ABSTRACT
Objective:To explore the effect of follow-up information platform combined with full-course health education on compliance and cardiac function in patients with chronic heart failure.Methods:A total of 150 patients with chronic heart failure treated in He′nan People′s Hospital between November 2018 and November 2019 were selected for study. Patients were divided into observation group and control group by random number table method, and each group had 75 cases. The control group received routine health education intervention, and the observation group implemented follow-up information platform combined with full-course health education intervention. The intervention time was 6 months, and then the compliance behavior, cardiac function and quality of life of the two groups of patients were compared.Results:The overall compliance rate of the observation group was significantly higher than that of the control group ( Z value was -5.634, P<0.01), and the total compliance rate of the observation group was 92.00% (69/75), which was significantly higher than 74.67% (56/75) of the control group ( χ2 value was 8.112, P<0.01). After the intervention, both the 6-minute walking test and the left ventricular ejection fraction in the observation group were (482.75±81.45) m, (48.34±6.10)%], which were significantly higher than (406.92±68.20) m, (39.61±5.73) % of the control group ( t values were 6.182, 9.034, P<0.01). After the intervention, the physical limitation, psychological mood, disease symptoms, and social relationship scores of the observation group patients were (11.00±1.58), (10.06±1.55), (6.06±1.29), and (5.09± 1.14) points, which were significantly lower than (17.15±1.90), (11.79±1.55), (9.52±1.23), and (8.09±1.02) points of the control group ( t values were 6.835-21.533, P<0.01). Conclusion:Compared with conventional health education, the whole course of health education combined with the follow-up information platform is beneficial to improve the compliance rate, quality of life and cardiac function of patients with chronic heart failure.
ABSTRACT
From the two aspects both at home and abroad endowment institutions the elderly family support commonly used assessment tool, this paper introduces the process of development of tools, dimensions, scoring method, and analyze the reliability and validity of the advantages and disadvantages of various assessment tools, aimed at the elderly family support for localization development of our country endowment institutions provide reference for the development and application of assessment tools.
ABSTRACT
Objective To investigate the clinical value of 18F-FDG PET-CT in the diagnosis, clinical staging and treatment guide of malignant lymphoma. Methods A total of 136 lymphoma patients confirmed by pathological diagnosis who received 18F-FDG PET-CT and contrast enhanced CT (CECT) examination in Gansu Provincial Hospital from January 2011 to December 2016 were collected. The sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of 18F-FDG PET-CT and CECT were evaluated, respectively. The effects of 18F-FDG PET-CT on diagnosis, clinical staging and treatment regimens of lymphoma were analyzed. Results The sensitivity, specificity, accuracy, PPV and NPV of 18F-FDG PET-CT in the diagnosis of lymphoma for all 136 patients was 98.2%, 82.1%, 94.9%, 95.5% and 92.0%, respectively. CECT was 80.6%, 67.9%, 77.9%, 90.6% and 47.5%, respectively. The difference in sensitivity and specificity between 18F-FDG PET-CT and CECT was statistically significant (χ2＝ 16.0, P<0.01). The accuracy of 18F-FDG PET-CT was higher than that of CECT. Compared with CECT, 26 (20.6%) patients with image of 18F-FDG PET-CT showed the increase of the clinical staging, 4 (2.9%) patients showed the decrease of the clinical staging, and 16 (11.8%) patients changed the treatment regimen after the stage alteration. Conclusion 18F-FDG PET-CT is superior to CECT in the diagnosis, clinical staging and treatment guide of lymphoma, which shows the promising prospect in the diagnosis and treatment of lymphoma.
ABSTRACT
Objective: To evaluate the application value of fluorine-18-fludeoxyglucose (18F-FDG) PET/CT maximal standard uptake (SUVmax) in the diagnosis of lymphoma. Methods: A total of 103 patients with lymphoma which confirmed by pathological diagnosis in Gansu Provincial Hospital from January 2011 to December 2016 were collected. All patients underwent a whole body simultaneous18F-FDG PET/CT and had complete clinical data. The possible relationships of SUVmax with the different pathological subtypes, clinical stages and risk grades of lymphoma were analyzed. The correlations of SUVmax value with Ki-67 index, lactate dehydrogenase (LDH) and erythrocyte sedimentation rate (ESR) were analyzed. Results: There was no significant difference in SUVmax between Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) (P > 0.05). The SUVmax in patients with strongly invasive diffuse large B-cell lymphoma (DLBCL), T-lymphoblastic lymphoma (T-LBL), anaplastic large cell lymphoma (ALCL) and natural killer (NK)/T cell lymphoma was higher than that in patients with relatively weakly invasive mantle cell lymphoma (MCL), peripheral T-cell lymphoma (PTCL), small lymphocytic lymphoma (SLL), follicular lymphoma (FL) (grade 1-2) and marginal zone lymphoma (MZL) (P 0.05). The SUVmax had no significant difference between stage -Ⅱ and III- in the patients with lymphoma (P > 0.05). The SUVmax in the patients with high-risk NHL was higher than that in the patients with intermediate- and low-risk NHL (both P 0.05). Conclusion:18F-FDG PET/CT SUVmax can be used as a reference indicator for evaluating the invasive degree of lymphoma, predicting Ki-67 index, and judging the risk classification of NHL.
ABSTRACT
Health education during pregnancy can reduce the incidence of maternal and child disease and improve their health level. As the implementation of the " universal two-child policy" and the change of the national fertility view, the number of maternal, especially the number of the advanced maternal age, is faster increase.While the health manpower in our country is short, so we need a convenient, fast and safe informationalizedway for maternal health education.This article comprehensive analyze the status of application health education about the form and content in the China and overseas,and discuss the advantages and limitations, in order to establish a scientific, effective, propagable and new model of maternity information health education, to provide experience and enlightenment for our clinical works.
ABSTRACT
Objective To evaluate the value of real-time three-dimensional transesophageal echocardiography (TEE) in the diagnosis of mitral valve structure in mitral valve prolapse, the significance of determining the prosthetic mitral valve ring size in the surgical treatment and the evaluation of immediate postoperative effect. Methods From November 2016 to March 2017, 19 patients with mitral prolapse performed with surgical treatment were diagnosed by transthoracic echocardiography at the echocardiography and vascular ultrasound center in the First Affiliated Hospital of Zhejiang University. All 19 patients underwent real-time three-dimensional TEE examination after anesthesia and before cardiopulmonary bypass. When the heart was recovered immediately after the operation, TEE was performed again to check the valve and the images were recorded in real time. During the whole examination, the images were observed by sonologists, surgeons and anesthesiologists, and the sonographic results were compared with the intraoperative findings. Totally 19 patients with moderate to severe mitral valve prolapse were examined and measured with real time three-dimensional ultrasound reconstruction. The mitral valve and tendons were observed and the mitral valve ring, the length of the valve and the diameter of the fiber triangle were measured. Results Intraoperative TEE examination could clearly display the anatomical structure and movement of mitral valve, annulus, chordae tendineae and papillary muscles from any angle. Real time observation of mitral valve thickness, mobility, calcification, vegetations and chordae tendineae rupture was effective. It was able to diagnose the thrombosis and patent foramen ovale. In the 19 patients, the TEE diagnosis of mitral valve prolapse was almost consistent with operative findings, and P2 was the most common area. The etiology was detected in 15 cases caused by rupture of mitral chordae tendineae, which was consistent with operative findings, and the accuracy rate was 100%. The size of the prosthetic ring provided by TEE in 14 cases was consistent with operative findings among 19 patients. The accuracy rate was 73.7% (4/9). Four cases were selected 1 size down than TEE, and 1 case was selected 1 size up than TEE. Conclusions The application of real-time three-dimensional ultrasound reconstruction can objectively reflect the pathogeny and pathological changes of prolapse, and provide a visual stereoscopic image, which is of great reference value for the formulation of the operation scheme. It also provides a basis for selecting the size of the forming ring and saves the operative time. It has practical clinical guiding significance. The function of the autologous valve is evaluated immediately after the operation, and the ventricular wall movement and left ventricular systolic function are detected in real time, and the left heart gas could be monitored. It is helpful to the intraoperative monitoring of the anesthesiologist and increase the success rate of the operation.
ABSTRACT
Objective To explore the application of protective restrain nicrovideo in the skill training of psychiatric low qualification nurses.Methods Totally 108 psychiatric low qualification nurses were trained with protective restrain micro video.Two microvideos were produced for theory part;for practice part,three cases of restrain were adopted and three microvideos were produced via standardized patients play and nurse scene simulation.Each microvideo was played through the platform for each week,combining periodic evaluation,which served as training for low qualification nurses.Five weeks after training,theory and practice evaluation were performed,and self-designed questionnaire was used to investigate feedbacks from nurses with regard to protective restrain training using microvideos.Clinical practicing effects were surveyed after six months.Results After the training,all the nurscs met the standard,with a good score of 95.4％.88.9％ of the nurses said the training stimulated the learning interest and initiative,94.4％ of nnrses and 93.3％ of head nurses said that training standardized the restrain behavior,90.7％ of nurses and 93.3％ of head nurses said that it could improve the ability of solving clinical emergency.After training,the injury ratc of nurses was significantly reduced,and the qualification rate of restrain nursing and restriction record and patient satisfaction were significantly improved (P＜0.05).Conclusion Protective restrain microvideo can stimulate nurse's learning interest,regulate nursiug behavior,inprove clinical nursing quality and reduce injury rate.
ABSTRACT
Objective To observe the effects of insulin caliper for blood glucose control on glycemic central tendency, fluctuation and incidence of hypoglycemia, etc., in emergent and critical patients to evaluate its application value.Methods A prospective single-blinded randomized parallel controlled intervention study was conducted. One hundred patients with severe hyperglycemia requiring treatment with insulin infusion admitted to emergency department and intensive care unit (ICU) of the First Hospital of Jiaxing from November 2015 to November 2017 were enrolled, and they were divided into the caliper group (used patented product insulin calipers for blood glucose control to adjust insulin dose for blood glucose control) and the conventional group (used paper-based insulin dose modification scheme to adjust insulin dose for blood glucose control) on average by random number table, 50 in each group. The gender, age, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), sequential organ failure assessment (SOFA), the principal diseases, main factors affecting blood glucose (hepatic and renal insufficiency, hypoglycemic drugs, glucocorticoids, mechanical ventilation, enteral nutrition, parenteral nutrition, intravenous glucose use, etc.), blood glucose levels at each time node (once every 2 hours after insulin use and once every 4 hours after 16-72 hours), glycemic coefficient of variance (CV), glycemic lability index (GLUGLI) and mean amplitude of glycemic excursion (GLUMAGE), insulin dose, incidence of hypoglycemia, proportion of achieving the glucose control target at each time point, the length of ICU stay and hospitalization cost per patient were recorded and compared between the two groups.Results After excluding those with incomplete data and withdraw in the midway, 92 patients were enrolled in the analysis finally,47 in caliper group and 45 in conventional group. There were no significant differences in the incidence of the gender, age, APACHEⅡ, SOFA, presence of infection at admission, previous diabetes history, glycosylated hemoglobin level, blood glucose at admission, proportion of patients after surgery, major diseases at admission and major factors affecting blood glucose between the two groups. A total of 1379 blood glucose measurements were obtained in the caliper group and 1332 blood glucose measurements were obtained in the conventional group. The glycemic measurements in caliper group were significantly lower than that in conventional group at each time point from 6-72 hours. Compared with conventional group, GLUGLI and GLUMAGE were significantly decreased in the caliper group [GLUGLI: 12.96 (8.73, 19.58) vs. 23.27 (13.07, 44.61), GLUMAGE (mmol/L): 0.66±0.22 vs. 0.87±0.28, bothP< 0.01]; there was a tendency towards decreasing incidence of hypoglycemia in the caliper group [8.51％ (4/47) vs. 15.56％ (7/45)], but no statistical difference was found (P > 0.05); the proportion of achieving the glucose control target was significantly increased in the caliper group [41.99％ (579/1379) vs. 27.18％ (362/1332),P < 0.01]. There were no significant differences in glycemic CV, insulin dose, proportion of hypoglycemic measurements in total measurements, and the length of ICU stay, the length of hospital stay, incidence of nosocomial infection, patient prognosis and cost between the two groups.Conclusion For emergent and critical patients, insulin caliper for blood glucose control presents favorable application value for achieving glucose control target, reducing glycemic fluctuation, and lowering the incidence of hypoglycemia.Clinical trial registration China clinical trial registration center, ChiCTR1800015024
ABSTRACT
Studies have shown that pregnant women due to their specificity and social factors during pregnancy, maternal mortality and postpartum serious complications were significantly higher. Taking effective measures to control maternal mortality and ensuring the safety of pregnant women is an urgent problem to be solved.The first measure to ensure the safety of pregnant women is to use appropriate assessment tools, accurate, dynamic and comprehensive risk assessment of pregnant women. At present, with the start of a comprehensive two-child policy,research related to obstetric early warning scores has become the focus of research in the field of obstetric care.Therefore,this article through the"obstetrics","maternal","risk warning","risk score"as the key word,search Wanfang database,Chinese Journal full-text database(CNKI),Chinese biomedical literature database(CBM);foreign language literature,such as PubMed,Web of Science,Springer,EBSCO and other databases,with"early warning score","risk score","risk score system","Obstetric","Obstetric care"Word for retrieval.So that to provide a comprehensive analysis of the status quo of the use of early risk assessment tools at home and abroad,and to summarize the contents of the assessment tools,and further point out the problems in the current research.
ABSTRACT
OBJECTIVE:To provide reference for medication and chemotherapy in patients with colorectal cancer. METH-ODS:Through retrospective study,case histories and doctor’s advice of the colorectal cancer patients receiving chemotherapy in our hospital during 2011-2014 were consulted to analyze the chemotherapy,medication and irrational drug use. RESULTS:A total of 593 cases of colorectal cancer patients with chemotherapy frequency of 1 940 times were collected to analyze the choice of che-motherapy regimen mainly from the following aspects:indications of chemotherapy,choice of chemotherapy regimen,chemothera-py process and chemotherapy period. There was 409 cases of irrational drug use according to the analysis of drug dosage,selection of solvents and drug concentration,the unqualified rate was 21.08% . CONCLUSIONS:The medication and chemotherapy in pa-tients with colorectal cancer in our hospital are basically rational,but there are still certain problems and shortcomings. In future clinical applications,the medication and chemotherapy need to be improved.