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On the background of high-quality development of public hospitals,the prevention and control of infectious diseases and various public health emergencies have become normal,which puts higher requirements on the emergency handling and management capacity of public hospitals.Large Grade three A hospitals should establish and improve the emergency com-mand system,improve the emergency plan system,strengthen training and drills,and improve the ability to deal with various public health emergencies and disasters,so as to protect people's health.This paper expounds the specific practice process,a-chievements and thinking of the special work of improving hospital emergency ability,summarizes and puts forward the methods of improving hospital emergency ability,in order to provide reference for emergency management of other hospitals.
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Objective:To investigate the application effect of a sequential clinical skill curriculum system in standardized residency training.Methods:A total of 300 residents who participated in the residency training of a clinical medical school from 2020 to 2022 were selected as the research subjects, among whom 46 residents in the experimental group had received the clinical skill training course of the clinical medical school in the undergraduate stage, and 254 in the control group had not received such training in the undergraduate stage. The teaching effect of the two groups was observed from the first year to the third year after they entered the residency training base and were trained together based on the curriculum system. SPSS 24.0 statistical software was used for data analysis, and the main statistical methods included descriptive analysis, the Kolmogorov-Smirnov test, the Mann-Whitney U test, and the chi-square test. Results:Before the residents entered the residency base, class 2020 [60.0(52.0,60.0) vs. 51.0(48.0,53.0)], class 2021 [54.0(52.0,56.0) vs. 51.0(48.0,53.0)] and class 2022 [53.0(51.0,55.0) vs. 50.0(47.0,51.0)] The difference between the entry base grades of the residents in the experimental group compared to the control group was statistically significant ( P<0.05). After 36 months of residency training, the difference between the residents in the trial group and the control group in the 2020 class was not statistically significant when it came to the passing rate of the final exam ( χ2=1.20, P=0.273). At the end of 12 months of residency training, there was a statistically significant difference ( P<0.05) between the scores of residents in the experimental group compared with the control group in the theoretical examination [124.0 (123.8,125.0) vs. 115.0 (101.0,125.0)] and medical history taking [92.0 (91.0,95.0) vs. 85.1 (79.3,94.5)]. The differences were not statistically significant ( P>0.05) at the end of 6, 18, and 24 months of residency training. At the end of 6 months [93.0(90.0,97.0) vs. 89.0(86.3,95.0)], 12 months [94.0(92.0,95.0) vs. 89.0(87.0,92.0)] and 18 months [90.0(86.5,93.5) vs. 81.0(69.0,91.0)] of residency training, residents in the experimental group Physical examination scores were statistically significant compared to the control group ( P<0.05). At the end of 24 months of residency training, there was no statistically significant difference ( P>0.05) between the physical examination scores of residents in the experimental group compared with the control group in the classes of 2020 [92.0(87.5,95.3) vs. 85.0(79.0,92.0)] and 2021 [94.0(87.0,96.0) vs. 90.0(84.0,95.0)]. Conclusions:The clinical skill curriculum system can help to improve the comprehensive clinical ability of residents, and the teaching contents and methods of physical examination should be further optimized, with a focus on the training of doctor-patient communication skills and humanistic literacy among residents in the future.
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Essential oils from Chinese medicine are popular in the fields such as medicine, food, and cosmetics because of their unique biological characteristics. However, since essential oils are lipophilic compounds with high volatility, poor stability, and strong irritation, various preparation technologies need to be employed to improve stability, reduce irritation, and increase bioavailability. At present, a variety of preparation technologies have been applied to the encapsulation of essential oils. Various encapsulation strategies are formed because of different delivery systems featured with multiple principles and characteristics and are widely used to improve the stability of essential oils. Essential oils of Chinese medicine are widely used in the medical field, and they are under continuous innovation and development in clinical research, the pharmaceutical industry, medical products, etc. The present study summarized various delivery systems that could improve the stability of essential oils and reviewed the applications of essential oils encapsulated in the delivery systems in the medical field to provide re-ferences for the improvement of stability of essential oils and their safety, efficiency, and wide use in the medical field.
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Chine , Huile essentielleRésumé
Objective:To explore the effect of evidence-based physical restraint practice in ICU patients based on the best evidence.Methods:Based on the previous studies of evidence- based nursing program of physical restraint in ICU patients, the nurses were trained, and the evidences were introduced into clinical application and the effect of program application on nurse level, patient level and organization system were evaluated. Results:The body restraint duration of ICU patients in the contrd group was 41 (14.25, 166.50) h, and the body restraint duration of intervention group was 37(16.75,107.50) h, the difference was statistically significant ( Z value was 1.71, P<0.05). The level of physical restraint knowledge, attitude, behavior and total scores of ICU nurses increased from (12.30±1.73), (33.69±3.80), (45.19±10.56), (91.17±13.38) before implementation to (13.37±2.07), (36.81 ±3.61), (49.17±4.98), (98.08±6.11) after implementation. The differences in attitude, behavior and total scores were statistically significant ( t values were 4.05, 0.96, 2.44, P<0.05).At the organizational system level, after the application of the program, the related procedures, norms, assessment tools, nursing record sheets, restraint tools, training materials courses and so on were improved in the department. Conclusions:By introducing the best evidence of physical restraint into clinical application, it can guide nurses to use physical restraint more scientifically and standardize physical restraint behavior.At the same time, it can reduce the use of physical constraints to a certain extent, reduce the rate of physical restraints, shorten the average length of restraint, and improve the flow system related to physical restraints, so as to provide reference for the implementation of physical restraints.
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Wearable physiological parameter monitoring devices play an increasingly important role in daily health monitoring and disease diagnosis/treatment due to their continuous dynamic and low physiological/psychological load characteristics. After decades of development, wearable technologies have gradually matured, and research has expanded to clinical applications. This paper reviews the research progress of wearable physiological parameter monitoring technology and its clinical applications. Firstly, it introduces wearable physiological monitoring technology's research progress in terms of sensing technology and data processing and analysis. Then, it analyzes the monitoring physiological parameters and principles of current medical-grade wearable devices and proposes three specific directions of clinical application research: 1) real-time monitoring and predictive warning, 2) disease assessment and differential diagnosis, and 3) rehabilitation training and precision medicine. Finally, the challenges and response strategies of wearable physiological monitoring technology in the biomedical field are discussed, highlighting its clinical application value and clinical application mode to provide helpful reference information for the research of wearable technology-related fields.
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Monitorage physiologique , Dispositifs électroniques portablesRésumé
As a low-load physiological monitoring technology, wearable devices can provide new methods for monitoring, evaluating and managing chronic diseases, which is a direction for the future development of monitoring technology. However, as a new type of monitoring technology, its clinical application mode and value are still unclear and need to be further explored. In this study, a central monitoring system based on wearable devices was built in the general ward (non-ICU ward) of PLA General Hospital, the value points of clinical application of wearable physiological monitoring technology were analyzed, and the system was combined with the treatment process and applied to clinical monitoring. The system is able to effectively collect data such as electrocardiogram, respiration, blood oxygen, pulse rate, and body position/movement to achieve real-time monitoring, prediction and early warning, and condition assessment. And since its operation from March 2018, 1 268 people (657 patients) have undergone wearable continuous physiological monitoring until January 2020, with data from a total of 1 198 people (632 cases) screened for signals through signal quality algorithms and manual interpretation were available for analysis, accounting for 94.48 % (96.19%) of the total. Through continuous physiological data analysis and manual correction, sleep apnea event, nocturnal hypoxemia, tachycardia, and ventricular premature beats were detected in 232 (36.65%), 58 (9.16%), 30 (4.74%), and 42 (6.64%) of the total patients, while the number of these abnormal events recorded in the archives was 4 (0.63%), 0 (0.00%), 24 (3.80%), and 15 (2.37%) cases. The statistical analysis of sleep apnea event outcomes revealed that patients with chronic diseases were more likely to have sleep apnea events than healthy individuals, and the incidence was higher in men (62.93%) than in women (37.07%). The results indicate that wearable physiological monitoring technology can provide a new monitoring mode for inpatients, capturing more abnormal events and provide richer information for clinical diagnosis and treatment through continuous physiological parameter analysis, and can be effectively integrated into existing medical processes. We will continue to explore the applicability of this new monitoring mode in different clinical scenarios to further enrich the clinical application of wearable technology and provide richer tools and methods for the monitoring, evaluation and management of chronic diseases.
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Humains , Rythme cardiaque , Monitorage physiologique , Mouvement , Syndromes d'apnées du sommeil , Dispositifs électroniques portablesRésumé
Objective:To explore the influence of training mode based on core competence of nurses on comprehensive performance, critical thinking ability and clinical communication ability of nursing students.Methods:A total of 102 Batch 2015 nursing students from the four-year program of Hubei University of Medicine who were interned in a "three A" general hospital in Shiyan City from May 2018 to January 2019 were selected as subjects, and were randomized into the control group ( n=51) and the intervention group ( n=51). The control group received traditional training mode and the intervention group adopted the training mode based on core competence of nurses. The two groups of nursing students were graded on the critical thinking scale and clinical communication ability scale before practice and at 2 months, 4 months, 8 months after intervention respectively. The comprehensive performance of two groups was assessed before and after 8 months of intervention. All data were analyzed by SPSS 19.0. Results:Comparison of effect, interaction effect, time effect of critical thinking scale and clinical communication ability scale between the two groups showed significant differences ( P<0.05). The comprehensive performance differences between the two groups were statistically significant after the intervention ( P<0.05). Conclusion:The practice training mode based on core competence of nurses can effectively improve the comprehensive performance, critical thinking ability and clinical communication ability of nursing students.
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The development of pharmaceutical analytical methods represents one of the most significant aspects of drug development. Recent advances in microfabrication and microfluidics could provide new approaches for drug analysis, including drug screening, active testing and the study of metabolism. Microfluidic chip technologies, such as lab-on-a-chip technology, three-dimensional (3D) cell culture, organs-on-chip and droplet techniques, have all been developed rapidly. Microfluidic chips coupled with various kinds of detection techniques are suitable for the high-throughput screening, detection and mechanistic study of drugs. This review highlights the latest (2010–2018) microfluidic technology for drug analysis and dis-cusses the potential future development in this field.
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According to the three steps of teaching design, teaching practice and teaching reflection, the research group organized and implemented WeChat public platform to assist the teaching of the battlefield first aid course. Teaching design focused on three aspects: teaching content setting, learning process development and learning effect evaluation. Content setting highlighted the relevance of key content and knowledge points. The learning process emphasized two steps:teaching before class and internalizing in class . A variety of evaluation methods were used in teaching effect evaluation . Through investigation , interview and analysis of test results, it was shown that this new teaching method was generally accepted by experimental class students. Students in this class have generally improved their three core abilities and their test scores were also higher than those of the control class. This research provides fresh ideas and a useful example for the implementing WeChat public platform as an assist in the teaching of other courses in the military medical university. In addition, the research group believe that in-depth research and discussions are still needed on how to effectively deal with such problems as the lack of diversification of contents in WeChat public platform.
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@#Stroke has high incidence,long course,high mutilation rate and high mortality rate,which brings heavy economic burden to patients and the society. This article introduces the research methods and achievements of economic burden of stroke; identifies the latest trend and the gap of applying these methods in this research area in China,in order to provide methodological reference for related research in the future.
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Objective To explore the effect of applying humanistic care concept in patients that were performed radical cystectomy and urinary diversion.Methods Eighty-eight patients undergoing radical cystectomy and urinary diversion in our hospital from January 2011 to May 2016 were selected.All patients were randomly divided into experiment group and control group.Of them,control group was given routine nursing care.Experiment group was administered humanistic care pattern-based nursing measures.Self-evaluation on social function was conducted in both groups 1,3 and 6 months after surgery,and the results were compared between two groups.All evaluation indexes were expressed as differences in all scales at various stages.Results Willingness score of ostomy self-nursing and score of ostomy nursing skill in experiment group upon discharge to 1 month after discharge,1 to 3 months after discharge,and 3 to 6 months after discharge,respectively,which were better than those in control group.Differences were of statistical significance(P<0.05).Anxiety score and depression score in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Evaluation score of self-nursing ability in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Score of quality of life in experiment group at those three periods were better than those in control group.All differences were of statistical significance(P <0.05).Judging from the point of view of incidence of complications 6 months after surgery,10 and 23 cases in experiment and control groups developed complications,respectively(P <0.05).Conclusions Applying humanistic care concept in clinical nursing contributes to effectively improving the postoperative recovery of social function in patients and enhancing their quality of life.It shows high application value in clinical practice.
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Objective This paper explores the application effects of the teaching mode of"Problem-based Learning (PBL)" in Chinese internal medicine teaching. Methods 73 students from the major of traditional Chinese medicine from the First Clinical Medical College of Shandong University of Traditional Chinese Medicine are divided into observation group(36)and control group(37)with the random number table. Two different teaching methods, i.e., PBL and LBL (Lecture Based Learning), are employed to carry out prospective and randomized controlled study at parallel level, and then questionnaire are used to evaluate the teaching effects. Results The average scores of the observation group are high than those of the controlled group in the following aspects:the active classroom atmosphere(3.5 ± 0.6 vs.3.2 ± 0.6,t=2.275),improving classroom attention(3.6 ± 0.6 vs.3.2 ± 0.7,t=2.778),benefiting to the grasping of knowledge(3.5 ± 0.6 vs.3.0 ± 0.6,t=2.818), improving the self-taught ability(3.6 ± 0.6 vs.3.0 ± 1.1,t=2.935),improving the ability of analyzing problems(3.7 ± 0.5 vs. 3.1 ± 1.0, t=3.072), improving TCM thinking ability (3.5 ± 0.6 vs. 3.1 ± 0.9, t=2.431), enhancing the cooperative ability(3.6 ± 0.6 vs.3.0 ± 1.0,t=3.049),improving the communication ability(3.7 ± 0.5 vs.3.0 ± 1.0, t=3.864)and improving the innovation consciousness(3.2 ± 0.7 vs.2.7 ± 0.9,t=2.423)(P<0.05 or P<0.01).The score of the comprehensive evaluation of the questionnaire in the observation group are higher than that in the controlled group (P<0.01). Conclusions PBL teaching method has remarkable advantages over LBL teaching method in training the knowledge, ability and quality of students, as well as the overall teaching effect.
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Objective To evaluate the reasonable individual program for upper urinary tract calculi in minimally invasive treatment. Methods From January 2013 to June 2016, 147 patients (sides) with upper urinary calculi who had some characteristics received laparoscopic nehprectomy or corresponding surgical treatment. The number of cases of postoperative stagnation, the average hospitalization time and the average cost of treatment were compared with those of 147 patients (lateral) who underwent PCNL and URSL with the similarity, shape and load of stones before June 2016, respectively. Results The removal rate of stage I was 100.00% (147/147) in laparoscopic group, which was significantly higher than that in PCNL and URSL group (91.84%, 135/147), the difference was statistically significant (P = 0.001); Laparoscopic group postoperative blood transfusion (0/147) and interventional hemostasis (0/147) were significantly lower in 6 cases (6/147) and 4 cases (4/147) in PCNL and URSL groups,the differences were statistically significant (P = 0.013, P = 0.044). There was no postoperative severe infection in laparoscopic group (0/147), which has no significant difference (P = 0.156) in postoperative severe infection between PCNL and URSL group (2/147). There were 9 cases of 134 cases of postoperative (9/134) fever at ≥ 38℃ in laparoscopic group, which was significantly lower than that in PCNL and URSL group (28/147), the difference was statistically significant (P = 0.002); Laparoscopic group of postoperative urinary tract stenosis in 3 cases (3/114), which was significantly lower than that of PCNL and URSL group (9/101), the difference was statistically significant (P = 0.045). The average length of stay in laparoscopic group was (10.12 ± 0.29) d, which was significantly lower (P = 0.011) than that in PCNL and URSL group (13.97 ± 0.38) days. The average cost of treatment in laparoscopic group (12541.84 ± 181.54) yuan was significantly lower than that in PCNL and URSL group (18124.65 ± 302.32) yuan, the difference was statistically significant (P = 0.018). Conclusion In some cases, when the upper urinary tract calcuci are suitable for 'cut out', the use of laparoscopic treatment is more secure; when there is a need for surgical treatment of complications, can be treated simultaneously. Laparoscopic technique is one of the important methods of minimally invasive treatment for upper urinary calculi.
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Objective To investigate the effects of the failure rate of laparoscopic apparatus with power through detecting the electrical properties before packaging it. Methods The laparoscopic apparatus with power used in the operation in January to June 2014 were randomly selected and divided into the control group and the observation group according to whether they underwent electricity performance detection. The control group did not receive testing of electrical properties before packing. The observation group tested the electrical conductivity of the single or double pole conductor, unipolar electric coagulation hook, bipolar electric coagulation forceps, the handle of electric knife by digital multimeter and the performance of the uterus rotary cutting machine by electric hysterectomy controller before packing. The difference of equipment in the number of failures, the type of failure, the number of cases and the satisfaction of medical personnel were observed between the two groups. Results In the observation group, 12 cases with unipolar and bipolar coagulation failure, 10 cases with electrocision handle failure, 2 cases with uterine rotary- cutting failure, 18 cases with adverse conductive or non-conductive, 6 cases with short circuit, which were significantly lower than those in the control group (36,25, 11, 48, and 26 cases), the differences were statistically significant (χ2=5.627-12.063, P<0.05). The satisfaction degree in the observation group was 94.74% (36/38), which was better than 76.32%(29/38) of the control group, the difference was statistically significant (Z=-2.267, P<0.05). Conclusions Testing the electric performance of laparoscopic apparatus with power before packing could reduce the incidence of intraoperative equipment failure rate, This method can provide safe and high quality surgical instruments.
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Objective To provide data support for safe and accurate lower cervical pedicle screw implantation by observing the lower cervical pedicle and its relationship between the adjacent spinal cord, endorhachis, nerve root and vertebral artery, particularly its relation-ship between the endorhachis and epidural sinus. Methods Measured the C3 ~ C7 cervical sample of 32 adult with vernier caliper and pro-tractor, including the distance between cervical pedicle and its upper and lower nerve root, the distance between cervical pedicle and en-dorhachis, the distance between cervical pedicle and vertebral artery, and the distance between cervical pedicle and epidural sinus. Results The distance betweencervical pedicle and its upper nerve root was 1. 18~1. 40 mm, the distance between cervical pedicle and its lower nerve root was 2. 33~3. 11 mm;the distance between cervical pedicle and endorhachis was 2. 75~3. 33 mm;and there was nearly no distance be-tween cervical pedicle and vertebral artery and epidural sinus. Conclusion Cervical pedicle has a very close relationship with spinal cord, endorhachis, vertebral artery and nerve root, and the cervical pedicle is narrow and small. Therefore, it requires fully assess accroding to in-dividualization so as to prevent injury of important anatomical structures.
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Objective To investigate the application effect of Kolb experience learning theory in community nursing teaching Methods Convenient sampling method was used to extract the class of 2013 nursing students of 120 people. They were divided into 2 groups with 60 people each. Class one was as control group, and class two was as experimental group. The control group used the tradition teaching, while the experimental group used the teaching mode based on Kolb experience learning theory with specific experience, observation, reflection, active practice four phase of the cycle of learning teaching method. After the teaching the teaching effectiveness was evaluated by the method of theory test, the questionnaire survey. Results The theory exam results of class and the end of the end term were (42.75±2.21),(79.67±3.61)scores in experimental group. The theory exam results of class and the end of term werer(40.65±2.68),(75.22±4.41)scores. There were significant differences, t=-4.68、-6.05,P<0.05. The score of learning different dimensions (interest in learning, evaluation thinking ability, cooperation and communication ability, comprehensive analysis ability and problem solving skills) were(2.03±1.01),(15.22±1.12),(12.82±1.00),(14.72±0.99),(12.68±0.95) points in experimental group and (4.02±0.77),(13.93±1.02),(11.98±1.19),(13.18±0.95),(11.43±0.98)points in control group. There were significant differences,t=-6.21、-6.55、-4.16、-8.65、-7.10,P<0.05. Conclusions The teaching mode based on Kolb experience learning theory in community nursing teaching can improve the students’ interest in learning and study effect, and push forward the reform of teaching the implementation of teaching reform.
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The statistical data on Traditional Chinese Medicine (TCM) has not been fully exploited,resulting in the gap between the storage and usage of the TCM statistical data resources. The study on the retrospective collection, arrangement and application of Traditional Chinese Medicine Statistical Data aims to enhance the usage of TCM statistical data, basing on the collection and arrangement of the authoritative TCM statistical data, common analysis of the TCM statistical data from the founding of the People Republic of China.A pilot TCM Statistics Information Database and a TCM Health Statistics Data Query System have been established with the computer database technology, the object-oriented programming tool (C#) and the Internet Browser-based presentation programming tool (ASP. Net), providing the initial functions of the data retrieval and the graphical presentation of the search results on TCM statistics data. This paper explores "statistical data-oriented with attributes description" as the idea to establish the statistical database of complex statistical data, with the solution of the data problems such as numerous of data, diverse of data units, lack of regularity and hard to be classified. The study realizes the building of TCM Statistics Information Database and the retrieval finction of TCM statistical data, which lays a foundation on the building of Traditional Chinese Medicine Industry Statistics Database and the information services of TCM statistics data in the future.
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The research of induced phripotent stem(ips)cells is a hotspot in the area of life sciences at present.Currently,the research of ips cells has focused on cells'induction methods,source and differentiation.At the same time,the research of ips cells'application has also made some achievements.With the extensive research of application,ips cells will have an inestimable effect on the future of biomedical development.This article will give an reviews the latest application and future research trends of ips cells.
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Objective To study the function, effect and mechanism of prevention of pressure sore formation with stimulation of the dorsal ramus of spinal nerve root by transcutaneous pulse using plateshape surface electrode. Methods According to the odd number and even number of admission date, 81 patients were divided into the control group (41 cases) and the observation group (40 cases). The control group received standard pressure sore prevention nursing according to Basic Nursing, the observation group received stimulation of the dorsal ramus of spinal nerve root by transcutaneous pulse using plate-shape surface electrode based upon routine nursing. Results 1 case caught grade Ⅰ pressure sere,1 case with grade Ⅱ pressure sere, and the incidence rate was 4.88% in the observation group, while in the control group, 5 cases caught grade Ⅰ pressure sore,4 cases with grade Ⅱ pressure sore, and the incidence rate was 22.50%. Conclusions Combination of routine prevention method with stimulation of the dorsal ramus of spinal nerve root by transcutancous pulse to prevent pressure sore formation can reduce the incidence rate of pressure sore in high risk population. This technique is easy, painless, noninvasive, and is a novel method for early prevention of pressure sore.
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ObjectiveTo improve nursing quality by paying attention to management of nurses' psychology and behavior and changing individual and collective behavior.MethodsGuided by dynamic field theory,giving nursing staff continuous periodic training and counseling,establishing a staff interview system,giving systematic support and enhancement to develop a high-performance team.A case-control study was carried out in eight wards to evaluate implementation effect by comparison study.ResultsBefore and after introducing dynamic field theory,there were significant differences in job satisfaction of nurse staff (P<0.01),in patients' satisfaction(P<0.05),in evaluation of nursing staff management efficiency(P<0.05).ConclusionsApplication of dynamic field theory in nursing management can improve job satisfaction of nurse staff,patients' satisfaction and nurses' post suitability,and obtain continuous nursing quality improvement.