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Objective To explore and analyze the application effect of hospital quality monitoring system in medical quality management.Methods 800 patients from March 2021 to March 2022 were selected as the control group and routine medical quality management was adopted;and 800 patients from April 2022 to April 2023 were selected as the experimental group and the hospital quality monitoring system was adopted for medical quality management.Results The complication rate and re-admission rate after implementation were significantly lower than before implementation,with statistical significance(P＜0.05).The satisfaction of patients after implementation was significantly higher than before implementation,and the difference was statis-tically significant(P＜0.05).The score of medical service quality after implementation was significantly higher than before im-plementation,and the difference was statistically significant(P＜0.05).Conclusion The application effect of hospital quality monitoring system in medical quality management is remarkable,and it is worthy of promotion.
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Objective To analyze the efficacy and safety of unilateral laminectomy and bilateral decompression under unilateral biportal endoscopy(UBE)and microendoscope(MED)in lumbar spinal stenosis.Methods 80 patients with lumbar spinal stenosis from January 2021 to December 2022 were selected and divided into two groups by numerical table method,the control group and the study group,and the number of cases was 40.The grouping method was random number table method.The control group was treated with unilateral laminectomy and bilateral decompression under MED,while the study group was treated with unilateral laminectomy and bilateral decompression under UBE.Operation time,intraoperative blood loss,Oswestry disability index(ODI)and visual analogue scale(VAS)of lumbago and leg pain were obtained before surgery,1,3 months after surgery and at the last follow-up,efficacy and complications were compared between the two groups.Result There were no significant differences in operative time and blood loss between the study group and the control group(P>0.05).1,3 months after surgery and at the last follow-up,ODI in both groups were lower than those before surgery(P<0.05),but there was no difference between the study group and the control group(P>0.05).The VAS of lumbago and leg pain in both groups were lower than those before surgery(P<0.05),at 1,3 months after surgery and the last follow-up,and the study group was significantly lower than the control group(P<0.05).The excellent and good rate of clinical treatment in the study group was 97.50%,and there was no difference compared with 92.50%in the control group(P>0.05).The complication rate of the study group was 2.50%,significantly lower than that of the control group(15.00%)(P<0.05).Conclusion Unilateral laminectomy and bilateral decompression under the UBE and MED have similar efficacy in the treatment of lumbar spinal stenosis,both of which can effectively promote functional recovery,but UBE can reduce pain more effectively and has fewer postoperative complications.
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Objective To investigate the application of anesthesia management plan based on the concept of enhanced recovery after surgery(ERAS)in thoracoscopic surgery.Methods From December 2021 to December 2022,100 patients underwent thoracoscopic surgery were randomly divided into control group and observation group with 50 patients in each.The control group received routine anesthesia management,and the observation group received anesthesia management based on ERAS concept.The two groups were compared in terms of clinical indicators,the degree of incision pain on day 1,3,5 and 7 after surgery,the levels of inflammatory factors on day 1 and 3 after surgery.The incidence rates of pulmonary complications,nausea and vomiting,and respiratory depression in the two groups were calculated.Results Awakening and extubation time and hospital stay of observation group were shorter than those of control group,the treatment costs of observation group was less than that of control group,the visual analogue scale(VAS)of observation group at each time point after surgery were lower than those of control group,the levels of C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)of observation group on day 1 and 3 after surgery were lower than those of control group,the differences were statistically significant(P<0.05).The total incidence of pulmonary complications of observation group was lower than that of control group(6.00%vs 22.22%),the difference was statistically significant(P<0.05).The incidence rates of respiratory depression and nausea and vomiting in the observation group were 0.00%and 2.00%,respectively,while the incidence rates of respiratory depression and nausea and vomiting in the control group were 4.00%and 6.00%,respectively.There was no statistically significant difference in the total incidence rates of other complications between the two groups of patients(P>0.05).Conclusion Applying the anesthesia management plan based on ERAS concept in thoracoscopic surgery can promote postoperative recovery,reduce pain and pulmonary complications,and save treatment costs.It is worthy of clinical application.
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Objective:To observe the application effect of a self-designed assisted abdominal breathing rehabilitation device in elderly patients undergoing postoperative chemotherapy for lung cancer.Methods:Self-designed an assisted abdominal breathing rehabilitation device. Used the convenience sampling method, 116 elderly patients admitted to the First Affiliated Hospital of Anhui Medical University from April 2021 to April 2022 undergoing postoperative chemotherapy for lung cancer were selected as study subjects, and they were divided into control and observation groups by the random number table method, with 58 cases in each group. The control group received routine abdominal breathing training, and the observation group used auxiliary abdominal breathing rehabilitation device for abdominal breathing training, and compared the training compliance rate, lung function indexes and six minutes-walk test scores of the two groups before and after 2 weeks of training.Results:After 2 weeks of training, the training compliance rate of patients in the observation group was 100.00% (58/58), which was higher than 87.93% (51/58) in the control group, and the difference was statistically significant ( χ 2=7.45, P<0.05). After 2 weeks of training, FEV 1, FVC, FEV 1/FVC were (1.81 ± 0.29) L, (1.98 ± 0.32) L, (91.91 ± 5.98) % respectively in the observation group, and (1.49 ± 0.31) L, (1.73 ± 0.41) L, (87.11 ± 9.44) % respectively in the control group, there were statistically significant differences between the two groups ( t=-4.13, -2.60, -2.36, all P<0.05). After 2 weeks of training, the six minutes-walk test score was (0.86 ± 0.71) points in the observation group and (1.02 ± 0.74) points in the control group, and the difference was statistically significant ( t=2.05, P<0.05). Conclusions:An assisted abdominal breathing rehabilitation device helps to improve the training compliance rate, enhance lung function recovery and improve exercise endurance in elderly patients undergoing chemotherapy after lung cancer surgery.
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Objective:To analyze the application effect of the information platform based on the Internet of Things (IoT) in the screening and management of patients with chronic obstructive pulmonary disease (COPD).Methods:In this cross-sectional study, 151 062 residents who participated in the screening in the districts covered by 33 general hospitals and 289 primary medical institutions within the framework of Henan Provincial Center for COPD Prevention and Treatment from November 2021 to October 2022 were included as the subjects. Spirometer based on the IoT was used to conduct pulmonary function tests for subjects who scored 16 points or more with COPD Screening Questionnaire (COPD-SQ), and the subjects were evaluated and managed through the structured electronic data in the information platform. The distribution characteristics and follow-up of the subjects and COPD patients were described and the application effect of this strategy in patients screening and management was analyzed.Results:A total of 151 062 residents with complete basic information in the information platform completed the questionnaire. High-risk population of COPD accounted for 26.5% (40 042/151 062) of the population who received the questionnaire screening, and more than 50% had respiratory symptoms, such as chronic cough (59.4%), or shortness of breath (77.6%). The proportion of high-risk population increased with age, especially after 50 years old. Compared with non-smokers, the proportion of high-risk group was significantly higher (77.1% vs 16.4%) in the group with smoking index over 600. Biofuel exposure (61.3% vs 22.1%) and family history of respiratory diseases (64.2% vs 22.6%) were associated with an increased proportion of high-risk groups, with statistically significant differences ( P<0.001). 5 268 patients were diagnosed with COPD by pulmonary function tests, and the prevalence of COPD in high-risk groups was 27.8% (5 268/18 965), the prevalence rate of male was 34.0% (3 942/11 588), which was higher than that of female 18.0% (1 326/7 377). 2 950 patients (56.0%) completed at least one follow-up of symptom questionnaire and 510 patients (9.7%) completed more than one follow-up of pulmonary function test. Conclusion:The screening and management strategy of COPD based on the IoT and information technology can improve the efficiency of COPD screening, and improve the status quo of under-diagnosis and discontinuous follow-up of COPD.
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Objective:To investigate the application effect of scenario infiltration combined with interactive teaching in the teaching of nursing interns in the department of infectious diseases.Methods:A total of 120 nursing students who received training in Department of Infectious Diseases, Beijing Luhe Hospital Affiliated to Capital Medical University, were selected as subjects; 58 nursing students who received routine teaching were enrolled as conventional teaching group, and 62 nursing students who received scenario infiltration combined with interactive teaching were enrolled as combined teaching group. The two groups were compared in terms of self-evaluation teaching effect, nurse-patient communication ability, assessment scores, awareness of protection, and teaching satisfaction. SPSS 22.0 was used for the t-test and the chi-square test. Results:After the end of internship, compared with the conventional teaching group, the combined teaching group had significantly higher self-evaluation scores of learning interest, thinking ability, operational skills, teamwork awareness, and problem-solving ability ( P<0.05), significantly higher scores of planning and preparing, initiating communication, collecting and providing information, obtaining and understanding patient perspectives, and ending communication ( P<0.05), and significantly higher assessment scores of theoretical knowledge, nursing operational skills, and emergency and rescue abilities ( P<0.05). Compared with the conventional teaching group, the combined teaching group had a significantly higher proportion of nursing students who correctly disposed medical waste (96.77% vs. 79.31%) and a significantly lower proportion of nursing students with insufficient self-protection ability (4.84% vs. 22.41%). Compared with the conventional teaching group, the combined teaching group had significantly higher satisfaction scores of teaching content, course design, and teaching effect ( P<0.05). Conclusion:The application of scenario infiltration combined with interactive teaching can better meet the teaching needs of nursing interns in the department of infectious diseases and effectively improve their communication skills, comprehensive abilities, and awareness of protection, and therefore, it holds promise for further application.
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Objective:Based on the business reengineering theory, to construct the emergency nursing process of acute massive hemoptysis in hospital and explore the effect of it.Methods:According to the order of hospitalization, 200 patients with acute massive hemoptysis admitted to the emergency department in Shanghai Pulmonary Hospital Affilated to Tongji University from January to June in 2020 were selected as the control group, and the original treatment process was adopted. Two hundred patients admitted to the emergency department of this hospital from July to December in 2020 were selected as the experimental group, and the reconstructed in-hospital emergency nursing process for acute massive hemoptysis was applied. In both groups, the researchers recorded the time spent in each sub-process by using the in-hospital treatment time record of acute massive hemoptysis and collected the clinical outcomes of patients through electronic cases. The time-consuming, treatment efficiency and patient outcome of each link of the treatment process in the backyard of the two groups were compared.Results:Finally, 192 patients were enrolled in the control group and the experimental group. The median time from admission to intravenous use of hemostatic drugs and from admission to endovascular treatment in the experimental group were 21.50(20.00, 22.50) and 82.50(79.50, 84.50) min, which were lower than those in the control group which spent 40.87(37.06, 44.43) and 135.50(123.50, 147.00) min, and the differences between the two groups were statistically significant ( Z=-16.84, 16.63, both P<0.01). The incidence of asphyxia caused by acute massive hemoptysis in the experimental group was 4.2%(8/192), which was lower than that in the control group, which was 13.0%(25/192) . There was a statistically significant difference in the incidence of asphyxia between the two groups( χ2=9.58, P<0.01). Conclusions:The emergency nursing process of acute massive hemoptysis effectively shortens the time of in-hospital treatment of acute massive hemoptysis, further promotes the seamless connection of multiple links of in-hospital treatment of acute massive hemoptysis, and improves the overall efficiency of in-hospital treatment of patients with acute massive hemoptysis.
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Objective:To explore the application effect of multimodal quantitative rehabilitation exercise in patients with ankylosing spondylitis and to provide reference for patients′ rehabilitation exercise.Methods:The quasi-experimental study method was used to select 78 patients with ankylosing spondylitis admitted to Rheumatology and Immunology Department of First Affiliated Hospital of Xinjiang Medical University from February 2021 to February 2022 as the research objects. The 39 patients admitted from February 2021 to August 2021 as the control group, and 39 patients admitted from September 2021 to February 2022 as the experimental group. The control group adopted conventional rehabilitation exercise program, and the experimental group adopted multimodal quantitative rehabilitation exercise program. The Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis function index, inflammatory factors after 6 months of intervention were compared between the two groups.Results:The Bath ankylosing spondylitis disease activity index in the experimental group after 6 months of intervention was (2.35 ± 0.81) points, and that in the control group was (3.47 ± 1.04) points, with a statistically significant difference ( t = 4.02, P<0.05). The Bath ankylosing spondylitis disease activity index in the two groups were analyzed by repeated measurement variance. The differences of time effect, inter group effect and interaction effect were statistically significant ( Fgroup = 11.27, Ftime = 62.05, Finteraction = 5.47, all P<0.05). The Bath ankylosing spondylitis function index in the experimental group after 6 months of intervention was (2.11 ± 0.32) points, and that in the control group was (3.07 ± 0.58) points, with a statistically significant difference ( t = 4.03, P<0.05). The Bath ankylosing spondylitis function index in the two groups were analyzed by repeated measurement variance. The differences in time effect, inter group effect and interaction effect were statistically significant ( Fgroup = 21.44, Ftime = 42.25, Finteraction = 16.67, all P<0.05). After 6 months of intervention, C-reactive protein, interleukin-6, transforming growth factor β, tumor necrosis factor-α were (43.15 ± 2.21) mg/L, (3.28 ± 0.85) mg/L, (41.67 ± 9.04) ng/L, (176.63 ± 20.15) ng/L respectively in the experimental group, and (50.12 ± 1.67) mg/L, (5.27 ± 0.68) mg/L, (48.65 ± 8.96) ng/L, (194.56 ± 19.45) ng/L respectively in the control group. There was a statistically significant difference in the content of inflammatory factors between the two groups ( t values were 2.05-4.45, all P<0.05). Conclusions:Multimodal quantitative rehabilitation exercise can improve the physiological function of ankylosing spondylitis patients′spine, reduce the disease activity of patients, and promote the rehabilitation of patients.
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Objective:To investigate the effect of self-made medical ventilation chair in patients with acute respiratory distress syndrome (ARDS) ventilated in prone position, with the aim of reducing the occurrence of complications in patients with ARDS ventilated in prone position.Methods:This study was a quasi experimental research method. In this study, 78 patients admitted to the respiratory intensive care unit of Changsha Central Hospital affiliated to South China University from October 2019 to September 2021 were selected for the study by convenience sampling method, and were divided into a control group and a experimental group according to the order of admission, with 39 cases in each group. The experimental group was ventilated in the prone position using a self-made medical ventilation chair, and the control group was ventilated in the prone position using the conventional turning method, comparing the facial skin injury, tracheal displacement, tracheal tube obstruction, and RICU hospitalization time in the two groups.Results:At the end of prone position ventilation, the incidence of facial skin intact and redness and swelling was 56.41% (22/39) and 43.59% (17/39) in the experimental group and 25.64% (10/39) and 69.23% (27/39) in the control group, respectively, with statistically significant differences ( χ2=7.63, 5.21, both P<0.05); there was no statistically significant difference in the incidence of facial skin breakdown between the two groups ( P>0.05); the incidence of complications was 5.13% (2/39) in the experimental group and 20.51% (8/39) in the control group, with statistically significant differences ( χ2=4.13, P<0.05); the duration of RICU stay was (13.34 ± 3.85) days in the experimental group and ( 15.80 ± 5.55) days, with a statistically significant difference ( t=2.25, P<0.05). Conclusions:The use of self-made medical ventilation chair can reduce the facial skin damage of patients, reduce the occurrence of related complications, and shorten the hospitalization time of RICU. It is worth popularizing and applying in ICU.
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Objective:To analyze the application effect of nano-carbon lymphatic tracer technology in laparoscopic colon cancer (CC) radical resection based on propensity matching.Methods:Retrospective case-control study was performed in this study. From January 2016 to April 2021, 714 cases of CC patients who underwent laparoscopic CC radical resection in Kunshan Second People′s Hospital were divided into groups according to whether or not the nano-carbon lymphatic tracing technique was applied. Seventy-eight cases in group A were applied with nano-carbon lymphatic tracing technique, while 636 cases in group B were not applied with nano-carbon lymphatic tracing technique. The initial data were matched 1∶3 by the propensity score matching method, and finally group A (73 cases) and group B (219 cases) were obtained. The detection of lymph nodes in the two groups after propensity score matching was compared.Results:By comparing the baseline data of the two groups after propensity score matching, it was found that there were no significant differences in gender, height, weight, body mass index, tumor T stage, tumor N stage, tumor TNM stage, preoperative chemotherapy, or tumor location ( P>0.05). The total number of lymph nodes in group A was higher than that in group B: (22.24 ± 7.08) pieces vs. (19.03 ± 6.29) pieces, and the difference was statistically significant ( t = 3.66, P<0.05); the number of positive lymph nodes and the degree of lymph node metastasis in group A were not significantly different from those in group B ( P>0.05). Tumor T stage T 3, tumor N stage N 0, tumor TNM stage Ⅱ, and preoperative chemotherapy, the total number of lymph nodes in group A was higher than that in group B: 23 (6, 60) pieces vs. 19 (4, 54) pieces , 20 (3, 62) pieces vs. 18 (3, 75) pieces, 23 (6, 59) pieces vs. 20 (7, 54) pieces, 22 (5, 45) pieces vs. 14 (4, 46) pieces, and the difference was statistically significant ( Z = 2.43, 2.70, 2.64 and 3.32; P<0.05); the number of positive lymph nodes and the degree of lymph node metastasis of tumor N stage N 2 in group A were lower than those in group B: 4 (4, 9) pieces vs. 6 (4, 25) pieces , 16 (10, 42) pieces vs. 32 (19, 100) pieces, and the difference between groups was statistically significant ( Z = -2.53 and -2.87, P<0.05). Followed up to April 2022, among the 292 patients, 5 were lost to follow-up, the 3-year disease-free survival rates of 72 patients in group A and 215 patients in group B were 83.33% (60/72) and 91.16% (196/215) respectively, there was no significant difference between two groups ( P>0.05). Conclusions:The number of lymph nodes detected in laparoscopic CC radical resection increases after the application of nano-carbon lymphatic tracing technology.
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【Objective】 To investigate the preparation quality and clinical application effect of pooled platelets with leukocytes reduced. 【Methods】 The quality and clinical effect of the buffy-coated method prepared pooled platelets leukocytes reduced (experimental group, n=40) and apheresis platelets leukocytes reduced (control group, n=40) were compared. 【Results】 The platelet volume (mL), platelet count (×1011), red blood cell contamination (×108) and residual white blood cell (×106) of the experimental group and control group were 278.90±7.92 vs 276.52±8.01, 2.66±0.09 vs 2.66±0.83, 0.54±0.42 vs 0.83±0.84, 0.29±0.54 vs 0.27±0.51, respectively, with no significant difference. The results of bacterial culture were negative, all met the requirements of relevant national standards. In addition, the CCI (×103, 24 h) and PPR (%) were 15.11±9.86 vs 14.61±12.55 and 54.23±18.70 vs 61.41±19.09 respectively, with no significant difference, indicating a certain degree of therapeutic effect. 【Conclusion】 The quality and clinical therapeutic effect of pooled platelets leukocytes reduced were consistent with that of apheresis platelets leukocytes reduced.
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【Objective】 To study the platelet transfusion predictive models in tumor patients and evaluate its application effect. 【Methods】 A retrospective study was conducted on 944 tumor patients, including 533 males and 411 females who received platelet transfusion in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, the Affiliated Cancer Hospital of Xinjiang Medical University and Kailuan General Hospital from August 2022 to January 2023. Multivariate Logistic regression analysis was used to establish the platelet transfusion predictive models, and Medcalc15.8 software was used to draw the receiver operating curve (ROC) to evaluate the application effect of the prediction model. The actual application effect of models was verified through 162 female clinical cases and 172 male clinical cases. 【Results】 The incidence of platelet transfusion refractoriness in tumor patients was 28.9% (273/944), with 33.2% (177/533) in males, significantly higher than that in females [23.4% (96/411)] (P<0.05). Platelet transfusion predictive models: Y1 (female) =-8.546+ (0.581×number of pregnancies) + (0.964×number of inpatient transfusion bags) + number of previous platelet transfusion bags (5-9 bags: 1.259, ≥20 bags: 1.959) + clinical diagnosis (lymphoma: 2.562, leukemia: 3.214); Y2 (male) =-7.600+ (1.150×inpatient transfusion bags) + previous platelet transfusion bags (10-19 bags: 1.015, ≥20 bags: 0.979) + clinical diagnosis (lymphoma: 1.81, leukemia: 3.208, liver cancer: 1.714). Application effect evaluation: The AUC (area under the curve), cut-off point, corresponding sensitivity and specificity of female and male platelet transfusion effect prediction models were 0.868, -0.354, 68.75%, 89.84% and 0.854, -0.942, 81.36%, 77.53%, respectively. Actual application results showed that the sensitivity, specificity, and accuracy of female and male model were 89.47%, 92.74%, 91.98% and 83.72%, 91.47%, 89.53%, respectively. 【Conclusion】 There is high incidence of platelet transfusion refractoriness in tumor patients, and the predictive model has good prediction effect on platelet transfusion refractoriness in tumor patients, which can provide reliable basis for accurate platelet transfusion in tumor patients.
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【Objective】 To explore the application and effectiveness of holistic nursing based on SWOT in platelet collection at blood stations. 【Methods】 SWOT analysis was used to analyze the causes of adverse reactions to blood donation in platelet donors, put forward countermeasures and take holistic nursing measures. Routine nursing was adopted from January to June 2021, and holistic nursing based on SWOT analysis was adopted from July to December 2021. The adverse reactions and the nursing quality before and after the implementation of holistic nursing in the two groups were compared, and the satisfaction of blood donors to the nurses was analyzed. 【Results】 After the implementation of holistic nursing based on SWOT analysis, the incidence of adverse reactions in blood donation was 2%(2/100) in the observation group, significantly lower than 11%(11/100) in the control group(P<0.05). Nursing satisfaction score of the observation group was (93.10±4.97 points), significantly higher than that of the control group (78.12±5.36 points)(P<0.05). 【Conclusion】 The implementation of holistic nursing based on SWOT analysis can significantly reduce the incidence of adverse reactions in platelet donors and improve the satisfaction of blood donors with the nursing work, thus significantly improving the quality of nursing in the department.
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Objective:To explore the application effect of micro-lecture based on virtual reality technology on the standardized residency training in the department of orthopedics.Methods:A total of 40 trainees who received standardized residency training in department of orthopedics from December 2019 to August 2020 were selected and randomly divided into control group and experimental group, with 20 cases in each group. For the same orthopedic teaching content, the control group received the conventional training, and the experimental group received micro-lecture teaching based on digital virtual reality technology. And the teaching effect of the two groups and the feedback of the trainees on the teaching were compared. SPSS 22.0 was used for t test. Results:Compared with the students in the control group, the trainees in the experimental group had better performance in theoretical knowledge, comprehension of surgery, and clinical skills, and the difference was statistically significant ( P<0.05). Compared with the control group, the trainees in the experimental group scored higher in satisfaction with class interest [(9.69±0.28) vs. (9.24±0.42)] and participation [(4.38±0.43) vs. (4.03±0.62)], with statistically significant differences ( P<0.05). Conclusion:For the standardized residency training in the department of orthopedics, micro-lecture teaching based on virtual reality technology is more conducive to improving students' academic performance and clinical skills compared with traditional teaching, and increasing the interest and participation of students in the process of standardized residency training.
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Objective To evaluate and analyze the feasibility and application effect of “DOTS + WeChat” in the treatment and management of tuberculosis patients. Methods From 2018 to 2019, a total of 2 420 active pulmonary tuberculosis patients were registered in Zibo City, and 1 988 patients meeting the inclusion criteria were selected as the research subjects. 836 patients were randomly enrolled under the “DOTS + WeChat” integrated management mode, while the other 1152 cases were treated with single DOTS management mode. The regular medication status, treatment and outcome, and core knowledge awareness of the two groups were analyzed by SPSS16.0 software, χ2- test and t- test methods. Result The “DOTS + WeChat” comprehensive management group had higher a regular medication rate (98.80%), coincidence rate of sputum test times (95.81%), and success rate of treatment (98.68%) than the single DOTS management group (92.10%, 90.19%, and 96.53%) (P=0.000, 0.000, 0.003). The rate of medical staff participating in supervision and management in the comprehensive management group (100%) was higher than that in the single management group (75.87%) (P=0.000). The complete follow-up rate in the consolidation period (100%) and the complete whole course follow-up rate (99.76%) were both higher than those in the single management group (P=0.000, 0.001). The awareness level of core knowledge in the comprehensive management group (78.58±4.32) was higher than that in the single management group (70.70±8.02) (P=0.000). Conclusion The application of WeChat management mode has a positive effect on the treatment and management of tuberculosis patients in Zibo City. It is a feasible and effective supplement and improvement to the current tuberculosis control and management measures, which is worthy of further promotion and exploration.
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Objective:To explore the application effect of the ternary linkage continuation care model based on cognitive balance theory in patients with rheumatoid arthritis (RA), and to provide a reference for the continuation care model of RA patients.Methods:The convenience sampling method was adopted. A total of 72 RA patients who were treated in Huainan First People's Hospital, Anhui Province from January to December 2020 were selected as the research objects, and they were divided into observation group and control group by random number table method with 36 cases in each group. The control group was given regular discharge guidance and health education, and the observation group was given ternary continuous care based on cognitive balance theory on the basis of the control group. The intervention time was 3 months. The fatigue state, pain catastrophe, exercise self-efficacy and hope index was evaluated by the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire (BRAF-MDQ), the Pain Catastrophic Scale (PCS), the Self-Efficacy for Exercise Chinese version(SEE-C), and the Herth Hope Index Scale-Chinese version (HHI-C) and the results were compared between the two groups before and after the intervention.Results:There was no significant difference in the score of BRAF-MDQ, PCS, SEE-C, HHI-C before the intervention between the two groups( P>0.05). The scores of physical fatigue, life fatigue, cognitive fatigue and emotional fatigue of BRAF-MDQ in the observation group after the intervention were (10.02 ± 0.85), (6.33 ± 0.58), (3.31 ± 0.48), (4.25 ± 0.56) points, respectively, significantly lower than those in the control group (12.97 ± 1.89), (8.94 ± 0.97), (6.55 ± 0.97), (5.92 ± 0.87) points, and the differences were statistically significant ( t values were 8.54-17.96, all P<0.05). The scores of contemplation, exaggeration, and helplessness of PCS in the observation group after the intervention were (5.66 ± 0.43), (4.12 ± 0.36), (3.31 ± 0.41) points, respectively, which were significantly lower than those in the control group (8.41 ± 0.88), (5.74 ± 0.85), (5.52 ± 0.86) points, and the differences were statistically significant ( t=16.85, 10.53, 13.92, all P<0.05). The scores of SEE-C and HHI-C were (60.22 ± 7.89), (37.48 ± 5.79) points in the observation group after the intervention, which were significantly higher than those in the control group (46.98 ± 5.84), (34.21 ± 4.93) points, and the differences were statistically significant ( t=8.09, 2.58, both P<0.05). Conclusions:The ternary linkage continuation nursing model based on the cognitive balance theory has a significant effect on alleviating the fatigue state and pain catastrophe of RA patients, and helps to improve the patients' hope level and exercise self-efficacy.
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Objective:To explore the application effect of massive online open course (MOOC) + case-based learning (CBL) in SPECT/CT practice teaching of nuclear medicine.Methods:Twenty-nine interns of nuclear medicine SPECT/CT in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2020 to October 2020 were selected as the research group and received MOOC + CBL teaching. Taking 31 interns from January 2019 to October 2019 as the control group, and the traditional teaching method was conducted. At the end of the internship, the students' theoretical and operational skills were assessed. Their learning motivation and thinking ability were evaluated by using the study process questionnaire (SPQ) and the Chinese version of California critical thinking disposition inventory (CTDI-CV), and the two groups' satisfaction with teaching was compared. SPSS 22.0 was used for Chi-square test and t-test. Results:The results of theoretical knowledge, PET/CT case analysis and image diagnosis in the study group were higher than those in the control group ( P<0.05). The total scores of surface motivation, deep motivation and SPQ in the study group were higher than those in the control group ( P<0.05). The self-confidence scores of open mind, analytical ability, systematization ability, and critical thinking and CTDI-CV total scores of the study group were higher than those of the control group ( P<0.05). The study group was more satisfied with the teaching and the enhancement of self-study ability than the control group ( P<0.05). Conclusion:MOOC + CBL teaching for nuclear medicine SPECT/CT interns can improve their examination results, learning motivation and thinking ability, and also enhance their self-study ability.
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Objective:To explore the application effect of self-efficacy theory combined with WeChat health education in patients with maintenance hemodialysis.Methods:Totally 112 patients with regular hemodialysis in Jiaxing Second Hospital from May 2018 to October 2019 were randomly divided into observation group and control group, 56 patients in each group. Conventional health education was used in the control group, while the health education based on the self-efficacy theory was used in the observation group. Awareness rate of health knowledge, incidence of adverse events in hemodialysis, treatment compliance and self-efficacy before and after intervention were recorded.Results:The Awareness rate of health knowledge in the observation group was 89.28% (50/56), which was higher than 69.65% (39/56) of the control group ( χ 2 value was 6.564, P<0.05). After intervention, the scores of dietary adherence, fluid adherence, medication adherence and dialysis scheme adherence in the observation group (29.53±4.74), (21.76±3.83), (26.25±4.64), (17.14±2.83) were higher than those of the control group (26.08±4.45), (18.12±3.66), (22.39±4.42), (14.76±2.69), the difference was statistically significant ( t values were 3.971-5.142, P<0.001); After intervention, the score of General Self-efficacy Scale (GSES) in the observation group (27.43±5.59) was higher than that of the control group (24.06±5.22), with statistical significance ( t value was 3.297, P<0.001). During the intervention, the incidence of adverse events in the observation group was 8.93% (5/56), which was lower than 23.21% (13/56) of the control group ( χ 2 value was 4.236, P<0.05). Conclusion:the self-efficacy theory combined with WeChat health education can promote the self-efficacy of patients with maintenance hemodialysis, improve the level of health knowledge and treatment compliance, and reduce the incidence of vascular access adverse events.
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Objective:To explore the application effect of magnetic service concept in clinical nursing for patients with acute gastroenteritis.Methods:A total of 101 patients with acute gastroenteritis undergoing magnetic service concept intervention in gastroenterology department of Lishui Central Hospital were selected as study group from January 2019 to January 2020, other 97 patients with acute gastroenteritis undergoing routine nursing intervention were enrolled as control group from January to December 2018. The scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), self-care ability and quality of life before and after intervention were observed and compared between the two groups. The scores of nursing satisfaction were recorded and compared between the two groups.Results:After nursing, HAMA and HAMD scores in study group were (13.39 ± 4.56) and (17.89 ± 6.63) points, which were significantly lower than those in control group (18.60 ± 6.79) and (21.51 ± 6.03) ( t values were 6.36 and 4.11, P<0.05). After nursing, scores of self-concept, self-responsibility, self-care skills and health awareness in study group were (79.12 ± 4.98), (79.85 ± 5.47), (80.22 ± 3.89) and (76.25 ± 5.98) points, which were higher than those in control group (52.08 ± 3.63), (58.88 ± 7.25), (57.65 ± 3.62), (54.12 ± 5.06) points (t values were 23.06-43.41, P<0.05). After nursing, scores of physiology, mentality, emotion and social contact in study group were (69.14 ± 4.21), (82.13 ± 6.12), (71.25 ± 5.28) and (82.95 ± 7.22) points, which were higher than those in control group (60.41 ± 3.26), (69.57 ± 4.26), (57.13 ± 3.21), (68.07 ± 5.14) points (t values were 16.27-33.63, P<0.05). The scores of satisfaction with life care, regular wards inspections, bell calling, service attitudes and health education in study group were (90.40 ± 6.80), (91.38 ± 6.82), (90.22 ± 4.96), (90.88 ± 5.56) and (92.46 ± 6.38) points, which were higher than those in control group (81.22 ± 5.83), (80.44 ± 4.25), (82.12 ± 4.65), (83.24 ± 4.56), (82.06 ± 3.55) points (t values were 10.18-14.09, P<0.05). Conclusions:The magnetic service concept can improve psychological status and quality of life in patients with acute gastroenteritis, enhance self-care ability and nursing satisfaction.
ABSTRACT
Objective:To analyze the effects of multidisciplinary cooperative nutrition management model in acute stroke patients with dysphagia.Methods:From February 2019 to February 2020, 69 acute stroke patients with dysphagia were enrolled in this study. After exclusion of those unable to complete the trial, patients were randomized into control group ( n=30) and experimental group ( n=30). Patients in the control group were given routine nutrition management, while patients in the experimental group were treated under multidisciplinary cooperative nutrition management model. Nutritional indicators were compared between the two groups on Day 1, 7 and 14 after admission, including levels of albumin (ALB), pre-albumin (PALB), hemoglobin (HB), triceps skin-fold (TSF) thickness on the uninjured side, upper arm muscle circumference etc. Incidence of gastrointestinal complications and infectious complications was also recorded. Results:There was no difference between two groups in the levels of HB, TSF thickness and upper arm muscle circumference on the uninjured side (all P>0.05). However, the serum levels of ALB and PALB on Day 7 and 14 in the experimental group were higher than that in the control group(all P<0.05), The incidence of gastrointestinal complications ( P=0.015)and infectious complications ( P=0.016) in the experimental group was lower than that in the control group. Conclusion:Multidisciplinary collaborative nutrition management improved nutritional indicators, reduced the incidence of gastrointestinal complications and infectious complications in acute stroke patients with dysphagia, making multidisciplinary collaborative nutrition management model worthy of clinical promotion and application.