Preliminary construction of a core index system of job responsibilities for specialist trauma nurses / 中华创伤杂志

Objective:To construct a core index system of job responsibilities for specialist trauma nurses tailored to the current trauma care system in China and provide a reference for trauma centers to set up specialist trauma nurses.Methods:Literature review and group discussion were used to develop the first draft of the core index system of job responsibilities for specialist trauma nurses. The Delphi method was used to conduct two rounds of consultation among 15 experts from 7 provinces or cities in China to determine the final draft. The two rounds of expert active coefficient, expert authority coefficient ( Cr), Kendal coefficient (Kendall′s W), and average value of the importance and variation coefficient ( CV) of each indicator were calculated. Results:In both rounds of consultations, the expert active coefficient was 100%, and the Cr was 0.953. In the second round of consultation, the Kendall′s W was 0.188 ( χ2 =155.29, P<0.001), and the average value of the importance of each indicator ranged from 4.27-5.00 points with the CV of less than 0.25 points. The final index system consisted of 7 first-level indicators and 49 second-level indicators. Conclusion:The core index system of job responsibilities for specialist trauma nurses is reasonable and comprehensive, which can provide guidance for setting up positions of specialist trauma nurses in China.

Expert statement on the construction criteria of critical care department in municipal and district designated hospitals under the pandemic prevention and control / 中华危重病急救医学

The global coronavirus disease 2019 epidemic is still in a pandemic state. Aging population with underlying diseases is prone to become severe, and have a higher mortality. The treatment capacity of the critical care department directly determines the treatment success rate of critical illness. At present, there is still a certain gap between domestic and foreign countries in intensive care unit (ICU), which is not only in the allocation of medical staff, but also in the beds and settings. The current medical model cannot fully meet the needs of development. The experience and lessons of many major public health emergencies suggested that " dual track of peace and war" approach in discipline construction of critical care is the best medical model. Following the concept of "combination of peace and war", strengthening the discipline construction of critical care department in municipal and district designated hospitals, allocating reasonable standard ICU, step-down ICU and combat readiness ICU, establishing rapid response team, and strengthening regular training and scientific management may be the key measures to deal with the epidemic.

Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) / 中华危重病急救医学

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

Construction and clinical practice of enteral nutrition nursing quality control system for critically ill patients / 中国实用护理杂志

Objective:To establish a quality control system of enteral nutrition nursing for critically ill patients, and to apply this system in clinical practice and evaluate its effect.Methods:Delphi method was used to construct the quality control system. By training nurses in this system, through the training of the system for nurses and clinical quality control, enteral nutrition complications of patients before and after the training and nurses' knowledge of enteral nutrition were compared.Results:after the system applied in the nursing clinic, the incidence of enteral nutrition gastrointestinal complications, infectious complications, metabolic complications and mechanical complications in patients with critical illness decreased from 11.3% (18/160), 1.9% (3/160), 5.6% (9/160), 6.9% (11/160) to 3.9% (6/152), 0.7% (1/152), 1.3% (2/152), 1.9% (3/152) respectively, with statistically significant differences ( χ 2 values were 6.35-91.33, P <0.01). ICU nurses' awareness of enteral nutrition theory was significantly improved, and the questionnaire score increased from (70.22±8.78) points to (95.25±4.18) points, with statistically significant difference ( t value was 18.792, P<0.01). Conclusion:The enteral nutrition nursing quality control system developed in this study can effectively guide nursing staff to implement enteral nutrition during nursing behavior, reduce the occurrence of enteral nutrition complications in patients with critical illness, to ensure the safety of patients, and is worthy of clinical promotion and application.

Joint effect of smoking and diabetes on stroke / 中华流行病学杂志

Objective To explore the interaction of smoking and diabetes on stroke.Methods In this case-control study,a face to face questionnaire survey was conducted.Logistic regression models were used to analyze the relationship between smoking or diabetes and stroke.The indicators of interaction were calculated according to the Bootstrap method in this study.Results A total of 918 cases and 918 healthy controls,who participated in the chronic disease risk factor survey in Xuzhou in 2013,were included in this study.Logistic regression analysis found that cigarette smoking was associated with stroke (OR=1.63,95％ CI:1.33-2.00),and diabetes was also associated with stroke (OR=2.75,95％CI:2.03-3.73) after adjusting confounders.Compared with those without diabetes and smoking habit,the odds ratio of stroke in those with diabetes and smoking habits was 8.94 (95％CI:3.77-21.19).Diabetes and smoking combined interaction index was 3.65 (95％CI:1.68-7.94),the relative excess risk was 5.77 (95％ CI:0.49-11.04),the attributable proportion was 0.65 (95％ CI:0.42-0.87).Conclusion The results suggest that there are additive interactions between smoking and diabetes on stroke.

Joint effect of smoking and diabetes on stroke / 中华流行病学杂志

Objective To explore the interaction of smoking and diabetes on stroke.Methods In this case-control study,a face to face questionnaire survey was conducted.Logistic regression models were used to analyze the relationship between smoking or diabetes and stroke.The indicators of interaction were calculated according to the Bootstrap method in this study.Results A total of 918 cases and 918 healthy controls,who participated in the chronic disease risk factor survey in Xuzhou in 2013,were included in this study.Logistic regression analysis found that cigarette smoking was associated with stroke (OR=1.63,95％ CI:1.33-2.00),and diabetes was also associated with stroke (OR=2.75,95％CI:2.03-3.73) after adjusting confounders.Compared with those without diabetes and smoking habit,the odds ratio of stroke in those with diabetes and smoking habits was 8.94 (95％CI:3.77-21.19).Diabetes and smoking combined interaction index was 3.65 (95％CI:1.68-7.94),the relative excess risk was 5.77 (95％ CI:0.49-11.04),the attributable proportion was 0.65 (95％ CI:0.42-0.87).Conclusion The results suggest that there are additive interactions between smoking and diabetes on stroke.

Study on anxiety status of college students in Xuzhou City and its influencing factors / 重庆医学

Objective To survey the anxiety status of university students in Xuzhou city ,and to analyze its influence factors to propose the effective improvement strategy .Methods The stratified cluster random sampling method was adopted to conduct the questionnaire survey on 1931 college students from 2 colleges in Xuzhou City .The statistical analysis was performed by using SPSS 16 .0 .Results The average score of anxiety in college students was (42 .23 ± 9 .70) points ,the total detection rate was 21 .4% .The main influencing factors of anxiety included the home ranking ,character ,specialty ,school record ,getting scholarship ,plan to partici-pate in graduate entrance examination ,employment prospect ,sleep quality ,physical condition ,relationship with classmates and ro-ommates ,love status ,work-study programs or go out to work situation ,family type ,communication with parents ,family income . Conclusion The anxiety status of college students in Xuzhou City is in middle level .So improving the college students′anxiety sta-tus needs the joint efforts of school ,family and students themselves .

Seroepidemiological analysis of hepatitis B among children aged 1-14 in 3 counties of Guangdong province in 2013 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the epidemic status of Hepatitis B in children aged 1-14 in 3 counties of Guangdong province in 2013, and to evaluate the effect of hepatitis control in children aged 1-14 after hepatitis B vaccine was integrated into the national immunization program in 2002 and catch-up vaccination was conducted from 2009 to 2011.</p><p><b>METHODS</b>A multi-stage stratified random sampling was designed to survey 1 621 children aged 1-14 in rural area of Nanxiong county, Haifeng county and Xinxing county by questionnaires including general information, medical history and risk factors. The samples were tested with chemiluminescence method to detect hepatitis B virus (HBV) surface antigen (HBsAg), antibody to HbsAg (anti-HBs) and antibody to HBV core antigen (anti-HBc). Chi-square test was used to compare the positive rate of HBV serum markers in different age groups, vaccine histories, birth weight and HBV infection status of mother.</p><p><b>RESULTS</b>Among the children aged 1-14 in 3 counties rural regions of Guangdong province, the positive rate of HBsAg, anti-HBs, and anti-HBc was 1.11% (18/1 621), 60.69% (982/1 618) and 1.92% (31/1 617), respectively. The HBsAg positive rate of vaccinated children (0.84%, 13/1 547) was lower than that of unvaccinated children (1/13) or children with unknown vaccination status (6.56%, 4/61) (χ² = 22.64, P < 0.001). The HBsAg positive rate (0.45%, 5/1 118) of the children with birth-dose given within 24 hours was lower than those that of children given beyond 24 hours (2.63%, 61/190) (χ² = 10.21, P < 0.001). The HBsAg positive rate (5/18) of children with birth weight under 2 kilogram was higher than that of children with birth weight above 2 kilogram (0.78%, 12/1 548) (χ² = 120.8, P < 0.001). The HBsAg positive rate of children born to HBsAg-positive mothers (2.80%, 3/107) was higher than that of children born to HBsAg-negative mothers (0.21%, 1/470) (χ² = 8.50, P = 0.004). With the age increasing, the coverage and timely birth-dose coverage of Hepatitis B vaccine (HepB) decreased, and the positive rate of anti-HBs gradually decreased.</p><p><b>CONCLUSION</b>After the catch-up vaccination was conducted in unvaccinated children aged 1-14 years from 2009 to 2011, the HBsAg and anti-HBc positive rate decreased, while the anti-HBs positive rate increased significantly.</p>

Airway care of a patient with motor neuron disease treated with mechanical ventilation for 8 years / 中华护理杂志

This paper introduces the airway care of a patient with motor neuron disease treated with mechanical ventilation for eight years. The airway care for the patient focused on individualized suctioning,measures to prevent atelectasis such as lung hyperinflation,adjustments of ventilator parameters,regular weaning exercise,as well as measures to prevent ventilator-associated pneumonia such as prevention of aspiration,strict disinfection and isolation,wound care of tracheotomy. The ventilator-associated pneumonia was effectively prevented. Effective nursing care for patients with long-term mechanical ventilation can prevent atelectasis and ventilator-associated pneumonia.

Analysis on Epidemiological Characteristic and the Influential Factors of Neonatal Tetanus(NNT) in Guangdong Province from 2001-2005 / 中国疫苗和免疫

Objective Analyzing NNT epidemiological characteristics and the influeutial factors in Guangdong province from 2001 to 2005 in order to formulate the strategies for elimination NNT.Methods To make descriptive study on the data collected from NNT surveillance system. Results 2832 cases were concentrated in the Pearl River Delta and the west of Guangdong.About 72.04% NNT cases occurred in the migrant children.Through analyzing the data of the year of 2004 and 2005,73.81% of migrant NNT cases occurred in the Pearl River Delta.The cases happened in the Pearl River Delta accounted for 90.18% of whole cases.Most of local cases occurred in the west of Guangdong,which accounted for 39.04% of local cases.The cases occurred all around the year.A seasonal peak of NNT was found from June to August.Most of the onset of disease were during 2～10 days after birth.There were a higher ratio of reported male cases to the female.The ratio was 2.08∶1.Most of the NNT cases were happened to the infants who delivered at home and most of the midmives who were responsible for delivery lacked of training.99.75% mothers did not kown or administe the tetanus toxoid vaccine. Conclusion The elimination of neonatal tetanus is a difficult task in Guangdong province.Publicity to the mass should be strenghtened.The cooperation between sectors should be conducted for NNT eliminodion.