The incidence of aspiration pneumonia was significantly decreased in the experimental group (2.4%,1/41) compared to the control group (16.3%,7/43), the difference was statistically significant ( χ2 value was 4.666, P<0.05). Conclusions:Iowa evidence practice mode-based management program can promote the swallowing function of stroke patients, as well as promote improve quality of life and decrease the incidence of aspiration pneumonia. It serves as an instruction for clinical intervention.
ABSTRACT
Objective To investigate the change of CNP (C-natriuretic peptides) in patients with PCOS (polycystic ovary syndrome) undergoing in vitro fertilization-embryo transfer (IVF-ET) with GnRH-α longprotocol for controll ovarian hyper-stimulation(COH).Methods From March 2012 to September 2014,22cases patients with PCOS undergoing IVF-ET in the Reproductive Medical Center of the Center Hospital of JiangMen were selected as study group(Group 1),and 32 cases patients with normal ovarian reserve,the age younger than 35,and the number of oocytes retrieved more than 6 at the same period were selected as control group(Group 2).The level of serum CNP and estradiol(E2) on the day of human chorionic gonadotropin (HCG) and retrieving oocytes,the level of CNP and E2 in follicular fluid were analyzed.In additional,the levels of CNP and E2 in follicular fluid of different fertility and embryo quality were compared.Results (1) CNP and E2 on the day of HCG were significantly higher than that on the day of retrieving oocytes (CNPof Group 1:(107.21±78.55) μg/L vs.(73.01±55.99) μg/L,CNP of Group 2:(69.16±32.39) μg/L vs.(44.11±27.23) μg/L;E2 of group 1:(5231.38±1489.00) ng/L vs.(1985.52±662.54) ng/L,E2 of Group 2:(3678.45±969.57) ng/L vs.(1567.71±493.93) ng/L;t =2.968,2.752,8.147,14.567;P＜0.05).CNP and E2 on the day of retrieving oocytes and E2 on the day of HCG of Group 1 were higher than that of Group 2(t=2.866,2.227,2.173;P＜0.05).CNP in follicular fluid in Group 1 was higher than that in Group 2,but E2 of in follicular fluid in Group 1 was lower than that in Group 2 (t =2.244,-2.650;P＜0.05).(2) In Group 1,CNP and E2 in follicular fluid of normal fertility were lower than that of unnormal fertility,and E2 in follicular fluid of unnormal fertility were higher than that of no-fertility,and there were significant differences(t =-6.117,-2.374,2.760;P＜0.05).(3) In Group 2,only E2 in follicular fluid of unnormal fertility were higher than that of no-fertility,and there was significant difference(t=2.658,P＜0.05).(4) In 2 groups,CNP in follicular fluid of high-quality embryo were lower than that of non-high-quality embryo,and there was significant difference (t =-2.910,-2.029;P＜0.05).CNP in follicular fluid of non-high-quality embryo in Group 1 were higher than that in Group 2,but E2 in follicular fluid of non-high-quality embryo in Group 2 were higher than that in Group 1,and there were significant differences (t =2.141,-2.009;P ＜ 0.05).Conclusion There are differences in the change of CNP in the patients with PCOS and non-PCOS,and there are some deficiencies of the first meiosis in the patients with PCOS.