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Objective:To promote the evidence application of the "Expert Consensus on Nursing Care for Prevention of Adult Oral Tracheal Intubation Unplanned Extubation" and verify its effectiveness.Methods:This was a quasi-experimental study. A total of 31 ICU nurses from Tianjin Teda Hospital were trained by workshops, in order to help promote the evidence transformation. With the evidence application model of the JBI Evidence-Based Health Care Center, we reviewed the measures for mechanically ventilated patients before and after intervention (51 cases at baseline and 77 cases at second review).Results:No unplanned extubation occurred during the period of two rounds of evidence review, the implementation rate of 9 review indicators had improved, and 6 of them showed statistically significant differences. indicator 1 increased from 3.92% (2/51) to 100.00% (77/77),indicator 3 increased from 86.27% (44/51) to 100.00% (77/77), indicator 5 increased from 27.45% (14/51) to 100.00% (77/77), indicator 7 increased from 45.10% (23/51) to 70.13% (54/ 77), indicator 8 increased from 50.98% (26/51) to 100.00% (77/77), indicator 9 increased from 45.10% (23/51) to 77.92 % (60/77), the difference was all statistically significant ( χ2 values were 8.02-119.87, all P<0.05). Conclusions:The "Expert Consensus on Nursing Care for Prevention of Adult Oral Tracheal Intubation Unplanned Extubation" can provide guidelines for clinical nursing practice. While preventing unplanned extubation, it can standardize nurses' behavior and promote medical-nursing cooperation.
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At present, countries around the world are paying greater attention to the protection of medicinal plants and traditional medicinal knowledge resources, and are looking for various ways to protect medicinal plants. Many countries have established their own databases to save the medicinal plant information resources. This paper focuses on the introduction of medicinal plant databases in six countries including Malaysia, Philippines, and Singapore, and compares their basic information. It is difficult to achieve integration and sharing among these databases. It brings certain difficulties to the use of researchers in related fields. It is suggested that the construction of a multinational common medicinal plant database should be included in the "Belt and Road Initiative" to systematically organize massive information, enhance exchanges between countries on traditional medicinal plants, and achieve medicinal plant information sharing, and the establishment of a shared database will reduce optimization and maintenance to a certain extent or renewal work, laying the foundation for the protection, development and sustainable use of traditional medicinal plant resources.
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Lancang-Mekong countries refer to the six countries that the Lancang-Mekong River flows through， including China， Laos， Myanmar， Thailand， Cambodia， and Vietnam. These countries are geographically adjacent with similar cultures and have long history of traditional medicine and high plant diversity. Since ancient times， medicinal plants have been introduced into China from the countries along the river， including a variety of medicinal plants with edible and healthcare values， which is an important way for the transnational circulation of medicinal resources. This paper briefly described the history and application of edible medicinal plants in the six Lancang-Mekong countries and summarized more than 150 edible medicinal plants from the other five countries except China. These 150 medicinal plants belong to 66 families such as Labiatae， and 12 species of them are used as edible medicinal plants in all the six countries. Further， we collected the information of these edible medicinal plants， including the origins， efficacy， indications， medicinal edible parts， edible values， and the traditional application of these plants in China. Some valuable edible medicinal plants in the other five countries are considered to have a promising prospect of application in China and may be introduced to China as new medicinal resources. These efforts will be conducive to the cooperation in traditional medicine among Lancang-Mekong countries.
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Germany owns the largest herbal market in Europe and has the world's leading R&D capabilities for herbal medicine products. Chinese herbal medicine (CHM) spreaded to Germany hundreds of years ago. Since the beginning of the 20th century, China and Germany have signed a series of agreements to support traditional medicine cooperation, and the exchange of herbs between China and Germany has become more frequent, bringing opportunities for CHM to enter into Germany. In recent years, China and Germany have gained progress in the fields of CHM research and trade, etc. However, there are differences in the understanding of herbal medicines, quality standard evaluation, usage, and medication rules between the two countries. By doing SWOT analysis of the development of CHM in Germany, this paper suggested to promote Sino-German medical exchanges and build a community of common health for mankind through strengthening the clinical application of CHM, finding new ways of CHM entering into German market, and building an international talent team of traditional Chinese medicine.
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Objective:To evaluate the distribution and drug sensitivity of pathogenic bacteria in patients with bacterial keratitis in recent 40 years in China.Methods:A Meta-analysis was conducted.Five databases including PubMed, ScienceDirect, Embase, CNKI and Wanfang Data Knowledge Service Platform were searched.The research was limited to the hospital-based cross-sectional studies published in Chinese and English between 1980 and 2020, without limitations of subject.Two researchers followed the inclusion and exclusion criteria to complete literature retrieval, data extraction and methodological quality evaluation.The literature quality was assessed with reference to a methodological scoring system for rates. Q test and I2 test were used to quantify the degree of heterogeneity of the included literature.According to the heterogeneity, the fixed effects model or random-effects model was used to calculate the combined rates indicators to perform the Meta-analysis. Results:Twenty-seven original studies were incorporated, including 50 046 cases of bacterial keratitis.A random-effects model for the Meta-analysis showed that the positive rate of bacterial culture in bacterial keratitis was 28% (95% CI: 0.24-0.32). Among the culture-positive bacteria, the percentages of gram-positive cocci and gram-negative bacilli were 57% (95% CI: 0.52-0.62) and 32% (95% CI: 0.28-0.37), respectively.The percentages of gram-positive bacilli and gram-negative cocci were 8% (95% CI: 0.06-0.10) and 1% (95% CI: 0.01-0.02), respectively.In the recent 40 years, the proportion of gram-positive cocci isolated from corneas in China was on the rise, and the proportion of gram-negative bacilli was on the decline.Among them, coagulase-negative Staphylococcus accounted for 23% (95% CI: 0.17-0.30), followed by Pseudomonas aeruginosa 18% (95% CI: 0.14-0.23), Streptococcus pneumoniae 8% (95% CI: 0.06-0.12), Staphylococcus aureus 6% (95% CI: 0.04-0.08), Corynebacterium 4% (95% CI: 0.03-0.07), and Escherichia coli 4% (95% CI: 0.02-0.06). The results of the drug sensitivity test showed that gram-positive cocci were highly sensitive to vancomycin, moxifloxacin, levofloxacin and ofloxacin. Pseudomonas aeruginosa was most sensitive to tobramycin, and Escherichia coli was most sensitive to ofloxacin. Conclusions:This Meta-analysis indicates that the proportion of gram-positive cocci isolated from corneas in China has been on the rise, while the proportion of gram-negative bacilli was on the decline during the recent 40 years.Coagulase-negative Staphylococcus and Pseudomonas aeruginosa have become the most common pathogens of bacterial keratitis in China.The sensitivity of various bacteria to commonly used antibiotics shows a downward trend.The sensitive antibiotics should be selected correctly according to the drug sensitivity results.
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Objective:To establish early warning indicators for Chinese nurses to recognize in-hospital cardiac arrest (IHCA) of adult inpatients.Methods:Computer retrieval of Chinese and English databases such as CNKI, Wanfang Database, VIP, National Medical Library of the United States PubMed Database, Web of Science, Embase Database of the Netherlands Medical Abstracts, Cochrane Library Database and other international guidelines collaboration network (GIN), National Institute for Health and Clinical Optimization (NICE), Scottish Intercollegiate Guidelines Network (SIGN), BMJ best clinical practice and other guidelines was performed. The retrieval time limit for respiratory and cardiac arrest early warning indicators or risk identification related content of the adult inpatient in the professional website was until June 30, 2020. After literature research and expert group analysis, the research group drew up an expert correspondence questionnaire, and selected 32 medical and nursing experts from Beijing, Tianjin, Jilin, Shandong, Shaanxi, Sichuan, Zhejiang and other grade three first-class general hospitals from July to September 2022. The Delphi method was used to conduct two rounds of expert correspondence, forming the final version of the early warning index of cardiac arrest in adult inpatients.Results:Five first-level indicators, 23 second-level indicators and 41 third-level indicators including vital signs, consciousness and pupils, postoperative blood drainage volume, lab results and other five aspects were initially formed. The effective response rates of the two rounds of expert correspondence were 100% (32/32) and 93.75% (30/32), respectively, the Kendall coordination coefficients W of the first round and the second round were 0.340 and 0.462, respectively, the expert authority coefficients Cr were 0.88 and 0.89, respectively, the mean value of importance assignment was 3.94-5.00, 4.07-5.00, and the coefficient of variation was 0-0.16, 0-0.14, with statistically significant differences (all P < 0.05). Finally, 5 primary indicators, 23 secondary indicators and 43 tertiary indicators were formed, including five aspects of vital signs, consciousness and pupils, postoperative blood drainage, lab results, symptoms and chief complaints. Conclusion:The expert consultation on the early warning indicators of IHCA for adult patients tends to be consistent and scientific, which is applicable to help nurses detect the changes of patients' condition as early as possible.
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This paper analyzes and compares the development of Traditional Chinese Medicine (TCM) in Germany, France, the UK and Netherlands, considering the economic and social situation of countries. The SWOT strategic analysis is carried out on the basis of the proposittion of China-Europe cooperation in TCM, which encourage to carry out joint tackling of TCM for common diseases, jointly promoting the legislation with the guidance of the government and the participation of the public, speeding up the registration and listing of Chinese patent medicine with the focus on the Netherlands and the UK, and optimizing the perspective and strength of TCM publicity with the help of new media. In this way, TCM should be promoted in Europe.
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Machine learning, as the main technical direction of artificial intelligence, can help ophthalmologists to interpret and analyze the large amount of data generated by imaging equipment, and also simplify the diagnosis and treatment process.The early diagnosis and classification of keratoconus became the most important application of machine learning.The modeling methods of machine learning for diagnosing keratoconus usually included neural network and decision tree method.The sensitivity and specificity of these models for diagnosing keratoconus were more than 85%.Because there were large number of research parameters for the diagnosis of keratoconus and no adequate public data sets, it was difficult to evaluate the advantages and disadvantages of different research methods, which limited the clinical application of machine learning in the evaluation of keratoconus.The corneal refractive surgery preoperative evaluation had clinical problems of large data volume and difficult decision-making.Machine learning can assist in evaluating whether the patient is suitable for refractive surgery, of which specificity and sensitivity were above 90%.It was also able to predict postoperative visual quality with ocular parameters.In addition, machine learning can also help us to count corneal endothelial cell density and assess corneal epithelial damage.Machine learning method and big data modeling evaluation can assist doctors in accurate diagnosis and personalized evaluation of keratopathy.This article reviewed the recent literature on the application progress of machine learning in corneal-related diseases in recent years.
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Objective:To validate the effectiveness of the "ventilator-associated pneumonia (VAP) cluster nursing package" in Tianjin.Methods:A self-test questionnaire was prepared based on the "Ventilator-associated pneumonitis bundled nursing package", and an electronic questionnaire was used to investigate the comprehensive ICU of 40 hospitals in Tianjin.Results:The average self-examination form of the comprehensive ICU "ventilator-associated pneumonia cluster nursing package" in Tianjin was 28.92 points (out of 30 points), of which the bedside elevation, sedation and wake up, timely extubation, strict hand hygiene, and maintenance Effective airbag pressure, timely dumping of condensate water, timely removal of stagnation, and prevention of the total score of VAP package execution were related to the occurrence of VAP in patients in Tianjin from August 2018 to August 2019 ( r value was 0.101, P <0.01); ICU unit layout, nurse level and prevention of VAP package implementation are the influencing factors of VAP in ICU patients. Conclusion:The "ventilator-associated pneumonitis cluster nursing package" has been well implemented in Tianjin ICU, and the implementation of this package can reduce the incidence of VAP.
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The paper introduces the current situation of traditional Chinese medicine (TCM) in Germany from the aspects of legislation and management, clinical treatment, education, scientific research, and medicinal plant resources. Based on this, this paper concludes that the major problems of TCM development in Germany are lack of effective legal protection, most TCM treatment therapiess are not covered by German health insurance, and the clinical level of TCM practioners is relatively low. Under the guildance of the Belt and Road Initiative, China should formulate relevant policies to promote international TCM cooperation between China and Germany, help Chinese institutions to build bridges with German institutions, cultivate German TCM talents, strengthen TCM cooperation on science and technology, and encourage Chinese enterprises to go global, therefore promoting the gradual development of TCM in Germany.
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This paper summarizes and analyzes the current conditions of Tanzania traditional medicine practitioners, organization structure, herbal medicine resources, and the exported pharmaceutic products and related companies. The result shows that Tanzania government gradually pays the attention to the development of its own traditional medicine industry. Due to the current TCM cooperation dilemma with Tanzania, coping strategies should be adopted to provide certain references for the next stage of China-Tanzania TCM cooperation, such as adjusting the professional fields of dispatched experts, adjusting cooperative fields, including the export and investigation of TCM companies to Tanzania.
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Electronic health record is an important part of medical information research and has been widely used in medical institutions to help medical personnel deal with various medical information. However, due to the lack of standardized nursing language, nurses are often unable to reuse nursing data in electronic health records, which hinders the further development of medical information sharing and electronic health records. The use of standardized nursing language can support efficient and complete nursing documents in electronic health records and meet the requirements of clinical and data interoperability. This paper summarizes the definition and significance of electronic health record and standardized nursing language and the application status of standardized nursing language based on electronic health record, so as to provide scientific reference for the development and improvement of electronic health record in China.
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Electronic health record is an important part of medical information research and has been widely used in medical institutions to help medical personnel deal with various medical information. However, due to the lack of standardized nursing language, nurses are often unable to reuse nursing data in electronic health records, which hinders the further development of medical information sharing and electronic health records. The use of standardized nursing language can support efficient and complete nursing documents in electronic health records and meet the requirements of clinical and data interoperability. This paper summarizes the definition and significance of electronic health record and standardized nursing language and the application status of standardized nursing language based on electronic health record, so as to provide scientific reference for the development and improvement of electronic health record in China.
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This paper aimed to provide reference for science and technology management staff as well as researchers to conduct international cooperation in the future. The paper analyzed and discussed the scale, achievements, character and trend of international cooperation projects by analyzing the international cooperation projects of China Academy of Chinese Medical Sciences from 2006-2017. The method of metrology was used.
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Objective@#To investigate the current status of fear of cancer recurrence in bladder cancer patients, and to explore the correlation between fear of recurrence and quality of life.@*Methods@#A total of 96 bladder cancer patients were recruited by convenience sampling method from April 2017 to July 2017. They were investigated through general information questionnaire, Chinese version of Fear of Progression Questionnaire Short Form and Functional Assessment of Cancer Therapy-Bladder cancer form respectively.@*Results@#The total score of fears of recurrence was 28.76±10.33, the total score of quality of life was 123.66±20.63. A total of 28 patients had a dysfunctional level of fears of recurrence (total score ≥34), the incidence was 29.2% (28/96). There were significant differences in the total scores of fears of recurrence at different ages, fears of recurrence were not related to another sociodemographic factors (gender, educational attainment and income) or disease, treatment related factors. The total scores of fears of recurrence and the total score of quality of life showed a high degree of negative correlation (r=-0.726, P < 0.01), the quality of life in physical, social and family, emotional, functional well being were negatively correlated with fears of recurrence (r=-0.841--0.592, P < 0.01).@*Conclusions@#Bladder cancer patients have a higher incidence of fears of recurrence and had an impact on quality of life from the physical, psychological and social domains, nurses should perceive the fears of recurrence of patients as soon as possible and give corresponding intervention measures to improve the quality of life of bladder cancer patients.
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Sedation is one of ICU routine treatment, understand the harm to patients caused by deep sedation; by enhancing the ability to regulate the sedation nurse, to help early shallow sedation for goal orientation in the implementation of the program is to reduce sedation, sedation complications, effective means of preventing excessive sedation, is an important measure to promote the development of clinical nursing.
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The paper analyzed the scale, educational background, degree, and financial source of the European students in Chinese TCM colleges and universities by using excel 2013. The results showed that there were 19 TCM colleges and universities recruiting European students, and the number of campus students, enrollment students, graduation students were 409, 257 and 280 in 2017 respectively. The campus students in 2017 was highest since five years ago, but was less than the Afro-Asia states. Training was main form of studying abroad. Most campus students were at their own expenses, or received the help from Chinese government. The education for European students in Chinese TCM colleges and universities has made some achievement, but there were still some questions: the European students was not too much, the education's attraction was not strong, and the financial help from international organization and foreign government was scarce.
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Objective To explore the effects of comprehensive restraint reduction program on preventing un-planned extubation among ICU patients with tracheal intubation. Methods Totally 266 cases of ICU patients with tracheal intubation in our hospital were selected as the research objects using the convenient sampling method.They were divided into two groups by time: the experimental group of 130 cases implementing a comprehensive reduction constraint program and the control group of 136 cases using conventional physical restraint in nursing process.The constraint rate, constraint length, UEX incidence, skin and satisfaction of the two groups were compared. Results In the experimental group, the rate of physical restraint and UEX decreased, the average restraint length of each patient was shortened, skin integrity at the site of restraint improved, and the satisfaction of patients increased. Compared with the control group, the differences were statistically significant(P<0.01 or P<0.05). Conclusion The com-prehensive restraint reduction program can reduce the rate of physical restraint and the incidence of unplanned ex-tubation among ICU patients with tracheal intubation.
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BACKGROUND: Prospective studies concerning bone metabolism and bone mineral density variation after fractures have been reported from the 1960s, but these studies are mainly focused on tibia and fibula and ankle fractures in patients with low sample size. OBJECTIVE:To observe the changes in bone mineral density and bone metabolism indexes in elderly women within 6 to 12 months after hip fractures, and to analyze the correlation. METHODS:We selected 48 elderly women with hip fractures admitted in the Department of Orthopedics, Beijing Aerospace General Hospital in China from May 2011 to July 2013. Standards for fol ow-up were developed to measure the bone mineral density and bone metabolism indexes in the L 1-4 spinal segments and both sides of the hip. The bone metabolism indexes included bone alkaline phosphatase, osteocalcin, cross-linked C-terminal peptide of col agen I, and serum tartrate-resistant acid phosphatase 5b levels. Multiple linear regression analysis was performed based on measurements of bone mineral density and bone metabolism indexes after fracture healing. RESULTS AND CONCLUSION:After fracture healing, bone mineral density of the fractured hip and lumbar vertebra was significantly lower than the baseline value. There was no statistical difference in bone mineral density between the healthy hip and the baseline value. At 6 months after fractures, bone alkaline phosphatase, osteocalcin, cross-linked C-terminal peptide of col agen I, and serum tartrate-resistant acid phosphatase 5b levels were significantly higher than the baseline values. At 12 months after fractures, osteocalcin level was significantly higher than the baseline value, while other indexes of bone metabolism measurements showed no statistical difference from the baseline values. When healing of hip fractures met the clinical and radiographic standards, the partial regression coefficient of delta-Z score reached peak in the changes of serum osteocalcin and bone mineral density of the fractured hip. Under clinical healing of fractures, serum osteocalcin level exhibits a higher value for the assessment of recovery speed of bone mineral density. Monitoring corresponding bone metabolism indexes after fracture healing can improve the accuracy of judging bone mineral density changes to reduce the risk of secondary fractures.
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Objective To compare the effect of insulin instiling and CSII in treatment of DKA and DHS Methods Patients with DKA (n=40) and DNHS (n=40)were chosen for comparing the effect between intravenous insulin instilling treatment and CSII therapy Results Both CSII and insulin instilling controlled effectively DKA and DHS,but the former surpassed the latter in the therapeutic respects of insulin dosage,hypoglycemic speed,glycemic stability,ketobody clearance.Conclusion CSII has an advantage over insulin instilling