Comparative analysis of low-dose bupivacaine and ropivacaine combined with spinal-epidural anesthesia in cesarean sections for pregnant women with coexisting mental illness.

OBJECTIVE: To analyze the application effects of low-dose bupivacaine and ropivacaine combined with epidural anesthesia. METHODS: The primary outcome measure was the anesthesia effect, assessed by the excellent anesthesia rate. Secondary outcomes included the occurrence of adverse reactions, blood pressure, and serum prolactin levels at different time points. The anesthesia effect, serum prolactin levels, occurrence of adverse reactions, and MAP at various time points [before anesthesia (T0), 5 min after anesthesia (T1), at the start of surgery (T2), at delivery of the fetus (T3), and at closure of the abdomen (T4)] were compared between the two groups. RESULTS: ① Anesthesia effect: The excellent anesthesia rate was 71.88% in the control group and 93.94% in the observation group, with a significantly higher rate in the observation group than in the control group (p = 0.017). ② Serum prolactin levels: The serum prolactin levels in both groups increased significantly after surgery compared to before surgery (p < 0.001); however, there was no statistically significant difference in serum prolactin levels between the two groups before and after surgery (p = 0.651). ③ Occurrence of adverse reactions: The occurrence rate of adverse reactions was 28.13% in the control group and 9.09% in the observation group, with a significantly lower rate in the observation group than in the control group (p = 0.048). CONCLUSION: In cesarean sections for pregnant women with coexisting mental illness, low-dose ropivacaine demonstrates significantly better anesthesia efficacy, blood pressure stability, and anesthesia safety compared to low-dose bupivacaine. Both low-dose bupivacaine and ropivacaine result in increased prolactin levels postpartum.

Analysis of the application effect of continuous care for patients with viral keratitis.

BACKGROUND: In recent years, the incidence of viral keratitis has been on the rise. OBJECTIVE: This study explored the application effect of continuous care for patients with viral keratitis. METHODS: A total of 148 patients with viral keratitis admitted to the ophthalmology department of the authors' hospital from January 2019 to December 2020 were selected and divided into the observation group and the control group via the random number table method, with 74 cases in each group. Continuous care was conducted following routine discharge guidance for patients in the observation group, while routine discharge guidance only was provided for the control group. The patients in both groups were continuously observed for one year. The medication compliance, return visit rate, recurrence rate, nursing satisfaction, and quality of life between the two groups were compared and analyzed after one year. RESULTS: The medication compliance was higher in the observation than in the control group and the difference was statistically significant (P< 0.05). The rate of return visits at 1 week, 1 month, 3 months, 6 months, and 1 year in the observation group were higher than those in the control group and the differences were statistically significant (P< 0.05). The difference in the recurrence rate between the two groups at 1 week was not statistically significant (P> 0.05), while the recurrence rate at 1, 3, and 6 months, and 1 year in the observation group were higher than those in the control group, and the difference was statistically significant (P< 0.05). The total score of the quality of life in the observation group was higher than in the control group and the difference was statistically significant (P< 0.05). CONCLUSION: Continuous care had a good application effect on patients with viral keratitis, which could potentially effectively improve medication compliance and the rate of return visits, reduce recurrence rate, and improve patient satisfaction and their quality of life. Accordingly, the results of this study present high clinical value.

Application effects of targeted nursing model in patients undergoing thyroid surgery and its influence on patients' negative emotions.

OBJECTIVE: To explore the effectiveness of a targeted nursing model for patients undergoing thyroid surgery, and to analyse the influence of intervention on the negative emotions of patients. METHODS: Eighty patients who received thyroid surgery in our hospital were enrolled and divided into a study group (n=40, given targeted nursing) and a control group (n=40, given routine surgical nursing) according to the difference of intervention measures. The postoperative bed-leaving time, hospitalization time, medical expenses, drainage tube indwelling time and incidence of postoperative adverse reactions were compared between the two groups. The degree of pain, anxiety and depression was compared between the two groups at 1 d, 3 d, 5 d, and 7 d after surgery. The scales of voice handicap index (VHI-10) and standard swallowing assessment (SSA) were used to evaluate voice quality and swallowing function in the two groups. RESULTS: The postoperative bed-leaving time, hospitalization time, medical expenses, drainage tube indwelling time and incidence of postoperative adverse reactions of patients in the study group were lower than those in the control group (P<0.05). The scores of visual analogue scale (VAS), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) in the study group at 3 d, 5 d and 7 d after surgery were lower than those in the control group (P<0.05). The scores of VHI-10 and SSA in the study group were lower than those in the control group at 7 d and 30 d after surgery (P<0.05). CONCLUSION: Targeted nursing for patients undergoing thyroid surgery can help accelerate the improvement of postoperative clinical symptoms, relieve the unhealthy emotions and pain of patients, and help improve their voice quality and swallowing function, which also has a positive effect on reducing postoperative complications. Therefore, it is worthy of clinical popularization and application.

Analysis of the Application Effects of High-alert Medications Management Review and Evaluation System Based on Tracer Methodology / 中国药房

OBJECTIVE:To explore the application and feasibility of tracer methodology in the continuous improvement of high-alert medications management in the hospital,and to improve the quality of high-alert medications management and ensure the safety of clinical medication. METHODS:According to the theory and requirements of tracer methodology,a series of interven-tions were applied to the management of high-alert medications in our hospital. The comparisons on the mastery of high-alert medi-cations knowledge,review and evaluation results and the incidence of adverse events were conducted before and after applying trac-er methodology,so as to evaluate the improvement effect of tracer methodology on high-alert medications management. RESULTS:After implementing intervention measures such as the reduction of high-alert medications list and medical staff training about high-alert medications,compared to before management,medical staffs had improved the knowledge level of high-alert medica-tions (the average awareness rate increased from 69.6% to 88.5%);the review and evaluation results had been improved signifi-cantly (the proportion of the terms with qualified level evaluation results or above increased from 66.67% to 88.89%);the inci-dence of adverse events was reduced(from 0.321% to 0.139%). CONCLUSIONS:The tracer methodology has a significant effect on the management of high-alert medications in our hospital. It is feasible and can be widely used in the management of high-alert medications in the hospitals.

EFFECTS OF HYPERTONIC SALINE IN THE TREATMENT OF CHILDREN WITH CRITICAL HAND, FOOT AND MOUTH DISEASE / 现代医院

Objective To investigate the effects of hypertonic saline in the treatment of children with critical hand, foot and mouth disease (HFMD).Methods The 250 pediatric patients with HFMD hospitalized from January 2011 to Januar-y 2013 in our hospital were randomized into the control group treated routinely and the experimental group treated with hyper-tonic saline on the basis of general conventional treatment .The therapeutic effect and sodium ion concentration in the children of two groups were observed and compared.Results The treatment effect of the experimental group was obviously better than that of the control group (p0.05), while the sodium ion concentration of the experimental group was much higher than that of the control group on the 4th and 6th treatment day (p<0.05).Conclusion Hypertonic saline treatment can significantly enhance the therapeutic effect, increase the sodium ion concentration and improve the prognosis in children with critical HFMD.Therefore, hypertonic saline treatment for patients with clinical HFMD has a very important clinical sig-nificance and it is worth popularization and application.