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Objective:To design a pediatric early warning score (PEWS) ruler and observe the effect of its application in the nursing of critically ill children hospitalized in neurology department.Methods:A total of 200 critically ill children admitted to Department of Neurology of Hunan Children′s Hospital from 2018 to 2019. 98 cases who were hospitalized from January to September 2019 were selected as the observation group, and 102 cases who were hospitalized from January to September 2018 were set as the control group. The control group received conventional care, while the observation group conducted PEWS ruler for nursing intervention on the basis of conventional care. The differences in hospital days, ICU transfer rate, and frequency of medical intervention between the two groups were compared.Results:The hospital days of the control group and observation group were 18.17 ± 6.33 and 13.33 ± 6.38 respectively, and the difference between the two groups was significant ( t=5.38, P<0.01). The ICU transfer rate was significantly different between the control group 17.6% (18/102) and observation group 8.2% (8/98) ( χ2=3.98, P<0.05). The reduction of increased intracranial pressure, cooling, calm, sedation and oxygen breathing in the control group were 6.86% (7/102), 13.73% (14/102), 6.86% (7/102), 7.84% (8/102), while the observation group were 17.35% (17/98), 27.55% (27/98), 24.49% (24/98), 28.57% (28/98), and the differences between the two groups were significant ( χ2 values were 5.20-14.55, all P<0.05). Conclusions:The application of PEWS ruler is helpful for nurses to recognize the progress of diseases of the critically ill children. Also, it can shorten the hospitalization days of these children, reduce the ICU transfer rate, as well as improve the nursing quality for them.
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Objective:To explore the application of Omaha system-based specialized precise nursing intervention in patients with acute coronary syndrome (ACS).Methods:This study recruited 120 hospitalized patients with ACS in the Department of Cardiology, the First Affiliated Hospital of Xi′an Jiaotong University from June 2019 to December 2019. These patients were randomly allocated into the experimental ( n=60) or control group ( n=60) by using a random number table. Patients in the control group received routine care only, while those in the experimental group also received the Omaha system-based specialized precise nursing intervention. Results:After the intervention, compared with the control group, the score of cognitive and behavioral status in the experimental was significantly improved. In particular, the cognitive scores of pain, chest tightness, arrhythmia, hypertension, edema, dizziness, constipation, wound bleeding, swelling, fatigue, insomnia, diet, medication, smoking, drinking, overweight, exercise, mental stress, social regression, and awareness were significantly improved ( t values were 1.39-5.06, P<0.05). The behavioral scores of pain, chest tightness, arrhythmia, hypertension, edema, dizziness, constipation, wound bleeding, swelling, fatigue, diet, medication, overweight, exercise, mental stress, and social regression were significantly improved ( t values were 1.41-4.80, P<0.05). The fatigue, insomnia, exercise compliance, mental stress, and social regression were significantly improved ( t values were 1.44-4.27, P<0.05). Conclusions:Omaha system-based specialized precise nursing intervention can comprehensively evaluate the nursing problems of patients with ACS, can implement precision specialized nursing, can effectively solve the nursing problems of patients, and can promote the recovery of heart function and rehabilitation of patients with ACS.
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Aiming at the current situation of high cost, huge volume, complex operation and difficulty in real application of pulse analyzer, this study designs and implements a portable pulse detection system based on IoT. The design utilizes Raspberry Pi 3B+, STM32 series MCU and cloud server to collect, store, display and recognize pulse signals at CUN, GUAN and CHI. The system is small in size and low in cost, which can be connected with cloud server through network to make full use of resources. The experimental results show that the recognition accuracy of the main feature points of the pulse signal by the portable pulse analyzer is higher than 97%, which has a broad prospect of development and application.
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Computers , Heart RateABSTRACT
Objective:To construct a nursing intervention program for patients with coronary heart disease based on the theory of Omaha intervention system, and to provide evidence for the specialist nursing of patients with coronary heart disease.Methods:Based on the Omaha intervention system, the specialist nursing intervention plan for patients with coronary heart disease was preliminarily established on the basis of reviewing the medical records, and was modified by the Delphi method.Results:Reviewing the medical records combined with the Omaha intervention system, preliminary development of nursing intervention programs for patients with coronary heart disease. The expert inquiry letter of the intervention program was 2 rounds, and the expert positive coefficients of the 2 rounds of inquiry letters were 91.67% and 93.94%, the authoritative coefficient was 0.92, and the Kendall Harmony Coefficient was 0.34 and 0.47 respectively. The specialist nursing intervention for patients with coronary heart disease was finally determined.Conclusion:The nursing intervention plan for patients with coronary heart disease based on Omaha theory has a good theoretical basis and has been unanimously recognized by experts.
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Objective@#To construct a nursing intervention program for patients with coronary heart disease based on the theory of Omaha intervention system, and to provide evidence for the specialist nursing of patients with coronary heart disease.@*Methods@#Based on the Omaha intervention system, the specialist nursing intervention plan for patients with coronary heart disease was preliminarily established on the basis of reviewing the medical records, and was modified by the Delphi method.@*Results@#Reviewing the medical records combined with the Omaha intervention system, preliminary development of nursing intervention programs for patients with coronary heart disease. The expert inquiry letter of the intervention program was 2 rounds, and the expert positive coefficients of the 2 rounds of inquiry letters were 91.67% and 93.94%, the authoritative coefficient was 0.92, and the Kendall Harmony Coefficient was 0.34 and 0.47 respectively. The specialist nursing intervention for patients with coronary heart disease was finally determined.@*Conclusion@#The nursing intervention plan for patients with coronary heart disease based on Omaha theory has a good theoretical basis and has been unanimously recognized by experts.
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Objective@#To explore the feasibility of applying Omaha system theory to patients with coronary heart disease (CHD) through comparative analysis of nursing description.@*Methods@#Using content extraction analysis method, the nursing records, nursing plans and nursing measures of discharged patients with CHD were retrieved from the medical records, and then the conceptual consistency of the extracted records and the problem classification system and intervention measures in the Omaha system were evaluated by cross mapping method.@*Results@#A total of 2 609 nursing problems and intervention measures were extracted from the medical records of 68 patients with CHD. Among them, 1 844 (70.68%) records were labeled as "perfect fit", 608 records (23.30%) as "partial fit", and 157 (6.02%) recordsas "not fit at all". The total fit rate was 93.98% (perfect fit and partial fit). The most frequently reported problems were in physiological domain, followed by health-related behaviors domain, psychosocial domain and environmental domain. The nursing interventions extracted accounted for 26.67% (1 968 sentences) of directions and l00.00% (4 kinds) of categories in the intervention scheme of Omaha system.@*Conclusions@#The conceptual congruence between the medical records of patients with CHD and the Omaha System is quite high. It can help to improve nursing problems of patients of CHD in health-related behavioral domain, psychosocial domain and environmental domain, and can be applied to such patients after appropriate adjustment, so as to help clinical nursing staff to provide specialized and all-round guidance for patients with CHD.
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Objective To explore the feasibility of applying Omaha system theory to patients with coronary heart disease (CHD) through comparative analysis of nursing description. Methods Using content extraction analysis method, the nursing records, nursing plans and nursing measures of discharged patients with CHD were retrieved from the medical records, and then the conceptual consistency of the extracted records and the problem classification system and intervention measures in the Omaha system were evaluated by cross mapping method. Results A total of 2 609 nursing problems and intervention measures were extracted from the medical records of 68 patients with CHD. Among them, 1 844 (70.68%) records were labeled as "perfect fit", 608 records (23.30% ) as "partial fit", and 157 (6.02% ) recordsas"not fit at all". The total fit rate was 93.98% (perfect fit and partial fit). The most frequently reported problems were in physiological domain, followed by health-related behaviors domain, psychosocial domain and environmental domain. The nursing interventions extracted accounted for 26.67% (1 968 sentences) of directions and l00.00% (4 kinds) of categories in the intervention scheme of Omaha system. Conclusions The conceptual congruence between the medical records of patients with CHD and the Omaha System is quite high. It can help to improve nursing problems of patients of CHD in health-related behavioral domain, psychosocial domain and environmental domain, and can be applied to such patients after appropriate adjustment, so as to help clinical nursing staff to provide specialized and all-round guidance for patients with CHD.
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Objective@#To evaluate the clinical performance of HPV genotyping with cytology for detecting cervical precancer among women attending co-testing.@*Methods@#A total of 2 883 females who participated in cervical cancer screening program were recruited from Erdos in 2016. All the participants were tested by cytology and HPV genotyping. In 2017, women with abnormal cytology results or HPV positive were followed up. Pathological cervical intraepithelial neoplasia (CIN) 2+ was the study end-point. Clinical performance indexes were calculated, including sensitivity, specificity, positive predictive value, negative predictive value, referral rate and missed cases.@*Results@#INNO-LiPA resulted in a detection rate of 18.87%(544/2 883) for the 14-type high risk HPV. HPV16 was the most common infectious genotype (4.06%), followed by HPV52 (3.61%), HPV51 (2.50%), HPV58 (1.98%), and HPV18 (1.56%). With more HPV genotypes added into the group, sensitivity increased and the specificity decreased. Addition of HPV16, 58, 33, 39, 52, 18, 31 for detection lead to the maximun value of area under the curve (AUC)=0.913 (95%CI: 0.882-0.944). Compared with traditional screening method by cytology, cotesting decreased the number of missed diagnosis. Meanwhile, the fifth method (co-testing: triage of women with HPV16/18+ , cytological minor abnormalities and HPV58, 33, 39, 52, 31+ or cytological high grade abnormalities) did not increase referral rate (8.99% vs. 8.71%, P=0.525), with five cases of missed diagnosis (sensitivity of 92.1% and specificity of 93.2%).@*Conclusions@#Co-testing with triage of women with HPV16/18+ , cytological minor abnormalities and HPV58, 33, 39, 52, 31+ or cytological high grade abnormalities would provide better clinical performance. In co-testing, triage of HPV16/18 was used in women with normal cytology; triage of HPV58, 33, 39, 52 and 31 was used in women with low-grade abnormal cytology; referral colposcopy was used in women with high-grade abnormal cytology, which would provide better clinical performance.
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Objective To investigate the feasibility,effectiveness,and technical superiority of Solumbra thrombectomy for treatment of acute large cerebral artery occlusion stroke.Methods 32 patients who had acute large cerebral artery occlusion stroke and received mechanical thrombectomy in TEDA Hospital of Tianjin between January 2013 and August 2016,were divided into two groups:stent group(with conventional stent-retrievers,n=21) and Solumbra group (with Solumbra thrombectomy,n =11).Clinical characteristics,variables correlated with operation,and clinical outcomes were compared and analyzed retrospectively.Results There were no differences in basic clinical and radiographic parameters between stent group versus Solumbra group (all P＞0.05).Moreover,there were no differences between Solumbra group versus Stent group in rates of embolus to new territory(18.2 ％ vs.28.6％,P=0.425),in times of thrombectomy(2.2± 1.0 vs.2.4± 1.3,P=0.657),in nonsymptomatic intracranial hemorrhage (18.2％ vs.14.3％,P =0.572),in symptomatic intracranial hemorrhage(18.2％ vs.9.5％,P =0.427),in TICI 2b/3 revascularization(81.8％ vs.81.0％,P =0.670),in puncture-to-reperfusion time[(66.4±39.0)min vs.(51.6±34.5)min,P=0.279],and in NIHSS at 7 days(11.6 ± 7.7 vs.11.3 ± 7.2,P =0.925).A modified Rankin Scale(mRS ≤2) is a variable of recovery of function and good clinical outcome at 90 days.The levels of mRS were similar(P =0.490)between Solumbra and stent groups,but there was a tendency to higher rate of good clinical outcome at 90 days in Solumbra group (63.6％,7/11)than in stent group (47.6％,10/21).Conclusions Solumbra thrombectomy as intravascular revascularization technique is an effective and safe strategy for endovascular recanalization of acute large cerebral artery occlusion stroke.Compared with conventional Stent-Retriever thrombectomy,Solumbra thrombectomy has a good clinical outcome tendency at 90 days after operation.
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Objective To investigate the effect of radial artery hemostat (TR Band) continuous compression time on bleeding of puncture point, thumb perception, palm swelling and subjective comfort in patients undergoing transradial percutaneous coronary intervention. Methods One hundred and fifty-five patients who underwent transradial percutaneous coronary intervention were randomly divided into two observation groups and a control group. All patients in the three groups were treated by TR Band patent hemostasis. All three groups received the consistent deflation schedule, except the TR Band was removed at the 12th hour post operation in the control group, and at the 6th hour in the 1st observation group and at the 4th hour in the 2nd observation group. Postoperative bleeding of puncture point, thumb perception, palm swelling and subjective comfort were observed in the three groups. Results The differences of postoperative bleeding of puncture point, thumb perception, palm swelling and subjective comfort among the three groups were statistically significant (χ2=6.31, P<0.05; F=5.26, 4.00, 14.69, P<0.01). In the 2nd observation group, palm swelling was the lowest, but perception, and comfort and bleeding rate is the highest among the three groups. In the 1st observation group, the overall indexes were medium among the three groups. Conclusions The optimal compression duration of TR Band post transradial percutaneous coronary intervention is 6 h, which does not increase the risk of bleeding, but also significantly improve local swelling and perceptual experience, and increase patient comfort.
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Objective To evaluate effects of design of compression and fixation device for wound after permanent pacemaker implantation on compression hemostasis, working intensity of nursing staff and patients′ comfort. Methods Cotton cloth, Velcro tape and snap-fastener were used to design a compression and fixation device for wound after permanent pacemaker implantation. Sixty patients after permanent pacemaker implantation were randomly divided into compression and fixation device group (observation group), and traditional compression group (control group). In addition, the effects of postoperative complications, allergy to medical tape and working intensity of nursing staff for caring wound were evaluated. Results Comparing to the control group, there were significantly lower incidence rate of skin allergy (P<0.05) and shorter working hours needed for nursing staff to care wound (P<0.05).The complications of two groups have no significant differences (P>0.05). Conclusions This design of compression for wound after permanent pacemaker implantation is able to decrease working intensity of nursing staff, improve patients′comfort and show no effects on increasing postoperative complications.
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Objective To evaluate effects of design of compression and fixation device for wound after permanent pacemaker implantation on compression hemostasis, working intensity of nursing staff and patients′ comfort. Methods Cotton cloth, Velcro tape and snap-fastener were used to design a compression and fixation device for wound after permanent pacemaker implantation. Sixty patients after permanent pacemaker implantation were randomly divided into compression and fixation device group (observation group), and traditional compression group (control group). In addition, the effects of postoperative complications, allergy to medical tape and working intensity of nursing staff for caring wound were evaluated. Results Comparing to the control group, there were significantly lower incidence rate of skin allergy (P<0.05) and shorter working hours needed for nursing staff to care wound (P<0.05).The complications of two groups have no significant differences (P>0.05). Conclusions This design of compression for wound after permanent pacemaker implantation is able to decrease working intensity of nursing staff, improve patients′comfort and show no effects on increasing postoperative complications.
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Objective To investigate the feasibility, safety and technical superiority of mechanical thrombectomy using a direct aspiration first-pass thrombectomy (ADAPT) in treatment of patients with acute cerebral artery occlusion. Methods A retrospective study was conducted on all patients with acute ischemic stroke treated with mechanical thrombectomy in our institution from January 2013 to August 2016.Patients using ADAPT or stent retriever as a first-line endovascular procedure were compared for clinical characteristics, procedural variables and clinical outcomes. The technical superiority of ADAPT was analyzed in depth. Results During observation period, a total of 91 cases were performed endovascular treatment with mechanical thrombectomy. ADAPT was designed in 46 cases as a first-line endovascular procedure and was utilized in 38 cases (82.6%;ADAPT group), while primary stent retriever thrombectomy was performed in 21 patients(stent group). There was no significant difference in baseline clinical or radiographic factors between ADAPT and stent groups. Although rates of good neurological outcome (modified Rankin Scale(mRS) score≤2) at 90 days were similar between the ADAPT and stent groups (61%(23/38) vs 48%(10/21), P=0.247), National Institute of Health Stroke Scale (NIHSS) score at seven days (6.0(2.0, 9.3) vs 9.0(5.5, 18.5),Z=-2.031,P=0.021) and full recovery rate of neurological outcome (mRS score=0, 37%(14/38) vs 10%(2/21), P=0.022) were significantly better in the ADAPT group than in the stent group. There were no significant differences in rates of embolus to new territory (21%(8/38) vs 29%(6/21), P=0.365), Thrombolysis In Cerebral Infarction (TICI) 2b/3 grade revascularization (84%(32/38) vs 81%(17/21), P=0.507) and symptomatic intracerebral hemorrhage (0%(0/38) vs 10%(2/21), P=0.123) between the ADAPT and the stent groups, but the figures were better in the ADAPT group. Conclusions Mechanical thrombectomy using ADAPT is feasible and safe compared with stent retriever, with higher full recovery rate of neurological outcome and better NIHSS score.It is a method worthy of further exploration for endovascular mechanical recanalization.
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Molecular cloning is one of the most important and widely used technologies in molecular biology research. Generally, the target DNA fragment and the vector are separately digested by restriction enzyme, then purified and recovered, and then ligated with DNA-ligase. For some very short gene fragments (<300 bp), the recovery efficiency of the purified fragment is very low after digestion and cleavage, leading to the difficulty in its inserting into the expression vector. To address this issue, we developed a cloning method based on restoration of antibiotic resistance in constructing recombinant plasmid, which proved highly efficient in cloning very short gene fragments.
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Objective:To investigate the influence of different salt concentration on the renal fibrosis and macrophages infiltration in salt sensitive hypertension.Methods:Dahl salt sensitive rats were randomly divided into the normal salt (0.3 ％ nacl) group,4 ％ high salt,8 ％ high salt groups at six weeks continuously feeding for 8 weeks,each group contained 15 rats.Tail-cuffmethod was used to value rat blood pressure at 8 weeks,Masson trichromatic method was used to detect renal fibrosis of the three groups at 8 week.Immunohistochemistry and Western blot method were used to depict the renal macrophage infiltration at 8 week.Results:1) The blood pressure of 4 ％ salt and 8％ high salt group rats were significantly higher than those of the normal salt group at 8week,meanwhile the blood pressure of 8 ％ high salt was further increased than that of 4 ％ high salt group at 8 week.2) The relative kidney weight and renal fibrosis of 4 ％ salt and 8 ％ high salt group rats were obviously higher than that of normal salt group at 8week,meanwhile the relative kidney weight and renal fibrosis of 8 ％ high salt were further increased than those of 4 ％ high salt group at 8 week.3) The macrophage infiltration of 4 ％ salt and 8％ high salt group rats were higher than that of the normal salt group at 8week,meanwhile the macrophage infiltration of 8 ％ high salt was further increased than that of 4 ％ high salt group at 8 week.Conclusion:Different high salt concentrations had different effect on the renal fibrosis and macrophage infiltration in the salt sensitive hypertension,high salt concentration could exacerbate the renal fibrosis and macrophage infiltration.
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Objective:To explore the effect of case teaching in clinical nursing teaching and medical ethics ed-ucation in the department of cardiology. Methods: A sample of 75 nurse interns came to practice in November 2014 to April 2015 were allocated to the control group, while 96 nurse interns came in July 2015 to December 2015 were allocated to the experimental group. The interns in control group were taught according to the traditional teach-ing method, and the case teaching method was used in the experimental group. The scores of critical thinking abili-ty and the times of praise were compared between the two groups. Results:Both critical thinking ability and praise of the interns in the experimental group were better than those in the control group ( P<0 . 01 ) . Conclusion:In-troducing the case teaching method to clinical nursing teaching and moral education can improve nurse interns′clin-ical critical thinking ability and stimulate the enthusiasm for learning. Meanwhile, it is beneficial to cultivate nurse interns′medical humanistic spirit and improve the medical humanistic quality.
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In the current study, the effects of ethanol [EtOH] on toxicokinetics of methamphetamine [MA] and its metabolite amphetamine [AP] were investigated. A single dose of MA hydrochloride at 15 mg/Kg was given intragastrically, either alone [MA group; n = 8] or in conjunction with 3 g/Kg EtOH [MA+EtOH group; n = 8] to rabbits. In placebo group, normal saline only was given [placebo group; n = 4]. Plasma and urine samples were collected and analyzed by gas chromatography/mass spectrometry [GC/MS] for MA and AP. Toxicokinetic parameters of MA and AP were determined using WinNonlin. Our results showed that toxicokinetic profiles of MA and AP in the two experimental groups were both fitted to an open two-compartment model with first-order kinetics. These were not affected by co-administration of EtOH. However, concomitant intake of EtOH significantly increased MA plasma absorption constant [Ka] and maximum concentration [Cmax]. The Ka of MA was increased from 0.679/h +/- 0.023/h to 0.964/h +/- 0.033/h [P < 0.05, the mean Cmax from 1.408 mg/L +/- 0.072 mg/L to 1.676 mg/L +/- 0.135 mg/L [P < 0.05], whereas the Tmax was significantly decreased from 1.620 h +/- 0.062 h to 1.259h +/- 0.033h [P < 0.05]. In contrast, no significant difference was observed on MA elimination. Furthermore, the plasma AP area under the curve [AUC0-30 h] increased from 5.281 mg/h/L +/- 0.264 mg/h/L to.13.052 mg/h/L +/- 0.956 mg/h/L and Cmax increased from 0.315 mg/L +/- 0.010 mg/L to 0.423 mg/L +/- 0.042 mg/L [P < 0.01]. Taken together, co-administration of EtOH with MA significantly accelerated MA absorption and subsequent metabolism to AP, but did not have significant effect on MA elimination
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Objective To summarize the nursing experience in patients with CT-assisted thoracoscopic surgery for small indeterminate pulmonary nodules.Method The data of 26 patients having undergone CT-assisted thoracoscopic surgery for small indeterminate pulmonary nodules were analyzed retrospectively for summarizing the nursing experience.Result The CT-assisted locations of nodules and the thoracoscopic resection of the pulmonary nodules in all the patients were successfully performed,without pneumatothorax,haematothorax and pneumorrhagia.Conclusion Such measures as setting the right time for locating,enhanced management of body position,accurate and safe punctuation and well performance of surgical cooperation are all critical for the success of the resection.
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Objective To investigate the effect of cerebral ischemia on functional parameters of affected arteries and probe into the possible pathogenesis of ischemia-reperfusion injury.Methods Intraluminal suture ischemic model was used by occlusion of left middle cerebral artery in rats.Two hours later,the middle cerebral artery segments were isolated from both ischemia and control groups for measurement of changes in vessel diameter induced by increasing pressure and vasoactive compounds.And then,distensibility,myogenic tone,reactivity to 5-HT and ACh were calculated and compared between groups.Results In lower pressure range,ischemic vessels showed an increased myogenic tone(at 40 mm Hg,1 mm Hg=0.133 kPa,19.3%±0.4% vs 10.0%±0.2%,t=20.568,P=0.000)and decreased diameter.In higher pressure range,ischemic vessels showed an increased diameter.distensibility and decreased myogenic tone(at 120 mm Hg,12.0%±0.2% vs 21.8%±0.4%,t=-23.575,P=0.000).In normal pressure range,myogenic tone was not altered after ischemia. Both groups constricted to 5-HT and dilated to ACh,however,the response was significantly diminished after ischemla.Conclusion These findings demonstrate that contractile and diastolic function of affected artery was impaired after ischemia,a result that may contribute to ischemia-reperfusion injury by losing upstream cerebrovascular resistance and increasing perfusion on the microcirculation.
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Objective The aim of this study is to provide guidance on rehabilitation nursing via observing the effect of comprehensive relaxation training on perioperative psychological stress in patients with coronary intervention treatment. Methods In this study, eighty patients ready to receive coronary intervention were randomly divided into the experimental group and the control group (40 patients in each). The control group were treated with routine percutaneous coronary intervention care, and the experimental group received both comprehensive relaxation training and routine care. The anxiety state and subjective feelings on comprehensive relaxation training in both groups were dynamically investigated via State-Trait Anxiety Inventory questionnaire and subjective feeling questionnaire from pre-operation to 7 days after operation. Results Anxiety levels between two groups showed the similar trend, and there was statistically significance between two groupsin the state anxiety level. The subjective feeling in the experimental group improved. Conclusions The psychological stress in patients receiving coronary intervention surgery maintains at high level form pre-operation to 24h post operation, and comprehensive relaxation training can significantly reduce the level of state anxiety. These patients consider that this simple training shows obvious relaxing effect.