T-score Research Articles

Comparison of the disinfection effects of different skin disinfectants on central venous catheter in immune-deficient patients

Objective To compare the effect of the 2% chlorhexidinegluconate disinfectant and 0.5% iodophor disinfectant on the maintenance of central venous catheter (CVC) in patients with immunodeficiency. Methods The patients were randomly divided into two groups. 2% chlorhexidinegluconate disinfectant was used in the experimental group, and 0.5% iodophor disinfectant was used in the control group. The CVC was sterilized once a week and continuously maintained for 3 weeks. According to the condition of catheter, the dressing was changed in time in case of any problem,and the reason and time for the catheter nursing care were recorded. The duration of changing the catheter dressing in different disinfectant, incidence rate of dressings looseness and incidence of catheter-related infections in two groups were analyzed. Results The duration of skin drying and duration of caring in the experimental group were (0.62±0.10)min, (11.67±0.33) min, significantly shorter than the control group [(1.97±0.18) min, (14.48±0.33) min](t values were 63.044, 57.296, P 0.05). Conclusions Both 2% chlorhexidinegluconate and 0.5% iodophor disinfectant have similar disinfection effect on CVC caring, but 2% chlorhexidinegluconate disinfection is more efficient and worthy of application in clinical settings. Key words: Chlorhexidinegluconate; Iodophor; Hematopoietic stem cell transplantation; Central venous catheter

Effect of multidisciplinary team-based precise nursing on fatigue-pain-sleeping disorder symptom cluster of lung cancer patients undergoing hemotherapy

Objective To investigate the effect of multidisciplinary team-based precise nursing on fatigue-pain-sleeping disorder symptom cluster of lung cancer patients received chemotherapy. Methods A total of 110 lung cancer patients who received chemotherapy were randomly divided into study group (55 cases) and control group (55 cases) . The control group received routine nursing, while the study group carried out multidisciplinary team-based precise nursing. The degree of fatigue, pain and sleeping disorder was assessed by Multidimensional Fatigue Inventory-20 (MFI-20), Brief Pain Inventory-Chinese version (BPI-C) and Pittsburgh Sleep Quality Index (PSQI), respectively. Results Before intervention, the scores of fatigue, pain and sleep quality showed no significant difference (P>0.05). After intervention, the scores of physical fatigue, psychological fatigue, mental fatigue and total fatigue in MFI-20 were 17.78±3.96, 8.02±1.58, 10.19±2.01, 35.98±4.96 in the study group; the scores of pain right now, pain at least in the 24 hours, pain at worst in the 24 hours and pain on the average in BPI-C were 3.76±0.53, 2.15±0.39, 4.11±0.77, (2.72±0.43) in the study group; the scores of the habitual sleep efficiency, sleep latency, subjective sleep quality, sleep duration, sleep disturbances, daytime dysfunction, use of sleeping medication scores and total scores in PSQI were 0.96±0.20, 1.66±0.27, 1.74±0.36, 1.58±0.22, 1.12±0.21, 1.70±0.30, 1.45±0.28, 10.20±0.61 in the study group. However, those scores were 18.84±2.99, 9.15±1.95, 11.06±3.71, 39.05±5.28 and 5.42±1.18, 3.58±0.59, 6.18±1.44, 3.85±0.78 and 1.12±0.19, 1.74±0.27, 1.91±0.25, 1.66±0.46, 1.33±0.32, 1.75±0.29, 1.33±0.42, 10.85±0.70 in the control group. The scores of psychological fatigue, total fatigue, pain right now, pain at least in the 24 hours, pain at worst in the 24 hours, pain on the average and habitual sleep efficiency, subjective sleep quality, sleep disturbances and total PSQI scores were all significantly decreased in the study group compared to the control group (t values were 2.815-14.873, P<0.01). Conclusion Multidisciplinary team-based precise nursing can alleviate fatigue-pain-sleeping disorder symptom cluster of lung cancer patients during received chemotherapy. Key words: Multidisciplinary team; Precise nursing; Lung cancer; Chemotherapy; Symptom cluster

Effect of chin-down-plus-larynx-tightening maneuver on improving choking cough and swallowing function in patients after esophageal cancer surgery

Objective To explore the effect of Chin-down-plus-larynx-tightening maneuver on improving choking cough and swallowing function in patients after esophageal cancer surgery. Methods A total of 121 patients with esophageal cancer surgery had been randomly divided into control group and observation group from November 2018 to September 2019. Starting from feeding after surgery, the head and neck were in normal habits when swallowing in the control group, and the observation group used Chin-down-plus-larynx-tightening maneuver to perform swallowing training. The feeding process of two groups was observed and recorded for one week. One week after eating, the water swallowing test and M. D. Anderson Symptom Inventory for Gastrointestinal cancer (MDASI-GI) were used to evaluate the difference of swallowing function and gastrointestinal symptoms between the two groups. Results During one week period of feeding, the incidence of choking cough in observation group was 3.39%, (2/59), which was significantly lower than that in the control group (14.52%, 9/62)(χ2 value was 4.53, P=0.033). After one week of feeding, the swallowing function showed significant difference (Z value was 6.07, P=0.014), the gastrointestinal symptoms and the degree of life interference caused by gastrointestinal symptoms of observation group scored 2.57 ± 0.81, 1.76 ± 0.84, lower than those of the control group (4.25 ± 1.54, 2.18 ± 1.24), and the difference was statistically significant(t values were -7.56, -2.17, P<0.05). Conclusions The Chin-down-plus-larynx-tightening maneuver can promote recovery of postoperative swallowing function in patients with esophageal cancer, reduce the incidence of choking cough, and help reduce the symptoms of digestive tract, and then raise the level of patient′s clinical prognosis. Key words: Chin-down-plus-larynx-tightening maneuver; Esophageal cancer; Choking cough; Swallowing function

STATISTICAL PROCESSING OF THE METEOROLOGICAL DATA FOR CONCLUSION ON THE PRESENCE OF THE TIME TRENDS

The technic of the processing of the meteorological data for conclusion on the presence of the time trends in the quantitative characteristics of the weather on the example of the analysis of the average yearly atmospheric temperature change at the meteorological station Minsk from 1989 is presented. The average yearly atmospheric temperature received from the measurements is approximated by the least square error method in the linear time dependence regression function. The linear time dependence regression function received in such a way has some positive growing (positive trend). The aim of this paper is to clarify the significance of this growth. For this aim, the usage of the regression analysis with its procedures of hypotheses testing is proposed. First of all, the performing of the demands presented to the regression analysis is checked: normality of the distribution of the disturbance and the homogeneity of the variance (dispersion) of the disturbance. The normality of the distribution of the disturbance was checked and confirmed by the Kolmogorov test. The homogeneity of the dispersion of the disturbance was checked and confirmed both by checking the hypotheses on the equality of the dispersions of two normal distributions and by the Smirnov test for checking the hypotheses on the equality of two distributions. For checking the significance of the positive trend of the yearly mean temperature, the hypotheses on the significance of the coefficients of the linear regression function by the Student t-statistics and the hypothesis on the linear connection presence by the analysis of variance were checked. As the result, the insignificance of the positive linear trend from 1998 to 2016 and from 1998 to 2017 and its significance from 1998 to 2018 and from 1998 to 2019 on the level of significance 0.05 for mean average yearly atmospheric temperature at the meteorological station Minsk was stated.

Effects of video teaching combined with empowerment theory on rehabilitation training in elderly patients undergoing total knee arthroplasty

Objective To investigate the effects of video teaching combined with empowerment theory on activation of rehabilitation training and prognosis in elderly patients undergoing total knee arthroplasty (TKA). Methods A total of 174 elderly TKA patients from September 2017 to September 2018 were selected and assigned into 2 groups (87 cases each group) by random number table, the control group was given routine nursing, on the basis of the control group, the observation group was given rehabilitation training instruction based on video teaching and empowerment theory. The time of intervention was 3 months. Patient Activation Measure(PAM) was used to assess the activation of rehabilitation training of patients in the 2 groups, Hospital for Special Surgery knee Score (HSS) was used to assess the patients′ prognosis. Results After intervention, the scores of cognitive, skill, action, belief dimensions and the total score of the observation group were (11.24±1.49), (31.94±3.59), (22.59±3.02), (16.82±2.34), (82.59±6.29) significantly higher than (9.42±1.47), (29.48±4.29), (20.24±3.31), (14.29±2.57), (73.43±5.63) of the control group, the difference was significant (t value was 4.102-10.121, all P <0.01). After intervention, the HSS scores of the observation group was (79.24±3.78), which was significantly higher than (72.45±3.13) of the control group (t value was 12.905, P<0.01). Conclusions The rehabilitation training instruction based on video teaching combined with empowerment theory can improve activation of rehabilitation training and function recovery of knee joint in elderly TKA patients. Key words: Health education; Empowerment theory; Total knee arthroplasty; Rehabilitation training

Effect of nurse-led multiple disciplinary team-based intervention in the prevention of venous thromboembolism in paitents undergoing general surgery

Objective To investigate the effect of nurse-led multiple disciplinary team-based intervention in the prevention of venous thromboembolism in paitents undergoing general surgery. Methods A total of 118 patients who underwent general surgery in the Tianjin First Central Hospital from May 2017 to October 2018 were divided into study group and control group by random digits table method, with 59 cases in each group. The control group received routine thrombosis prevention nursing, the study group carried out nurse-led multiple disciplinary team-based intervention. The condition of lower limbs deep venous hemodynamic was detected by color Doppler ultrasonography at 3 days after surgery, the levels of D-dimer, thrombelastograph coagulation analyzer (TEG) coagulation parameters were also measured at after 24 hours of admission and postoperative day 3, respectively. Results The vein blood stasis rate was 94.9% (3/59) in the study group, 79.7% (12/59) in the control group, the venous blood flow of the lower 1imbs in the study group was better than that in the control group (Z value was 2.477, P<0.05). At 3 days after surgery, the levels of D-dimer were (5.26±1.42) mg/L in the study group, (6.36±1.58) mg/L in the control group, D-dimer was decreased in study group compared to the control group, the difference was statistically significant (t value was 3.991, P<0.05). Coagulation reaction time(R) value and solidification angle(Angel), maximum thrombus intensity(MA), composite coagulation index(CI) levels were (5.30±0.91) min, (69.64±21.93) deg, (65.40±13.76) mm and (1.23±0.20) in the study group, those index were (4.41±0.75) min, (76.64±16.02) deg, (70.98±13.39) mm, (2.09±0.36) in the control group, R value were increased and Angel, MA, CI levels were decreased in the study group compared to the control group (t value was 2.001-15.997, P<0.05). Conclusions Nurse-led multiple disciplinary team-based intervention improves the lower limbs deep venous hemodynamic and coagulation function, as well as reduce the incidence of venous thromboembolism. Key words: Nurses; Multiple disciplinary team; Venous thromboembolism; Prevention

The current status on attitude to death and its influencing factors among oncology nurses

Objective To investigate the attitude to death of oncology nurses and analysis its influencing factors,so as to provide scientific references and basis for care of the dying patients. Methods A convenience sampling method was used to 309 nurses from Eastern Hepatobiliary Surgery Hospital,the Third Affiliated Hospital of Naval Military Medical University.The survey was conducted by filling in the electronic questionnaire which powered by sojump.com. The questionnaire was composed with a demographic survey and Chinese version Death Attitude Profile-Revised. Results In the five dimensions of Death Attitude Profile-Revised,the highest factor score was in Approach Acceptance(3.56±0.74),the second was in Escape Acceptance(3.54±0.85) and the lowest was in Natural Acceptance(2.30±0.53).There was a statistically significant difference in the number of years of work in Nautral Acceptance(F value was 3.400, P<0.05).Parents with or without religious beliefs had statistically significant differences in Death of Avoidance(t value was 6.207, P<0.05). Consciously aware that the current physical condition was statistically different from Approach Acceptance and Escape Acceptance(F value was 3.494, 2.606, all P<0.05).Consciously the current psychological status was statistically different in Death Fear and Approach Acceptance and Escape Acceptance(F value was 3.381, 3.125, 3.911, all P<0.05).The situation of talking death in the family was statistically different between Death Fear and Death of Avoidance (F value was 2.899, 2.762, all P<0.05).There was a statistically significant difference in Death Fear and Death of Avoidance and Death Education (F value was 3.581, 5.336, all P<0.05). Conclusions The attitude to death in 309 oncology nurses is relatively passive.The main influencing factors are work experience and parents with or without religious beliefs and the situation of talking death in the family physiology and psychology conditions,whether or not receive death education. Key words: Attitude to death; Oncology nurse; Influencing factors

Effect of swallowing training on dysphagia patients after anterior cervical decompression and interbody fusion

Objective To explore the effect of swallowing function training on dysphagia patients after anterior cervical decompression and interbody fusion. Methods From January 2014 to January 2018, 119 patients with anterior cervical decompression and interbody fusion and difficulty in swallowing were divided into intervention group (59 cases) and control group (60 cases) by random digits table method. Patients in the control group were given routine hospital nursing and health education, while patients in the intervention group were given swallowing function training for 6 months, and swallowing function and quality of life were evaluated by Water Swallow Test and M.D.Anderson Dysphagia Inventory(MDADI) and compared between the two groups. Results There was no significant difference in swallowing function and quality of life between the two groups(P> 0.05). After intervention, Water Swallow Test score was 2.00 (1.00, 3.00) in the intervention group, and 3.00 (2.00, 4.00) in the control group, the difference was statistically significant (Z value was 3.205, P < 0.01). After intervention, the total score of MDADI and general, emotional, social and physiological functions dimensions was (69.91 ± 10.59), (3.37 ± 0.63), (21.37 ± 2.97), (17.91 ± 2.14), (27.26 ± 4.19) in the intervention group, and (64.61 ± 9.78), (2.96 ± 0.66), (19.69 ± 3.03), (16.48 ± 4.41) in the control group, the difference was statistically significant (t value was 2.257-3.714, all P < 0.05). Conclusions Swallowing function training can improve the range and strength of patients' oral, tongue, cheek, mandible and pharynx and larynx muscles, and help improve patients' dysphagia and quality of life. Key words: Nursing care; Dysphagia; Intervertebral fusion; Cervical vertebra

The clinical research on the efficacy of Tanreiqing injection combined with routine western medicine in treating chronic obstructive pulmonary disease at acute and aggravating period with syndrome of phlegm-heat obstructing lung

Objective To evaluate effect of Tanreqing injection combined conventional western medicine therapy on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of Phlegm heat obstructing Lung. Methods A total of 112 patients with AECOPD were randomly divided into two groups with digital table method from February 2015 to February 2018, 56 cases in each group. The control group was treated byconventional western medicine therapy, and treatment group was treated by Tanreqing injection based on control group. Both groups' treatment lasted for 2 weeks. The modified version of British Medical Reseach Council respiratory questionnaire (mMRC) was used for severity evaluation in breath difficulty. The COPD assessment test (CAT) was used for the assessment of symptoms, activity ability, psychological, social impact and sleep. The FEV1% and FEV1/FVC were recorded. The SaO2, PaO2 and PaCO2 were recorded. The phlegm heat obstructing lung symptom scores were detected. The adverse reactions were recorded. Results The total effective rate of treatment group was 94.4% (51/54), and the control group was 77.3% (41/53). There was statistically significant difference between two groups (χ2=5.138, P=0.023). After treatment, the mMRC and CAT scores in the treatment group were significantly lower than those in the control group (t value were 17.233, 17.111, respectively, all Ps<0.01); the cough, wheezing, shortness of breath, fever, dry mouth, constipation scores were significantly lower than the control group (t value were 27.717, 29.387, 27.227, 30.268, 28.430, 29.738, respectively, all Ps<0.01). After treatment, the FEV1% (52.34% ± 5.79% vs. 46.98% ± 5.72%, t=4.817), FEV1/FVC (61.36 ± 6.52 vs. 56.93 ± 5.94, t=3.675) in the treatment group were significantly higher than the control group (P<0.01); SaO2 (90.11% ± 9.53% vs. 83.56% ± 8.84%, t=3.684); the PaO2 (91.22 ± 9.79 mmHg vs. 85.18 ± 8.80 mmHg, t=3.354) significantly higher than the control group (P<0.01), and PaCO2 (44.75 ± 4.94 mmHg vs. 51.05 ± 5.46 mmHg, t=6.261) significantly lower than the control group (P<0.01). The incidence of adverse reactions in the treatment group was 11.1% (6/54), and the control group was 7.5% (4/53). There was no statistically significant difference between two groups (χ2=0.091, P=0.763). Conclusions Tanreiqing injection combined with conventional western medicine therapy can take effectsimprove levels of SaO2 and PaO2, reduce PaCO2 level of the AECOPD patients. Key words: Pulmonary disease, chronic obstructive; Acute disease; Phlegm heat obstructing Lung; Tan Re Qing Zhu She Ye; Integrated Chinese traditional and western medicine therapy; Drug-related side effects and adverse reactions

Comparison of 18F-Flurpiridaz and 13N-NH3·H2O PET/CT myocardial perfusion imaging in animal experiments

Objective To explore the biodistribution and quantitative value of 18F-Flurpiridaz in mini-swine, and compare with 13N-NH3·H2O. Methods Ten Bama mini-swine were divided into normal group and myocardial infarction group (n=5 in each group). Normal group was not treated and myocardial infarction group was modeled by thoracotomy and coronary artery ligation. Both groups were preceded by 13N-NH3·H2O imaging, followed by 18F-Flurpiridaz imaging (time interval >40 min). Injection dosage of 2 tracers was the same (185-370 MBq). 18F-Flurpiridaz whole-body PET/CT imaging was also performed in normal group. Biological distribution of 18F-Flurpiridaz was observed, and the ratio of radioactive uptake of 18F-Flurpiridaz between myocardium and adjacent tissues or organs was calculated. Image quality score and rest myocardial blood flow (rMBF) of 2 imaging tracers in normal group were measured and compared. MPI image quality score, cardiac function parameters such as summed rest score (SRS), myocardial infarction area percentage, total perfusion defect (TPD), and left ventricular ejection fraction (LVEF) of 2 imaging tracers were compared in myocardial infarction group. Data was analyzed by paired t test. Results In normal group, 18F-Flurpiridaz in the myocardium was clearly observed, with high radioactive uptake maintaining within 2 h postinjection. The radioactivity count ratios of left ventricular myocardium to cardiac pool, the lungs and liver were high (5.19-12.87, 4.17-50.51, 2.08-6.92). The quality of 18F-Flurpiridaz MPI images in both groups was excellent (10/10). The rMBF (ml·g-1·min-1) in different regions of left ventricle measured by 18F-Flurpiridaz and 13N-NH3·H2O imaging were not significantly different (left anterior descending: 0.98±0.06 vs 0.92±0.13; left circumflex: 0.98±0.05 vs 0.88±0.12; right coronary artery: 0.95±0.07 vs 0.88±0.15; left ventricle: 0.96±0.07 vs 0.90±0.13; t values: from -1.70 to -0.90, all P>0.05). There was no significant difference in SRS, myocardial infarction area percentage, TPD, rMBF or LVEF between 18F-Flurpiridaz and 13N-NH3·H2O (SRS: 10.6±4.1 vs 9.2±4.6; myocardial infarction area percentage: (15.2±9.0)% vs (12.6±6.6)%; TPD: (11.6±6.3)% vs (9.6±3.9)%; LVEF: (68.6±11.1)% vs (71.4±11.3)%; t values: -2.33-2.75, all P>0.05). Conclusions Comparing with 13N-NH3·H2O, 18F-Flurpiridaz has the advantages of good MPI image quality, accurate measurement of cardiac function parameters and quantitative potential of myocardial blood flow, which make it as a promising positron myocardial perfusion imaging agent. Key words: Myocardial perfusion imaging; Pyridazines; Fluorine radioisotopes; Ammonia; Positron-emission tomography; Tomography, X-ray computed; Swine

Experimental study of SPECT imaging with novel myocardial perfusion imaging tracer: 99Tcm-3SPboroxime

Objective To assess the superiority of 99Tcm-3SPboroxime (99Tcm-3SP for short) as a fast-myocardial perfusion imaging (MPI) tracer in normal and acute myocardial infarction (AMI) mini-swine. Methods 99Tcm-3SP and 99Tcm-Teboroxime (99Tcm-TEBO for short) were prepared. Approximately 370 MBq 99Tcm-3SP or 99Tcm-TEBO was injected intravenously in 2 healthy mini-swine separately. Dynamic planar images were acquired immediately after injection and continued for 20 min using a standard SPECT camera. The radioactivity uptakes in the heart, liver, and lungs were measured, and heart/liver and heart/lung ratios over time were calculated. Dynamic SPECT studies were performed in 4 normal swine and 1 AMI-swine using cadmium zinc telluride-SPECT (CZT-SPECT). List mode acquisitions were immediately started and continued for 15 min after intravenous injection of approximately 370 MBq 99Tcm-TEBO and 99Tcm-3SP. The injection of two radiotracers in the same swine was completed within 2 d. The radioactivity uptakes in heart and liver were measured, and heart/liver ratio was calculated. Image quality was also evaluated. Paired t test was used to analyze the data. Results The radiochemical purity of 99Tcm-TEBO or 99Tcm-3SP were both above 95%. The initial heart uptake of 99Tcm-3SP was very close to that of 99Tcm-TEBO (planar image, 2 min postinjection: 309.32×103vs 314.13×103 counts/MBq; SPECT image, 2 min postinjection (corrected): 7.96±0.87 vs 8.24±1.53, t=0.277, P>0.05), but the myocardial retention time was much longer than that of 99Tcm-TEBO (planar image, 20 min postinjection: 218.67×103vs 143.19×103 counts/MBq; SPECT image, 15 min postinjection (corrected): 6.76±0.45 vs 5.06±0.33, t=-12.412, P=0.001). The uptake of liver and heart/liver ratio between 99Tcm-TEBO and 99Tcm-3SP were similar (t values: -1.332-1.101, all P>0.05 within 15 min). SPECT MPI images demonstrated uniform tracer distribution with clearly visualizable myocardial boundary in normal myocardium and intense perfusion defect in infarct myocardium. High quality SPECT images could be obtained in any of the 5 min imaging windows over the first 15 min after injection of 99Tcm-3SP in normal swine and AMI-swine. Conclusion 99Tcm-3SP is a promising 99Tcm-labeled radiotracer for fast-MPI considering its high heart uptake, long myocardial retention time (20 min postinjection) and superior SPECT image quality. Key words: Myocardial perfusion imaging; Oximes; Boronic acids; Technetium; Tomography, emission-computed, single-photon; Swine

Effect of health management based on protection motivation theory on the outcome of stroke patients

Objective To investigate the effects of health management based on the theory of protection motivation on fatigue status, neurological function recovery and life ability of stroke patients, and evaluate its clinical effects. Methods A total of 120 stroke patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2019 were selected as subjects. Randomized digital table method was used to divided them into observation group and control group, 60 cases in each group; the control group underwent routine nursing and follow-up of neurology, and the observation group was given health management based on protection motivation theory on the basis of the control group. The Fatigue Severity Scale (FSS) was used to assess the patient's fatigue, the European Stroke Scale (ESS) was used to evaluate the patient's neurological function, the modified Barthel index was used to assess the patient's viability. The fatigue, neurological recovery, and changes in living ability were compared between the two groups before and after the nursing intervention. Results The Scores of FSS, MBI and ESS of the observation group were 45.34±8.84, 54.3±4.69 and 45.24±4.18 before intervention and 32.48±5.80, 75.50±4.93, 63.12±3.32 after intervention. The Scores of FSS, MBI and ESS of the control group was 44.97±8.47, 53.47±4.20, 43.48±5.67 before intervention and 39.59±7.43, 63.81±3.25, 55.32±3.48 after intervention. The difference after intervention between the two groups was statistically significant (t values were 15.335, 12.562, 5.843, P<0.01). The difference in the observation group before and after intervention was statistically significant (t values were 9.422, 24.133, 25.945, P<0.01). The differences in the control group before and after intervention was statistically significant (t values were 3.699, 15.082, 13.786, P<0.01). Conclusions Health management based on the theory of protection motivation is more effective than routine nursing to improve the fatigue, neurological function and life ability of stroke patients. Key words: Protection motivation theory; Health management; Stroke; Fatigue; Neurological function; Living ability

Discussion on the effect of comprehensive nursing in endoscopic treatment of esophageal and gastric varicose bleeding

Objective To explore and analyze the effect of comprehensive nursing care in endoscopic treatment of esophageal and gastric varicose bleeding. Methods A retrospective analysis of 60 cases of patients with esophageal and gastric varicose hemorrhage admitted to the hospital was conducted. The patients were randomly divided into 30 cases of control group and 30 cases of observation group. Routine nursing and comprehensive nursing were adopted respectively to evaluate different nursing effects. Results Intraoperative and postoperative heart rate of the observation group (91.0 ± 4.0) times/min, (89.2 ± 4.2) times/min, which were lower than (98.0 ± 4.2) times/min, (94.7 ± 4.5) times/min of the control group. There was statistically significant difference (t values were 6.610, 4.894, P < 0.05). The bleeding prevention effectiveness rate of the observation group (93.33%, 28/30) was higher than the control group (73.33%, 22/30), The difference was statistically significant (χ2 value was 4.32, P < 0.05). The total nursing satisfaction rate (100.00%, 30/30) in the observation group was higher than that in the control group (86.70%, 26/30), the difference was statistically significant (χ2 value was 4.29, P< 0.05). Quality of life, disease cognition, compliance behavior, proper rest, self-protection, General Quality of life Inventory (GQOLI) score in the observation group were (33.5 ± 3.5), (21.5 ± 3.7), (32.5 ± 2.8), (21.5 ± 3.3), (22.0±4.2), (130.2 ± 17.4) points, which were higher than those in the control group (28.2 ± 3.2), (17.5 ± 2.5), (28.5 ± 3.0), (17.2 ± 3.0), (18.0 ± 3.0), and (110.2 ± 15.2) points. The differences were statistically significant (t values were 4.245-6.121, P<0.05). Conclusions Endoscopic treatment of esophageal and gastric varicose bleeding patients combined with comprehensive nursing intervention, can effectively prevent the occurrence of rebleeding, improve the quality of life of patients. The application effect is significant. Key words: Nursing care; Endoscopy; Esophageal and gastric varicose bleeding

Effect and satisfaction evaluation of post-abortion care service based on Wechat follow-up on contraceptive compliance of repetitive induced abortion patients

Objective To explore the effect of post-abortion care service based on Wechat follow-up on contraceptive compliance of multiple induced abortion patients, and to evaluate the satisfaction with PAC service. Methods A quasi-experimental method was adopted. A total of 300 cases of induced abortion were selected in Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University from March 2018 to March 2019, with 150 cases from eastern branch in the experimental group and 150 cases from western branch in the control group. The control group received routine nursing care and post-abortion care service based on telephone follow-up, while the experimental group received routine nursing care and post-abortion care service based on Wechat follow-up. The missing rate of follow-up, the contraceptive method and the occurrence of unexpected pregnancy within one year after operation were collected in the two groups. Patients′ follow-up compliance and nursing satisfaction were evaluated. Results The awareness of the risk of induced abortion in the experimental group was 90.4% (120/135) higher than that in the control group 77.5% (88/111), and the difference was statistically significant (χ2 value was 9.128, P=0.010). The contraceptive consciousness of the two groups was 99.3% (134/135) and 94.6% (105/135), respectively, and the difference was not statistically significant (χ2 value was 3.256, P=0.071). There was a statistically significant difference in the missing rate of follow-up between the two groups in January, March, June, and December (χ2 value was 13.664, P=0.003). Compared with 19.8% (22/111) in the control group, 73.3% (99/135) patients in the study group chose high-efficiency contraception, the difference was statistically significant (χ2 value was 69.795, P<0.01).There were no recurring pregnancies in the experimental group within one year, compared with 6.3% (7/111) in the control group, the difference was statistically significant (χ2 value was 6.630, P=0.003). In the experimental group, the participation rate of the follow-up were (95.37±12.29)%, which were higher than that in the control group (90.77±16.49)%. The difference was statistically significant (t value was 2.438, P<0.05). The overall satisfaction score of the experimental group was 26.55 ± 2.80, which was higher than that of the control group (23.66 ± 3.32). The difference was statistically significant (t value was 7.285, P <0.01). Conclusion Post-abortion care service based on Wechat follow-up could enhance patients′ compliance and satisfaction, guide patients to choose the right contraceptive methods, reduce the rate of repeated abortion and promote female reproductive health. Key words: Post-abortion care; Repeated induced abortion; Contraception; Follow-up; Compliance

Application effect of synchronous disinfection of lower limbs in PICC puncture of very low birth weight infants

Objective To explore the study of synchronous disinfection of lower limbs and unilateral limb disinfection when peripheral inserted central catheters is inserted into the lower limbs of very low birth weight infants, and to find a better and safer method of puncture disinfection. Methods Total of 30 cases of children who received unilateral limb disinfection from January 2016 to February 2017 were selected as the control group, and 30 cases of children who received simultaneous disinfection of both lower limbs from March 2017 to June 2018 were selected as the experimental group, and non-random and non-synchronous control studies were conducted. The operation time, blood loss, times of placing sterile table and retained site of the two groups were analyzed retrospectively. Results The operation time of synchronous disinfection of lower limbs in the experimental group and the control group were (43.67±28.04) min, (60.33±35.40) min; the amount of blood loss were (1.64±0.90) ml, (2.34±1.50) ml, the differences were statistically significant (t values were 2.021, 2.176, P<0.05). In the control group, 76% (21/30) completed the PICC operation after laying a sterile operation table, while in the experimental group, 96% (28/30) did. In the control group, 5 cases were successfully indwelling via femoral vein, and in the experimental group, 2 cases were successfully indwelling via femoral vein. Conclusion The method of simultaneous disinfection of lower limbs increases the selection of peripheral veins, reduces the frequency of sterile table, blood loss and operation time, and reduces the number of inguinal vein puncture, which is relatively safe and effective. Key words: Method of disinfection; Very low birth weight infant; Peripheral inserted central catheters of the lower limbs

Study of clinically-indicated replacement of peripheral intravenous catheters in old adults

Objective To evaluate the safety of clinically-indicated replacement of peripheral intravenous catheters (PIVCs) in old adults. Methods Total of 1 627 patients with peripheral intravenous catheters in emergency wards at a tertiary hospital in shanghai were recruited. Patients were randomly divided into an experimental group (817 cases) and control group (810 cases) by random digits tale method. PIVCs in the experiment were replaced only when clinical indications appeared, while PIVCs in the control group were routinely changed every 72-96 hours. Indwelling time, complications associated with PIVCs and nurse compliance were compared after indwelling peripheral intravenous catheters. Results PIVC indwelling time was (3.43±1.36) days in the experimental group, and (3.18±1.16) days in the control group ,there was significant difference between two groups (t value was 4.07, P 0.05). The severity of phlebitis in the experiment group was higher than that in the control group, and there was significant difference between two groups (χ2 value was 20.99, P<0.05). Nurse compliance achieved in the experimental group 100.00% (817/817) was higher than that in the control group 87.65% (710/810), which showed statistically difference (χ2 value was 107.47, P<0.05). Conclusion Indwelling time in the clinically- indicated replacement group was longer than that of the routine replacement group. Peripheral intravenous catheters in old adults can be remove as clinically-indicated with a close monitoring of complications. Key words: Aged; Peripheral intravenous catheters; Clinically- indicated replacement

Application of gradient cushion on prevention of supine hypotension syndrome undergoing cesarean section

Objective To investigate the application of gradient cushion on prevention of supine hypotension syndrome (SHS) undergoing cesarean section. Methods 450 parturients undergoing cesarean section with spinal and epidural anesthesia, aged 20-45 years, ASA Ⅰ, Ⅱor Ⅲ grades, were randomly assigned into three groups: gradient cushion group (group A), sandbag group (group B) and left-leaning-operating table group (group C), 150 cases in each. The posture intervention was alternated after completion of spinal and epidural anesthesia. Recorded the cases of SHS, and collected systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR) and saturation of pulse oximetry (SpO2) before anesthesia, 2 min, 5 min, 10 min after anesthesia and prefetus removal from uterus. And assessed the position comfort with surgical posture comfort scale. Results The incidence of SHS in group A was 8.0%(12/150), in group B was 20.0% (30/150), and in group C was 21.3% (32/150). The rate of SHS was higher in group A than other groups (χ2 value was 8.970, 10.653, all P<0.01). The score with surgical posture comfort scale was (47.03 ± 3.01), (38.13 ± 4.70), (36.10 ± 4.04), which was higher in group A than group B or group C, and the score with surgical posture comfort scale was higher in group B than group C (t value was 27.413, 30.227, 2.542, P<0.01 or 0.05). SBP and DBP were higher in group A and group B than group C at 2 min, 5 min, 10 min after anesthesia and prefetus removal from uterus, and SBP and DBP were higher in group A than group B at 2 min, 5 min, 10 min after anesthesia and prefetus removal from uterus, HR and RR were higher in group A and group B than group C at 2 min, 5 min, 10 min after anesthesia and prefetus removal from uterus, and HR and RR were higher in group A than group B at 2 min, 5 min, 10 min after anesthesia and prefetus removal from uterus (t value was -15.842-21.117, P<0.05 or 0.01). Conclusion After spinal and epidural anesthesia, applying the gradient cushion for adjustment of position would be effective to reduce the occurrence of SHS, simple to handle, decreasing to change the position and increasing to comfort after position in cesarean section. Key words: Supine hypotension syndrome; Cesarean section; Spinal andepidural anesthesia; Comfort; Gradient cushion

The application effect of family-centered care mode in children′s health care

Objective To study the application effect of family-centered care (FCC) model in children′s health care. Methods The data of 200 children who came to the hospital for outpatient care in our hospital were analyzed. They were divided into two groups according to the principle of random number. 100 cases in the control group were given traditional child health care, and 100 cases in the observation group were treated with FCC. Service care, comparing the implementation of child care services under different care modes. Results After the FCC model was used in the observation group, parents′ knowledge of children′s health knowledge (79.0±6.6), child care compliance 98.0% (98/100), health service effect 95.0% (95/100), nursing satisfaction 96.0% (96/100), the control group was (65.0±5.8), 88.0% (88/100), 80.0% (80/100), and 80.0% (80/100), respectively. There was statistical significance (t value was 15.934, χ2 value was 7.68, 16.50, 12.12, P<0.05). The neuropsychological development scores were evaluated in the two groups. The observation group had a large exercise score (90.9±6.2) and a fine action score (86.8±7.2), adaptability score (96.5±6.5), language score (89.2±2.5), and social development score (88.3±2.5). The control group was (88.2±6.0), (84.0±6.0), (94.0±4.8), (87.9±3.0), (87.0±2.5), and there were statistics between the two groups. Academic significance (t value was 2.253-3.329, P<0.05). Conclusion The implementation of the FCC model in children′s health care can improve children′s understanding of disease knowledge and child care compliance. Key words: Family-centered care; Child care; Children′s diagnosis and treatment compliance; Nursing satisfaction

Effect of normal limbs active exercise rehabilitation training in fear of falling and motor function in patients with cerebral infarction after intervention

Objective To investigate the effectiveness of normal limbs active exercise rehabilitation training in fear of falling and motor function in patients with cerebral infarction after intervention. Methods A total of 74 cerebral infarction after intervention patients were enrolled in Wanbei Coal-Electricity Group General hospital from May 2016 to April 2018. Patients were randomly divided into the observation group 37 patients and the control group 37 patients according to the random number table method. The control group received routine rehabilitation training, normal limbs active exercise rehabilitation was carried out in the observation group. After 3 months of intervention, the fear of falling, activities of daily living, limbs motor function was assessed by short Falls Efficacy Scale International (FES-I), Barthel index, Fugl-Meyer motor function scoring, respectively. Results Before intervention, the short FES-I score was (15.32±3.15) and (15.47±4.89) in the observation group and in the control group respectively, after intervention, the score was (10.21±2.67) and (12.28±4.05), respectively. There was no significant difference in short FES-I scores between the two groups pre-intervention (P> 0.05). However, the short FES-I scores were significantly decreased in the observation group compared to the control group at post-intervention (t value was 2.468, P 0.05). However, those scores were significantly increased in the observation group compared to the control group at post-intervention (t value was 2.562, 2.878, 4.553, P<0.05). Conclusion Normal limbs active exercise rehabilitation training can alleviate the fear of falling and promote motor function and self-care ability of patients with cerebral infarction after intervention. Key words: Cerebral infarction; Interventional therapy; Active exercise; Fear of falling; Motor function

Effects of neonatal intensive care unit environmental factors on the physiological functions of low birth weight premature infants

Objective To explore the influence of neonatal intensive care unit (NICU) environmental factors on physiological function of premature infants, and propose improvement plan. Methods A total of 40 cases of low body mass premature infants from June to December in 2017 in Chongqing Center for Women and Children were selected as the research objects, and 8:00-9:00 of working day was set as the daily period, 10:00-11:00 as the quiet period. Light, sound, touch and other environmental factors in NICU were detected quantitatively, basic vital signs, activity, stress hormones and other changes were recorded, and the impact of environmental factors on the children was analyzed. Results Touch times in daily and quiet periods were (5.02±0.54) times/h and (4.56±0.55) times/h, with no significant difference (P>0.05). The same time as the next two days, the activity of premature infants in quiet period was (8.26±3.10), which was lower than that in daily period (17.52±5.78), and the difference was statistically significant (t value was 8.967, P<0.01). The sleep time of premature infants during quiet period (23.24±8.38) was significantly higher than that of daily period (4.80 ±5.39), the difference was statistically significant (t value was-11.679, P<0.01). The levels of cortisol, epinephrine and norepinephrine in premature infants were (61.53±13.47), (15.91±3.94), (49.22±15.15) μg/L in quiet period, which were significantly lower than those in daily period (74.52±20.98), (23.40±11.66), (80.32±32.43) μg/L (t value was 3.295, 3.848, 5.502, P<0.01). The heart rate and systolic pressure of premature infants in quiet period (130.44±8.06) beats/min, (64.05±10.40) mmHg (1 mmHg=0.133 kPa) were significantly lower than those in daily period (145.21±10.52) beats/min, (72.85±13.36) mmHg, and the difference was statistically significant (t value was 3.340, 2.166, P<0.01 or 0.05). Different time periods on the same day, the activity of premature infants in quiet period was (9.87±3.31), which was lower than that in daily period (19.82±5.57), and the difference was statistically significant (t value was 9.761, P<0.01). The sleep time of premature infants during quiet period (25.75±9.07) was significantly higher than that of daily period (4.70±3.89), the difference was statistically significant (t value was-13.457, P<0.01). The levels of cortisol, epinephrine and norepinephrine in premature infants were (59.42±11.95), (15.78±1.45), (50.90±14.73) μg/L in quiet period, which were significantly lower than those in daily period (71.50±20.56), (25.62±11.95), (79.87±29.91) μg/L (t value was 3.212, 5.169, 3.585, P<0.01). The heart rate and systolic pressure of premature infants in quiet period (136.02±11.22) beats/min, (65.35±9.56) mmHg were significantly lower than those in daily period (144.10±9.18) beats/min, (73.47±12.92) mmHg, and the difference was statistically significant (t value was 3.533, 2.008, P<0.01 or 0.05). Conclusions Children with NICU are generally in high noise and strong light environment, these factors will cause adverse physiological reactions to a certain extent. Key words: Neonatal, premature; Intensive care units; Stress sex hormone