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Objective:To analyze the delivery room disaster vulnerabilities of 7 tertiary hospitals in Liaoning Province, evaluate the nursing management disasters vulneratility, and provid support for emergency management of delivery room nursing.Methods:The Kaiser model analysis was used to design a disaster vulnerability assessment form for the delivery room, combined with the actual risk prevention and control in the delivery room. The survey was conducted from March 18 to 27, 2020 by paper questionnaire among 200 nursing staff in the delivery room, and the risk values for emergencies were calculated and the matrix distribution was analyzed and evaluated.Results:Totally 190 valid questionnaires were collected. The top 10 risk events faced by the delivery room were epidemic outbreaks, failure to adequately protective equipment for emergency admission to the delivery room, maternal poor protection awareness, nursing staff were contaminated with amniotic fluid and body fluids, poor maternal compliance with midwife orders, shortage of supplies of medical care protective equipment, nursing staff suffered needlestick injuries, high fever in patients, masks and gloves were worn or removed incorrectly, and doctor-patient tension due to poor compliance.Conclusion:Kaiser model-based hazard vulnerability analysis of delivery rooms can provide an important basis for risk identification and early warning and emergency plan improvement and formulation, which should be applied flexibly with the actual and specific characteristics of delivery rooms and dynamic changes of risks.
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Objective:To evaluate the efficacy and safety of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in patients with HIV-1 or chronic HBV infection through observing the dynamic changes in antibody responses to two-dose inactivated SARS-CoV-2 vaccines.Methods:This cohort study recruited 169 people (including 39 with HIV-1 infection, 36 with chronic HBV infection and 94 individuals without chronic diseases) who completed two doses (prime and boost) of inactivated SARS-CoV-2 vaccination from January to December 2021. The levels of SARS-CoV-2 IgM and IgG antibodies at 14 d, one month and two months after boosting and neutralizing antibodies at one month were detected by chemiluminescence immunoassay and competitive ELISA method.Results:The positive rates of antibodies against SARS-CoV-2 in the HIV-1 and HBV groups were higher at one month after booster immunization, but significantly decreases at two months. The double-negative rate of SARS-CoV-2 IgM and IgG antibodies was higher in the HIV-1 and HBV groups than in the control group. The single positive rate of IgG antibody at one month in the control group was 2.01-fold higher than that of the HIV-1 group and 3.17-fold higher than that of the HBV group. The single positive rate of IgG antibody in people aged 18-39 years in each group was higher than that in the 40-59 age group. The antibody persistence was better in the HBV group than in the HIV-1 group, and the levels of IgG antibody in the HBV group was higher than that in the HIV-1 group. The neutralizing capacity of serum antibodies was significantly lower in the HIV-1 group than in the other groups ( P<0.000 1). The inhibition rate of serum neutralizing antibodies in the HBV group was lower than that in the control group among people aged 18-39 years [(34.050±6.031)% vs (64.220±3.845)%, t=4.43, P<0.000 1]. SARS-CoV-2-specific antibody responses were induced in 73.08% (19/26) of the patients aged 18-39 years in the HIV-1 group and 80.00% (4/5) in the HBV group. Conclusions:There were differences in the antibody responses to inactivated SARS-CoV-2 vaccines between different age groups, and infectious diseases affected the positive rates of antibodies and the neutralizing capability against SARS-CoV-2.
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Objective To study the protective effect of trimetazidine pretreatment on myocardial I/R in a rat I/R model and its mechanism.Methods One hundred and twenty SD rats were divided into control group,I/R group,HSP70 inhibitor group,trimetazidine treatment group and combined treatment group (24 in each group).The rats in each group were further divided into 30 min reperfusion group,4 h reperfusion group and 8 h reperfusion group (8 in each group).Their HSP70-positive myocardial cells were calculated,their serum CK,CK-MB,MDA,SOD levels and their myocardial infarction size were measured.Results The serum CK and CK-MB levels were significantly higher in I/R group,HSP70 inhibitor group,trimetazidine treatment group and combined treatment group than in control group and were significantly lower in trimetazidine treatment group than in combined treatment group and I/R group after reperfusion for 4 and 8 h (P＜0.01).The serum levels of HSP70 and SOD were significantly higher,the MDA levels were significantly lower in trimetazidine treatment group than in combined treatment group and I/R group after reperfusion for 30 min,4 and 8 h (P＜0.01).The infraction size was significantly smaller in trimetazidine treatment group than in combined treatment group and I/R group after reperfusion for 4 and 8 h (P＜0.05).Conclusion Trimetazidine can increase the serum HSP70 level in myocardial cells,reduce the infarction size,and protect the myocardium against I/R in rats.
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Objective:To investigate the effect of Tongrnai Yangxin Pill on the serum hepcidin level of patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease.Methods:Seventy patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease whose age were above 40 years old were enrolled as the research group and divided into the medication group (group Ⅱ) (n=35) and the nonmedication group (group Ⅲ)(n=35),while 40 CAD patients were enrolled as the normal control group (group Ⅰ).Before and after medication,the Hepc,Hb,etc levels were compared between two groups.Results:Before medication,the levels of Hepc in the two research subgroup were significantly higher than that of the control group (P＜0.05).At 8 weeks after treatment,the Hepc level of group Ⅱ was significantly declined,and the level of Hb was increased than those before treatment (P ＜0.05);the Hepc levels of group Ⅰ and group Ⅲ showed no significant difference (P＞0.05),the Hepc levels of group Ⅱ and group Ⅲ were obviously higher than that of the control group (P ＜0.05),the Hepc levels of group Ⅲ was obviously higher than that of the group Ⅱ(P＜0.05),the Hb level of group Ⅲ was obviously lower than those of group Ⅰ and group Ⅱ (P＜0.05).Conclusion:Tongmai Yangxin Pill could reduce the level of Hepc and enhance the Hb levels of patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease.It was useful to the patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease,especially patients with mild anemia.
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Objective To evaluate metamorphopsia and vision-related quality of life (VRQoL) and its influencing factor after vitrectomy for idiopathic macular hole (IMH).Methods This is a prospective and nonrandomized clinical cohort study.Thirty eyes of 30 IMH patients who received vitrectomy and inner limited membrane (ILM) peeling were included.The best-corrected visual acuity (BCVA),medical refraction test and optical coherence tomography (OCT) were performed.BCVA was recorded as logarithm of the minimum angle of resolution (logMAR).The macular hole index (MHI) was measured using OCT.The average logMAR BCVA and MHI in suffering eyes at baseline were 1.02± 0.07 and 0.47 ± 0.02,respectively.The uncorrected visual acuity of the fellow eyes was less than 0.1.Follow-up period was longer than 6 months.At 6 months after surgery,the central retinal thickness (CRT) was measured by OCT;vertical and horizontal metamorphopsia were measured by metamorphopsia charts;VRQoL was evaluated by Chinese VRQoL-25.Spearman correlation analysis was performed to analyze the relationship of VRQoL and postoperative BCVA,metamorphopsia and preoperative MHI.Results At 6 months after surgery,macular hole closure was confirmed by OCT in all patients.The vertical and horizontal metamorphopsia were (0.17± 0.03)° and (0.11 ± 0.03)°,respectively.The VRQoL-25 composite score was 79.81 ± 1.29.The average BCVA was 0.59±0.05.The average CRT was (155.10± 6.27) μm.The postoperative VRQoL was positive correlated with preoperative MHI (r=0.491,P=0.002),and negative correlated with preoperative BCVA (r=-0.445,P=0.014),postoperative BCVA (r=-0.530,P=0.003) and postoperative metamorphopsia (r=-0.532,P=0.006),but not correlated with the postoperative CRT (r=0.231,P＞0.05).Conclusions IMH patients improved their visual acuity after surgery,but still have metamorphopsia.VRQoL was negative correlated with metamorphopsia,positive correlated with preoperative MHI.
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In vitro fertilization and embryo transfer (IVF- ET) technology is now widely used in the world in infertility patients. Psychological intervention can help the IVF- ET patients and their spouses reduce the negative emotions and improve pregnancy outcomes. This review provides a summary of the negative emotions in IVF- ET couples and the psychological intervention on them, so as to provide reference to establish a systematic and standardized clinical psychological nursing mode.
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Objective To analyze the characteristics of patients involved in identification error events,try to recognize patients group who had high risk of being wrongly identified.Methods 68 patient identification error events in 64 hospitals in Liaoning province from 2007 to 2011 were investigated.The results were analyzed from four aspects,which were education,age,consciousness and sensory disability state of patients.Results 68 identification error events were investigated.Among these events,patients who graduated from middle school or less constituted 79.41％ ;patients older than 60 years old constituted 55.88％;patients with hearing and speaking inability constituted 41.18％;patients without clear consciousness constitutes 14.70％ Conclusions Patients who graduated from middle school or less,older than 60 years old,with heating and speaking inability constitute the group who has high risk of being wrongly identified.Enhancing the education of patients,promoting the use of wrist band,and decreasing the dependence on hearing and speaking ability during identification process constitute the main reformation aspect of new patient identification rules.
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Objective To evaluate quantification of metamorphopsia in eyes with idiopathic macular hole (IMH) before and after surgical treatment, and investigate its relationship between postoperative visual acuity, the macular hole index (MHI), and the macular hole prognostic factor (HPF). Methods Thirty eyes of 30 patients, who underwent successful vitrectomy and internal limiting membrane (ILM) peeling for IMH and were followed up more than 6 months, were included in the study. The uncorrected visual acuity of the fellow eyes was better than 20/25 and there was no metamorphopsia in that eye. The macular hole closure was confirmed by optical coherence tomography (OCT) scans. Metamorphopsia was evaluated by metamorphopsia-charts (M-chart). OCT, best corrected visual acuity (BCVA) and metamorphopsia were obtained before and after surgery. Vertical (MV) and horizontal (MH) metamorphopsia, macular hole index (MHI, the ratio of the height to the diameter of the base) , and macular hole prognostic factor (HPF,the ratio of the height to the minimum diameter) were measured. The metamorphopsia score was the average value of MV and MH. SPSS 16. 0 statistical analysis software was used for data analysis. Results Preoperative MV and MH were (1.82±0.04)° and (1.81±0.04)°, respectively. Six months after surgery,the MV and MH were (0.17±0.03)° and (0.11±0.03)° respectively. There was significant difference between pre- and post-operative metamorphopsia results (Z=-0.788, P＜0.05). The metamorphopsia score at 6 months after surgery were positively correlated with the value of the postoperative BCVA (LogMAR) (r=0.540, P=0.004) and negatively correlated with the values of preoperative MHI and HPF (r=-0.676,-0.518; P＜0.05). Conclusions Successful vitrectomy and ILM peeling can improve metamorphopsia of IMH. Postoperative metamorphopsia was correlated with the postoperative BCVA and the preoperative macular hole contour.