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Objective:To explore the construction and clinical practice of the training system for nurses in operating room subspecialty based on ORTCC model (including objectives, rules, training, assessment and culture), and to provide theoretical and practical guidance for the development of nursing subspecialty in operating room.Methods:This was a quasi-experimental study. The Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology was convenient to select 23 operating room nurses who rotated in orthopedic surgery rooms from January 2019 to June 2020 as the control group, and the traditional training model for specialized nurses in operating rooms was adopted. From July 2020 to December 2021, the 24 operating room nurses rotating orthopedic surgery rooms were selected as the experimental group, and ORTCC teaching mode was adopted. The degree of mastery of theoretical knowledge, standardization of operation skills, correct rate of standard preventive implementation and satisfaction rate of doctors of operating room nurses under two different training methods were compared.Results:The theoretical score of operating room nurses increased from (84.71 ± 5.70) points in the control group to (92.68 ± 3.64) points in the experimental group, and the skill score increased from (90.17 ± 4.69) points in the control group to (95.43 ± 2.61) points in the experimental group, with statistical significance ( t = 13.76, 5.64, both P<0.01). The satisfaction rate of surgeons to nurses′ surgical cooperation ability communication, cooperation ability and emergency treatment ability increased from 82.61%(19/23), 73.91%(17/23) and 78.26%(18/23) in the control group to 100.00%(24/24), 95.83% (24/24) and 100.00% (24/24) in the experimental group, respectively, with statistically significant differences ( t = 4.56, 4.45, 5.84, all P<0.05). Conclusions:The training system of operating room subspecialty nurses based on ORTCC model is conducive to improving the theoretical knowledge mastery, standard operation skills and doctor satisfaction rate of operating room nurses to the specialty and subspecialty, providing training basis for the development of operating room subspecialty, and worthy of clinical promotion.
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Objective@#To understand the preparation of evidence-based nursing practice for postoperative venous thrombosis in the department of spine and orthopedics in our hospital, and to identify the obstacle factors in the process of evidence-based nursing practice so as to promote the successful transformation and application of evidence.@*Methods@#A questionnaire survey was conducted among 164 nurses in Department of Orthopedics of Wuhan Union Hospital in Hubei Province by using self-made general data questionnaire and Clinic Readiness of Evidence-Based Nursing Assessment (CREBNA).@*Results@#The total score of CREBNA was (135.99 ±14.52) points, accounting for 87.10% of the full score. The average score of each subscale item was from high to low: organization environment subscale (4.44±0.67) points, evidence subscale (4.41±0.60) points and promotion factor subscale (4.31±0.69) points. Multiple stepwise regression analysis showed that different levels of understanding of evidence-based nursing practice was the main influencing factor of spine orthopedic nurses′ evidence-based practice readiness (P<0.05).@*Conclusion@#In this study, there were good level of readiness for evidence-based nursing practice and the current environment is conducive to the development of evidence-based practice programs. Before the application of evidence, managers should clarify the obstacles to change and formulate individual intervention measures to promote the clinical application of evidence.
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Objective:To understand the preparation of evidence-based nursing practice for postoperative venous thrombosis in the department of spine and orthopedics in our hospital, and to identify the obstacle factors in the process of evidence-based nursing practice so as to promote the successful transformation and application of evidence.Methods:A questionnaire survey was conducted among 164 nurses in Department of Orthopedics of Wuhan Union Hospital in Hubei Province by using self-made general data questionnaire and Clinic Readiness of Evidence-Based Nursing Assessment (CREBNA).Results:The total score of CREBNA was (135.99 ±14.52) points, accounting for 87.10% of the full score. The average score of each subscale item was from high to low: organization environment subscale (4.44±0.67) points, evidence subscale (4.41±0.60) points and promotion factor subscale (4.31±0.69) points. Multiple stepwise regression analysis showed that different levels of understanding of evidence-based nursing practice was the main influencing factor of spine orthopedic nurses′ evidence-based practice readiness ( P<0.05). Conclusion:In this study, there were good level of readiness for evidence-based nursing practice and the current environment is conducive to the development of evidence-based practice programs. Before the application of evidence, managers should clarify the obstacles to change and formulate individual intervention measures to promote the clinical application of evidence.
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Objective@#To investigate the epidemiological data of ventilator-associated pneumonia(VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients.@*Methods@#Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed.@*Results@#Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively; Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48%. Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors.@*Conclusions@#The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care
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Objective To investigate the epidemiological data of ventilator-associated pneumonia (VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients. Methods Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed. Results Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively;Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48% . Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors. Conclusions The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care
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Objective To evaluate the impact of the re-modified Sugiura procedure on portal hemodynamics and liver function in cirrhotic patients with portal hypertension.Methods Forty patients with cirrhosis and portal hypertension who underwent the re-modified Sugiura procedure in the Yichang Second People's Hospital from June 2006 to October 2014 were studied.Changes in the free portal pressure (FPP),portal venous flow (PVF) and liver functions before and after operation were analyzed.Results (1) The FPP at different phases of the operation (after opening the abdomen,after splenectomy,and after devascularization) were (43.2 ± 1.8) cmH2O,(34.8 ± 1.6) cmH2O and (35.2 ± 1.7) cmH2O,respectively.There were significant differences in FPP between the phases of after splenectomy and after opening the abdomen,as well as after devascularization and after opening the abdomen (P ＜ 0.05).There was no significant difference in FPP between after devascularization and after splenectomy (P ＞ O.05).(2) The PVF,which were measured with Doppler sonography at 4 time points (preoperative 1 day,postoperative 10 days,postoperative 6 months,postoperative 18 months),were (1 420.4 ± 137.7) ml/min,(1 205.2 ± 126.7) ml/min,(875.8 ± 118.0) ml/min and (893.8 ± 114.7) n1/min,respectively.There were significant differences in PVF between postoperative 10 days and preoperative 1 day,between postoperative 6 months and postoperative 10 days,as well as between postoperative 18 months and preoperative 1 day (P ＜0.05).There was no significant difference in PVF between postoperative 18 months and postoperative 6 months (P ＞0.05).(3)The liver functions were evaluated using the Child-Pugh score at 4 time points (preoperative 1 day,postoperative 10 days,postoperative 6 months,postoperative 18 months).There were no significant differences among the time points,(P ＞ 0.05).Conclusion The re-modified Sugiura's procedure durably,appropriately and effectively reduced the PVF and FPP,but it did not have any negative effects on the liver functions of patients with cirrhosis.
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OBJECTIVE:To observe clinical efficacy and safety of alprostadil combined with salvia ligustrazine in the treat-ment of aged patrents with unstable angina pectoris. METHODS:A total of 150 patients with unstable angina pectoris department of our hospital during Oct. 2011-Mar. 2015 were randomly divided into alprostadil group,salvia ligustrazine group and combination group according to random number table,with 50 cases in each group. Three groups received routine treatment. Alprostadil group additionally received Alprostadil injection 100 μg added into 0.9％ Sodium chloride injection 250 mL,ivgtt,qd,on the basis of routine treatment. Salvia ligustrazine group additionally received Salvia ligustrazine injection 10 mL added into 0.9％ Sodium chlo-ride injection 250 mL,ivgtt,qd,on the basis of routine treatment. Combination group additionally received constant dose of Al-prostadil injection and Salvia ligustrazine injection. Hemorheological indexes (high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity,hematocrit,fibrinogen),cardiac function indexes(LVEF,SV,LVEFD,LVST),serum CRP, NO,ET,SOD and clinical efficacies were observed in 2 groups before and after treatment;the occurrence of ADR was compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in hemorheological indexes,cardiac function indexes or serum CRP,NO,ET,SOD level between 2 groups (P>0.05). After treatment,plasma viscosity,the whole blood high and low shear viscosity,hematocrit,fibrinogen,serum CRP and ET levels of 3 groups were decreased significantly,while LVEF,SV,serum levels of NO and SOD were increased significantly,combination group was significantly better than alprostadil group and salvia ligustrazine group,with statistical significance (P0.05). CONCLUSIONS:Alprostadil combined with salvia ligustrazine can effectively reduce the blood viscosity of patients with unstable angina pectoris,improve cardi-ac function and endothelial function,reduce myocardial ischemia injury and show significant therapeutic efficacy and safety without increasing the incidence of ADR.
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While currently therapeutic vaccines for chronic hepatitis B virus (HBV) infection are actively being developed to complement standard antiviral treatments, their immune activity, especially T cell activity, remains to be further improved. Here, we investigated the role of heat shock proteins HSP70 and gp96 on cellular and humoral immunity, using the main structure antigens of hepatitis core (HBcAg) and surface (HBsAg) as the DNA vaccine. By ELISPOT (enzyme linked immunospot assay), IFN-gamma intracellular staining, [3H]-thymidine incorporation and ELISA (enzyme linked immunosorbent assay) analyses, we showed that immunization with HBsAg/HBcAg DNA formulation along with HSP70 or gp96 induced significant increase of T-cell (about 1-6-fold) and antibody (about 20%-60%) immunity against HBsAg and HBcAg. These results may provide bases for designing HSP70- and gp96-based vaccines aimed at eliciting T-cell responses for therapeutic applications.
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Animals , Female , Humans , Mice , Adjuvants, Immunologic , Pharmacology , HSP70 Heat-Shock Proteins , Allergy and Immunology , Hepatitis B Core Antigens , Allergy and Immunology , Hepatitis B Surface Antigens , Allergy and Immunology , Hepatitis B Vaccines , Allergy and Immunology , Hepatitis B virus , Allergy and Immunology , Hepatitis B, Chronic , Allergy and Immunology , Therapeutics , Immunoglobulin G , Allergy and Immunology , Membrane Glycoproteins , Allergy and Immunology , Mice, Inbred BALB C , T-Lymphocytes , Allergy and Immunology , Vaccines, DNA , Allergy and ImmunologyABSTRACT
Objective:To investigate the expression of Cyclin D 1?p16?p27 and PCNA in glioma with different pathological classification, and to explore the correlationship among Cyclin D 1?p16?p27 and PCNA.Methods:Cyclin D 1?p16?p27 and PCNA protein expressions in 12 normal brain tissues and 58 glioma cases were examined by immunohistochemical staining and hemiquantity analysis.Results:With the increasing of glioma malignancy, the expression level of Cyclin D 1 protein increased gradually (P
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Objective To assess the clinical value of HRCT in diagnosis of cholesteatomatous tympanitis.Methods HRCT findings of 26 patients with cholesteatomatous tympanitis proved by surgery and pathology were analyzed.Results HRCT findings of cholesteatomatous tympanitis included:soft tissue mass in the superior tympanium,tympanal sinus and mastoid(100%,26/26),destruction of the bone includeing ossicles chain (92%,24/26),secutum(46%,12/26),facial nerve canal (54%,14/26);enlargement of the tympaniosinus with sclerosing borders;intracranial complications including temple abscess(1 case),meningitis(1 case).Conclusion HRCT is of great value in diagnosis of cholesteatomatous tympanitis.