Objective To determine whether Nutritional Risk Screening 2002 (NRS2002) of admission independently predicts outcome of non-invasive positive pressure ventilation (NIPPV) in chronic obstructive pulmonary disease (COPD) patients during hypercapnic respiratory failure.Methods Patients with COPD presenting with hypercapnic respiratory failure at Sichuan University Hospital between December 2010 and May 2012 and receiving NIPPV were studied prospectively.NRS2002 was measured before NIV administration.233 patients met the inclusion criteria,with NIPPV failed in 71 cases and succeed in 162 cases.The patients were followed up till they were discharged.Results After multivariate Logistic regression,the items such as baseline PaCO2,NRS2002 score could predicted 76.4％ of the failure outcome.The area under the curve was 0.767.The positive predictive value was 35.23％.The negative predictive value was 84.21％.Conclusions We can predict the risk failure of NIPPV in patients with COPD and hypercapnic respiratory failure with NRS2002 score and baseline PaCO2,and adjust the treatment project according to the evaluation result.NRS2002 supply non-invasive and portable method for predicting the failure of NIPPV.

The effect of atorvastatin on warfarin-induced aortic medial calcification and systolic blood pressure (SBP) of rats induced by warfarin was studied. Thirty healthy and adult rats were randomly divided into Warfarin group (n=10), Atorvastatin group (n=10) and normal control group (n=10). Caudal arterial pressure of rats was measured once a week, and 4 weeks later, aorta was obtained. Elastic fiber, collagen fiber and calcium accumulation in tunica media of cells were measured by Von Kossa staining. The results showed that warfarin treatment led to elevation of systolic blood pressure and aortic medial calcification. The chronic treatment also increased collagen, but decreased elastin in the aorta. However, the atorvastatin treatment had adverse effects. It was concluded that treatment with atorvastatin presented evidence of blood pressure lowing and calcification reducing. These data demonstrate that atorvastatin protected aortic media from warfarin-induced calcification and elevation of systolic blood pressure.
Aortic Diseases/chemically induced ; Aortic Diseases/drug therapy ; Aortic Diseases/*pathology ; Blood Pressure/*drug effects ; Calcinosis/chemically induced ; Calcinosis/*drug therapy ; Calcinosis/pathology ; Heptanoic Acids/*pharmacology ; Heptanoic Acids/therapeutic use ; Hypertension/chemically induced ; Hypertension/*drug therapy ; Pyrroles/*pharmacology ; Pyrroles/therapeutic use ; Random Allocation ; Rats, Wistar ; Warfarin

Summary: The effect of atorvastatin on warfarin-induced aortic medial calcification and systolic blood pressure (SBP) of rats induced by warfarin was studied. Thirty healthy and adult rats were randomly divided into Warfarin group (n=10), Atorvastatin group (n=10) and normal control group (n=10). Caudal arterial pressure of rats was measured once a week, and 4 weeks later, aorta was obtained. Elastic fiber, collagen fiber and calcium accumulation in tunica media of cells were measured by Von Kossa staining. The results showed that warfarin treatment led to elevation of systolic blood pressure and aortic medial calcification. The chronic treatment also increased collagen, but decreased elastin in the aorta. However, the atorvastatin treatment had adverse effects. It was concluded that treatment with atorvastatin presented evidence of blood pressure lowing and calcification reducing. These data demonstrate that atorvastatin protected aortic media from warfarin-induced calcification and elevation of systolic blood pressure.

Abstract The concepts and theoretical mechanisms of interpersonal psychotherapy are discussed in detail. The review focuses on the effectiveness of interpersonal psychotherapy on depression among adolescents and the expansion of its applications. The feasibility of localized adapted interpersonal psychotherapy interventions in adolescent depression groups is proposed, to provide a reference for the applied practice of interpersonal psychotherapy.

Objective:To explore the application effect of flipped classroom teaching combined with micro-classes and PBL in the training of refresher nurses.Methods:Using the cluster sampling method, 35 refresher nurses from March 2017 to February 2018 were collected as the control group, and 38 refresher nurses from March 2018 to February 2019 were included as the observation group. The control group received the theoretical knowledge training of respiratory specialty by traditional teaching method, and the observation group received theoretical knowledge training of respiratory specialty by using flipped classroom teaching combining micro-classes and PBL. Before and after the training, the special theory assessment with the same difficulty was carried out, and the clinical teaching evaluation was carried out after the training.Results:After the training, the special theory assessment scores of the observation group were significantly higher than those of the control group ( t=7.560, P<0.05), with significant differences. Compared with the control group, the clinical teaching evaluation scores of the nurses in the observation group were significantly improved ( t=24.657, P<0.05), with significant differences, especially in the nurses' learning attitude, learning ability, teaching style and teaching satisfaction scores. Conclusion:The flipped classroom teaching combining micro-classes and PBL can significantly improve the special theory assessment scores of refresher nurses, promote the internalization of specialized knowledge, turn to active learning from the passive mode, change the learning attitude of refresher nurses, improve their recognition of clinical teachers and realize teaching benefits as well as learning benefits.

Objective To systematically analyze the research trend of home non-invasive positive pressure ventilation in China. Methods The related literature in CBM database, CNKI database, Wanfang database and VIP database about home non-invasive positive pressure ventilation were reviewed and analyzed by Bibliometric. Results There were 214 articles retrieved, which had an increasing tendency.They were distributed in 135 kinds of journals and 28 provinces.The most research type was the experimental research(39.72%)and the research content focused on clinical effects of home non-invasive ventilation (47.67%). The average duration of researches was 12.33 months and the average interval for follow-up was 6.33 weeks. Conclusions Providing scientific and effective long-term medical support, optimizing the application process of home non-invasive ventilation and formulating scientific clinical standard should be the future research direction.

Objective To compare the application effects of different aerosol inhalation methods of continuous non-invasive positive pressure ventilation (NIPPV)in the treatment of the patients with AECOPD combined withⅡ type respiratory failure and offer reference for the appropriate choice of patients' aerosol inhalation methods.Methods With the convenience sampling method, totals of 150 continuous NIPPV patients with AECOPD combined withⅡ type respiratory failure were divided into the observation group and the control group according to the hospitalization time (75 patients in each group). The patients in the control group used NIPPV and the standard oral spray driven by the atomizing pump. In the observation group the aerosol inhalation device was connected between the nasal face mask/nasal mask and the pipeline of the breathing machine. The patients in the observation group used NIPPV combined with the inhalation of atomizing drugs. Patients' oxygen saturation,heart rate, respiratory rate, dyspnea, dry mouth and sore throat, expectoration difficulties and comfort level in the two groups were compared between before and after the aerosol inhalation.Results After the aerosol inhalation,the heart rate and the respiratory rate in the observation group were (98.32±3.39)times/min and (23.16±1.30) times/min respectively, which were significantly lower compared with the control group [heart rate:(100.18±3.16)times/min,t=3.476,P<0.05; respiration rate: (25.67±1.21) times/min,t=12.240,P<0.05].The scores of dry mouth and sore throat, expectoration difficulties, and the comfort level in the observation group were (17.53±2.73), (20.49±3.71)and (17.81±4.47),which were significantly higher compared with the control group [dry mouth and sore throat:(16.48±3.07),t=2.213,P<0.05; expectoration difficulties:(14.43±2.18),t=12.196,P<0.05; comfort level:(16.37±3.74),t=2.140,P<0.05].Conclusions In the process of the continuous NIPPV, the aerosol inhalation device and nasal face mask are connected in the pipeline of the non-invasive breathing machine for the aerosol inhalation treatment, which can improve the therapy effect and the comfort level for patients and decrease the adverse effect level due to the use of the breathing machine.

Objective:To explore the transition from hospital discharge to home care in heart transplant recipients based on the Meleis' transition theory, so as to provide a basis for improving the quality of life of recipients.Methods:In July 2021, purposeful sampling was used to select heart transplant recipients from the First Affiliated Hospital of Zhejiang University School of Medicine as the research subject. A total of 12 recipients of one year after heart transplantation were selected for semi-structured interviews by snowballing. The interview data were analyzed using the Colaizzi 7-step method.Results:Through reading, analysis, sorting and summarizing, 4 themes and 11 sub-themes were extracted, namely, relatively stable recovery of physical condition, lack of medication and emotional management (unmet needs for medication cognition and management, good physical condition, early emotional experience of vulnerability) , the support of family and social resources affected the transition (the communication and support of patients promoted the transition, the support of the family promoted the transition, the lack of community resources hindered the transition, and the reimbursement policy affected the transition) , a positive experience in the transition (confidence to deal with future life, return to society and self-realization) , and expecting to obtain comprehensive and continuous management of body and mind (the needs of nursing care centered on mental health, the needs of professional management teams and the communication platform among doctors, nurses and patients) .Conclusions:The experience of home self-care after discharge has many physical and psychological impacts on heart transplant recipients. It is necessary to pay attention to the recipients in the transition period, and to build a whole-of-society support system to give help to heart transplant recipients.

Objective? To expLore the knowLedge, attitude and practice status quo of puLmonary rehabiLitation among nurses in respiratory department, and to provide theoreticaL basis for cLinicaL training and quaLity controL. Methods? From JuLy to August 2018, a totaL of 134 respiratory nurses who participated in a continuing education training course in Sichuan Province were convenientLy seLected as the research objects. The questionnaire of knowLedge, attitude and practice of Lung rehabiLitation of nursing staff was used to investigate them. The univariate anaLysis of knowLedge, attitude and practice of Lung rehabiLitation of nursing staff were anaLyzed by t test and variance anaLysis. ResuLts? The totaL score of knowLedge, attitude and practice in puLmonary rehabiLitation among nurses was (101.63±19.58). The average scores of the three dimensions from high to Low were attitude (4.07±0.98), practice (3.08±1.09) and knowLedge (3.03±1.01). There were statisticaL differences in the totaL score of knowLedge, attitude and practice of nurses with different professionaL titLes and whether they had received Lung rehabiLitation training or not (P＜0.05). ConcLusions? The knowLedge, attitude and practice of puLmonary rehabiLitation of nursing staff in respiratory department need to be improved. Nursing administrators shouLd strengthen guidance and training of puLmonary rehabiLitation and strengthen nurses' abiLity to impLement puLmonary rehabiLitation so as to ensure the effective impLementation of puLmonary rehabiLitation in cLinicaL work.

Discussing the cognition, attitude and influencing factors of the family members of organ donors towards advance care planning (ACP) to provide a basis for the further promotion of ACP in the field of organ donation. Using qualitative research methods, 8 family members of organ donors were selected purposefully for semi-structured interviews, and the 7-step of Colaizzi was used to analyze and summarize the themes of the interview data. The results showed that the cognition status of the family members of organ donors of ACP could be summarized into 3 themes: problems faced by ACP implementation, positive recognition of the implementation of ACP, factors affecting the promotion of ACP. Organ donors’ family members are unfamiliar with the concept of ACP and have unclear cognition, but think that the implementation of ACP is of positive significance. It is suggested to further strengthen the publicity of ACP, medical autonomy, death education, so as to promote the development of ACP and improve the willing to donate organ.