Objective To carry out the systematic clinical management to reduce the incidence of femoral pseudoaneurysm after interventional treatment. Methods A historical controlled study was used to compare the management effect before (from October 2012 to October 2013) and after (from March 2014 to March 2015) the application of doctor-nurse integrated systematic clinical management mode. This work mode enhanced cooperation between doctors and nurses, formed the clinical path for nursing workflows and contingency plans, and strengthened specialized education and training for nurses. Results After the implementation of systematic clinical management, the incidence of femoral pseudoaneurysm was significantly lower than before (1.0% vs. 2.7%), and the difference was statistically significant (P<0.05). Conclusions The systematic clinical management, carrying out in the doctor-nurse integration mode, can improve the quality of nursing and reduce the incidence of femoral pseudoaneurysm. And the management model has achieved remarkable results. So it is worth to be applied in the clinical practices.
Objective To investigate the ways of scientific research knowledge acquirement, and the situation of research capacity and demand of neurological nurses in Sichuan Province. Methods From May to June 2015, 153 neurological nurses from 7 hospitals of Sichuan Province were enrolled by convenient stratified sampling method. The ways of acquiring scientific research knowledge, research capacity, and research demand of the nurses were investigated by questionnaire. Results Among the 153 nurses, there were 50.3% with low level, 47.7% with moderate level, and 2.0% with high level of scientific research capacity, respectively. The total scores of nursing research capacity ranged from 4 to 101. The dimension of " capacity of generating the research ideas” was the highest, and the dimensions of " capacity of designing research protocol” and " capacity of analyzing research data and material” were the lowest. Of the respondents, 66.2% had never attended any research training program, 51.3% acquired scientific research knowledge by themselves, and 65.6% were willing to participate research training courses. The respondents tended to study on their own by internet. There were significant differences in scientific research capacity among neurological nurses with different initial education, attending the college entrance examination or not, having attended research training and self-study or not (P<0.05). Conclusions Most nurses acquire scientific research knowledge by themselves, and insufficient research training couldn’t satisfy the research demand of neurological nurses. The initial education degree and research study intention are related to research capacity. However, due to the limited amount of samples, the positive influence of self-study and research training on the research capacity still need to be further explored.
ObjectiveTo explore the clinical features of myasthenia gravis (MG) harboring both acetylcholine receptor antibody (AChRAb) and muscle-specific tyrosine kinase antibody (MuSKAb) positivity.MethodsWe searched PubMed, Web of Science, Embase and China National Knowledge Infrastructure databases (from inception to November 2016), to collect the case reports of MG with both AChRAb and MuSKAb positivity. Along with one case discovered in Department of Neurology, West China Hospital, the clinical data of the cases were retrospectively analyzed.ResultsA total of 13 double-seropositive MG patients were enrolled in this study, demonstrating a marked female predominance (including 1 male and 12 females) and a younger age at onset [(31.07±24.77) years]. During the disease course, 10 of the included patients presented severe bulbar involvement, dyspnea and neck weakness, with myasthenic crisis in 6 individuals. Among the 11 patients with detailed records, abnormal thymus glands comprised 4 thymus hyperplasia and one thymoma. While the response to oral pyridostigmine was unsatisfactory in 11 double-seropositive MG patients, ranging from mild benefit to overt intolerance; the patients treated with plasma exchange (3/3), rituximab (1/1) or corticosteroid (7/12) improved dramatically, with other immumosuppressants and intravenous immunoglobulin partially responsive. Moreover, 5 patients undergoing thymectomy improved markedly or partially.ConclusionsCompared with MG patients with MuSKAb positivity merely, the condition of the double-seropositive MG patients seem to be more severe and further inclined to myasthenic crisis. The incidence of abnormal thymus, such as thymus hyperplasia, is higher. Thymectomy may be an effective treatment for such patients.