Objective To explore the potential legal issues about mandatory nursing intervention in psychiatric wards,and put forward the strategies of nursing management.Methods The causes and the potential legal issues of the action of psychiatric nurses to carry out mandatory nursing intervention were analyzed.Results There were legal issues on the right to life and health,the right of informed consent,the right of personal freedom and the right of personality respected about mandatory nursing intervention in psychiatric wards and there might be negligence,misconduct and responsibility of violating the laws and regulations.Conclusions While carrying out mandatory nursing intervention in psychiatric wards,nurses need to respect the patients,make related informed well,protect various related rights of patients and families,implement seriously the relevant system so as to make mandatory nursing interventions more humanized,scientific,standardized,programming,and avoid the occurrence of medical disputes.

Objective To explore the correlation between the cancer-related fatigue and uncertainty in illness among breast cancer inpatients. Methods Totally 90 patients with breast cancer were involved in the study by cancer fatigue scale (CRS) and Mishel's uncertainty in illness scale-adult (MUIS-A). The correlations were analyzed. Results Approximately 100.00%patients experienced fatigue during hospitalization. The total score of uncertainty in illness was 107.51 ± 21.26. There was a positive correlation between each fatigue dimension and uncertainty in illness (P<0.001). Conclusions Cancer-related fatigue is widespread among breast cancer inpatients and sense of uncertainty in illness of patients is at a moderate level. Nursing staff can help patients to reduce disease uncertainty and improve the life quality of patients by strengthening health education , providing comprehensive information support, fully mobilizing patients' social support system.

Antineoplastic Agents, Phytogenic ; adverse effects ; therapeutic use ; Chemical and Drug Induced Liver Injury ; prevention & control ; Female ; Glutathione ; therapeutic use ; Humans ; Male ; Middle Aged ; Paclitaxel ; adverse effects ; therapeutic use

Objective To assess influence factors of imaging quality with 64-slice spiral CT angiography (CTA) of renal artery. Methods A total of 305 hypertension patients underwent CTA of renal artery, and 108 of them were examined with DSA. The imaging quality was classified as Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ, and the degree of stenosis wass classified as <50%, 50%-74%, 75%-99% and occlusion. The sensitivity and specificity of CTA of renal artery was analyzed taking DSA as the standard. Results The influence factors of CTA of renal artery included the delayed time set, rotation time, the units dose of contrast medium and the speed of injection, breath-holding, the patients age and vascular calcification. The sensitivity and specificity of CTA of arterial stenosis <50%, 50%-74%, 75%-99%, occlusion was 76.30% and 76.80%, 89.70% and 90.40%, 96.30% and 97.10%, 100% and 100%, respectively. Conclusion The influence factors of CTA of renal artery are the delayed time set, rotation time, the units dose of contrast medium and the speed of injection, breath-holding, the patients age and vascular calcification. CTA of renal artery can meet the clinical requirements in assessing the renal arterial stenosis.

Objective To explore the relationship between infant feeding practices and infants growth,especially the weight gain for length in the first 6 months of life. Methods Two-hundred healthy full-term singlet normal birth weight 5 - 6 months old infants and their main care givers were recruited in Kongjiang community health service center in Shanghai. The questionnaires included infants feeding pattern, feeding environment and care givers feeding behaviors, and were completed on-site by investigators. The birth weight was obtained. The weight and length of infants at 6 months were measured. Results There were 70/200 (35.0%) infants overweight (BMI for age Z score>+1) at 6 months. There were more overweight boys than girls (40.0% vs. 30.9%, x2 = 1.798, P = 0.180). Compared with normal weight infants, the overweight infants had same birth weight (3.30 ± 0.35 kg vs. 3.35 ± 0.32 kg, t =1.010, P = 0.314) and same length at 6 months (67.64 ± 2.10 cm vs. 67.91 ± 1.97 cm, t=- 0.896, P = 0.371). However, the overweight infants gained much more weight for length in the first six months of life. At 6 months, the weight and BMI of overweight infants was significantly higher than that of normal weight infants (9.16 ± 0.67 vs. 7.94 ±0.64, t = 12.324, P < 0.01;19.86 ± 1.24 vs. 17.41 ± 0.80, t = 14.953, P < 0.01). The rates of exclusive breastfeeding for at least four months, continued breastfeeding at six months, complementary food consistency, and complementary feeding frequency, were not significantly differenct between overweight and normal weight infants (x2 =0.723 - 2.701, P > 0.05). The grandparents played an important role in infants feeding in Shanghai. There were 39.0% infants fed only by grandparents, and 23.0% infants fed jointly by grandparents and parents (x2 = 0.175, P > 0.05).The care givers' educational level and knowledge of feeding skill were similar in overweight and normal weight infants (x2 = 0.446, t = 0.949, P > 0.05). However, the overweight infants were fed more quickly than normal weight infants (Z = 2.753, P < 0.01), and there was less language communication between care givers and overweight infants during feeding (Z = 2.932, P < 0.01). In overweight infants, the overfeeding behaviors of care givers were positively correlated with BAZ (r = 0.281, P < 0.05). Conclusions Overweight in early life is associated with some particular infants feeding behaviors of care givers in Shanghai. The long term effect of more rapid weight gain for length in the first 6 months of life on the risk of childhood obesity warranted to be further followed and researched.

Objective To evaluate the clinical value of tube-sealing with norvancomycin and heparin saline mixture for prevention of central venous catheter-related infection (CRI).Methods A prospective randomized controlled trial was performed.120 patients who were admitted to department of critical care medicine from January 2012 to January 2014 were included,with their subclavian vein catheterization installation time longer than 48 hours,age over 18 years and younger than 80 years,and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score reaching 10-29.The patients were divided into two groups using a random number table,and finally 116 patients were enrolled.Norvancomycin and heparin saline mixture were used for tube sealing in the intervention group (n=56),while only heparin saline was used in the control group (n=60).The incidence of CRI,catheter correlated spectrum of pathogens,adverse events,mortality,hospital day,catheter retention time,and hospital costs were compared between two groups.Results ① There was no significant difference in the incidence of CRI between intervention group and control group [7.14％ (4/56) vs.8.33％ (5/60),x2=0.058,P=1.000].There was no catheter pathogenic colonization in the intervention group,but there were 2 cases of catheter pathogenic colonization in control group.② A total of 7 pathogens were found in two groups.Three cases with pathogenic bacteria was found in the intervention group,with 1 case of Pseudomonas aeruginosa,1 case Acinetobacter baumannii,and 1 case fungi.Staphylococcus aureus,Staphylococcus epidermidis,fungi,and Acinetobacter baumannii was found in the control group,with 1 case of each.There was no significantly statistical difference between two groups (all P＞0.05),but there was a decreasing trend of Gram-positive cocci infection in the intervention group.③ There was no significant difference in the catheter thrombosis,local bleeding or hematoma,catheter dislocation and other adverse events between intervention group and control group [21.43％(12/56) vs.23.33％ (14/60),x2=0.060,P=0.806].④ There were no significant differences in mortality [7.14％(4/56) vs.8.33％ (5/60),x2=0.058,P=1.000],hospital day (days:35.9 ± 15.2 vs.34.1 ± 16.3,t=16.330,P=0.620),catheter retention time (days:25.0 ± 4.5 vs.24.5 ± 5.1,t=26.427,P=2.560) and cost of hospitalization (10 thousand Yuan:3.42 ± 1.22 vs.3.72 ± 1.30,t=13.215,P=1.560) between intervention group and control group.Conclusions For patients with central venous catheter,application norvancomycin with heparin saline mixture for tube sealing did not reduce the incidence of CRI,the incidence of adverse events and mortality,does not reduce hospitalization time,catheter retention time and hospital costs,but may reduce the catheter colonization and infection of Gram-positive bacteria.

Objective To observe the effects of functional ambulation training in a realistic environment based on the activities of daily living among stroke patients with hemiplegia.Methods Thirty-two stroke survivors with hemiplegia were randomly divided into an experimental group and a control group,each of 16.Both groups were given routine rehabilitation training,while the experimental group was additionally given functional ambulation training based on the activities of daily living in a realistic environment for 60 min per day,five days a week for six weeks.Both groups were evaluated using the mini-mental state examination (MMSE),the Holden walking functional class assessment (HWFCA),the Berg balance scale (BBS),functional gait assessment (FGA),the 5 times sit to stand test (FTSST),the timed up and go test (TUGT),and rated using the specific activity balance confidence scale (ABC) and the modified Barthel index (MBI).Results Before the training,no significant differences between the two groups were found in terms of any of the measurements.After the six weeks of training,significant improvement was observed in all of the outcome measures except the MMSE and the HWFCA,with the experimental group scoring significantly better,on average,than the control group.Conclusion When combined with routine rehabilitation training,functional ambulation training based on the activities of daily living in a realistic environment can significantly enhance the functional gait,balance and postural control of stroke survivors.This should facilitate their activities in daily life and improve their confidence in maintaining their balance.

Objective:To explore the effect of traditional Chinese medicine fumigation and washing on the clinical indicators of elderly patients with distal radius fractures after small splint fixation.Methods:From November 2015 to November 2018, 180 elderly patients with fracture of the distal radius in Ningbo Hospital of Traditional Chinese Medicine were selected, and they were divided into control group and observation group according to the random digital table method, with 90 cases in each group.The two groups were given manual reduction and small splint fixation treatment, and the observation group was treated with traditional Chinese medicine fumigation on the basis of the control group therapy.The related inflammatory cytokines in patients plasma and serum viscosity(TNF-α, IL-1, IL-6) were detected, and the clinical curative effect and adverse reactions were observed.Results:Before treatment, there were no statistically significant differences in plasma viscosity and blood inflammatory factors(TNF-α, IL-1, IL-6) between the two groups( t=-0.171, -0.126, 0.483, 0.459, all P>0.05). After treatment, the above indicators in the two groups were significantly lower than those before treatment(observation group: t=38.970, 14.684, 72.258, 53.612; control group: t=20.098, 19.045, 33.962, 34.822, all P<0.05), which in the observation group were lower than those in the control group ( t=-30.239, -7.043, -31.815, -10.359, all P<0.05). The total effective rate of the observation group was 88.88%(80/90), which was higher than 71.11%(64/90) of the control group, the difference was statistically significant between the two groups(χ2=8.889, P<0.05). Conclusion:For the elderly patients with distal radius fracture, the combination of reduction and small splint fixation and fumigation with traditional Chinese medicine can significantly improve the hemorheology of the patients and reduce the contents of inflammatory factors in the body, with significant efficacy and no adverse reactions, which is worthy of clinical application.

Objective:To compare the curative efficacy in the treatment of humeral surgical neck fractures between open reduction and locking plating versus closed reduction and interlocking intramedullary nailing.Methods:From July 2018 to July 2020, 60 patients with humeral surgical neck fracture were treated at Department of Orthorpaedic Trauma, Jiangmen Wuyi Hospital of Traditional Chinese Medicine. They were 24 males and 36 females, aged from 40 to 70 years and injured at the left side in 35 cases and at the right side in 25 ones. Of them, 30 underwent open reduction and locking plating (open group) and the other 30 closed reduction and interlocking intramedullary nailing (closed group). The 2 groups were compared in terms of operation time, intraoperative blood loss, surgical incision length, fracture healing time, Neer shoulder function scoring 3 months after surgery, and postoperative complications.Results:There were no statistically significant differences between the open and closed groups in preoperative general data, showing they were comparable ( P>0.05). The length of surgical incision [(5.2±1.1) cm], operation time [(34.3±12.7) min], intraoperative blood loss [(52.5±7.3) mL] and fracture healing time [(9.2±1.5) weeks] in the closed group were significantly better than those in the open group [(11.1±2.5) cm, (69.4±21.4) min, (123.5±5.2) mL and (14.2±3.4) weeks)] ( P<0.05). The excellent and good rate by Neer shoulder function scoring at 3 months after operation in the closed group (93.3%, 28/30) was significantly higher than that in the open group (66.7%, 20/30) ( P<0.05). There were no postoperative complications in either group. Conclusion:In the treatment of humeral surgical neck fractures, the curative efficacy of closed reduction and interlocking intramedullary nailing is better than that of open reduction and locking plating.