ABSTRACT
Objective:To investigate the implementation status of sepsis hour-1 bundle strategy for patients with septic shock in emergency department.Methods:A total of 116 septic shock patients admitted to the emergency department from January 2020 to December 2020 were included in this prospective study, and the implementation of sepsis bundles and the clinical outcomes of patients were recorded.Results:Among 116 patients, 20 cases (17.2%) had lactic acid monitored within 1 h, 20 cases (17.2%) had blood culture before antibiotics, 82 cases (70.1%) received broad-spectrum antibiotics, 16 cases (13.8%) received fluid resuscitation ≥30 ml/kg, and 57 cases (49.1%) received vasoactive drugs during resuscitation. Finally, the sepsis hour-1 bundle strategy was fully implemented only in 13 cases (11.2%). Compared with the group with incomplete implementation of sepsis hour-1 bundle strategy, the volume of fluid recovery in the group with full implementation was significantly increased [33.7 (30.0,37.5) vs. 8.9(7.3,10.8) ml/kg, Z=-4.78, P<0.001], mean artery blood pressure significantly increased [70.0 (70.0,76.7) vs. 67.7 (61.7,76.7)mmHg(1 mmHg=0.133 kPa) , Z=-2.00, P<0.001], and lactic acid significantly decreased [3.0 (2.0,3.2) vs. 4.4 (3.7,7.2) mmol/L, Z=-2.76, P=0.006]. However, there were no significant differences in ICU mortality, in-hospital mortality and 28-day mortality between the two groups ( P>0.05). Conclusions:Septic shock patients in emergency department have poor compliance with the implementation of sepsis hour-1 bundle strategy, and relevant management training should be strengthened.
ABSTRACT
Objective:To determine the effect of prolonging the interval of flushing on ports′ function and catheter related complications for cancer patients after completing chemotherapy.Methods:A prospective randomized controlled trial was conducted in 190 patients who undergoing ports-maintenance in outpatient clinical, the First Affiliated Hospital of Sun Yat-sen University, after they finished the chemotherapy from April 2017 to February 2018. According to the random number table, the patients were divided into 4-week group, 8-week group and 12-week group after completing chemotherapy, then returned to the hospital to maintain the port every 4 weeks, every 8 weeks and every 12 weeks, respectively. Then evaluated the function and complications of catheter among different groups.Results:After completion of chemotherapy, the rate of catheters′ patency of tumor patients in 12-week group was 98.5% (66/67), while that in 4-week group was 98.1% (53/54) and in 8-week group was 98.6% (68/69), there was no statistically significant difference on catheters′ patency among different groups ( χ 2=0.48, P>0.05). The rate of catheters′ asymptomatic thrombosis in 12-week group was 18.9% (10/53), which was not significantly different from that of 4-week group 27.0% (10/37) and 8-week group 14.0% (7/50) ( χ 2=2.33, P>0.05). Conclusions:Tumor patients maintaining port every 12 weeks after completion of chemotherapy can ensure the safety of patients using the port. It is favorable for application and promotion of port in cancer patients.
ABSTRACT
Objective:To sum up nursing experience of a multi-drug resistant patient with upper gastrointestinal hemorrhage who underwent Lateral skull base.Methods:One patient with multi-drug resistant was admitted to our hospital in October, 2019. To observe and prevent the postoperative complications of lateral skull base and to prevent the rupture bleeding of carotid artery. The early detection and treatment the symptoms of upper gastrointestinal bleeding is effective and necessary. Intervention for patient receiving nutrition therapy is promoted.Results:By giving psychological care to improve patient compliance. The patient had no postoperative complications of lateral skull base, and the bleeding symptoms of upper gastrointestinal hemorrhage was controlled in time.Conclusion:The patient was discharged from the hospital with a tracheal tube in a stable condition.
ABSTRACT
During the Huai′an Emergency Alliance meeting in January 2020, 143 emergency physicians from 21 level Ⅱ general hospitals in the region who attended the meeting, participated in a questionnaire survey on the knowledge of hour-1 bundle therapy for septic shock. The average score of the correct answer was (5.4±2.9), that for senior ( n=39), intermediate ( n=50) and primary ( n=54) physicians was (6.4±3.3), (6.0±3.2) and (3.4±1.9), respectively ( P<0.01); the rate of failure (≤5) for them was 28% (11/39), 40% (20/50) and 56% (30/54) ( P=0.03), respectively. The hour-1 bundle was summarized into four measures. For the measure of "blood culture", 95% of all levels emergency physicians answered correctly. In answering question of "liquid resuscitation and vasoactive drugs" the accurate rate was 15% (6/39), 24% (12/50) and 7% (4/54) for senior, intermediate and primary physicians; while in answering questions about other measures the overall correct rates were all around 50%. The correct rate for "time of implementing the bundle" in intermediate, senior and primary physicians was 60% (30/60), 59% (23/39) and 44% (24/54); for "monitoring lactate timing" in intermediate, senior and primary physicians was 64% (32/50), 80% (31/39) and 65% (35/54); for the target value of "MAP" was 68% (34/50), 62% (24/39) and 50%(27/54); for the "use time of vascular active drug" was 50% (25/50), 46% (18/39) and 17% (9/54), respectively. The survey suggested that the knowledge of hour-1 bundle therapy for septic shock among emergency physicians in Huai′an secondary general hospitals are insufficient, and relevant training should be strengthened.
ABSTRACT
Objective:To design and evaluate a new type of clothes for patients with reconstruction after oral cancer resection.Methods:According to the characteristics of patients after oral tumor resection and reconstruction, a new type of patient clothing was designed. From January 2018 to June 2018, 79 patients with oral malignant tumor radical resection combined with reconstruction were selected as the control group, using traditional patient clothing. 64 patients with the same operation were selected as the experimental group from July 2018 to December 2018, and the new patient clothing was used. The time of changing clothing, wearing comfort and privacy protection, the convenience for medical staff to observe and change wound dressing were to evaluate.Results:The clothing change time of the patients was (124.00±23.35) s in the experimental group, and (156.09±25.66) s in the control group,the difference was statistically significant( t value was 14.97, P<0.01). The scores of clothing comfort and privacy protection were 8.23±0.91, 7.17±0.94 in the experimental group, and 4.78±0.94, 5.50±0.89 in the control group, the difference were statistically significant( t values were -15.21, -9.95, P<0.01). The scores of medical staff observing wounds and changing wound dressings were 7.88±0.89, 7.87±0.83 in the experimental group, and 4.15±0.78, 4.15±0.78 in the control group, the difference was statistically significant( t values were -18.98, -17.75, P<0.01). Conclusions:The new clothes is effective for patients with reconstruction after oral cancer resection. It can be popularized in patients with oral cancer resection and reconstruction.
ABSTRACT
Objective To investigate current status of knowledge-attitude-behavior about unplanned extubation (UEX) of central venous catheter among infusion nurses in Guangdong Province.Methods The nurses who attended the 2015 intravenous therapy nursing training provided by Guangdong Nursing Association were selected as participants.A self-designed questionnaire about nurses' knowledge-attitude-behavior about UEX of central venous catheter was used to investigate 450 nurses.Results The proportion of nurses who reached good level in knowledge were 41.1％,nurses who had positive attitude were 71.0％,nurses who had positive behaviors were 30.0％.There were significant differences among nurses with different educational background,different titles and different hospital ranks(P＜0.05).Conclusion The knowledge-attitude-behavior of nurses are not satisfactory,especially those who are junior or have lower education or work in non-tertiary hospital.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the value of G-banded karyotyping in combination with multiplex ligation-dependent probe amplification (MLPA) as a tool for the detection of chromosomal abnormalities in fetuses with congenital heart defects.</p><p><b>METHODS</b>The combined method was used to analyze 104 fetuses with heart malformations identified by ultrasonography. Abnormal findings were confirmed with chromosomal microarray analysis (CMA).</p><p><b>RESULTS</b>Nineteen (18%) fetuses were found to harbor chromosomal aberrations by G-banded karyotyping and MLPA. For 93 cases, CMA has detected abnormalities in 14 cases including 10 pathogenic copy number variations (CNVs) and 4 CNVs of uncertain significance (VOUS). MLPA was able to detect all of the pathogenic CNVs and 1 VOUS CNV.</p><p><b>CONCLUSION</b>Combined use of G-banded karyotyping and MLPA is a rapid, low-cost and effective method to detect chromosomal abnormalities in fetuses with various heart malformations.</p>
Subject(s)
Female , Humans , Pregnancy , Chromosome Aberrations , Chromosome Banding , Chromosome Disorders , Diagnosis , Genetics , DNA Copy Number Variations , Fetal Diseases , Diagnosis , Genetics , Genetic Testing , Methods , Heart Defects, Congenital , Diagnosis , Genetics , Karyotyping , Methods , Multiplex Polymerase Chain Reaction , Methods , Prenatal Diagnosis , Methods , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Objective To evaluate the efficacy of Alvenor on acute attack of hemorrhoids Methods We have enrolled 1?103 cases with acute attack of hemorrihoids from 29 hospitals in all over the country treated by Alvenor. Dosage was 1?500 mg twice daily for four days followed by 1?000 mg twice daily for 3 days Signs and symptoms of pain, bleeding, prolapse, edema, pruritus were scored at day 0, day 4 and day 7 Global treatment efficacy assessment was conducted by both the doctors and the patients themselves Statistical analysis was conducted Results Pain, bleeding, prolapse, edema, pruritus etc were significantly improved Conclusion Alvenor is effective in the treatment of patients with acute attack of hemorrhoids especially in relief of symptoms such as pain, bleeding, prolapse etc