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Objective:To construct a sensitive index system of nursing quality for patients with acute ischemic stroke patients undergoing interventional thrombectomy, so as to provide a scientific basis for interventional thrombectomy care for acute ischemic stroke.Methods:Taking the "structure-process-result" three-dimensional quality model as the theoretical framework, through evidence-based literature search, the item pool was drawn up, and finally the indicators and their weights at each level were determined by two rounds of Delphi method in December 2021 and January 2022 and analytic hierarchy process.Results:The positive coefficients of the two rounds of inquiries to experts were 0.92 and 1.00, respectively, the authority coefficients were 0.913 and 0.917, and the Kendall coefficients were 0.141 and 0.202, respectively. The final index system consisted of 3 primary indicators, 9 secondary indicators and 50 three-level indicators.Conclusions:The nursing sensitive quality index system for patients with acute stroke patients undergoing interventional thrombectomy constructed in this study has high reliability and scientificity, which can provide target incentives for clinical nurses and provide reference for the development of specialized nursing sensitive quality indicators.
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Berberine (BBR) as one of the most effective natural products has been increasingly used to treat various chronic diseases due to its immunosuppressive/tolerogenic activities. However, it is unknown if BBR can be applied without abrogating the efforts of vaccination. Here we show that priming of CD8+ T cells in the presence of BBR lead to improved central memory formation (Tcm) with substantially reduced effector proliferation, primarily orchestrated through activation of AMPK and Stat5. Tcm derived from vaccinated mice fed with BBR were able to adoptively transfer protective immunity to naïve recipients. Vaccination of BBR-fed mice conferred better memory protection against infection without losing immediate effector efficacy, suggesting appreciable benefits from using BBR in vaccination. Thus, our study may help to lay the groundwork for mechanistic understanding of the immunomodulatory effects of natural products and their potential use as adjuvant that allows the design of novel vaccines with more desirable properties.
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【Objective】 To analyze the value of plasmin-α2-plasmin inhibitor complex (PIC) and thrombin-antithrombin complex (TAT) for risk stratification of massive transfusion (MT) in patients with postpartum hemorrhage (PPH). 【Methods】 Clinical data and blood samples of patients with PPH in our hospital from January 2019 to December 2022 were retrospectively analyzed. MT (MT group, n=60) was defined as transfusion of red blood cells≥10 U within 24 h after delivery, and 3.25 ng/mL and PIC level>1.04 μg/mL were independent risk factors for MT after PPH. 【Conclusion】 Elevated TAT and PIC levels are independent predictors of MT in patients with PPH, and their combined predictive efficacy is better.
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Objective:To investigate the current situation and influencing factors of patients′ satisfaction with nursing humanistic care, and to provide reference for improving the quality of such care provided by hospitals.Methods:From July to August 2022, outpatients and inpatients in 30 provinces were selected by multi-stage stratified sampling as the survey objects. A cross-sectional survey was conducted on an online platform, using the general information questionnaire and Chinese version of methodist health care system nurse caring instrument revised by the research group. The latter instrument consists of 12 dimensions. namely care coordination, competence, teaching/learning, emotional support, respect for individuality, physical comfort, availability, helping/trusting relationship, patient/family engagement, physical environment, spiritual environment and outcomes. Descriptive analysis was performed on the data collected by the questionnaires, and independent sample t-test and one-way ANOVA were used to analyze the influencing factors of patient satisfaction. Results:A total of 107 hospitals were selected for questionnaire survey, including 86 tertiary hospitals and 21 secondary hospitals, and 29 108 valid questionnaires were recovered. The patient satisfaction with nursing humanistic care scored (5.40±0.86); the top three dimensions were competence (5.50±0.89), emotional support (5.47±0.88) and helping/trusting relationship (5.46±0.86); the lowest scoring dimensions were teaching/learning (5.38±1.01), spiritual environment (5.36±1.04) and patient/family engagement (5.11±1.28). Differences with gender, age, marital status, child status, educational level, occupation, place of residence, economic region, per capita monthly income of the family, type of medical insurance, medical department visited and surgery or not presented significant differences on the patient satisfaction with nursing humanistic care scores ( P<0.05). Conclusions:The satisfaction of patients with hospital′s nursing humanistic care in China was at the middle to upper level. In the future, health education for patients should be strengthened, and a mode of family-engaged nursing humanistic care should be constructed in line with the Chinese cultural background. In the process of nursing services, the particularity of patient groups should be considered to better meet their needs.
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Studies have shown that rosacea is related to inflammatory factors, neurovascular function, micro-ecological environment and other factors. The Janus kinase (JAK) -signal transducer and activator of transcription (STAT) signaling pathway involves a variety of inflammatory cytokines, and plays an important role in cell proliferation, differentiation, apoptosis, angiogenesis and immune regulation. This review summarizes the JAK-STAT signaling pathway and explores its potential role in rosacea.
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Objective:To explore the elements of the diversified caring bank based on long-term care insurance system to provide a basis for the construction of diversified caring bank framework system.Methods:The phenomenological research method was adopted to conduct semi-structured interviews with 15 nursing management personnel in pension institutions in Suzhou and Suzhou long-term care insurance policy implementation management personnel in March to May 2021. NVivo 11 was used to manage interview data, and applied Colaizzi 7-step analysis to conduct inductive analysis and extract the themes.Results:The elements of the diversified caring bank based on long-term care insurance system were divided into three main modules: diversified caring personnel, diversified caring content and diversified incentive measures. The diversified caring personnel module included full-time and part-time caring personnel. Diversified caring content included six elements: daily life assistance, professional life caring, professional medical caring, communication and emotional support, emergency caring and special disease caring. Diversified incentive measures module included two elements: labor currency and "benefit" care currency.Conclusions:The diversified caring personnel provides continuous power for disabled caring; diversified caring content provides ways to meet the various needs of the disabled elderly; diverse incentives are effective ways to attract and stabilize the caring workforce.
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Long-term care is a long-term guarantee mechanism to meet the care needs of the old adults and ensure the quality of life. Among them, the professionalism and stability of the care team is a key factor to ensure the development of long-term care work. This paper analyzes the possible reasons for slow development of time bank with volunteers as the main body in the process of localization, and constructs a new model of diversified caring bank from the construction of care team, so as to promote the high-quality and sustainable development of long-term care in China.
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Objective:To develop a questionnaire for voluntary care of the disabled elderly based on the theory of planned behavior, and test its reliability and validity.Methods:With the theory of planned behavior as the theoretical framework, a questionnaire entry pool was formed on the basis of extensive reading of domestic and foreign literatures and semi-structured interviews, and the questionnaire items were screened by Delphi method. From July to August 2020, 350 nursing staff from 10 hospitals in Suzhou were selected by convenience sampling method, and the reliability and validity of the questionnaire were tested, and the formal questionnaire was finally formed.Results:Totally 350 questionnaires were distributed in this study, and 330 copies of effective questionnaires were recovered, with an effective recovery rate of 94.29%. This questionnaire included a total of 26 items in 4 dimensions, including attitude, subjective norms, perceived behavioral control and behavioral intention. Cronbach′s α coefficient was 0.977, split-half reliability was 0.906, test-retest reliability was 0.84, the content validity index (CVI) of total questionnaire was 0.97, item-level CVI value was 0.88 to 1.00. Four exploratory factors were extracted, and cumulative contribution rate was 80.03%.Conclusions:The questionnaire has good reliability and validity, which can well explain and predict the willingness of nursing staff to volunteer for the disabled elderly, and can also provide incentive basis for policy makers and managers.
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EEG and EMG, as important classical techniques in electrophysiology, play a special role in both basic scientific research and clinical application. Based on the mature application of EEG and EMG recording technology of the school, the authors have carried out an experimental course for postgraduate students on the topic of "practice of EEG/EMG recording based on flipped classroom". And this teaching method has been introduced from three aspects of experiments design, implementation significance and practical reflection, aiming at cultivating active knowledge-seeking practice and rigorous scientific thinking of students, and improving the comprehensive teaching quality of teachers. At the same time, the experience reflection can provide beneficial reference for other courses to implement the teaching model of "technology+flipped classroom".
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Objective:To understand the real experience of emotional labor of hospice nurses.Methods:A total of 8 hospice nurses from Shanghai, Shenzhen and Lianyungang hospice care units took part in the field study. They were observed and interviewed for one week.Results:The emotional labor of hospice nurses included natural expression, surface expression and deep expression. The emotional labor of nurses was affected by individual factors, organizational factors and social factors, including factors of the setting of hospice nursing posts was not clear, the proportion of multi-disciplinary team was insufficient, public awareness of hospice care was insufficient, and social security policy was imperfect, which was easy to make the role of nurses maladjustment, increase nurses' occupational fatigue and make nurses' emotional labor behavior lack of stable and long-term power source, thus affect the expression of their emotional labor behavior.Conclusions:We should pay attention to the expression and outcome of emotional labor of hospice nurses, to intervene and improve the individual factors, organizational factors and social factors that affect the expression of nurses' emotional labor.
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【Objective】 A framework to support nurses and midwives making the clinical decision and providing the written instruction for blood transfusion has been developed and implemented in the United Kingdom as a response to the changing needs of the patient and in recognition that blood transfusion services to patients could be improved by using the untapped knowledge and expertise of experienced nurses and midwives.Special education and training program for this role development are provided jointly by the national blood and nurse management authority, higher education institutions and transfusion societies.The British government has issued and implemented a compulsory professional indemnity which cover nurses and midwives as well.The development and implementation of the framework, policies and procedures for this role development is based on the regulatory compliance and the collaboration of, and beneficial to the multiple stakeholders, with the gaps left by doctors being fillled, work load of doctors reduced, nurses and midwives achieving professional development, hospitals performing more efficiently, and most importantly, the patients having a better transfusion services.At present, there is no similar policy or program for nurses and midwives in China.Therefore, this paper introduces the policy framework and implementation for this role development in UK, which would be a valuable reference for the role development and extension of nurses and the organization, education and training for transfusion professional teams as well in China in the near future.
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【Objective】 To pilot an informed consent audit system for clinical transfusion in a large tertiary hospital, so as to provide evidence and recommendations to improve the consent system. 【Methods】 A report table containing key items of transfusion informed consent such as transfusion risk, transfusion benefit and alternative treatment was developed in compliance with the national guidelines and regulations, and issued to a total of 206 patients with records on red blood cell transfusion from April 1 to June 30, 2019 in a tertiary hospital. 【Results】 The audit results showed that 98.06% (202/206) of transfusion informed consents were signed by patients, but only 65.05% (134/206) were signed by doctors. 31.07% did not record the reasons for transfusion, and 46.6% did not record the transfusion plan. 99.31% of the doctors participated in the audit claimed that the patients were informed of the risk of blood transfusion, but only 79.8% (158/198) patients recalled that the doctors mentioned the risk. Although 80.5% (116/198) of the patients were informed of alternative treatment, only 28.79% (57/198) recalled being told about alternative treatment. Allogeneic blood transfusion was the most frequently choice for patients recommended by doctors, accounting for 98.61% (142/144). However, only 48.99% (97/198) of patients could recall allogeneic blood transfusion. 80.5% of the patients recalled being informed of alternative treatment plans, and only 28.79% of the patients recalled being offered alternative treatment plans. Only 43.43% of the patients considered themselves as the main participants in decision-making of blood transfusion. In terms of training, 82.64% (119/144) doctors described having attended training programs. 【Conclusion】 The written consents for blood transfusion in our hospital were not well recorded. Patients received less information of blood transfusion informed by the doctors and did not fully participant in the decision-making of blood transfusion. There is a gap between the practice and the current national guidelines and regulations. The audit results indicated that it is necessary to further strengthen the professional knowledge of clinicians and communication skills between the doctors and patients. This audit results in this study will provide recommendations for further transfusion informed consent audit and continuous improvement of clinical transfusion informed consent practice in China in the future.
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【Objective】 To assess the sufficient information got by the informed transfusion recipients from the consents for blood transfusion and to explore the influencing factors, so as to provide scientific evidences for patients to comprehend the consent better. 【Methods】 A cohort study using questionnaire was conducted among 198 patients who received red blood cell transfusion from April 2019 to June 2019 in a tertiary hospital. 18 options were investigated, including basic information of patients, recall of the informed consent process performed by physicians and how well they comprehend the information. SPSS 23.0 statistical software was used for data statistical processing. 【Results】 All 198 questionnaires were returned and valid (100%, 198/198). The score of 198 informed transfusion recipients was 2~9 (5.293±1.549), and the score of Internal Medicine and Surgical transfusion patients was 6.07±1.77 vs 6.07±1.77 (P<0.05). Univariate comparative analysis showed that the clinical department, age, education background, instructions, including its time and identity of instructors, before transfusion were the variables that affected the comprehension of informed patients (P<0.05). Linear regression analysis indicated that the clinical department, pre-transfusion instruction and its time were independent influencing factors on the comprehension(P<0.05). The top 3 poorly-understood items included auto-transfusion, alternative transfusion therapy and 1-year donation deferral after blood transfusion. 【Conclusion】 More efforts are needed to help transfusion candidates to comprehend consent for blood transfusion better since their knowledge varied with clinical departments. Physicians′ transfusion knowledge and communication skills also need to be enhanced to provide targeted and multi-form informing methods.
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Objective To evaluate the clinical efficacy of lymphoplasma exchange (LPE) for the treatment of severe refractory immune-related skin diseases.Methods From May 2013 to October 2015,8 patients with toxic epidermal necrolysis,drug-induced hypersensitivity syndrome (DIHS),pemphigus vulgaris,pemphigoid or paraneoplastic pemphigus were enrolled from Department of Dermatology,Xiangya Hospital,Central South University,who showed no response to conventional therapy or presented with multiple organ dysfunction.After the treatment with LPE,the efficacy was evaluated,and adverse reactions were observed.Results After one session of LPE therapy,6 patients received marked improvement,and were cured at last.In 1 patient with pemphigus vulgaris who was resistant to the treatment with high doses of glucocorticoids and immunosuppressive agents,the rashes regressed during the treatment with LPE,but recurred after the end of treatment.One patient with bullous pemphigoid presented with eruptive blisters on the next day after the treatment with LPE,which were considered as allergic reactions to allogeneic plasma.There were no obvious differences in white blood cell count,lymphocyte count,neutrophil count and blood platelet count in the peripheral blood of 8 patients before and after the treatment with LPE.During the follow-up of 3-5 years,all of the patients were recovered without recurrence,except 1 patient with bullous pemphigoid who died of disseminated tuberculosis after 1 year.Conclusion LPE is effective for the treatment of severe immune-related skin diseases,but attention should be paid to potential transfusion reaction and allergic reactions.
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Background The clinical effectiveness of soft corneal contact lens for correction of myopia has been confirmed.Theoretically,aspherical soft hydrophilic corneal contact lens has better visual qualify for myopic eyes,and the lenses have been applied widely.But abnormal tear film,even many cornea and conjuctiva diseases caused by soft contact lens have been reported,so the effectiveness and safety of aspherical soft hydrophilic corneal contact lens are worth concerning.Objective This clinical trail was to compare the effectiveness and safety between aspherical and NUV soft hydrophilic contact lens for myopic eyes.Methods A randomized,double-blind and controlled clinical study was performed under the approval of Ethic Committee of Qingdao Municipal Hospital and informed consent of each patient.One hundred and forty eyes of 70 myopic patients were enrolled in QingdaoMunicipal Hospital from July to October,2012.The subjects were randomized into the trial group and control group using random number table.Aspherical soft hydrophilic contact lenses were worn in the trial group and NUV soft hydrophilic contact lenses were worn in the control group.The characteristics of the lens surface,outcomes and the eye number in different scores of ocular signs and symptoms were assessed before and 15 minutes,1 week,2 weeks and 1 month after wearing lenses.Results The sores of humidity of anterior surface,the sediment in anterior and posterior surface are 0 in both lenses in various time points after wearing.The corrected visual acuity of all the subjects were ≥ 1.0.The eye number of 2-3 scores in various ocular signs was 0 in both groups,but the eye number of 1 score in palpebral conjunctival congestion and limbus congestion were more in the trail group than those in the control group in different time points (all at P＜0.05).There were significant differences in corneal fluorescine staining between the groups in different time points (all at P＞0.05).There was no eye for 2-3 scores of eye symptoms in both groups.The eye number for 1 score in foreign body sensation increased in the target-trail group compared to the control group at various time points (P =0.002,0.006,0.005,0.005).However,there was no statistically significant differences in the eye number for 1 score in visual clearness and stability between the two groups at the follow-up duration (all at P＞ 0.05).Conclusions Aspherical soft hydrophilic corneal contact lens has good outcomes in corrected visual acuity for myopia like NUV soft hydrophilic contact lens,but the wearing of aspherical soft hydrophilic corneal contact lens induces more ocular discomfortableness.
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Objective To observe the efficacy of antiviral therapy of pegylated interferon (Peg-IFN) α-2a combined with ribavirin for patients with hepatitis C cirrhosis and hypersplenism underwent splenectomy or partial splenic embolization. Methods Thirty-eight patients with hepatitis C cirrhosis (genotype Ⅰ HCV infection) hypersplenism failed to the anti-viral therapy were performed splenectomy or partial splenic embolization to improving hypersplenism. After 3 months,Peg-IFNα-2a 90μg or 135 μg was given subcutaneously once weekly, plus ribavirin 600-1 000 mg/d orally for 1 year of the treatment. During the treatment, patients were followed at four-week intervals, and then followed-up every month until the 24th week after stopping. Liver function, blood routine, renal function, HCV RNA, and adverse reaction of medication were observed during treatment and the follow-up period. Results Splenic function of patients with hepatitis C cirrhosis and hypersplenism was improved after hypersplenism splenectomy or partial splenic embolization. The sustained virologic response (SVR) rate was 63.88%after giving Peg-IFNα-2a combined with ribavirin anti-viral treatment. Conclusion After splenectomy or partial splenic embolization, patients with hepatitis C cirrhosis and hypersplenism showed the better SVR at the treatment of Peg-IFNα-2a combined with ribavirin. The treatment could delay the progress of the hepatitis C cirrhosis and reduce the incidence of liver failure and liver cancer.
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<p><b>OBJECTIVE</b>To study the olfactory function in rats by manganese-enhanced magnetic resonance imaging (MEMRI) and explore the regeneration of olfactory system from the imaging.</p><p><b>METHODS</b>Thirty-five adult male Sprague-Dawley (SD) rats were randomly divided into three groups. Twenty rats with bilateral nasal instillation of TritonX-100 were used as olfactory dysfunction model group (M group). The rats in this group received menthocamphorate stimulation. Ten rats with bilateral nasal instillation of sterile saline were used as olfactory normal group (N group), and were randomly divided into two groups:one group received menthocamphorate stimulation (N1 group), another group received odorless air (N2 group). The remaining five rats were used as the blank control (control group). All images were acquired with a 7.0 T micro-MR scanner. Signal-to-noise ratios (SNR) in the olfactory bulb (OB) were measured by Image J.</p><p><b>RESULTS</b>MEMRI could clearly show the normal olfactory pathway in rats. MEMRI displayed a reversible change during the stages of olfactory recovery after injury. For the olfactory dysfunction model group (M group), the total volume of rat olfactory bulb at the initial, the 10th day, the 20th day, the 30th day and the 60th day were (49.44 ± 0.81), (32.85 ± 0.79), (27.78 ± 1.07), (35.89 ± 1.04), (43.63 ± 1.13) mm(3) respectively. At the 20th day after olfactory injury, the SNR in the OB was the lowest for 9.78 ± 0.07, when at the 60th day, the SNR recovered to 30.68 ± 1.01, which increased to near normal (N1group, 33.08 ± 0.15; N2 group, 31.31 ± 1.12), the SNR had no significant difference among the three groups (F = 3.04, P > 0.05).</p><p><b>CONCLUSION</b>The MEMRI is an objective method to detect the olfactory function, and the olfactory system has the regenerative property after injury.</p>
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Animals , Male , Rats , Magnetic Resonance Imaging , Methods , Manganese , Olfactory Bulb , Olfactory Pathways , Rats, Sprague-Dawley , SmellABSTRACT
Objective The purpose of this study was to explore the effect of nursing intervention on xerostomia in patient with AIDS. Methods From October 2010 to April 2012, nursing interventions were administered in 53 AIDS patients with xerostomia during treatment. The self-designed evaluation form was used to evaluate the oral dryness of patients before and after nursing intervention. Results There were significant changes on oral dryness of patients before and after nursing invention ( < 0.01) . There was a progressive decrease in the occurrence degree of oral dryness from level 0 to level 4. The number of patients decreased by 11.4%in level 4, but increased by 9.4% in level 0. There was a positive correlation between the intervention time and treatment effect. Establishment of an effective oral care hygiene behavior intervention could help patients create a healthy lifestyle. Conclusion Nursing intervention is important to relieving xerostomia of AIDS patients.
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Objective To explore the correlation between serum Lipoxin A4 and clinical grading of chronic hepatitis B patients. Method The serum Lipoxin A4 was detected by Enzyme-Linked Immunosorbent Assay in 94 chronic hepatitis B patients. Results It was found that the level of serum Lipoxin A4 of severe hepatitis patients were significantly lower than mild hepatitis patients and moderate hepatitis patients ( =0.04 and =0.03) . The serum Lipoxin A4 levels were correlated negatively with the ALT and AST levels,respectively =-0.41, =0.019 and R=-0.37,P=0.034. Conclusion These findings support the fact that the serum Lipoxin A4 may contribute to clinical grading of chronic hepatitis B patients.
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Objective To study the pathogenic bacteria distribution and drug resistance characteristics in HIV/AIDS patients with lower respiratory tract infection in Yunnan province, so as to guide the clinical medication. Methods We collected 278 cases of hospitalized patients with sputum,alveolar lavage specimen smear, culture, positive specimens from HIV/AIDS patients with lower respiratory infection in The Third People’s Hospital of Kunming from January 2008 to December 2012. Then we retrospectively analyzed the collected data. Results From 278 cases of sputum and alveolar lavage fluid specimens,we isolated a total of 127 strains of bacteria (45.7%), 53 strains of fungus (19.1%),50 strains of white candida,3 strains of aspergillus,49 strains of mycobacterium, 44 strains of mycobacterium tuberculosis,and the rest of atypical mycobacteria. Gram negative bacilli accounted for 64.6%,followed by pneumonia klebsiella bacteria, pseudomonas aeruginosa,e. coli,acinetobacter,sewer,e. coli, gram-positive bacteria accounted for 15.4%. Fungi accounted for 19.1%, and candida albicans was the common fungus. Mycobacterium tuberculosis accounted for 17.6%. Gram-negative bacilli were sensitive to imipenem, ptilinum ketone/sulbactam and amikacin,gram-positive bacilli were sensitive to vancomycin, nitrofurantoin and imipenem. Conclusions The major pathogenic bacteria are gram-negative bacilli in HIV/AIDS patients with lower respiratory tract infection in Yunnan province,but fungal infection ratio is increasing year by year, and conditional pathogenic bacteria are the major pathogen,which have antimicrobial resistance with different degree,TB infection rate is high and multi-drug resistant TB appears. Antimicrobial agents should be rationally used to delay the appearance of pathogen resistance.