Clinical analysis of 15 cases with myeloperoxidase antineutrophil cytoplasmic antibody associated hypertrophic pachymeningitis / 中华内科杂志

To study the clinical features of myeloperoxidase(MPO) antineutrophil cytoplasmic antibody (ANCA) associated hypertrophic pachymeningitis (HP). Clinical data of 15 cases diagnosed with MPO-ANCA vasculitis complicated with HP were retrospectively analyzed. Nine cases were males and the other 6 were females, with an average age of (58±8) years. All cases presented with chronic headache. Contrast-enhanced magnetic resonance imaging (MRI) scan showed local or diffused thickening of cerebral and/or spinal dura matter while brain parenchyma were normal. Nine cases developed multiple cranial nerve paralysis, with trigeminal nerve and auditory nerve involved most commonly. The main clinical manifestations were facial pain, hearing loss and tinnitus. Two cases were complicated with hypertrophic spinal pachymeningitis (HSP) and 4 cases were complicated with pulmonary diseases. Positive serum perinuclear pattern ANCA (pANCA) and MPO could be found in all cases, positive serum IgG 4 was seen in two patients. erythrocyte sedimentation rate(ESR;25-116 mm/1h) and C-reactive protein (CRP;29.02-146.00 mg/L) were both elevated in 14 cases. Nine cases had elevated intracranial pressure[180-235 mmH 2O (1 mmH 2O=0.009 8 kPa)] and abnormal protein level (457.6-3710.0 mg/L) in cerebrospinal fluid. Six cases were treated with glucocorticoids (prednisone 20-60 mg/d) and 9 cased with glucocorticoids and immunosuppressants (methotrexate 15 mg/week or cyclophosphamide 100 mg/d po). All patients achieved remission. MPO-ANCA associated HP is a special type of central nervous system involvement in ANCA associated vasculitis (AAV). It rarely involves the lung or kidney. Steroids and immunosuppressive agents are effective. In HP with unknown underlying diseases, it is suggested to screen ANCA and IgG 4 tests for AAV or IgG 4-related disease.

Clinical characteristics of patients with antisynthetase syndrome and positive anti-Ro52 antibody / 中华内科杂志

To analyze the clinical characteristics of patients with antisynthetase syndrome (ASS) and positive anti-Ro52 antibody. The clinical data of 203 ASS patients admitted to the First Affiliated Hospital of Zhengzhou University from 2017 to 2020 were analyzed retrospectively. Demographics, clinical manifestations, laboratory results, treatment and outcome were collected including data of 18 patients with rapidly progressive interstitial lung disease (RP-ILD). In total, the majority were women (148,72.9%). The average onset age was (51.9±13.3) years. There were 163 (80.3%) patients with positive anti-Ro52 antibody. The positivity in women (77.3% vs. 55.0%, P=0.004) was higher, and the median time from disease onset to diagnosis [4.5 (2.0, 24.0) months vs. 2.0 (1.0, 12.0) months, P=0.024] was longer in patients with positive anti-Ro52 antibody than those negative. Compared with negative patients, patients with positive anti-Ro52 antibody had a higher incidence of interstitial lung disease (ILD) (96.9% vs. 65.0%, P<0.001), arthritis (33.7% vs. 17.5%, P=0.046), and arthralgia (39.3% vs. 20.0%, P=0.022). Higher rate of positve antinuclear antibody (ANA) (85.3% vs. 55.0%, P<0.001), lower rate of positive anti-Jo-1 antibody (32.5% vs. 50.0%, P=0.039), lower albumin level [(34.6±5.2) g/L vs. (37.3±4.7) g/L, P=0.004] and lower lymphocyte counts [(1.4±0.8) ×10 9/L vs. (1.8±0.8) ×10 9/L, P=0.014] were more common in patients with positive anti-Ro52 antibody. The presence of anti-Ro52 antibody is associated with a particular phenotype of ASS, leading to common ILD, involvement of joints, high ANA positivity, low albumin and low lymphocyte counts.

Reliability and validity of the Chinese version of Safety Attitudes Questionnaire / 中国实用护理杂志

Objective To translate the English version of Safety Attitudes Questionnaire (SAQ) into Chinese,and to test the reliability and validity of the Chinese version of SAQ. Methods The SAQ was developed into Chinese version through translation, back-translation and cross-culture adaption. The reliability and validity of the Chinese version of SAQ were tested in 823 first-line nurse managers in Henan. Results The scale content validity index was 0.90 of the Chinese SAQ, and the item content validity index ranged from 0.83 to 0.96. The correlations between the items and the full scale, the dimensions and the full scale separately ranged from 0.32 to 0.64 and 0.50 to 0.81 (P<0.01). The confirmatory factor analysis resulted in a good model fit for the six dimensions and the full construct, the goodness-of-fit index was 0.96, Tucker-Lewis index was 0.93, comparative fit index was 0.95, and root mean square error of approximation was 0.06. The Cronbach alpha coefficient for the scale was 0.913 and for the six dimensions were 0.565, 0.655, 0.825, 0.804, 0.880, 0.725 separately, the test-retest reliability coefficient was 0.934. Conclusions The Chinese version of SAQ is a valid and reliable tool to assess the safety culture of first-line nurse managers in Chinese hospitals.

The level and influencing facts of PICC catheter patients′ willingness to participate in patient safety / 中国实用护理杂志

Objective To investigate the level and influencing factors of PICC catheter patients' willingness to participate in patient safety. Methods A total of 198 PICC catheter patients were sampled from the targeted hospital by convenience sampling,and investigated by the Patient Participate Patient Safety Willingness and Behavior Scale ( PSWBS). Results The PSWBS score of PICC catheter patients was 3.73 ± 0.52 , including initiative willingness 4.13 ± 0.54, initiative tendency 3.82 ± 0.49, attention for technique level 3.70 ± 0.50, attention for environmental safety 3.27 ± 0.48. Among these factors, age(F=14.75, P<0.01), education degree(F=9.588, P<0.01), occupation(25.070, P<0.01), residence(t=8.570, P<0.01)and complications(t=8.880, P<0.01)were the influencing facts with statistical difference (P<0.05) . Conclusions Most of the patients have a high willingness to participate in patient safety , the distribution of impact factors have certain characteristics. Clinical nurses should take targeted nursing measures according to these different characteristics.

Application of Orem self-care model in assessing dependency care ability of caregivers for surgery orphans / 中国实用护理杂志

Objective To adopt Orem self-care model to assestt the dependency care ability of care-givers for surgery orphans and analyze its defective level of dependency case,then propose corresponding nursing policy. Methods 16 caregivers for surgery orphans were surveyed with self-made questionnaire which included the general condition of the caregivers,the nursing situation for orphans and the require-ment for dependency care ability of the caregivers.Results All questionnaires were withdrew.The pro-portion of providing correct primary care for orphans was up to 62.50%～93.75%.But the proportion of pro-viding correct rehabilitation exercises was lower than 43.75%.96% caregivers wished to obtain the relative nursing knowledge by training and improve their dependency care ability.Conclmions The caregivers' dependency care ability can meet the needs of orphans' basic dependency care.But the defect still exists,the nurses should adopt different nursing compensation for different orphans and different care defects.