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Objective:To evaluate the effects of oropharyngeal administration of colostrum on feeding intolerance in preterm infants.Methods:A total of 87 preterm infants from December 2016 to December 2017 in the Second Affiliated Hospital of Wenzhou Medical University were distributed to the study group(41 cases) and the control group(46 cases) by random digits table method. The study group got oropharyngeal administration of 0.4 ml of own mother’s colostrum three times a day for 5 days. The control group got sterile water. The research data included early gastric residual volumes(the first to fourteenth day), gastric residual times and feeding status.Results:The gastric residual volumes on the eighth day, the eleventh day, the twelfth day were 8.5(0, 18.25), 0(0, 13.50), 2.5(0, 5.00) ml in the control group and 0(0,9.00), 0(0,1.00), 0(0,2.50) ml in the study group, the differences were statistically significant ( t values were -2.001, -1.987, -2.061, all P<0.05). The gastric residual times on the eighth day, the eleventh day were 1.5(0, 4.0), 0(0, 2.0) times in the control group, and 0(0, 1.0), 0(0, 0.5) times in the study group, the differences were statistically significant ( t values were -1.984, -2.267, all P<0.05).The vomiting times on the tenth day, the twelfth day were 0(0, 1.0), 0(0, 1.0) times in the control group and 0(0, 0.0), 0(0, 0.0) times in the study group, the differences were statistically significant ( t values were -3.149, -2.098, P<0.01 or 0.05). The time reaching full enteral feeding was (17.45±10.44) d in the study group, and (21.62±5.52) d in the control group, the difference was statistically significant ( t value was -2.022, P<0.05). Conclusions:Oropharyngeal administration of colostrum can better the condition of feeding intolerance.
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Objective To explore the effect of application of task-based learning with experiential teaching on nursing clinical decision making ability. Methods A total of 96 nursing students were divided into experimental group and observation group with each of 48 nursing students. The experimental group used the application of task-based learning with experimental teaching, the control group used the traditional scenario simulation. At the end of the course, the final scores, skill operation scores and nursing students'evaluation of the course and clinical decision-making ability of nursing were observed in the two groups. Results The final scores, chapters related to task-based learning with experiential teaching, skill operation scores was (82.06±0.98), (12.01±0.88), (94.99±0.34) points in the experimental group, and (78.34±0.98), (9.32±0.76), (91.87±0.98) points in the control group, and the difference was significant(t=12.958, 9.872, 10.834, all P<0.01). The evaluation of teaching methods, teaching process and teaching effect was (20.06±0.98), (23.01±0.88), (35.99±0.34) points in the experimental group, and (17.34±0.98), (20.32±0.76), (30.87±0.98) points in the control group, and the difference was significant (t=5.96, 6.87, 6.99, all P<0.01).The score of clinical decision-making ability of nursing was (137.50 ± 12.61) points in the experimental group, and (123.88±9.89) points in the control group,and the difference was significant (t=5.891, P<0.01). Conclusions The effect of task-based learning with experiential teaching in teaching of nursing in vocational nursing students, enable students to transfer knowledge and experience in experience, it can improve the students' clinical decision making ability.
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Objective To explore the effect of four-element teaching design model based on comprehensive learning in teaching of basic nursing in vocational nursing students. Methods Ninety-six nursing students at Taizhou Vocational and Technical College in Zhejiang Province were selected as the study subjects. Ninety-six nursing students were divided into the experimental group and the control group with 48 nursing students in each. The experimental group used four-element teaching design model for teaching, and the control group adopted traditional teaching methods.The testing results and evaluation of nursing students for this curriculum were compared. Results The theoretical assessment and skill assessment of nursing students in the experimental group were 82.09±8.05 and 90.65±4.93 respectively, and in the control group were 76.30±10.20, 85.33±6.01. The difference was statistically significant (t =3.06,4.74, P<0.01). The scores of curriculum setting, teaching methods, assessment methods, and teaching effects in the experimental group were evaluated as 35.08±3.64, 42.06±4.75, 18.15±1.60, 40.35±6.20, in the control group were 29.63 ± 4.65, 36.02 ± 6.20, 14.04 ± 2.69, 36.35 ± 6.56. The difference was statistically significant (t=3.07-9.09, P<0.01). Conclusion The four-element teaching design model based on comprehensive learning can improve the students′ learning initiative and teaching effect of basic nursing, promote the coordinated development of nursing students'professional knowledge, skills and professional ability.
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Objective To investigate the status quo of junior nurses' nursing work environment and clinical decision making perception,and to analyze the influence of nursing work environment on clinical decision making perception.Methods The general data questionnaire,nursing work environment scale and clinical decision making perception scale was used to investigate 633 Junior nurses in hospitals.Results The overall mean score of nursing work environment was (2.99±0.37) points,the dimensions score from high to low were:medical cooperation (3.12 ± 0.47) points,nursing management and leadership style (3.06 ± 0.47) points,nurse participation in hospital affairs (2.91 ±0.48) points,high quality nursing service (2.78 ± 0.48) points,sufficient manpower and material resources (2.75 ± 0.52) points,;clinical decision—making perception of Junior nurses was (143.36 ± 14.01) points,the dimensions score from high to low were:the decision—evaluative feedback (37.31 ± 4.53) points,determine the goal of solving the problem (36.16 ± 4.39) points,find the information again (35.04 ± 3.76) points,gather information ability (30.98 ± 3.80) points.The Total score of nursing work environment were positively correlated with the clinical decision making perception of junior nurses(r =0.08-0.28,P＜ 0.01).Conclusions Junior nurse's nursing work environment remains to be improved,nursing work environment has a good effect on clinical decision making perception,therefore,nursing managers should create a positive working atmosphere.It is beneficial to improve the awareness of nursing clinical decision-making by giving specific support to the needs of junior nurses.
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Background Corneal epithelial remodeling will happen after laser refractive surgery,But there have been few studies to evaluate the changes of the corneal epithelial thickness after integrated transepithelial photorefractive keratectomy (TranspRK).Objective This study was to evaluate the changes in epithelial thickness profile within the optical zone and its related factors following TransPRK for myopia.Methods In this retrospective non-randomized controlled study,forty-three patients (43 eyes) who underwent TransPRK with the spherical equivalent refraction-1.25 to-6.25 D from August 2014 to May 2015 in Jinan Mingshui Eye Hospital were included under the informed consent.Epithelial thickness was measured using spectral-domain optical coherence tomography in different corneal zones (central,2 mm;paracentral,2-5 mm,and mid-peripheral,5-6 mm) preoperatively at 1 week and 1,3,and 6 months postoperatively.Correlations between epithelial thickness changes and the amount of correction,optical zone,and Q-value changes (△Q) were analyzed 6 months postoperatively.Results The mean epithelial thickness in the central zone were (53.97±4.33),(51.03 ±4.11),(55.14±5.46) and (56.68 ± 5.09) μm at 1 week,1 month,3 months and 6 months after surgery,respectively.The epithelium were thicker at 3 months and 6 months after surgery compared to preoperative measurements ([52.37±3.42] μm),with significant differences between them (both at P＜0.05).Compared to preoperative values,the epithelial thickness at 6 months after surgery was (3.69 ±4.23),(5.19 ±3.88) and (6.23 ±3.91) μm thicker in the center,paracenter,and midperiphery zone,respectively,with significant differences between them (all at P ＜ 0.01).Epithelial thickness was positively correlated with programmed spherial equivalent correction and △Q (all at P＜0.05).A significant positive relationship was observed between epithelial thickening and ablation depth paracentrally and mid-peripherally (r=0.380,0.383;both at P＜0.05).Significantly negative relationships were observed between epithelial thickening and optical zone at the center,paracenter,and mid-periphery,respectively (r =0.405,0.485,0.384;all at P＜0.05).No correlation betwcen epithelial thickness change and ablation depth at the central zone was detected (P＞0.05).Conclusions The epithelial thickness shows a lenticular change with more thickening mid-Peripherally after TransPRK,which results in increased oblateness postoperatively.Epithelial remodeling may modify the profile after surface ablation.
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Background Integrated transepithelial photorefractive keratectomy (TransPRK) is a new kind of surface ablation and has a fast reepithelialization and uncorrective visual acuity (UCVA) recovery as well as slighter postoperative pain,and epipolis laser in situ keratomileusis (Epi-LASIK) has been recognized to be an effective method for myopia.But there have been few studies to evaluate the dynamic change of the corneal biomechanical properties and posterior corneal elevation after TransPRK.Objective This study was to assess and compare the effectiveness and safety between TransPRK and Epi-LASIK for myopia with thin cornea.MethodsThis study was approved by Ethic Committee of Jinan Mingshui Eye Hospital,and written informed consent was obtained from each patient.In this prospective non-randomized controlled study,93 right eyes of 93 myopic patients with the central corneal thickness 460 to 500 μm were included in Jinan Mingshui Eye Hospital from June to December 2013 under the informed consent.The eyes were divided into TransPRK group for 46 eyes and Epi-LASIK group for 47 eyes.UCVA,manifest refraction,haze,corneal biomechanical properties,posterior corneal elevation,Qvalue and corneal high order wavefront aberration were analyzed before and 1 week,1 month,3 months and 6 months after operation,respectively,and the examination results were compared between the two groups.Results There was no statistically significant difference in the eyes of postoperative UCVA and manifest refraction between the TransPRK group and the Epi-LASIK group at various time points (all at P＞0.05).Six months after surgery,the percentage of eyes with UCVA of 1.0 or better was 93.9％,and 90.9％ eyes exhibited the targeted refraction in ± 1.00 D in the TransPRK group.Corneal haze was most obvious 1 month after surgery in both groups,with the incidence of 32.6％ (15/46) in the TransPRK group and 17.4％ (8/47) in the Epi-LASIK group,but no significant difference was found in the eye numbers with haze between the two groups (x2 =2.841,P =0.092).No significant differences were seen in the corneal hysteresis(CH) values and corneal resistance factor(CRF) values between the two groups (CH:Fgroup =0.000,P =0.999;CRF:Fgroup =0.110,P =0.741),however,the postoperative CH values and CRF values were significantly declined in comparison with preoperative ones,with significant differences among various time points (CH:Ftime =103.658,P =0.000;CRF:Ftime =132.008,P =0.000),while there were no remarkable differences between any two time points in postoperation (all at P＞0.05).Posterior corneal surface height shifted rearward 1 week,1 month,3 months and 6 months after surgery,showing remarkable differences in comparison with before surgery in both groups (Ftime =12.868,P =0.001),but no significant differences between the two groups (Fgroup =1.923,P=0.169).No significant differences were found in Q-value between the two groups (Fgroup =0.191,P=0.663).Root mean square (RMS) and spherical aberration values elevated in postoperation compared with preoperation,with significant differences between them(all at P＜0.01),but the comparison between intergroup was insignificant (RMS:Fgroup =0.299,P =0.586;Spherical aberration:Fgroup =1.290,P =0.259).Conclusions TransPRK for myopia with thin cornea is safe and stably effective like Epi-LASIK.TransPRK affects corneal biomecbanical properties early after surgery but the effect gradually lessens over time.The posterior corneal elevation shows a tiny backward displacement,while posterior corneal asphericity has no change.
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@# ObjectiveTo discuss the effect of argon laser on retinal vein obstruction (RVO) . Methods428 eyes of 422 patients with RVO were treated by argon laser.Among them, there were 386 eyes with ischemic RVO,42 eyes with no-ischemic RVO, and 129 eyes with macular vesicular edema(MVE).ResultsThe vision acuity of 207 eyes is improved, and not changed in 138 eyes. The disappearing rate of MVE is 84.45%(82/97). ConclusionUsing argon laser to treat RVO can curb new vascular of retina building, lighten MVE and protect vision function.
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Objective To evaluate the predictability of ablated depth in photorefractive procedures by Zeiss MEL80 and VISX Star S4 excimer laser.Design Prospective,comparative case series.Participants 168 eyes of 84 people with myopia and cylinder.Main Outcome Measures Corneal thickness and ablated depth.Methods The thickness of cornea by Zeiss MEL80 and VISX Star S4 were measured by anterior segment OCT.The actuality ablated depth and calculated depth were compared.Results There were no significant differences between actuality ablated depth and calculated depth in Zeiss MEL80.And in VISX Star S4,the actuality ablated depth was more than calculated depth.Linear regression of changes in ablated depth on myopia and cylinder yielded the following formulaus:△ablated depth(VISX Star S4)= 2.324 *|myopia|+ 5.270 *|cylinder|-6.772.Conclusions Different excimer laser has different changes between actuality ablated depth and calculated depth.To guarantee the safety of LASIK,Ophthalmologists should know the characteristics of the excimer laser.