Objective To analyze the clinical and nursing care of peripartum reversible posterior leukoencephalopathy syndrome (RPLS).Methods Thirty five cases with peripartum RPLS were retrospectively reviewed.Results All patients developed acutely,22.9％ in the antepartum period and 77.1％ in the postpartum period.The major clinical characteristics were headache (65.7％),seizures(62.9％),visual disturbances (54.3％),altered mental status (22.9％).The most common abnormality on neuro-imaging was edema predominantly involving the cortex and subcortical white matter in the posterior portions of the cerebral hemispheres,including the occipital lobes (77.1％),parietal lobes (65.7％),temporal lobes (28.6％) and frontal lobe (20.0％).MR diffusion-weighted imaging and ADC mapping revealed vasogenic edema.The treatments included aggressive blood pressure control and anticonvulsants with special nursing care.The clinical symptoms and the lesions on neuroimaging improved or resolved within 1 day to 2 months.Conclusions The prognosis for peripartum RPLS is ensured as long as the diagnosis is made properly and reasonable application of care program.

Objective:To explore the effect of the stroke first aid process based on healthcare failure mode and effect analysis in primary hospitals.Methods:Using convenience sampling, 88 patients with acute ischemic stroke (AIS) admitted to Shaoxing People's Hospital from August 2017 to July 2018 were randomly selected in control group, and 96 patients with AIS admitted to Shaoxing People's Hospital from October 2018 to September 2019 were randomly selected in observation group. Patients in control group were treated with routine stroke first aid process for nursing intervention. On the basis of control group, observation group was provided with stroke first aid process based on healthcare failure mode and effect analysis. We compared the time required for each link of the first aid process, clinical outcome indicators and total nursing satisfaction of patients between two groups.Results:The time required for each link of the first aid process of observation group was less than that of control group, and the difference was statistically significant ( P<0.05) . The vascular recanalization rate of observation group was higher than that of control group, and the postoperative complication rate of observation group was lower than that of control group, the difference was statistically significant ( P<0.05) . The total nursing satisfaction of patients in observation group was 95.8% (92/96) , which was higher than 86.4% (72/88) of control group, and the difference was statistically significant ( P<0.05) . Conclusions:The stroke first aid process based on healthcare failure mode and effect analysis has a good application effect in primary hospitals, which can effectively shorten the first aid time of patients with AIS, reduce the incidence of patient complications, and improve nursing satisfaction. It is worthy of clinical application.

Objective To explore the relationships among hope level, coping style and quality of life (QOL) in myasthenia gravis (MG) patients. Methods From September 2016 to September 2017, 139 MG patients of Shaoxing People's Hospital were selected by convenience sampling. The hope level, coping style and QOL of patients were investigated with the Herth Hope Index (HHI), Medical Coping Modes Questionnaire (MCMQ) and Quality of Life Questionnaire-Core 30 (QLQ-C30). Pearson correlation and multiple linear regression were used to analyze the correlations among them and influencing factors of QOL respectively. Results The total score of HHI, score of confrontation dimension, avoidance dimension, yield dimension of MCMQ and score of total QOL of MG patients was (35.85±3.14), (18.78±3.67), (15.82±2.37), (9.94±2.79) and (52.33±11.83) respectively. Correlation analysis showed the total score of HHI of MG patients was positively associated with the total score of total QOL (r=0.675, P<0.05); the confrontation coping style was positively associated with the total QOL (r=0.613, P<0.05); the yield coping style had a negative correlation with the total QOL (r=-0.582, P<0.05). Multiple linear regression analysis revealed the influencing factors of QOL of MG patients included the burden of medical expense, classification of Myasthenia Gravis Foundation of America (MGFA), total score of HHI and yield. Conclusions The QOL of MG patients is in a low level. The main influencing factors of QOL of patients involve the burden of medical expense, classification of MGFA, hope level and yield coping style.