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Objective:To construct an "Internet+nursing service" model for elderly patients at home led by the continuing care service center from the perspective of the Internet, and to provide reference for different types of professional home care services for elderly patients.Methods:From March 2019 to December 2021, relying on the continuing care service center, six links of "discharge preparation, discharge follow-up service, home care service, online diagnosis and treatment, institutional return visit, health guidance" in Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology were interconnected to construct a closed-loop "Internet+nursing service" model for elderly patients at home. Summarized the workload after the implementation of "Internet+nursing service", and investigated the satisfaction of 149 patients and 112 home sevice nurses.Results:After 2 years and 9 months of implementation, the team provided 11 home care services for elderly patients with diabetes foot dressing change, PICC catheter maintenance, replacement of catheter, wound stoma care and home membrane dialysis etc, and provided 452 home care services for 149 patients. Patient satisfaction was (94.47 ± 3.07) points; the approval of this model by 112 home service nurses was (4.69 ± 0.43) points.Conclusions:The "Internet+nursing service" model for elderly patients at home, which is dominated by the continuous nursing service center, can meet the continuous nursing needs of elderly patients at home. At the same time, expanding nurses′ practice space and enhancing nurses′ professional value will play a positive role in promoting the development of nursing service industry.
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Objective:To evaluate the application effect of virtual reality in labor pain management by Meta analysis.Methods:The randomized controlled trials on the impact of virtual reality on labor pain was searched by PubMed (Medline), Web of Science, The Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang database, Chinese biomedical database, and VIP database from their inception until July 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bais of included studies. Meta-analysis was performed using the Comprehensive Meta-Analysis (CMA) software Version 3.Results:Totally, 658 pregnant women were identified in the search, which were narrowed down to 8 studies. The results of Meta-analysis showed that the virtual reality group decreased the labor pain compared with the normal nursing group ( MD=-1.13, 95% CI-1.59 to -0.67, P<0.01), especially during the active phase of labor ( MD=-1.20, 95% CI-1.96 to -0.45, P<0.01). Besides, compared with the normal nursing group, the virtual reality group had a shorter first stage duration of labor ( MD=-0.93, 95% CI-1.51 to -0.34, P<0.01) and a lower level of anxiety ( SMD=-1.54, 95% CI-2.22 to -0.85, P<0.01). However, there was no significant difference between two groups in the pain scores during the latent phase of labor ( MD=-0.41, 95% CI-1.30 to 0.47, P>0.05) and the second stage duration of labor ( MD=-0.37, 95% CI-3.27 to 2.53, P>0.05). Conclusions:The findings of this Meta-analysis showed that the virtual reality significantly reduced the labor pain, shorted the first stage labor duration and lowered anxiety level. However, due to the limited quantity and quality of the included studies, its conclusions need to be verified by more large sample multicenter randomized controlled trials with rigorous design in the future.
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Objective To detect the oxidative and anti-oxidative imbalance of Hashimoto′s thyroiditis (HT) with specific thyroid function through specific serum.Methods 41 patients with normal thyroid function of Hashimoto′s thyroiditis and 43 healthy controls were enrolled in our hospital from May 2016 to May2017.Through specific serum tests, such as derived active oxygen metabolism (d-ROM) and biological antioxidant potential (BAP), advanced glycation end products (AGE) and advanced oxidized protein products (AOPP) were used to assess oxidative stress.Results The levels of d-ROM and AGEs were significantly increased (P＜0.05) and BAP was significantly lower in both groups compared with HT patients (P＜0.001).In univariate analysis, serum TSH, TgAb and TPOAb were significantly associated with d-ROMs (P＜0.05).HDL-C, serum TSH, TgAb and TPOAb were significantly associated with BAP (P＜0.05).Total cholesterol and LDL-C were significantly associated with AGEs (P＜0.05).Multivariate analysis showed that serum TPOAb was a predictor of d-ROMs (P＜0.001), BAP (P＜0.001), and AGEs (P=0.003).In addition, HDLC was also an independent predictor of BAP levels (P=0.012, R2=2.354, 95％CI:1.191-5.433).While LDL-C was an independent predictor of AGEs (P =0.004, R2=1.102, 95％CI:0.915-1.253).Conclusion HT patients increased oxidant, antioxidants decreased.And AGEs were significantly higher, AGEs levels can be used as a new HT oxidative stress a reliable biomarker.
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The present study is designed to conduct, the analysis on the curative effect of Lamivudine in treating liver function lesion caused by hepatitis B combined anti-TB drugs. The 4200 patients who have been treated for hepatitis B combined with pulmonary TB in 8 different hospitals from Feb 2014 to Feb 2016 were selected as research objects. They were randomly divided into control group and observation group, each containing 2100 patients. In control group, patients was applied with conventional Anti-TB therapy and liver-protecting therapy; while in observation group, patients were apllied with lamivudine in addition to conventional therapies. The variattions of liver functions of both groups before and after therapies were observed. After treatment, the liver function lesions of patients in observation group were significantly lower than that in control grop; moreover, the drug withdrawal rats of patients in control group were significantly higher. There was statistical difference between both group, P<0.05. In the prcess of treating patients with liver function lesions caused by hepatitis B combined with anti-TB, applying Lamivudine on the basis of conventional liver protection therapy and anti-TB therapy can effectively inhibit HBV replication, and prevent liver disease from getting worse, so as to reduce the liver function lesions in treating patients with hepatitis B combined with anti-TB and accelerate rehabilitation