ABSTRACT
Objective To systematically review the obstacles that hindered participants to attend at or adhere to cardiac rehabilitation program. Methods We searched databases including PubMed, Medline, Ovid, EBSCO host, The Cochrane Library, CNKI and Wanfang Data, to find out qualitative and mix-method studies published from establish of data base to April 2017, which explore the barriers patients encountered when they decided to attend at a cardiac rehabilitation program or comply with cardiac rehabilitation suggestions. At the same time, quality of included studies was assessed. Data was synthesized using qualitative ethnography. Results A total of 13 qualitative researches were included in this systematic review. Synthesis of study yields three themes and nine sub-themes, which indicates that "personal factors" "program factors" and"contextual factors" interact and influence patients′ access to cardiac rehabilitation. Conclusions In order to improve participation rate in and firm adherence to cardiac rehabilitation, health workers should help patients to get deep insight into their conditions and cardiac rehabilitation; besides, cardiac rehabilitation prescription should be individually designed and take contextual factors into consideration.
ABSTRACT
Objective To study the value of intensive care nursing scoring system(ICNSS) on care resource allocation in intensive care unit(ICU). Methods 108 ICU patients were divided into the observation group (55 cases) and the control group (53 cases) randomly. In the observation group,the ICNSS scale was applied to evaluate nursing workload, and care resource was allocated according to intensive care nursing scoring. In the control group, care resource was allocated according to dynamic monitoring of acute physiology and chronic health evaluation (APACHE Ⅱ ) scoring. The ICU monitoring time,medical cost,incidence of complications during the hospitalization,satisfaction of the nurses and the patients or their relatives were compared between two groups. Results The ICU monitoring time,medical cost and incidenceof complications during the hospitalization in the observation group were significantly less than those in the control group, while the satisfaction of the nurses and the patients or their relatives in the observation group was markedly better than that in the control group. Conclusions Care resource allocation according to ICNSS is worthy of promotion and application in ICU because it can more significantly improve nursing quality,satisfaction of nurses and patients or their relatives than care resource allocation according to APACHE Ⅱ scoring.
ABSTRACT
BACKGROUND: With the development and application of molecular biology and molecular genetic techniques,people research the production of human insulin by means of genetic engineering,and consider from the molecular level to reconstruct the cloning cell line which excretes insulin,so as to replace insulin injection and islet transplantation to treat diabetes mellitus.OBJECTIVE: To construct and screen human insulin gene eukaryon expression carrier of high performance.DESIGN: A randomized control experiment.SETTING: Experimental Animal Department of China Medical University.MATERIALS: Forty healthy adult Kunming mice of clean degree, weighing 20-30 g, half males and half females, were provided by the experimental animal center of Munitions University of Chinese PLA,and they were free to the access of the artificial granule food and water,and all the mice were lighted for 14 hours every day. Escherichia coli DH5α and BHK cell line were preserved by the experimental animal center.METHODS: Recombinant plasmid pEF1α-ImINS was constructed with routine method.The baby hamster kidney (BHK) cells were transfected with recombinant plasmid pEF1α-ImINS and other 3 recombinant plasmids of insulin, then screened with G418, and the positive clone cells were passaged to the 20th generation, the expressions of insulin and/or proinsulin in BHK cells were detected with radioimmunoassay and immunohistochemical technique. The PBS suspension (5×107) and the supernatant (0.5 mL) of the 20th generation BHK positive cells trasnfected with pEF1α-ImINS were injected intraperitoneally to each mice, the blood glucose was detected before and after injection to analyze the biological effect of the transgeneic product in decreasing blood glucose.MAIN OUTCOME MEASURES: The integration and expression of insulin gene in BHK cells and the changes of blood glucose before and after injection were mainly observed.RESULTS: The highest insulin expression was 7.984 mIU/L,the gray value of insulin expression was 177.50±5.10 in the cytoplasm of BHK cells, and 150.30±1.43 in the nuclear. The blood glucose at 6 hours after injection of the suspension of pEF1α-ImINS transfected BHK clone cell strain was obviously decreased,which was very significantly different from that at 24 hours before injection (P ＜ 0.01).CONCLUSION: The recombinant plasmid pEF1α-ImINS is the plasmid with the highest expression of insulin in BHK cells.The pEF1α-ImINS transfected clone cell strain has insulin expressions in the mice, and plays a role in decreasing the blood glucose of normal mice.