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Objective@#To examine the effect of early comprehensive interventions on the physical growth and nerve development among premature infants, so as to provide insights into the follow-up management of premature infants after discharge from hospital.@*Methods@#A total of 130 premature infants delivered in Shaoxing Municipal Maternal and Child Health Care Hospital from 2019 to 2021 were selected and divided into high- and low-risk groups according to gestational age and birth weight, while 306 full-term normal infants in the same hospital during the study period served as controls. All premature infants were given early comprehensive interventions until age of 12 months, including nutritional support and parental guidance of children's feeding and development, and all normal infants received periodical health checkup according to the basic public health service program. All infants received periodical measurements of height, weight and head circumference, and the 12-month intellectual and motor development ability was measured using the Bayley Scales of Infant Development revised in Chinese cities was used to assess. Infants' physical growth, mental development index (MDI) and motor development index (PDI) were compared among groups.@*Results@#There were 130 premature infants with gestational ages of 28 to 36 weeks and birth weight of 1 200 to 3 440 g, including 79 male infants, and there were 80 infants in the low-risk group and 50 infants in the high-risk group. The full-term infants had a gestational age of 37 to 42 weeks, and birth weights of 2 500 to 4 000 g, including 162 male infants. There were significant differences in height (Wald χ2=28.664, P<0.001) and head circumference growth (Wald χ2=19.312, P=0.013) among the three groups as revealed by the generalized estimating equation; however, no significant differences were seen in the 12-month weight (F=0.639, P=0.528), height (F=1.051, P=0.350) or head circumference (F=0.318, P=0.728) among the three groups. The percentages of abnormal MDI were 2.00%, 0 and 1.31% among the high-risk premature infants, low-risk premature infants and full-term infants at ages of 12 months (χ2=1.319, P=0.517), while the percentages of abnormal PDI were 20.00%, 7.50% and 5.56% among the three groups at ages of 12 months (χ2=12.818, P=0.002).@*Conclusions@#Following implementation of early comprehensive interventions, the premature infants have favorable physical growth and comparable MDI with full-term infants; however, a high percentage of abnormal PDI is seen in high-risk premature infants. An improvement in the motor development among high-risk premature infants is recommended to be emphasized during the management of premature infants.
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Objective:This study was to evaluate the effects of comprehensive intervention， at different stages， in community osteoporosis patients. Method:Osteoporosis intervention was set up for years in a follow-up cohort community， in which patients with primary osteoporosis who volunteered to participate in the research were divided into control and intervention groups. The latter received comprehensive intervention consisting of physical therapy with osteoporosis therapeutic instrument， treatment with the prescription of strengthening waist and keeping bones in combination with calcitriol， health Qigong and changing tendon exercise， and health education lectures. The therapeutic effect was assessed at three different stages： prior to intervention， 3 and 6 months after intervention. The effect indicators included the following： visual anologue scale （VAS） pain score， clinical symptom total score， general condition total score， bone density and bone metabolism. Results:VAS pain index， total clinical symptom score and total systemic condition score in the intervention group were significantly lower than those in the control group （P<0.05）. Bone density in the intervention group increased at 6 months and the difference was statistically significant （P<0.05）， compared with the control group （P<0.05）. All the four bone biochemical indexes in the intervention group changed compared with those before intervention， and the improvement of PINP， β-CTX， 25（OH）D in the intervention group was better than that in the control group. Conclusion:Result of effect evaluation with multiple indicators demonstrates that comprehensive intervention is suitable for promotion in prevention and treatment of primary osteoporosis in community.
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Objective To investigate the comprehensive intervention of special-use-grade antibacterial agents and their effects on bacterial resistance in oncology department, and analyze the effects of comprehensive intervention. Methods The medical records of 63 patients discharged from January to June 2017 were used as the control group, and the medical records of 61 patients discharged from January to June 2018 were used as the intervention group. The changes in the indicators of special-use-grade antibacterial agents before and after the intervention were compared. Results After comprehensive intervention, the pass rate of online consultation of special-use-grade antibacterial agents increased from 65.34% to 98.00%, with a statistical difference (P<0.05). DUI values of linezolid, amitraconam, carbophenazim and voriconazole decreased from more than 1 to less than 1. The usage rate of single use antibacterial agents was significantly increased, and the usage rate of combination of antibacterial agents was significantly decreased (P<0.05). Main pathogenic bacteria for escherichia coli, klebsiella pneumoniae, pseudomonas aeruginosa, staphylococcus aureus, white smooth candida yeast and candida, and their constituent ratio had no significant change. Except for klebsiella pneumoniae, the resistance rate of imipenem increased by 16.67%, while resistance rate of other pathogens is in a downward trend. Conclusion The comprehensive intervention makes the clinical application of special-use-grade antibacterial agents in oncology department increasingly reasonable.
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Objective To evaluate the impact of comprehensive intervention mode on osteoporosis related knowledge and behavior among city residents aged over 40-year-old and to provide reference for osteoporosis prevention and treatment. Methods Health education including self-management of osteoporosis was conducted among Chongqing city residents aged over 40-year-old for 4 consecutive months.All the subjects were asked to fill out the questionnaire during face-to-face interview before and after the intervention.The changes in knowledge and daily life style were tested by Chi-square test. Results The residents surveyed were 2 028 before the intervention and 1 986 after the intervention.After the intervention, the proportion of awareness was significantly higher (P < 0.01) than that before the intervention in the following: features of osteoporosis(33.23% vs 18.49%), sensitive population of osteoporosis(10.52% vs 3.75%), balanced diet to prevent osteoporosis (23.82% vs 11.09%), bone health supplements (51.06% vs 32.84%), recommended daily calcium intake for postmenopausal women and older people (34.89% vs 13.91%).After the intervention, the proportions of residents who never drink milk and its products, and never eat beans and their products were decreased significantly (13.49% vs 23.09%, and 4.94% vs 7.00%, P < 0.01).The proportion of residents who take average more than 30 minutes daily outdoor activity under sunlight was increased significantly after the intervention (64.25% vs 59.27%, P < 0.01).The proportion of residents preferring salty food was decreased significantly after the intervention (8.26% vs 14.89%, P < 0.01). Conclusion The comprehensive intervention mode of health education in combination with traditional and new media as well as health self-management is a cost-effective prevention measure for osteoporosis, which can improve the osteoporosis cognitive level of middle-aged and senile people and the development of good behavior.
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Objective To investigate the obesity of primary and secondary school students in Chengdu City, and to analyze the effects of comprehensive intervention. Methods A total of 1 500 children in Jinniu District of Chengdu were selected for health check-ups. Questionnaires were distributed to children and their parents to investigate the incidence of obesity and analyze the risk factors. Obese children were randomly divided into a control group and an intervention group. The control group was given routine health education while the intervention group was given comprehensive management intervention. The obesity indicators and compliance were compared between the two groups. Results Among 1 500 children, there were 192 obese children. Multivariate logistics regression analysis showed that males (OR=1.881, P<0.05), fetal macrosomia (OR=1.790, P<0.05), premature infants (OR=2.261, P<0.05), parental obesity (OR=1.774, P<0.05), eating midnight snack (OR=3.943, P<0.05), fast eating speed (OR=2.980, P<0.05), addiction to meats such as pigs/chickens/bovines (OR=1.956, P<0.05), addiction to fried foods (OR=1.662, P<0.05), addiction to desserts (OR=2.361, P<0.05), liking eating sugary drinks (OR=1.547, P<0.05), lack of exercise (OR=2.428, P<0.05) and parental cognition towards body shape of children (OR=14.629, P<0.05) were risk factors for childhood obesity. After intervention for risk factors of obesity, the levels of obesity indexes in the two groups were significantly decreased compared with those before intervention (P<0.05), and the levels of obesity in the intervention group were significantly lower than those in the control group (P<0.05). The rate of compliance in the intervention group was significantly higher than that in the control group (P<0.05). Conclusion Male gender, fetal macrosomia, premature infants, parental obesity, eating midnight snack, fast eating speed, addiction to meats such as pigs/chickens/bovines, fried foods, desserts and sugary drinks, lack of exercise and parental thinking of moderate body shape of children were risk factors for obesity in primary and secondary school students in Chengdu. The implementation of comprehensive interventions can help obese students lose weight.
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Objective@#To explore the comprehensive intervention mode of compliance with analgesics for home-based patients with moderate or severe cancer pain and to improve the medication compliance of home-based patients with cancer pain.@*Methods@#A self-designed questionnaire was designed to investigate the influencing factors of taking analgesics for home-based patients with moderate or severe cancer pain, 143 home-based patients with moderate to severe cancer pain were conveniently selected from Hospice Unit of Zhongnan Hospital of Wuhan University, from February 2016 to December 2017. To investigate the subjective, objective and psychological factors affecting patients' compliance with analgesics, comprehensive interventions such as health education, behavioral intervention, cognitive intervention and psychological counseling were carried out. Before and after the intervention, Morisky′s self-report questionnaire on medication compliance, pain digital grading (NRS score), and pain relief degree were assessed. Using self control design method and comparing the compliance of patients taking analgesics, number of complete compliance and non-compliance in patients taking analgesics and NRS score and pain relief before and after 8 weeks of intervention. Pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after comprehensive intervention were evaluated.@*Results@#The main factors affecting patients' medication compliance with analgesics were fear of morphine addiction(16.37%, 37/226), single use of drugs and insufficient dosage (15.93%, 36/226), and fear of adverse drug reactions(13.72%, 31/226). The scores of NRS decrease in patients with different influencing factors were compared, with statistical difference (F=5.367, P=0.006). There were significant differences in the number and compliance of patients with complete compliance and non-compliance before and after 8-week-comprehensive intervention (χ2=25.583, P=0.000; t=-7.387, P=0.000). There were significant differences in pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after 8-week-comprehensive intervention (χ2=76.572, 62.998, all P=0.000).@*Conclusions@#Comprehensive intervention on subjective, objective and psychological factors affecting the medication compliance of home-based patients with moderate or severe cancer pain can improve the medication compliance of patients to take analgesics and alleviate pain.
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Objective@#To evaluate the effectiveness of AIDS intervention programs on men aged 50 or over and having had non-marital sexual behavior.@*Methods@#A community-based intervention/experimental and based on individual level study was adopted. Stratified sampling method was used. 12 townships/streets in Fuyang district of Hangzhou were identified as intervention or control group (six research sites each). All of the subjects in the township (street) were included. The inclusion criteria of study objects would include men aged 50 or older who reported having unmarried sex in the last year. Estimated sample size was 290, with each 145 in the intervention group and the control group. All the intervention group participants were provided with a total of 4 intervention-related items (knowledge and education on AIDS prevention, information radiation and behavioral change, broadcast expert lectures), every 3 months, for 12 month, the main evaluation indicators would include: incidence of non-marital sex and commercial sex in the last year, condom use when having non-marital sex in the last episode.@*Results@#A total of 312 subjects were recruited. 300 of them completed the baseline study while 284 of them completed the follow-up survey. Among the subjects who had undergone the baseline study, the average age was (65.58±7.89), 71.33% were married or cohabiting with someone, 52.00% having had primary school education. After the implementation of intervention programs, the incidence of non-marital sex dropped to 59.42% (82/138) and the incidence of commercial sex dropped from 79.73% (118/148) to 55.07% (76/138). Condom use rate in the last non-marital sexual contact increased from 19.59% (29/148) to 51.22% (42/82). In the control group, the incidence of non-marital sex in the year before dropped to 74.66% (109/146) and the incidence of commercial sex dropped from 91.45% (139/152) to 72.60% (106/146). Rates of condom use during the last non-marital sexual contact dropped from 32.89% (50/152) to 31.19% (34/109). Statistically, there were significant differences appeared between the two groups on the incidence of non-marital sex in the past year (χ2=7.48, P=0.008), the incidence of commercial sex in the last year (χ2=9.47, P=0.003) and the rate of condom use in the last sex experience (χ2=7.83, P=0.007).@*Conclusions@#Results from this intervention study showed that: in the intervention group, both the incidence rates of non-marital or commercial sex had reduced, together with the increase of condom use in non-marital sex in the last sexual experience. Intervention strategies that involving knowledge and education on AIDS prevention, information radiation and behavioral change, broadcasting lectures by experts etc. were all proved effective.
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Comprehensive interventions have been widely used in health system, public health, education and communities and have become increasingly focus of systematic reviews. There have been many reporting guidelines about systematic reviews, but they do not take the features of comprehensive interventions in medical area into consideration. As a result, PRISMA-CI has been developed as an extension of PRISMA, which adds or modifies the essential items of PRISMA. This paper introduces the items of PRISMA-CI and explains the items with an example to help authors, publishers, and readers understand PRISMA-CI and use it in systematic reviews on comprehensive interventions. As it become more and more popular with comprehensive interventions, PRISMA-CI will provide important structure and guidance for its systematic review and Meta-analysis.
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OBJECTIVE： To provide reference for reducing the rate of outpatient/emergency intravenous infusion in paediatric and improving the safety of drug use in children. METHODS： The comprehensive intervention of outpatient/emergency intravenous infusion in paediatric by pharmacists of our hospital though multiple measures was introduced， such as education training， system construction and management， multi-party monitoring and intervention. Related data were selected before （Jan-Jun. 2018） and after intervention （Jul.-Dec. 2018） to evaluate intervention effects， involving paediatric outpatient/emergency intravenous infusion rate， antibiotics intravenous infusion rate， the rate of intravenous infusion prescription， total cost of antibiotics， TCM injection， adjunctive drugs and key monitoring drugs in infusion prescriptions. RESULTS： Through the comprehensive intervention of pharmacists， related indexes of outpatient/emergency intravenous infusion in paediatric were decreased greatly in our hospital. The rate of intravenous infusion， the rate of antibiotics intravenous infusion， the rate of intravenous infusion prescription and the rate of antibiotics intravenous infusion prescription were decreased from 19.52％， 15.46％， 20.29％， 11.20％ to 10.37％， 8.55％， 10.25％， 6.64％（P＜0.001）， respectively. Total cost of antibiotics， TCM injection， adjunctive drug and key monitoring drug were decreased respectively in infusion prescriptions （P＜0.001）. CONCLUSIONS： The comprehensive intervention measures taken by pharmacists in our hospital can reduce the rate of outpatient/emergency intravenous infusion in paediatric and the medical cost， and promote the safety of drug use in children.
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Objective To evaluate the effect of comprehensive intervention program on hypertension control in workplaces in China.Methods The study design was a non-randomized controlled trial.First,20 sub-centers were selected across China,then hypertension patients in 2-4 workplaces were selected as the intervention group,and hypertension patients in 1 comparable workplace selected,as the control group in each sub-center.The comprehensive intervention strategy which integrating workplace primary prevention of cardiovascular diseases and standardized management of hypertension was adopted in the intervention group for at least 2 years.Patients in the control group continued their usual health care,and only baseline data and 2-year data was collected.Analyses were conducted for hypertension patients in 30 stated-owned enterprises (SOEs),including 20 for the intervention group and 10 for the control group.The primary outcome was the control rate ofhypertension while the intervention effect (IE) was estimated by using the formula:differential value of intervention group [rate (mean)] — differential value of control group [rate (mean)].Results Overall,2 622 patients completed the 2-year follow-up,of which 2 055 were in the intervention group and 567 in the control group,respectively.After 2 years of intervention,the IE on the level of SBP and DBP for intervention group and control group were-7.5 and-3.9 mmHg,respectively (P＜0.05).BMI decreased by 0.4 kg/m2,with the regular exercise rate as 36.4％ and alcohol consumption rate decreased by 14.0％,respectively (P＜0.05).The smoking rate decreased by 6.1％ (P＞0.05).The overall hypertension control rate was 25.0％,and further subgroup analysis showed that our intervention program was particularly effective for those with high education level (27.6％),white-collar employees (41.9％),and those from SOEs whose affiliated hospital had been separated away (41.9％).Conclusion The comprehensive intervention program could greatly improve the hypertension control in the workplaces in China.
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Objective To evaluate the effect of comprehensive intervention program on hypertension control in workplaces in China.Methods The study design was a non-randomized controlled trial.First,20 sub-centers were selected across China,then hypertension patients in 2-4 workplaces were selected as the intervention group,and hypertension patients in 1 comparable workplace selected,as the control group in each sub-center.The comprehensive intervention strategy which integrating workplace primary prevention of cardiovascular diseases and standardized management of hypertension was adopted in the intervention group for at least 2 years.Patients in the control group continued their usual health care,and only baseline data and 2-year data was collected.Analyses were conducted for hypertension patients in 30 stated-owned enterprises (SOEs),including 20 for the intervention group and 10 for the control group.The primary outcome was the control rate ofhypertension while the intervention effect (IE) was estimated by using the formula:differential value of intervention group [rate (mean)] — differential value of control group [rate (mean)].Results Overall,2 622 patients completed the 2-year follow-up,of which 2 055 were in the intervention group and 567 in the control group,respectively.After 2 years of intervention,the IE on the level of SBP and DBP for intervention group and control group were-7.5 and-3.9 mmHg,respectively (P＜0.05).BMI decreased by 0.4 kg/m2,with the regular exercise rate as 36.4％ and alcohol consumption rate decreased by 14.0％,respectively (P＜0.05).The smoking rate decreased by 6.1％ (P＞0.05).The overall hypertension control rate was 25.0％,and further subgroup analysis showed that our intervention program was particularly effective for those with high education level (27.6％),white-collar employees (41.9％),and those from SOEs whose affiliated hospital had been separated away (41.9％).Conclusion The comprehensive intervention program could greatly improve the hypertension control in the workplaces in China.
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Objective To study the effect of AIDS intervention programs among college students, and to provide fundamental support for the formulating of AIDS prevention strategies. Methods A cluster sampling methods was used to conduct a longitudinal follow-up survey among 2 000 freshmen from four colleges in Yantai in 2016, The knowledge, attitudes and behaviors related to AIDS were analyzed by generalized estimating equation analysis method. We also conducted in-depth personal interviews among university leaders. Results The awareness rate of AIDS among young students in Yantai was 70.4%, 85.9%, and 95.8%, respectively. The generalized estimating equation showed that the total awareness rate of AIDS knowledge increased year by year (Z=-23.42, P<0.001). The occurrence of different types of sexual behaviors maintained at a low level, and no obvious trend changes were observed. Multivariate Logistic regression showed that a high occurrence of sexual behaviors among young college students was found related to male, poor knowledge of AIDS prevention, having not received public services related to AIDS prevention, and having not participated in public services related to AIDS prevention (all P<0.05). Interview results showed that, three of the four colleges have included AIDS health education into their teaching plans, and the AIDS epidemic notification system has been fully implemented. Conclusions The awareness rate of AIDS knowledge among college freshmen in Yantai is relatively low. Implementing comprehensive intervention measures and establishing a multi-sectoral cooperation mechanism are the most effective measures to improve the knowledge of AIDS prevention, and promote safe sexual behaviors among young college students.
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Using intelligent rehabilitation robot to intervene hand function after stroke is an important physical treatment. With the development of biomedical engineering and the improvement of clinical demand, the comprehensive intervention of hand-function rehabilitation robot combined with new technologies is gradually emerging. This article summarizes the hand rehabilitation robots based on electromyogram (EMG), the brain-computer interface (BCI) hand rehabilitation robots, the somatosensory hand rehabilitation robots and the hand rehabilitation robots with functional electrostimulation. The advantages and disadvantages of various intervention methods are discussed, and the research trend about comprehensive intervention of hand rehabilitation robot is analyzed.
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Objective To explore the comprehensive intervention mode of compliance with analgesics for home-based patients with moderate or severe cancer pain and to improve the medication compliance of home-based patients with cancer pain. Methods A self-designed questionnaire was designed to investigate the influencing factors of taking analgesics for home-based patients with moderate or severe cancer pain, 143 home-based patients with moderate to severe cancer pain were conveniently selected from Hospice Unit of Zhongnan Hospital of Wuhan University, from February 2016 to December2017. To investigate the subjective, objective and psychological factors affecting patients' compliance with analgesics, comprehensive interventions such as health education, behavioral intervention, cognitive intervention and psychological counseling were carried out. Before and after the intervention, Morisky′s self-report questionnaire on medication compliance, pain digital grading (NRS score), and pain relief degree were assessed. Using self control design method and comparing the compliance of patients taking analgesics, number of complete compliance and non-compliance in patients taking analgesics and NRS score and pain relief before and after 8 weeks of intervention. Pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after comprehensive intervention were evaluated. Results The main factors affecting patients' medication compliance with analgesics were fear of morphine addiction(16.37％, 37/226), single use of drugs and insufficient dosage (15.93％, 36/226), and fear of adverse drug reactions(13.72％, 31/226). The scores of NRS decrease in patients with different influencing factors were compared, with statistical difference (F=5.367, P=0.006). There were significant differences in the number and compliance of patients with complete compliance and non-compliance before and after 8-week-comprehensive intervention (χ2=25.583, P=0.000; t =-7.387, P=0.000). There were significant differences in pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after 8-week-comprehensive intervention (χ2=76.572, 62.998, all P=0.000). Conclusions Comprehensive intervention on subjective, objective and psychological factors affecting the medication compliance of home-based patients with moderate or severe cancer pain can improve the medication compliance of patients to take analgesics and alleviate pain.
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Objective@#To explore the effects of multidisciplinary comprehensive intervention in integrated treatment of patients with extremely severe burns.@*Methods@#One hundred and ten patients hospitalized in our center from July 2013 to August 2017 met the criteria for inclusion in this study, and their medical records were retrospectively analyzed. According to the medical model at that time, 56 patients hospitalized from July 2013 to July 2015 received routine comprehensive treatment led by doctors, and they were included in the conventional intervention group. From August 2015 to August 2017, 54 patients were treated with integrated multidisciplinary interventions performed by a team consisting of physicians, intensive care nurses, burn nurses, intravenous infusion nurses, wound stoma nurses, and rehabilitation therapists, and they were included in the integrated intervention group. Acute Physiological and Chronic Health Assessment Ⅱ (APACHE Ⅱ) scores on admission and 4 weeks after treatment, incidences of pressure injury, wound sepsis, lung infection, and catheter-related infection during hospitalization, length of stay in intensive care unit (ICU) and total length of hospital stay, and Abbreviated Burn Specific Health Scale (BSHS-A) scores at discharge and 3 months after discharge were analyzed. Data were processed with t-test and chi-square test.@*Results@#The APACHE Ⅱ scores of patients in the two groups were close on admission (t=0.573, P>0.05). Four weeks after treatment, the APACHE Ⅱ scores of patients in the two groups were obviously lower than those on admission within the same group (t=5.697, 4.853, P<0.01), and the score of the integrated intervention group was obviously lower than that of the conventional intervention group (t=2.170, P<0.05). No pressure injury was observed in patients of any group during hospitalization. The incidences of wound sepsis, lung infection, and catheter-related infection of patients in the integrated intervention group were 18.5% (10/54), 3.7% (2/54), and 9.3% (5/54), respectively, significantly lower than 42.9% (24/56), 21.4% (12/56), and 26.8% (15/56) of the conventional intervention group, χ2=4.073, 6.075, 3.962, P<0.05. The length of stay in ICU of patients in the integrated intervention group was (50±5) d, obviously shorter than (62±4) d of the conventional intervention group (t=2.852, P<0.01). The total length of hospital stay of patients in the integrated intervention group was (115±8) d, obviously shorter than (140±7) d of the conventional intervention group (t=16.885, P<0.01). At discharge and 3 months after discharge, the scores of BSHS-A, physical function, psychological function, and general health status of 50 patients in the integrated intervention group were significantly higher than those of 48 patients in the conventional intervention group (t=2.886, 3.126, 2.416, 2.544, 2.033, 3.471, 2.588, 2.210, P<0.05 or P<0.01), while the scores of social function of patients in the two groups were close (t=1.570, 1.350, P>0.05).@*Conclusions@#Integrative treatment of patients with extremely severe burns by multidisciplinary comprehensive intervention can significantly alleviate the severity of burns, reduce the incidences of wound sepsis, lung infection, and catheter-related infection, shorten the length of stay in ICU and total length of hospital stay, and improve the quality of life.
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Due to the characteristics of the complicated and critical deseases, therapeutic measures in the TCM clinical trials need to be multiple rather than single indexes. It is the flexibility and principle reflection of treatment based on syndrome differentiation. The advantage is more suitable for severe and complex diseases, but the adverse effect is mis-understood by the confounding bias. According to the characteristics of traditional medicine, a new method was proposed for the complicated and critical deseases. Firstly, the randomization with the inclusion criteria was made by the same symptom in a certain stage of disease; and secondly, the comprehensive intervention measures were adopted of processing; Eventually, the statistical difference was calculated. The symptom directed comprehensive interventions have provided the experimental design of the TCM therapeutic clinical trials.
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Objective To observe the effect of early comprehensive intervention on the clinical efficacy of patients with acute poisoning combined with inhalation pneumonia. Methods One hundred and eighty-seven patients with acute severe poisoning combined with coma [Glasgow coma scale (GCS) ≤ 8] were admitted to the department of emergency intensive care unit (EICU) of Luoyang Central Hospital Affiliated to Zhengzhou University from January 2013 to December 2016. Forty-eight patients treated from January 2013 to December 2014 by conventional and symptomatic therapies were taken as a control group, and 56 cases treated with early comprehensive intervention method from January 2015 to December 2016 were assigned as an experimental group. The differences in the incidences of aspiration pneumonia and respiratory failure, the usage rate of antimicrobial drugs and their combination condition, length of hospital stay, length of stay in ICU and prognosis were compared between the two groups. Results After treatment, the incidence of aspiration pneumonia [10.71% (6/56) vs. 58.33% (28/48)], and the incidence of respiratory failure [8.93% (5/56) vs. 29.17% (14/48)] in the experimental group were significantly lower than those in the control group, the utilization rate of antimicrobial drugs [14.3% (8/56) vs. 62.5% (30/48) ], especially the combined use of triple and above was significantly reduced [0 vs. 10.0% (3/30)], the length of hospital stay (days: 7.80±3.79 vs. 10.21±4.58) and length of stay in ICU (days: 3.48±1.56 vs. 6.56±2.92) were obviously shorter in experimental group than those in control group (both P < 0.05). The clinical cure rate was also significantly higher in the experimental group [91.07% (51/56) vs. 77.08% (37/48), P < 0.05]. Conclusions The early comprehensive intervention for treatment of patients with GCS score ≤ 8 and acute poisoning can reduce the risks of the occurrences of inhalation pneumonia and respiratory failure and improve the medical pharmacy index and the prognosis of patients, thus the method is worthwhile to be applied extensively.
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Objective To investigate the effect of comprehensive intervention led by nursing staffers on the drug compliance in patients with hepatitis B virus-related hepatocellular carcinoma (HCC) after receiving transcatheter arterial chemoembolization (TACE) treatment.Methods By using random sampling method,a total of 96 patients with hepatitis B virus-associated HCC,who had been treated with TACE and had taken nucleotide analogue drug for one month in the interventional department of a certain grade Ⅲ tumor hospital,were enrolled in this study.Under the premise of informed consent,comprehensive intervention,which was led by nursing staffers and was participated by both doctors and nurses,was conducted.Results After comprehensive intervention,the average score of drug compliance was (93.670±6.046) points,while the pre-intervention average score of drug compliance was (82.040±10.024) points,the difference between the two was statistically significant (P＜0.05).The ratio of patients who showed good drug compliance changed from pre-intervention 62.4％ to post-prevention 97.8％(P＜0.05).The post-prevention of patients,whose hepatitis B virus deoxyribonucleic acid (HBVDNA) level was within the normal range,was 45.16％,which was highcr than the pre-intervention ratio of 15.05％,the difference between the two was statistically significant (P＜0.05).Conclusion The comprehensive intervention led by nursing staffers can effectively improve the drug compliance in patients with hepatitis B virus-associated HCC after receiving TACE,and can reliably control serum HBVDNA level as well.
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Objective To evaluate the effect of targeted monitoring and comprehensive intervention measures on reducing the occurrence of catheter-associated urinary tract infection(CAUTI)in patients in non-intensive care unit(Non-ICU).Methods In quarter 4 of 2015,patients with indwelling urinary catheter in clinical departments were conducted a baseline survey(before intervention),risk factors for CAUTI in patients were analyzed,targeted monitoring programmes and comprehensive intervention measures were initiated in 2016(after intervention),incidence of CAUTI before and after intervention was compared.Results After taking intervention measures,hand hygiene compliance rate increased from 78.51%in quarter 4 of 2015 to 92.99%in quarter 3 of 2016 and 90.73%in quarter 4 of 2016(x2=7.342,3.998,respectively,both P<0.05),the correct disposal rate of patients' urinary catheterization system increased from 72.83%in quarter 4 of 2015 to 95.44%in quarter 4 of 2016(x2=30.267,P<0.05).A total of 12 067 patients with indwelling urinary catheter were monitored,incidence of CAUTI dropped from 1.03%(24/23 313)in quarter 4 of 2015(before intervention)to 0.53%(14/26 595)in quarter 4 of 2016(after intervention),difference was statistically significant(x2=4.126,P=0.042).Conclusion Improving the quality of urinary catheterization system in patients with indwelling catheter through targeted monitoring can effectively reduce the incidence of CAUTI in patients in Non-ICU.
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Objective To investigate the current status of multidrug-resistant organism (MDRO) infection in the general surgery department of a tertiary first-class hospital, and understand the efficacy of comprehensive intervention measures.Methods Targeted monitoring on MDROs was implemented among patients who were hospitalized in a general surgery department for>48 hours between March 2015 and October 2016, comprehensive intervention measures were taken since January 2016.MDRO infection before and after intervention was compared.Results Between March 2015 and October 2016, a total of 6 406 hospitalized patients were monitored, 155(2.42%) developed MDRO infection.The most common infection sites were abdominal cavity(hydrops, bile) (n=76, 49.03%) and surgical site (n=43, 27.74%).MDRO infection rate dropped from 2.79% (99/3 549) before intervention (March-December, 2015) to 1.96% (56/2 857) after intervention (January-October, 2016) (x2=4.612, P=0.032).There was no difference in MDROs between before and after intervention, the major were both Escherichia coli.Conclusion Comprehensive intervention measures can reduce the incidence of MDRO infection in the general surgery department of this hospital.