Nurses′ experience and reality dilemma in advance care planning:a qualitative meta-synthesis / 中国实用护理杂志

Objective:To systematically evaluate and integrate the qualitative research of the practical experience and practical difficulties of advance care planning (ACP), so as to provide a reference for subsequent clinical nurses to better carry out ACP.Methods:PubMed, Web of Science, Embase, Cochrane Library, CINAHL, CNKI, Wanfang, VIP, Chinese Biomedical Literature Database were collected the qualitative research on the practical experience and practical difficulties of nurses′advance care planing, and the search time was the database establishment until August 1, 2022. Literature quality evaluation was conducted by the Joanna Briggs Institute (JBI) (2016), and the results were summarized using Meta integration method.Results:A total of 13 studies were included, and 39 studies were summarized into 11 new categories, forming 4 integrated results: nurses′ cognition of ACP practice, emotional experience of nurses′ ACP practice, personal factors that hinder ACP practice, and external environmental factors that hinder ACP practice.Conclusions:In ACP practice, nurses should be actively guided to have positive cognitive and emotional experience to improve their competence in ACP practice. At the same time, government departments should be united to support, integrate hospitals, society and other forces to formulate coping strategies against obstacles, so as to promote the development and practice of ACP.

Research on quality improvement based on action research study to reduce unplanned interruption during continuous renal replacement therapy / 中国实用护理杂志

Objective:To explore the effect of quality improvement based on action research study to reduce unplanned interruption during continuous renal replacement therapy.Methods:From June 2020 to December 2021, 175 patients who were treated CRRT in SICU of Beijing Chaoyang Hospital Affiliated to Capital Medical University were selected as research objects. The objects were divided into control group, observation group 1 and observation group 2 according to the time of admission. Routine nursing was used in the control group (55 cases), the first cycle of plan-action-observation-reflection according to the problems of unplanned interruption was used in the observation group 1(62 cases), the quality improvement was carried out on the basis of the first cycle, and then formulated the second cycle used in the observation group 2(58 cases). The incidence of unplanned interruption of CRRT, the duration of hemofiltration line and the ability of nurses to prevent unplanned interruption of CRRT were compared before and after implementation.Results:The baseline data of CRRT patients in the three groups were comparable ( P>0.05). After cycle quality improvement, the alarm frequencies of unplanned interruption in the observation group 1 and 2 was (8.87 ± 2.66) times and (8.07 ± 2.80) times respectively, which was significant lower than the (12.04 ± 4.23) times in the control group ( t = 3.17 and 3.97, both P<0.01). The cases of coagulation filter≥Ⅱ in the observation group 1 and 2 were 25 cases and 20 cases, which were significant lower than the 32 cases in the control group ( χ2 = 3.72, 6.38, both P<0.05). The duration of blood purification line use was (15.04 ± 7.51) h and (18.16 ± 7.67) h in the observation group 1 and 2, which were significant better than the (11.75 ± 6.84) h in the control group ( t = 3.29 and 6.41, both P<0.01). The ability of nurse to prevent unplanned interruption of CRRT in the control group, the observation group 1 and 2 were (72.62 ± 6.03), (84.77 ± 5.59) and (89.64 ± 4.54), the difference was sigaificant ( F = 146.97, P<0.001). Conclusions:The application of action research study in CRRT quality improvement could reduce the occurrence of unplanned interruption of CRRT and related complications, prolong the use time of hemofiltration line, improve the therapeutic effect of CRRT, improve the quality of nursing, and is worthy of clinical promotion.

Qualitative research on home-based hospice care experiences of nurses: a Meta-synthesis / 中国实用护理杂志

Objective:To systematically review the experience of nurses′ in providing home-based hospice care, so as to provide a basis for improving the quality of home-based hospice care and the nursing service system.Methods:Qualitative researches on nurses′ experience of providing home-based hospice care were retrieved from the Cochrane Library, PubMed,Web of Science, EBSCO, Medline, China National Knowledge Internet, China Biomedical Literature Database, Wanfang Database, VIP Database from inception to April 1, 2022. Adopting Joanna Briggs Institute Critical Appraisal Tool (2016) to evaluate the quality of included studies, the Meta-synthesis was used to explain and integrate the research results.Results:A total of 9 articles were included. This study extracted 23 clear results, 8 new categories, and 3 integrated results, including the significance of nurses′ acceptance of home-based hospice care; positive and negative emotions coexist when nurses provide home-based hospice care; challenges in implementing home-based hospice care.Conclusions:The development of home-based hospice care service is helpful to provide continuous care for the terminally ill patients and improve their quality of life, but at the same time, the ability of home-based hospice care of nurses should be further improved and the related policy guarantee should be perfected to promote the steady development of home-based hospice care in China.

Research progress on moral distress of nursing interns / 中国实用护理杂志

Moral distress generally exists in the nursing interns and has a far-reaching impact. This paper analyzed and summarized the current situation, influencing factors and coping strategies of the nursing interns at home and abroad, in order to provide reference for promoting the professional development of nursing students, strengthening their professional beliefs and stabilizing the nursing team.

Prokaryotic expression of the GapC protein of Streptococcus uberis and prediction, identification of its B-cell epitopes / 生物工程学报

The GapC protein of Streptococcus uberis located on the surface of bacteria is a protein with glyceraldehyde-3-phosphate dehydrogenase activity. It participates in cellular processes and exhibits a variety of biological activities. In addition, it has good antigenicity. The aim of this study was to predict the possible B-cell epitopes of the GapC protein and verify the immunogenicity of candidate epitope peptides. The gapC gene of S. uberis isolate RF5-1 was cloned into a recombinant expression plasmid pET-28a-GapC and inducibly expressed. The purified protein was used to immunize experimental rabbits to produce anti-GapC polyclonal antibodies. The three-dimensional structure and three-dimensional location of the GapC B-cell epitopes and the homology comparison of the GapC protein and its B-cell epitopes were carried out using bioinformatics softwares. The results showed that the 44-kDa GapC protein had a good immunological reactivity. Six linear and 3 conformational dominant B-cell epitopes against the GapC protein were selected and synthesized. Three dimensional analysis indicated that the selected peptides have better antigen epitope formation potential. Rabbit anti-GapC polyclonal antibodies were generated after immunized with the purified GapC protein, and the polyclonal antibodies were used to identify the epitope peptide by an indirect ELISA. The ELISA results showed that all of the 9 epitope peptides could react with anti-GapC polyclonal antibodies with varying titers. Among them, the epitope polypeptide 266AANDSYGYTEDPIVSSD282 reacted with the polyclonal antibodies significantly stronger than with other epitope peptides. This study laid an experimental foundation for in-depth understanding of the immunological properties and utilizing effective epitopes of the GapC protein of S. uberis.

Application and implications of nursing risk management in ICU nursing supervision / 中国实用护理杂志

Nursing risk management is an important part of nursing management and of great significance to improve patient safety and nursing quality. This article summarized systematically current studies and effects of nursing risk management in ICU. Besides, this paper provided strategies about nursing risk management of ICU combined with the development of foreign nursing risk management so as to provide nursing risk early warning,avoid nursing risk and decrease the incidences of nursing risks and accidents.

An observation on application of modified perfusion device pre-flushing method in double plasma molecular adsorption system treatment and nursing care effect on patients with liver failure / 中国中西医结合急救杂志

Objective To observe the application of modified perfusion device pre-flushing method in double plasma molecular adsorption system (DPMAS) treatment and nursing care effect on patients with liver failure. Methods A retrospective analysis was conducted; 56 patients with liver failure who were consistent with the enrolled standard and admitted to the Surgical Intensive Care Unit (SICU) of Beijing Chaoyang Hospital fromJune 2014 to December 2016 were the objects of the study and their clinical data were collected. Ten patients involving the results of 17 case times from June 2014 to April 2015 were selected as the control group by using the traditional method of pre-flushing, and 46 patients involving the results of 68 case times from May 2015 to December 2016 were chosen as the observation group by using the modified perfusion device pre-flushing method. Both groups adopted effective nursing care cooperation: such as closely observe the changes of symptoms and signs of patients during the peri-treatment period, strengthen psychological care, maintain pipeline properly, and carry out the preventive management of anticoagulation and potential complications. The changes of symptoms and signs in the patients of two groups were observed, the DPMAS pre-flushing time and single time effective treatment time of the two groups were compared, before and 3 days after DPMAS treatment, the changes of serum total bilirubin (TBil), total bile acid (TBA) and its clearance rate, the changes of electrolytes, liver and kidney functions, blood routine and blood coagulation function were observed and compared between the two groups to evaluate and analyze the therapeutic effect of DPMAS.Results In the two groups, there were 56 patients involving 85 case times of DPMAS treatment all successfully completed, and the patients' symptoms and signs were improved significantly. The pre-flushing time of the observation group was obviously shorter than that in the control group (minutes: 29.5±13.1 vs. 38.9±14.7), and the single effective treatment time was obviously longer than that in the control group (minutes: 6.7±1.1 vs. 3.4±0.9,P 0.05), and urea nitrogen (BUN), creatinine (Cr), hemoglobin (Hb), platelet count (PLT), Na+ and K+ had no significant changes compared with those before treatment (allP > 0.05). The TBil clearance rate [(42.5±15.5)% vs. (32.9±13)%] and TBA clearance rate [(27±8.9)% vs. (17.1±5.8)%] in the observation group were significantly higher than those in the control group (allP < 0.05). There were no adverse events such as electrolyte disturbance, errhysis or bleeding found in the two groups during the treatment. In the study, there were 8 case times with self feeling of skin itching, 8 case times of skin rash, 6 case times of nausea and vomiting, 6 case times of chest tightness, 5 case times of blood pressure dropping phenomena and 4 case times of fever symptoms, and after the symptomatic treatments and nursing intervention, all the above symptoms were relieved or disappeared.Conclusion The modified perfusion device pre-flushing method can effectively elevate the pre-flushing effect and therapeutic effect, it is simple, time-saving, can reduce the economic burden of the patients, thus it is worthy to be used widely in clinic, during the therapeutic process, reasonable and effective nursing measures are practiced, that is the key to guarantee the successful treatment of patients.

A survey of illness uncertainty and its influencing factors among family members of patients in surgical intensive care unit / 中国实用护理杂志

Objective To investigate the level of illness uncertainty among family members of patients in surgical intensive care unit (ICU) and analyze its potential influencing factors based on Mishel′s theory. Methods A sample of 260 family members were recruited from the surgical ICU during the period from September 2014 to June 2015. Illness uncertainty was assessed by the Mishel Uncertainty of Illness Scale-Family Member. General variables questionnaire, Social Support Rating Scale, Simplified Coping Style Questionnaire were also examined to explore the influencing factors. Results The score of illness uncertainty was ( 96.75 ± 13.90 ) points in family member of patients in surgical ICU, at a high level. Multiply liner regression showed that social support (P=0.011), positive coping style (P=0.027) and average family income (P=0.033) were significant influencing factors of illness uncertainty. Conclusions The level of illness uncertainty is high among family members of patients in surgical ICU. There is a need for nurses to provide accessible social support and psychological intervention, help them cope with illness uncertainty positively.

The application of enzyme-sensitive activatable cell-penetrating peptides to targeted delivery system / 药学学报

Cell-penetrating peptides (CPPs) offer a non-selective and receptor-independent mode to promote cellular uptake. Although the non-specificity of CPP-mediated internalization allows this approach applicable to a wide range of tumor types potentially, their universality is a significant obstacle to their clinical utility for targeted delivery of cancer therapeutics and imaging agents. Accordingly, many reports have focused on selective switching of systemically delivered inert CPPs into their active form in lesions (tumor). In this review, our attention is mainly confined to such an enzyme-sensitive domain incorporated delivery system with activatable CPPs (ACPPs), which have displayed the exciting strength in balancing the CPPs' pros and cons, and potential in the treatment and diagnosis of some diseases.

The training results and it's influence factors of the training rural health appropriate technology in Jiangsu / 中华医学科研管理杂志

ObjectiveTo acquire the basic information of trainees and analyze the training results and it' s influence factors in the training of rural health appropriate technology in Jiangsu.MethodsWe used the questionnaire to collect data of the trainees' personal information and training results after training.Results A total of 2284 valid questionnaires were collected. There were 73.6％ trainees came from township hospitals,95.1 ％ of them under 45 years old,62.9％ for females,79.2％ have been working for 8 years,3％ with senior professional titles,only 0.4％ had acquire the master's degree or above.Multiple regression analysis showed that the different level of hospitals,the training needs, suitable degree,knowledge familiarity before the training,expert instruction and learning were the main influence factors for the master of the technology; The influence factors for the wish to be re-training were working age,education,the demand for training technology,ease of learning,expert instruction,grasp of this time,appliance of the technology.Conclusionlong-term mechanism for trainning and continue education should be established,and medical workers in rural areas should be strengthen to take the technical training to further improve the rural medical services.

Teaching practice and experiences for foreign students on clinical probation in Cardiology department / 中华医学教育探索杂志

Clinical probation is an important part of clinical teachings for foreign students in Medical Colleges.We chose some physicians and candidate doctors as teachers,who had both high professional level and English ability,according to the characteristics of the students.Before class,teachers had to complete the teaching plan,prepare for the language and lectures,and choose a good case.During the procedure,teachers began the training from the trivial matter,and used PBL teaching methods,put emphasis on care history collecting and physical examination,paid a great attention to the culture of clinical thinkings,etc.At last,some suggestions were put forward to solve the existing problems.

Analysis of disease spectrum of village clinics patients in rural areas of Jiangsu Province / 中华医学科研管理杂志

We investigated the common diseases in patients from village clinics and compared them to those of the general population in rural areas of Jiangsu Province.We found that the treatment rates of chronic diseases such as hypertension and diabetes mellitus were quite low.Village clinics should play a more active role in health record management,healthcare education,and management of chronic diseases for the farmers.

Methylation state of p16 gene promoter in peripheral CIM~+ T cells of patients with systemic lupus erythematosus / 中华皮肤科杂志

Objective To detect the methylation status of p16 gene promoter in CD4~+ T cells of patients with systemic lupus erythematosus(SEE),and its significance in the pathogenesis of SLE.Methods The pl 6 gene promoter methylation in peripheral CD4~+ T cells was detected with the Taqman probe-based realtime PCR(Methylight)technology in 28 patients with SLE and 20 healthy human controls.Results The methylation rate of p16 gene promoter in peripheral CD4~+ T cells was higher in patients with SLE than that in the controls(35.7%VS 10%,x~2=4.11,P<0.05).There was no correlation between SLE disease activity index (SLEDAI)and the normalized index of methylation(NIM)of p16 gene promoter(r_s=-0.29,P>0.05).Conclusion The methylation status of p16 gene promoter is aberrant in CD4~+ T,:ells of SLE patients,suggesting that the hypermethylation of p16 gene plays a certain role in the pathogenesis of SLE.

The community prevention,therapy and rehabilitation of psychiatric patients undergoing "unlock program" / 中国实用护理杂志

Objective To discuss the effect of community prevention,therapy and rehabilitation for psychiatric patients undergoing "unlock program" and free from captivity. Methods We collected and compared the result for 71 pschiatric patients before and after free from captivity by the Brief Psychiatric Rating Scale(BPRS)and Global Assessment Scale(GAS)according to the work model of the psychiatric prevention,therapy and rehabilitation nursing program which complied with "socialization,comprehension and accessibility". Results After the unlock program the total score of BPRS and GAS greatly dropped to (22.57±3.13)and (80.67±15.57)respectively 2 years later,which were statistically different from those before the attendance of the unlock program (P＜0.01). Conclusions The unlock program proved to be a novel and effective nursing program for community prevention,therapy and rehabilitation of psychiatric patients free from captivity.

Inhibition of Smilax Glabra Roxb on VCAM-1 Expression Induced by IL-1 of Human Vascular Endothelial Cells / 中国中医药信息杂志

Objective To investigate the protective effect of Smilax Glabra Roxb on the expression of vascular cell adhesion molecule-1 (VCAM-1) induced by IL-1 in human vascular endothelial cells (HUVECs). Methods Take human umbilical vascular endothelial cells as study subject, use immunofluorescence staining, serum pharmacology of the traditional Chinese medicine and flow cytometer. The level of VCAM-1 is represented by the mean fluorescence intensity. Results IL-1 increases the expression of VCAM-1, the expression of VCAM-1 in group of serum containing drugs is lower than control group. Conclusion Smilax Glabra Roxb can inhibit the effect of IL-1 induced increase of VCAM-1 expression in HUVECs.

Psychotic investigation in Huicheng District of Huizhou City, Guangdong / 中国康复理论与实践

@#ObjectiveTo investigate the morbidity rate, states of distribution and therapy of psychosis, and the influence of the patients with psychosis to society. MethodsClue exploration was used mainly, assisted with filling vacancy.ResultsTotal of the patients with psychosis was 4253,the time-spot rate of every psychosis was 4.59‰, the all-life rate was 6.24‰. ConclusionSome data of psychosis in Huicheng District have been obtained.

The teaching reform role of case-analysis in Traditional Chinese Medicine / 中华医学教育探索杂志

Pathology is an important basic medical science,a bridge between the preclinical medicine and the clinical medicine. Because of the close connection between pathology and the clinical medicine and the characteristic of pathological textbook in college of Traditional Chinese Medicine,we undertook case-analysis integrating the teaching contents appropriately during the teaching course.,aiming at enhancing the teaching quality and training the high-diathesis medical students.

Comparison of Psychological Problems Between the Male and Female Workers in the “Three Form Enterprises” / 中国医师杂志

Objective To evaluate mental health among male and female workers in the “three form enterprises”. Methods Data from 7779 participants using self-report Symptom Checklist 90 (SCL-90) were statistically analyzed. HZ Results ⑴All the statistical parameters and average factor scores of each item were all significantly higher than the normal group (U test, P

Quality standard for Compound Shengui Capsules / 中成药

AIM: To establish quality standard for Compound Shengui Capsules. METHODS: Glycyrrhiza uralensis Fisch.、Panax notoginseng(Burk.) F.H.Chen、Salvia miltiorrhiza Bge.and Ligusticum chuanxiong Hort.were identified by TLC.Ammonium glycyrrhizinate and tanshinoneⅡ_A were determined by HPLC.(RESULTS): (TLC) spots developed were fairly clear and the blank test showed no interference.The linear rangers were 0.5-4?g(r=0.999 8)for ammonium glycyrrhizinate;0.04-0.32?g(r=0.999 6) for tanshinoneⅡ_A.The average recoveries of them were 98.9%,97.8%,respectively. CONCLUSION: The methods is effective for the quality control of Compound Shengui Capsules.