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Objective:To find the preferences of nursing staff when they provide " Internet + nursing service" for elderly patients.Methods:By means of the discrete choice experiment, a questionnaire was designed to investigate the preferences of nursing staff when they provide " Internet + nursing services" for elderly patients. In-service nursing staff from 8 medical and health institutions in Ningbo city and Wenzhou city were selected by random sampling, for an online questionnaire survey conducted from May to June 2022. The preferences of nursing staff on their service income, service content, service distance, service continuity and residence status of elderly patients when providing " Internet + nursing service" were analyzed by mixed logit regression.Results:A total of 420 valid questionnaires were collected. Compared to 50 yuan/order, nursing staff preferred to a price of 150 yuan/order ( β= 1.22, P<0.001) nursing services; Compared to specialized nursing services, nursing staff preferred to the routine care ( β= 0.86, P<0.001) and health promotion ( β= 0.86, P<0.05) service; Compared to<5 km, nursing staff were unwilling to provide nursing services for elderly patients at distances of 5-10 km and 11-15 km ( β=-0.66, P<0.05; β=-0.95, P<0.001) ; Compared to 1-2 visits per month, nursing staff preferred not to provide continuing care services ( β=-0.70, P<0.05); Compared to homestay with the patient family, nursing staff preferred to provide nursing services for elderly patients residing in nursing homes ( β= 1.21, P<0.001) . Conclusions:Considering the preference of nursing staff tend to provide " Internet + nursing service" for the elderly patients with services featuring appropriate price, non-specialist care, close distance, low continuity (moderate intensity used as the reference) and security assurance for practice.
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Objective:To investigate the current situation of the " Internet plus nursing services" for the elderly in Ningbo, and evaluate the promotion effect of the pilot policy, for reference to further optimize such service policy of China nationwide.Methods:The data came from the orders for " Internet plus nursing services" by elderly users over 60 years on the " cloud hospital" platform in Ningbo from 2016 to 2021. Descriptive analysis was used to study major demographic information, types of service items and number of person-times of the elderly users; The promotion effect of the pilot policy on " Internet plus nursing services" for the elderly in 2019 was analysed by Chow test.Results:The number of elderly users increased from 76 person-times in 2016 to 5 923 person-times in 2021, accumulating up to 12 209 person-times. The number of nursing service items increased from 18 in 2016 to 36 in 2021. The person-times of users of common clinical nursing and specialized nursing service items were 11 850 and 359 respectively. After the pilot policy was issued, the number of service items and the number of users were significantly increased in 2020( P<0.05). Conclusions:The development of " Internet plus nursing services" for the elderly in Ningbo had achieved certain results, especially with the promotion of the pilot policy in 2019, the types of service items and the number of elderly users had increased year by year. In the future, we should continue to focus on the elderly living alone and other special elderly groups with the support of relevant policies, further expand the scale of elderly users, improve the types of service items, and optimize the charging standards to help China′s healthy aging process.
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Medical record information is the core data source for diagnosis related groups(DRG)payment, and high-quality of medical record information is the foundation for DRG payment. The development of medical record management towards medical record information management, pushes up the demand for high-quality medical record information management professionals in hospitals. The conventional practice of professional training had resulted in such setbacks as professionals mismatch, long pre-employment training period, and large demand for continuing education. Based on the triple helix model theory, the study established a production-education integration training mode of university-government-hospital for medical record information management professionals. Capacity development was set as the goal and job demand as the guidance, for effectively integrating the educational resources, and promoting the model of " posts linked to training, employment following graduation" production-education integration training. The aim is to expand the quantity of talent team and improve the quality of talent training, thus effectively easing the shortage of medical record information management professionals.
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Objective To investigate the mechanism of cellular senescence in ischemia reperfusion injury (IRI)-induced acute kidney injury (AKI) that leads to chronic kidney disease (CKD) in elderly mice.Methods An acute kidney injury model was established in C57B1/6 male mice at ages 8-10 weeks (young group) or 20-24 months (old group) by bilateral IRI.The animals were randomly divided into 4 groups as follows:Young-Sham (n=8),Old-Sham (n=8),Young-IRI (n=8),and Old-IRI groups (n=8).All mice were weighted,and their blood was collected from the tail vein at days 1,3,and 7 after surgery.The mice were killed on day 14 after surgery,and their kidneys were harvested for further analysis.Serum was used for the creatinine test.The changes of the renal tissue morphology and pathology were assessed using hematoxylin-eosin staining and sirius red staining.Immunofluorescence staining of collagen Ⅰ,F4/80,phosphor-histone H3 (p-HH3),and Ki67 were performed to determine the stage of the collagen deposit,macrophage filtration,and cell cycle G2/M arrest.The collagen Ⅰ expression was analyzed using western blot.The expression levels of TNF-α,IL-6,TGF-β,and collagen Ⅰ were determined using real-time PCR.Results Compared with that in the sham group,the serum creatinine levels in both Young-IRI and Old-IR1 groups were obviously increased.The Young-IRI group recovered completely on day 7.The Old-IRI group had higher creatinine levels than the Young-IRI group at each time point.Morphology and pathology analyses revealed that acute injury was repaired in the Young-IRI group,but slight inflammatory cell filtration and collagen deposition were observed in the Old-Sham and Old-IRI groups,respectively.Immunofluorescence staining revealed some F4/80-positive macrophage filtration,collagen Ⅰ deposition,and p-HH3 and Ki67 double-positive nuclear tubular epithelial cells in the Old-Sham group,but considerably more positive results were found in the Old-IRI group.Western blot analysis revealed that collagen Ⅰ expression level was higher in the Old-IRI group than in the Young-IRI group (P ＜ 0.01) and in the Old-Sham group than in the Young-Sham group (P ＜ 0.05).Real-time PCR demonstrated that the mRNA expression levels of cytokines and fibrosis markers,including of TNF-α,IL-6,TGF-β,and collagen Ⅰ,in the Old-Sham and Old-IRI groups were increased as compared with those in the Young-Sham and Young-IRI groups (P ＜ 0.05).Conclusions The levels of kidney inflammation,fibrosis,and cell-cycle arrest are lower in the old mice.After IRI injury,a sustained and ongoing inflammatory reaction is involved and more cells are arrested in the cell cycle G2/M,which inhibit renal repair and promote fibrosis progression.
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Objective To explore the relationship between benign prostatic hyperplasia and renal function in men aged 80 years and over.Methods Eighty-three clinical BPH patients (mean age of 85.8±4.7 years,range of 80-98 years) admitted to Geriatric Department of the First Affiliated Hospital of Zhengzhou University were recruited to this cross-sectional study from January 2017 to June 2017.They were grouped into treatment group (Gt,n=43) and non-treatment group (Gn,n=40) based on their choices for a therapy or observation.The prostate volume (PV) and post-void residual urine volume (PVR) were measured by abdominal ultrasound.A self-reported lower urinary tract symptoms (LUTS) was evaluated by International Prostate Symptoms Score (IPSS).An estimated glomerular filtration rate (eGFR) was calculated based on the serum level of creatinine and other indexes.Spearman and multiple linear regression analysis were applied to analyze correlations between BPH and renal function.Results The systolic and diastolic blood pressures were lower in Gt group than in Gn group (all P＜0.05).The PVR and IPSS were significantly lower in Gt group than in Gngroup[(28.9±16.6) ml vs.(67.3±32.8) ml;(18.2±9.1)vs.(24.7±10.3),all P＜0.05].The serum level of creatinine was lower in Gt group [(73.7±16.3) μmol/L] than in Gn group [(85.4±19.8) μmol/L] (P＜0.05).The eGFR was higher in Gt group[(77.2±11.4) ml · min 1 ·1.73 m-2] than in Gn group[(69.8±13.9) ml · min 1 · 1.73 m-2] (P＜0.05).No statistical differences were observed in PV between Gt group[(24.6 ± 11.4) ml] and Gn group[(27.0 ± 20.8) ml] (P＞0.05).Spearman relation analysis showed that creatinine level was negatively correlated with treatment for BPH (r=-0.337,P＜0.05).Multiple linear regression analysis showed that non-receiving of treatments for BPH was an independent risk factor for an increased creatinine level(r=-0.349,t=-2.802,P＜0.01).Conclusions For men aged 80 years and over,BPH is associated with decreased eGFR,and the treatment for BPH may improve renal function.
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Pneumonia is a major disease threatening the health of children, and its diagnosis mainly depends on medical history, physical examination, chest X-ray and CT examination. The reliability of the physical examination was low, while the chest X-ray and CT examination had certain radiation damage to children. Therefore, in recent years, the application of lung ul-trasound is popular in diagnosis of pneumonia in pediatric patients. This article reviewed the application of lung ultrasonography in diagnosis and follow-up of pneumonia in pediatric patients..
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Objective To understand the needs and suggestions of respiratory medicine specialist nurses training, in order to provide some basis for the establishment of training mode of respiratory medicine specialist nurses. Method Using objective sampling method, we interviewed 12 students of different seni-ority , qualifications , title in the first session of training of nurse specialist in department of respiratory medicine of Chongqing, using qualitative research methods to analyze the data of the interview. Result Respondents had unified opinion on the curriculum setting, conditions of the training base, the requirements of core competence of junior nurses in department of respiration, but there existed differences about the length of service of the students . And the length of service of the teachers needed further discussion . Conclusion The opinions of the respondents collected provide reference for the establishment of training mode of nurse specialist in department of respiratory medicine. However, the students' opinions on the estab-lishment of the training standards are not uniform, which is worth further discussion.
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Objective To optimize a W/O microemulsion formulation of troxerutin and evaluate its physical properties such as morphology, droplet size, stability and content of troxerutin. Methods The W/O microemulsion was optimized using a pseudoternary phase diagram and the area of the microemulsion region was used to screen and determine microemulsion components.HPLC assay was used for determination of the loading content. Results The optimal formulation contained lecithin, ethanol, isopropyl myristate and water (23.30:11.67:52.45:12.59).The microemulsion was physicochemically stable with round shape and uniform size, and the mean droplet size was about 50. 20 nm. Conclusion Microemulsion was developed successfully.It will expect to be the new preparation for troxerutin.