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Objective:To investigate the application of objective-based teaching combined with Roy adaptive situational teaching in emergency nursing teaching.Methods:A total of 110 nursing students who were assigned to Emergency Department of Xijing Hospital, The First Affiliated Hospital of Air Force Medical University, as interns were selected and divided into control group and observation group according to the order of admission, with 55 students in each group. The students in the control group received traditional teaching, while those in the observation group received objective-based teaching combined with Roy adaptive situational teaching. The two groups were evaluated in terms of the assessment score of situational simulation and the ability for emergency medicine and treatment. SPSS 22.0 was used to perform the t-test and the chi-square test. Results:For the nursing students in the observation group, the mean scores of theoretical knowledge objective, skill objective, and attitude objective were (9.09±1.21) points, (13.98±1.87) points, and (9.32±0.95) points, respectively, and for those in the control group, the mean scores of these objectives were (8.41±1.17) points, (12.43±1.72) points, and (8.72±0.83) points, respectively, suggesting that compared with the control group, the observation group had a significantly higher mastery degree of the teaching objectives (theoretical knowledge objective, skill objective, and attitude objective) ( P < 0.05). The observation group had significantly better abilities for emergency medicine and treatment than the control group ( P < 0.05). Conclusion:Objective-based teaching combined with Roy adaptive situational teaching can be used in emergency nursing teaching and may help to improve the theoretical and practical skills of nursing students and cultivate the abilities for emergency medicine and treatment.
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Objective:To investigate the expression and clinical significance of long non-coding RNA (lncRNA) H19 and lncRNA maternally expressed gene 3 (MEG3) in the serum of patients with gastric cancer (GC).Methods:A total of 87 GC patients admitted to the First People′s Hospital of Suqian (July 2017 to August 2018) were selected as the GC group, 51 patients with benign tumors as the benign tumor group, and 40 healthy people with physical examination as the healthy control group. The expression levels of lncRNA H19 and lncRNA MEG3 in serum were measured; the relationship between the expression levels of the two and clinicopathological features and prognosis of patients with GC was analyzed.Results:The levels of serum lncRNA H19 in healthy control group, benign tumor group and GC group were gradually increased, and lncRNA MEG3 level was gradually decreased ( P<0.05); the serum lncRNA H19 level in GC group was related to tumor invasion depth, tumor node metastasis (TNM) stage and lymph node metastasis. The level of lncRNA MEG3 was related to the degree of differentiation, TNM stage and lymph node metastasis ( P<0.05). Among the 87 GC patients , 63 patients were followed up for 13-32 months with an average of (23.54±4.18)months. Kaplan Meier survival curve showed that the overall survival rate of high serum lncRNA H19 group and low serum lncRNA MEG3 level group was significantly lower than that of low serum lncRNA H19 level group and high serum lncRNA H19 level group. Multivariate Cox regression analysis showed that lncRNA H19 ( HR=3.442, 95% CI=0.089-23.421) was an independent prognostic factor for GC patients, and lncRNA MEG3 ( HR=4.386, 95% CI=0.934-20.596) was a protective factor ( P<0.05); receiver operating characteristic (ROC) curve showed that the sensitivity, specificity and accuracy of serum lncRNA H19+ lncRNA MEG3 [area under curve (AUC)=0.922, 95% CI=0.861-0.962] were higher than those of serum lncRNA H19 (AUC=0.840, 95% CI=0.771-0.904) and lncRNA MEG3 (AUC=0.830, 95% CI=0.753-0.890). Conclusions:The level of serum lncRNA H19 in GC patients is significantly increased, and the level of lncRNA MEG3 is significantly reduced, which is closely related to tumor occurrence, development and prognosis. Combined detection of the two can enhance the diagnostic value of GC.
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Objective To compare differences in mechanical stability of intramedullary fibular allograft with cannulated screw (modified method) and cannulated screw alone (conventional method) for fixing young and middle-aged Pauwels Ⅰ, Ⅱ, Ⅲ femoral neck fractures. Methods Models of Pauwels Ⅰ, Ⅱ, Ⅲ femoral neck fracture fixed by conventional method and modified method were constructed. Stress distributions on weight-bearing area of the femoral cortical bone shell and the end of femoral neck fracture, as well as shear stress distributions on cortical bone shell of the femoral head and femoral neck fracture surface were analyzed, the maximum principal strain cloud maps of the femur in coronal position were drawn according to the predicted data, and the displacements of femoral neck fracture end between two groups were compared. Results The shear stress distributions on cortical bone shell of the femoral head in two directions (S12, S13) showed that femoral neck fractures fixed by modified method was superior or close to that by conventional method. Besides, the shear stress distributions on fracture surface of the femoral neck in two directions (S12, S23) showed that modified internal fixation was superior to conventional internal fixation. The displacements of femoral neck fracture end in Pauwels Ⅱ and Ⅲ fracture fixed by conventional method were greater than those by modified method and the displacements of Pauwels Ⅱ fracture fixed by conventional method were obviously larger than those of Pauwels Ⅱ fracture fixed by modified method. But Pauwels Ⅰ fracture fixed by modified method showed a larger displacement than that fixed by conventional method. Conclusions Modified method is more suitable for fixing femoral neck fracture with large angles (Pauwels Ⅱ and Ⅲ fracture), and conventional method is more suitable for fixing neck fracture with small angles (Pauwels Ⅰ fracture).
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Objective To investigate the effects of self-efficacy intervention on activities of daily living and outcomes in patients with acute ischemic stroke complicated with white matter lesions (WML).Methods From March 2016 to June 2017,patients with acute ischemic stroke complicated with WML admitted to the Departments of Neurology,the Second People's Hospital of Lianyungang were enrolled prospectively.They were randomly divided into intervention group and control group.The control group received routine treatment and nursing,and the intervention group implemented self-efficacy intervention on the basis of the control group.They were followed up until 90 d after onset.Stroke Self-Efficiency Questionnaire (SSEQ) was used to assess the stroke self-efficacy level.The Barthel Index (BI) was used to assess the activities of daily living (ADL) of the patients.The National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) were used to assess the outcomes of the patients.Results The SSEQ scores in the intervention group were significantly higher than those at the time of admission and in the control group at 90 d (all P ＜0.01).The BI in the intervention group was significantly higher than that in the control group (66.51 ±22.35 vs.58.41 ±23.17;t =3.473,P =0.001),and the NIHSS score was significantly lower than the control group (5.51 ±2.98 vs.6.95 ±2.94;t =-2.094,P=0.040),and the proportion of patients with good outcomes (mRS score 0-2) was significantly higher than that of the control group (73.7％ vs.56.6％;x2 =4.896,P =0.027).Conclusion For patients with acute ischemic stroke complicated with WML,active self-efficacy intervention could improve the ADL and it was helpful to improve the outcomes of patients.
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[Objective] Examine the expression of Galectin-3 (Gal-3),B cell lymphoma-2 protein (Bcl-2) in epithelial ovarian cancer tissues with regard to clinicopathological and survival variables,testing whether they can serve as prognostic markers and provide evidence for further research.[Methods] 98 EOC tissues and 10 normal ovarian tissues were collected,as well as their clinical documents.The expression of Gal-3 and Bcl-2 was tested via immunohistochemical staining analysis.Then the correlation between these two proteins and the clinicopathological and survival variables of these patients were evaluated.[Results] Of the 98 EOC,Gal-3 and Bcl-2 were all cytoplasmic staining.Gal-3 was observed in a majority of the EOC tumor cell proper (75/98,76.5％) but not in normal ovarian tissues.Bcl-2 was observed in a majority of the EOC tumor cell proper (50/98,51.0％) but not in normal ovarian tissue.Spearman bivariate correlation test show that there was no correlation between the expression Gal-3 and Bcl-2 (P =0.867).Gal-3 expression in EOC was associated with histology and platinum sensitivity (P =0.043,P =0.038),while Bcl-2 was associated with FIGO stage (P =0.029).Cox univariate analysis revealed that Gal-3,Bcl-2 expression,platinum sensitivity,stage were associated with overall survival (P =0.008,P =0.021,P ＜ 0.001,P ＜ 0.001).Further multivariate analysis showed that only Gal-3 expression,platinum sensitivity,stage affected the survival of these patients (P =0.014,P =0.021,P ＜ 0.001).[Conclusions]The expression of Gal-3 and Bcl-2 in EOC was significantly higher than that in normal ovarian tissue,supposed that they may involve in the development and progression of EOC.Gal-3 expression was associated with histology,platinum sensitivity and survival,it may be an independent predictive factor for EOC prognosis.There was no correlation between the expression Gal-3 and Bcl-2 in EOC,the functional mechanism between these two protein need further research.
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Objective To survey symptom occurrence degree of maintenance hemodialysis (MHD) patients,and its related factors,and to provide a basis for clinical symptom management. Methods A total of 142 MHD patients were selected with convenience sampling method from a hospital in Ningxia from July 2015 to September 2015 and investigated with the Dialysis Symptom Index ,the Pittsburgh Sleep Quality Index and the family Adaptation,Partnership,Growth,Affection and Resolve(APGAR)Scale. Results The occurrence rate of various symptoms ranged from 53.5%to 92.3%. Fatigue(92.3%),itching(86.6%)and dry skin(85.9%)were the top three prevalent symptoms. Fatigue (30.3%),difficulty falling asleep (27.5%),hyposexuality (27.5%) and trouble in sleeping deeply(27.5%)were the most serious symptoms.Multivariate linear regression analysis showed that gender,nationality,sleep quality,combining with hypertension and arrhythmia had significant influence on the occurrence degree of symptom in MHD patients(P < 0.05). Conclusion Symptoms in MHD patients are preva-lent. Efficient symptom management should be performed to improve the quality of life of MHDpatients.
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Cerebral hemorrhage is a common type of stroke, it is characterized by high morbidity and mortality.Many studies have shown that alcohol consumption is associated with the risk of intracerebral hemorrhage, and alcohol consumption is one of the independent risk factors for cerebral hemorrhage.This article reviews the relationship between alcohol consumption and the risk of intracerebral hemorrhage, the influence of heavy alcohol drinking on intracerebral hemorrhage, and the possible mechanism of chronic alcohol consumption associated with hypertensive intracerebral hemorrhage.
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Objective To investigate the status of diabetes distress in patients with middle-andhigh risk of diabetic foot and explore the impact of self-perceived burden and social support on diabetes distress.Methods Totally 205 patients with middle-and-high risk of diabetic foot were investigated with Diabetes Distress Scale,Self-perceived Burden Scale and Social Support Scale.Results The total average score of diabetes distress was (2.59±0.57),the diabetes distress level was correlated with self-perceived burden,dimensions of social support (r=0.481～0.653) and were influenced by gender,vocation,objective support,use of support.Conclusions Diabetes distress is widespread in patients with middleand-high risk of diabetic foot and was influenced by many factors,these provide the basis for taking effective interventions to reduce diabetes distress.
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Objective To explore the glucose and liplid metabolism changes of pregnant rats and the birth weight of their offsprings due to pregnancy malnutrition,including overnutrition and undernutrition.Methods Thirty pregnant Wistar rats were randomly divided into three groups on the day of conception,the high-fat-diet group,normal control group and 50％ food-restricted diet group.Increase of body weight and serum level of triglycerides,high-density lipoprotein,low-density lipoprotein,oral glucose tolerance test (OGTT) and insulin release test(IRT) levels during pregnancy were measured.The birth weight of offsprings was recorded within 12 h after birth.One-way ANOVA,LSD or Dunnett T3,and Chi-square test were applied for statistical analysis.Results The body weight at late pregnancy and the level of triglycerides and low-density lipoprotein were significantly increased in the high-fat-diet rats compared to normal control ones [(1.68±0.13) mmol/L vs (0.78±0.08) mmol/L,(0.57±0.04) mmol/L vs (0.35±0.07) mmol/L; both P＜0.01].While the level of high-density lipoprotein of high-fat-diet rats was lower than that of the normal control rats [(0.56±0.06) mmol/L vs (1.09±0.08) mmol/L,P＜0.05].The level of triglycerides,low density lipoprotein and high density lipoprotein in 50％ food restricted group [(0.47±0.06) mmol/L,(0.21±0.06) mmol/L and (0.42±0.05) mmol/L] were lower than the control group (all P＜0.05).Impaired glucose tolerance,abnormal OGTT and IRT results were found in both high-fat-diet and 50％ foodrestricted diet rats.The fasting plasma glucose level in high-fat-diet group was significantly increased in late pregnancy compared to the control [(6.63±0.53) mmol/L vs (4.90±0.26) mmol/L,P＜0.05],while there was no significant difference between rats in 50％ food-restricted diet [(4.18±0.26) mmol/L]and control group (P＞0.05).There was no statistical difference in fasting serum insulin level among the three groups.The average birth weight was significantly increased in high-fat-diet rats than in the control group [(6.14±0.31) g vs (5.73±0.26) g,P＜0.05],and the incidence of macrosomic newborn rats in the high-fat-diet group was also higher than that of the control group [19.2 ％ (19/99)vs 7.84％(8/102),P＜0.05].The birth weight of offspring in 50％ food-restricted diet group was decreased with their average birth weight of (4.54±0.23) g,which was lower than that of the control group (P＜0.05).The incidence of macrosomic [13.40％ (11/76)] and low birth weight newborn rats [15.90％ (13/76) vs 3.92％(4/102)] in food-restricted diet group were both higher than in the control group (P＜0.05); and smaller number of offsprings was obtained than the control group (76 vs 102,P＜0.05),the number of offsprings in high-fat-diet group was 99,which was less than the control group without statistical difference (P＞0.05).Conclusions Pregnancy malnutrition,including overnutrition and undernutrition,may affect the lipid metabolism and glucose tolerance of pregnant rats,leading to insulin resistance,and may also contribute to the abnormal birth weight of the offspring,including macrosomia and low birth weight.