ABSTRACT
In the COVID-19 epidemic prevention and control work, not only the safety management of in-hospital organ transplantation is facing severe challenges, but also a large number of patients at home after transplantation are in immunosuppressive state, and professional protection management is urgently needed. Since the outbreak of the epidemic, Shulan(Hangzhou)hospital fully identified the risks of transplant patients, established a special team, and formulated and implemented the control management plan for organ transplant patients based on the crisis leadership model. The control management plan has achieved staged results.From January 15 to March 2, 2020, 29 liver transplants and 31 kidney transplants were performed in our hospital. The remote health education of 1 002 patients after liver and kidney transplantation was completed. The goal of " zero infection" was achieved, and the protection management quality indicators were ideal.
ABSTRACT
A 44 years old male patient suffered from flame burn of 20% total body surface area was admitted to our hospital on February 14th, 2018. On admission, his abdominal CT was not obviously abnormal. Eleven hours after burn, the patient had left upper abdominal pain, accompanied by reduction of urine output. Then he suffered from sudden hypotension and hypoglycemia. Acute pancreatitis was diagnosed by abdominal CT reexamination. Low glucose level was ameliorated slowly through positive rescue, and pancreatitis crisis progressed rapidly. The family members gave up rescue care, and patient discharged. The case indicates that physicians should pay attention to glucose levels of severe burn patients, and be cautious of appearance of postburn pancreatitis.
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On March 18, 2016, one 53 years old man with burns on perineal region and complicated by secondary multiple organ injuries by exposing to paraquat fluid was admitted to our department. Comprehensive treatment measures including protective mechanical ventilation, intensive care, vacuum sealing drainage, anti-infection, and organ protection were conducted sequentially. Through 33 days of comprehensive treatment and nursing, the patient′s condition substantially improved and he left hospital. This case presents that paraquat fluid absorption through skin and mucosa can also lead to severe systemic poisoning, and multiple organ protection is the key to improve the prognosis of this patient.
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Objective To investigate the effects of Neuman System Model on acute stress disorder after severe blast injury. Methods In the nursing course of a severe blast injury patient, by using Neuman SystemModel, we evaluated the patient′s stress source according to five aspects, including physiology, psychology, society culture, development and spirit, and then through drafting the intervention program with the patient together, he was guided to take part in the management of their own symptoms, cognitive therapy was undertaken, and his parents were also assisted to create an effective supporting system. What′s more, level Ⅲ Neuman preventive measures were taken in the septal fibrosis and bridging. Results Satisfying results were acquired after sixty days′ interventions. The patient could almost properly face the blast injury, and discharge healthily. Conclusion Neuman System Model is really helpful in relieving the acute stress disorder of severe blast injury patients, so as to promote rehabilitation physically and mentally.
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This paper summarized the experience of caring a patient with pancreatic cancer-related depression treated with pancreaticoduodenectomy and postoperative delayed gastric emptying.The nursing included several key points.On the base of collaboration of muhi-disciplinary teams,to strengthen supportive psychological intervention and safety management after admission;to use multimodal analgesia combined with cognitive behavioral therapy to reduce postoperative pain.After the patient was complicated with gastric emptying obstacles,solution-focus mode,sham feeding and nutritional support programs were implemented.Long-term follow-up with physician-nurse collaboration mode was implemented to enhance quality of life of the patient.
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Using indirect immunofluorescent method, immunocytochemical staining (APAAP) technique and molecular hybridization, 111 cases of T cell acute lymphoblastic leukemia (T-ALL) were subclassified by a panel of monoclonal antibodies against human cell surface antigens and TcR ? and JH gene probes. According to their immunophenotypes, the T-ALL could be divided into three main subtypes: immature T-ALL (I, 41.5%), common thymocytic T-ALL (Ⅱ, 20.7%) and mature T-ALL (Ⅲ, 36.9%), in addition to one hybrid acute leukemia (0.9%). Among the 46 immature T-ALL, fifty percent cases expressed CD7 T-cell-associated antigen in blast surface only, so called as pre-T-ALL. Whereas 73.9% of pre-T-ALL blasts expressed cytoplasmic CD 3 (cCD3) antigen and presented TcR ? gene rearrangement. Those mentioned above confirmed their origin from T lymphoid lineage. Thus, CD7 and cCD 3 diagnostic combination provided a very sensitive assay for T-ALL, and had advantages over CD7 only. because the latter appeared on some cases with AML. Our data indicated that most of immunophenotypes in T-ALL reflected the phenotypic characters of normal thymocytes at various differentiation stages or certain rare population of lymphocytes. But a few of phenotypes had not been found normal counterparts in human thymus and bone marrow lymphoid. therefore, the heterogeneity of T-ALL was also observed.