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Objective:To construct the evidence-based care bundles for enteral nutrition-related diarrhea in ICU patients and evaluate its effectiveness.Methods:Evidence-based care bundles for enteral nutrition-related diarrhea in ICU patients were constructed according to the best evidence from 5 guidelines. 12 best evidences were summarized, and 12 cluster schemes for diarrhea management were constructed. 175 patients admitted to ICU of Shandong Provincial Hospital Affiliated to Shandong First Medical University from June to December 2020 were selected as the pre implementation group which was given enteral nutrition nursing according to routine nursing measures, and 186 patients admitted to ICU from March to October 2021 were selected as the post implementation group which received nrusing care with evidence-based cluster schemes. The rate of diarrhea in ICU patients undergoing enteral nutrition support before and after using best evidence was compared, and awareness of best evidence among nurses before and after training, and implementation of various measures by nurses after the plan were also compared.Results:After the care bundles were applied, the incidence of diarrhea decreased from 26.29% (46/175) to 11.83% (22/186) with statistically significant difference ( χ2=12.33, P<0.05). The diarrhea knowledge score was improved from 52-100 (75.79 ± 10.18) points to 72-100 (90.00 ± 6.71) points and had a significant difference ( t=-8.88, P<0.05). After the care bundles were applied, the rate of ICU nurses′ diarrhea identification and evaluation, analysis of influencing factors of enteral nutrition associated diarrhea, nasal feeding, selection of enteral nutrition formula and drug were 94.83% (55/58), 91.38% (53/58), 100.00 (58/58), 93.10% (54/58), 94.83% (55/58),significantly improved than 68.97% (40/58), 63.79% (37/58), 81.03% (47/58), 62.07% (36/58), 70.69% (41/58) before applied ( χ2 values were 8.66-14.33, all P<0.01). The implementation rate after the plan was more than 95.00%. Conclusions:The application of the evidence-based care bundles can effectively reduce the incidence of enteral nutrition diarrhea in ICU patients, improve nursing practice and the quality of care.
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objective:This paper summarizes the nursing care of a case of severe acute pancreatitis complicated with intra-abdominal hypertension by ultrasonic-guided enema.Methods:One patient with severe acute pancreatitis internal high pressure from February 28, 2021 in Shandong Provincial Hospital Affiliated to Shandong First Medical University setting indiidualized enema scheme, advantage of the characteristics of ultrasonic visualization, before and after the enema examine case of intestinal cleaning and waste water accumulation, enema, positioning enemator catheter and cutting-edge position, ensure the accuracy of the enema, normal irrigation using configuration at the same time, the relaxation anal sphincter and so on, to observe the therapeutic effects enema.Results:After careful treatment and nursing, the patient achieved satisfactory results of exhaust and defecation, enema, abdominal distention improved, intra-abdominal pressure returned to normal, 10 days later, the condition was stable and transferred to the general ward.Conclusions:For the nursing of patients with severe acute pancreatitis complicated with intra-abdominal hypertension, it is particularly important to reduce intra-abdominal pressure by enema. Nurses should make reasonable use of new technology to implement individualized enema nursing, promote the excretion of stool, reduce intra-abdominal pressure, and facilitate the early recovery of the disease.
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Objective:To study the application of the best evidence of dysphagia recognition in acute stroke patients.Methods:The study was performed guided by JBI evidence-based continuous quality improvement pattern, including evidence acquisition, baseline audit, evidence implementation and re-audit. Data were collected by using field observation, questionnaire survey and review of nursing records. 80 patients and 18 nurses were recruited in the study. Barriers to evidence implementation and available solutions were analyzed. Before and after the application of evidence, the compliance of audit criterion, screening rate of swallowing disorder, screening accuracy, screening record rate and knowledge of nurses were compared.Results:Before and after the implementation of evidence, the compliance of all audit criterion was 0-33.3% and 95.0%-100.0%, and had a significant difference ( P<0.05). The dysphagia recognition knowledge score was improved from 40-80(60.56±10.69) to 60-100 (82.78±10.18) and had a significant difference ( t value was -6.39, P<0.05). The screening rate for dysphagia increased from 7.5% to 95.0%, with statistically significant difference ( χ2 value was 119.10, P<0.05). The screening accuracy was 100%, and the screening record rate was 97.4%, only 4 of the 24 patients at risk of dysphagia developed pulmonary infection. Conclusion:The application of the best evidence of dysphagia recognition in acute stroke patients can improve the nurses′ ability of dysphagia screening and improve nursing practice in dysphagia management.
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Objective:To explore the effect of chest physical therapy guided by ultrasound in patients with severe pneumonia.Methods:One hundred patients with mechanical ventilation in the ICU were divided into a control group and a test group according to the occupancy time. The control group was given chest physical therapy according to routine imaging data and pulmonary auscultation. The experimental group was given physical therapy of the chest according to the routine imaging and pulmonary auscultation, also according to the BLUE ultrasound protocol. The mechanical ventilation time, ICU hospitalization time and the drainage capacity of 1 day, 2 days, 4 days, and 7 days after treatment were observed.Results:The mechanical ventilation time was (7.82±1.38) days and ICU hospitalization time were (10.16±1.88) days in the test group. The mechanical ventilation time was (10.14±1.73) days and ICU hospitalization time were (12.78±2.11) days in the control group. There were significant differences between the two groups ( t=7.42, 6.56, P<0.05). There was a significant difference in the ability of spontaneous drainage on the 4th and 7th day after treatment between the two groups ( Z=-2.47, -2.52, P<0.05). The sputum ability on the first and second day after treatment were not statistically significant between the two groups ( P>0.05). Conclusions:Pulmonary ultrasound can continuously monitor lung changes. Nurses can perform targeted nursing treatment on the basis of ultrasound.
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Objective@#To explore the effect of chest physical therapy guided by ultrasound in patients with severe pneumonia.@*Methods@#One hundred patients with mechanical ventilation in the ICU were divided into a control group and a test group according to the occupancy time. The control group was given chest physical therapy according to routine imaging data and pulmonary auscultation. The experimental group was given physical therapy of the chest according to the routine imaging and pulmonary auscultation, also according to the BLUE ultrasound protocol. The mechanical ventilation time, ICU hospitalization time and the drainage capacity of 1 day, 2 days, 4 days, and 7 days after treatment were observed.@*Results@#The mechanical ventilation time was (7.82±1.38) days and ICU hospitalization time were (10.16±1.88) days in the test group. The mechanical ventilation time was (10.14±1.73) days and ICU hospitalization time were (12.78±2.11) days in the control group. There were significant differences between the two groups (t=7.42, 6.56, P<0.05). There was a significant difference in the ability of spontaneous drainage on the 4th and 7th day after treatment between the two groups (Z=-2.47, -2.52, P<0.05). The sputum ability on the first and second day after treatment were not statistically significant between the two groups (P>0.05).@*Conclusions@#Pulmonary ultrasound can continuously monitor lung changes. Nurses can perform targeted nursing treatment on the basis of ultrasound.
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Objective@#To investigate the effect of glycogen synthase kinase 3β (GSK3β) on the decreased expression of Bmal1 induced by amyloid-beta protein 31-35 (Aβ31-35) in HT22 cells.@*Methods@#HT22 mouse hippocampal cells were divided into control group, Aβ31-35 group and LiCl+Aβ31-35 group by random number table method in the present study. Cells were synchronized to G0/G1 phase by 1% serum starvation for 1 hour (circadian time 0 (CT0)). Cell viability was detected by the cell counting kit-8 assay. The mRNA expression of clock gene Bmal1 was examined by real-time PCR at different CT times. The expression of GSK3β and BMAL1 protein was detected by Western blotting.@*Results@#Compared with the control group, Aβ31-35 induced the decreased expression of Bmal1 mRNA; The expression of both Bmal1 mRNA and BMAL1 protein was decreased significantly at CT20 (Bmal1 mRNA: 0.38±0.06 vs 0.83±0.08, t=4.549, P=0.001; BMAL1 protein: 0.67±0.04 vs 1.00±0.04, t=5.943, P<0.001). In the Aβ31-35 group, GSK3β activity was increased and the ratio of phosphorylated GSK3βS9 to GSK3β was decreased compared to the control group (0.66±0.08 vs 1.02±0.14, t=2.217, P=0.025). Aβ31-35 decreased the viability of HT22 cells (71.85%±6.20% in the Aβ31-35 group vs 98.14%±2.68% in the control group, t=3.891, P=0.006), and the GSK3β inhibitor LiCl pretreatment effectively reversed the decline of the viability induced by Aβ31-35 (90.74%±5.74% in the LiCl+Aβ31-35 group vs 71.85%±6.20% in the Aβ31-35 group, t=3.412, P=0.010). LiCl (in the LiCl+Aβ31-35 group) increased the expression of Bmal1 mRNA and BMAL1 protein significantly at CT20 compared with the Aβ31-35 group (Bmal1 mRNA: 0.72±0.05 vs 0.38±0.06, t=4.378, P=0.001; BMAL1 protein: 0.90±0.04 vs 0.67±0.04, t=4.052, P=0.002).@*Conclusion@#Increased GSK3β activity involved in the decreased expression of Bmal1 induced by Aβ31-35 in HT22 cells.
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Objective@#To investigate the effect of glycogen synthase kinase 3β (GSK3β) on the decreased expression of Bmal1 induced by amyloid-beta protein 31-35 (Aβ31-35) in HT22 cells.@*Methods@#HT22 mouse hippocampal cells were divided into control group, Aβ31-35 group and LiCl+Aβ 31-35 group by random number table method in the present study. Cells were synchronized to G0/G1 phase by 1% serum starvation for 1 hour (circadian time 0 (CT0)). Cell viability was detected by the cell counting kit-8 assay. The mRNA expression of clock gene Bmal1 was examined by real-time PCR at different CT times. The expression of GSK3β and BMAL1 protein was detected by Western blotting.@*Results@#Compared with the control group, Aβ31-35 induced the decreased expression of Bmal1 mRNA; The expression of both Bmal1 mRNA and BMAL1 protein was decreased significantly at CT20 (Bmal1 mRNA: 0.38±0.06 vs 0.83±0.08, t=4.549, P=0.001; BMAL1 protein: 0.67±0.04 vs 1.00±0.04, t=5.943, P<0.001). In the Aβ31-35 group, GSK3β activity was increased and the ratio of phosphorylated GSK3βS9 to GSK3β was decreased compared to the control group (0.66±0.08 vs 1.02±0.14, t=2.217, P=0.025). Aβ31-35 decreased the viability of HT22 cells (71.85%±6.20% in the Aβ31-35 group vs 98.14%±2.68% in the control group, t=3.891, P=0.006), and the GSK3β inhibitor LiCl pretreatment effectively reversed the decline of the viability induced by Aβ31-35 (90.74%±5.74% in the LiCl+Aβ31-35 group vs 71.85%±6.20% in the Aβ31-35 group, t=3.412, P=0.010). LiCl (in the LiCl+Aβ31-35 group) increased the expression of Bmal1 mRNA and BMAL1 protein significantly at CT20 compared with the Aβ31-35 group (Bmal1 mRNA: 0.72±0.05 vs 0.38±0.06, t=4.378, P=0.001; BMAL1 protein: 0.90±0.04 vs 0.67±0.04, t=4.052, P=0.002).@*Conclusion@#Increased GSK3β activity involved in the decreased expression of Bmal1 induced by Aβ31-35 in HT22 cells.
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Objective To investigate the effect of glycogen synthase kinase 3β (GSK3β) on the decreased expression of Bmal1 induced by amyloid-beta protein 31-35 (Aβ31-35) in HT22 cells.Methods HT22 mouse hippocampal cells were divided into control group,Aβ31-35 group and LiCl+Aβ 31-35 group by random number table method in the present study.Cells were synchronized to G0/G1 phase by 1％ serum starvation for 1 hour (circadian time 0 (CT0)).Cell viability was detected by the cell counting kit-8 assay.The mRNA expression of clock gene Bmal1 was examined by real-time PCR at different CT times.The expression of GSK3β and BMAL1 protein was detected by Western blotting.Results Compared with the control group,Aβ31-35 induced the decreased expression of Bmal1 mRNA;The expression of both Bmal1 mRNA and BMAL1 protein was decreased significantly at CT20 (Bmal1 mRNA:0.38±0.06 vs 0.83±0.08,t=4.549,P=0.001;BMAL1 protein:0.67±0.04 vs 1.00±0.04,t=5.943,P＜0.001).In the Aβ31-35group,GSK3β activity was increased and the ratio of phosphorylated GSK3βS9 to GSK3β was decreased compared to the control group (0.66±0.08 vs 1.02±0.14,t=2.217,P=0.025).Aβ31-35 decreased the viability of HT22 cells (71.85％±6.20％ in the Aβ31-35 group vs 98.14％±2.68％ in the control group,t=3.891,P=0.006),and the GSK3β inhibitor LiC1 pretreatment effectively reversed the decline of the viability induced by Aβ31-35 (90.74％±5.74％ in the LiCl+Aβ31-35 group vs 71.85％±6.20％ in the Aβ31-35 group,t=3.412,P=0.010).LiCl (in the LiCl+Aβ31-35 group) increased the expression of Bmal1 mRNA and BMAL1 protein significantly at CT20 compared with the Aβ31-35 group (Bmal1 mRNA:0.72±0.05 vs 0.38±0.06,t=4.378,P=0.001;BMAL1 protein:0.90±0.04 vs 0.67±0.04,t=4.052,P=0.002).Conclusion Increased GSK3β activity involved in the decreased expression of Bmal 1 induced by Aβ31-35 in HT22 cells.
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Objective To understand the personality characteristics of excellent and generalnurses, extract personality characteristics from excellent nurses, and to establish Personality Characteristics Questionnaire and post personality model of nurses, and explore influencing factors of nurses personality characteristicsfor providing a theoretical reference in selection and training of nurses. Methods A total of 523 staff nurses from one class 3-A hospital general hospitalsin Shandong province were investigated with Sixteen Personality Factor Questionnaire(16PF). Results Excellent nurses possessed higher dominance, rule-consciousness, social boldness, shrewdness, perfectionism and lower apprehension than general nurses (t=-2.54-2.92, P<0.05), then six personality characteristics were extracted from excellent nurses to establish Personality Characteristics Questionnaire and post personality model of nurses; The difference was statistically significant in perfectionism with different age, work experience, and professional title in excellent of nurses (F=4.04-7.36, P < 0.05). Conclusions 16PF is suitable for evaluating personality characteristics of nurses, the personality characteristics questionnaire and post personality model can be used as selection criteria for new nurses.
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A sensitive and selective method based on gas chromatography hyphenated to mass spectrometry (GC-MS) was developed and validated for the determination of atractylon in rat plasma. Plasma samples were processed by liquid-liquid extraction with ethyl acetate-n-hexane (1:1, v/v) using acetophenone as an internal standard (IS). Analytes were determined in selective ion monitoring (SIM) mode using target ions at m/z 108.1 for atractylon and m/z 105.1 for acetophenone. The calibration curve was linear over the concentration range of 10-1000 ng/mL with lower limit of quantification of 10 ng/mL. The intra- and inter-day precision variations were not more than 10.4% and 9.6%, respectively, whilst accuracy values ranged from -6.5% to 4.9%. Extraction recovery of the assay was satisfactory. This method was suc-cessfully applied to quantification and pharmacokinetic study of atractylon in rat plasma after in-tragastric administration of Atractylodis extract.
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Objective To investigate the Survivin and Cyclooxygenase-2 (COX-2) expression and their relationship in cervical carcinoma tissues and to investigate the relationship with the genesis and devclopment of cervical carcinoma.Methods The expression of Survivin and COX-2 was assayed by immunohistochemical technique in 60 cervical carcinoma and 30 normal cervical tissue specimens.The relation with its clinical pathology characters were analysed.Results Survivin and COX-2 expression in the tissues of cervical carcinoma [76.7 ％ (46/60),63.3 ％ (38/60)] were higher than that in normal cervical tissues evidently [6.7 ％ (2/30),10.0 ％ (3/30)] (P ＜ 0.05).The COX-2 expression in cervical carcinoma was positively associated with lymph node metastasis (P ＜ 0.05),but no correlation was found between COX-2 expression and age,clinical stages,grades and invasive depth (P ＞ 0.05).Any correlation between Survivin expression and classical prognostic factors of cervical carcinoma was found.Moreover,these two proteins were positively correlated.Conclusion The Survivin and COX-2 might play important roles in the development of cervical carcinoma.
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Objective To investigate the clinical feature and strategy on diagnosis and treatment of cervical ulcer in Behcet's disease. Methods From Jan 2000 to Apr 2008,the medical documents of 6 cases with cervical ulcer in Behcet's disease were reviewed retrospectively, who were treated in No.2 hospital affiliated to Wenzhou Medical School Results (1) General information : all 6 patients with cervical ulcer were diagnosed as Behcet's disease clinically, the mean age of all patients is 33.5 years. (2) Clinical feature: the initial symptoms was oral ulcer in 5 cases and erythematic nodosum in 1 case. The typical characteristics of cervical ulcer in Behcet's disease was vaginal purulent discharge. Five among 6 cases presented it. The cervical ulcer in Behcet's disease exhibited the following features : the isolated well-defined ulcers with different size and different deep distributed on the uterine cervix, and the top of ulcer was covered by yellow discharge which was not easy to erase. The duration between the onset symptom and cervical ulcer was calculated to be 2.1 to 7 years. (3) Risk factors for cervical ulcer: operation of drawing intrauterine devices (IUD) in 2 cases, artifical abortion in 2 cases, cervical biopsy in 1 cases, and no factors in the other one case was identified. (4)Treatment: The cervical ulcer in Behcet's disease can be treated by the topical application of recombinant bovine basic fibroblast growth factor (rb-bFGF). If ulcer disease existing in other site, systemic corticosteroids management was warranted. (5) Recurrence : 1 case with recurrent disease was observed after 8 months when completing treatment, the other 5 cases did not show recurrence during 3 months-8 years follow-up. Conclusions The cervical ulcer in Behcet's disease most commonly occurred after cervical operation. The diagnosis should be derived from comprehensive symptoms analysis. The topical application of rb-bFGF on ulcer site of cervix could get satisfied outcome. When necessary, systemic corticosteroids administration could be considered.
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Objective This study aimed to explore issues about dysandia female during pregnancy,peripartum and contraception and to supply reference for their reproductive health improvement. Methods Purposive sampling strategy was used. With the aid of an interview guide, 12 dysaudia women who met inclu-sion and exclusion criteria were invited to be interviewed. Interviews were recorded, validated and then ana-lyzed. Results Four themes were generated, limited knowledge, passive information acquisition, total depen-dence on family and reluctant to talk about contraception. Total dependence on family was noticeable during pregnancy and peripartum. Though little was known about health protection related to pregnancy, peripartum and contraception, participants were passive at seeking for relevant information. Conclusions Deaf women may experience more threats to reproductive health in relation to pregnancy, peripartum and contraception that they require more guidance and assistance.
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Objective To study the action of enantone in chocolate cyst after laparoscopic surgery. Methods To devide the 76 patients into two groups, study group(50 patients, additional enantone after laparoscopic surgery) and the control group (26 patients, only laparoscopic surgery), to analyse their recurrence rate and pregnancy rate. Results The recurrence rate of study group was obviously lower than control group. In the 48 patients with infertility, the pregnancy rate of study group was higher than control group. Conclusions In chocolate cyst after laparoscopic surgery, enantone can decrease the recurrence rate and increase pregnancy rate.