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Palliative and hospice care is an emerging medical care model for the development of modern medicine,and its emergence is not only a sign of social demand and the development of human civilization,but also an important manifestation of the change in the modern medical model.Hospice care is the final stage of palliative care,which is of great significance for the end-of-life treatment of incurable diseases.Palliative and hospice care has become an independent discipline in many countries,and its development has been rapid.However,the develop-ment of hospice and palliative care in China is not satisfactory,and the lack of money and human resources are the main reasons limiting its development.Many scholars have carried out a lot of useful practices in this regard.How to explore a road of hospice and palliative care development suitable for China′s national conditions is an urgent problem to be solved.By reviewing domestic and foreign literature,this paper summarizes the development mode and payment method of palliative and hospice care abroad,identifies the challenges encountered in the practice of hospice care in China,and draws on the development experience of palliative and hospice care in foreign countries.We aimed to identify pain points and difficulties faced in developing palliative and hospice care in China,so as to better serve patients at the end of life,gradually promote the concept of palliative and hospice care,and contribute to the sustainable development of palliative and hospice care in China.
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Objective To investigate the distribution and clinical characteristics of pathogens in children with acute respiratory infection (ARI). Methods A total of 85 children with ARI in our hospital from January 2018 to May 2019 were enrolled. The distribution of pathogens, clinical characteristics, and the detection rate among different, ages, and seasons were observed. Results Among 85 children, 35 cases (41.18%) were positive for serum IgM. The total positive rate of IgM among children aged between 20d and 28d was higher than those aged less than 20d (χ2=10.365，P=0.001). MP, RSV, INFB and PIV showed significant difference between two age groups (P2=17.775，P=0.001). The clinical characteristics of 85 cases of ARI included 50 cases (58.85%) of dry cough, 84 cases (98.82%) of pharyngeal congestion, 56 cases (71.76%) of body temperature > 38.5°C (65.88%), 61 cases of pulmonary texture disorder with spot shadow and 65 cases (76.47%) of white blood cells > 10.0×109/L. Conclusion MP is the main pathogen in ARI children. age and season are important factors for respiratory tract pathogen infection, and summer is the peak period of infection.
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Objective To investigate the pressure changes of cuff in the tapered-cuff endotracheal tubes and the frequency of cuff pressure monitoring in patient with trachea intubation. Methods From December 2016 to October 2017, 80 patients with oral tracheal intubation in the emergency department were divided into group A (n =25) and group B (n =23) according to the principle of randomized control. Group A with odd number was treated and tapered-cuff endotracheal tubes and group B with ever number and cylindrical-cuff endotracheal tubes. Continuous cuff pressure monitoring device was used to continuously monitor the cuff pressure. The two groups were compared in terms of time for keeping the normal cuff pressure and cuff pressure (average pressure, maximum pressure and minimum pressure). Results The total time for keeping the normal cuff pressure in group A was significantly shorter than that in group B (P＜0.05). The average cuff pressure in group A was smaller than that of group B (P＜0.05). The maximum pressure in group A is larger than that in group B and the maximum cuff pressure in group A was smaller than that of group B (P＜0.05). Conclusion Compared with the cylindrical cuff catheter, the tapered-cuff tube can maintain the normal pressure for a shorter period and easily produce needed pressure. It is a need to enhance the monitoring of cuff pressure to ensure good airway closure and reduce artificial airway complications.
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Purpose To study of predictive value for detection of high-grade cervical intraepithelial neoplasia (CIN2 +) by p16/Ki-67 dual-stained liquid-based cytology.Methods Random collection of 123 women including 103 samples of atypical squamous cell of undetermined significance (ASC-US) and above with results of high-risk human papillomavirus (HR-HPV)testing and cervical biopsy,20 samples of negative for intraepithelial lesion or malignancy (NILM) by using immunocytochemical p16/Ki-67 dual-stained and the morphology assessment.Results In normal control group,the expression of p16/Ki-67 dual-stained in squamous epithelial cells were negative.Sensitivity of p16/Ki-67 dual-staind cytology for biopsy-confirmed CIN2 + was 66.67％ (ASC-US),91.67％ (LSIL) and 92.86％ (HSIL),specificity rates were 95.92％ (ASC-US),95.00％ (LSIL) and 0 (HSIL),positive predictive value were 50.00％ (ASC-US),91.67％ (LSIL) and 92.86％ (HSIL),negative predictive value were 97.92％ (ASC-US),95.00％(LSIL) and 0 (HSIL),respectively.Condusion p16/Ki-67 dual-stained cytology are improved obviously the predictive value for detection of CIN2 +,p16/Ki-67 dual-stained cytology may efficiently complement HPV-based screening programs to prevent cervical cancer.
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Objective To investigate the diagnostic value of DNA ploidy analysis combined with immunocytochemistry p16/ki-67 double staining in cervical high grade squamous intraepithelial neoplasia(HSIL) and cervical squamous cell carcinoma(SCC).Methods A total of 73 cases of cytological tests were randomly collected.Among them,53 cases were small DNA ploidy abnormal cells and 20 cases were DNA ploidy negative.The p16/Ki-67 results were detected by immunocytochemistry double staining.With the pathological results as the golden standard,the diagnostic values of DNA ploidy analysis and DNA ploidy analysis combined with p16/Ki-67 double staining in HSIL + was contrastively analyzed by pathologic results.Results Among 20 samples of DNA ploidy negative,the p16/Ki-67 double staining results all were negative.The positive predictive value of DNA ploidy analysis for HSIL + was 34.62％.The sensitivity of DNA ploidy analysis combined with p16/Ki-67 double staining for HSIL + was 84.62％,and its specificity was 92.31％,the positive predictive value was 78.57％ and the negative predictive value was 94.74％,which were significantly higher than those of DNA ploidy analysis(P＜0.05).Conclusion p16/Ki-67 double staining can significantly im prove the prediction value of HSIL.The DNA ploidy analysis combined with p16/Ki-67 double staining is an effective method for predicting HSIL +,which is suitable for the implementation in the areas with lack of medical resources.
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Objective To describe the status of nurses′professional identity and the self-concept and to explore the relationship between nurses′professional identity and the self-concept. This will be the base for intervening nurses′professional identity. Methods A convenience sample of 250 nurses from one major hospital in Beijing was recruited. The Macleod Clark Professional Identity Scale and the Professional Self-Concept Instrument were introduced. A standard translation procedure was carried out. Results A total of 250 questionnaires were sent out, 241 questionnaires were withdrawed with an effective rate of 96.4%. The mean score of nurses′professional identity was 42.54±8.70, which was at moderate level. The mean score of nurses′professional self-concept was 86.28 ±22.86, also at moderate level, among which,knowledgescores highest (25.91±6.00), leadership scored 20.84±8.02, inter-personal relationship scored (20.28±4.18), caring scored the lowest (19.25±4.67). There was significant difference among the professional identity in the different departments (P<0.05) , while the same results were not seen in professional self-concept. Nurses′professional identity was positively correlated with professional self-concept′s four dimensions (P<0.05). Conclusions The nurse managers should pay attention to the cultivation of professional self-concept in the training of nurses in order to improve the professional identity of nurses and the whole nurses′development.