Construction of a knowledge base for hierarchical prevention care of neonatal hypoglycemia based on risk prediction model / 中国实用护理杂志

Objective:To build the standardized knowledge base for hierarchical prevention care of neonatal hypoglycemia based on the risk prediction model of neonatal hypoglycemia, and to provide a decision-making basis for risk management to achieve predicitive neonatal hypoglycemia.Methods:Based on the best evidence summarized in strategies for the prevention and management of neonatal hypoglycemia published in 2020, evidence on the prevention and management of neonatal hypoglycemia was searched from BMJ Best Practice, UpToDate, Registered Nurses Association of Ontario, CNKI and other domestic and foreign databases and professional association websites. The retrieval period was from September 1, 2019 to August 31, 2022. The quality of newly included literature was evaluated, new evidence was extracted, and the best evidence in the prevention and management strategy of neonatal hypoglycemia published in 2020 was summarized and combined to form the first draft of the knowledge base. Experts in the field of neonatal nursing were invited to revise and discuss each item of the knowledge base, and the final draft of the knowledge base was formed. The final draft of the knowledge base was coded using the 2.5 version of the Clinical care classification system as the standardized language.Results:The risk prediction model of neonatal hypoglycemia was used as a grading tool, the final draft of the knowledge included 1 nursing diagnosis, 6 modules and 18 specific preventive nursing measures.Conclusions:The knowledge base for hierarchical prevention care of neonatal hypoglycemia based on risk prediction model can realize the prospective hierarchical nursing of neonatal hypoglycemia, which is scientific and practical, and is the basis to assist nurses to make clinical decisions.

Modelo de Integración DIA-Persona para incrementar la calidad de la docencia, investigación y atención médica. Estrategia orientada a la persona / DIA-Person Integration Model to increase the quality of teaching, research and medical care. A person-oriented strategy

Resumen El modelo actual de la medicina ha distanciado la atención médica, la docencia y la investigación, con impacto en el paciente: durante la atención, el médico omite aplicar el método científico, solo atiende la dolencia sin acompañar al paciente; el investigador médico busca respuestas a preguntas alejadas de las dolencias del paciente y, en el mejor de los casos, realiza investigación en especímenes provenientes de este; la díada estudiante-profesor se caracteriza por la transmisión de conocimiento y deja de lado la comprensión del paciente. Pacientes, médicos, investigadores y estudiantes son ajenos a la toma de decisiones y sin cuestionamientos solo siguen procesos. Una manera de abordar el problema es regresar al Modelo de Integración DIA-persona: "la preocupación y el hacer por la persona, acompañados por la integración de docencia, investigación y atención médica", lo que permitiría el traslado del conocimiento, destrezas y beneficios de una actividad a otra. El modelo consiste en contrastar la condición del paciente con el conocimiento, realizar investigación durante y en paralelo al proceso de atención-docencia médica, así como aplicar el modelo arquitectónico de la investigación "descripción estructurada del juicio clínico", como proceso de referencia y reflexión que integra las actividades de docencia-investigación y atención médica orientadas a la persona.

Abstract Current model of medicine has made for medical care, teaching and research to be driven apart, with an impact on the patient: during the process of care, the doctor fails to apply the scientific method, he only treats the ailment without accompanying the patient. The medical researcher looks for answers to questions far removed from patient ailments and, in thebest-case scenario, conducts research on patient specimens. In addition, the student-teacher dyad is characterized by thetransmission of knowledge and leaves aside understanding of the patient. Patients, doctors, researchers and students are oblivious to decision-making and, without questioning, they merely follow processes. One way to address the problem is to return to the DIA-person Integration Model "concern and doing for the person, accompanied by the integration of teaching, research and medical care", which would allow the transfer of knowledge, skills and benefits from one activity to others. The model consists of contrasting the patient condition with knowledge, carrying out research during and parallel to the medical care-teaching process, as well as applying the architecture of research model "clinical judgment structured description", as a reference and reflection process that integrates the activities of teaching-research and person-oriented medical care.

Guía de actuación y abordaje frente a intoxicación por dióxido de cloro/clorito de sodio, a partir de la experiencia de los CIAT de América Latina / Guidelines for action and approach to chlorine dioxide/sodium chlorite poisoning based on the experience of the CIATs in Latin America

Resumen El 11 de marzo de 2020, la Organización Mundial de la Salud, declaró la pandemia a nivel mundial por la COVID-19. Ante este escenario, los centros de información y asesoramiento toxicológico (CIAT) de América Latina comenzaron a recibir consultas por exposición/intoxicación a dióxido de cloro/clorito de sodio y sus compuestos relacionados, por desvío de uso, destinado a la prevención y/o tratamiento de la COVID-19 sin aval científico alguno ni contar con registro sanitario para ese fin. A través de la Red de Toxicología de América Latina y el Caribe (RETOXLAC), se comprobó que no eran hechos aislados, sino que se estaba produ ciendo el mismo fenómeno en toda la región y que existían antecedentes de intoxicaciones con dichos productos y alertas desde hace más de una década, con indicaciones no aprobadas, para el tratamiento de distintas patologías como SIDA, cáncer, esclerosis lateral amiotrófica ELA, malaria, autismo, entre otras, sin evidencia. Ante esta realidad, los CIAT presentan una revisión de los signos y síntomas observados según la vía de ingreso, basados en la comunicación de riesgo en salud; proponiéndose pruebas de apoyo al diagnóstico, algoritmo de tratamiento para las intoxicaciones y modelo de ficha clínica para la vigilancia epidemiológica de los casos atendidos. Recomendamos a las autoridades y organismos responsables, reforzar las acciones tendientes a la vigilancia, control y prevención de este tipo de intoxicaciones, producto del mal uso de un desinfectante no autorizado para fines terapéuticos/médicos.

Abstract On March 11th, 2020, the World Health Organization declared a global pandemic due to COVID-19. Faced with this sce- nario, the Poison Control Centers (CIATs for its initials in spanish) in Latin America began to receive consultations for exposure/poi- soning to chlorine dioxide/sodium chlorite and its related compounds for their use aimed to prevent or treat COVID-19 without any scientific endorsement or having a sanitary registry for that purpose. It was found through the Toxicology Network of Latin America and the Caribbean (RETOXLAC) that they were not isolated events but rather that the same phenomenon was occurring throughout the region and that there has been a history of poisoning and alerts with these products for more than a decade with unapproved indications for the treatment of different pathologies such as AIDS, cancer, amyotrophic lateral sclerosis (ALS), malaria, autism, among others, without evidence. In the light of this situation, the CIATs present a review of the signs and symptoms observed ac- cording to the route of exposure based on health risk communication; proposing tests to support the diagnosis, an algorithm for poisoning treatment, and a model of a clinical record for the epidemiological surveillance of the assisted cases. We recommend to the authorities and responsible organisms reinforce the actions aimed at surveillance, control, and prevention of this type of poisoning due to the misuse of an unauthorized disinfectant for therapeutic or medical purposes.

"Ciência da mãe": modos de cuidados clínicos com bebês prematuros à luz da teoria psicanalítica / "Science of the mother": modes of cinical care with premature babies in the light of the psychoanalytic theory / "Ciencia de la madre": modos de atención clínica con bebés prematuros a la luz de la teoría psicanalítica

O presente artigo tem como objetivo investigar os modos de cuidados clínicos com bebês prematuros internados em uma Unidade de Terapia Intensiva Neonatal (UTIN), à luz do referencial teórico da psicanálise, considerando os processos de instauração do sujeito e apontando para possíveis contribuições à atenção em saúde mental de bebês. A escuta psicanaliticamente orientada e as observações norteadas pelo uso do instrumento Indicadores de Risco para o Desenvolvimento Infantil (IRDI) compuseram as notas do diário de campo e permitiram a apresentação de vinhetas que ilustram a construção de possíveis dispositivos de trabalho clínico. Destaca-se a importância da sustentação de um espaço de escuta no qual se sobressaia o discurso familiar sobre o bebê, possibilitando a produção de narrativas singulares.

This article aims to investigate the clinical care modalities with premature newborn infants admitted to a Neonatal Intensive Care Unit (NICU), in the light of the theoretical framework of psychoanalysis, considering the processes of instituting the subject and pointing to possible contributions to care in mental health of babies. The psychoanalytically oriented listening and the observations guided by the use of the Risk Indicators for Child Development (IRDI) instrument compose the notes of the field diary and allowed the presentation of vignettes that illustrate the construction of possible clinical work devices. It stands out the importance of supporting the space of listening in which the familiar discourse on the baby, making possible the production of singular narratives.

El presente artículo tiene como objetivo investigar los modos de atención clínica con bebés prematuros internados en una Unidad de Terapia Intensiva Neonatal (UTIN), a la luz del referencial teórico del psicoanálisis, considerando los procesos de instauración del sujeto y apuntando para posibles contribuciones a la atención en salud mental de los bebés. La escucha psicoanalítica orientada y las observaciones orientadas por el uso del instrumento Indicadores de Riesgo para el Desarrollo Infantil (IRDI) compusieron las notas del diario de campo y permitieron la presentación de viñetas que ilustran la construcción de posibles dispositivos de trabajo clínico. Se destaca la importancia de la sustentación de un espacio de escucha en el que se sobresalía el discurso familiar sobre el bebé, posibilitando la producción de narrativas singulares.

Postoperative Nursing Care in Head and Neck Reconstructive Surgery: A Prospective Review

Objective: In this study our main goal is to evaluate etiology ofthe patients with large gut obstruction.Method: This prospective study was done in total 50 patientspossessing the symptoms and signs of suspected large bowelobstruction irrespective of age and gender at different surgicalunits of Shaheed Ziaur Rahman Medical college Hospital,Bogra from May 2009 to April 2010.Results: During the result, 46 patients (92%) come withconstipation and 43 patients come with abdominal distension,27 patients (54%) with absent bowel sound, some hadabdominal pain (62%) and nausea & vomiting (58%), 5 patients(10%) complaint per rectal bleeding. Out of 50 patients plain xray abdomen in erect posture including both domes ofdiaphragm and digital rectal examination done in all patientsand found positive in 43 cases (86%) and 3 cases (6%)respectively, on USG whole abdomen7 patients (33.33%)found positive result, in rectoscopy out of 26 patients 5 patients(19.23%) found positive result.Conclusion: From our result, we can conclude that, large gutobstruction is fairly common surgical emergency in developingcountries, where volvulus is the commonest pattern ofpresentation, followed by colonic carcinoma.

Quando chega a aurora: a relação mãe e filha sob a perspectiva da clínica psicanalítica / In the crack of the dawn: the mother-daughter relationship from the perspective of the psychoanalytic clinic / Cuando llega la aurora: la relación entre madre e hija desde la perspectiva de la clínica psicoanalítica

Este artigo é o efeito de um atendimento clínico psicanalítico realizado ao longo da disciplina de Estágio, no Curso de Psicologia da Universidade Federal de Goiás (UFG), apresentado como um relato de atendimento. O estudo será composto pela apresentação do caso e, posteriormente, serão feitos alguns apontamentos teóricos pela perspectiva da psicanálise freudiana e lacaniana. A escolha do nome fictício Aurora, nomeação definida para se referir à analisante atendida, é uma aproximação metafórica do nascer do dia ao nascimento do sujeito. O objetivo principal deste relato clínico é o de promover uma discussão que aponte para como o sujeito se vê às voltas com a ascensão a seu lugar de ser desejante. Mais especificamente, a discussão se atém à problemática mãe/filha relatada pela paciente durante o atendimento. Presa à teia dos significantes maternos, Aurora se demora a acontecer como sujeito desejante. Contudo, apesar de todos os desvios, e mesmo diante da impossibilidade de se apontar para um nascimento definitivo e pontual, ao longo do trabalho de escuta, conseguimos vislumbrar ao menos os primeiros raios de uma aurora.

This paper is the effect of a psychoanalytic clinical care performed during the supervised training program in the Psychology course at the Federal University of Goiás (UFG), presented as an assistance report. The study will hold the presentation of the case and later on some theoretical notes will be made from the perspective of Freudian and Lacanian psychoanalysis. The choice of the fictitious name Aurora (which means dawn in Portuguese), refers to a metaphorical approach of the rising of the day, to the subject’s birth. The main objective of this clinical report is to forward a discussion that points to how the subject deals with the ascent to his/her place of a desiring being. More specifically, the discussion addresses the mother/ daughter problematics reported by the patient during treatment processes. Caught up in the web of maternal signifiers, Aurora lingers to rise as a desiring subject. However, despite all the deviations, and even in the face of the impossibility of pointing to a definitive and punctual birth, throughout the listening task, we, at least, managed to catch sight of the first rays of an aurora.

Este artículo es el efecto de sesiones clínicas psicoanalíticas realizadas a lo largo de una disciplina Práctica, del curso de Psicología de la Universidad Federal de Goiás (UFG), presentado como un relato de caso. El estudio consiste en la presentación del caso y, posteriormente, algunos apuntes teóricos son hechos en la perspectiva del psicoanálisis freudiano y lacaniano. La elección del nombre ficticio Aurora, nombramiento definido para referirse a la analizante, es una aproximación metafórica del nacer del día al nacimiento del sujeto. El objetivo principal de este relato clínico es de promover una discusión que señale cómo el sujeto se ve a sí mismo con la ascensión a su lugar de ser deseante. Más específicamente, la discusión se atiene a la problemática madre/hija relatada por la paciente durante las sesiones. Presa a la red de los significantes maternos, Aurora se demora a suceder como sujeto deseante. Sin embargo, a pesar de todas las desviaciones, e incluso frente a la imposibilidad de apuntar a un nacimiento definitivo y puntual, a lo largo del trabajo de escucha conseguimos vislumbrar al menos los primeros rayos de una aurora.

Effect of health seeking interval on outcome in swine flu cases attended a tertiary care hospital in southern Rajasthan region of India

Background: Swine flu influenza is an infection by H1N1 type of swine influenza virus. Swine influenza virus or swine-origin influenza virus (SIV or S-OIV) is a strain of the family of influenza viruses that’s endemic in swine (pigs). Early diagnosis and treatment is key approach to control the morbidity and mortality associated with swine flu which can be achieved by improving health seeking behaviour of community. Understanding of behaviour of community is essential for planning strategies for prevention and control. Aim of this study is to establish a relation between healthcare interval and outcome of swine flu.Methods: A complete data of all the patients visiting swine flu OPDs, swine flu wards and ICU were maintained for year 2015. Each patient visiting either the swine flu OPD or the swine flu ward, who was suspected clinically to be H1N1 positive were tested for real time PCR. Data was collected in a standardized pre-structured questionnaire.Results: Out of 1247 samples tested for rt-PCR, number of patients found to be swine positive was 491 (39.37%). Total 267 patients were admitted in swine flu ward and ICU, out of them 62 was expired. Clinical care intervals of more than 5 days from onset of symptoms to swab collection, diagnosis and admission were more in female and rural population. Mean duration between onset of symptom to hospitalization, swab collection and diagnosis was significantly higher in deceased patients than survived.Conclusions: Early presentation to healthcare facility is associated with better prognosis and outcome. After patient report to the health care setup, early sample collection and diagnosis help to reduce mortality.

Term structure, code formation and application tools of the clinical care classification system / 中华医学图书情报杂志

The term structure of the clinical care classification system(CCC) is consisted of nursing model, nursing components, nursing terms and term modifiers. Briefly described in this paper are its code formation, code genera-tion steps and application tools.

Clinical application of nitroglycerin combined with foresight nursing in patients with coronary heart disease with angina pectoris / 中国生化药物杂志

Objective Analysis of nitroglycerin combined with predictive nursing in the clinical application of coronary heart disease patients. Methods From January 2015 to December 2016, 200 patients with coronary heart disease were treated with angina pectoris. The patients were randomly divided into observation group and control group (100 cases). The control group was treated with routine nursing mode, and the patients in the observation group were treated with predictive nursing mode. The differences of hospitalization time and quality of life scores between the two groups were observed. The anxiety and depression of the two groups were observed before and after treatment, and the satisfaction of the two groups was observed. Results The scores of hospitalization and quality of life in observation group were better than those in control group (P<0.05). There was no statistically significant difference between SAS score and SDS score before treatment, but SAS score and SDS score of observation group were significantly lower than those of control group (P<0.05). The satisfaction degree of the patients in the observation group was better than that in the control group (P<0.05). Conclusion Predictive nursing has a good effect in the clinical nursing of patients with coronary heart disease and angina pectoris. It can effectively improve the patients' anxiety and depression, shorten the hospital stay and improve the quality of life. It is worth to be used in clinical practice.

Study on responsibility of the clinical nursing post in wards based on the post management / 中国实用护理杂志

Objective To study the responsibilities of nurses at different levels in providing clini cal care for patients in wards.Methods On the basis of conducting hierarchical management on nurses,the tasks of nurses in providing patients in wards with clinical care were summed up by means of data analysis and field observation.According to the tasks,a questionnaire about the responsibilities of nurses at all levels was designed.The 132 nurses from a Grade-3 Class-A general hospital in Chongqing Municipality who were responsible for providing clinical cares for patients in wards completed these questionnaires.Results Nurses in charge of providing clinical care for patients in wards usually undertook 11 tasks which could be divided into four aspects,which were,clinical nursing,nursing management,teaching on nursing and research into nursing.Based on the 11 tasks,44 responsibilities these nurses shouldered were defined,which included 4 responsibilities for N0-level nurses,6 for N1-level nurses,10 for N2-level nurses,11 for N3-level nurses,8 for N4-level nurses and 5 for N5-level nurses.Conclusions By defining in a scientific and systematic way the responsibilities and tasks of nurses at different levels in providing clinical cares for patients in wards,the research offered clinical nurses clear guidance on their work,and provided basis for the hospital's decision on clinical nurses,such as the personnel allocation,performance assessment and training; it could also help promote the position management on the work of nurses in China.

Process management of health education pathway to patients with rheumatoid arthritis / 医学研究生学报

Objective It is necessary for nursing staff members to assign priorities in health education to hospitalized patients to ensure curative effect .The purose of the study was to explore the effect of process management application in health education path -way to patients with rheumatoid arthritis ( RA) . Methods A total of 70 patients with rheumatoid arthritis were randomly divided into observation group and control group , 35 patients in each group .Traditional health education was done in control group , while health education pathway was performed in observation in observation group according to process management .A study of patients′satisfaction with hospitalization , compliance of medication and knowledge of health education was undertaken . Results Observation group had priority to control group in satisfaction with hospitalization and medication compliance (77.1% vs 42.9%,P 0.05). Conclusion Compared with traditional health educa-tion, the process management application of RA health education pathway helps to improve patients ′health konwledge and medical compliance , which is an effective adjuvant treatment .

Establishment of assessment scale based on the Omaha system with Delphi method for hospital stroke patients / 中国实用护理杂志

Objective To establish an assessment scale for hospital stroke patients with Delphi method,by using it to help the nurses evaluate patients' existing and potential problems,and to provide foundations for specific assessment on different patient groups.Methods The first-level indicators and second-level indicators were developed on the basis of the Omaha system.210 nursing records of hospital stroke patients were then combined with to form concrete items.Totally 22 nursing specialists were interviewed with two rounds in order to further collect the opinions and suggestions about the assessment scale.Results 4 first-level indicators,35 second-level indicators and a number of items were included in the assessment scale.Conclusions The assessment scale for hospital stroke patients established by Delphi method comprehensively shows the environmental,physical,mental and behavioral condition in hospital,and it could be used as a tool to assess the hospital stroke patients.

Clinical nursing experience of patients complicated with tuberculosis during pregnancy or puerperal state / 中国实用护理杂志

Objective To analyze the clinical nusing care methods and effects of patients complicated with tuberculosis during pregnancy or puerperal state.Methods Clinical data of 39 cases of patients complicated with tuberculosis during pregnancy or puerperal state were retrospective analyzed.Results After comprehensive treatment and nursing care,4 cases died,others got good prognosis.Conclusions Meticulous treatment and nursing can promote the rehabilitation of patients complicated with tuberculosis during pregnancy or puerperal state.For these patients,the cure rate can be improved and the recurrence rate can be reduced by choosing suitable treatment and nursing care programs,paying attention to psychological care and health education,ensuring patients taking medicine regularly.

Relações entre pesquisa e clínica em estudos em cogestão com usuários de saúde mental / Relations between research and clinical care in co-management studies with mental health care users

O artigo parte da experiência de pesquisar com usuários de saúde mental (e não sobre eles, ou para eles), narrando cenas de um estudo no qual se colocaram em jogo modos distintos de articulação entre pesquisa e clínica, problematizando suas fronteiras e as questões éticas implicadas. Situa o campo da clínica e da pesquisa de que se trata com o aporte de autores que, desde a análise institucional, propõem a ideia de pesquisa-intervenção; e, no contexto da saúde coletiva, resgatam o conceito de clínica ampliada. Fundamenta-se a articulação entre esses dois termos - pesquisa-intervenção e clínica ampliada - desde a noção de subjetividade que opera no âmbito da saúde coletiva e que culmina na ideia de autonomia. Finalmente, propõe-se a cogestão como estratégia a partir da qual os diferentes atores implicados na condução da pesquisa e no exercício da clínica constroem coletivamente uma direção de trabalho, ao mesmo tempo terapêutica e ética.

This paper is derived from the experience of conducting research with mental health users (not about them, nor for them), analyzing aspects of a study in which different ways of structuring the relationship between clinical practice and research were put into play, thereby questioning the boundaries and ethical issues involved. The clinical practice and research fields that are dealt with are studied with the input of authors who, on the basis of institutional analysis, propose the idea of interventional research, and in the context of public health, revert to the concept of broadened clinical care. The relationship between these two terms - interventional research and broadened clinical care - is based on the notion of subjectivity that operates within the scope of public health and which culminates in the concept of autonomy. Lastly, co-management is proposed as a strategy based on which the different actors involved in conducting research and exercising clinical care can collectively build working principles that are both therapeutic and ethical.

Por uma clínica infinitamente minúscula: o que pode o corpo em uma unidade de terapia intensiva neonatal / Towards clinical care for infinitely tiny babies: what the body is capable of in a neonatal intensive care unit / Por una clínica infinitamente minúscula: lo que puede el cuerpo en una unidad de cuidados intensivos neo-natal

O objetivo deste trabalho é problematizar a clínica e o corpo no hospital, especificamente em uma Unidade de Terapia Intensiva Neonatal, a partir da experiência da autora como psicóloga nesse contexto. Utilizando uma metodologia cartográfica que resgata um plano de sensibilidades, frequentemente higienizadas no hospital, percorremos as singularidades dos encontros clínicos, atravessados pelos agenciamentos das instituições hospital e família. Com isso, evidenciamos as marcas homogeneizantes e apacientadoras dos encontros com o bebê prematuro que ali se encontra, mas também percebemos linhas de fuga a esses modos dominantes que abrem novas possibilidades de cuidar. Ao nos interrogarmos sobre a potência do corpo e da clínica, fomos percorrendo e afirmando uma clínica minúscula, que se compõe nos encontros singulares e coloca em cena outra ética intensiva da vida.

The aim of this study was to raise questions regarding clinical care and the body in hospital, and specifically in a neonatal intensive care unit, based on the author's experience as a psychologist in this context. Using cartographic methodology that retrieved the plane of sensitivities, which are often cleansed in hospitals, we explored the singularities of clinical encounters, with the intermediation of hospital and family institutions. Through this, we showed the homogenizing and patient-forming characteristics of encounters with premature babies present there. However, we also could see lines of flight from these dominant ways, which might open new care possibilities. In ask ourselves about the power of the body and clinical care, we went on exploring, with affirmation of clinical care for tiny babies, built through singular encounters, which brings in another intensive ethical paradigm for life.

El objetivo de ese trabajo es problematizar la clínica y el cuerpo en una Unidad de Cuidados Intensivos Neo-natal, desde la experiencia como psicóloga en este contexto. A través de una metodología cartográfica que rescata un plano de sensibilidades, a menudo higienizadas en el hospital, buscamos recorrer las singularidades de los encuentros clínicos, atravesados por las instituciones hospital y familia. Así, encontramos las marcas homogeneizantes de los encuentros con el bebé prematuro que ahí se encuentra. Pero, pudimos ver las líneas de fuga a esos modos dominantes que van abriendo nuevas posibilidades de cuidar. Cuando nos preguntamos sobre la potencia del cuerpo y de la clínica, fuimos recorriendo y afirmando una clínica minúscula que se compone en los encuentros singulares y pone en escena otra ética intensiva de la vida.

Discussion on clinical characteristics analysis and nursing care of menopause depression / 中国医学装备

Objective:To analyze the depression incidence in premenopausal or postmenopausal women, find out the countermeasures to control or eliminate depression. Methods:Randomly divided the menopause group and premenopausal group in 724 patients who were assessed using Zung depression scale and venous blood determination of endocrine hormone FSH, LH, E2. Zung score≥40 points can diagnose depression. Results:The incidence in premenopausal group of climacteric depression was 13.3%, and postmenopausal group was 5.6%. The incidence of climacteric depression premenopausal group was obviously higher than that after menopause (x2=12.797, P<0.05). Conclusion:Menopause depression patients often have some physical or mental factors as incentive, spirit and body disease, etc.;Patients often change in physical and psychological. So the comprehensive care in the biological, psychological and social are necessary.

Insulin resistance and polycystic ovary syndrome / 中华内分泌代谢杂志

Insulin resistance likely plays a central pathogenic role in polycystic ovary syndrome and may explain the pleiotropie presentation and involvement of multiple organ systems.Hyperinsulinaemia leads to increased production of androgens resulting in anovulatory infertility.Women,especially those obese women with polycystic ovary syndrome,have an increased risk of developing type 2 diabetes and cardiovascular disease in their later life.Treatment of insulin resistance through lifestyle therapy or with a diabetes drug has become mainstream therapy to reduce the risk of diabetes,endometrial abnormalities,and cardiovascular disease events in women with polycystic ovary syndrome.

Effect of clinical nursing pathway on the mechanical ventilation effect of ARDS patients / 中国实用护理杂志

Objective To investigate the effect of clinical nursing pathway on mechanical ventilation effect of ARDS patients. Methods 59 ARDS patients with mechanical ventilation from June 2008 to December 2010 were randomly divided into the observation group (30 cases)and the control group (29 cases). The control group used the traditional care model, conventional mechanical ventilation monitoring,treatment and care according to routine measures; the observation group used clinical nursing pathway. The mechanical ventilation time, complication rate of mechanical ventilation, and the gratification level of patients in the two groups of patients were observed. Results The mechanical ventilation time in the observation group was less than the control group, and incidence of complications was lower, and satisfaction degree of patients and their families was better, the difference was statistically significant. Conclusions The clinical nursing pathway can shorten the time of mechanical ventilation, lower incidence of complications of mechanical ventilation, and it improves satisfaction degree of patients and their families.

Perioperative clinical care of parenteral and enteral nutrition supports in post-hepatectomy patients / 中华临床营养杂志

Objective To summarize the perioperative clinical care experience of parenteral and enteral nutrition supports in post-hepatectomy patients.Methods The clinical data of 146 consecutive post-hepatectomy patients in Beijing Hospital were collected and analyzed.For these patients,nutritional risk screening (NRS) 2002 was performed after admission,enteral nutrition support was provided before operation,and enteral and parenteral nutrition supports were provided after operation.Nutritional parameters,clinical outcomes,and nursing methods were evaluated.Results Among these 146 patients,91 patients had≥3 NRS2000 scores,and the remaining 55 patients scored ＜ 3.A total of 118 patients were administrated with enteral and pareteral nutrition;the average enferal nutrition time was 9.6 days,and the average pareteral nutrition time was 5.4 days.The average onset time of passage of gas by anus afar operation was (70.7±17.1) hours.Three patients died,15 patients suffered from infections after operation,and 13 patients experienced other complications.The median hospital stay was 25.5 days.Conclusions Post-hepatectomy patients need take nutritional risk screening after admission and receive appropriate nutritional supports in the perioperative period.It is equally important to strengthen clinical nursing for nutrition support.