Design and Application of Health Education Apps Based on WeChat for Self-Management among Patients.

Background: We started to design and test health education Apps for self-management among patients to provide a rich source of clinical support and information for patients to increase their ability of self-management. Methods: First, a multidisciplinary research team worked together to design and conduct the research. With their help, we redesigned an apps to incorporate some personalized changes for patients' needs. Second, we chose a questionnaire from the Comprehensive Service Platform for the Elderly self-designed by CHENYu. Finally, a purposive sample of 34 users were tested experiences and satisfaction of users in Jul 2021. Results: This research was successfully conducted in 22 wards among 23159 patients and 40440 chapters about healthy information sent to patients from Mar 2019 to January 2021 by smartphone. The data showed that 91.2% of participants resolved that the evaluation effect of the proposed application was better, in comparison with the paper version as routine verbal instruction. Additionally, 85.3% of participants wanted to continue to receive medical education information after discharge from the hospital. The top four most popular medical education information that they would like to receive included drug administration, disease prevention, nursing, and home care. Moreover, the top four most popular types of user suggestions were one-on-one online Q & A, continue to see every session, accelerate the speed of browsing and page updated, and free Wifi. The user satisfaction of the application was considerably high. Conclusion: The apps was welcomed by patients who wanted to increase their knowledge level of disease and perform self-management better.

Readmission Risk Prediction Model for Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis.

Background: The present systematic review and meta-analysis aimed to systematically evaluate a risk prediction model for the readmission of patients with CHF. Methods: The search was carried out in databases including PubMed, Embase, EBSCO, Web of Science, Cochrane Library and also domestic databases including Chinese Biomedical Literature Database, Chinese Academic Journal Full Text Database, Wanfang Database, and Vipu Chinese Journal Service Platform. All the original studies published by July 2021. Two researchers identified previous studies involving readmission risk prediction models that met our selection criteria. The quality of the included studies was evaluated based on the CHARMS checklist, and the prediction models were systematically evaluated. Results: Of the overall 4787 studies retrieved, nine studies-two prospective, seven retrospective-met our selection criteria. The area under the receiver operating characteristic curve exceeded 0.63 (0.63-0.80) for all the studies. The most common predictors in the model were B-type natriuretic peptide (BNP) or N-terminal pro-brain BNP (Odds Ratio 4.35; 95% confidence interval (CI) 2.53-7.49; P<0.001), renal insufficiency (Odds Ratio 1.60; 95%CI 1.24-2.08; P<0.001), comorbidities, and a history of hospitalization. Conclusion: The use of non-parametric statistical methods and assessment of large samples of electronic data improve the predictive abilities of the risk assessment models. It is necessary to calibrate and verify such models and promote the combined use of parametric and non-parametric methods to establish precise predictive models for clinical use.

Disaster Nursing Competency of Intensive Care Nurses in Jinan, China: A Multicenter Cross-Sectional Study.

BACKGROUND: Patients in disaster areas require the most urgent assistance. In recent large-scale natural disasters, intensive care nurses have served as an important reserve component of disaster response teams. In disaster nursing, ability and attitude directly affect the quality and effectiveness of disaster rescues. However, few studies have examined the disaster nursing competency of intensive care nurses in China. PURPOSE: This study was designed to describe the current status of disaster nursing competency among intensive care nurses, analyze the related factors affecting the disaster response effectiveness, and evaluate the values of disaster nursing continuing education and training in cultivating professional personnel with disaster emergency rescue competence. METHODS: This cross-sectional study was conducted at six tertiary general government hospitals in Jinan, Shandong Province, China. A convenience sampling method was adopted, and the Wenjuanxing website was used to compile the network questionnaire, which participants completed via a WeChat group. Descriptive, correlation, and regression analyses were performed using SPSS software. RESULTS: The participants in this study included 285 registered intensive care nurses employed at six hospitals in Jinan. Most were female (77.9%), and the mean age was 29.9 years. The mean total disaster nursing ability score was 122.98 (SD = 31.70), and the average scores for each item ranged from 2.78 to 3.70. The incident command system item earned the highest mean score (3.70, SD = 1.22), followed by triage (3.24, SD = 0.93). The biological preparedness item earned the lowest mean score (2.78, SD = 1.04). Being male, being < 30 years old, having an understanding of disaster nursing, having previously participated in disaster emergency simulation drills or training, and having a higher self-evaluation of rescue competence were all associated with higher disaster-nursing knowledge scores. Multiple linear regression analyses indicated that understanding of disaster nursing and experience participating in disaster emergency rescue drills or training had the most significant influence on the disaster nursing emergency knowledge score, followed by positive self-evaluation of disaster nursing ability and demand for training. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study indicate that the participants had a moderate disaster-nursing competency and that this competency may be improved through disaster-related continuing education and training. The cognitive attitude of disaster nursing was found to correlate positively with self-efficacy. Simulated emergency drills may effectively improve the disaster nursing competency of critical care nurses. The findings emphasize that experiences other than direct clinical practice such as specialized simulated emergency drills and training as well as willingness for such training are stronger factors for identifying and developing overall disaster nursing competency.

Effects of medical insurance system on the hospitalization cost of acute myocardial infarction patients.

BACKGROUND: Acute myocardial infarction is still a burden on Chinese patients. Whether different medical insurance system have any influence on the hospitalization cost and therapeutic effect of acute myocardial infarction patient needs further investigation. METHOD: In this study, 600 patients were stratified by health insurance status to investigate the cost effectiveness. RESULT: Compared with free medical care, patients with other health insurance status have a significantly lower age (P Ë‚ 0.05-0.001), the youngest of which is new rural cooperative medical system. The hospital expense, nursing fee, length of stay, daily hospitalization cost, daily drug cost, daily nursing cost and percent of nursing cost of different health insurance status were statistically significant. ANCOVA analyses controlling for age showed that the differences of hospital expenses, nursing fee, length of stay and daily hospitalization cost were still statistically significant. Further studies found that health insurance status was the leading factors influencing length of stay (ß = - 0.305, P = 0.0000001), nursing costs (ß = - 0.319, P = 0.004), daily hospitalization costs (ß = 0.296, P = 0.0001) and occurrence of clinical events (ß = - 0.186, OR = 0.830, 95% CI 0.694-0.993, P = 0.041). CONCLUSIONS: The hospitalization cost, length of stay, nursing work and therapeutic effect of acute myocardial infarction patients are affected by different health insurance status and age.

Application of a modified surgical position in anterior approach for total cervical artificial disc replacement.

BACKGROUND: Total cervical artificial disc replacement (TDR) has been considered a safe and effective alternative surgical treatment for cervical spondylosis and degenerative disc disease that have failed to improve with conservative methods. Positioning the surgical patient is a critical part of the procedure. Appropriate patient positioning is crucial not only for the safety of the patient but also for optimizing surgical exposure, ensuring adequate and safe anesthesia, and allowing the surgeon to operate comfortably during lengthy procedures. The surgical posture is the traditional position used in anterior cervical approach; in general, patients are in a supine position with a pad under their shoulders and a ring-shaped pillow under their head. AIM: To investigate the clinical outcomes of the use of a modified surgical position versus the traditional surgical position in anterior approach for TDR. METHODS: In the modified position group, the patients had a soft pillow under their neck, and their jaw and both shoulders were fixed with wide tape. The analyzed data included intraoperative blood loss, position setting time, total operation time, and perioperative blood pressure and heart rate. RESULTS: Blood pressure and heart rate were not significantly different before and after body positioning in both groups (P > 0.05). Compared with the traditional position group, the modified position group showed a statistically significantly longer position setting time (P < 0.05). However, the total operation time and intraoperative blood loss were significantly reduced in the modified position group compared with the traditional position group (P < 0.05). CONCLUSION: The clinical outcomes indicated that total operation time and intraoperative blood loss were relatively lower in the modified position group than in the traditional position group, thus reducing the risks of surgery while increasing the position setting time. The modified surgical position is a safe and effective method to be used in anterior approach for TDR surgery.

miR-147a suppresses the metastasis of non-small-cell lung cancer by targeting CCL5.

OBJECTIVE: MicroRNA (miR)-147a acts as an inhibitory miRNA in many cancers. However, its potential roles in non-small-cell lung cancer (NSCLC) remain unclear. METHODS: Levels of miR-147a and C-C motif chemokine ligand 5 (CCL5) were measured using a quantitative real-time PCR assay. Cell growth, migration, and invasion of NSCLC cells were assessed by colony formation, wound healing, and Transwell invasion assays, respectively. The role of miR-147a in the growth and metastatic ability of NSCLC in vivo was detected using a xenograft model and experimental lung metastasis model. RESULTS: miR-147a was downregulated in NSCLC cell lines as well as in tissues. Gain-of-function and loss-of-function analyses demonstrated that upregulation of miR-147a decreased the aggressiveness of NSCLC cells in vitro. In addition, CCL5 was identified as a target of miR-147a. We also demonstrated the effect of miR-147a in the progression of NSCLC cells via targeting CCL5. Finally, the in vivo mouse xenograft model showed that miR-147a inhibited progression of NSCLC cells. CONCLUSIONS: Overall, expression of miR-147a was downregulated in NSCLC. Importantly, upregulation of miR-147a suppressed the growth and metastasis of NSCLC cells in vivo by targeting CCL5.

Ginsenoside Rb1 enhances atherosclerotic plaque stability by skewing macrophages to the M2 phenotype.

Atherosclerosis (AS) is characterized as progressive arterial plaque, which is easy to rupture under low stability. Macrophage polarization and inflammation response plays an important role in regulating plaque stability. Ginsenoside Rb1 (Rb1), one of the main active principles of Panax Ginseng, has been found powerful potential in alleviating inflammatory response. However, whether Rb1 could exert protective effects on AS plaque stability remains unclear. This study investigated the role of Rb1 on macrophage polarization and atherosclerotic plaque stability using primary peritoneal macrophages isolated from C57BL/6 mice and AS model in ApoE-/- mice. In vitro, Rb1 treatment promoted the expression of arginase-I (Arg-I) and macrophage mannose receptor (CD206), two classic M2 macrophages markers, while the expression of iNOS (M1 macrophages) was decreased. Rb1 increased interleukin-4 (IL-4) and interleukin-13 (IL-13) secretion in supernatant and promoted STAT6 phosphorylation. IL-4 and/or IL-13 neutralizing antibodies and leflunomide, a STAT6 inhibitor attenuated the up-regulation of M2 markers induced by Rb1. In vivo, the administration of Rb1 promoted atherosclerotic lesion stability, accompanied by increased M2 macrophage phenotype and reduced MMP-9 staining. These data suggested that Rb1 enhanced atherosclerotic plaque stability through promoting anti-inflammatory M2 macrophage polarization, which is achieved partly by increasing the production of IL-4 and/or IL-13 and STAT6 phosphorylation. Our study provides new evidence for possibility of Rb1 in prevention and treatment of atherosclerosis.

Experiences of patients with abnormal extubation of PICC tubes: a qualitative study.

OBJECTIVE: To explore the experiences of patients with abnormal extubation of PICC tubes. METHODS: Using phenomenological research methods, 15 cases of patients with abnormal extubation of PICC tubes were enrolled in semi-structured interviews. Data were analyzed by Nancy's phenomenological procedure. RESULTS: After abnormal extubation, patients exhibited conflicting complicated mood which combined negative experience and positive experience. Negative experience was mainly for complaint, helpless, worry and fear. Positive experience was mainly for relief and peace of mind. CONCLUSIONS: Patients with abnormal extubation often possessed negative experience. So nursing staff should be suggested to communicate with patients before extubation in order to reduce the dispute between nurses and patients. At the same time, we should summarize and analyze the reasons and factors for abnormal extubation, and take targeted intervention measures in clinical to ensure the safety and effectiveness of PICC extubation.