Comparison of clinical effect of two different Kirschner wire fixations after closed reduction on supracondylar fracture of humerus in children with GartlandⅡand Ⅲ / 中国骨伤

OBJECTIVE@#To compare clinical effect of Kirschner wire radial sector fixation and bilateral ulnar radial cross fixation in treating supracondylar fracture of humerus in children after closed reduction.@*METHODS@#From March 2017 to December 2018, 60 children with supracondylar fracture of humerus treated with closed reduction and Kirschner wire fixation were analyzed retrospectively, and divided into two groups according to different needling methods. Thirty patients in radial three needles fan fixation group (group A), including 19 males and 11 females, aged from 2 to 10 years old with an average of (5.00±2.10) years old, 21 patients were typeⅡ and 9 patients were typeⅢ according to Gartland classification. Thirty patients in cross fixationwith 3 needles on both ulnar and radial side group(group B), including 22 males and 8 females, aged from 1 to 9 years old with an average of(5.13±2.08) years old, 19 patients were typeⅡand 11 patients were typeⅢ. Healing time of fracture, postoperative complications, elbow flexion and extension activity, forearm rotation activity recovery, elbow carrying angle and angle loss after operation between two groups were observed and compared. Mayo Elbow function score at the final following up was used to evaluate clinical efficacy.@*RESULTS@#All patients were followed up, while there were no significant difference in follow-up time and fracture healing time between two groups (@*CONCLUSION@#Closed reduction and Kirschner wire at the early stage of fracture has advantages of less trauma, easy reduction, stable fixation, and early functional exercise. The risk of iatrogenic ulnar nerve injury caused by fan-shaped fixation of three radial needles is less than that of cross fixation of three radial needles.

Basis of the replacement of short peripheral intravenous catheters for clinical nurses: a qualitative study / 中国实用护理杂志

Objective@#To investigate the current status and influencing factors of basis of the replacement of short peripheral intravenous catheters for clinical nurses and explore the obstruction of the latest guide promoted in practice.@*Methods@#The qualitative research method was adopted, and semistructured interviews were used to interview 11 clinical nurses. Data were analyzed by the method of category analysis.@*Results@#Although the clinical nurses mainly used the national standards to do practical operation, they preferred to carry out catheter replacement according to clinical indications. The difference between the latest guide and the national standards was the main obstruction in the practical promotion of the latest guide.@*Conclusions@#The removal of short peripheral intravenous catheters according to clinical indications is more suitable for clinical practice. Further improving the standards of intravenous therapy in China has become a fundamental measure to solve the contradictions of work of clinical nurses, improve patients′ medical experience and save medical resources.

Construction and application of self-management program based on WeChat platform among colorectal cancer survivors with ostomies / 中国实用护理杂志

Objective To construct and evaluate the effect of WeChat platform self-management program among colorectal cancer survivors with ostomies. Methods Totally 80 colorectal cancer survivors with ostomies were divided into two groups according the inclusive time with 40 cases each. The patients in the experimental group were applied WeChat platform self-management program, the control group were applied regular discharge telephone follow-up. The patients′ self-efficacy and quality of life were measured and compared prior to discharge, at 1 and 6 weeks after discharge. And the patients' occurrence of stoma complications were measured at 1 and 6 weeks after discharge. Results Due to quit research, finally complete the study of the experimental group for 36 cases, the control group for 35 cases. The total score of self-efficacy at 1 and 6 weeks after discharge were (72.05± 9.68), (84.91±16.01) points in the experimental group, and (63.00 ± 13.26), (72.20 ± 15.61) points in the control group, and there were statistically significant differences (t=-2.586, 3.388, P<0.01). The total score of quality of life at 1 and 6 weeks after discharge were (43.68±8.32), (49.49±8.61) points in the experimental group, and were (37.09± 5.57), (40.42 ± 8.01) points in the control group, and there were statistically significant differences (t=3.926, 4.596, P<0.05). Repeated measures analysis of variance showed that the intervention effect on the overall self-efficacy, stoma care self-efficacy, social self-efficacy and stoma quality of life was significant (F=4.287-10.744, P<0.05);the time effect on the overall self-efficacy and quality of life was significant (F=146.109, 90.105, P < 0.05); there were interactions between the effect of WeChat platform self-management program and time on the overall self-efficacy, stoma care self-efficacy, social self-efficacy, dietary efficacy, sexual life satisfaction efficacy, keep active efficacy and stoma quality of life ( F=4.452-21.777, P<0.05) . Chi-square analysis showed that the patients′occurrence of stoma complications at 1 and 6 weeks after discharge in the experimental group were lower than those in the control group:8.33%(3/36), 5.56%(2/36) and 31.43%(11/35), 25.71%(9/35), the differences were significant (χ2=5.980, 5.508, P < 0.05). Conclusions WeChat platform self-management program may be helpful for colorectal cancer survivors with ostomies after discharge in improving self-efficacy and quality of life, and in reducing stoma complications incidence.