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Objective:To analyze the status quo of occupational engagement of junior nurses and related influencing factors, and to provide reference for managers to develop a positive incentive mechanism.Methods:From November 2020 to December 2020, 255 junior nursing staff with less than or equal to 3 years seniority at 3 tertiary general hospitals in Tianjin were selected. Questionnaire surveys were made on their occupational engagement, occupational values, job satisfaction for nursing, and general self-efficacy. Descriptive analysis and t test were used to probe into their current occupational engagement, and build a relational model on the occupational satisfaction, and the relational model of between their occupational values and self-efficiency in general of these nursing staff. Results:The total scoring of the occupational engagement scale for 255 junior nursing staff was 78.47±19.93, which was higher than the domestic norm level, and the difference was statistically significant( t=11.48, P<0.001). The results of the structural equation model showed that the overall effect on the occupational engagement of junior nurses from high to low were as follows: self-efficacy( β=0.599), professional values( β=0.323)and job satisfaction( β=0.275). Conclusions:These nursing staff feature high occupational engagement. Hospital administrators are recommended to strength training, provide timely support and incentives for their sustained improvement of self-efficiency, meet their individual career development needs for higher job satisfaction, and focus on shaping their occupational values as well.
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Objective:To investigate the relationship between double-triggering and abnormal movement of air in the lungs (pendelluft phenomenon) under pressure support ventilation (PSV).Methods:A prospective observational study was conducted, postoperative patients admitted to department of critical care medicine of Beijing Tiantan Hospital, Capital Medical University from April 1, 2019 to August 31, 2020 and received invasive mechanical ventilation with PSV mode were enrolled. Electrical impedance tomography (EIT) monitoring was performed. Airway pressure-time, flow-time, global and regional impedance-time curves were synchronously collected and analyzed offline. The volume of abnormal movement of air in the lungs at the beginning of inspiration was measured and defined as pendelluft volume. Double-triggered breaths were identified by trained researchers. Pendelluft volume during double-triggering was measured including the first triggered breath, the double-triggered breath, and the breath immediately following the double-triggered breath. Pendelluft volume was also measured for normal breath during the study. According to the frequency of double-triggering, patients were divided into severe (≥1 time/min) and non-severe double-triggering group. Pendelluft volume, parameters of respiratory mechanics, and clinical outcomes between the two groups were compared.Results:In 40 enrolled patients, a total of 9 711 breaths [(243±63) breaths/patient] were collected and analyzed, among which 222 breaths (2.3%) were identified as double-triggering. The Kappa of interobserver reliability to detect double-triggering was 0.964 [95% confidence interval (95% CI) was 0.946-0.982]. In 222 double-triggered breaths, pendelluft volume could not be measured in 7 breaths (3.2%), but the pendelluft phenomenon did exist as shown by opposite regional impedance change at the beginning of double-triggered inspiration. Finally, pendelluft volume was measured in 215 double-triggered breaths. Meanwhile, 400 normal breaths (10 normal breaths randomly selected for each patient) were identified as control. Compared with normal breath, pendelluft volume significantly increased in the first breath, the double-triggered breath, and the following normal breath [mL: 3.0 (1.4, 6.4), 8.3 (3.6, 13.2), 4.3 (1.9, 9.1) vs. 1.4 (0.7, 2.8), all P < 0.05]. Patients in severe double-triggering, pendelluft volume of normal breath and double-triggered breath were significantly higher than those in non-severe double-triggering group [mL: 1.8 (0.9, 3.2) vs. 1.1 (0.5, 2.1), P < 0.001; 8.5 (3.9, 13.4) vs. 2.0 (0.6, 9.1), P = 0.008]. Patients in severe double-triggering group had significantly higher respiratory rate than that in the non-severe double-triggering group (breaths/min: 20.9±3.5 vs. 15.2±3.7, P < 0.001). There were no significant differences in other respiratory mechanics parameters and main clinical outcomes between the two groups. Conclusions:During PSV, the abnormal movement of air in the lungs (pendelluft phenomenon) was more likely to occur in double-triggering especially in double-triggered breath. The more frequent the double-triggering occurred, the more serious the pendelluft phenomenon was. A higher pendelluft volume of normal breath and a higher respiratory rate were related to severity of double-triggering.
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OBJECTIVE@#To establish a prognostic model for preterm birth in women after cervical conization, and to evaluate its effectiveness.@*METHODS@#Seventy three women after cervical conization in Women's Hospital of Zhejiang University were included for this retrospective study. The influencing factors of preterm delivery were analyzed by Logistic regression analysis and a prognostic model was created. Receiver operating characteristic (ROC) curve was used for evaluation of the predictive ability of the model. Forty five women who underwent cervical conization were included for testing the validity of the model.@*RESULTS@#For women after cervical conization, mother's age (=1.20, 95%:1.01-1.43, <0.05) and cervical length during middle pregnancy (=0.06, 95%:0.01-0.21,<0.01) were independent predictors for preterm birth. The regression model was Logit ()=1.408-2.903×cervical length+0.186×age. The areas under the ROC curve (AUC) of the training dataset was 0.93 (95%:0.87-0.99). The sensitivity, specificity, Youden index, positive predictive value (PPV), negative predictive value (NPV) and accuracy with the cutoff value of -1.512 were 91.7%, 81.5%, 0.732, 68.8%, 95.7% and 84.5% respectively. The AUC of the testing dataset was 0.94 (95%:0.86-1.00). The sensitivity, specificity, Youden index, PPV, NPV and accuracy with the cutoff value of -0.099 were 92.9%, 90.3%, 0.832, 81.3%, 96.5% and 91.1%, respectively.@*CONCLUSIONS@#The model based on the age and cervical length during middle pregnancy can effectively predict preterm delivery in pregnant women after cervical conization.
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Feminino , Humanos , Gravidez , Colo do Útero , Cirurgia Geral , Conização , Modelos Biológicos , Nascimento Prematuro , Diagnóstico , Prognóstico , Curva ROC , Estudos RetrospectivosRESUMO
Objective To study the value of ultrasonic diagnosis of chorionic bump in early pregnancy and the relationship between the sonographic features and the pregnancy outcome . Methods A retrospective analysis of the ultrasonography of 76432 cases in early pregnancy was designed ,including 137 cases with chorionic bump ,their pregnancy outcomes were counted ,and were compared with the control group of 8139 cases of early pregnancy without chorionic bump . The sonographic features of chorionic bump ,such as the size and number were analyzed . Results There were 55 cases of miscarriage in 137 cases ,the rate happened in early pregnancy was 40 .1％ . The rate of miscarriage between the chorionic bump group and the control group had statistical difference( P =0 .000) . The chorionic bump group was divided into two subgroups according to the different number of chorionic bump ,single and multiple bumps , the rates of abortion were 35 .2％ and 80％ ,respectively . There was significant difference between the two sub groups in the rate of miscarriage( P =0 .001) . In 82 cases of intrauterine live pregnancy ,73 cases were found the disappearance of chorionic bump in the early stage of pregnancy . Conclusions Diagnosis of chorionic bump in early pregnancy has some clinical value ,and the first trimester is the critical period to determine the outcome of pregnancy .
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Objective To investigate the impact of high intra-abdominal pressure on intracranial pressure in patients with traumatic brain injury and discuss the clinical significance of abdominal decom-pression. Methods Intra-abdominal pressure and intracranial pressure of 15 patients with abdominal trauma and brain injury were observed to discuss changes of intracranial pressure after abdominal decom-pression. Results After abdominal decompression, all patients got lower intracranial pressure, with decrease of (15.2±3.6) mm Hg. Conclusion Intra-abdominal pressure does affect intracranial pres-sure for patients with abdominal trauma and brain injury. Abdominal decompression may be effective for high intracranial pressure.
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Bone marrow-derived mesenchymal stem cells(BMSCs)exist in and can be isolated from the bone marrow of adult human being and animals and can be induced to differentiate into different cells.They are easy to be isolated,cultivated,and amplified.They are also less immunogenic in the body and can avoid ethical dispute when applied in transplantation.Studies have shown that BMSCs can be induced to differentiate into neural cells under certain conditions in vitro.This article reviewed the recent development in the research on the induction protocols for neural differentiation of BMSCs and the possible mechanisms.
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A sample investigation is conducted among 109 political affairs staff from different scales of hospitals in Yancheng city.By analyzing the investigation data,this paper points out there is a lack of humanities qualification among hospital political affairs staff.Some countermeasures are also come up with as follows.The enhancement of humanities knowledge should be the first step to improve qualification of political affairs staff.Political affairs staff should take a positive role in adapting to the challenges of information economics.The political affairs work should be initiated with humanities culture in order to keep pace with social progress.The mutual improvement in humanities education and political affairs work lies a solid foundation for the construction of a harmonious physician-patient relationship.