Nursing of a case of goal-directed pulmonary rehabilitation after spinal cord surgery for type Ⅱ spinal muscular atrophy / 中国实用护理杂志

Objective:To summarize the nursing care measures of a patient after spinal orthopedic surgery for spinal muscular atrophy type Ⅱ.Methods:The patient was provided with a goal-directed pulmonary rehabilitation nursing program during ICU resuscitation by exercise pulmonary function, monitor difficult airway extubation and alleviating anxiety.Results:The patient postoperative pulmonary function recovered well, the difficult airway was extubated smoothly and the anxiety was relieved. The patient was discharged from the hospital on the 17th day after the operation.Conclusions:Goal-directed pulmonary care can help promote pulmonary rehabilitation and improve the quality of patient survival after orthopedic surgery for spinal muscular atrophy typeⅡ.

Correlation between capillary filling time and lactate clearance rate in patients with septic shock / 中国实用护理杂志

Objective:To analyze the correlation between capillary filling time (CRT) and lactate clearance rate in patients with septic shock, so as to provide reference for the clinical application of CRT in patients with septic shock.Methods:A prospective study was conducted on 70 patients with septic shock. CRT, mean arterial pressure (map) and sequential organ failure (SOFA) score, Acute Physiology and Chronic Health Evaluation Scoring System (APACHE Ⅱ) score, mechanical ventilation and lactate clearance rate were collected at 3 sites (forehead, knee and nail bed) respectively at 2 time points after admission and 6 hours after admission. The correlation between CRT changes and lactate clearance rate was compared.Results:When lactate clearance rate of more than 10% in 6 hours, the Pearson coefficients of the three sites were 0.823 for nail bed ( P<0.05), 0.232 for forehead and 0.254 for knee ( P>0.05). When lactate clearance rate of less than 10% in 6 hours, the Pearson coefficients of the three sites were 0.299 for nail bed, 0.247 for forehead and 0.254 for knee ( P>0.05). Conclusion:When lactate clearance rate of more than 10% in 6 hours, there is a good correlation between the CRT of nail bed and the lactate clearance rate of patients. The CRT of nail bed can be a practical tool for clinical evaluation of microcirculation.

The Trans-omics Landscape of COVID-19

System-wide molecular characteristics of COVID-19, especially in those patients without comorbidities, have not been fully investigated. We compared extensive molecular profiles of blood samples from 231 COVID-19 patients, ranging from asymptomatic to critically ill, importantly excluding those with any comorbidities. Amongst the major findings, asymptomatic patients were characterized by highly activated anti-virus interferon, T/natural killer (NK) cell activation, and transcriptional upregulation of inflammatory cytokine mRNAs. However, given very abundant RNA binding proteins (RBPs), these cytokine mRNAs could be effectively destabilized hence preserving normal cytokine levels. In contrast, in critically ill patients, cytokine storm due to RBPs inhibition and tryptophan metabolites accumulation contributed to T/NK cell dysfunction. A machine-learning model was constructed which accurately stratified the COVID-19 severities based on their multi-omics features. Overall, our analysis provides insights into COVID-19 pathogenesis and identifies targets for intervening in treatment.

A qualitative study on the effect of nursing team leader rotation system in ICU / 中国实用护理杂志

Objective:To explore the effect of nursing team leader rotation in ICU nursing team, so as to provide reference for optimizing the allocation of nursing human resources, promoting the cooperation of nursing team and improving the quality of nursing care.Methods:The ICU nursing team leader rotation was implemented from October 2018 to June 2019, semi-structured interview method was used to understand the feeling and experience of medical staff in the department on team cooperation, workflow, nursing quality and other aspects after the implementation of the rotation, so as to evaluate the effectiveness.Results:According to the results of interviewing, by implementing the nursing team leader after rotation, most staff feel the improvement of care team, as well as the enthusiasm of learn and work. The new leader′ ability is got promoted, former leader feeled working pressure eased, some medical workers think that nursing quality was not affected, and there performance appraisal was reduced in an acceptable range.Conclusion:The implementation of the nursing team leader rotation may be able to improve teamwork, work enthusiasm,and the ability of overall leader team, alleviate the workload, future studies could evaluate its specific effect by quantitative indicators, and discusses the impact on the quality of care and patient outcomes, to further explore the feasibility and effectiveness of the system.

The construction of nursing index of prone position ventilation based on patient safety / 中国实用护理杂志

Objective:By building a patient safety oriented nursing-sensitive indicator system, this study aimed to help clinical evaluation and nursing for patients in prone position, to constantly optimize management of prone position and promote patient safety.Methods:First drew up initial indicators through literature search and personal interviews, then modified and finally formed the prone position nursing indicators within two rounds of experts consultation. Verified the indicators by evaluating nursing staff satisfaction after half-year′s implementation.Results:Finally, the indicator system included 9 first level, 13 second level and 71 third level indicators. The reliability of experts and the satisfaction of nurses were both high.Conclusions:With the purpose of patient safety, the nursing indicator system of prone position ventilation for critically ill patients are comprehensively covered ever aspect of key component. Specific effect needs to be further verified in the hospital management practice.

Nursing care of a patient with postpartum cardiomyopathy treated by ECMO combined with CRRT, IABP and prone position ventilation / 中国实用护理杂志

Objective:We reported nursing care of a patient with postpartum cardiomyopathy treated by extracorporeal membrane oxygenation (ECMO) combined with intra-aortic balloon pump (IABP), continuous renal replacement therapy (CRRT) and prone position ventilation.Methods:Multidisciplinary cooperation was made to guide the monitor of patients' condition. Refined integrated management measures of multi-equipment were adopted and standardized management process was formulated. Strict requirements were made in treatment and nursing care to prevent hospitalized infection, humanistic care and rehabilitation exercise were conducted to improve patient′s quality of life.Results:After 47 days of nursing care, the patient′s vital signs were stable, the condition was improved and then discharged.Conclusions:Close observation under the guidance of multiple disciplines is an important prerequisite for the treatment. Integrative management of multi-equipment, strict control of hospitalized infection, humanistic care and rehabilitation exercise can effectively improve the prognosis and quality of life of perinatal cardiomyopathy patient.

Critical care ultrasonography: the development and clinical practise in ICU nursing / 中国实用护理杂志

Objective:To establish a practical framework for critical ultrasonography to provide a basis for clinical practice.Methods:With reference to domestic and foreign literature, expert interviews and research groups developed a preliminary draft of the practice framework for critical ultrasonography, and conducted two rounds of consultation using the Delphi method.Results:A practical framework for critical ultrasonography was developed, including 5 primary indicators and 20 secondary indicators. In the two rounds of expert consultation, the expert′s positive coefficient was 100% and the authoritative coefficient was 0.836.Conclusions:Expert opinion has good coordination and high authority, which can provide clinical basis for ICU nurses to carry out ultrasound examination.

Critical care ultrasonography: the development and clinical practise in ICU nursing / 中国实用护理杂志

Objective@#To establish a practical framework for critical ultrasonography to provide a basis for clinical practice.@*Methods@#With reference to domestic and foreign literature, expert interviews and research groups developed a preliminary draft of the practice framework for critical ultrasonography, and conducted two rounds of consultation using the Delphi method.@*Results@#A practical framework for critical ultrasonography was developed, including 5 primary indicators and 20 secondary indicators. In the two rounds of expert consultation, the expert′s positive coefficient was 100% and the authoritative coefficient was 0.836.@*Conclusions@#Expert opinion has good coordination and high authority, which can provide clinical basis for ICU nurses to carry out ultrasound examination.

Nursing care of a patient with postpartum cardiomyopathy treated by ECMO combined with CRRT, IABP and prone position ventilation / 中国实用护理杂志

Objective@#We reported nursing care of a patient with postpartum cardiomyopathy treated by extracorporeal membrane oxygenation (ECMO) combined with intra-aortic balloon pump (IABP), continuous renal replacement therapy (CRRT) and prone position ventilation.@*Methods@#Multidisciplinary cooperation was made to guide the monitor of patients' condition. Refined integrated management measures of multi-equipment were adopted and standardized management process was formulated. Strict requirements were made in treatment and nursing care to prevent hospitalized infection, humanistic care and rehabilitation exercise were conducted to improve patient′s quality of life.@*Results@#After 47 days of nursing care, the patient′s vital signs were stable, the condition was improved and then discharged.@*Conclusions@#Close observation under the guidance of multiple disciplines is an important prerequisite for the treatment. Integrative management of multi-equipment, strict control of hospitalized infection, humanistic care and rehabilitation exercise can effectively improve the prognosis and quality of life of perinatal cardiomyopathy patient.

Construction of ICU nursing workload performance appraisal index based on information system / 中国实用护理杂志

Objective@#To develop a reasonable performance evaluation index system for ICU nursing workload based on the hospital information system and the "structure-process-result" model.@*Methods@#The preliminary indicators of ICU nurses' performance appraisal system were constructed by the research group. Delphi method was used for expert consultation to evaluate the importance of the indicators of the performance appraisal system. After summarizing, sorting out and modifying the expert opinions, the performance appraisal index system of ICU nurses was obtained. SPSS 19.0 software is used to describe the importance of experts' evaluation of indicators at all levels, such as mean, standard deviation, coordination coefficient of experts' opinions and degree of coordination.@*Results@#The effective recovery rate of expert consultation papers was 100%. In the first round of inquiry, the average of importance assignment was 2.05-5.00, the average of rationality assignment was 2.13-5.00, and the average of importance assignment in the second round was 4.57-5.00. The average of rationality assignment was 4.71-5.00. The coefficient of variation of all levels of indicators in the first round was 0.02-0.18, the coefficient of variation in the second round was 0.02-0.12, which was less than 0.2, the positive coefficient of experts was 100%, and the authoritative coefficient of experts in the second round was 0.86 and 0.88. After two rounds of Delphi expert consultation, the ICU nurses' performance appraisal index system was finally formed, including three first-level indicators and 37 second-level indicators.@*Conclusion@#This study is based on the information system, according to the "structure-process-result" model, using the expert consultation method to construct the ICU nursing workload performance assessment index system, and establish the weight of each index, the research results are helpful to further improve the performance appraisal system of ICU nursing staff and improve the scientific management level of ICU.

Construction of ICU nursing workload performance appraisal index based on information system / 中国实用护理杂志

Objective To develop a reasonable performance evaluation index system for ICU nursing workload based on the hospital information system and the "structure-process-result" model. Methods The preliminary indicators of ICU nurses' performance appraisal system were constructed by the research group. Delphi method was used for expert consultation to evaluate the importance of the indicators of the performance appraisal system. After summarizing, sorting out and modifying the expert opinions, the performance appraisal index system of ICU nurses was obtained. SPSS 19.0 software is used to describe the importance of experts' evaluation of indicators at all levels, such as mean, standard deviation, coordination coefficient of experts'opinions and degree of coordination. Results The effective recovery rate of expert consultation papers was 100% . In the first round of inquiry, the average of importance assignment was 2.05-5.00, the average of rationality assignment was 2.13-5.00, and the average of importance assignment in the second round was 4.57-5.00. The average of rationality assignment was 4.71-5.00. The coefficient of variation of all levels of indicators in the first round was 0.02-0.18, the coefficient of variation in the second round was 0.02-0.12, which was less than 0.2, the positive coefficient of experts was 100%, and the authoritative coefficient of experts in the second round was 0.86 and 0.88. After two rounds of Delphi expert consultation, the ICU nurses'performance appraisal index system was finally formed, including three first-level indicators and 37 second-level indicators. Conclusion This study is based on the information system, according to the "structure-process-result"model, using the expert consultation method to construct the ICU nursing workload performance assessment index system, and establish the weight of each index, the research results are helpful to further improve the performance appraisal system of ICU nursing staff and improve the scientific management level of ICU.

Feasibility study of ICU nurses screening the causes of dyspnea in severe patients by using pulmonary ultrasound / 中国实用护理杂志

Objective@#To evaluate the feasibility of ICU nurse-performed lung ultrasound in screening the reason of dyspnea in ICU patients, and to explore the effect on nursing decisions.@*Methods@#ICU nurses trained on lung ultrasound with 16 hours performed point-of-care lung ultrasound in patient with acute respiratory failure to assess the condition of the patient′s lungs and screen for pleural effusion, atelectasis/lung consolidation. Etc; Repeated examinations by ICU physicians accredited by the International Critical Ultrasound Alliance to evaluate the accuracy of ICU nurse interpretation.@*Results@#A total of 510 lung ultrasonographic examinations were performed in 51 patients. Compared with physicians, ICU nurses correctly interpreted 472 ultrasound signs, accounting for 92.53%. ICU nurses found that the sensitivity of the pleural effusion was 86.7%, the specificity was 95.2%, and the diagnostic accuracy rate was 90.2%, and Youden index was 81.9%. The ultrasonography revealed a sensitivity of 92.1% for atelectic/pulmonary consolidation and a specificity of 92.3.%, the diagnostic accuracy rate was 92.2% and Youden index was 84.4%.@*Conclusion@#ICU nurses who have undergone standardized training can correctly interpret lung ultrasound signs and have good diagnostic value for screening of pleural effusions and atelectasis/lung consolidation; they provide the basis for optimization of chest physiotherapy programs.

Establishment of a method for the evaluation of emergency granulopoiesis in mouse bone marrow with EdU / 中华微生物学和免疫学杂志

Objective To label granulocytes in a state of differentiation in mouse bone marrow (BM) with EdU (5-ethynyl-2′-deoxyuridine) for further understanding the changes in granulocyte produc-tion at different stages of differentiation during inflammation. Methods C57BL/6 mice were intraperitoneal-ly (i.p.) injected with EdU and heat-inactivated Escherichia coli(HI E.coli). BM cells were harvested at different time points after HI E.coli injection and then stained with fluorescent-conjugated antibodies(Abs). Myeloblasts,promyelocytes,myelocytes, metamyelocytes and band and segmented neutrophils were identi-fied by fluorescence-activated cell sorting(FACS). The percentage of EdU-positive cells in each population was recorded. Results The percentage of EdU-positive myeloblasts in mice increased by 10.0% at 24 h af-ter intraperitoneal injection with HI E.coli,but decreased by 75.0% and 23.0% at 48 h and 72 h,respec-tively. The percentage of EdU-positive promyelocytes declined by 23.0%,54.5%,64.3% and 77.8% at 24 h,48 h,72 h and 96 h,respectively. The percentage of EdU-positive myelocytes increased by 60.0% and 10.0% at 24 h and 48 h,but decreased by 80.0% and 90.0% at 72 h and 96 h. The percentage of EdU-positive metamyelocytes increased by 50.0% at 24 h,but decreased by 33.3%,61.5% and 66.7% at 48 h,72 h and 96 h. The percentage of EdU-positive band and segmented cells increased by 14.0% at 24 h,but decreased by 50.0%, 77.8% and 88.0% at 48 h, 72 h and 96 h. Conclusion Emergency granulopoiesis occurred 24 h after the establishment of HI E.coli-induced model of acute peritonitis, which meant that the proliferation of myeloid precursor cells,especially that of myelocytes and metamyelocytes,was accelerated and resulted in increasing number of mature neutrophils immigrating to sites of inflammation.

Investigation of doctors' and nurses' perceptions and implementation of delirium management in intensive care unit / 中华内科杂志

Objective To investigate doctors' and nurses' perceptions and implementation of delirium management in intensive care unit. Methods A total of 197 doctors and nurses in 2 general ICUs and 3 special ICUs at Peking Union Medical College Hospital finished a self-designed questionnaire of delirium management. Results There were 47 males and 150 females, 43 doctors and 154 nurses who participated in the survey.One hundred and twenty five participators were from general ICU and the others from special ICU. The ICU staff had a significant difference on the perceptions and implementation of delirium management(P< 0.001) including. Doctors and nurses scored lowest in"family engagement and empowerment"and"sleep management"with (4.620 ± 2.393) and (5.430 ± 2.153) respectively. There was a significant difference between nurses and doctors in the management of analgesia and sedation (P< 0.05). Doctors and nurses from different ICUs had significant discrepancy in the implementation of"delirium assessment"(P<0.05). Conclusions The ICU staff should improve the perceptions and the implementation of delirium management,especially in special ICUs. Delirium management should be included as a routine care in ICU to improve patients' outcome.

Effect of shenqifuzheng injection on CX3CR1 in colonic mucosa of patients with ulcerative colitis / 重庆医学

Objective To observe the clinical efficacy of shenqifuzheng injection combined with sulfasalazine (SASP) in the treatment of ulcerative colitis (UC) ,and to evaluate the effect of CX3CR1 on colonic mucosa of UC in treatment with shenqifuzheng injection .Methods Fifty‐one patients with active mild to moderate UC were collected during the period from January 2012 to June 2014 in the second people′s hospital of Lianyungang ,which randomly divided into experimental group and control group ,and setting up health group of 15 cases .Experimental group were treated with shenqifuzheng injection combined with SASP ,control group were only with SASP ,health group were no‐treatment control .The modified Mayo scoring results and the expression of CX3CR1 on co‐lonic mucosa of the same lesion site were observed before and two weeks after treatment separately .Results The total positive rate of CX3CR1 on colonic mucosa in patients with ulcerative colitis was 88 .37% before treatment ,The total positive rate of CX3CR1 on colonic mucosa in health group was 20 .00% ,There was significant difference between two groups (Z= -2 .689 ,P<0 .01) .Two weeks after treatment ,the expression of CX3CR1 on colonic mucosa and the modified Mayo scoring results in the experimental group were significantly lower than those in the control group (P<0 .05) .The clinical comprehensive efficacy of the experimental group was significantly better than the control group (Z= -2 .085 ,P<0 .05) .Conclusion Combination of shenqifuzheng injection and SASP is more effective than using SASP alone in the treatment of UC .Shenqifuzheng injection may play important role in the treatment of UC by inhibiting the expression of CX3CR1 on colonic mucosa .

Impact of asymptomatic internal carotid artery moderate to severe stenosis and stenting on cognitive function of patients / 中国脑血管病杂志

Objective To investigate the impact of internal carotid artery stenosis on cognitive function of patients and the improvement of cognitive function after internal carotid artery stenting. Methods The clinical data of 92 patients with asymptomatic internal carotid artery stenosis on segment C1 segment diagnosed by cerebral angiography at the Department of Neurology,Urumqi General Hospital of Lanzhou Military Hospital from May 2007 to June 2013 were analyzed retrospectively,including 49 with moderate stenosis and 43 with severe stenosis. Thirty-one patients had stenting. The enrolled patients were evaluated with the Montreal Cognitive Scale (MoCA)score and the National Institutes of Health Stroke Scale (NIHSS) score,and the improvement of the MoCA score at 3 month after stenting was evaluated. Results (1)The MoCA score of the severe stenosis group was lower than that of the moderate stenosis group(22. 6 ± 2. 9 vs. 27. 4 ± 2. 3,P0.05);3 months after stenting,the MoCA score (25. 4 ± 2. 7)of the stenting group was significantly better than that of the non-stenting group (22. 2 ± 2. 8). There was significant difference (P<0. 01);and after stenting,the proportion of patients with the MoCA score <26 (48. 4%,15/31)was significantly lower than those of the non-stenting (83. 3%,10/12,P=0. 037). Conclusion Severe stenosis of internal carotid artery may cause cognitive dysfunction. Carotid artery stenting is conducive to improve cognitive function in patients with severe stenosis.

The correlation between N-terminal pro-brain natriuretic peptide and D-dimer in coronary artery disease pa-tients with type 2 diabetes / 中国基层医药

Objective To explore the correlation between N-terminal pro-brain natriuretic peptide ( NT-porB-NP) and D-dimer in coronary artery disease patients with type 2 diabetes .Methods 50 coronary heart disease patients with type 2 diabetes were selected as the study group ,and 30 healthy subjects at the same period were select-ed as the healthy control group .The serum levels of NT-porBNP and D-dimer were detected in two groups ,and the cor-relation between NT-porBNP and D-dimer was analyzed .Results The serum D-dimer and NT-porBNP levels in the study group were significantly higher than those in the control group [(2.43 ±0.58)mg/L vs (0.26 ±0.13)mg/L, (1 487.8 ±201.5)pg/L vs (83.3 ±21.4)pg/L](t=21.34,32.12,all P<0.05).The D-dimer level was positively correlated with the NT-porBNP level (r=0.564,P<0.05).Conclusion In coronary heart disease patients with type 2 diabetes ,the serum levels of D-dimer and NT-proBNP are high and closely related .

Study on HPLC Fingerprint of Guizhou Zheng'an Standardized Cultivation of Chaenomeles Speciosa / 世界科学技术-中医药现代化

This study was aimed to establish HPLC fingerprint of Chaenomeles speciosa for the place of production and quality control. HPLC was used to comparatively analyze 7 groups of C. speciosa crude drugs from Guizhou Zheng'an and 8 groups of C. speciosa crude drugs from other different production places. The results showed that after the mutual mode of HPLC fingerprint was set up, and the 11 common peaks were pinpointed, comparison of similar degree to crude drugs of other producing areas had been carried on. The main kinds of ingredient in C. speciosa from different places are nearly the same, but the content of each component was different. It was concluded that the method can be used as the identification and quality control of Guizhou Zheng'an C. speciosa, as well as the evaluation of herb quality and standardized planting of GAP, establishment of standard operating procedures of planting and the quality control of C. speciosa.

Expression of autophagy-associated protein induced by β-amyloid and effect of tetrahydroxy stilbene glucoside on it in hippocampus / 中华神经科杂志

Objective To observe the effect of tetrahydroxy stilbene glucoside (TSG) on the behavior on rat model and the expressions of autophagy-associated protein Beclin-1 and LC3- Ⅱ induced by Aβ1-42 Methods Eighty rats were equally randomized into 4 groups (n =20):The control group,the sham operated group,the model group and the TSG group.The behavior of rats was measured by using Y-maze and Morris water maze.The expression of Beclin-1 and LC3- Ⅱ in rats hippocampus was detected by Western blot and RT-PCR at the time points.Results The number of electric-stimulus in hippocampus significantly increased and the Morris water maze test showed that the escape latency prolonged,swimming distance increased and the times of crossing the exact former platform location decreased both in the model and TSG groups after 21 days compared with those in control group.The mRNAs and protein expressions of Beclin-1 (0.51 ±0.03)and LC3-Ⅱ (0.68 ± 0.04) in model group were higher than that in control group (0.31 ± 0.01,0.31 ± 0.02) at that time point ( Beclin-1:t =28.2843,P ＜ 0.05 ; LC3- Ⅱ :t =37.0000,P ＜0.05).Compared to model group,the expression of the Beclin-1 and LC3- Ⅱ was decreased at 21 d in TSG group (Beclin-1:t =9.8387,P ＜ 0.05 ; LC3- Ⅱ :t =16.2698,P ＜ 0.05 ).Conclusions Autophagy self-regulated system is started through the increased expressions of Beclin-1 and LC3- Ⅱ after Aβ deposition in rats,so as to attenuate cerebral injury caused by Aβ neurotoxicity.Autophagy pathway is possible one of the mechanisms in Aβ neurotoxic injury. Tetrahydroxy stilbene glucoside from polygonum multiflorum has protective effect on it.

A study of the treatment method of cerebral artery dissection / 中华放射学杂志

ObjectiveTo explore the best treatment method of cerebral artery dissection.Methods This study included eight patients who were definitely diagnosed as cerebral artery dissection by the cerebral angiography in our department of neurology during Oct.2009 and Nov.2011.They were all treated by the anticoagulation or anti-platelet methods.Some patients received the stent therapy.All patients' were followed for at least three months. The treatment effect was assessed by NIHSS,mRS and by the cerebral angiography.ResultsSix patients had carotid artery dissection,2 had vertebral artery dissection.Four patients were given anticoagulant therapy and the other 4 were given anti-platelet therapy. The reexamination by angiography 10-14 days after admission showed that in 3 patients,the stenosis was aggravated or the infarction occurred.They were diagnosed as having repeated transient ischemic attack (TIA) during pharmacotherapy and received stents for treatment.There was no TIA and cerebral infarction in the follow-up period after individualized therapy.Mean NIHSS scores of 8 patients between pre and post treatment were 5.9,1.6 respectively. Mean mRS scores pre and post treatment were 2.5,0.9respectively.Conclusion The treatment for patients with cerebral artery dissection should be individuated.The patients in acute stage should get anticoagulation,anti-platelet therapy and angiography re-examination.According to the clinical manifestation and cerebral angiography,the next step for the treatment should be done.