【摘要】 目的 探讨优质护理活动中应用风险管理措施提高住院老年患者安全的作用和意义。 方法 对2010年2月-2011年3月开展优质护理活动实施风险管理后，其老年住院患者安全事件预防控制情况进行回顾分析。 结果 应用风险管理措施后老年住院患者的护理不良事件发生减少，患者对护理工作的满意度提高。 结论 加强风险管理有助于保障患者安全，提高患者满意度，构建和谐护患关系。【Abstract】 Objective To investigate the role and the effect of risk management in good care service on the safety of elder in-patients. Methods From February 2010 to March 2011, the risk management was carried out during applying good care service. The prevention and control of the poor nursing events for the elder in-patients were retrospectively analyzed. Results The poor nursing events for the elder in-patients decreased obviously after the application of risk management, and the patients were pleased with the service of nurses. Conclusion Risk management is conducive to prove the safety of the in-patients, improve the degree of satisfaction of the patients, and make the harmonious relations between the nurses and the patients.
Objective To seek evidence based methods to treat bedsore of aged patients. Methods We raised clinical questions according to the condition of an eighty-year old male patient, and then, with "bedsore" (treatment or prevention) as key words we searched evidences from Cochrane Library (2nd edition 2002), Medline (1996-2002.4), and Sumsearch. Results We found 3 SR (systematic review) from Cochrane Library, 3 Meta-analyse and 38 RCT (randomized controlled trial) from medline, and 3 SR and 9 RCT from Sumsearch. Conclusion 1 Various types of mattress are useful in prevention the bedsore. 2 There is still not enough evidences of electromagnetic therapy. 3 In state II bedsore, healing is faster in using collagen Dressing than using water-glue Dressing. 4 Local application of antibiotics and Phenytoin sodium can accelerate the growth of new granulation tissue. 5 Nutritional support is necessary for bedsore prevention and healing. According to these evidence, we make the best care plan for this patient. After our treatment, the wound healed 10 days later, and he doesn’t occur bedsore any more.
To review the latest development of amniotic fluid-derived stem cell(AFS) and to predict its future appl ication. Methods The recent articles about AFS were extensively reviewed. The origin, culture, identification, and directional differentiation as well as future appl ication of AFS were summarized and discussed. Results In 1993, AFS were thought to be exist possibly, and it was confirmed in recent years. AFS have some surface markers l ike other stem cells, and has multi-differentiated potential and extensive future appl ication in cell therapy and tissue engineering approaches. Conclusion As a new stem cell, AFS remains to be further researched.
Objective To compare the effectiveness and safety of linezolid with vancomycin for the treatment of people with Gram-positive bacteraemia. Methods We electronically searched The Cochrane Library (Issue 1, 2009), MEDLINE, EMbase, Current Controlled Trials, The National Research Register, CBM disc and CNKI. We also handsearched some relevant journals. The search time was up to March 10, 2009. Randomized controlled trials of linezolid versus vancomycin for treatment of Gram-positive bacteraemia were included. Meta-analyses were performed for the results of homogeneous studies using the Cochrane Collaboration’s RevMan 5.0 software. Results A total of 8 randomized controlled trials involving 670 patients with Gram-positive bacteraemia were included. The results indicated that there was no significant difference between linezolid and vancomycin groups in treatment of Gram-positive bacteraemia [RR= 1.07, 95%CI (0.98,1.17), P= 0.15], MRSA bacteraemia [RR=1.22, 95%CI (0.97,1.53), P= 0.10] or catheter-related bacteraemia [RR= 1.01, 95%CI (0.86,1.19), P= 0.90]. There was no difference between groups in the total adverse effect (P=0.64). The rate of renal dysfunction was higher in vancomycin group (P=0.0003) and the rate of thrombopenia was higher in linezolid group (P=0.01). Conclusion Linezolid is associated with the outcomes that are not inferior to those of vancomycin in the patients with Gram-positive bacteraemia. More high-quality, large-scale randomized controlled trials exclusive for the bacteraemia are required.
目的 了解成都市卧床老年人的抑郁发生情况及影响因素。 方法 对2009年12月－2011年2月卧床时间＞1个月的325例卧床老年人采用老年抑郁量表、焦虑自评量表、生活满意度指数A进行调查，并对影响的抑郁的相关因素进行统计分析。 结果 成都市卧床老年人抑郁的发生率为57.5%。不同病情、生活自理能力、焦虑情况、社会交往情况、生活的满意度和家庭功能的老年人，其抑郁评分差异有统计学意义（P＜0.05）。多重线性回归分析发现影响老年人抑郁的主要因素有病情、卧床分级、焦虑、社会活动、满意度、文化程度，其中对生活满意、有社会活动、文化程度高是保护因素，而焦虑、病情较重、卧床等级高是抑郁的危险因素。 结论 卧床老年人的抑郁发生率较高，应加强对卧床老年人，特别是病情重、焦虑、大部分或者全天卧床、低文化的卧床老人抑郁发生的关注，鼓励老年人增加社会活动、提高老年人对生活的满意度和增进他们的心理健康。
Methods To explore the level of delirium knowledge of geriatric nurses in Sichuan province and analyze the factors, so as to provide the basis for systematic and targeted knowledge training on delirium and clinical management. Methods Using the self-designed “the Questionnaire of Elderly Delirium Knowledge”, geriatric nurses from 22 hospitals in Sichuan province were investigated through a convenient sampling method from September 2018 to February 2019. Results A total of 475 geriatric nurses were investigated. The average delirium knowledge score of the 475 geriatric nurses was 69.51±12.42. Multiple linear regression analysis showed that the main factors affecting the score of delirium-related knowledge were the education of nurses (P=0.037), technical title (P<0.001), years of working in the geriatric department (P=0.001), and the level of working hospital (P=0.001). Conclusions The level of delirium knowledge of geriatric nurses is low and can not meet the needs of clinical work. Nursing managers should carry out delirium knowledge training according to the different characteristics of nurses.
Objective To assess the prevalence of malnutrition in patients with advanced non-small cell lung cancer (NSCLC) using the Global Leadership Initiative on Malnutrition (GLIM) criteria, analyze its associated factors, and explore the adverse effects of malnutrition on advanced NSCLC patients in multiple aspects. Methods Patients with NSCLC who were hospitalized for the first time in the Department of Oncology, Shangjin Hospital, West China Hospital, Sichuan University between January and December 2021 were retrospectively selected as the study objects. Malnutrition assessment was carried out in all patients according to GLIM criteria, and the current situation and related factors of malnutrition were analyzed. The Barthel index scale was used to compare the daily activity ability between the malnourished group and the non-malnourished group, the Quality-of-Life Questionnaire-Core 30 scale was used to compare the quality of life between the two groups, and the adverse reactions of the two groups were compared by the hospital information system course records. Results According to GLIM diagnostic criteria, 134 of 285 patients (47.0%) were diagnosed with malnutrition. The results of binary multiple logistic regression analysis showed that age [60-69 vs. <60 years old: odds ratio (OR)=2.323, 95% confidence interval (CI) (1.277, 4.397); ≥70 vs. <60 years old: OR=10.816, 95%CI (4.185, 27.959)], previous medical history [OR=2.740, 95%CI (1.313, 5.717)], and albumin level [OR=0.905, 95%CI (0.848, 0.965)] were associated with malnutrition in patients with advanced NSCLC (P<0.05). The daily activity ability and quality of life in the malnourished group were significantly worse than those in the non-malnourished group (87.57±12.48 vs. 91.82±6.77, P<0.05; 76.22±11.52 vs. 83.96±9.75, P<0.05), and the incidence of adverse reactions in the malnourished group was higher than that of the non-malnourished group (50.7% vs. 31.8%, P<0.05). Conclusions The prevalence of malnutrition in patients with advanced NSCLC is high, and advanced age, previous medical history and albumin are related factors of malnutrition in patients with advanced NSCLC. Combined malnutrition may have adverse effects on mobility, quality of life and adverse effects of anti-tumor therapy in advanced NSCLC patients.
【Abstract】Objective To provide experimental evidence for gene therapy of thrombophilia diseases by constructing eukaryotic expression plasmid of human thrombomodulin(hTM) gene and transfecting the plasmid into COS7 cell and human umbilical vein endothelial cells(HUVECs). Methods The coding fragment of hTM gene was amplified by PCR. Both hTM gene and pcDNA3.1(+)/neo empty vector were digested with HindⅢ and EcoRⅠ. Two digested fragments were combined into pcDNA3.1/hTM with T4DNA ligase. After identification, the pcDNA3.1/hTM was transfected into COS7 cell and HUVECs using cation liposome. The expression of hTM mRNA and protein on the COS7 cell and HUVECs was detected by RTPCR and immunohistochemistry respectively. Results The hTM recombinant plasmid was confirmed by double endonuclease digesting and sequencing. It was transfected into COS7 cell and HUVECs successfully with liposome.Conclusion The pcDNA3.1/hTM plasmid can be successfully constructed and highlevel hTM can be expressed in eukaryotic cells. All of this provides us experimental evidence for gene therapy and further study of TM anticoagulant mechanism.
Objective To analyze the clinical characteristics of the Guang’an Omicron epidemic and summarize the management experiences and practices in pandemic prevention and control of major infectious diseases.Methods Retrospective analysis was performed on patients infected with coronavirus disease (COVID-19), afterwards treated and observed in the isolation ward of Guang’an People’s Hospital and the shelter of Guang’an City from May 9 to June 26, 2022. The characteristics of patients at different age stages and the related factors affecting the severity, re-positive and negative conversion was analyzed. Results Finally 1 278 patients were collected, including 508 males and 770 females, with an average age of 41.3±22.6 years. Among them, 1 054 patients were asymptomatic carriers. The overall severe rate was 0.86%, the severe rate of the high-risk group was 3.06%. The median negative conversion time was 10.0 days and re-positive rate was 7.36%. Patients aged＞60 years were 2.589 times more likely to have a longer negative conversion time than those aged≤60 years (95%CI 1.921-3.489, P＜0.001). Conclusion The clinical characteristics of Guang’an COVID-19 epidemic are mainly that the elderly with high risk factors are more likely to develop severe cases, have longer clearance time, and re-positve is more likely to occur.
Objective To investigate and assess the current status of communication between medical students and old patients so as to improve the communication skills of medical students. Methods A total of 90 medical students were surveyed by a questionnaire. Data analysis was performed with SPSS 13.0 software. Results Medical students have recognized the importance of communication with patients, but they rarely had active communication behaviors. In addition, their knowledge of communication skills was utterly inadequate. Conclusion It is necessary to strengthen the training of communication skills among medical students.