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Aerosol microorganisms are important constituents of aerosols. They participate in physical and chemical reactions in the air and are also closely related to disease transmission and human health. With the SARS-CoV-2 pandemic， aerosol microorganisms have become a public health topic of great concern. Studying the composition and influencing factors of the air microbiome therefore has significant public health implications. Due to the limitations of traditional technologies for sampling and determination， the aerosol microbiome has not been fully understood. However， with the development and maturity of high-throughput sequencing technology， the aerosol microbiome has shown promising research prospects. This article reviews the composition， characteristics， detection methods and influencing factors of aerosol microorganisms， providing basic knowledge for further research on the air microbiome. In-depth research on microbial aerosols has significant implications on urban air quality control， national security and public health.
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Objective:To summarize the nursing experience of a patient with refractory hypoxia, septic shock and delirium after pulmonary endarterectomy combined with coronary artery bypass grafting for severe chronic thromboembolic pulmonary hypertension.Methods:An elderly patient with severe chronic thromboembolic pulmonary hypertension admitted to China-Japan Friendship Hospital in December 2020 was given nursing measures in terms of hemodynamic management, anticoagulant management, nursing of intractable hypoxia and balloon pulmonary arterioplasty, infection prevention and control, lung rehabilitation, early functional exercise and transitional nursing etc.Results:After multiple consultations with multidisciplinary experts inside and outside the hospital, the patient′s diagnosis and treatment plan was refined. After individualized and comprehensive nursing, the patient recovered well after surgery and was transferred back to the common ward 57 days after surgery, and discharged successfully 73 days after surgery.Conclusions:The individual and comprehensive nursing measures for this patient have effectively improved the prognosis of the patient and improved the quality of life of the patient.
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Objective:To systematically review the barriers encountered by nursing staff in the implementation of early activities in adult ICU units.Methods:A systematic search was conducted on CNKI, Wanfang Database, VIP Database, China Biomedical Database, PumMed, Web of Science, Cochrane Library and EMBASE for the research on the obstacles of early activity nursing implementation in adult ICU from the establishment of the database to July 2020, and the final integrated analysis of the included literature was carried out.Results:A total of 26 articles were included, and 59 obstacles in 5 categories were integrated, including 6 kinds of technical level, 13 kinds of organizational culture level, 7 kinds of personnel level, 4 kinds of structural level, and 29 kinds of 6 sub categories of patients level. The most frequent obstacles were unstable condition of patients, sedation or continuous deep sedation, low staffing level, disturbance of consciousness of patients, insufficient equipment related to early activities, and low willingness or compliance of patients to participate.Conclusion:The nursing staff are facing with many obstacles in guiding and assisting ICU adult patients to carry out early activities. It is necessary to formulate modified policies aiming at changeable factors in order to promote the application of early activities in adult ICU units.
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Objective:To explore the application value of quantitative assessment in the pipeline nursing after tracheotomy in elderly critical patients.Methods:A total of 108 elderly critically ill patients admitted to our hospital from January 2018 to January 2020 were treated with tracheotomy and given plumbing care after surgery. According to the random number table method, it was divided into a control group (54 cases) and an observation group (54 cases).The control group received routine nursing, and the observation group received nursing according to the quantitative evaluation results. The tube placement time, ventilator use time, monitoring time, and total hospitalization time were compared between the two groups. The changes of blood oxygen saturation (SpO 2), diastolic blood pressure (DBP), systolic blood pressure (SBP) and heart rate (HR) were compared on the 1st and 7th days after operation. The incidence of complications was recorded and the patients' satisfaction and quality of life were evaluated. Results:In the observation group, the catheter placement time, ventilator use time, monitoring time, and total hospital stay were (20.35±5.37) days, (9.65±3.53) days, (14.81±3.34) days and (31.29±4.87) days, respectively, compared with the control group (24.91±4.79) days, (11.81±4.02) days, (16.95±3.99) days, (35.97±6.51) days were significantly shortened ( t values were 3.153 to 4.657, P<0.05). SpO 2, DBP, and SBP of the control group were 0.975 2±0.018 3, (79.39±7.41) mmHg (1 mmHg=0.133 kPa) and (137.46±7.09) mmHg, respectively, at 1 week after operation, which were all higher than the preoperative 0.953 4±0.015 9 and (75.45± 8.01) mmHg, (134.66±6.61) mmHg ( t values were 6.608, 2.653, 2.123, P<0.05). SpO 2, DBP, and SBP in the observation group were 0.959 1±0.017 2, (76.13±6.94) mmHg, and (134.56±7.33) mmHg, respectively, in the observation group one week after operation, which were significantly lower than those in the control group ( t values were 4.711, 2.360, 2.090, P<0.05).The complication rate in the observation group was 11.11% (6/54), which was significantly lower than the 25.93% (14/54) in the control group ( χ2 value was 3.927, P<0.05). The total score of nursing satisfaction in the observation group was (61.52±8.03) points, which was higher than the (52.11±7.99) points in the control group ( t value was 6.104, P<0.05). Conclusion:Quantitative assessment can shorten the tube placement time, ventilator use time, monitoring time and total hospitalization time of elderly patients with critical tracheotomy, ensure stable postoperative vital signs. It can reduce the complication rate and improve the patients' satisfaction.
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Objective:To explore the effect of evidence-based physical restraint practice in ICU patients based on the best evidence.Methods:Based on the previous studies of evidence- based nursing program of physical restraint in ICU patients, the nurses were trained, and the evidences were introduced into clinical application and the effect of program application on nurse level, patient level and organization system were evaluated. Results:The body restraint duration of ICU patients in the contrd group was 41 (14.25, 166.50) h, and the body restraint duration of intervention group was 37(16.75,107.50) h, the difference was statistically significant ( Z value was 1.71, P<0.05). The level of physical restraint knowledge, attitude, behavior and total scores of ICU nurses increased from (12.30±1.73), (33.69±3.80), (45.19±10.56), (91.17±13.38) before implementation to (13.37±2.07), (36.81 ±3.61), (49.17±4.98), (98.08±6.11) after implementation. The differences in attitude, behavior and total scores were statistically significant ( t values were 4.05, 0.96, 2.44, P<0.05).At the organizational system level, after the application of the program, the related procedures, norms, assessment tools, nursing record sheets, restraint tools, training materials courses and so on were improved in the department. Conclusions:By introducing the best evidence of physical restraint into clinical application, it can guide nurses to use physical restraint more scientifically and standardize physical restraint behavior.At the same time, it can reduce the use of physical constraints to a certain extent, reduce the rate of physical restraints, shorten the average length of restraint, and improve the flow system related to physical restraints, so as to provide reference for the implementation of physical restraints.
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Objective@#To understand the attitude of college students in Zhejiang towards e cigarette and its influencing factors, so as to provide basis for making prevention and control strategies.@*Methods@#In September 2020, 10 colleges and universities in Zhejiang Province were selected to conduct an online survey by a combination of typical sampling method and convenience sampling method. A multivariable Logistic regression model was used to analyze the influencing factors.@*Results@#Among 884 subjects, 93 (10.52%) were positive about e-cigarettes, 310 (35.07%) thought e-cigarettes were harmless, 252 (28.51%) thought e-cigarettes were not addictive and 67 (7.58%) of respondents were using e-cigarettes. Multivariate Logistic regression analysis showed that gender, grade, cost of living, whether or not smoking e-cigarettes were harmful to college students attitudes towards e-cigarettes( OR =0.59, 0.47, 1.87, 0.34, 0.54, P <0.05).@*Conclusion@#College students in Zhejiang Province have a positive attitude towards electronics and are not active in avoiding the dangers of smoking. To make full use of the work of concentrated trainees in tobacco control, efforts should be made to break the positive image of e-cigarettes. Junior college students should be the prioritized population for intervention, and female students should not be neglected.
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Objective:To standard the behavior of clinical physical restraint and reduce the rate of physical restraint.Methods:Evidence-based method was used to screen the clinical practice guide of physical restraint, and the recommendations were integrated and the clinical applicability was evaluated. The nursing scheme of physical restraint evidence-based practice for ICU patients was constructed through group discussion, and 12 experts were consulted by Delphi method for 2 rounds of correspondence.Results:Included 2 high quality guidelines, integrated the recommendations and evaluated the clinical applicability, and then summarized them into 11 recommendations on three major topics: practical recommendation, educational recommendation and organizational recommendation. Constructed nursing programs including physical restraint implementation process, treatment relationship, physical restraint evaluation, physical restraint dynamic monitoring, restraint substitution method and so on. The enthusiasm of experts was 100%, the authority coefficient was 0.87. The expert acceptance rate was 0.75-1, and the coefficient of variation of expert letter was 0.14-0.26.Conclusions:The construction process of evidence-based nursing scheme for ICU patients with physical restraint is rigorous and the results are reliable, which can be used to guide and standardize the implementation and nursing of physical restraint for ICU patients in clinic.
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Objective To investigate the effects of magnesium sulfate and magnesium L-sulfonate on the neurobehavioral response and the expression of induced nitric oxide synthase (iNOS) in neurons after acute cerebral ischemia in rats. Methods One hundred and twelve male Sprague-Dawley ( SD) rats were double-blinded randomly divided into sham-operated group, middle cerebral artery occlusion ( MCAO ) group,MgSO4 treatment group,L-MgT treatment group. Each group was further divided into 6 h,12 h and 24 h subgroups according to the different detection time points. Rat MCAO models were produced following the Longa's method. And the Longa score,limb-placing test,rotarod test,and sticky tape test were performed to evaluate the neurological damage,autonomous movement and coordinate perception in the 24 h subgroup. At the end of the experiment,2,3,5-triphenyltetrazolium chloride ( TTC) was used to evaluate the area of cerebral infarction at 24 h reperfusion. Immunohistochemical staining was employed to determine the altera-tions in iNOS expression in neurons 6 h,12 h and 24 h after reperfusion. Results In behavioral evaluation:Longa score:Normal performance was observed in sham-operated group. Compared with the MCAO group,the scores of MgSO4 treatment group(1. 71±0. 18) and L-MgT treatment group(1. 14±0. 14) were decreased (t=0. 548,3. 873,all P<0. 05),and the score of L-MgT treatment group was lower than that of the MgSO4 group(t=2. 828,P<0. 05). Limb symmetry score:There was no statistically significant difference between MgSO4 group and MCAO group,but there was a statistically significant difference between L-MgT group and MCAO group (t=7. 071,P<0. 05). The roding experiment:The time of MgSO4 group and the L-MgT group were significantly different from that of the MCAO group (t=9. 588,20. 776,P<0. 05),and the time of the L-MgT group was significantly higher than that of the MgSO4 group (t=4. 983,P<0. 05). The right limb strip removal experiment: The time of MgSO4 group and L-MgT group were statistically different from that of MCAO group (t=6. 135,5. 825,P<0. 05),and the time of L-MgT group was increased compared with that of MgSO4 group(t=4. 507,P<0. 05). TTC test:No infarction was formed in the sham group. Compared with MCAO group ((36. 82±1. 35)%),the cerebral infarction volume of MgSO4 group ((17. 39±1. 72)%) and L-MgT group ((10. 81 ± 1. 35)%) significantly decreased, with statistically significant differences ( t=8. 874,11. 105,P<0. 05). Compared with MgSO4 group,cerebral infarction volume in L-MgT group was sig-nificantly reduced,with statistical significance (t=2. 593,P<0. 05). HE staining:There was no statistically significant difference in cell morphology between MgSO4 group and MCAO group at each time point,but the cell morphology of L-MgT group was intact compared with that of MCAO group. INOS staining at 24 h:There was no statistically significant difference in the positive cell density between the MgSO4 group and the MCAO group,but the L-MgT group (cortex:(196. 7±8. 1);striatum:(153. 3±3. 8)) positive cell density was lower than that of the MCAO group (cortex:(375. 0±6. 7),striatum:(358. 3±4. 5)),and the difference was sta-tistically significant (t=11. 113,36. 231,P<0. 05). Conclusion L-MgT may have a significantly protective effect on MCAO rats,and its mechanism may be related to the level of iNOS in neurons.
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Since the scale of student-recruitment was enlarged in 1999,the competition of colleges and universities are getting fiercer day by day.Under the effect of the famous schools,the better the schools are,the more resource and the more excellent students can the school win.The article analyses how colleges and universities carry out education planning and setting up the colleges and universities brand from the necessities and the measures of education planning,every stage of setting the school brand and the problems which should be thought over.