Design and application of ventilator-associated pneumonia prevention checklist in ICU / 中华护理杂志

Objective To design and apply ventilator-associated pneumonia prevention checklist in ICU.Methods The ventilator-associated pneumonia prevention checklist was designed by referring to guidelines and related literature.The checklist was applied to ventilator-dependent patients.The head of nursing group evaluated prevention status of ventilator-associated pneumonia performed by nurses every day.Results After application of the checklist,the average indwelling time of tracheal catheter and the incidence of ventilator-associated pneumonia decreased among ICU patients.Conclusion Using the ventilator-associated pneumonia prevention checklist in quality management in the prevention of ventilator-associated pneumonia can shorten the average indwelling time of tracheal catheter,and reduce the incidence of ventilator-associated pneumonia,and the checklist can be promoted and applied.

Case control study on ultrasound guided microtraumatic treatment of acute subacromial bursitis / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the efficacy of ultrasound guided microtraumatic treatment of acute subacromial bursitis.</p><p><b>METHODS</b>The patients with shoulder pain from June 2012 to March 2014 were treated with musculoskeletal bone ultrasound examination. A total of 120 patients were diagnosed with acute subacromial bursitis, who were randomized divided into two groups:US guided injection group(ultrasound group) and palpation guided injection group(closed group). The patients in each group were injected with a mixture of 3.5 ml Betamethasone compound lidocaine mixture and 2.5 ml Sodium hyaluronate into the subacromial bursa. The outcome measures were the visual analog scale(VAS) for analyzing pain degree, the night rest pain and Constant-Murley score for detecting shoulder function, rate of secondary injection, and comprehensive effect. The VAS, the night rest pain and CMS were evaluated before, 1 day, 1 week, and 1 month after the injection.</p><p><b>RESULTS</b>After treatment, the shoulder pain and function were improved. One day and 1 week after the injection, the VAS between the two groups were compared. The pain improvement in ultrasonic group was better than in the traditional group, and the difference was statistically significant(<0.05). In the two groups, the night rest pain was relieved after treatment, and 1 day after the injection, the night rest pain in the ultrasonic group was significantly lower than that in the traditional group(<0.05). One day, 1 week and 1 mouth after the injection, the CMS between the two groups were compared, and the improvement of CMS in the ultrasonic group was significantly better than that in the traditional group(<0.05). The patient number with secondary injection in the ultrasonic group was 13 cases, which was significantly less than that in the closed group 45 cases(<0.05). The recovery number of ultrasonic group was significantly better than that of the traditional group(<0.05).</p><p><b>CONCLUSIONS</b>The ultrasound guided microtraumatic treatment of acute subacromial bursitis worked faster than traditional closed therapy. The short term curative effect and the comprehensive curative effect is better than the traditional closed treatment. The US guided subacromial injection technique is effective in guiding the needle into the subacromial bursa in patients with acute subacromial bursitis.</p>

Correlation factor analysis on uterine anomalies in patients with abortion / 中国综合临床

Objective To explore the relationship between the times of abortion and congenital and acquired uterine anomalies.Methods One hundred and eighty-five patients underwent diagnostic hysteroscopy following abortion were selected and diagnosed by hysteroscopy,then divided into congenital and acquired uterine abnormalities according to the morphology and the formation of uterine cavity lesions.The relationship of 1 times,2 times,equal or more than 3 times of different number of abortion and uterine congenital and acquired abnormalities were compared respectively.Results Diagnostic hysteroscopy revealed anomalies uterine cavity was 79.9％ (148/185),of them congenital uterine anomalies was 52.4％ (97/185),and acquired uterine pathologies was the most of 21.1％ (39/185),acquired uterine abnormalities was 21.1％ (39/185),and intrauterine adhesion was the most common of 11.9％ (22/185).Incidence of intrauterine adhesions of natural abortion with 1 times,2 times and 3 times or more were 7.4％ (5/68),14.1％ (11/78) and 15.4％ (6/39).Hysteroscopy showed that the detection rates of normal uterine cavity,congenital abnormalities,acquired uterine and congenital and acquired pathologies in 3 groups were 27.9％ (19/68),51.5％ (35/68),17.6％ (12/68)and 2.9％(2/68);17.9％(14/78),51.3％(40/78),24.3％(19/78) and 6.4％(5/78);10.3％(4/39),56.4％ (22/39),20.5％ (8/39) and 12.8％ (5/39),respectively,the differences were not significant (x2 =8.823,P=0.184).Conclusion Hysteroscopy is a simple and efficient tool in the early diagnosis of congenital and acquired uterine anomalies.Diagnostic hysteroscopy can be performed after the first miscarriage in order to early diagnose and treat congenital and acquired uterine pathologies.

Prospective study on comparing two methods: for dynamic monitoring of minimal residual disease in acute promyelocytic leukemia / 中国实验血液学杂志

This study was purposed to comparatively analyse the value of PCR and FCM for dynamic monitoring minimal residual disease (MRD) of acute promyelocytic leukemia. The patients with acute promyelocytic leukemia hospitalized in our hospital from January 2011 to December 2012 were observed and all achieved complete remission after remission induction therapy. Before the chemotherapy, the bone marrow cell morphology examination, polymerase-chain reaction (PCR) and multi-parameter flow cytometry (FCM) were performed for each patient. Then the detection results were statistically analyzed. The 477 specimens were achieved from 159 detections for 48 patients. The results showed that 3 specimens were found to be relapsed by bone marrow cell examination, and other specimens were complete remission;PCR detection confirmed 7 positive, and the FCM confirmed 19 positive. There wasn't significant difference between PCR and FCM by kappa test (P > 0.05). It is concluded that FCM is as sensitive as PCR in evaluating the treatment effect of acute promyelocytic leukemia.

multivariate Logistic regression analysis of risk factors for ventilator- associated pneumonia in comprehensive ICU and nursing countermeasures / 中国实用护理杂志

Objective To explore the morbidity, risk factors and nursing of ventilator-associated pneumonia (VAP) in comprehensive ICU. Methods It was a retrospective survey. 98 mechanical ventilation (＞ 48 h) patients from Jan to Dec, 2009 in comprehensive ICU were reviewed using questionnaires to collect the clinical data. They were divided into the VAP and the non-VAP group. Several statistically significant risk factors were screened out with univarite analysis, then independent risk factors were determined with multiple Logistic regression. Results The morbidity of VAP was 35.7%. Univariate analysis showed that the level of APACHE Ⅱ score, duration of mechanical ventilation, whether primary lung disease, whether acid-suppressing agents, whether the semi-supine, whether accidental tube removal, oral care approach, whether attracted to subglottic were statistically significant risk factors of VAP. While multivariate Logistic regression analysis showed that the duration of mechanical ventilation, whether the semi- supine,whether attracted to subglottic were the major risk factors of VAP. Conclusions The occurrence of VAP is related with multiple factors. Application of comprehensive prevention strategies in accordance with these risk factors of VAP can reduce the morbidity of VAP effectively.