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The latest progress of modern radiotherapy techniques in the management of breast cancer after breast-conserving surgery was introduced first.Then the clinical effect and the adverse effect of these advanced techniques were analyzed.Finally,in order to provide an up-to-date evidence based data on the role of modern radiotherapy techniques in the management of breast cancer,the importance of how to choose appropriate patients for these advanced techniques was discussed.
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<p><b>OBJECTIVE</b>The aim of this study was to explore the association between acquired multi-drug resistant organism (MDRO) and ventilator-associated pneumonia (VAP) in patients hospitalized at the intensive care unit(ICU).</p><p><b>METHODS</b>Real-time monitoring system for hospital infection was used to track VAP patients. The period of study was from January 1, 2013 to December 31, 2013. Both a nested case-control study design and logistic multivariable regression model were performed to explore the association.</p><p><b>RESULTS</b>A total of 142 VAP cases and 342 non-VAP controls were available in this study. Duration of Hospital stay, ICU stay and mechanical days were statistically significant between the case and the control group (P≤0.001). Compared with MDRO negative patient, the MDRO colonization or infection patients showed an 3.05-time increase on the risk of VAP (adjusted OR = 4.05, 95% CI:2.51-5.46). Remarkably,MDRO-positive patients were significantly associated with increased duration of mechanical ventilation and antimicrobial drug use (P < 0.001).</p><p><b>CONCLUSION</b>MDRO colonized and infection patients would significantly increase the risks of VAP, with prolonged hospitalization and ICU stay. Effective measures should be taken to promote and control patient's safety at the hospital.</p>
Subject(s)
Humans , Case-Control Studies , China , Epidemiology , Cross Infection , Microbiology , Drug Resistance, Multiple, Bacterial , Intensive Care Units , Length of Stay , Logistic Models , Multivariate Analysis , Pneumonia, Ventilator-Associated , Epidemiology , Respiration, Artificial , Time FactorsABSTRACT
Objective To explore tolerance-related factors of enteral nutrition(EN) by nasogastric (NG) tube in ICU patients, and to provide several nursing strategies for improving the patients' tolerance. Methods 83 patients using EN with NG tube in ICU were collected.Tolerance-related factors of EN were analyzed by multivariate Logistic regression analysis. Results Among the 83 patients, 36 patients (43.3%) could tolerate very well, 47 patients (56.6%) couldn't tolerate.After treatment 27 patients' tolerance was fair, the other was poor.Multivariate Logistic regression analysis showed that age, APACHE-Ⅱ score, the time of beginning EN, albumin level, drug administration by NG tube or not were the major factors affecting tolerance of NG tube feeding. Conclusions Patients' feeding with NG tube was well-tolerated in ICU.Besides the factors from patients as the severity of disease status and level of serum albumin,the time of beginning EN, drug administration by NG tube were significantly correlated with tolerance.
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Objective To study the effect of perioperative psychological nursing on living-related liver transplantation. Methods The following measures were adopted according to the donors' concrete condition: using nursing procedure in holistic nursing, to assess and determine the main problems in perioperative period, nurses mastered psychological nursing knowledge and skills in individualized psychological nursing, giving pertinent and individualized health education to patients in accordance with their psychological problems during the perioperative period. Results The donors could face the operation with good psychological state after being given fully-integrated and whole-system psychological nursing. Conclusions Psychological nursing is important for living-related liver transplantation during the perioperative period.
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Objective To establish the evidence-based nursing educational programme for preventing ventilator-associated pneumonia (VAP) and evaluate the effects in critical care nurses. Methods The evidence-based nursing practice guidelines for preventing VAP from 2008 American Association of Critical Care Nurses was used as training materials,which guided the curriculum design. Seventeen critical care nurses were trained. The difference of the nurses' knowledge and practice was evaluated before and after training by an evaluation scale of nursing quality criteria for preventing VAP. Results After the training,nurses' knowledge and practice of preventing VAP were improved(Z=-3.624,P=0.000). Except the factor score of handwashing,there were significant differences on the factor scores of body position care,endotracheal tube care,enteral nutrition,maintaining the tube cuff pressure,oral care and ventilator equipment management (P<0.01). Conclusion The educational programme of evidence-based nursing for preventing VAP can improve the nurses' knowledge and practice of preventing VAP. Furthermore,it can promote the application of evidence-based nursing for preventing VAP,and thereby to improve the quality of nursing,and provide guidance for the training of critical care nurses and continuing education.