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Objective:To investigate the status of aged nursing assistants post competency under the regional linkage mechanism in the elderly and the impact on nursing staff post competency factors.Methods:In December 2019, in Baoshan district of Shanghai elderly regional linkage center, the 159 nursing staff from 8 medical institutions were selected by stratified cluster random sampling method and investigated by the post competency questionnaire.The post competency of nursing staff was evaluated from three dimensions of work attitude, work ability and communication adjustment.Results:A total of 157 elderly care workers participated in the survey, age was (50.9±5.4)years old. The total score of post competency was (73.21±14.26) points, which belonged to the general level. In three dimensions,the work attitude dimension scored the highest, (28.92±7.40) points, and the communication adjustment dimension score was the lowest, (21.08±6.41) points. Among the items, the item of "ethics" had the highest score, and the item of "resolving contradictions" had the lowest score. Single factor analysis showed that there were differences in job competency of aged nursing assistants with different educational levels, with or without work experience, length of service ( F values were 1.229, 0.068, t value was 1.147, all P<0.05). Multiple linear regression analysis showed that the work experience of senior care workers ( B value was 0.435, P<0.05), length of service ( B value was -1.792, P<0.05) were the factors that affected the competency of aged nursing assistants. Conclusions:The work attitude, basic knowledge, work enthusiasm, and basic care skills of elderly care workers in the district have been effectively supervised under the regional linkage mechanism for the elderly, but they are relatively weak in solving conflicts, communication skills, thinking skills, and listening skills. Therefore, the role of the regional linkage mechanism for the elderly should be strengthened to improve the job competence of the elderly care workers in the grass-roots medical institutions, thereby improving the service level of the elderly and improving the quality of elderly care.
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Objective To explore the feasibility and safety of kidney transplantation for pre-sensitized infants using deceased donors and summarize the relevant literature reports .Methods A second kidney transplantation was successfully performed for an 8-month-old pre-sensitized girl in July 2017 .She had a low level of donor specific antibody (DSA ) against human leucocyte antigen (HLA ) B62 due to severe acute rejection (AR) after her first kidney transplantation .For desensitization , plasmapheresis and intravenous immunoglobulin plus anti-CD20 antibodies were offered on operative day .Clinical data and outcomes were retrospectively analyzed .Results Renal graft regained immediate function after transplantation .Preformed DSA could be detected at 1 week .However ,there was no de novo DSA .At 1 year post-transplantation ,preformed DSA turned negative .During a follow-up period of 2 years ,renal graft showed an excellent function with a serum creatinine of 31 μmol/l and eGFR of 110 ml/min/1 .73m2 .No AR episode or proteinuria occurred .DSA stayed negative .Simultaneously physical development also caught up .Her height of 93 cm tall and weight of 13 .5 kg at month 24 & 8 months corresponded to normal grow th curve of her age .Conclusions Pre-sensitized infant could tolerate desensitization therapy well and achieve satisfactory outcomes .With surgical precisions and optimized managements ,kidney transplantation provides excellent renal functions and survivals for infants with organs from deceased donors .
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Severe acute pancreatitis (SAP) is still with a high incidence and mortality. Early onset is usually non-infectious inflammation caused by systemic inflammatory response syndrome (SIRS), with the further progress into pancreatic necrosis, which is the main cause of death. The occurrence of infection can induce or aggravate multiple organ failure (MOF), leading to death. Therefore, whether early use of antibiotics to prevent the occurrence of pancreatic infection and how to identify early pancreatic infection, how to choose the start of antibiotic therapy is the hot and difficult point of current study. Although multiple versions of the acute pancreatitis (AP) treatment guidelines don't recommend to prevent the use of antibiotics, its compliance in clinical practice is not high, which is explored in clinical research. This paper summarized the progress on research status of antibiotics for AP, to provide basis for the establishment of treatment of AP.
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@#Objective To observe the expression of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway in substantia nigra in rats with Parkinson's disease (PD). Methods A total of 96 Sprague-Dawley rats were randomly divided into sham group, model group, PI3K inhibitor LY294002 group and mTOR inhibitor rapamycin group. Each group was divided into 4 days and 8 days subgroups after the model. PD model was established by injecting rotenone subcutaneously. The expres-sion of PI3K, p-Akt and p-mTOR in substantia nigra was detected with immunohistochemistry and Western blotting. Results Compared with the sham group, the expression of PI3K, p-Akt and p-mTOR increased in the model group (P<0.05), and was more in 8 days subgroup than in 4 days subgroup (P<0.05). Compared with the model group, the expression of p-Akt and p-mTOR reduced in the LY294002 group (P<0.05), while the expression of PI3K varied little (P>0.05);the expression of p-mTOR decreased in the rapamycin group (P<0.05), while the expression of PI3K and p-Akt varied little (P>0.05). Conclusion PI3K/Akt/mTOR signaling pathway is over activated in substantia nig-ra in rats with Parkinson's disease, which may play an important role in occurrence and development of the disease.
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Aim To investigate the protective effects of beraprost sodium on cerebral cortical neuron injury in chronic aluminum-overload rats and its effects on PGIS-IP signaling pathway. Methods 75 SD rats were randomized into five groups: normal control group, chronic aluminum-overload group ( model group) and beraprost sodium groups-low dose (6 μg· kg-1 ), medium dose ( 12 μg · kg-1 ) and high dose (24 μg·kg-1). Aluminum gluconate (Al3+ 200 mg ·kg-1 d-1, once a day, 5d a week, for 20 weeks, p. o. ) was administered to rats of cerebral damage model. The rats of experimental groups were concomi-tantly treated with beraprost sodium ( p. o. ) daily for 20 weeks. After the model was built successfully, the spatial learning and memory( SLM) function was done by Morris water maze. The cortical neurons damage was detected by HE staining, SOD activities and MDA contents. The 6-k-PGF1α levels in cortex were meas-ured by ELISA. The expressions of PGIS, IP mRNA and IP protein were also studied. Results Compared with the rats of normal control group, the SLM function was significantly impaired ( P<0. 01 ) and considera-ble karyopycnosis was observed in model group rats. The SOD activities were weakened ( P <0. 01 ), the MDA contents increased ( P<0. 05 ) and the levels of 6-k-PGF1α raised significantly ( P <0. 01). The ex-pressions of PGIS and IP mRNA in the rats cortex obvi-ously increased ( P<0. 01 ), so did the expression of IP protein(P<0. 05). Compared with the rats of mod-el group, the SLM function of rats in experimental groups decreased significantly ( P<0. 01 ) and damage of cortical neurons reduced remarkably. The SOD ac-tivities increased ( P <0. 01 ) and the MDA contents decreased ( P <0. 01). Besides, the content of 6-k-PGF1α, the expressions of PGIS mRNA and IP protein in the rats cortex decreased significantly ( P<0. 05 ) as well as IP mRNA ( P<0. 01). Conclusion Our re-sults demonstrate that in cerebral cortical neuron of chronic aluminum-overload rats, beraprost sodium has notably protective effects and the mechanism might be related to PGIS-IP signaling pathway.