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Objective:To evaluate the status of position management of anesthesia specialist nurses in China.Methods:From January 2022 to March 2022, a cross-sectional survey was conducted using a self-made questionnaire through convenience sampling to assess the current situation of position management of anesthesia specialist nurses in tertiary hospitals in mainland China.Results:A total of 154 questionnaires were distributed, 137 of which were recovered, the response rate was 89%, and 36 questionnaires were excluded. The survey involved 101 tertiary hospitals in 25 provincial administrative regions in China, and 90% of hospitals were general hospitals. Eighty-three percent of hospitals had separate anesthesia care units, anesthesia specialist nurses accounted for ≥ 10% of nurse anesthetists in 53% of hospitals. Ninety-four percent of hospitals had the position management system of specialist nurses, more than 50% of hospitals had position responsibility and hierarchical management systems and showed difference in position benefits. Less than 50% of hospitals had employed and full-time anesthesia specialist nurses. Fifty percent of hospitals conformed to the advocacy scope of anesthesia specialist nurse service. Fifty-five percent of hospitals carried out the qualification certification of anesthesia specialist nurses, and 37% of hospitals were the training bases for anesthesia specialist nurses. Ninety-six percent of hospitals formulated the development plan of anesthesia specialist nurses.Conclusions:The position management of anesthesia specialist nurses has begun to take shape in tertiary hospitals in China at present, but the institutional system of position management and specialized management need to be strengthened.
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ObjectiveTo investigate the effect of intermittent theta burst stimulation (iTBS) of the multi-target cerebral cortex after stroke on functional recovery of the upper limb of the hemiplegic side. MethodsFrom November, 2019 to August, 2020, 40 stroke patients in Gansu Provine Hospital Rehabilitation Center were included and randomly divided into single-target stimulation group (n = 20) and multiple-target stimulation group (n = 20). Both groups underwent basic neurorehabilitation drug therapy and conventional rehabilitation exercises. The single-target stimulation group received repetitive transcranial magnetic stimulation (rTMS) (iTBS mode) only in the primary motor cortex (M1) of the affected side. The multi-target stimulation group received rTMS (iTBS mode) in the cerebellar cortex of the healthy brain and M1 of the affected side, once a day, six days a week, for four weeks. Before and after treatment, the scores of Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT) and modified Barthel Index (MBI), and the latency and amplitude of somatosensory-evoked potentials N20 were compared. ResultsNo serious adverse reaction occurred during treatment. After treatment, the scores of FMA-UE, MBI and ARAT, and the amplitude and latency of N20 improved in both groups (|t| > 3.478, |Z| > 2.243, P < 0.05); and the scores of FMA-UE and ARAT, and the amplitude of N20 were better in the multiple-target stimulation group than in the single-target stimulation group (t > 2.939, Z = -2.697, P < 0.01). ConclusionMulti-target stimulation is superior to single-target stimulation for improving upper limb motor function and N20 amplitude in the hemiplegics after stroke.
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Objective@#To establish the mouse aorta dissection (AD) model through drinking water containing β-aminopropionitrile (BAPN).@*Methods@#Forty 3-week-old C57B1/6J male mice were divided into four groups according to randomized block design: control, 0.2, 0.4 and 0.8 g·kg-1·d-1 BAPN groups (dissolving respective dose of BAPN in the drinking water, n=10 each group). Arterial systolic blood pressure and heart rate were measured weekly in conscious, restrained mice using a noninvasive computerized tail-cuff system. Mice those died of rupture of aortic dissecting aneurysm during the study were autopsied and the aorta was examined. After 4 weeks, survived mice were sacrificed by an overdose of sodium pentobarbital and the whole aorta was harvested and analyzed.@*Results@#The incidence of AD and the mortality of ruptured AD was 0 and 0 in control group, 30% (3/10) and 20% (2/10) in 0.2 g·kg-1·d-1 BAPN group, 50% (5/10) and 40% (4/10) in 0.4 g·kg-1·d-1 BAPN group, 90% (9/10) and 70% (7/10) in 0.8 g·kg-1·d-1 BAPN group (both P<0.05 vs. control group). The incidence of AD and the mortality of ruptured AD increased in proportion to BAPN concentration increase. In 0.8 g·kg-1·d-1 BAPN group, 7 mice died of dissecting aneurysm rupture during the experiment, among which 5 dissecting aneurysms were mainly located in the thoracic aorta and 2 dissecting aneurysms in abdominal aorta. The diameters of thoracic aorta and abdominal aorta were (1.38±0.19) and (1.23±0.13) mm in control group, (2.43±1.56) and (1.30±0.26) mm in 0.2 g·kg-1·d-1 BAPN group, (2.45±1.28) and (1.30±0.31) mm in 0.4 g·kg-1·d-1 BAPN group, (2.87±0.57) and (1.95±0.81) mm in 0.8 g·kg-1·d-1 BAPN group (both P<0.05 vs. control group). The diameters of thoracic aorta and abdominal aorta in mice also increased in proportion with BAPN concentration increase. Furthermore, blood-filled false lumen formation and elastic fibers fragmentation were evidenced in hematoxylin-eosin stained and Vitoria blue-Sirius red stained aortic cross-sections of mice in the 0.8 g·kg-1·d-1 BAPN group.@*Conclusion@#BAPN treatment induced aortic dissection model in C57Bl/6J mice can serve as a useful wild-type mouse model for the mechanism and pharmaceutical studies of AD.
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Objective This study developed the post competency evaluation questionnaire of anesthesia nurses and tested its reliability and validity. Methods The item pool was developed through literature analysis, behavioral event interview and Delphi method, which was based on the post competency model. A total of 222 anesthesia nurses were investigated firstly, and the formal questionnaire was formed by item analysis, exploratory factor analysis and correlation analysis. Then the reliability and validity were tested. A total of 214 anesthesia nurses were investigated, the data was used to analyze the confirmatory factor, and the SEM was constructed finally. Results Six factors were identified including 35 items and the cumulative contribution of variance was 65.898%. The correlation coefficient between each factor and total score ranged from 0.793 to 0.863, and the correlation coefficient among each factor ranged from 0.512 to 0.739. The Cronbach′s α coefficient was 0.96 and the Spearman-Brown was 0.883 for the total scale. The model fitting indexes of structural equation model were as below, RMR=0.044, RMSEA=0.064, CFI=0.901, IFI=0.902, PNFI=0.727, PCFI=0.807. Conclusions This evaluation questionnaire has good reliability and validity, and it could be used as a tool to evaluate the post competency of anesthesia nurses in China.
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Heat shock protein 27 ( HSP27 ) is an endogenous protein that plays an important role in a great variety of physio-logical and pathological processes. It can express a large number under body stress conditions. Recent studies have shown estro-gen upregulates the expression of HSP27 through a number of ways, playing a perfect “triple protection” role. In the early stage of atherosclerosis, estrogen induces the phosphorylation of HSP27 via PI3K/Akt signaling pathway. Phosphorylation of HSP27 can resist the injury of vascular endothelial cells( VECs) through an antioxidant and anti-apoptotic pathway as well as the inhibition of cytochrome C. In the stage of forming foam cells, estrogen induces the expression and release of HSP27 from mac-rophages by stimulating the estrogen receptor β ( ERβ) , then HSP27 inhibits the LDL uptake and the release of proinflammato-ry cytokine by binding scavenger receptor A ( SR-A) . During the proliferation and migration of vascular smooth muscle cells ( VSMCs) , estrogen induces estrogen receptor α ( ERα) and protein phosphatase 2 ( PP2A) to form a complex that enhances the activity of PP2A, then it can lead to the dephosphorylation of HSP27 and finally inhibit cells proliferation and migration. In summary, the anti-atherosclerotic effect of estrogen is closely re-lated to the role of HSP27. Given the side effects of estrogen re-placement therapy( MHT) , regulating HSP27 may provide a no-vel therapy for the prevention and treatment of cardiovascular dis-eases in menopausal women clinically.
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Objective To understand the working stress source of nurse anesthetists and its coping measures. Methods The semi-structured in-depth interview was conducted in 11 nurse anesthetists from 4 hospitals. The collected data were analyzed and concluded by using Colaizzi’s seven step method of phenomenological analysis. Results Four themes were extracted and a series of sub-themes, including work environment, work characteristics and nature, confusion of career prospects and coping styles. Conclusions Managers should pay close attention to anesthesia care. The laws and policy of the qualifications standards for nurse anesthetists should be made, which can reduce the stress of nurse anesthetists including healthy and harmonious working environment, a professional training system of nurse anesthetists and career planning. So that we can improve the professionalism of nurse anesthetists.
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Objective To investigate the clinical application of nasal-insertion type ileus-tube in the treatment of adhesive small intestinal obstruction. Methods A total of 221 patients with simple adhesive small intestinal obstruction, who were admitted to authors’ hospital during the period from January 2010 to Aug. 2014, were enrolled in this study. The patients were randomly divided into nasal-insertion type ileus-tube group (n=111) and nasogastric tube group (n=110). After the procedure, the patients were kept under close observation, focusing on the abdominal distention, gastrointestinal decompression amount, the recovery time of anal exhaustion and defecation, the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film, etc. The cure rate, effective rate and transit-operation rate were calculated. The results were compared between the two groups. Results The tube placement operation was successfully performed in all patients. Compared with the nasogastric tube group, in the nasal-insertion type ileus-tube group the recovery time of abdominal distention, anal exhaustion and defecation and the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film were obviously shorter, and the gastrointestinal decompression amount was larger. In the nasal-insertion type ileus-tube group the cure rate and effective rate were significantly increased, while the transit-operation rate was decreased; the differences between the two groups were statistically significant (P<0.05). Conclusion For the treatment of adhesive small intestinal obstruction, the placement of nasal-insertion type ileus-tube is effective and reliable. This technique can strikingly improve the clinical symptoms, therefore, it is worthy of promotion and application in clinical practice.