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Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.
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Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.
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Objective:To evaluate postoperative pain control and functional recovery of standardized pain management after total hip arthroplasty.Methods:A retrospective analysis between December 2018 and August 2019 included 100 patients who underwent unilateral total hip arthroplasty in department of arthroplasty at the First Affiliated Hospital of Xinjiang Medical University. After informed consent were obtained, the 100 subjects were randomly divided into the control group and the study group according to the inclusion and exclusion criteria, which totaled 50 patients in each group. Traditional postoperative pain management was used in control group and a self-made standardized pain management strategy was chosen in the study group. The prognosis of postoperative pain and the Harris Hip Score (HHS) were compared between the two groups.Results:Before intervention, there was no statistically significant difference in pain outcomes and HHS ( P>0.05). After standardized management of pain, the pain outcome scores of the intervention group were all higher than those of the control group, and the total pain outcome score of the intervention group (12.23±2.39) points was lower than that of the control group (14.50±2.18) points, with statistically significant difference ( t value was 4.962, P<0.001). All the Harris scale scores of the intervention group were higher than those of the control group, and the total score of the intervention group (73.61±5.06) was higher than that of the control group (64.98±7.35), with statistically significant differences ( t value was -6.652, P<0.001). Conclusion:Standardized pain management protocol can be fairly effective in the prognosis of postoperative pain and functional recovery and therefore improve patients′ satisfaction after total hip arthroplasty.
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Objective To explore occupational stress level and chronic illnesses prevalence of nurses in Xinjiang first-class hospital and provide scientific basis of reducing the nurses' occupational stress and improving health interventions.Methods Using stratified cluster sampling method,1 585 nurses were investigated occupational stress level and the chronic diseases who were from Xinjiang around the five states 3 armour hospital.Results Compared with national norm,the nurses had high professional task scored 177.79±29.85 and tension scored 102.46±22.18,individual coping scores from resources scored 119.84±24.06 were lower.The propotion of low,moderate,high tension nurse respectively was 6.1% (97/1 585),47.1% (746/1 585),46.8% (742/1 585).Night shift frequency,nationality,title and average monthly income difference were statistically significant in terms of occupational stress level (x2=1.28-37.96,all P<0.05).Joint disease,neck lumbar disease,chronic digestive system disease prevalence of nurse were higher,its morbidity rates were 10.9%(172/1 585),24.9%(394/1 585) and 22.1%(350/1 585) respectively.Presence of chronic diseases of the digestive system in high,medium and low tension was statistically difference (x2=9.558,P < 0.01).Conclusions Occupational stress level of nurse is higher,and chronic diseases occurences are associated with occupational stress level.So the nurses occupational stress need to control so as to reduce chronic diseases.
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Today's society, many people are plagued by tinnitus and deafness. Chinese medicine on tinnitus and deafness disease and its therapies and for-mulas have discussed quite wel . It is believed that according to the features of the organs, treating tinnitus and deafness from the five internal organs is much better .The virtual is mostly related to the heart, spleen and kidney, but the real mostly related to the heart, liver and lungs. In the treatment of tin-nitus and deafness from the perspective of the kidney, attention should be paid to nourishing the kidneys and strengthening the essence. Treating from the spleen, attaches great importance to the spleen and replenishing qi, clearing material. Treatment from the aspects of liver, the first is to make qi run unob-structed, to prevent generating phlegm and fire. From pulmonary vessels, great importance should be attached to the recovery of dispersing the descending lung. Treated from heart, benefiting qi and nourishing blood should be given much attention not only to make up for its deficiency, but also attach great importance to the qi, send a fire on its reduction. Sick of longer time, compatibility on the basis of syndrome differentiation and treatment to invigorate the flux pulse, aromatic resuscitation of Chinese herbal medicine shal be used.
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<p><b>OBJECTIVE</b>To investigate the modulating effect on lipid and gene expressions of CPT I A caused by berberine (Ber) in experimental hyperlipidemia rats.</p><p><b>METHOD</b>Male SD rats were randomly divided into 5 groups according to the blood lipid values: normal group, hyperlipidemia group, 300 mg x kg(-1) x d(-1) Ber-treated group, 60 mg x kg(-1) x d(-1) Ber-treated group, and 7.2 mg x kg(-1) x d(-1) lovastatin-treated group. Normal group were fed with base diet and other groups were fed with high fat and cholesterol diet. 12 weeks after drugs were given the TC, TG, LDL-C, and HDL-C from rat blood samples were tested by automatic biochemistry analyzer. Gene expressions of CPT I A and PPARalpha were evaluated by RT-PCR and Western blot, respectively.</p><p><b>RESULT</b>It was shown that Ber significantly decreased TC and LDL-C, but increased HDL-C in dose-dependent manner, elevated expressions of CPT I A mRNA and protein without influence on PPARalpha expression. Similar effects from lovastatin on lipidemia were observed except the Ber effect on CPT I A gene expression.</p><p><b>CONCLUSION</b>Ber has modulating effect on the lipid metabolism, the mechanism of which may be by promoting the CPT I A gene expression.</p>
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Animales , Humanos , Masculino , Ratas , Berberina , Carnitina O-Palmitoiltransferasa , Genética , Metabolismo , Modelos Animales de Enfermedad , Medicamentos Herbarios Chinos , Expresión Génica , Hiperlipidemias , Quimioterapia , Genética , Metabolismo , Metabolismo de los Lípidos , PPAR gamma , Genética , Metabolismo , Distribución Aleatoria , Ratas WistarRESUMEN
Aim To obtain high pure hPPAR?1LBD fusion protein.Methods A cDNA encoding ligand binding domain(LBD)of PPAR?1 was amplified by RT-PCR from human fatty tissue and the product was inserted into the downstream of the malE gene in the vector pMAL-p2X,which encoded maltose-binding protein(MBP).The recombinant plasmid containing MBP-PPAR?1 gene was transformed into E.coli.TB1 and the expression conditions of the recombinant strain were optimized.Results The DNA strap of MW(909 bp) was presented after re-combinant plasmid was digested by Hind Ⅲ and BamH Ⅰ.The high efficient expression of MBP-PPAR?1 fusion protein in TB1 cells was observed with 38.54% product of the total cytoplasm proteins when 0.4 mmol?L-1 IPTG and 6 h incubation were taken at 30℃.Conclusion The recombinant vector was successfully constructed.It could high efficiently express hPPAR?1LBD fusion protein in TB1 cells and obtain the hPPAR?1LBD fusion protein with high bioactivity.