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Objective:To develop a training program for specialty nurses of traditional Chinese medicine (TCM) technology, in order to provide a basis for the training of traditional Chinese medicine nursing techniques for traditional Chinese medicine speciallty nurses.Methods:Literature review and semi-structured interviews were conducted to preliminarily develop training program outline. From February to April 2022, a total of 18 experts were invited to finish the questionnaire survey. And the items were modified according to the experts′ advice.Results:The response rates of 2 rounds of consultation were both 100%, the authority coefficients of experts were 0.894 and 0.903 respectively, and the kendall harmony coefficients were 0.201 and 0.272 respectively. Finally, the training program was formed, which consists of 6 first-level indexes, 25 second-level indexes and 81 third-level indexes.Conclusions:The training program for specialty nurses of TCM technology constructed in this study is scientific, reliable and practical, which can provide a basis for the training of TCM nursing technology.
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Objective:To reports the nursing care of a patient with superior mesenteric artery syndrome after posterior spinal correction for adolescent idiopathic scoliosis.Methods:While in hospital, conservative treatment requires fasting and water deprivation, gastrointestinal decompression. Combined with perioperative nursing measures of spinal orthopedics, the nursing focus of patients during hospitalization includes: enteral and parenteral nutrition, designed the condition record sheet, and dynamically monitor the patient′s condition; personalized guidance about function exercise was gibien.In addition,continuous care after discharge were provided through health education before discharge and post-discharge follow-up.Results:After the implementation of the nursing measures, the patient recovered well after surgery, the symptoms of superior mesenteric artery syndrome were effectively controlled, and the patient resumed eating through the mouth. Two months after discharge, the patient gained 4kg of body weight.Conclusion:The treatment and nursing of superior mesenteric artery syndrome is a long-term process, nurses should place emphasis on observation and nutrition support, and also the patient psychological care.
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Objective:To investigate the effects of laparoscopy assisted complete mesocolon resection on the stress response and immune function of patients with colon cancer.Methods:From January 2013 to January 2016,130 patients with colon cancer in our hospital were selected and randomly divided into the observation group and the control group with 65 cases in each group according to the random lottery envelopes.The observation group was treated with laparoscopy assisted complete mesocolon resection,the control group was treated with open operation.The changes of semm IL-6,TNF-α and amours of CD4+ cells,blood loss,bowel function restoration time,hospital stays and complication rate of two groups were compared before and after treatment.Results:Both groups of patients were successfully completed the surgery and there was no serious complications occurred in both groups.The amount of bleeding,postoperative intestinal recovery time and postoperative hospital stay in the observation group were significantly less than those of the control group (P＜0.05).The chylous fistula,wound infection,pulmonary infection and complication rate on the 14th day postoperation in the observation group was 1.5％,which was 12.3％ in the control group and significantly higher than that of the control group (P＜0.05).The contents ofCD4+ cells in the observation group and the control group were 36.34± 7.83％ and 33.66± 9.82％,respectively,which were significantly higher than those before treatment(30.33± 6.49％ and 30.49± 5.33％)(P＜0.05),and the contents of CD4+ cells of observation group was significantly higher than that of the control group after treatment (P＜0.05).The serum levels ofIL-6 and TNF-α in both groups were significantly lower than those before treatment on the 14th day postoperation (P＜0.05),and the serum IL-6 and TNF-α levels of observation group were significantly lower than those in the control group on the 14th day postoperation (P＜0.05).Conclusion:Laparoscopy assisted complete mesocolon resection could promote the immune function and inhibit the stress response,which further promoted the rehabilitation and induced the complications in the treatment of patients with colon cancer.
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Objective To investigate the diagnostic value of lung ultrasonography for meconium aspiration syndrome (MAS).Methods From August 2014 to October 2015,a total of 67 cases of MAS patients were included in this study based on the medical history,typical clinical symptoms and chest X ray findings.The control group comprised 100 neonates without pulmonary disease.In a resting state,each patient was placed in a supine,lateral recumbent,or prone position.Using the anterior and posterior axillary lines as boundaries,each side of the lung was divided into 3 regions:anterior,lateral and posterior.The probe was held perpendicular or parallel to the ribs,and each region of both sides of the lung was scanned.Results In this study,the main lung ultrasonographic findings in MAS patients were as follows:(1) Lung consolidation with air bronchograms,which was found in all patients.Generally,the large area of lung consolidation with irregular margins was seen in severe MAS patients while the small area of lung consolidation was seen in mild patients.(2) Pleural line anomalies and the disappearance of the A-lines,which were found in all patients.(3) Atelectasis,which was found in 12 severe cases(17.9％),with severe massive atelectasis and visible lung pulse.(4) Pleural effusion,which was found in 9 cases (13.4％) including mild or severe patients.(5) Alveolar-interstitial syndrome (AIS) or B-line in the non-consolidation area was found in all patients.Conclusions There were specific imaging findings in lung ultrasound in MAS patients.Lung ultrasonography can be used for the routine diagnosis of MAS because of its accuracy,reliability,low-cost and simplicity,no risk of radiation damage as well as it is convenience to observe and understand the dynamic changes of the patients' condition timely.
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Objective To evaluate the diagnostic value of lung ultrasonography for transient tachypnea of new-born (TTN).Methods From January to December 201 4,a total of 1 358 children were hospitalized in the Neonatal Intensive Care Center and underwent lung ultrasonography at the Bayi Children′s Hospital,Beijing Military General Hospital.According to the patients′medical histories,clinical presentations,arterial blood gas analysis,chest X -ray examinations,and lung ultrasound examinations,there were 41 2 cases of patients without pulmonary lesions,228 cases of TTN,358 cases of respiratory distress syndrome (RDS),85 cases of meconium aspiration syndrome (MAS),21 5 ca-ses of infectious pneumonia,and 60 other cases at the time of hospital admission.In a resting state,the patients were placed in a supine,lateral recumbent or prone position.By using the anterior and posterior axillary lines as boundaries, the lung was divided into 3 regions:anterior,lateral,and posterior.The probe was perpendicular or parallel to the ribs, and each region of both sides of the lung was scanned.The scan results were compared to the conventional chest X -ray results.Results The main ultrasonic characteristics of TTN was pulmonary edema.In severe cases,the ultrasound showed a white lung or compact B -line.Compact B -line had 1 00.0% sensitivity and 95.3% specificity for diagno-sing severe TTN.Mild TTN presented as pulmonary interstitial syndrome or double lung point.Double lung point might appear during the recovery period of mild TTN or other diseases,such as RDS,MAS,and pneumonia,among others. Lung consolidation and air bronchogram were not observed in patients with TTN.Pleural effusion might occur in a varie-ty of lung diseases,and pleural line abnormality,A -line disappearance,and B -line or pulmonary interstitial syndrome were common ultrasonic manifestations of a variety of lung diseases.Conclusions Ultrasonic diagnosis of TTN,mainly based on pulmonary edema without lung consolidation and air bronchogram,is accuracy and reliable;however,double lung point is not a specific sign of TTN,whereas the identification of a white lung and compact B -line is a sensitive and specific sign of severe TTN.
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Objective To evaluate the value of lung sonography in diagnosis of neonatal pulmonary diseases and to provide a reliable and simple method for diagnosing neonatal pulmonary diseases.Methods From May 2012 to August 2012,105 newborns who admitted into Bayi Children's Hospital were enrolled into this study,including respiratory distress syndrome 40 cases (three of them with difficulty in withdrawing mechanical ventilation),meconium aspiration syndrome 17 cases,wet lung of newborn 17 cases and 30 health neonates without lung diseases.Lung ultrasound was performed at bedside by a single expert physician within the first 24 h of life.All patients with neonatal lung diseases were diagnosed by clinical manifestations,arterial blood gas analysis and chest X-ray.Results (1) Lung sonography of normal neonates showed hypo-echo (black),smooth and clear hyper-echoic pleural line.A line was hyper echo too.(2) All 40 neonates with respiratory distress syndrome showed lung consolidation with air bronchograms; abnormal pleural line,disappeared A-lines,pleural effusion and alveolar-interstitial syndrome.Five out of the 40 (12.5％)infants showed pleural effusion.(3) All 18 meconium aspiration syndrome infants showed focal lung consolidation under pleural membrane,alveolar-interstitial syndrome,atypical changes of abnormal pleural line and disappeared A-line in lesion area with lung sonography.(4) All infants with wet lung of newborn (100.0％,17/17) showed double lung point,with which all wet lung of newborn could be diagnosed.(5) Differential diagnosis of respiratory distress syndrome with wet lung of newborn:five infants with severe dyspnea showedwhite lung in X-ray and were diagnosed as respiratory distress syndrome,while sonography only showed severe lung edema and one infant showed pleural effusion which was in accordance with wet lung of newborn,so was their courses of disease.(6) Three cases of respiratory distress syndrome showed dyspnea after withdrawing mechanical ventilation,and lung sonography showed local atelectasis but normal in X-ray.Conclusions Lung ultrasound has many advantages,such as accurate,reliable,no radiation damage,low-cost and simple; therefore,it is feasible in neonatal ward.
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Objective To study the variation of endothelin 1(ET 1) and calcitonin generelated peptide(cGRP) and its clinical implication, and to analyze the influence of ET 1 and cGRP on cerebral arteries hemodynamics in neonates with hypoxic ischemic encephalopathy(HIE). Methods The variation of ET 1,cGRP in cord blood and peripheral blood were prospectively observed at the time of 1 day,3 days and 7 days after birth in HIE and healthy control infants by radioimmuneassay. The cerebral arteries hemodynamics were determined immediately using color Doppler ultrasonography at 1 day after blood samples were obtained. Results (1) The following factors in cord blood and vein one day after birth in neonatal HIE and healthy controls was: ET 1(70?25)ng/L vs (38?19) ng/L ( P