Evaluation of readiness of evidence-based practice for the prevention and management of deep vein thrombosis after spinal orthopedic surgery / 中国实用护理杂志

Objective:To understand the preparation of evidence-based nursing practice for postoperative venous thrombosis in the department of spine and orthopedics in our hospital, and to identify the obstacle factors in the process of evidence-based nursing practice so as to promote the successful transformation and application of evidence.Methods:A questionnaire survey was conducted among 164 nurses in Department of Orthopedics of Wuhan Union Hospital in Hubei Province by using self-made general data questionnaire and Clinic Readiness of Evidence-Based Nursing Assessment (CREBNA).Results:The total score of CREBNA was (135.99 ±14.52) points, accounting for 87.10% of the full score. The average score of each subscale item was from high to low: organization environment subscale (4.44±0.67) points, evidence subscale (4.41±0.60) points and promotion factor subscale (4.31±0.69) points. Multiple stepwise regression analysis showed that different levels of understanding of evidence-based nursing practice was the main influencing factor of spine orthopedic nurses′ evidence-based practice readiness ( P<0.05). Conclusion:In this study, there were good level of readiness for evidence-based nursing practice and the current environment is conducive to the development of evidence-based practice programs. Before the application of evidence, managers should clarify the obstacles to change and formulate individual intervention measures to promote the clinical application of evidence.

Evaluation of readiness of evidence-based practice for the prevention and management of deep vein thrombosis after spinal orthopedic surgery / 中国实用护理杂志

Objective@#To understand the preparation of evidence-based nursing practice for postoperative venous thrombosis in the department of spine and orthopedics in our hospital, and to identify the obstacle factors in the process of evidence-based nursing practice so as to promote the successful transformation and application of evidence.@*Methods@#A questionnaire survey was conducted among 164 nurses in Department of Orthopedics of Wuhan Union Hospital in Hubei Province by using self-made general data questionnaire and Clinic Readiness of Evidence-Based Nursing Assessment (CREBNA).@*Results@#The total score of CREBNA was (135.99 ±14.52) points, accounting for 87.10% of the full score. The average score of each subscale item was from high to low: organization environment subscale (4.44±0.67) points, evidence subscale (4.41±0.60) points and promotion factor subscale (4.31±0.69) points. Multiple stepwise regression analysis showed that different levels of understanding of evidence-based nursing practice was the main influencing factor of spine orthopedic nurses′ evidence-based practice readiness (P<0.05).@*Conclusion@#In this study, there were good level of readiness for evidence-based nursing practice and the current environment is conducive to the development of evidence-based practice programs. Before the application of evidence, managers should clarify the obstacles to change and formulate individual intervention measures to promote the clinical application of evidence.

Clinical study of ventilated-associated pneumonia after cardiac surgery in adults / 中国实用护理杂志

Objective@#To investigate the epidemiological data of ventilator-associated pneumonia(VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients.@*Methods@#Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed.@*Results@#Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively; Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48%. Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors.@*Conclusions@#The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care

Clinical study of ventilated-associated pneumonia after cardiac surgery in adults / 中国实用护理杂志

Objective To investigate the epidemiological data of ventilator-associated pneumonia (VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients. Methods Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed. Results Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively;Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48% . Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors. Conclusions The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care

Application of dilution regression method in the coagulation detection of fat blood samples / 国际检验医学杂志

Objective To explore the dilution regression method of coagulation detection(PT ,APTT) in fat blood samples . Methods We collected 40 normal blood coagulation specimens (no fat blood ,no jaundice ,no hemolysis) in Yan′an hospital of Kun-ming ,then we detected the PT and APTT of the original plasma and 3-fold diluted plasma and 5-fold diluted plasma ,the we used the data both of before dilution and diluted to do the linear regression analysis ,and finally we got the regression equations of each index .we also collected 33 fat blood samples in Yanan hospital of Kunming ,which be divide into three groups through the severity of triglycerides :mild fat blood group(1 .7 mmol/L≤TG0 .05) .Conclusion Dilution regression method can be used to detect the fat blood samples in the clinical coagulation detection .

Clinical Observation of Homemade Medicated and Dietary Compound Granules in Treating Sub-health Insomnia with Deficient Cultivation of Heart-spirit / 广州中医药大学学报

Objective To observe the clinical effects of the homemade medicated and dietary compound granules in treating sub-health insomnia with deficient cultivation of heart-spirit. Methods Sixty qualified patients were randomly divided into treatment group and control group, 30 cases in each group. The treatment group was given homemade medicated and dietary compound granules(mainly composed of Semen Ziziphi Spinosae, Radix Codonopsis, Sclerotiium Poriae Circum Radicem Pini, Radix Polygalae, Flos Rosae Rugosae, Plumula Nelumbinis, Fructus Ziziphi Jugubae, and Arillus Longan). The control group was given Oryzanol powder. The course of treatment lasted for half a month. Before and after treatment, the scores of Pittsburgh Sleep Quality Index(PSQI) and the traditional Chinese medicine(TCM)symptom rating scale were observed, and the clinical efficacy of the two groups were also evaluated. Results After treatment for half a month and after suspension of medicine for half a month , (1) the total effective rate of the treatment group was higher than that of the control group (P 0.05). The total PSQI scores , sleep quality scores , falling asleep time scores, and daytime function disorder scores of the treatment group were lower than those of the control group (P<0.01);(3) the total scores of TCM symptoms as well as the scores of dreaminess and susceptibility to awakening, palpitation and amnesia, lassitude and weakness, poor appetite, pale complexion, vertigo and dizziness, abdominal distension and loose stools were declined in the treatment group (P < 0.05 or P < 0.01 compared with those before treatment). Conclusion Medicated and dietary compound granules are effective on improving sleep quality, shortening time to fall asleep, improving sleep disorder, increasing the efficiency of daytime function, improving patients’ mental state entirely, and maintaining the short-term curative effect.

Attempts made by Xiamen Cardiovascular Hospital in building a regional first-aid network for chest pain rescue / 中华医院管理杂志

Xiamen Cardiovascular Hospital set up the first chest-pain center in Fujian province,and launched the first citywide regional chest pain network in China.Their experiences prove that the first-aid network can effectively integrate ambulances,primary hospitals,general hospitals,and special hospitals for seamless connection between EMS and in-house rescue.These efforts can minimize the mortality and disabilities of myocardial infarction,effectively elevating the myocardial infarction treatment efficiency and capabilities of the region.

The short-term therapeutic effects of DNA immunoadsorbent combined with medication on patients with ;severe systemic lupus erythematosus / 中国中西医结合急救杂志

Objective To evaluate the short-term therapeutic effects of DNA immunoadsorbent (IA) combined with glucocorticoid and immune depressant on patients with severe systemic lupus erythematosus(SLE). Methods 32 patients with severe SLE were selected to undergo DNA IA treatment combined with glucocorticoid plus cyclophosphamide therapy, and each patient received IA therapy 3 times, once 2.5 hours, with an interval of 24-48 hours to take another two times of IA. The changes in SLE disease activity index(SLEDAI)score, health status evaluation indexes〔 physiologic functional( PF) and emotional health( MH) scores〕,renal function indexes〔 blood urea nitrogen(BUN)and serum creatinine(SCr)〕 were observed; and anti-double stranded DNA antibody( ds-DNA), immunoglobulin (IgA, IgG, IgM), complements(C3 and C4)and high-sensitivity C-reactive protein (hs-CRP) were examined before and after IA treatment for 2 weeks. Results Two weeks after the combination therapy, the SLEDAI score, BUN, SCr, dsDNA, IgA, IgG, IgM, hs-CRP were significantly lower than those before treatment 〔SLEDAI score : 14.38±3.85 vs. 15.69±1.40, BUN (mmol/L): 11.22±4.78 vs. 16.31±7.90, SCr (μmol/L): 127.02±38.17 vs. 167.25±45.63, dsDNA( U/L): 1.36±0.12 vs. 1.43±0.18, IgA( g/L): 2.41±0.73 vs. 2.59±0.86, IgG( g/L): 16.82±4.83 vs. 21.01±4.84, IgM( g/L): 1.64±0.45 vs. 1.75±0.58, hs-CRP( mg/L): 14.41±2.20 vs. 14.94±2.60, P<0.05 or P<0.01〕; PF score, MH score, complement C3 were increased〔 PF score : 71.19±17.53 vs. 56.66±22.41, MH score : 74.01±15.72 vs. 61.50±17.98, C3( g/L): 0.56±0.09 vs. 0.52±0.10, all P<0.05〕; clinical symptoms were improved significantly, and no significant adverse reactions were found. Conclusion IA combined with medical treatment has shown that it has significant therapeutic effect for treatment of patients with severe SLE, and it may decrease the levels of dsDNA, IgA, IgG, IgM,hs-CRP, and increase the level of complement C3.

Clinical significance of the change of the cardiac enzymes in the critical patients after operation / 中国综合临床

Objective To explore the changes of the cardiac enzymes in the critical patients after operation and to analyze their relationship with the patient's condition level and the prognostic.Methods Fittyseven critical patients after operation were enrolled to observation group,and 55 small operation patients acted as control group.Their cardiac enzymes in three days after operation were detected and compared.Results The cardiac enzymes of the observation group increased significantly when compared with the control group(aspartate aminotransferase (AST) (153.1 ± 211.0) U/L vs (54.7 ± 39.0) U/L,t =3.404,P ＜ 0.01) ; lactic acid dehydrogenase(LDH) (381.0 ± 216.1) U/L vs (194.6 ± 75.3) U/L,t =6.050,P ＜ 0.01) ; creatine kinase (CK) (882.9 ±630.7) U/L vs (130.1 ± 71.8) U/L,t =8.796,P ＜0.01) ;creatinine kinase,MB isoenzyme (CK-MB)(314.3 ± 164.2) U/L vs (164.9 ± 87.7) U/L,t =5.979,P ＜ 0.01) ; α-hydroxybutyrate dehydrogenas(α-HBDH) (410.1 ± 327.6) U/L vs (27.8 ± 36.3) U/L,t =8.605,P ＜ 0.01) ; The fatality ratio was 24.6％ (14/57) in the observation group.The cardiac enzymes of the survival group existed significant difference compared with the death group(AST:(81.3 ± 40.5) U/L vs (373.6 ±342.1) U/L,t =5.585,P ＜0.01) ;LDH:(303.6±134.0) U/Lvs (618.6±250.1) U/L,t=6.064,P＜0.01) ;CK:(658.5±328.0)U/Lvs (1572.0±829.4) U/L,t =6.001 P＜0.01) ;CK-MB:(303.2±184.3) U/Lvs (738.6±445.6)U/L,t=5.242,P＜0.01) ;α-HBDH:(254.1±118.6) U/Lvs (499.3 ±147.6) U/L,t=6.320,P＜0.01).Conclusion Elevated myocardiac enzymes are common in the critical patients after operation.The change of the cardiac enzymes is related with the degree of disease and the wound.

Comparison of epidemiological situation in chronic kidney disease between urban and rural areas in Guangxi province / 中华肾脏病杂志

ObjectiveTo investigate and compare the prevalence,awareness and risk factors of chronic kidney disease (CKD) between urban and rural population in Guangxi province in order to provide information for prevention and treatment of CKD.MethodsBy a stratified multistage random sampling method,18 to 74 years old residents in Guangxi province were surveyed. They wereevaluatedbyquestionnaire,urinaryalbumin/creatinineratio, hematuria (microscopic examination of centrifuged urine sediment),kidney B-mode ultrasound,and abnormal results were reviewed 3 months later.Estimated glomerular filtration rate(eGFR) was calculated with the simplified MDRD equation modified by a Chinese coefficient.The risk factors associated with CKD were also investigated.Results There were no significant differences between urban and rural residents in the prevalence of albuminuria (5.22％ vs 5.47％) and hematuria (1.07％ vs 1.11％)(all P＞0.05).The prevalence of renal lithiasis in rural residents was significantly higher than that in the town(10.54％ vs 6.95％)(P＜0.05).The decreased renal function between urban and rural residents(3.87％ vs 4.04％,P＞0.05) had no significant difference.The prevalence of CKD was 9.58％ in urban and 9.42％ in rural(P＞0.05).The prevalence of albuminuria according to the age distribution was different between urban and rural,which increased along with the age in urban but showed two peaks(30-40 years old and 60-74 years old) in rural.Based on logistic regression analysis,the risk factors for albuminuria were diabetes,hyperuricemia,the history of cardiovascular disease,chronic tonsillitis and HBsAg positive.The risk factors for kidney function decline were age,hyperuricemia,hypertension,diabetes,renal lithiasis and history of cardiovascular disease.The awareness rate of CKD in urban was significantly higher than that in rural (14.45％ vs 6.27％,P＜0.05).Conclusions The prevalenceof CKD has no significant difference between urban and rural in Guangxi province.The awareness rate of CKD in urban is significantly higher than that in rural.It is needed to enhance the prevention and treatment of CKD in rural.

Image fusion between ~(18)F-deoxyglucose-positron emission tomo graphy and CT in con for mal radiotherapy for non-small-cell lung carcinoma / 中华放射肿瘤学杂志

Objective To study 18F-deoxyglucose-positron emission tomography and CT fusion (FDG PET) in three dimensional conformal radiotherapy for non-small -c ell lung carcinoma (NSCLC). Methods Gross tumor volume (GTV) of 13 NSCLC patient s were determined by FDG PET and CT separately (GTV PET-CT and GTV CT ), which were then compared. Results Except 2 patients, all the other patients' GTV PET-CT dif fered from their GTV CT. Compared with GTV CT, GTV PET-CT was in creased by an avera ge of 29.2?cm3 in 5 patients and decreased by an average of 41.6?cm3 in 6 patien ts. Conclusions 18F-deoxyglucose-positron emission tomography, which can improve target definition between benign and malignant lesions in the lung, is proved t o be more sensitive and specific in detecting mediastinal lymph node involvement . FDG PET may provide accurate target definition and improve the local control.