ObjectiveTo explore the application and effect of clinical nursing pathway based on information-knowledge-attitude-practice (IKPA) theory in percutaneous renal needle biopsy.MethodsThis is a historical control study. A total of 460 patients who underwent percutaneous renal biopsy in West China Hospital of Sichuan University between April and December 2020 were prospectively recruited as the pathway group, and a clinical nursing pathway based on IKAP theory was implemented. By contrast, the data of 617 patients who underwent percutaneous renal biopsy and received routine care in the same hospital between April and December 2019 were retrospectively collected as the control group. The length of hospital stay, hospitalization expenses, the incidences of postoperative complications (macroscopic haematuria, perirenal hematoma, and acute urinary retention), the incidence of postoperative postural hypotension, and the management enrollment rate of chronic kidney disease patients were compared between the two groups.ResultsThe length of hospital stay [median (lower quartile, upper quartile): 8 (7, 11) vs. 8 (7, 12) d] and the hospitalization expenses [median (lower quartile, upper quartile): 7380.50 (6401.86, 8789.21) vs. 8167.00 (6816.50, 10044.50) yuan] were less in the pathway group than those in the control group, the incidences of postoperative macroscopic haematuria (1.52% vs. 6.97%) and perirenal hematoma (2.61% vs. 5.02%) were lower in the pathway group than those in the control group, the management enrollment rate of chronic kidney disease patients was higher in the pathway group than that in the control group (26.09% vs. 6.16%), and the differences between the two groups were statistically significant (P<0.05). The differences in the incidences of acute urinary retention (8.26% vs. 11.18%) and postoperative postural hypotension (0.00% vs. 0.81%) between the two groups were not statistically significant (P>0.05).ConclusionThe application of clinical nursing pathway in percutaneous renal needle biopsy can effectively reduce the length of hospital stay and hospitalization expenses, and improve the management enrollment rate of chronic kidney disease patients.
Mild cognitive impairment (MCI) is a clinical transition state between age-related cognitive decline and dementia. Researchers can use neuroimaging and neurophysiological techniques to obtain structural and functional information about the human brain. Using this information researchers can construct the brain network based on complex network theory. The literature on graph theory shows that the large-scale brain network of MCI patient exhibits small-world property, which ranges intermediately between Alzheimer's disease and that in the normal control group. But brain connectivity of MCI patients presents topologically structural disorder. The disorder is significantly correlated to the cognitive functions. This article reviews the recent findings on brain connectivity of MCI patients from the perspective of multimodal data. Specifically, the article focuses on the graph theory evidences of the whole brain structural and functional and the joint covariance network disorders. At last, the article shows the limitations and future research directions in this field.
The paper discusses the scientificity, evidence-based research, clinical practice and related problems of traditional Chinese medicine (TCM) from three aspects: theory, demonstration and application, and attempts to clarify ambiguities and misconceptions, further correctly evaluate the historical status, important value and realistic significance of TCM, strengthen our national and cultural confidence, reinforce our theoretical and practical confidence, and strongly refute the derogation and stigmatization towards TCM theory and practice by very few people, in order to provide suggestions for the progress and development of TCM.
Since 2015, when the day surgery mode was officially reckoned and supported by the National Health Commission, the day surgery model has entered the new period of rapid development. But at the same time, challenges in the vacancy of the evaluation indexes of the medical quality and safety of day surgery still pose obstacles to its growth. At present, there is no nationally unified evaluating index or appraising system for the day surgery-related medical quality and safety. In this paper, based on structure-process-outcome theory, the day surgery practice and involved researching literature were retrieved, reviewed, and analyzed. Also, the practice model at West China Hospital of Sichuan University (a pioneer day surgery hospital in China) was comprehensively compared with the National Clinical Improvement System. From the aspect of day surgery medical quality and safety evaluation indicators, it is hoped to provide an evidence-based method and evaluation of day surgery, and a theoretical basis for establishing policies and data reference.
ObjectiveTo explore the use of comprehensive treatment including drugs, devices and electrophysiology for heart failure patients with surgical indications. MethodsWe collected the clinical data of 65 consecutive cardiac surgical patients with chronic left ventricular dysfunction in our department between March 2014 and May 2016. There were 49 males and 16 females with an average age of 61.3±11.4 years ranging from 37 to 80 years. Their left ventricular ejection fraction was less than 40%. Patients with ventricular dysfunction caused by acute myocardial infarction were excluded. A comprehensive treatment strategy was performed according to patients’ individual disease.ResultsFourty patients underwent cardiopulmonary bypass with asisting time of 55-400 (148.1±69.8) min; 35 patients needed cross-clamping with time of 44-203 (95.7±39.6) min. Intra-aortic balloon pump (IABP) was assisted in 3 patients. Two patients died in hospital. During the follow-up of 13.4 months, the patients’ cardiac function significantly improved and the heart size reduced. Two patients died and two were readmitted for heart failure. Four patients underwent cardiac pacemaker implantation. Other patients with unstable symptoms were stabilized after medical dose adjustment.ConclusionUnder the concept of neuroendocrine inhibition, the comprehensive treatment for heart failure can effectively reduce surgical mortality and improve the patient’s quality of life.
Abstract There have been many types of bone-grafting operation dealing with the congenital pseudarthrosis of the tibia (CPAT), but the failure rate is fairly high. Since 1990, 2 children with CPAT, who had received repeated bone-grafting operation in failure, were treatedaccordingto the Ilizarovs theory and its related technique. The essentials of the operation were: (1) Thorough resection of abnormal bone tissues at pseudarthrosis might freshen the ends of the bone and facilitate bone union. (2) The firm fixation and constant compression force to the bone ends might promote bone healing. (3) The tibial lengthening was performed by osteotomy at the upper tibia. The pseudarthrosis was united in 2～3 months after operation. The patients were followed up from 1 to 3 years, and it was found that the remodelling of thebone was good, no recurrence occured. The advantages were: (1) The bone grafting was no longer necessary. (2) It could give a chance to equalizethe limb length. (3) It could enable early weight bearing and functional exercise.
With the range of application of computational biology and systems biology gradually expanding, the complexity of the bioprocess models is also increased. To address this difficult problem, it is required to introduce positive alternative analysis method to cope with it. Taking the dynamic model of the epidemic control process as research object, we established an evaluation model in our laboratory. Firstly, the model was solved with nonlinear programming method. The results were shown to be good. Based on biochemical systems theory, the ODE dynamic model was transformed into S-system. The eigen values of the model showed that the system was stable and contained oscillation phenomenon. Next the sensitivities of rate constant and logarithmic gains of the three key parameters were analyzed, as well as the robust of the system. The result indicated that the biochemical systems theory could be applied in different fields more widely.
With the surged prevalence of myopia, the pathogenic mechanism underlying myopia has attracted attention. At present, it is generally believed in the flied that the reduced blood perfusion in the choroid is crucial for myopigenesis. Then, in the process of myopigenesis, how are the blurred visual signals transmitted to the choroidal blood vessels through the retina and retinal pigment epithelium, leading to the reduced choroidal blood perfusion. The cellular and molecular mechanisms underpinning this process remain elusive. In recent years, the theory of scleral hypoxia has attracted much attention. Popular signaling molecules in current research include dopamine, epidermal growth factor, retinoic acid, cholinergic molecules and adenosine, etc. These factors are likely to participate in signal transduction in retina and RPE, thus causing changes in choroidal blood flow and affecting the occurrence and development of myopia. Therefore, these signaling factors and their downstream pathways may provide new ideas for the prevention and control of myopia targets.
ObjectiveTo investigate the effect of positive family behavior support on emotional and behavioral problems in preschool children with epilepsy. Methods A total of 80 preschool epileptic children and their parents who were admitted to the Department of Neurology of our hospital from October 2022 to February 2023 were selected as the research objects, and were divided into experimental group and control group with 40 cases each by random number table method. The control group received neurology routine nursing, and the experimental group received positive family behavior support intervention based on the control group. The scores of family intimacy and adaptability scale, strengths and difficulties questionnaire, medication compliance and quality of life of epilepsy children were compared before and after intervention between the two groups. ResultsAfter intervention, the scores of strength and difficulty questionnaire in experimental group were lower than those in control group (P<0.05), and the scores of family intimacy and adaptability scale, quality of life and medication compliance in experimental group were higher than those in control group (all P<0.05). ConclusionThe application of positive family behavior support program can reduce the occurrence of emotional behavior problems, improve family closeness and adaptability, improve medication compliance, and improve the quality of life of preschool children with epilepsy.
Objective To introduce a new theory of shoulder stability mechanism, rebalancing theory, and clinical application of this new theory for the shoulder instability and dysfunction of motion. Methods Through extensive review of the literature related to shoulder instability and dysfunction of the motion in recent years, combined with our clinical practice experience, the internal relation between passive stability mechanism and dynamic stability mechanism were summarized. Results Rebalancing theory of shoulder stability mechanism is addressed, namely, when the shoulder stability mechanism is destructive, the stability of the shoulder can be restored by the rebalance between dynamic stability mechanism and passive stability mechanism. When dynamic stability is out of balance, dynamic stability can be restored by rebalancing the different parts of dynamic stability mechanism or to strengthen the passive stability mechanism. When passive stability mechanism is out of balance, passive stability can be restored by rebalancing the soft tissue and bone of the shoulder. ConclusionRebalancing theory of shoulder stability mechanism could make a understanding the occurrence, development, and prognosis of shoulder instability and dysfunction from a comprehensive and dynamic view and guide the treatment effectively.