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Objective:To make a self-made fall/fall protection cover and explore its application effect.Methods:Five high-risk fall wards in Songjiang District Central Hospital were selected as the pilot wards. According to the length of stay, 80 elderly patients treated from June to December in 2020 were selected as the control group and 80 patients treated from January to June in 2021 were selected as the experimental group. The control group was treated with routine fall prevention / bed falling intervention measures, and the experimental group was treated with self-made fall prevention / bed falling protective cover on the basis of routine intervention measures. The incidence of falling/falling bed, physical restraint rate, comfort and satisfaction of hospitalized patients were compared between the two groups.Results:During the study period, there was no fall in the experimental group and one patient in the control group. The incidence of fall was 0.125 ‰ (1/8 000) ( t=-0.06, P>0.05). The rate of physical restraint was 8.75%(875/10 000) in the experimental group, and 26.25%(2 100/8 000) in the control group, the difference was statistically significant( t=-5.51, P<0.05). The scores of comfort and satisfaction were (93.43 ± 13.01), (134.50 ± 15.56) points in the experimental group and (81.68 ± 13.41), (111.88 ± 16.22) points in the control group, the differences were statistically significant ( t=8.03, 12.92, both P<0.05). Conclusions:The self-made fall / fall protection cover can reduce the utilization rate of physical constraints, improve the overall comfort of patients, improve patients′ satisfaction.It has clinical promotion value.
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Objective:To study the optimal pain control goal for preventing delirium in critical patients.Methods:A prospective cohort study were conducted. The patients admitted to general departments and transferred to the intensive care unit (ICU) due to critical illness in the First People's Hospital of Changde from January 2017 to November 2019 were enrolled. The General data of the patients were collected within 48 hours after admission. All patients admitted to the ICU were evaluated for pain level using the critical care pain observation tool (CPOT) every 8 hours by nurses, and confusion assessment method of ICU (CAM-ICU) was used to screen delirium patient every 8 hours by the leader of nursing team without knowing the pain level of the patients, until the subjects were transferred out of ICU. The receiver operating characteristic (ROC) curve was drawn, the area under ROC curve (AUC) and the optimal threshold were analyzed with delirium as the reference standard; according to the optimal threshold, multivariate Logistic regression analysis was used to evaluate the correlation between CPOT score and delirium.Results:During the study period, 575 patients were admitted to the participating departments and passed the preliminary screening according to the inclusion and exclusion criteria. During the study period, 34 patients were excluded due to incomplete data. Finally, a total of 541 patients were enrolled in the analysis, including 149 patients in delirium group and 392 patients in non-delirium group. There was no significant difference in gender, age, source of patients, education level, smoking history, drinking history, family mental history, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or other general information between the two groups. There were 10.1% (15/149) of patients in the delirium group used opioids, which was significantly higher than 4.3% (17/392) in the non-delirium group, and the difference was statistically significant ( P < 0.05). The CPOT score in the delirium group was significantly higher than that in the non-delirium group (4.24±1.78 vs. 2.75±1.95, P < 0.01). The patients were subdivided into young group (< 40 years old), middle-aged group (40-65 years old) and old group (> 65 years old) according to age. The analysis results were consistent with the overall analysis results. ROC curve analysis showed that the AUC of CPOT score predicting delirium was 0.719; when the best threshold value of CPOT score was 2.5, the sensitivity was 91.3%, the specificity was 49.0%, the positive predictive value was 40.5% and the negative predictive value was 93.7%. Multivariate Logistic regression analysis showed that the risk of delirium in ICU patients with CPOT score ≥ 3 was 10.043 times higher than that in patients with CPOT score < 3 [odds ratio ( OR) = 10.043, 95% confidence interval (95% CI) was 5.498-18.345, P < 0.001]. When the gender, age, APACHEⅡ score, smoking history, drinking history, opioids usage were adjusted, the risk of delirium in patients with CPOT score ≥ 3 was 10.719 times higher than that in patients with CPOT score < 3 ( OR = 10.719, 95% CI was 5.689-20.196, P < 0.001). Conclusion:The best pain control goal for preventing the occurrence of delirium in ICU patients is a CPOT score of 3 or less.
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Objective:To establish a method for determining the content of imperatorin,phillyrin and forsythoside A in Kanggan Jiedu granules by UPLC. Methods:An Agilent Eclipse Plus C18 column(100 mm × 2. 1 mm,1. 8 μm)was used,the mobile phase was acetonitrile-0. 2% acetic acid with gradient elution,the flow rate was 0. 2 ml· min-1 and the column temperature was 30℃. The de-tection wavelength was set at 335 nm in the first 8 min for forsythoside A, and then changed to 277 nm for phillyrin between 8 and 10 min followed by 300 nm for imperatorin between 10 and 15 min. Results:The linear range of imperatorin was 0. 374-3. 366 μg·ml-1 (r=0. 999 6)and the average recovery was 99. 12%(RSD=1. 07%),that of phillyrin was 0. 568-5. 112 μg·ml-1(r=0. 999 4)and the average recovery was 100. 39%(RSD=0.93%,n=9),and that of forsythoside A was 0.738-6.642μg·ml-1(r=0.999 7)and the average recovery was 99. 78%(RSD=1. 14%,n=9). Conclusion:The method is rapid,simple,accurate and specific,which can be used for the determination of imperatorin,phillyrin and forsythoside A in Kanggan Jiedu granules.
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After the scientific research data management service model in Indiana University Library and Massa-chusetts University Library of USA was investigated, the contents, methods and tools of their scientific research data management service were comparatively analyzed and certain suggestions were put forward for scientific research data management service in domestic libraries.
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Objective:To establish a UPLC method for the content determination of chlorogenic acid, baicalin and phillyrin in Yinhuanglian oral liquids. Methods:An Agilent Eclipse Plus C18 column(100 mm × 2. 1mm,1. 8 μm)was used,the mobile phase was acetonitrile -0. 4% phosphoric acid with gradient elution,and the flow rate was 0. 2 ml·min-1 . The detection wavelength was set at 324 nm in the first 5 min for chlorogenic acid, and then changed to 277 nm for baicalin and phillyrin between 5 and 12 min . Results:The linear calibration curve of chlorogenic acid, baicalin and phillyrin was within the range of 39.4-355.0μg·ml-1(r=0.999 7), 90.0-810.0 μg·ml-1(r=0.999 9) and 9.4-84.6 μg·ml-1(r =0.999 5), respectively . The average recovery was 99.44%, 98. 82% and 98. 64%,respectively. Conclusion:The method is simple,reliable and accurate in the content determination of chloro-genic acid, baicalin and phillyrin in Yinhuanglian oral liquids.
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Objective To detect the opening of the myocardial mitochondrial permeability transition pores (MPTP) after intrauterine asphyxia in neonatal rats,and to explore the mechanism of the myocardial hypoxic-ischemic and reperfusion injury caused by the opening of MPTP after asphyxia.Methods Cesarean sections were undertaken in female SD rats at the 21st day after pregnancy.The uterine arteries were clamped for 30 minutes followed by releasing for 1 hour and the pups were allocated into the asphyxia group.The uterine arteries were isolated but not clamped and the pups were allocated into the control group.There were 30 neonatal rats in either group and all of them were sacrificed 24 h after birth.Serum cardiac troponin Ⅰ (cTn Ⅰ) levels were detected by enzyme linked immunosorbent assay.The opening degree of MPTP was detected by fluorospectro-photometry.Myocardial ischemic areas were detected by TTC staining.Tissues from the cardiac apex were taken and the pathologic changes of the myocardium were explored by hematoxylin-eosin staining.SPSS for Windows 13.0 was used for statistic analyses.Results In HE staining slices,the myocardial cells in asphyxia group were disarranged and edematous.In control and asphyxia group,the serum cTn Ⅰ levels were (0.08 ±0.04) μg/L and (0.40 ±0.29) μg/L (P ＜0.01),the myocardial ischemic areas were (8.01 ±3.48) ％ and (42.50 ± 15.90)％ (P ＜0.01),and the opening degrees of MPTP were (118.10 ± 19.10) RFU and (79.40 ± 10.57) RFU (P ＜ 0.01) respectively.The serum levels of cTn Ⅰ,the myocardial ischemic areas,and the opening degrees of MPTP were significantly increased in asphyxia group compared with control group.The serum level of cTn Ⅰ was positive correlated with the opening degree of MPTP in either group(r =-0.384,P ＜ 0.01).Conclusion There are myocardial injuries in neonatal rats after asphyxia,which represent as high level of serum cTn Ⅰ,myocardial ischemia and necrosis.Opening of the myocardial MPTP is one of the causes of myocardial injury.