Objective To evaluate the skills in using inhalers among the asthmatic patients who visited the out-patient clinic and whether or not the nursing intervention could further improve the efficacy of the drug delivery device. Methods 321 asthmatic patients who had visited the clinic and prescribed inhalers from April to December 2009 were investigated of the basic status, former medication history and skills in using metered dose inhaler (MDI) and dry powder inhaler (DPI). Nursing intervention had been carried out and the results were analyzed. Results Subjects belonging to different educational level groups were significantly different in mastering skills using MDI and DPI after reading instructions. There also existed significant difference between MDI and DPI users. Among patients who had already used inhalers, there was significant difference between subjects who had received instruction from medical personnel and subjects who had only read paper directions. Nursing intervention could significantly improve the skills in handling the device. Conclusions Proper skills in using inhalers could not be possessed just by reading paper directions. Instructions or even multimedia presentation from medical personnel are vital for asthmatic patients to master the skills in using MDI and DPI.

Objective:To evaluate and summarize the best evidence of health workers respiratory protection during aerosol-generating procedures in patients with acute respiratory infectious diseases.Methods:We searched EBM Guidelines, Essential Evidence Plus, Dynamed, UpToDate, JBI, BMJ, Clinical Key, Cochrane Library, NICE, AARC, PubMed, EMbase, CKNI, Wanfang to collect related literature including guidelines,evidence summary, recommended practices, standards, consensus and systematic reviews.Results:A total of 20 articles were included, including 10 guidelines, 1 consensus, 2 standards, 2 evidence summaries, and 5 systematic reviews. 24 best evidences including aerosol-generating procedures, training of protective equipment using, principles of protective equipment using, protective equipment using, aerosol operating environment control and medical staff self-monitoring were summarized.Conclusion:The study integrated the best evidence of healthcare workers respiratory protection during aerosol-generating procedures in patients with acute respiratory infectious disease. It is recommended to combine the current status of institutional protection resources and clinical practice experience to promote the conversion of the best evidence to clinical practice.

Objective To carry out bacteriological analysis between re-used and disposable oxygen humidification devices. Methods Reused oxygen equipment and disposable oxygen moisture bottles from 6 randomly selected elderly wards were collected, patients who used oxygen will be randomized into 3 groups, group A used cold water as the oxygen humidification liquid, group B used distilled water as humidification liquid, group C used AQUAPAK disposable oxygen humidification devices, sample taking in group A and group B happened on every Monday and Thursday before the replacement of sample moisture bottles, sample was taken in group C after the use of disposable oxygen humidification devices, according to "hospital disinfection health standards" (GB5982-1995)sampling method of disinfection liquid sample was taken and sent to test in the disinfectant laboratory. Results Of 61 samples in group A bacteria cartier rate was 81.97%, bacteria carrier rate of 71 samples in group B was 47.89%, of 52 samples in group C the carrier rate was 0. The comparing of bacterial contamination rate of three kinds of oxygen moisture bottles after using was statistically significant. Take group A, B for comparison, the average severity level of bacteria in group A is higher than group B. In group A, the level of the Gram-negative bacteria as well as Gram-positive bacteria colonization was higher than group B. Conclusions Whether use of cold water or distilled water, oxygen humidification liquids have different degrees of pollution. Currently there is no general criteria and norms in the context of sterilization of oxygen humidification, for patients on long-term oxygen using, to choose disposable oxygen humidification device to reduce the incidence of hospital infections is recommended.

Objective To investigate the role of the percentage of the total cross-sectional area of small pulmonary vessels for the lung area (%CSA) from multi-slice CT (MSCT) in evaluating the severity of chronic obstructive pulmonary disease (COPD). Methods One hundred and sixty-six COPD patients and 166 normal subjects underwent chest MSCT scans and all data were analyzed retrospectively. COPD patients underwent pulmonary function tests (PFT), including forced expiratory volume in one second (FEV1%) and FEV1/forced vital capacity (FEV1/FVC), and were classified into mild (n=32), moderate (n=65), severe (n=69) groups according to pulmonary function results, respectively. The%CSA less than 5 mm2 and 5—10 mm2 for the lung area (%CSA<5 and %CSA5-10) of small pulmonary vessels were measured with Image J image-processing program. Comparison of%CSA<5 and%CSA5-10 between the COPD and control groups was perfomred using t test, and the comparison between the 3 COPD subgroups and control group were carried out using ANOVA test. The correlation between %CSA and PFT was evaluated by the Spearman rank correlation test. The sensitivity and specificity of %CSA to diagnose COPD and the best cutoff were calculated from areas under the ROC curves. Results %CSA<5 of COPD patients and control group were (0.56 ± 0.19)%and (0.82 ± 0.15)%(t=12.80, P<0.001), respectively.%CSA5-10 of the two groups were (0.19 ± 0.09)%and (0.33 ± 0.16)%(t=8.93,P<0.001), respectively. The AUC values of%CSA<5 and%CSA5-10 were 0.866 and 0.790, respectively. When the cut-off values of%CSA<5 and%CSA5-10 were 0.65%and 0.24%, the sensitivities and specificities were 88%and 71%, 76%and 81%, respectively. The mean values of%CSA<5 in mild, moderate and severe groups were (0.67±0.20)%, (0.61±0.16)%and (0.44±0.14)%, respectively (P<0.05). The mean values of %CSA5-10 in the three groups were (0.19 ± 0.06)%, (0.19 ± 0.10)% and (0.20 ± 0.08)%, respectively.%CSA5-10 in the three groups were of no significant difference (P>0.05). FEV1%and FEV1/FVC in COPD patients were (60.38±15.52)%and 57.95±22.27.%CSA<5 in COPD patients correlated positively with both FEV1%and FEV1/FVC (r=0.609 and 0.721, P<0.01, respectively).%CSA5-10 in COPD patients correlated positively with both FEV1%and FEV1/FVC (r=0.271 and 0.288, P<0.01, respectively). Conclusion The measurement of%CSA<5 and%CSA5-10 in MSCT images correlated with PFTs and%CSA<5, which may play an important role in evaluating the severity of COPD.

Objective To retrieve,appraise and summarize the available evidence on management and prevention of implantable venous access port occlusion in adult patients.Methods We searched the BMJ best practice,UpToDate,Cochrane Library,Joanna Briggs Institute Library,Registered Nurses' Association of Ontario,National Guideline Clearinghouse,PubMed,EMbase,CNKI and CBM to collect literatures including guidelines,evidence summary,best practice information sheet,recommended practice,systematic review and consensus.Results Five references including one guideline,one systematic review,two evidence summaries,and one expert consensus were included.A total of eight items of best evidence were summarized with regard to syringe size,flush volume,flush technique and frequency of administration,choose of needleless connectors,management of mechanical occlusion,drug/mineral precipitation,and thrombotic occlusion.Conclusion Healthcare workers should regulate the standard of venous access port flushing and locking and manage catheter occlusion in a timely manner,to avoid adverse incidents like interruptions in treatment,bacteremia,and venous thrombosis.

Objective:To explore the relationship among illness perception, patient activation and self-management in patients with lung cancer, and to investigate the mediating effect of patient activation between illness perception and self-management.Methods:A total of 270 inpatients with lung cancer were selected by convenience sampling method.They were investigated by self-made social demographic questionnaire, brief illness perception questionnaire(BIPQ), patient activation measure(PAM13)and cancer patient self-management scale.SPSS 26.0 software was used for data analysis.T-test, analysis of variance, Pearson correlation analysis and mediating effect test were used for statistical analysis.Results:A total of 255 questionnaires were collected effectively.The total score of illness perception, patient activation and self-management in patients with lung cancer were (41.91±7.94), (62.31±16.39)and (142.20±20.59) .The total score of illness perception of lung cancer patients was significantly negatively correlated with the total score of patient activation and patient self-management( r=-0.652, P<0.01; r=-0.762, P<0.01), and the total score of patient activation was significantly positively correlated with the total score of self-management in patients with lung cancer( r=0.746, P<0.01). Patient activation had a partial mediating effect between illness perception and self-management in patients with lung cancer, and the mediating effect accounted for 37.10% of the total effect. Conclusion:Patient activation plays a partial mediating role between illness perception and self-management in lung cancer patients, and it is an important protective factor for patients to actively participate in self-management of disease.On the basis of assessing the illness perception and patient activation of lung cancer patients, medical staff can timely correct the negative illness perception and help them establish and maintain a high positivity level to improve their self-management.

BACKGROUND: Venous thromboembolism (VTE) as the most common cancer-associated complication has become the second death-causing reason among cancer patients. The management of VTE in patients with lung adenocarcinoma should focus on early and timely detection of risk factors. The aim of the study is to investigate the current situation of VTE in patients with lung adenocarcinoma treated with anti-tumor therapy and then explore the risk factors associated with the occurrence of VTE during anti-tumor therapy for early detection and screening of VTE. METHODS: The present study included patients diagnosed as lung adenocarcinoma undergoing anti-tumor therapy in First Affiliated Hospital of Nanjing Medical University between December 2019 and May 2021. The risk factors were identified via univariate and multivariate Cox analysis. The incidence of independent risk factors were investigated through Kaplan-Meier curves combined with Log-rank test. RESULTS: The results of univariate and multivariate Cox regression showed that history of VTE, targeted therapy and radiotherapy were risk factors for VTE in patients with lung adenocarcinoma treated with anti-tumor therapy (P<0.05). Furthermore, the results of Kaplan-Meier curves and Log-rank tests indicated the incidences of VTE in patients with history of VTE, targeted therapy and radiotherapy were higher (P<0.05). CONCLUSIONS History of VTE, radiotherapy and targeted therapy are found as independent risk factors for the occurrence of VTE, which should be identified and monitored for reduction of VTE incidence.
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Humans ; Venous Thromboembolism ; Incidence ; Lung Neoplasms ; Adenocarcinoma of Lung ; Risk Factors