The application of wound care technologies combined with other multiple treatments in the hepatolithiasis patient who suffered from postoperative severe intestinal fistula / 中国实用护理杂志

Objective:To assess the nursing care experiences and curative effects of the application of wound care technologies combined with other multiple treatments in the hepatolithiasis patient who suffered from postoperative severe intestinal fistula.Methods:The wound care difficult points were analyzed,the wound care technologies combined with other multiple treatments including multiple debridement methods were applied according to the severity of the intestinal fistula:multiple debridement, new skin protection, continuous flushing and drainage with double cannula, improved negative pressure closure drainage and wound pull-in technology, combined with systemic treatment and nursing intervention.Results:The intestinal fistula was treated for 12 days, and the wound infection was controlled for 24 days. Finally the wound was healed after 43 days and patient was discharged from hospital.Conclusions:In the case of severe intestinal fistula after hepatolithiasis operation, the application of wound nursing technology combined with treatment scheme provides a new treatment idea and scheme for intestinal fistula and wound healing.

Evidence summary for prevention and management of Incontinence-associated dermatitis in adult inpatients / 中国实用护理杂志

Objective:To retrieve, appraise and synthesize the best available evidence on prevention and management of incontinence-associated dermatitis in adult inpatients.Methods:All the evidence on prevention and management of incontinence-associated dermatitis in adult inpatients was searched by computer from domestic and foreign electronic databases, guide.com and related professional websites from January 2010 to January 2020. Literature evaluation tools such as AGREEⅡ, AMSTAR were used for evaluation. Data extraction of documents that met the inclusion criteria.Results:A total of 28 pieces of relevant evidence were obtained. It includes 6 aspects: assessment and prevention, management of incontinence, cleaning, moisturizing and protection, treatment, monitoring and management.Conclusions:the 28 pieces of evidences in this study can better guide the medical staff in the prevention and management of incontinence-associated dermatitis in adult inpatients. It is suggested that the medical staff should carefully apply the evidence in combination with the specific clinical environment and the patient ′s will, and pay attention to the update of relevant evidence in time.

Disposable versus reusable flexible ureteroscopes for treatment of upper urinary stones: a multicenter prospective randomized study / 中华泌尿外科杂志

Objective:To compare the performance and surgical outcomes of disposable digital flexible ureteroscope with a reusable fiberoptic flexible ureteroscope in treatment of upper urinary stones.Methods:A prospective, multicenter, single-blind and randomized controlled study was performed from April 2018 to December 2018. Eligible patients were randomized, in a ratio of 1∶1, to either experimental group or control group. The inclusion criteria for the study were: aged 18-60 years, solitary upper urinary stone or multiple stones with stone size less than 2 cm, absence of urinary tract infection (UTI) or UTI was controlled, normal liver and renal function. Exclusion criteria included: patients with congenital anomalies, calyceal diverticular stone, IP angle less than 30°, renal insufficiency. pregnancy or lactation, cardiopulmonary function abnormality and coagulation abnormalities. Patients in experimental group received ureteroscopy through a disposable digital flexible ureteroscope (PU3022A, PUSEN), while patients in control group received ureteroscopy through a reusable fiberoptic flexible ureteroscope (Flex-X2, STORZ). The primary endpoint was the high-quality rate of images during the operation. The secondary endpoints included success rate of fragmentation and postoperative complication rates.Results:93 patients were recruited, and 90 of them were finally complete the study (i.e., 45 patients in each group). The demographic and preoperative parameters were comparable between the two groups except the stone size in patients with solitary stone. The high-quality rate of images was significantly higher in experiment group than that in control group (100.0% vs. 15.6%, P<0.001). There were no significant differences in terms of success rate of fragmentation(68.9% vs. 71.1%, P=0.818), hemoglobin dropped (3.91 g/L vs. 3.62 g/L, P=0.880), serum creatinine changed, and postoperative complication rates(6.7% vs.6.7%, P=1.000). Conclusions:Disposable digital flexible ureteroscope achieves similar surgical outcomes to the reusable fiberoptic flexible ureteroscope with a better quality of endoscopic images.

Effect of ball compression to prevent jugular vein malposition in peripherally inserted central catheter insertion / 中国实用护理杂志

Objective@#To detect the effect of the ball compressor method to prevent jugular vein malposition in peripherally inserted central catheter insertion (PICC).@*Methods@#Convenient sampling method was used to recruit 1 358 patients with PICC insertions during October 2017 to September 2018 in Second affiliated hospital Zhejiang University, school of medicine. 681 were included in experimental group, and 677 patients were included in control group. The control group used traditional turning head to the PICC insertion side or fingers compression to block the entrance of jugular vein to prevent jugular vein malposition in control group. While in experimental group, rugby- shape ball compression were used to block jugular vein to reduce jugular vein malposition. The rate of jugular vein malposition in the first try of catheterization was calculated in both groups.@*Results@#The rate of jugular vein malposition in the first try of catheterization was 19.1%(130/681) in experimental group and 23.5% (159/677) in control group respectively. There is statistically significant difference between two groups (χ2=3.917, P=0.047 8).@*Conclusion@#Rugby- shape ball compression could reduce jugular vein malposition in the first try of catheterization effectively.

Effect of ball compression to prevent jugular vein malposition in peripherally inserted central catheter insertion / 中国实用护理杂志

Objective To detect the effect of the ball compressor method to prevent jugular vein malposition in peripherally inserted central catheter insertion (PICC). Methods Convenient sampling method was used to recruit 1 358 patients with PICC insertions during October 2017 to September 2018 in Second affiliated hospital Zhejiang University, school of medicine. 681 were included in experimental group, and 677 patients were included in control group. The control group used traditional turning head to the PICC insertion side or fingers compression to block the entrance of jugular vein to prevent jugular vein malposition in control group. While in experimental group, rugby- shape ball compression were used to block jugular vein to reduce jugular vein malposition. The rate of jugular vein malposition in the first try of catheterization was calculated in both groups. Results The rate of jugular vein malposition in the first try of catheterization was 19.1% (130/681) in experimental group and 23.5% (159/677) in control group respectively. There is statistically significant difference between two groups (χ2=3.917, P=0.047 8). Conclusion Rugby- shape ball compression could reduce jugular vein malposition in the first try of catheterization effectively.

Expression of long non-coding RNA in renal clear cell carcinoma / 中华泌尿外科杂志

Objective To analyze the expression of long non-coding RNA ( lncRNA) in renal clear cell carcinoma ( RCCC ) , the association of lncRNA with RCCC, as well as the role of lncRNA in the diagnosis and treatment of RCCC.Methods Forty fresh RCCC tissues and their normal adjacent tissues were collected from March 2012 to June 2013, and total RNA was extracted using Trizol reagents, purified and tested by denaturing agarose gel electrophmesis and NanoDrop 1000.Through Arraystar Human LncRNA Microarray, the different expression of lncRNA between RCCC and normal adjacent tissues was screened. RT-qPCR was used to verify the expression of lncRNA in 40 pair RCCC tissues and normal adjacent tissues. The receiver-operating characteristic ( ROC ) curve was adopted to verify the diagnostic efficiency of the selected lncRNA.Results LncRNA expression profile showed 1 787 lncRNA with expression alteration in two fold or above, up-regulated and down-regulated candidate lncRNAs were 941 and 846 respectively. Compared with the adjacent tissues, NR_034095 and NR_038974 were up-regulated in RCCC, and ENST00000571724 and ENST00000566575 were down-regulated, which were consistent with the microarray analysis.By the ROC curves of NR_034095, NR_038974, ENST00000571724 and ENST00000566575 to discriminate the RCCC from normal adjacent tissue, the area under curve was 0.928 ( 95%CI 0.873 -0.984), 0.759 (95%CI 0.647-0.871), 0.833 (95%CI 0.747-0.919) and 0.887 (95%CI 0.815-0.959 ) , respectively.Conclusions NR _ 034095, NR _ 038974, ENST00000571724 and ENST00000566575 are significantly differently expressed in RCCC.The different expressed lncRNA might be closely related to the process of RCCC, and may be used as a new candidate target for molecular diagnosis and gene therapy of RCCC.

Causes and nursing strategy of gastroesophageal reflux in 31 patients with cervical vertebra fracture and paraplegia / 中华护理杂志

In order to explore the causes and nursing care of gastroesophageal reflux in patients with ceryical vertebra frac-ture and paraplegia,the clinical data of 79 patients were retrospectively analyzed. Among which,31 patients suffered from gas-troesophngeal reflux. The main causes of gastroesephageal reflux were improper body position,gastrointestinal dysfunction,con-sciousness disorders,lnappropriate nasngastric feeding,drng adverse reaction,inappropriate feeding time,lack of knowledge in nurse aids and family members. It is suggested to take proper body position,assess gastrointestinal functions,implement naso-gastric feeding correctly,observe patient carefully to detect gastroesophageal reflux as early as possible,as well as provide health education for the nurse aids and family members to prevent gastroesophageal reflux and complications.