Objective To study the causes and nursing points of re-operation after orthotopic liver transplantation (OLT). Methods The clinical data of 241 patients who underwent OLT in the past three years were analyzed, and the causes and nursing of re-operation were summarized. Results In the 241 patients,30 cases underwent re-operation. The incidence of re-operation was 12.4%. The causes included: intra-abdominal bleeding in 14 cases with the incidence of 46.7%, biliary complications in 8 cases with the incidence of 26.6%, 4 cases infection in different organs with the incidence of 13.3%, wound dehiscence in 2 cases with the incidence of 6.7% and recurrence of carcinoma in 2 cases with the incidence of 6.7%. 7 patients died after re-operation with the mortality rate of 13.3%. Conclusions The causes of re-operation after OLT were various, intra-abdominal bleeding and biliary complications were the main factors. Knowing the causes and taking rational nursing helped to raise the survival rate and quality of life after OLT.

Objective:To explore the application and nursing of protein A immunosorbent in patients with neuromyelitis optica spectrum diseases.Methods:Ten patients with neuromyelitis optica spectrum diseases were treated with protein A immunoadsorption therapy. Psychological nursing was emphasized. Comprehensive evaluation was conducted before adsorption to determine the prescription of adsorption therapy. During adsorption therapy, hypotension, membrane rupture and hemolysis of plasma separator, shivering and other adverse reactions were accurately prevented and treated. After treatment, attention should be paid to the prevention of nosocomial infection, regeneration and preservation of adsorption column.Results:After immunoadsorption therapy, the serum IgG level, antibody and EDSS score of 10 patients decreased to varying degrees. The serum IgG decreased from (6.04±2.77)g/L to (2.23±1.74)g/L. No serious complications occurred, no failure of immunosorbent operation, and the patients′ condition was better than before.Conclusions:Protein A immunosorbent therapy for neuromyelitis optica spectrum diseases is safe and effective. Standardized evaluation, operation and nursing are the key to achieve good results.

Objective To explore the mediating effect of health belief on the relationship between health knowledge and health behavior among hypertensive patients with stroke.Methods The questionnaire of Stroke Knowledge Questionnaire (SKQ),Short Form Health Belief Model Scale (SF-HBMS)and health behavior scale for stroke patients (HBS-SP) were used to investigate the health knowledge,health belief and health behavior among 151 hypertensive stroke patients.The structural equation model was established using SPSS 17.0 and Mplus7.0 software.Results The total score of SKQ,SF-HBMS and HBS-SP were (86.23±.14.67),(4.26±0.54) and (3.01 ± 0.46).The Pearson r value for SKQ and SF-HBMS,SF-HBMS and HBS-SP,SKQ and HBS-SP were 0.516,0.603 and 0.449,respectively,P＜0.01.Health knowledge had no direct effect on health behavior.but had an indirect effect through health belief=0.338 (P＜0.01).The health knowledge has direct and positive effect on the health belief including perceived susceptibility,health motivation,and perceived benefit to health behaviors;the health belief of perceived seriousness to stroke has direct and positive effect on the health behavior,while perceived barrier has direct and negative effect on the health behavior,all P＜0.05.Conclusion The health belief has mediator effect between health knowledge and health behavior among hypertensive stroke patients.Stroke education efforts should be targeted at not only health knowledge but also health belief in order to increase patients’health behavior so as to prevent secondary stroke.

Objective: To explore the effect of early pulmonary rehabilitation on stroke associated pneumonia by the ICU specialist nurses. Methods: Totally 40 cases of stroke patients from January 2017 to June 2017 were selected into the control group, and 44 cases of stroke patients from July 2017 to December 2017 were set as the intervention group. The patients in the control group were given routine care, and those in the experimental group were given early pulmonary rehabilitation in addition to routine care by ICU specialist nurses. The clinical outcome such as the occurrence of SAP, the length of intensive care units (ICU) stay and the duration of mechanical ventilation were compared. Results: The incidence of SAP in the intervention group was 13.64%(6/44), significantly lower than that 32.50(13/40) in the control group (χ²=4.26, P<0. 05), and the length of ICU stay the duration of mechanical ventilation were (5.59±3.93), (3.2±0.84)days, which were lower than (8.50±7.89), ((13.13±9.58)days in the control group (t=2.106,2.678, P<0.05) , the prealbumin levels was (219.43±59.71) mg/L,higher than (192.20±54.85) mg/L in the control group (t=-2.170, P<0.05) , the difference was statistically significant. Conclusion Early pulmonary rehabilitation can effectively reduce the incidence of SAP and better clinical outcome. And we also should improve the SAP risk assessment and the management of swallowing and nutrition.