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Organic transformation by light-driven catalysis, especially, photocatalysis and photothermal catalysis, denoted as photo(thermal) catalysis, is an efficient, green, and economical route to produce value-added compounds. In recent years, owing to their diverse structure types, tunable pore sizes, and abundant active sites, metal-organic framework (MOF)-based photo(thermal) catalysis has attracted broad interest in organic transformations. In this review, we provide a comprehensive and systematic overview of MOF-based photo(thermal) catalysis for organic transformations. First, the general mechanisms, unique advantages, and strategies to improve the performance of MOFs in photo(thermal) catalysis are discussed. Then, outstanding examples of organic transformations over MOF-based photo(thermal) catalysis are introduced according to the reaction type. In addition, several representative advanced characterization techniques used for revealing the charge reaction kinetics and reaction intermediates of MOF-based organic transformations by photo(thermal) catalysis are presented. Finally, the prospects and challenges in this field are proposed. This review aims to inspire the rational design and development of MOF-based materials with improved performance in organic transformations by photocatalysis and photothermal catalysis.
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Perovskite solar cells (PSCs) are usually modified and passivated to improve their performance and stability. The interface modification and bulk doping are the two basic strategies. Fluorine (F)-containing materials are highly favored because of their unique hydrophobicity and coordination ability. This review discusses the basic characteristics of F, and the basic principles of improving the photovoltaic performance and stability of PSC devices using F-containing materials. We systematically summarized the latest progress in the application of F-containing materials to achieve efficient and stable PSCs on several key interface layers. It is believed that this work will afford significant understanding and inspirations toward the future application directions of F-containing materials in PSCs, and provide profound insights for the development of efficient and stable PSCs.
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AIM: To understand the real experience of family members of patients in neurosurgical intensive care unit (NICU) during intra-hospital transport (IHT), explore their inner needs and provide effective intervention measures for the construction of standardized IHT plan. DESIGN: A descriptive qualitative study. METHODS: For the purposes of this study, 10 family members of IHT patients were included using a purposive sampling method. Semi-structured in-depth interviews were used to collect the data, Nvivo 11 software was used to organize the data, and Colaizzi's 7-step descriptive phenomenology method was used to analyse the data. RESULTS: A total of three themes and nine subthemes were extracted, namely: Experience of emotional changes at different stages (uncertainty before transfer, complex internal activity during transit, ambivalence after transfer); Perception of problems in IHT (poor doctor-patient communication, weak awareness of risk assessment, deficiencies in the transfer procedure); Consciousness of the real needs (emotional respect and closeness, stay informed of the progression of the disease, greater social support). CONCLUSION: Family members of patients in the NICU have complex internal experiences and multiple support needs during IHT, reflecting the need for further standardization of the transport process. In the future, we should improve the mode of safe IHT involving doctors, nurses and family members of patients, ensure the safety of patient transport, meet the social support needs of family members and improve the experience of IHT and the medical satisfaction of family members.
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Emoções , Família , Unidades de Terapia Intensiva , Pesquisa Qualitativa , Humanos , Família/psicologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Transferência de Pacientes , Transporte de Pacientes , Idoso , Entrevistas como AssuntoRESUMO
Interface modification and bulk doping are two major strategies to improve the photovoltaic performance of perovskite solar cells (PSCs). Dipolar molecules are highly favored due to their unique dipolarity. This review discusses the basic concepts and characteristics of dipoles. In addition, the role of dipoles in PSCs and the corresponding conventional characterization methods for dipoles are introduced. Then, we systematically summarize the latest progress in achieving efficient and stable PSCs in dipole materials at several key interfaces. Finally, we look forward to the future application directions of dipole molecules in PSCs, aiming at providing deep insight and inspiration for developing efficient and stable PSCs.
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Background. Characteristics of X-linked Alport syndrome (XLAS) in a cohort of Chinese children. Methods. This work is a retrospective study covering the clinical information, pathological data, and gene sequencing results of 32 cases with XLAS from 2011 to 2022. Results. Among these 32 patients, the youngest age of onset was 3 months. Renal biopsy was performed on 29 children. The lamellated glomerular basement membrane was observed in 19 children using electron microscopy (65.5%). Of the 26 samples tested, 73.1% were found to be negative for collagen-a5 under immunohistochemical staining, showing clinical significance. Next-generation sequencing (NGS) detected 27 pathogenic gene mutations. A total of 15.4% of patients carried de novo mutations. Conclusions. The boys with XLAS showed more typical pathological performance than the girls. Patients with severe mutation were more likely to have proteinuria and hearing impairment. Renal pathology combined with NSG is an important means of diagnosis of AS.
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Hydrogen production from photocatalysis via the usage of multicomponent photocatalysts represents a promising pathway for carbon peaking and carbon neutrality, owing to their structural advantages in dealing with the three crucial processes in photocatalysis, namely, light harvesting, charge transfer, and surface redox reactions. We demonstrate the fabrication of a MOF-based multicomponent photocatalyst, denoted as semiconductor/MOF/cocatalyst, by a one-pot electrochemical synthetic route. The as-fabricated multicomponent photocatalyst has a clean interface among the components, leading to close connections that contribute to high-quality heterojunction and facilitate photogenerated charge transfer and separation, thereby the efficient hydrogen evolution. The hydrogen production rate of the resultant ZrO2 /Zr-MOF/Pt is 1327â µmol â g-1 â h-1 , which is much higher than that of ZrO2 /Zr-MOF (15â µmol â g-1 â h-1 ) and pure Zr-MOF (10.1â µmol â g-1 â h-1 ), as well as the photodeposited-Pt products ZrO2 /Zr-MOF/PtPD (287â µmol â g-1 â h-1 ) and Zr-MOF/PtPD (192â µmol â g-1 â h-1 ) obtained by the step-wise synthetic approach. The work gives a good inspiration for the rational design and construction of MOF-based multicomponent photocatalysts through the one-pot electrosynthesis.
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Nickel-iron-based layered double hydroxides (NiFe-LDHs) are promising catalysts for the oxygen evolution reaction (OER) because of their high activity, availability, and low cost. Defect engineering, particularly the formation of oxygen vacancies, can improve the catalytic activity of NiFe-LDHs. However, the controllable introduction of uniform oxygen vacancies remains challenging. Herein, an n-butyllithium treatment method is developed to tune oxygen vacancy defects and change the degree of amorphization in NiFe-LDHs via deep reduction, followed by partial oxidization at low temperatures. Interestingly, the Ni in the NiFe-LDHs is selectively reduced to the alloy state by n-butyllithium, whereas Fe is not. The different structural transformations of Ni and Fe during the treatment successfully produce an oxygen-defect-rich amorphous/crystalline electrocatalyst. Under optimal conditions, the treated NiFe-LDHs exhibit high OER activity with an overpotential of 223 mV at 10 mA cm-2 (68 mV lower than that of a commercial IrO2 electrocatalyst) and long-term stability. Notably, the n-butyllithium treatment can be applied to other electrocatalysts, such as CoFe-LDHs and IrO2 (treated IrO2 with an overpotential of 197 mV at 10 mA cm-2). This n-butyllithium reduction/partial oxidization treatment constitutes a novel top-down strategy for the controllable modification of metal oxide structures, with various energy-related applications.
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Electroreduction of carbon dioxide into readily collectable and high-value carbon-based fuels is greatly significant to overcome the energy and environmental crises yet challenging in the development of robust and highly efficient electrocatalysts. Herein, a bismuth (Bi) heterophase electrode with enriched amorphous/crystalline interfaces was fabricated via cathodically in situ transformation of Bi-based metal-phenolic complexes (Bi-tannic acid, Bi-TA). Compared with amorphous or crystalline Bi catalyst, the amorphous/crystalline structure Bi leads to significantly enhanced performance for CO2 electroreduction. In a liquid-phase H-type cell, the Faraday efficiency (FE) of formate formation is over 90% in a wide potential range from -0.8 to -1.3 V, demonstrating a high selectivity toward formate. Moreover, in a flow cell, a large current density reaching 600 mA cm-2 can further be rendered for formate production. Theoretical calculations indicate that the amorphous/crystalline Bi heterophase interface exhibits a favorable adsorption of CO2 and lower energy barriers for the rate-determining step compared with the crystalline Bi counterparts, thus accelerating the reaction process. This work paves the way for the rational design of advanced heterointerface catalysts for CO2 reduction.
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Objective:To carry out evidence-based nursing practice of nutritional management of patients in the perioperative period of hepatobiliary surgery, formulate review indicators based on the best evidence, analyze obstacles, and provide reference for the application of evidence in clinical practice.Methods:According to the "6S" evidence model, the search was conducted on Cochrane Library, Joanna Briggs Institute evidence-based Health Care Center Database, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, the British Journal of Medicine, PubMed, SinoMed, CNKI and Wanfang Database from the date of database construction to September 30, 2021. Through systematic search, evaluation and summary of evidence, the evidence-based nursing review plan for perioperative patients in hepatobiliary surgery was determined and the status review was conducted. Influencing factors were analyzed, and action strategies were formulated.Results:A total of 14 pieces of best evidence were included in this study, and 16 review indicators were formulated, of which the implementation rate of one indicator was 85%, and the implementation rate of the other indicators was 0-55%. The main obstacles include the following: the lack of relevant knowledge at the medical and nursing level; the resistance of medical staff caused by the increasing clinical work, the lack of systems, procedures, quantitative tools, and instruments and equipment; insufficient leadership, etc.Conclusions:There is a big gap between evidence-based nursing evidence and clinical practice. It should be combined with the judgment of clinical professionals and the results of the baseline review to analyze the obstacles and formulate action strategies to promote the effective transformation of evidence.
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This article reported a case of multiple mitochondrial dysfunction syndrome type 3 with the early manifestation of dyspnea and hypoxemia. The patient was a male newborn who had dyspnea, which was manifested as nasal flaring, three concave sign, and hypoxemia after birth. These manifestations were improved after oxygen support through nasal cannula, but continuous low-flow oxygen therapy was needed. Chest X-ray indicated a bell-shaped thorax with pulmonary hypertension. Whole-exome sequencing identified compound heterozygous variants of c.341+1G>A and c.785G>A (p.G262D) in IBA57 gene of the patient, which were pathogenic and inherited from his mother and father, respectively. Symptomatic epilepsy, nystagmus, and central respiratory failure appeared at the age of 3 months. Cranial magnetic resonance image findings were consistent with the signs of mitochondrial leukoencephalopathy. The patient still had recurrent convulsions despite the treatment with levocarnitine, vitamin B 2, vitamin B 1, vitamin E, coenzyme Q10, levetiracetam, and mechanical ventilation through a tracheal tube. The patient showed a poor response to the treatment and died after withdrawing from treatment.
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Metal-organic frameworks (MOFs) represent a novel class of crystalline inorganic-organic hybrid materials with tunable semiconducting behavior. MOFs have potential for application in photocatalysis to produce sustainable solar fuels, owing to their unique structural advantages (such as clarity and modifiability) that can facilitate a deeper understanding of the structure-activity relationship in photocatalysis. This review takes the photocatalytic active sites as a particular perspective, summarizing the progress of MOF-based photocatalysis for solar fuel production; mainly including three categories of solar-chemical conversions, photocatalytic water splitting to hydrogen fuel, photocatalytic carbon dioxide reduction to hydrocarbon fuels, and photocatalytic nitrogen fixation to high-energy fuel carriers such as ammonia. This review focuses on the types of active sites in MOF-based photocatalysts and discusses their enhanced activity based on the well-defined structure of MOFs, offering deep insights into MOF-based photocatalysis.
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Objective:To analyze the risk factors for premature infants with hemodynamically significant patent ductus arteriosus (hs-PDA) requiring surgical treatment, and to explore the indications for surgical treatment in premature infants with hs-PDA.Methods:A nested case-control study was conducted.The data of premature infants with gestational age<30 weeks who were diagnosed with hs-PDA in the Neonatal Intensive Care Unit of Peking Union Medical College Hospital from January 2007 to May 2020 were analyzed retrospectively.The hs-PDA patients treated surgically were included in the operation group.The hs-PDA patients of the same gestational age and gender who were not treated surgically were taken as the control group.The ratio of the case number between the operation and control groups was 1∶2.The clinical data during pregnancy, at birth and after birth of premature infants were compared between the 2 groups.The measurement data were tested by the independent sample t test or Mann- Whitney U test.The classification and enumeration data were compared by the Fisher′ s exact probability method.The risk factors for premature infants with hs-PDA requiring surgical treatment were analyzed by the conditional Logistic regression method. Results:A total of 182 premature infants with hs-PDA were enrolled in the study, including 10 in the operation group and 20 in the control group.The patients underwent PDA ligation 30.5(22.7, 37.0) d after birth, and the median preo-perative invasive ventilation duration was 9.7(17.5, 27.2) d. Compared with the control group(20 cases), the preterm infants in the operation group had a lower birth weight [(891.5±118.0) g vs.(1 054.4±230.2) g, t=2.091], a wider arterial duct diameter [3.2(2.8, 4.0) mm vs.2.0(2.0, 3.0) mm, Z=-3.300], and longer invasive ventilation duration [25.0(18.7, 38.2) d vs.3.0(1.0, 7.5) d, Z=-3.688]. Besides, the operation group applied the pulmonary surfactant for more times [2(1, 3) times vs.1(1, 2) times, Z=-2.440], and inhaled a higher concentration of oxygen on the 14 th day after birth [29(25, 36)% vs.21(21, 29)%, Z=-2.358] than the control group.Moreover, compared with the control group, the operation group took longer to achieve adequate enteral feeding [48.2(51.5, 63.5) d vs.42.5(23.5, 48.0) d, Z=2.789], and gained a higher maximum vasoactive inotropic score (VIS) [3.0(0, 3.5) points vs.0(0, 0) points, Z=-2.630]. The difference in all the above-mentioned indicators between the 2 groups was statistically significant (all P<0.05). Univariate Logistic regression analysis showed that the arterial duct diameter, application times of the pulmonary surfactant, the maximum VIS score, and the time taken to achieve sufficient enteral feeding were all related to the need for surgical treatment of hs-PDA in the operation group (all P<0.05). Multivariate Logistic regression analysis revealed that the invasive ventilation duration ( OR=0.747, 95% CI: 0.560-0.998, P=0.048) was an independent risk factor for hs-PDA premature infants requiring surgical treatment. Conclusions:The factors related to the need for surgical treatment in preterm infants with hs-PDA include a wide arterial duct diameter, multiple applications of the pulmonary surfactant, a high concentration of inhaled oxygen on the 14 th day, and the long time to achieve sufficient enteral feeding.The independent risk factor for the surgical treatment in hs-PDA children is the long invasive ventilation duration.
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Objective:To systematically review the association between delivery mode and exclusive breastfeeding rate during hospitalization and within the first six months of life.Methods:Observational studies on the association between delivery mode and feeding pattern were searched from PubMed, Web of Science, Cochrane Library, EBSCO, China Biomedical Literature Database, CNKI, Wanfang Database, and VIP Database from inception to October 2022. Two independent reviewers screened the literature, extracted data, and assessed the quality of included studies using Critical Appraisal Tools published by Joanna Briggs Institute or Newcastle-Ottawa Quality Scale (NOS). This meta-analysis was performed using R 4.1.0 software. Fixed-effect or random-effect models were used to pool data. Egger test and funnel plot were used to assess publication bias.Results:A total of 34 studies involving 597 203 subjects were included, including 22 cross-sectional studies and 12 cohort studies. All of the 22 cross-sectional studies were B-level quality, and eleven out of the 12 included cohort studies scored 7 points or above on the NOS scale with high quality. The results of meta-analysis showed that the likelihood of exclusive breastfeeding during hospitalization of women who had cesarean section was lower than those who delivered vaginally ( OR=0.33, 95% CI: 0.22-0.50, P<0.001); and so was the likelihood of exclusive breastfeeding at six months postpartum ( OR=0.61, 95% CI: 0.47-0.79, P<0.001). Conclusion:Current evidence suggests that cesarean section is a disadvantage to exclusive breastfeeding during hospitalization and within six months after delivery.
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Objective:To investigate the incidence of delayed onset of lactogenesis Ⅱ (DOL Ⅱ) in mothers of preterm infants and its influencing factors.Methods:This retrospective cohort study involved women who delivered prematurely at the Department of Obstetrics of the First Affiliated Hospital of Zhengzhou University from September 2021 to March 2022. Demographic and perinatal data of the subjects were collected. According to lactation outcome on the third day after delivery, these women were divided into DOL Ⅱ and non-DOL Ⅱ groups. The two groups' differences in general conditions were compared, and the potential factors influencing DOL Ⅱ were also analyzed. Chi-square test, two independent samples t-test, Mann-Whitney U test, and logistic regression analysis were used for statistical analysis. Results:There were 286 mothers of premature infants enrolled in this study, and 73 (25.5%) of them experienced DOL Ⅱ. The other 213 cases without DOL Ⅱwere included as the non-DOL Ⅱ group. Univariate analysis showed significant differences between the DOL Ⅱ and non-DOL Ⅱ groups in the following aspects: the proportion of women with adverse pregnancy history [28.8% (21/73) vs 41.8% (89/213), χ2=3.89], the proportion of primiparas [60.3% (44/73) vs 38.0% (81/213), χ2=10.93], the incidence of hypertensive disorders of pregnancy [35.6% (26/73) vs 16.4% (35/213), χ2=11.92], the time to initiate breastfeeding after birth[5.0 h (3.0-7.0 h) vs 4.0 h (2.0-5.0 h), Z=-4.27], and the frequency of breastfeeding or pumping within 48 h after delivery [7.0 times (6.0-9.0 times) vs 9.0 times (7.0-11.0 times), Z=-3.62] (all P<0.05). Multivariate logistic regression showed that primipara ( OR=2.720, 95% CI: 1.485-4.982), hypertensive disorders of pregnancy ( OR=3.178, 95% CI: 1.609-6.274), the time to initiate breastfeeding ( OR=1.394, 95% CI: 1.211-1.604) and the frequency of breastfeeding/pumping within 48 h after delivery ( OR=0.861, 95% CI: 0.772-0.962) were independent influencing factors for DOL Ⅱ (all P<0.05). Conclusions:?The factors that influence the occurrence of DOL Ⅱ in preterm mothers are primipara hypertensive disorders of pregnancy, breastfeeding initiation time after delivery, and the frequency of breastfeeding or pumping within 48 h postpartum.
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AIM: To investigate the image features of dynamic changes of tear film break-up after corneal fluorescein staining(FL)combined with tear film lipid layer(TFLL)dynamic changes in patients with dry eye and its value of diagnosis in dry eye. METHODS: A prospective study. A total of 66 patients(132 eyes)with dry eye admitted to our hospital during September 2019 to December 2020 were divided area break-up group(17 cases, 28 eyes), circle break-up group(20 cases, 27 eyes), line break-up group(25 cases, 28 eyes), spot break-up group(21 cases, 24 eyes)and random break-up group(20 cases, 25 eyes)according to the different fluorescein tear film break-up patterns(BUPs). The image features of tear film break-up dynamic changes and the image features of TFLL dynamic changes were compared in each group, and the differences in the first non-invasive tear film break-up time(NIBUTf), average non-invasive tear film break-up time(NIBUTav), tear meniscus height(TMH)and fluorescein staining scores were compare,RESULTS:A statistically significant differences were observed in NIBUTf among the groups of patients(P<0.001). Except that there was no difference between spot break-up group and random break-up group(7.56±1.54s vs 8.02±1.86s, P=0.881), other groups had significant differences in pairwise comparisons(P<0.05). There were statistically differences among the groups for NIBUTav(P<0.001). Except that there was no difference between spot break-up group and random break-up group(9.54±2.12s vs 9.73±1.94s, P=0.997), other groups had significant differences in pairwise comparisons(P<0.05). There was statistically difference among the groups for TMH(P<0.001). Except that there was no difference between circle break-up group and line break-up group(0.16±0.03mm vs 0.17±0.03mm, P=0.986), there was no difference between spot break-up group and random break-up group(0.22±0.03mm vs 0.21±0.05mm, P=0.993), other groups had significant differences in pairwise comparisons(P<0.05). There were statistically significant differences among the groups for FL scores and TFLL grading(P<0.001).CONCLUSION:It is shown that different fluorescein BUPs intuitively reflects the tear film structure of the pathological changes according to evaluation and analysis of images feature of dynamic changes of FL tear film and TFLL combined with the results of static examination of tear film. It is helpful for clinicians to identify subtypes of dry eye, which has potential clinical value for the diagnosis and classification of dry eye.
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Objective:To explore the prevalence and risk factors of thyroid nodules in physical examination population.Method:A total of 5934 Han people who underwent physical examination in the physical examination center of the Affiliated Hospital of Hubei University of Arts and Sciences from August 2016 to August 2019 were selected as the research objects. Retrospective research methods were used to divide them into thyroid nodule group and thyroid non nodule group according to the results of thyroid ultrasound examination, and statistical analysis was carried out in combination with relevant data. T-test was used for the comparison between measurement data groups that conform to the normal distribution and χ 2 test was used for the comparison between counting data groups. Binary Logistic regression was used to analyze the relationship between different factors and thyroid nodules, and the odds ratio ( OR) and 95% confidence interval (95% CI) were calculated. Results:(1) The prevalence of thyroid nodules in all population is 28.1% (1 668/5 934), the prevalence of thyroid nodule is 23.1% (977/4 230) in men and 40.6% (691/1 704) in women separately, and the distribution is obviously higher in women than that in male (χ 2=183.13, P=0.008). The prevalence increased with aging in both sexes ( P=0.001). (2) The correlation between the clinical data of physical examination population and thyroid nodules was analyzed according to gender. Among male patients, the rates of BMI≥23.0 kg/m 2 (82.2% (803/977)), diabetes (14.7% (144/977)), hypertension (44.4% (434/977)) and smoking history (63.1% (616/977)) in thyriod nodule group were higher than those in the non thyroid nodule group (78.9% (2 565/3 253), 8% (260/3 253), 29.3% (952/3 253), 56.9% (1 851/3 253)) (χ 2 were 5.17, 39.59, 78.35 and 11.80, respectively; P values were 0.023, 0.009, 0.005 and 0.007, respectively). Among female patients, the rates of BMI ≥23.0 kg/m 2 (55% (380/691)), obesity (31.1% (215/691)), diabetes (6.2% (43/691)), hypertension (28.9% (200/691)), high total cholesterol (43.6% (301/691)), low high-density lipoprotein cholesterol (7.1% (49/691)), high triglycerides (28.4% (196/691)), and high low-density lipoprotein cholesterol (29.1% (201/691)) in thyroid nodule group were higher than those in the non thyroid nodule group (43.6% (442/1 013), 22.5% (228/1 013), 1.9% (19/1 013), 19.2% (195/1 013), 34.7% (352/1 013), 17.9% (181/1 013), 21.5% (218/1 013), 4.5% (46/1 013)), and the differences were statistically significant (χ 2 were 21.23, 15.82, 22.14, 21.68, 13.51, 26.27, 12.69 and 5.08, respectively; P values were 0.007, 0.006, 0.009, 0.007, 0.008, 0.005, 0.005 and 0.024, respectively). (3) Multiple logistic regression analysis reveal that age ( OR=1.530, 95% CI:1.463-1.621, P=0.009), sex ( OR=3.580, 95% CI:2.931-4.381, P=0.005), smoking ( OR=1.360, 95% CI:1.161-1.592, P=0.007) and high blood pressure ( OR=1.290, 95% CI:1.121-1.482, P=0.006) were the risk factors of thyroid nodule. Conclusion:The prevalence of thyroid nodules is 28.1% in XiangYang and surrounding areas, and the elders, women, smoking and high blood pressure were the risk factors of thyroid nodule.
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Objective:To analyze the factors influencing breast milk volume in mothers of preterm infants during the period of maternal separation.Methods:This study retrospectively analyzed the data from lactation diaries of mothers of preterm infants ( n=371) in neonatal intensive care unit from the first Affiliated Hospital of Zhengzhou University from January 2017 to August 2021. According to whether the milk production reached 800 ml/d or not within two weeks after delivery, these women were divided into the reached group ( n=289) or unreached group ( n=82). Two independent sample t-test and Chi-square test were used for univariate analysis, and logistic regression was used to analyze the influencing factors. Results:Mothers who achieved the target milk volume accounted for 77.9% (289/371). There were no statistically significant differences in the ratio of milk production ≥50 ml between breasts or between two adjacent breastfeeding sessions (both P>0.05), while there were statistically significant differences in the maternal education background[high school education or below:16.3% (47/289) vs 41.5% (34/82); junior college or above:83.7% (242/289) vs 58.5% (48/82); χ2=23.77], type of breast pump [diaphragm breast pump:34.9% (101/289) vs 51.2% (42/82); piston pump: 65.1% (188/289) vs 48.8% (40/82); χ2=7.14], pre-pregnancy body mass index [<18.5 kg/m 2: 3.5% (10/289) vs 4.9% (4/82);≥18.5~<24.0 kg/m 2: 90.7% (262/289) vs 61.0% (50/82); ≥24.0 kg/m 2: 5.9% (17/289) vs 34.1% (28/82); χ2=40.89], and the initiation of lactation instruction [within 7 d after delivery: 77.2% (223/289) vs 45.1% (37/82);at 7-14 d after delivery: 22.8%(66/289) vs 54.9%(45/82); χ2=31.28] between the reached and unreached group (all P<0.05). Logistic regression analysis showed that high school education or below ( OR=4.279, 95% CI: 2.253-8.126, P<0.001), diaphragm breast pump ( OR=2.352, 95% CI: 1.309-4.226, P=0.004), pre-pregnancy body mass index ≥24.0 kg/m 2 ( OR=9.352, 95% CI: 4.389-19.928, P<0.001), and seeking lactation consultation at 7-14 d after delivery ( OR=3.654, 95% CI: 2.043-6.535, P<0.001) were risk factors for not achieving the target milk volume. Conclusions:Instruction on breastfeeding for less-educated mothers of preterm infants should be strengthened. Using piston breast pump, maintaining pre-pregnancy body mass index within the normal range, and receiving lactation instruction as early as possible will contribute to achieving the target milk volume.
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Objective:To explore the risk factors of delayed onset of lactogenesis stage Ⅱ(DOL Ⅱ) after cesarean section, and to establish a risk prediction model.Methods:This study involved 330 women who underwent cesarean section in the First Affiliated Hospital of Zhengzhou University from September 2021 to January 2022 and were further divided into DOL Ⅱ group ( n=104) or non-DOL Ⅱ group ( n=226). All clinical data were compared. Univariate analysis and multivariate logistic regression were used to analyze the independent risk factors of DOL Ⅱ after cesarean section to establish the risk prediction model and draw nomogram. The predictive validity of the model was evaluated by the area under the receiver operating curve (AUC) and the goodness of fit was verified by Hosmer-Lemeshow test. Another 129 women who underwent cesarean section in our hospital from February to March 2022 were recruited for external validation. Results:The incidence of DOL Ⅱ in the model development and validation cohort were 31.5%(104/330) and 31.0%(40/129), respectively . In the model developing cohort, significant differences were shown in the constituent ratio of different groups of pre-pregnant body mass index {lean:[9.7%(22/226) vs 3.8%(4/104)]; fit: [66.8%(151/226) vs 62.5%(65/104)]; overweight or obsess:[23.5%(53/226) vs 33.7%(35/104)]}, the proportion of primiparas [50.4%(114/226) vs 61.5%(64/104)], breastfeeding education during pregnancy [64.2%(145/226) vs 40.4%(42/104)] and maternal separation [36.3%(82/226) vs 50.0%(52/104)], and the gestational age at delivery[38.0(36.0-39.0) vs 37.0(35.0-38.5) weeks] and frequency of breastfeeding within 48 h post-delivery [6.0(3.0-9.0) vs 2.0(0.5-5.0)] between the DOL Ⅱ and non-DOI Ⅱ group (all P<0.05). The predictors included in the model were pre-pregnancy overweight or obese ( OR=4.040, 95% CI:1.196-13.651), primipara ( OR=1.866, 95% CI:1.079-3.227), breastfeeding education during pregnancy ( OR=0.582, 95% CI:0.339-1.000), and frequency of breastfeeding within 48 h after delivery ( OR=0.791, 95% CI:0.720-0.857). The Hosmer-Lemeshow test showed that P=0.814 and the AUC was 0.784(95% CI:0.731-0.837). The Youden index was 1.504 with a sensitivity of 0.769 and a specificity of 0.735. While for the external validation, Hosmer-Lemeshow test showed that P=0.260 and the AUC was 0.751(95% CI:0.661-0.840). The Youden index was 1.460 with a sensitivity of 0.775 and a specificity of 0.685. Conclusion:The risk prediction model for DOL Ⅱ developed in this study has a good consistency and predictive performance, which can provide a reference for clinical screening of mothers at high risk of DOL Ⅱ following cesarean section.
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AIM: To select and obtain relevant evidence of airway management in adult critically ill patients at home and abroad, formulate clinical quality review indicators based on evidence and analyse obstacle factors and promoting factors in evidence-based nursing practice. To promote standardized ICU airway management evidence-based nursing practice to provide the basis. DESIGN: Obstacle factor analysis. METHODS: Take the Joanna Briggs Institute (JBI) evidence-based healthcare model as theoretical guidance, establish evidence-based problems, form a team, systematically search for literature, evaluate quality and summarize evidence, establish quality review indicators and review methods, analyse obstacles and facilitating factors based on the review results and formulate corresponding action strategies. RESULTS: According to the 29 best evidences, 21 review indicators were developed. Through the results of clinical quality review, the main barriers to evidence-based practice were analysed: the lack of nurse training and relevant evidence-based knowledge at the practitioner level, the lack of standardized procedures for airway management and the lack of materials at the system level. CONCLUSION: There is a big gap between airway management evidence and clinical practice in critically ill adult patients. Therefore, improvement measures should be formulated for obstacle factors to promote effective transformation of evidence into clinical practice.
Assuntos
Estado Terminal , Enfermagem Baseada em Evidências , Adulto , Manuseio das Vias Aéreas , HumanosRESUMO
OBJECTIVE@#To study the epidemiologic characteristics of human herpes virus (HHV) activated infection in the diseases of blood system and patients received allo-HSCT by statistically analyzing the screening results of 8 human herpes viruses (HHVs) of 4164 patients in Hebei Yanda LU Dao-Pei Hospital from 2012 to 2017.@*METHODS@#PCR was used to screen 8 HHVs.@*RESULTS@#Two thousand and fifty-two patients (49.28%) were HHV-positive among 4164 patients screened. Among these patients screened, the infection spectra of 8 human HHVs in hematological diseases as well as patients received allogeneic hematopoietic stem cell transplantation of totally 2994 patients were summarized as follows: the positive rate of EBV (29.49%) was the highest, that of HCMV (23.15%), HHV-6 was 18.77% and HHV-7 was 17.64%, while the remaining 4 HHVs all≤2.1%. The rate of co-infection of various HHVs was significantly higher than that of single infection of HHV among all these disease groups except familial hemophagocytic lymphohistiocytosis, for which single EBV infection was the most common. The differences of positive rates among these 8 human HHVs in hematological diseases as well as patients received allogeneic hematopoietic stem cell transplantation were statistically significant by Chi-square test of R*C tables (χ=54.99, P<0.05). For each HHV, the differences of positive rates among the above-mentioned disease groups were also statistically significant except HHV-8 (P<0.05).@*CONCLUSION@#The patients with various blood diseases have different activated infection spectra of HHVs. EBV, HCMV, HHV-6 and HHV-7 are most common in HHVs infection. Different HHVs infections correlate with different hematologion diseases.