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Objective To observe the effect of self-practice-oriented teaching method on injection skills, psychological status and blood glucose control of type 2 diabetes mellitus patients receiving pen insulin injection for the first time. Methods A total of 105 patients with type 2 diabetes mellitus who received insulin injection for the first time were divided into the control group and the observation group according to admission sequence. The control group adopted the method of one-to-one bedside health education of primary nurses. Insulin injection demonstration and disease-related knowledge education were conducted on the day of the medical order to start insulin treatment. Health education was conducted once a day for 3-5 minutes each time for a total of 5 days. The observation group adopted centralized health education, which insulin injection teaching desk, video and other teaching aids, combined with the guidance and correction of primary nurses were used, focusing on the use of teaching aids and self-injection as early as possible during hospitalization. The levels of fasting and postprandial blood glucose, insulin injection skills and anxiety and depression scale (HADS) were compared between the two groups. Results There was no statistically significant difference in blood glucose level, anxiety scores and depression scores between the two groups before the intervention (P>0.05). Two weeks after the hospital discharge, the anxiety and depression scores of the observation group was 7.31 ± 1.78, 7.00 ± 1.73, significantly lower than the anxiety and depression points of the control group 9.33 ± 2.21, 8.61 ± 1.79 (t=2.492, 3.097, P<0.05);The insulin injection skills assessment score of patients in the observation group was (90.90 ± 4.15) points, significantly higher than the points of the control group (83.74 ± 6.22) (t=-6.593,P<0.01);In the observation group, fasting blood glucose and postprandial 2-hour blood glucose were (7.56 ± 1.86) mmol/L and (10.61 ± 2.25) mmol/L, respectively Compared with the control group (8.55 ± 1.96) mmol/L ,(12.91 ± 2.95) mmol/L, there was statistically significant difference between the two groups(t=2.542, 4.301, P<0.05). Conclusion The self-practice-oriented teaching method can effectively alleviate the negative emotions of the patients with the first insulin injection, improve their insulin injection skills to better control blood glucose.
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Objective The study aimed to improve the medication safety of aged patients through the reengineering of the dispense process of discharge medications for elderly cardiac patients.Methods The original dispense process was analyzed to find the existing problems,changing the order of process,increasing or decomposing steps of process in order to redesign,perfect and implement the distribution process of medications.Time and correction rate of drug dispensing for three times a day,mastering degree of related knowledge of oral medication and satisfaction degree with medication instruction were compared before and after reengineering of the process.Results Compared with the original process,patients' ability to understand the drug knowledge,the timing when the patients take three medications per day and the satisfaction degree with the instructions of taking medications all had statistical significance.Conclusions Reengineering of the dispense process of discharge medications for elderly cardiac patients can help to improve patients' understanding of drug knowledge,improve the security of taking medications outside the hospital as well as their satisfaction degree with nursing.
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Objective To approach the changes of cytosol phospholipase A2α(cPLA2α)and nitric oxide (NO)in patients with chronic obstructive pulmonary disease(COPD)and its significance. Methods One hundred patients with COPD admitted into Department of Critical Care Medicine of Affiliated Wuqing Traditional Chinese Medicine(TCM)Hospital of Tianjin University of TCM were enrolled,and according to the COPD severity grading standards,they were divided into mild group(25 cases),moderate group(25 cases),severe group(26 cases) and extremely severe group(24 cases);simultaneously,90 cases with normal pulmonary function who had taken health examination were chosen and assigned to the healthy control group. The cPLA2α level was detected by enzyme linked immunosorbent assay(ELISA),the level of uric acid(UA),total cholesterol(TC),triacylglycerol (TG)were detected by enzymatic method,and serum NO metabolites(NOx)level was detected by nitrate reductase method. Results Compared with the healthy control group,the serum levels of cPLA2α and UA in patients with different severity of COPD were significantly increased;along with the increase of patient's COPD grade of severity,the cPLA2α,UA levels were gradually increased,while NOx level was gradually decreased in mild, moderate, severe, extremely severe groups〔cPLA2α(ng/L):125.60±8.17, 155.20±6.42, 190.20±9.32, 255.80±11.28 vs. 88.50±7.99;UA(μmol/L):381.23±32.22,434.95±87.71,464.81±52.65,487.45±82.61 vs. 241.95±52.33;NOx(μmol/L):59.90±17.52,45.60±6.17,38.20±4.08,25.70±3.04 vs. 74.90±18.31,all P0.05). The cPLA2αand NOx levels presented significant negative correlation(rs=-0.798,P=0.013). Conclusion The combined examination of blood cPLA2αand serum NOx levels can evaluate the severity degree of COPD patients,and cPLA2αcan be used as a new target index for COPD grading.
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Objective To evaluate the urodynamic and functional characteristics of 26 patients who had underwent orthotopic contient globular ileal neobladder. Methods The clinical date of 26patients who underwent radical cystectomy were reviewed. The neobladder pressure, capacity, urethral pressure and urinary flow rate were collected at 3-12 months after operation. Results The neobladders average pressure was less than 15 cm H2O when the volume was 400 ml. The pressure was 22.4 cm H2O at 100% capacity. The mean pressure of contractions was less than 40 cm H2O. The mean filling pressure after operation was relative stable while the difference between 3 months and 6 months was statistically significant. The difference between 6 and 9 and 12 month showed no statistical significance. The mean post-void residual was 42 ml. A mean voiding flow rate of 19. 6 ml/s could be obtained by Valsalva. Conclusion The neobladder not only could offer adequate capacity at low pressures but also could give a satisfied continent.