ABSTRACT
Objective To investigate the surgical patients' needs of community nursing services and actual utilization within one week of out hospital. Methods Sampled 257 adults surgical patients from certain general hospital, interviewed them by self-designed queostionnair to know their needs of community nursing services and actual utilization within one week after out of hospital. Results There were 96% pa-tients required community nursing services at the point of discharge. The content of services needs included dise ases cares, health teaching and prevention services. Different moded of community nursing cares were required. The actual utilization rate within one week was 16.5%, there were 54.5% and 63.6% of patients received wound care and medication administration separately, which were mainly provided by center visit. Conclusions There is a contradiction between the needs and actual utilization of com-munity nursing services. It is meaningful to enhance the utilization rate, extend the content and perfect the modes of community nursing services so as to satisfy discharged surgical patients' needs.
ABSTRACT
Transvaginal bladder neck suspension(TVBNS) by Raz is an acceptable procedure for the treatment of stress urinary incontinence(SUI) with high cure rate, operative simplicity, short hospitalization and little morbidity. We had treated 89 patients of stress urinary incontinence with or without cystocele. Age of the patients ranged from 28 to 78 years(mean 47.7) and mean parity was 2.9. According to the symptom grading by Stamey, Grade 1 was 18.0%(16), Grade II was 79.8%(71) and Grade III was 2. 2%(2). Coexisting cystocele were 8 cases. TVBNS by Raz were undertaken for the 82 patients of Grade I and II SUI and also with coexisting Grade 1 cystocele, 4-corner bladder neck suspension were undertaken for the 3 patients of SUI with coexisting Grade II cystocele, and TVBNS with cystocele repair were undertaken for the 2 patients of SU with coexisting Grade III cystocele. For the 2 patients of total incontinence, vaginal wall sling operation were undertaken. Mean operation time for the cases treated by Raz procedures was 56.3+/-12.3 min.; whereas it was 98.3+/-25.3 min. for the cases with coexisting cystocele. Intra or post-operation blood transfusion was performed in 7 cases. Mean duration of hospital stay after Raz procedures were 4.5+/-0.9 days and 7.3+/-1.9 days for the treated by cystocele repair. Mean interval for returning to normal voiding after operation were 11.9+/-3.0 days after Raz procedures and 22.3+/-4.3 days after the correction of coexisting cystocele. Residual urine at discharge was less than 100 ml in 54 cases(60.7%). After the mean followup of 3.5 months, urinary incontinence was disappeared completely in 83 cases(93.3%). For the 2 cases of total incontinence, symptoms were disappeared completely after the vaginal wall sling operation. Complications included persistent voiding difficulty in 3 patients(improved after suspension take down in 2 cases and following up in 1 case), recurrence of urinary incontinence in 3 cases(which was disappeared by periurethral injection of collagen in 2 cases), frequency in 16 cases(improved by medication), bladder stone in 1 case(treated by cystolithorapaxy), and dyspareunia in 1 case. Conclusively, it could be suggested that the Raz procedures and vaginal wall sling operation are reliable techniques or the treatment of SUI and cystocele with little morbidity and high cure rate.
Subject(s)
Female , Humans , Blood Transfusion , Collagen , Cystocele , Dyspareunia , Follow-Up Studies , Hospitalization , Length of Stay , Neck , Parity , Recurrence , Urinary Bladder Calculi , Urinary Bladder , Urinary IncontinenceABSTRACT
AIM: To study the feasibility, security a nd validity of the intrapericardial injection with a trans-diaphragmatic approach in chronic heart failure rats and its value in the study of gene therapy for hea rt diseases, and further investigate whether adeno-associated virual gene transf er of sarcoplasmic reticulum Ca 2+-ATPase (SERCA2a) gene can improve ven tricular function in chronic heart failure (HF) rats. METHODS: An animal model of heart failure was obtained by creati ng descending aortic constriction in rats. Recombinant adeno-associated virus, c arrying enhanced green fluorescent protein (EGFP) gene and recombinant adeno-ass ociated virus carrying SERCA2a gene, were respectively injected into pericardium of heart failure rats in different groups (group HF+EGFP and group HF+SERCA2a) by intrapericardial injection with a trans-diaphragmatic approach. After 30 days , hemodynamic parameters were measured and analyzed. Cryosection was analyzed by fluorescence microscopy to examine the expression of green fluorescent protein, and Western blotting was performed to detect the expression of SERCA2a. RESULTS: Green fluorescence was detected in cryosection of the h earts in all rats in group HF+EGFP and the expression of green fluorescent prote in was ubiquitously. The expression of SERCA2a in all rats in group HF+SERCA2a w as more than those in group HF and group HF+EGFP. And overexpression of SERCA2a improved the systolic and diastolic function of heart failure rats significantly and the hemodynamic parameters were similar with those of the controls. CONCLUSION: The intrapericardial injection with a trans-diaphrag matic approach suggests a simple, safe, efficient and cheap technique for the ge ne therapy of chronic heart failure. Gene thransfer of SERCA2a may be a new appr oach for the treatment of chronic heart failure.
