Evidence-based nursing practice has received wide attention by scholars both domestically and abroad since it was proposed, and evidence utilization forms the key link of evidence-based practice activities. Promoting action on research implementation in health services framework (PARIHS) has been widely accepted and applied in the innovation of clinical practice. The research team has improved it to i-PARIHS based on years of continuous testing and improvement, as well as feedback from users. This article aims to compare PARIHS and i-PARIHS, and elaborates on basic connotations and core elements of i-PARIHS, so as to provide basis for the innovation of clinical nursing practice in China.
【摘要】 目的 评价青年人颈动脉彩色多普勒超声检查的临床意义，并探讨青年人脑梗死与颈动脉粥样硬化的关系。 方法 2008年2月-2011年3月，对256例青年脑梗死患者进行颈动脉彩色多普勒超声检测，选择性别和年龄匹配的健康青年143例作对照组，比较两组人群颈动脉彩色多普勒超声特点的差异。 结果 脑梗死组颈动脉粥样硬化斑以中等、强回声斑块为主，斑块积分、血管壁内-中膜厚度（ITM值）及斑块检出率（34.77%，89例）均明显高于对照组（Plt;0.01）；脑梗死组颈动脉硬化狭窄率及血栓发生率明显高于对照组（Plt;0.05，lt;0.01）。 结论 青年脑梗死患者颈动脉粥样硬化及血栓形成发生率均高，提示青年脑梗死患者的发病主要原因与动脉粥样硬化有关。IMT值的增加、斑块的检出率及形态学特征等是颈动脉病变与脑梗死发生的有意义的检测指标，在青年人脑梗死的防治中是有参考意义较大的超声学指标。【Abstract】 Objective To assess the clinical significance of color Doppler ultrasonography in examining carotid arteries of young patients, and explore the relationship between cerebral infarction and carotid arteriosclerosis in young patients. Methods A total of 256 patients with cerebral infarction and 143 people without cerebral infarction diagnosed between February 2008 and March 2011 were assessed by color doppler ultrasonography. The ultrasonic characteristics of the two groups were compared and analyzed. Results Plaques incidence in cerebral infarction group was 81.43% which was higher than that in the control group. The most common sites of plaque formation were common carotid artery (CCA) bifurcate and the initial segment of internal carotid artery (ICA) in young people with cerebral infarction. In the cerebral infarction group, the rate of middle-echoic plaques was higher than that in the control group (Plt;0.05). The rate of low-grade carotid stenosis was higher in the cerebral infarction group than that in the control group (Plt;0.05). Conclusions Cerebral infarction occurrence in young people is closely correlated to carotid artery atherosclerosis. Ultrasonography can provide objective evidences for preventing and treating cerebral infarction.
目的 探讨优质护理服务在妇科临床护理路径（CNP）实施中的应用效果。 方法 2010年4月－2011年4月纳入妇科CNP的住院患者中随机抽取150例，并选择同期病区全部17名护士作为对照组；在2011年5月－12月纳入妇科CNP并实施优质护理服务的住院患者中随机抽取150例，并选择同期病区全部22名护士作为试验组。比较两组患者疾病相关知识知晓率、患者及护士工作满意率、平均住院日的差异。 结果 试验组患者疾病相关知识知晓率、患者及护士满意率优于对照组，且平均住院日明显缩短。 结论 优质护理服务应用于改进CNP管理质量，可提高患者疾病相关知识知晓率和护患满意率，缩短住院时间，减轻医疗负担，有利于CNP的实施。
Objective To systematically review the prevalence, clinical characteristics, and prognosis of fulminant type 1 diabetes mellitus (F1DM) in China. Methods The CNKI, WanFang Data, CBM and PubMed databases were searched to collect Chinese F1MD case reports from January 1, 2000 to March 30, 2022. Data analysis was performed using Stata 16.0 software and RevMan 5.3 software. Results A total of 874 cases were included in 233 papers, involving 410 males (46.91%) and 464 females (53.09%). The age of onset was 29.32±1.09 years and the course of disease was 3.74±0.63 days. The BMI was 21.18±0.52 kg/m2, HbA1c was 6.58%±0.08%, the level of fasting C-peptide was 0.04±0.010 ng/mL, level of C-peptide 2 h after meal was 0.09±0.020 ng/mL, the level of blood glucose at the doctor’s office was 34.72±2.89 mmol/L, and the level of arterial blood gas pH was 7.09±0.015. Among them, 734 patients had diabetic ketoacidosis (84.55%), 496 patients had infection of the upper respiratory or digestive tract before onset (56.75%), 4 patients died (0.46%), 78 patients were GADA positive, 11 patients were ICA positive, 13 patients were IAA positive, and 109 were pregnant patients (90 fetal deaths, 82.57%). Conclusion Chinese F1DM is a special but common subtype of diabetes. Its characteristics include a relatively young age of onset, devastating islet damage, and rapid progression, and it is often accompanied by severe metabolic disorders, complications, and grim prognosis. Clinicians should pay more attention to F1DM.
Objective To discuss how to improve organization and management of first-aid nursing during the rescue work. Methods Data about the wounded patients in the Emergency Department of our hospital were collected from 12 to 21 May, 2008. The relevant information concerning the interventions and effects of the organization of first-aid nursing was analyzed. Results In the first ten days after the quake, 1 766 wounded patients were received and treated in the Emergency Department. The results of post-evaluation showed that the rescue work was successful including the first-aid path, rationality of the rescuer dispatch, management of the medical resources, collection of the patients information, and high-quality nursing. Conclusion Effective organization and management of first-aid nursing guarantee the rescue work.