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Objective:To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) on the discharge outcome in elderly patients with acute ischemic stroke (AIS) receiving intravenous thrombolysis (IVT).Methods:Elderly patients with AIS received IVT in the Department of Neurology, the Second Affiliated Hospital of Soochow University from August 2018 to August 2020 were retrospectively included. The modified Rankin Scale was used to evaluate discharge outcome, and the score >2 was defined as poor outcome. Symptomatic intracranial hemorrhage (sICH) was defined as any intracranial hemorrhage found on imaging examination accompanied by neurological deterioration, where the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 from baseline or bleeding led to death. Multivariate logistic regression analysis was used to determine independent risk factors for sICH and poor discharge outcome. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of NLR for sICH and poor discharge outcome. Results:A total of 228 elderly patients with AIS receiving IVT were enrolled, including 118 males (51.8%), aged 73.64±8.16 years, with a baseline NIHSS score of 6.23±6.54. Ninety patients (39.5%) had poor outcome at discharge, and 16 (7.0%) developed sICH. Univariate analysis showed that the NLR in the poor outcome group was significantly higher than that in the good outcome group ( P<0.01). Multivariate logistic regression analysis showed that a higher NLR was an independent risk factor for poor discharge outcome (odds ratio [ OR] 1.245, 95% confidence interval [ CI] 1.044-1.484; P< 0.05) and sICH ( OR 1.124, 95% CI 1.010-1.251; P<0.05). ROC curve analysis showed that the area under the curve of NLR for predicting poor discharge outcome was 0.693 (95% CI 0.620-0.765; P<0.01). The optimal cutoff value was 4.345. Its corresponding sensitivity and specificity were 47.8% and 87.7%, respectively. The area under the curve of NLR for predicting sICH was 0.651 (95% CI 0.498-0.804; P<0.05). The optimal cutoff value was 3.515. Its corresponding sensitivity and specificity were 68.8% and 61.8%, respectively. Conclusions:A higher NLR is independently associated with sICH and poor discharge outcome in elderly patients with AIS receiving IVT, and have certain predictive value for sICH and poor discharge outcome.
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Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.
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Objective:The risk factors and survival conditions of cardiomyopathy in childhood septic shock were retrospectively analyzed.Methods:Children with septic shock admitted to the PICU at Children′s Hospital of Chongqing Medical University from January 2015 to March 2021 were collected.The case group included children with septic shock and cardiomyopathy.The propensity score matching method was used to match children with septic shock without cardiomyopathy in a 1∶2 ratio as the control group.Basic clinical data, myocardial biomarkers, cardiac ultrasound indicators, organ function indicators and clinical outcome indicators were collected from two groups.Results:Forty-six patients were included in the case group and 92 patients in the control group.There were no significant differences in age, sex, pediatric critical care score, and basic disease between two groups.Moreover, left ventricular ejection fraction[51.0%(43.0%, 62.0%) vs.65.5%(60.6%, 69.0%)], left ventricle short-axis shortening rate (FS)[26%(21%, 33%) vs.35%(32%, 38%)], and oxygenation index(PaO 2/FiO 2)[324.0(234.3, 400.0) mmHg vs.400.0(265.8, 445.0)mmHg] in case group were lower than those in control group, while the incidence of the ST segment changes of the ECG index (21.7% vs.3.3%), lactate[3.20(1.20, 5.87)mmol/L vs.1.80(1.20, 3.40)mmol/L], and vasoactive drug score[25.14(14.84, 42.70)points vs.15.04(10.00, 26.70) points] in case group were higher than those in control group, the differences were all statistically significant (all P<0.05). The differences of PICU mortality (15.2% vs.14.1%) and 28 d mortality (29.1% vs.29.3%) between two groups were not significant ( P>0.05). The Logistic regression analysis showed that the FS was associated with cardiomyopathy occurring in septic shock[ OR (95% CI): 0.795 (0.714~0.870), P<0.001]. Children with septic shock with elevated cardiac troponin I had an increased risk of death. Conclusion:FS is an independent risk factor for cardiomyopathy in septic shock.There is no difference in survival between septic shock with and without cardiomyopathy.Cardiac troponin I is associated with the prognosis of septic shock in children.
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Objective:The risk factors and survival conditions of cardiomyopathy in childhood septic shock were retrospectively analyzed.Methods:Children with septic shock admitted to the PICU at Children′s Hospital of Chongqing Medical University from January 2015 to March 2021 were collected.The case group included children with septic shock and cardiomyopathy.The propensity score matching method was used to match children with septic shock without cardiomyopathy in a 1∶2 ratio as the control group.Basic clinical data, myocardial biomarkers, cardiac ultrasound indicators, organ function indicators and clinical outcome indicators were collected from two groups.Results:Forty-six patients were included in the case group and 92 patients in the control group.There were no significant differences in age, sex, pediatric critical care score, and basic disease between two groups.Moreover, left ventricular ejection fraction[51.0%(43.0%, 62.0%) vs.65.5%(60.6%, 69.0%)], left ventricle short-axis shortening rate (FS)[26%(21%, 33%) vs.35%(32%, 38%)], and oxygenation index(PaO 2/FiO 2)[324.0(234.3, 400.0) mmHg vs.400.0(265.8, 445.0)mmHg] in case group were lower than those in control group, while the incidence of the ST segment changes of the ECG index (21.7% vs.3.3%), lactate[3.20(1.20, 5.87)mmol/L vs.1.80(1.20, 3.40)mmol/L], and vasoactive drug score[25.14(14.84, 42.70)points vs.15.04(10.00, 26.70) points] in case group were higher than those in control group, the differences were all statistically significant (all P<0.05). The differences of PICU mortality (15.2% vs.14.1%) and 28 d mortality (29.1% vs.29.3%) between two groups were not significant ( P>0.05). The Logistic regression analysis showed that the FS was associated with cardiomyopathy occurring in septic shock[ OR (95% CI): 0.795 (0.714~0.870), P<0.001]. Children with septic shock with elevated cardiac troponin I had an increased risk of death. Conclusion:FS is an independent risk factor for cardiomyopathy in septic shock.There is no difference in survival between septic shock with and without cardiomyopathy.Cardiac troponin I is associated with the prognosis of septic shock in children.
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Objective:To analyze the effect of inhibiting excessive mitochondrial fission mediated by dynamic related protein 1 (Drp1) on the function of injured cells and mitochondria in the septic myocardium, and to explore the protective effect of maintaining mitochondrial dynamic balance in the pathogenesis of sepsis induced cardiomyopathy(SIC).Methods:Rat H9C2 cardiomyocytes were cultured and stimulated with lipopolysaccharide (LPS) to establish a model of SIC. Mitochondrial division inhibitor 1 (Mdivi-1) was given 30 min before LPS stimulation. They were divided into the control group, LPS stimulated group (LPS), Mdivi-1 control group (Mdivi-1), and LPS+Mdivi-1 intervention group (LPS+Mdivi-1). CCK-8 was used to detect the cell viability, and lactate dehydrogenase (LDH) was used to detect cellular damage. A MitoTracker probe was used to observe mitochondrial morphology by laser scanning confocal microscopy, JC-1 staining was used to detect mitochondrial membrane potential level, a DCFH-DA probe was used to detect total ROS level, and an AnnexinV-FITC/PI probe was used to detect the cell apoptosis ratio. The expression levels of mitochondrial fission protein Drp1 and fusion proteins Optic Atrophy 1(Opa1) and Mitofusin2 (Mfn2) were detected by real-time PCR and Western blot. One-way ANOVA was used to compare the differences between groups, and the LSD- t test was used for pairwise comparisons between groups. Results:Compared with the control group, cell viability, the average length of mitochondria and the mitochondrial membrane potential were decreased, and ROS production, the cell apoptosis rate and LDH were increased in the LPS group (all P<0.05). After Mdivi-1 intervention, compared with the LPS-stimulated group, the cell viability was increased, myocardial cell damage was reduced, the average length of mitochondria was prolonged, mitochondrial dysfunction was alleviated, and the cell apoptosis rate was inhibited in the LPS+Mdivi-1 group (all P<0.05). Conclusions:Mdivi-1 might inhibit mitochondrial fission mediated by Drp1, maintain mitochondrial dynamic balance, alleviate mitochondrial dysfunction and protect myocardial cells from LPS-induced injury.
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Objective:To develop and validate a model for predicting death risk in septic shock patients using LASSO-Logistic methods.Methods:A retrospective cohort study was conducted. Based on the open-source database Medical Information Mart for Intensive Care-Ⅲ v1.4 (MIMIC-Ⅲ v1.4), the septic shock patients meeting the Sepsis-3 criteria were included, and the data on demographic characteristics, major signs, laboratory examinations, hospitalization, and outcomes were extracted. Predictive variables were selected by LASSO regression and predictive models were derived using Logistic regression. The calibration of the model was evaluated using the Hosmer-Lemeshow test and discrimination was evaluated using the receiver operator characteristic curve (ROC curve).Results:A total of 693 patients with septic shock were enrolled, in which 445 patients survived and 248 patients dead within 30 days and the mortality was 35.8%. Logistic regression model was constructed according to nine predictive variables and outcome variables screened by LASSO regression method, which showed that advanced age, Elixhauser index, blood lactic acid (Lac), K + level and mechanical ventilation were associated with increased 30-day mortality [odds ratio ( OR) and 95% confidence interval (95% CI) was 1.023 (1.010-1.037), 1.047 (1.022-1.074), 1.213 (1.133-1.305), 2.241 (1.664-3.057), 2.165 (1.433-3.301), respectively, all P < 0.01], and reduced systolic blood pressure (SBP), diastolic blood pressure (DBP), body temperature, and pulse oxygen saturation (SpO 2) were also associated with increased 30-day mortality [ OR (95% CI) was 0.974 (0.957-0.990), 0.972 (0.950-0.994), 0.693 (0.556-0.857), 0.971 (0.949-0.992), respectively, all P < 0.05]. The calibration curve showed that the predicted risk of septic shock death risk prediction model had good agreement with the real situation. ROC curve analysis showed that the area under the ROC curve (AUC) of the prediction model was 0.839 (95% CI was 0.803-0.876), which could distinguish patients at risk of death from those at risk of survival. Conclusions:The septic shock death risk prediction model has a good ability to identify the 30-day mortality risk of septic shock patients, including nine hospital readily variables (age, Elixhauser index, mechanical ventilation, Lac, K +, SBP, DBP, body temperature and SpO 2). The model could be used by clinicians to calculate the risk of death in septic shock individuals.
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Objective:To explore the teaching effect of case-based learning (CBL) teaching combined with high-fidelity simulation (HFS) system training mode in first aid skills training for postgraduates majoring in pediatrics.Methods:In this study, 200 pediatrics graduate students in emergency clinical rotation were randomly divided into 4 groups: control group, traditional lecture teaching combined with simple simulation training; CBL group, CBL case combined with simple model training; HFS group, traditional lecture teaching combined with high-fidelity simulation training; CBL+HFS group, CBL case combined with high-fidelity simulation training. All the data were statistically analyzed with STATA 14.0 software.Results:Recent assessment results showed that in cardiopulmonary resuscitation, electroshock therapy, tracheal intubation skills, the average score of the CBL group was higher than that of the control group, and the average score of the HFS group was higher than that of the control group, with statistically significant differences ( P<0.05). In terms of non-technical ability, the average score of CBL group was higher than that of control group, and that of HFS group was higher than that of control group, with statistically significant differences ( P<0.05). There was interaction and cooperation between CBL and HFS, and the analysis results of the long-term assessment results were the same as those of the short-term assessment results. Conclusion:CBL combined with HFS is helpful to improve the first aid technical ability and non-technical ability of postgraduates majoring in pediatrics, which is worth further popularizing.
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Lignocellulose can be hydrolyzed by cellulase into fermentable sugars to produce hydrogen, ethanol, butanol and other biofuels with added value. Pretreatment is a critical step in biomass conversion, but also generates inhibitors with negative impacts on subsequent enzymatic hydrolysis and fermentation. Hence, pretreatment and detoxification methods are the basis of efficient biomass conversion. Commonly used pretreatment methods of lignocellulose are chemical and physic-chemical processes. Here, we introduce different inhibitors and their inhibitory mechanisms, and summarize various detoxification methods. Moreover, we propose research directions for detoxification of inhibitors generated during lignocellulose pretreatment.
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Biocombustibles , Biomasa , Fermentación , Hidrólisis , Lignina/metabolismoRESUMEN
Objective:To investigate the incidence and risk factors of delirium after coronary artery bypass grafting(CABG) and evaluate the predictive efficacy of these risk factors.Methods:The Confusion Assessment Method for the Intensive Care Unit(CAM-ICU) was used to evaluate the incidence of delirium in 314 CABG patients. Multivariate Logsictic regression analysis was used to determine the independent risk factors for delirium after CABG.Results:The incidence of delirium after CABG was 24.8%(78/314). The incidence of delirium after CABG was 25.7%(54/210) in the training set, and 23.1%(24/104) in the validation set. American Society of Anesthesiologists Physical State≥4 points, cardiopulmonary bypass, Mini-Mental State Examination <27 points, mechanical ventilation time, postoperative midazolam application, and serum albumin <30 g/L were independent risk factors for delirium after CABG.In the training set and validation set, patients with delirium score> 2.11 were in high-risk groups, and patients with delirium score ≤2.11 were in low-risk groups.Conclusions:The established delirium predictive model can not only stratify the risk of delirium, but also provide clinical scientific basis for postoperative delirium prevention and early screening.
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Sepsis is a common disease the field of critical care medicine. It is easy to be complicated by acute lung injury (ALI) or even acute respiratory distress syndrome (ARDS), which lead to high mortality. Although domestic and foreign scholars have carried out a large number of research on the pathogenesis of sepsis-related ALI/ARDS, it has not been fully elucidated so far. Recent studies have found that mitochondrial DNA (mtDNA) may play an important role in sepsis-related ALI/ARDS. This article reviews the current role of mtDNA in the pathogenesis of sepsis-related ALI/ARDS, with a view to providing new clues and evidence for the treatment of sepsis-related ALI/ARDS.
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Objective:To establish evidence-based perioperative nursing quality indicators of TAAD which assess and monitor the quality of nursing care in Chinese hospitals.Methods:Based on the "structure-process-result" three dimensional quality evaluation model, the perioperative nursing quality sensitivity index of TAAD and its calculation formula as well as data collection method were extracted from domestic and foreign literature. The results were demonstrated and revised by using Delphi method.Results:Sixteen sensitive indicators of perioperative quality of care for TAAD such as pain relief rate, preoperative dissection rupture mortality,emergency surgery and incidence of transfusion reactions were constructed.After two rounds of expert consultation, the expert positive coefficients were 91.6% and 100%, the expert authority coefficients were 0.96 and 0.93, and the coefficients of variation were 0.000-0.278.Conclusion:The perioperative nursing quality sensitivity indicators of TAAD were scientific and reliable,which can be applied to clinical utilization,and to inspire the nursing team to formulate an efficient specialist nursing strategy.
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Objective To understand the working experience of responsible nurses after the day surgery in the ward under the concept of accelerated rehabilitation surgery, in order to provide reference for the development of targeted interventions. Methods In this study, 10 primary nurses in 4 departments of day surgery in Shanghai Tenth People′s Hospital were interviewed by using the method of objective sampling in April_ May, 2018. The semi_ structured interview was conducted using the phenomenological research method in the qualitative study, and the Colaizzi phenomenological data was used. The analysis method analyzes the interview data. Results Through the repeated refinement, analysis and extraction of the interview data, the following two themes reflecting the work experience of the daytime surgical department responsible nurses: own growth and harvest, difficulties and challenges. Conclusion Based on the concept of accelerated rehabilitation surgery, daytime surgery is carried out to encourage responsible nurses to continuously improve their knowledge level and interpersonal communication skills. The nurses'professional identity is continuously improved. At the same time, due to the increase in nursing workload, the increase in nurse training needs and the incomplete workflow make nursing management Facing new problems and challenges.
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Objective@#To understand the working experience of responsible nurses after the day surgery in the ward under the concept of accelerated rehabilitation surgery, in order to provide reference for the development of targeted interventions.@*Methods@#In this study, 10 primary nurses in 4 departments of day surgery in Shanghai Tenth People′s Hospital were interviewed by using the method of objective sampling in April-May, 2018. The semi-structured interview was conducted using the phenomenological research method in the qualitative study, and the Colaizzi phenomenological data was used. The analysis method analyzes the interview data.@*Results@#Through the repeated refinement, analysis and extraction of the interview data, the following two themes reflecting the work experience of the daytime surgical department responsible nurses: own growth and harvest, difficulties and challenges.@*Conclusion@#Based on the concept of accelerated rehabilitation surgery, daytime surgery is carried out to encourage responsible nurses to continuously improve their knowledge level and interpersonal communication skills. The nurses' professional identity is continuously improved. At the same time, due to the increase in nursing workload, the increase in nurse training needs and the incomplete workflow make nursing management Facing new problems and challenges.
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Objective To analyze the clinical diagnosis and treatment of drug hypersensitivity syndrome (DIHS) in children. Method The allergenic drugs, clinical manifestations, laboratory examinations, treatment effects, complications and prognosis in 22 children with DIHS were analyzed retrospectively. Results All 22 patients had a medication history and fever. Among them, 90.9% patients had erythema morbilliforme, 90.9% had liver damage, 18.2% had renal damage, 54.5% had superficial lymph node enlargement and 36.4% had granulocytosis. Five patients had serious complications. One patient was complicated by autoimmune hemolytic anemia, 3 patients had transaminase elevated greater than 10 times and 1 patient died due to hepatic failure, hepatic encephalopathy and multiple organ failure. The treatment mainly included the use of glucocorticoid and gamma globulin, and, if necessary, plasma exchange. Conclusion The incubation period of children with DIHS is long, and the skin lesions are mainly erythema morbilliforme. Most of the affected organs are mainly liver, and some of patients can be combined with eosinophilia. Glucocorticoid therapy is effective.
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Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.
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Objective To investigate the variation of serum Thymidine Kinase 1(TK1) in patients with non‐small cell lung canc‐er(NSCLC) and its clinical value .Methods Serum TK1 level of 129 patients with NSCLC and 90 healthy volunteers were measured by sensitive chemiluminescence dot‐blot assay .The serum TK1 level variation of 76 patients with NSCLC were compared before and after operation .Results Serum TK1 level of NSCLC patients were significantly higher than the level of healthy control group(PStage Ⅳ >Stage Ⅰ + Ⅱ >Stage Tis ,comparison between each other was of statistical differ‐ence(P<0 .05) .The serum TK1 level of NSCLC patients at 30th day after surgery was remarkably lower than which before surger‐y(P=0 .001 ,P<0 .01) .The serum TKl level was correlated with lymphatic metastasis(P<0 .01) ,but not with other factors such as pathology types ,age ,sex and smoking .The serum TK1 measurement was high sensitivity and specificity to the diagnosis of NSCLC .Conclusion The serum TK1 level detection has important clinical significance in diagnosis and evaluation of NSCLC pa‐tients .
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Objective The study aimed to investigate the influence of head nurse's transformational leadership style on emotional labor and psychological empowerment of nurses.Methods Totally 851 staff nurses from four 3A hospitals were investigated with the Transformational Leadership Style Sub Scale of Multifactor Leadership Questionnaire,Psychological Empowerment Scale and Emotional Labor Scale.Results The head nurse's transformational leadership style scored (2.41±0.81).The psychological empowerment of nurses scored (3.27±0.47),its autonomy dimension scored (3.81±0.50),staying at medium level.The emotional labor of nurses scored (3.68±0.61),its deep acting dimension scored (4.67±0.76),which was above medium level.The indirect correlation coefficient between head nurse's transformational leadership style and emotional labor (r=-0.13) was far higher than direct correlation coefficient (r=-0.04).The psychological empowerment was the full mediation variable by which head nurse's transformational leadership style influence emotional labor of nurses.Conclusions Head nurse's transformational leadership style can enhance nurse's selfefficacy,cognition of work significance and work autonomy,so that nurse's deep acting and positive perception of emotional display can be increased,and nurse's emotional exhaustion and job burnout can be decreased to retain nurses.
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The objective of this study was to genetically characterize isolates of Giardia duodenalis and to determine if zoonotic potential of G. duodenalis could be found in stray cats from urban and suburban environments in Guangzhou, China. Among 102 fresh fecal samples of stray cats, 30 samples were collected in Baiyun district (urban) and 72 in Conghua district (suburban). G. duodenalis specimens were examined using light microscopy, then the positive specimens were subjected to PCR amplification and subsequent sequencing at 4 loci such as glutamate dehydrogenase (gdh), triose phosphate isomerase (tpi), beta-giardin (bg), and small subunit ribosomal RNA (18S rRNA) genes. The phylogenetic trees were constructed using obtained sequences by MEGA5.2 software. Results show that 9.8% (10/102) feline fecal samples were found to be positive by microscopy, 10% (3/30) in Baiyun district and 9.7% (7/72) in Conghua district. Among the 10 positive samples, 9 were single infection (8 isolates, assemblage A; 1 isolate, assemblage F) and 1 sample was mixed infection with assemblages A and C. Based on tpi, gdh, and bg genes, all sequences of assemblage A showed complete homology with AI except for 1 isolate (CHC83). These findings not only confirmed the occurrence of G. duodenalis in stray cats, but also showed that zoonotic assemblage A was found for the first time in stray cats living in urban and suburban environments in China.
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Animales , Gatos , Enfermedades de los Gatos/parasitología , China , Análisis por Conglomerados , ADN Protozoario/química , ADN Ribosómico/química , Heces/parasitología , Giardia lamblia/clasificación , Giardiasis/parasitología , Microscopía , Datos de Secuencia Molecular , Filogenia , Proteínas Protozoarias/genética , ARN Ribosómico 18S/genética , Análisis de Secuencia de ADNRESUMEN
The objective of this study was to genetically characterize isolates of Giardia duodenalis and to determine if zoonotic potential of G. duodenalis could be found in stray cats from urban and suburban environments in Guangzhou, China. Among 102 fresh fecal samples of stray cats, 30 samples were collected in Baiyun district (urban) and 72 in Conghua district (suburban). G. duodenalis specimens were examined using light microscopy, then the positive specimens were subjected to PCR amplification and subsequent sequencing at 4 loci such as glutamate dehydrogenase (gdh), triose phosphate isomerase (tpi), beta-giardin (bg), and small subunit ribosomal RNA (18S rRNA) genes. The phylogenetic trees were constructed using obtained sequences by MEGA5.2 software. Results show that 9.8% (10/102) feline fecal samples were found to be positive by microscopy, 10% (3/30) in Baiyun district and 9.7% (7/72) in Conghua district. Among the 10 positive samples, 9 were single infection (8 isolates, assemblage A; 1 isolate, assemblage F) and 1 sample was mixed infection with assemblages A and C. Based on tpi, gdh, and bg genes, all sequences of assemblage A showed complete homology with AI except for 1 isolate (CHC83). These findings not only confirmed the occurrence of G. duodenalis in stray cats, but also showed that zoonotic assemblage A was found for the first time in stray cats living in urban and suburban environments in China.
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Animales , Gatos , Enfermedades de los Gatos/parasitología , China , Análisis por Conglomerados , ADN Protozoario/química , ADN Ribosómico/química , Heces/parasitología , Giardia lamblia/clasificación , Giardiasis/parasitología , Microscopía , Datos de Secuencia Molecular , Filogenia , Proteínas Protozoarias/genética , ARN Ribosómico 18S/genética , Análisis de Secuencia de ADNRESUMEN
Objective To discuss the effect of the PDCA cycle in enhancing the case care ability of nurses in order for nurses to adapt to the assessment model of cases tracking.Methods The training was carried out for enhancing nurses' ability of case care according to the PDCA cycle.Results The scores of the case care,the quality of care in wards and the patient satisfaction degree increased significantly after applying the PDCA cycle compared with those before.The aims of ensuring medical safety,improving the work quality,and increasing patient satisfaction were achieved.Conclusions Training nurses' ability of case care following the PDCA cycle can effectively improve the nurses' ability of case care,make them adapt to the case tracking assessment model,which is worthy of promotion.