RESUMO
Objective To construct the performance evaluation index system of head nurses in tertiary grade A hospitals in Heilongjiang Province,in order to provide reference for clinical nursing management.Methods Through literature analysis and theoretical research,the framework and content of performance evaluation index system for head nurses in tertiary grade A hospitals in Heilongjiang Province were preliminarily established,and two rounds of expert letters were conducted by Delphi method,and finally the performance evaluation index system for head nurses in tertiary grade A hospitals in Heilongjiang Province was established.Results The evaluation index system of head nurses'performance in a tertiary grade A hospital in Heilongjiang Province included 5 first-class indicators,14 second-class indicators and 49 third-class indicators,and the expert consultation was highly reliable.Conclusion The construction of the performance evaluation index system for head nurses in tertiary hospitals in Heilongjiang Province can not only provide reference for nursing managers and researchers at all levels of medical institutions in the province,but also provide practical guidance for head nurses to improve their own nursing management level.
RESUMO
Abstract@#Improving the system of adolescent myopia prevention and control and promoting adolescent healthy development is one of the main directions of healthy China construction in the new era. The paper reviewed national myopia policies and local practices, and proposed reflections on the high burden and complex etiology of myopia among adolescents, as well as unclear role and lack of coordination mandate during the COVID 19 epidemic. Based on the synergy theory, through the analysis of the functional positioning of multiple subjects in the prevention and control of myopia, the paper highlighted the multi party linkage of government, schools, medical institutions, communities, families and markets, profiling the resources and advantages of each subject, as well as dynamic management of adolescent myopia, as well as a multi subject collaborative prevention and control system with national unity, clear rights and responsibilities, and long term cooperation.
RESUMO
ABSTRACT Introduction People's living standards have gradually improved with rapid economic development, and physical exercise has become a viable alternative for people to relax and improve their quality of life. Among the forms of physical exercise, the most traditional and simplest is aerobics, despite few current studies on the physiological evidence of its adherence. Objective Evaluate the effects of aerobic gymnastics on heart rate and physique of college students. Methods 10 male college students volunteered for an experiment involving a specific aerobic gymnastics protocol over six weeks. To explore the effects of aerobic exercise on heart rate variability and physique of male college students, vital and anthropometric data were collected before and after the intervention for a statistical comparison and scientific discussion according to current literature. Results There were significant differences in heart rate variability indexes SDNN, RMSSD, TP, HF, lf/hf before and after training. Conclusion There were some significant differences in vital capacity, grip strength, flexion of sitting and standing posture after the intervention protocol. It is suggested that aerobic gymnastics training can improve cardiac function and fitness of its practitioners, especially among college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução O nível de vida das pessoas tem melhorado gradualmente com o rápido desenvolvimento econômico e o exercício físico tornou-se uma alternativa viável para as pessoas relaxarem e melhorarem sua qualidade de vida. Dentre as formas de exercício físico, o mais tradicional e simples é a ginástica aeróbica, apesar de poucos estudos atuais sobre as evidências fisiológicas de sua adesão. Objetivo Avaliar os efeitos da ginástica aeróbica sobre o ritmo cardíaco e sobre o físico dos estudantes universitários. Métodos 10 estudantes universitários masculinos foram voluntários para um experimento envolvendo um protocolo específico de ginástica aeróbica durante 6 semanas. No intuito de explorar os efeitos do exercício aeróbico na variabilidade do ritmo cardíaco e no físico dos estudantes universitários do sexo masculino, os dados vitais e antropométricos foram coletados antes e após a intervenção para uma comparação estatística e discussão científica segundo a bibliografia atual. Resultados houve diferenças significativas nos índices de variabilidade da frequência cardíaca SDNN, RMSSD, TP, HF, lf/hf antes e depois do treinamento. Conclusão Foram evidenciadas algumas diferenças significativas de capacidade vital, força de preensão, flexão da postura sentada e ortostática após o protocolo de intervenção. Sugere-se que o treinamento de ginástica aeróbica possa melhorar a função cardíaca e a condição física de seus praticantes, principalmente entre os estudantes universitários. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción El nivel de vida de las personas ha mejorado gradualmente con el rápido desarrollo económico y el ejercicio físico se ha convertido en una alternativa viable para que la gente se relaje y mejore su calidad de vida. Entre las formas de ejercicio físico, la más tradicional y sencilla es la gimnasia aeróbica, a pesar de los escasos estudios actuales sobre las pruebas fisiológicas de su adherencia. Objetivo Evaluar los efectos de la gimnasia aeróbica sobre la frecuencia cardiaca y el físico de estudiantes universitarios. Métodos 10 estudiantes universitarios varones se ofrecieron voluntarios para un experimento que incluía un protocolo específico de gimnasia aeróbica durante 6 semanas. Con el fin de explorar los efectos del ejercicio aeróbico sobre la variabilidad de la frecuencia cardiaca y el físico de estudiantes universitarios varones, se recogieron datos vitales y antropométricos antes y después de la intervención para realizar una comparación estadística y una discusión científica según la bibliografía actual. Resultados Hubo diferencias significativas en los índices de variabilidad de la frecuencia cardiaca SDNN, RMSSD, TP, HF, lf/hf antes y después del entrenamiento. Conclusión Se evidenciaron algunas diferencias significativas en la capacidad vital, la fuerza de prensión, la flexión de sedestación y la postura ortostática tras el protocolo de intervención. Se sugiere que el entrenamiento de gimnasia aeróbica puede mejorar la función cardiaca y la forma física de sus practicantes, especialmente entre los estudiantes universitarios. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
RESUMO
OBJECT IVE To study the effects of ergosterol peroxide derivatives EP-3P on the proliferation ,migration and invasion of human tripe negative breast cancer cell MDA-MB- 231,and to provide reference for the development of breast cancer related drugs. METHODS MTT assay was adopted to detect the proliferation of MDA-MB- 231 cells after treated with 0(blank control),1.25,2.5,5,10,20,40 μmol/L EP-3P for 24,48 and 72 h. Wound healing assay and Transwell chamber method were adopted to detect the migration and invasion ability of MDA-MB- 231 cells after treated with 0(blank control ),5,10,20 EP-3P for 24 h. The apoptosis and cell cycle distribution were detected by flow cytometry. Western blot assay was used to detect the expressions of B-cell lympho ma-2(Bcl-2),Bcl-2 associated X protein (Bax),caspase-3,cleaved-caspase-3,cytochrome C (Cyt-C),matrix metalloproteinase- 2(MMP-2)and MMP- 9. RESULTS Compared with blank control group ,2.5,5,10,20,40 μmol/L EP-3P could significantly increase the inhibitory rate of cell proliferation (P<0.05 or P<0.01)in a dose and time- dependent manner. After 24 h treatment of EP- 3P(10,20 μmol/L),the rate of cell migration and the number of invasive cells were decreased significantly (P<0.01),and cell was arrested at G 2/M stage (P<0.05 or P<0.01);the apoptotic rate was increased significantly (P<0.05);the protein expressions of Bax ,Cyt-C and cleaved-caspase- 3 were upregulated significantly , while those of Bcl- 2,caspase-3,MMP-2 and MMP- 9 were downregulated significantly (P<0.01). CONCLUSIONS EP-3P can inhibit the proliferation ,migration and invasion of human tripe negative breast cancer cells MDA-MB- 231 through mitochondrial mediated endogenous caspase pathway ,and induce the apoptosis of cells .
RESUMO
Objective:To explore the different types and characteristics of rehabilitation exercise compliance of patients with first stroke at 2 weeks of onset, and analyze its influencing factors, so as to provide reference for the formulation of targeted health education.Methods:A cross-sectional investigation was conducted in Neurology Department of the Second Affiliated Hospital of Zhejiang University School of Medicine from January to June, 2021. 276 patients with first-episode stroke were investigated by the Questionnaire of Exercise Adherence at 2 weeks of the onset. The potential profile analysis was conducted to explore characteristics classification of the rehabilitation exercise compliance. And the chi-square test was used to compare demographic differences among different categories and ordered multi classification Logistic regression was used to explore the influencing factors of rehabilitation exercise compliance.Results:The patients were divided into 109 cases with high rehabilitation exercise compliance (39.5%), 114 cases with moderate rehabilitation exercise compliance (41.3%), and 53 cases with low rehabilitation exercise compliance (19.2%). There were statistically significant differences in education level, consciousness level at admission, complications and limb muscle strength among the three types of patients ( χ2 values were 6.17-31.50, all P<0.05). Ordered multi classification Logistic regression showed that the patient′s education level, the patient′s consciousness level at admission, whether there were complications and limb muscle strength would affect the rehabilitation exercise compliance of stroke patients ( P<0.05). Conclusions:There are three potential categories of rehabilitation exercise compliance in patients with first stroke. Patients with illiteracy, drowsiness, complications and poor limb muscle strength have poor rehabilitation exercise compliance.
RESUMO
Objective:To investigate the distribution and clinical significance of subtypes of antimitochondrial antibodies (AMA)-M2, M4, M9 in primary biliary cholangitis (PBC).Methods:A total of 1 367 patients were detected with AMA-M2, M4, M9 in Peking Union Medical College Hospital (PUMCH) from Jan 2014 to Dec 2019 and the clinical parameters were collected. The distribution patterns of AMA subtypes in different groups were analyzed and the diagnostic sensitivity and specificity of AMA subtypes in PBC were calculated. Chi-square test was used for statistical analysis.Results:In 1 367 patients, 236 of whom were positive for AMA subtypes. The positivity of AMA subtypes in female was significantly higher than in male (20.34% vs 9.41%, χ2=23.792, P<0.01). In addition, the positivity of AMA subtypes was significantly higher in 30-65 years old patients than in patients younger than 30 years old or older than 65 years old [(20.00%(193/965) vs 10.97%(17/155) vs 10.53%(26/247), χ2=17.209, P<0.01]. 110 patients with positive AMA subtypes were diagnosed with PBC. The diagnostic sensitivity and specificity of AMA-M2 were both desirable [94.64%(106/112) and 92.35%(1 159/1 255)]. Although the specificity of AMA-M4 was as high as 99.12%(1 244/1 255), its sensitivity was very low [15.18%(17/122)]. Combined detection of different AMA subtypes could not improve the diagnostic sensitivity and specificity significantly. Diseases other than PBC can be positive for AMA subtypes, predominantly for AMA-M2. Conclusion:Female and 30-65 years old patients were more frequently positive for AMA subtypes. AMA-M2 was the most valuable AMA subtype for diagnosing PBC.
RESUMO
Objective:To investigate the effects of sinomenine on brain edema and the expression of aquaporin 4 (AQP-4) and aquaporin 5 (AQP-5) in rats with acute brain injury.Methods:According to random number table method, rats were divided into sham operation group, model group, low-dose sinomenine group, high-dose sinomenine group, 20 in each group. In addition to the sham operation group, the rat brain injury model was established by Feeney free falling impact method. Rats in low and high dose of sinomenine group were given sinomenine 30, 60 mg/kg by intraperitoneal injection, and the sham operation group and model group were injected intraperitoneally with the same volume of normal saline, once per day for 7 days. Histopathological changes in each group were observed by HE staining and electron microscope. Western blot and RT-PCR were used to detect AQP-4 and AQP-5 protein and gene expression in brain tissue.Results:The pathological results showed that the nerve cells in the model group were loosely arranged, disordered in hierarchy, some cells appear to have degenerated. The degeneration and necrosis of nerve cells in the low and high dose sinomenine group were less than those in the model group. Compared to the model group, the expression of AQP-4 (0.74 ± 0.13, 0.49 ± 0.11 vs. 1.30 ± 0.21), AQP-5 (0.98 ± 0.07, 0.45 ± 0.10 vs. 1.47 ± 0.18) in the low dose and high dose sinomenine group significantly decreased ( P<0.05). The expression of AQP-4 (1.48 ± 0.18, 1.26 ± 0.12 vs. 2.04 ± 0.14), AQP-5 (1.31 ± 0.17, 1.20 ± 0.11 vs. 1.87 ± 0.15) mRNA in the low dose and high dose sinomenine group significantly decreased ( P<0.05). Conclusions:Sinomenine could alleviate cerebral injury by lowering the expression of AQP-4 and AQP-5.
RESUMO
Objective:To study relationship between sense of coherence and anxiety-depression in elderly patients with gestational diabetes mellitus (GDM).Methods:A total of 360 gestational pregnant women who were admitted to the hospital from November 2018 to January 2019 were enrolled by simple random sampling. The Sense of Coherence Scale (SOC-13), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were applied to survey them. The scores of SOC-13, SAS and SDS of them were observed. The correlation between sense of coherence and anxiety-depression was analyzed.Results:Among 360 gestational pregnant women, there were 98 cases with age-appropriate GDM (less than 35 years old, age-appropriate GDM group), 159 cases with advanced GDM (not less than 35 years old, advanced GDM group), and 103 advanced non-GDM pregnant women (advanced non-GDM group). Arranging SOC-13 scores from low to high, the corresponding order was advanced GDM group, age-appropriate GDM group and advanced non-GDM group (with scores of 52.25±10.57, 60.18±9.31, 63.24±8.57) ( F value was 45.109, P<0.01). SAS score was the highest in advanced GDM group, followed by age-appropriate GDM group and advanced non-GDM group (50.33±5.85, 45.62±6.77, 42.26±5.34) ( F value was 59.598, P<0.01). SDS score was the highest in advanced GDM group, followed by age-appropriate GDM group and advanced non-GDM group (52.59±5.62, 47.64±4.83, 45.48±4.72) ( F value was 65.419, P<0.01). SOC-13 of 160 advanced GDM patients was negatively correlated with SAS ( runderstanding sense=-0.532, rcontrol sense=-0.653, rsignificance sense=-0.631, rtotal score=-0.735, all P<0.01). And SOC-13 was negatively correlated with SDS ( runderstanding sense=-0.438, rcontrol sense=-0.562, rsignificance sense=-0.581, rtotal score=-0.685, all P<0.01). Conclusions:Sense of coherence in elderly GDM patients is negatively correlated with anxiety and depression. Nursing staff can improve their anxiety and depression by intervening in sense of coherence.
RESUMO
Objective:To study the effect of the psychological counseling on the delivery mode of single birth elderly primiparas with anxiety and depression, and to seek a new and effective intervention way to improve the vaginal delivery rate.Methods:A preliminary screening was carried out for 486 single birth elderly primiparas received in the birth cohort research center of China Medical University from April 2018 to September 2019. Among them, 274 cases had mild, moderate or severe anxiety and depression. They were randomly divided into the observation group and the control group (n=137). The control group was given routine nursing measures and simple psychological education and the intervention group was given extra psychological counseling. Psychological counseling adopted the mode of combination of online and offline. The degree of anxiety and depression and the delivery mode were compared between two groups.Results:Before intervention, the degree of anxiety and depression between the observation group and the control group showed no significant difference. After intervention, the degree of anxiety and depression in the observation group was lighter than that of the control group ( χ2 value was 12.782, 6.647, P<0.05). The proportion of cesarean section, vaginal delivery, forceps delivery accounted for 32.1% (44/137), 67.2%(92/137), 0.7%(1/137) in the observation group, and 45.3% (62/137), 54.7%(75/137), 0 in the control group. The difference between the two groups showed statistical significance ( χ2 value was 5.787, P<0.05). Conclusion:The psychological counseling for the single birth elderly primiparas with anxiety and depression can effectively improve the psychological situation and increase the vaginal delivery rate.
RESUMO
Objective@#To investigate the effects of sinomenine on brain edema and the expression of aquaporin 4 (AQP-4) and aquaporin 5 (AQP-5) in rats with acute brain injury.@*Methods@#According to random number table method, rats were divided into sham operation group, model group, low-dose sinomenine group, high-dose sinomenine group, 20 in each group. In addition to the sham operation group, the rat brain injury model was established by Feeney free falling impact method. Rats in low and high dose of sinomenine group were given sinomenine 30, 60 mg/kg by intraperitoneal injection, and the sham operation group and model group were injected intraperitoneally with the same volume of normal saline, once per day for 7 days. Histopathological changes in each group were observed by HE staining and electron microscope. Western blot and RT-PCR were used to detect AQP-4 and AQP-5 protein and gene expression in brain tissue.@*Results@#The pathological results showed that the nerve cells in the model group were loosely arranged, disordered in hierarchy, some cells appear to have degenerated. The degeneration and necrosis of nerve cells in the low and high dose sinomenine group were less than those in the model group. Compared to the model group, the expression of AQP-4 (0.74 ± 0.13, 0.49 ± 0.11 vs. 1.30 ± 0.21), AQP-5 (0.98 ± 0.07, 0.45 ± 0.10 vs. 1.47 ± 0.18) in the low dose and high dose sinomenine group significantly decreased (P<0.05). The expression of AQP-4 (1.48 ± 0.18, 1.26 ± 0.12 vs. 2.04 ± 0.14), AQP-5 (1.31 ± 0.17, 1.20 ± 0.11 vs. 1.87 ± 0.15) mRNA in the low dose and high dose sinomenine group significantly decreased (P<0.05).@*Conclusions@#Sinomenine could alleviate cerebral injury by lowering the expression of AQP-4 and AQP-5.
RESUMO
Objective@#To investigate the quality of life of patients with dysphagia after stroke, and to explore the relationship between perceived social support and resilience and quality of life.@*Methods@#From October 2016 to June 2018, a total of 338 patients with dysphagia after stroke were selected as the subjects. The general information, perceived social support, resilience and swallowing quality of life questionnaire (SWAL-QOL) were used to evaluate the general information, perceived social support, resilience and survival of the patients. Quality.@*Results@#The overall score of QOL was 176.30+2.67. There was a significant positive correlation between QOL and resilience (P<0.05). There was a significant positive correlation between QOL and perceived social support and various dimensions (P<0.05).@*Conclusions@#The quality of life of patients with dysphagia after stroke is low. Age, endotracheal intubation, resilience and perceived social support are important factors affecting the quality of life.
RESUMO
Objective To investigate the quality of life of patients with dysphagia after stroke, and to explore the relationship between perceived social support and resilience and quality of life. Methods From October 2016 to June 2018, a total of 338 patients with dysphagia after stroke were selected as the subjects. The general information, perceived social support, resilience and swallowing quality of life questionnaire (SWAL-QOL) were used to evaluate the general information, perceived social support, resilience and survival of the patients. Quality. Results The overall score of QOL was 176.30+2.67. There was a significant positive correlation between QOL and resilience (P<0.05). There was a significant positive correlation between QOL and perceived social support and various dimensions (P<0.05). Conclusions The quality of life of patients with dysphagia after stroke is low. Age, endotracheal intubation, resilience and perceived social support are important factors affecting the quality of life.
RESUMO
Objective To explore the correlation between limb heaviness and muscle strength, post-stroke fatigue (PSF) in stroke patients. Methods A total of 110 stroke patients were selected. The general information scale, Modified Rankin Scale (MRS), Modified Barthel Scale, Fatigue Severity Scale (FSS) were used to assess limb heaviness and muscle strength, PSF, and functional status. And to research the relationship of limb heaviness and muscle strength, PSF in stroke patients. Results The incidence of limb heaviness in stroke patients was 40.91%(45/110). FSS and Modified Barthel Score showed significant difference in whether patients have limb heaviness (t=-3.244, P=0.002; t=2.019, P=0.046). Spearman correlation analysis results showed that the FSS score was positively related with limbs heaviness ( r=0.384, P=0.000), but muscle strength, Modified Barthel Score, Modified Rankin Score had no correlation with limbs heaviness (r=0.091, P=0.346;r=0.185, P=0.053;r=0.132, P=0.132). Conclusion A higher incidence of stroke patients with limb heaviness. The change of muscle strength won′t promote limbs heaviness, but patients with PSF were easier to concurrent limbs heaviness, also affect the ability of the patients life, should be highly valued by medical workers, and have to intervention.
RESUMO
Objective To explore a novel strategy to repair traumatic soft tissue defects in the head and face by tissue expansion in the early stage.Methods Eighteen patients with traumatic soft tissue defects were treated with thorough debridement leaving the wound unclosed or simply closed with thin split-thickness scalp skin grafting,and adjacent expander implantation in the early stage and expanded flap transposition in the second stage.Results There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years [mean,(19.4±12.2) years],with average 15 months follow-up (range,3-67 months).The average expansion time was 74.3 days (range,53-96 days).The total of 18 patients with 22 expanders were treated with satisfactory results.All the flaps survived and the skin color,texture and contour well matched to those of the peripheral tissue.Only one complication of infection happened in the 18 cases (5.56%) and total 22 expanders (4.55%),which was similar to the rate reported in the literature.There were no any other complications related to the expander.Conclusions Debridement and tissue expansion in the early stage have been proved a more effective strategy to repair traumatic soft tissue defects in the head and face,which can not only achieve satisfactory color,unbulky and well matched texture similar to normal,but also can avoid unnecessary donor site injuries and does not increase the infection rate of tissue expansion.
RESUMO
Objective To analyze the risk factors for ventilator-associated pneumonia(VAP) in the intensive care unit(ICU) of a hospital,and provide theoretical reference for preventing and controlling VAP.Methods ICU patients receiving mechanical ventilation for more than 48 hours between October 2013 and December 2014 were monitored by targeted monitoring method,risk factors for the occurrence of VAP were analyzed.Results A total of 483 patients received mechanical ventilation for more than 48 hours,76 (15.73%) of whom developed VAP;the overall ventilator days were 5 347 days,incidence of VAP was 14.21 per 1 000 ventilator days.Univariate analysis showed that groups of gender,age,length of hospital stay,and duration of artificial airway were all significantly different,VAP rate in male patients was higher than that in female patients(x2 =9.838,P<0.01);VAP rate was highest in patients aged 41-70 years(x2 =10.242,P<0.01),followed by patients aged≥71 years;VAP rate were relatively higher in patients with longer length of hospital stay and longer duration of artificial airway(x2 =59.533,P<0.01;x2 =74.215,P<0.01,respectively).Conclusion Incidence of VAP in the ICU of this hospital is higher,especially in male patients,patients aged 41-70 years,as well as patients with long length of hospital stay and long duration of artificial airway.
RESUMO
Objective The objective of this study was to investigate a risk of prostate cancer(PCa) at a repeat biopsy in patients with chronic prostate inflammation and widespread high grade prostatic intra epithelial neoplasia(wHGPIN).Methods From July 2006 to December 2014,172 cases of prostate biopsy were collected.All of them were diagnosed as HGPIN for the first biopsy,punctured by transrectal ultrasound for 12 points.After the first puncture for 6 months,patients were punctured for rebiopsy.Multi-focal wHGPIN was defined as a high -grade prostate intraepithelial neoplasia with 2 or more cores detection in a prostate biopsy.Isolated HGPIN was defined as a high-grade prostate intraepithelial neoplasia with only one core detection in a prostate biopsy.Results Seventy-two patients with HGPIN were isolated from primary HGPIN,102 patients with isolated HGPIN,17 patients with chronic prostatitis,70 with multifocal HGPIN and 54 with chronic prostatitis.Forth-eight of 172 patients initial diagnosis of HGPIN was diagnosed as PCa at rebiopsy.The detection rate of wHGPIN was 52.86% (37/70)and isolated HGPIN for 10.88% (11/102).They showed a statistically difference between two groups(P <0.001).The detection rate of PCa in HGPIN patients with chronic prostatitis was higher than that in patients without chronic prostatitis(P =0.011).Chronic prostatitis and multifocal wHGPIN were a risk factor for prostate cancer independent by rebiopsy,confirmed by the logistic regression model.Conclusion Rebiopsy is a high risk factor of prostate adenocarcinoma for patients with chronic prostatitis and multifocal HGPIN initially diagnosed by the first biopsy.Therefore,these patients are recommended under ultrasound induced by rectal prostate rebiopsy.
RESUMO
Objective@#To investigate the value of Multislice computed tomography volume rendering(VR) technique and 3D printing technique in auricular reconstruction.@*Methods@#Six patients were enrolled for auricular reconstruction with costal cartilage, including 5 congenital microtia patients and 1 traumatic auricular defect patient. We harvest the three-dimensional reconstructive data of the contralateral sixth, seventh, eighth and ninth costal cartilage with VR technique. Three-dimensional solid models were 3D printed with nylon material according to the data exported in STL format. Preoperative simulation was performed on the models, accordingly, we determined the strategies of costal cartilage harvest and framework fabrication, and operations were performed based on the pre-designed plan.@*Results@#In all 6 patients, the actual costal cartilage harvest and framework fabrication process was consistent with the preoperative design and simulation results, and more scientific than before. The shapes of reconstructed ears were vivid and natural. No complications such as infection, absorption, distortion and chest deformity happened.@*Conclusions@#Through costal cartilage VR and 3D printing technique, we could make more reasonable preoperative design and simulation. The results can be improved with reduced injury, while avoiding the risks of thoracic deformity.
RESUMO
Objective To improve health care workers’(HCWs)infection prevention and control consciousness through carrying out catheter-associated urinary tract infection(CAUTI)prevention and control project,and imple-ment prevention and control measures in practical work.Methods Diagnostic criteria of CAUTI issued by the U.S. Centers for Disease Prevention and Control/National Healthcare Safety Network were adopted,from October 2013 to September 2014,monitoring was conducted on CAUTI in patients with indwelling urinary catheters for >2 con-secutive days at different types of ICUs in hospitals participated in the project .Results A total of 14 124 CAUTI cases were collected,410 patients developed CAUTI,urinary catheter usage rate was 79.33%(203 114/256 042), incidence of CAUTI was 2.02‰(410/203 114),urine specimen detection rate was 46.52%(6 570 /14 124).The detection rate of urine specimens increased from 37.24% (the fourth quarter of 2013)to 49.76% (the third quarter of 2014).Of prevention measures,the difference in the indication of catheterization was significantly different(P <0.01).Conclusion Through the development of competence building project of healthcare-associated infection pre-vention and control,prevention and control of CAUTI has achieved good intervention effect.
RESUMO
Objective To intervene hand hygiene(HH)of health care workers (HCWs)in an intensive care unit(ICU)of a hospital,and evaluate HH compliance of HCWs and influencing factors.Methods 37 HCWs from an ICU of a teaching hospital were chosen as studied subjects,HH status before and after intervention was observed and analyzed by direct and indirect methods.Results In the first monitoring stage,HH rate in baseline and post-intervention survey stage was signifi-cantly different (46.96% vs 63.30%,χ2 =7.344,P =0.007);in the second monitoring stage,HH compliance rate in-creased from 57.85% to 88.58%.HH compliance rate was positively correlated with consumption of HH product per bed-day(r=0.725,P <0.001),but negatively correlated with incidence of healthcare-associated infection(HAI)and case rate of HAI(r=-0.983,-0.990,respectively,both P <0.001),HH rate to alcohol-based hand sanitizers was positively correlated with consumption of HH product per bed-day (r=0.391,P <0.001 ).Conclusion Long-term monitoring and intervention of HH compliance is necessary,combination of direct observation and indirect assessment of HH product con-sumption is helpful for effective monitoring and intervention of HH compliance among HCWs.
RESUMO
Objective To study the saving effect of preemptive analgesia with dezocine on fentanyl use of radical resec-tion of esophageal carcinoma postoperative. Methods Eighty patients(the ASAⅠ~II)who underwent the general anes-thesia downlink esophageal cancer radical operation were randomly divided into two groupsthe control group (group C) and pholcodine group (group D),40 cases in each group.Patients in group D were given 10mg dezocine through intra-venous injection 15 min before skin incision,patients in group C were given the same capacity of saline. After opera-tion,two groups were given fentanyl for postoperative patient-controlled intravenous analgesia (PCIA),keeping the Vi-sual Analog Scale(VAS) lower than 3 scores. The tracheal extubation time,waking time,Ramsay sedation scores at 2 h、6 h、12 h、24 h、48 h, dosage of fentanyl and the occurrence of adverse reactions within 48 h of postoperative were compared. Results The tracheal extubation time and waking time had no significant difference between the two groups(P>0.05). The Ramsay sedation scores at 2 h、6 h、12 h of group D were lower than those in group C (P<0.05), the Ramsay sedation scores at 24 h、48 h had no significant difference between the two groups(P>0.05),dosage of fentanyl and the occurrence of restlessness,vomiting,respiratory depression and dizziness were lower than those in group C(P<0.05). Conclusion Preemptive analgesia with dezocine through intravenous injection can reduce the fentanyl dosage of radical resection of esophageal carcinoma postoperative, the occurrence of restlessness, vomiting, respiratory depres-sion and dizziness,which is worth wide use in the clinical.