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Liver transplantation has become the most effective treatment of end-stage liver disease. Nursing care for enhanced recovery is safe and effective in the management after liver transplantation, which is conducive to the early recovery of body function of the recipients. In this article, relevant literature review was conducted to summarize the standard operation procedure (SOP) of nursing care for enhanced recovery after liver transplantation from the postoperative vital signs and fluid temperature management, gastrointestinal function and nutrition management, early grading activities, sedation, analgesia and sleep management, infection prevention and control, etc.
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Objective To investigate the effects of breviscapine injection on intestinal mucosal barrier damage induced by intestine ischemia-reperfusion (IIR). Methods 44 old SD rats were randomly divided into four groups:sham,intestine ischemia-reperfusion(IIR),EB+IIR,LN+IIR. Breviscapine injection 20 mg/(kg·d) was given intraperitoneally in EB+IIR group. L-NAME(100 mg/kg)was given intravenously 30 min before surgery in LN+IIR group. Rats were subjected to superior mesenteric artery occlusion consisting of 45 min of ischemia and 4 h of reperfusion;sham laparotomy served as controls. Intestine pathology was assayed by H&E staining. Concen-trations of SIgA,iNOS,eNOS and NO in intestinal mucosa,also endotoxine in plasma,were determined by ELI-SA. Results IIR induced serious intestinal mechanical and immune barrier damage ,evidenced as poor intestine pathology,depression of intestinal SIgA and eNOS levels,elevation of intestinal iNOS/NO levels. However,brevis-capine injection pretreatment could promote eNOS/NO production ,down-regulated iNOS expression ,leading to ele-vating SIgA concentration in intestine ,attenuate endotoxemia induced by IIR. The protection was canceled when application of L-NAME. Conclusion Breviscapine pretreatment attenuates ischemia-reperfusion-induced intestinal mucosal barrier damage via promoting eNOS/NO production.
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Objective To study the expression of miR-146a in the serum of sepsis and the diagnostic value.Methods Serum miR-146a expression was detected in 98 patients diagnosed with sepsis,69 patients with severe sepsis and 30 healthy controls.ROC plots were used to evaluate the diagnostic value.Results The expression of miR-146a was decreased successively in healthy group,general sepsis group and severe sepsis group.In the diagnosis of sepsis,at the optimal expression cutoff miR-146a value of 0.805,the sensitivity was 0.967 and specificity 0.940,with an AUC of 0.983.In the diagnosis of sepsis severity degree,at the optimal expression cutoff miR-146a value of 0.530,the sensitivity was 0.796 and specificity 0.986,with an AUC of 0.943.Conclusion miR-146a can be a potential marker in diagnosis of sepsis and severity degree .
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Objective To explore the value of early arterial blood lactate clearance rate and central venous oxygen saturation (ScvO2 ) monitoring in patients with severe pneumonia .Methods A total of 56 patients with severe pneumonia treated during the period from January 2012 to December 2013 were reviewed retrospectively .The arterial blood lactate concentration and ScvO2 were determined immediately after admission to hospital and 6 hours after admission to calculate the 6‐hour lactate clearance rate .APACHE II score was evaluated at the same time .The patients were divided into three groups according to APACHE II score:10 to ＜20 (group A) ,20 to ＜30 (group B) ,≥30 (group C) .The three groups were compared in terms of early arterial blood lactate clearance rate and ScvO2 and estimate their association with the prognosis of patients .Results The initial arterial blood lactate concentration did not show significant difference between the three groups (P>0 .05) .The early lactate clearance rate and ScvO2 at 6 hours in group C were significantly lower than in group B .The values in group B were significantly lower than in group A (P＜0 .05) .The mortality rate in group C was significantly higher than in group B ,and the mortality rate in group B was significantly higher than in group A (P＜0 .05) .The APACHE II score of the dead patients was higher than that of the suevivors ,but early lactate clearance rate and ScvO2 level were lower than those of the survivors (P＜0 .05) .APACHE II score was negatively correlated to early lactate clearance rate (r=0 .661 ,P＜0 .01) and early ScvO2 level (r=0 .579 , P＜ 0 .01) .Conclusions Early lactate clearance rate and ScvO2 level are good indicators to reflect the severity of disease and predict the outcome in the patients with severe pneumonia .
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Objective To explore a set of suitable content and methods of evaluation for nursing students' humanistic quality. Methods Using dynamic evaluation theory, from three aspects of the evaluational main body, evaluation content and evaluation way, we assessed 261 nursing students' humanistic quality of the five-year undergraduate. Results Based on students' four consecutive years of assessment,results showed that the students' spirit had obviously changed, the students' comprehensive achievements had obviously promoted, the students' employment was obviously higher than other professionals and the students' degree of satisfaction from employing unit had increased yearly. Conclusions Dynamic evaluation can evaluate the best development of students, to strengthen nursing students' humanities education, to improve level of nursing students' humanities education, it is feasible in humanities education of higher nursing profession.
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Objective Analysis the risk factors which maybe caused the cerebral hemorrhage after the liver transplantation, and then make out the counter nursing measures. Methods Selected 12 patients with cerebral hemorrhage after the liver transplantation as the experimental group, and then matching 48 patients without cerebral hemorrhage after the liver transplantation as the control group. Analysis the factor which related the cerebral hemorrhage. Results The factors which related the cerebral hemorrhage after the liver transplantation included in the Intensive Care Unite, heme level, Child level, APTT, albumin, blooding volume during the operation, operation time and the postoperative blood platelet level. The factors of Child level and the blooding volume during the operation were the independence risk factors of cerebral hemorrhage. Conclusion The factors of Child level and the blooding volume during the operation were the independence risk factors of cerebral hemorrhage, we should carry out counter nursing measures to prevent them.