Experiences and Needs of Patients and Relatives During Hospitalization in an Intensive Care Unit in China: A Qualitative Study.

INTRODUCTION: In comparison with Western cultures, the closed management system makes it difficult to implement family-centered nursing in many intensive care unit (ICU) in China. There are differences in cultural cognition and social environment between China and the West. The purpose of this study was to explore the experience and needs of critically ill patients and their relatives from a Chinese cultural perspective. METHOD: This was a qualitative study using semistructured interviews conducted in a 26-bed integrated ICU at a Tertiary Grade A comprehensive hospital in Nantong, China. The participants included patients admitted in the ICU and their relatives. We used Colaizzi's seven-step procedure to analyze interview data. FINDINGS: A total of 15 participants were recruited. Main categories within the patient perspective were variety of feelings, staff assistance required, and expectations for relatives. Patient opinions differed about the feelings of hospitalization and whether they needed the help of staff and relatives. The main categories from the relatives' perspective were life is disrupted, information needs, and emotional needs. Relatives of patients in the ICU experienced a lot of physical and mental pressure. The lack of timely understanding of the patient's condition and needs made them feel anxious. CONCLUSION: The closed management system currently used in China limits contact between ICU patients and their relatives, increasing their physical and emotional discomfort. Hospitals in China should consider updating to a more open visiting policy based on current guidelines for family-centered care. Such policies enable staff to continue providing quality care for their patients while addressing patient and family needs.

Activation of M1 macrophages in sepsis-induced acute kidney injury in response to heparin-binding protein.

BACKGROUND: In the early stage of sepsis, M1 macrophages result in the production of inflammatory mediators and AKI. Heparin-binding protein (HBP) have been shown to play important roles in sepsis-induced AKI. In this study, we investigate the association of HBP with M1 macrophages in sepsis-induced AKI. METHODS: Male C57BL6 mice were subjected to cecal ligation and puncture (CLP) or sham surgery. Biochemical and histological renal damage was assessed. Macrophage infiltration was assessed by immunohistochemistry. RT-PCR was used to investigate the expression of heparin-binding protein (HBP), the inducible nitric oxide synthase (iNOS) and arginase 1 (Arg-1) mRNAs. Western blots were performed to assay the tissue levels of HBP, tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6). RESULTS: High levels of HBP were obviously detected 24 h after sepsis-induced AKI. Heparin inhibited HBP expression during sepsis-induced AKI. The suppression of HBP expression by heparin injection after the establishment of sepsis-induced AKI resulted in a reduction in renal injury severity accompanied with a significant repression of M1 macrophage activation and expression of TNF-α and IL-6. CONCLUSIONS: HBP plays an important role in the initial inflammatory reaction associated with sepsis-induced AKI, presumably by activating M1 macrophages and suppressing TNF-α and IL-6 secretion.

Investigation on training mode and practice of clinical teachers in teaching hospitals / 中华医学教育探索杂志

‘Two-way’ training of teaching basic skill and medical education method was conducted for young and middle-aged teachers according to characteristics of clinical teachers in teaching hospitals.After two years of training,clinical teachers' teaching ability and teaching enthusiasm and the quality of classroom teaching have obviously improved based on the analysis of related data.Clinical teacher training strengthen the teaching faculty quantitatively.This thesis discussed the importance of clinical teachers' training and further explored the improvement of clinical teacher education mode.

The clinical utilization of B-type ultrasonic diagnosis instrument in measuring sebum thickness / 肠外与肠内营养

Objectives:B type ultrasonic diagnosis instrument is used to measure the sebum thickness and the relevance vs evaluated with sebum thickness calipers in sebum thickness determination. Methods:The study included 219 healthy adult persons and 11 cases of corpse dead of non disease reason for less than 10 hours.The measurements of sebum thickness were made by B type ultrasonic diagnosis instrument and sebum thickness calipers respectively. Results:The measurement results of two different methods were not significantly different. Conclusions:It is feasible to use B type ultrasonic diagnosis instrument for the measurement of the sebum thickness in clinic.