ABSTRACT
Objective:To establish a scientific and practical evaluation index system of nursing quality of intravenous thrombolysis for ischemic stroke based on three-dimensional quality model, so as to scientifically evaluate the nursing quality in thrombolytic period.Methods:Based on the three-dimensional quality structure model, read the literature related to intravenous thrombolysis in ischemic stroke patients, and used semi-structured interview to construct the framework of nursing quality evaluation index system for patients with ischemic stroke during thrombolytic period. Delphi method was used for expert consultation, and the results were analyzed.Results:The positive coefficient of the two rounds of expert consultation was 100%, and the degree of authority in the first round was 0.881, and that in the second round was 0.879. The coefficient of variation of 10 second level indexes and 51 third level indexes were all smaller than 0.15.The second round of coordination coefficients were 0.504 for the first-level index, 0.509 for the second-level index, and 0.541 for the third-level index. The chi-square test was all P<0.001.The weight values of structural quality, process quality and result quality indicators were 0.189, 0.601, 0.210, respectively. The evaluation index system of nursing quality of intravenous thrombolysis for ischemic stroke was constructed, including 3 first level items (structure quality index, process quality index, result quality index), 10 second level items and 51 third level items. Conclusions:Consulting experts are highly motivated, authoritative, and coordinated. It also provides managers with standard and practical tools for evaluating the quality of intravenous thrombolytic care for ischemic stroke.
ABSTRACT
BACKGROUND:Recently,the development of tissue-engineered technique lms broadened the study of artificial esophagus.Some investigators have inoculated esophageal epithelial cells cultured in vitro onto compound polymer material and successfully constructed tissue-engineered esophagus.OBJECTIVE:To investigate the feasibility of tissue-engineered artificial esophagus by combining dog esophageal epithelail cells and an acelhilarized porcine thoracic aorta allogenic matrix.DESIGN:An experimental observation.SETTING:Central Laboratory,Taishan Medical College.MATERIALS:This study was carried out in the Central Laboratory.Talshan Medical College from June to December in 2004.Three hybrid dogs,24-hour-old,were provided by the Laboratory Animal Center,Taishan Medical College.The protocol was performed in accordance with ethical guidelines for the use and care of animals.The experimenhal instruments and reagents were as follows:CO2 incubator(MCO-15AC,SANYO),hypothermal high-speed centrifuge(RC-26,Dupont),trypsin,transferrin,type Ⅱ collagenase(Gibco),dulbecco's modified eagle's medium(DMEM),DispaseⅡ isolated enzyme,and rat monoclonal anti-keratin antibody(Sigma).METHODS:Acellularization of porcine aortas was performed by a method of enzyme-detergent.Esophageal epithelial cells of hybrid dogs were in vitro isolated,cultured and proliferated.Next,they were inoculated onto an acellularized porcine thoracic aortas allogenic matrix seaffold.Three and seven days later,the growth of esophageal epithelial cells on the acellularized matrix was observed under an electron microscope.MAIN OUTCOME MEASURES:Morphology of esophageal epithelial cells cultured in vitro;Biocompatibility of acellular matrix and dog esophageal epithelial cells.RESULTS:The acellularized procedure resulted in an almost complere removal of the cells and the loose three-dimensional matrix.The acellular matrix could be reseeded with expended esophageal epithelial cells in vitro.and esophageal epithelial cells had the potential of spread and proliferation.CONCLUSION:Acellular matrix possesses satisfactory biocompatibility for allogenic esophageal epithelial cells.Tissue-engineered artificial esophagus can be generated in vitro by a combination of esophageal epithelial cells and allogenic aceilularized matrix.