Objective:To explore the clinical effect of negative pressure wound therapy and to discuss the ethi-cal issues in this therapy and seek a solution. Methods:Sixty patients with negative pressure wound therapy in our hospital were invited to participate in this study. Patients were all with deep pressure ulcers or diabetic foot, of which the Wagner Scores were graded as three or four. They were divided into two groups randomly. The subjects in control group received standard treatment, while those in experimental group were treated by self -designed closed negative pressure drainage settings. The wound healing time, the cost of the treatment and comfort were compared between the two groups. Results:The cost of wound care in the experimental group was less than those in the control group (P<0. 001). There was no significant difference in comfort between two groups (P>0. 05). But the wound healing time was longer in the experimental group than those in the control group. Conclusion:Self-designed closed negative pressure settings can decrease the cost of patient care with the equal patient comfort and acceptance as the standard negative pressure, however, the wound healing time has been extended. So before using negative pressure technique, the medical staff should comprehensively analyze, be guided by medical ethics and choose the appropriate treatment for different patients.

Objective To design a kind of aseptic drainage device with safe practice and accurate measurement for clinical nurses. Methods The experiment group included 63 cases using drainage device with accurate measurement,and control group included 63 cases using disposal drainage bag with scale of visual measurement.The accuracy of drainage liquid measurement was compared between two groups,and bacterial culture was made for the drainage liquid of two groups.Results The measurement error of experiment group and control group was(3.31±1.8)mL and(56.0±5.8)mL,respectively.The difference was significant(t=-4.593,P<0.01).The bacterial culture results showed no obvious difference between two groups(positive rate were 15.9%vs 17.5%,χ2=0.057,P>0.05). Conclusion The accurately measured aseptic drainage device is convenient for nurses to practice in clinics,and its application can reduce workload of nurses and decrease the occurrence of pollution.

Objective To investigate the effect of FOCUS-PDCA program on pressure ulcers nursing quality management. Methods By using the 9 steps of FOCUS-PDCA program of exploring, organizing, clarifying, understanding, selecting, planning, enforcing, checking and executing, we looked into the primarily factors for pressure ulcers and modified and improved our pressure ulcer nursing management system. Then training was done to the nurses, and the pressure ulcer management system was used. The effects in implementation of pressure ulcers prevention, mastery of pressure ulcers prevention knowledge among nurses and occurrence of pressure ulcers in the high-risk patients were studied after applying the program. Results After use of FOCUS-PDCA program, the qualification rate of pressure ulcers prevention implementation and mastery of pressure ulcers prevention knowledge were both higher than before the use. The occurrence rate of pressure ulcers in the high-risk patients was lower than before the use (P<0.05). Conclusion By using the FOCUS-PDCA program in the nursing quality management for patients with pressure ulcers, we can effectively improve the implementation of pressure ulcers preventive measures, enhance the nursing staff to master knowledge on pressure ulcers and reduce the incidence of pressure ulcers.

Objective:To investigate the impact of nursing simulation training combined with mentor responsibility system teaching on the thinking ability and core competence of interns receiving surgical nursing training.Methods:A total of 96 nursing students who were trained in Department of General Surgery in our hospital were selected as subjects, and they were randomly divided into control group (conventional teaching+mentor responsibility system) and observation group (nursing simulation training+mentor responsibility system) using a random number table, with 48 students in each group. The two groups were compared in terms of assessment score, clinical thinking ability, creative ability, core competence, and degree of satisfaction with teaching. SPSS 24.0 was used for the t-test, the chi-square test, and the Fisher's exact test. Results:After teaching, the observation group had significantly higher theoretical[(75.92±1.15) vs. (73.01±0.89)] and skill test scores[(16.96±1.17) vs. (15.10±1.03)] than the control group ( P<0.05). After teaching, both groups had significant increases in the scores of evidence-based thinking, critical thinking, and systematic thinking abilities, and the observation group had significantly higher scores than the control group ( P<0.05). After teaching, both groups had significant increases in the scores of curiosity, adventure, challenge, and imagination, and the observation group had significantly higher scores than the control group ( P<0.05). After teaching, both groups had significant increases in the scores of practical ability, organization and communication, quality evaluation improvement, critical thinking, scientific research innovation, and training guidance, and the observation group had significantly higher scores than the control group ( P<0.05). After teaching, the observation group had significantly higher scores of each dimension of teaching satisfaction than the control group ( P<0.05). Conclusion:Nursing simulation training combined with mentor responsibility system teaching can effectively improve the teaching quality of surgical nursing training, enhance clinical thinking ability and core competence, and increase the degree of satisfaction with teaching.

OBJECTIVETo investigate the abnormal changes in the testes and semen parameters in patients with varicose veins and analyze the possible relationship between clinical varicocele and infertility.

METHODSWe retrospectively reviewed the records of 172 male patients consulting for varicocele in our hospital since 2003. All these patients were examined for the size of the testes with scrotal ultrasound. The semen samples of the patients with varicocele except for 5 under the age of 17 years were collected and analyzed, using the data of semen analyses of 163 healthy young male volunteers (aged 18-29 years) as control.

RESULTSAll the 172 patients had left-sided varicose veins. Sixty-three patients were found to have bilateral varicocele, and in most of them, the clinical grades of the left-sided varicose veins were higher than those of the right-sided ones. The mean volume of the left testis of the patients was 10.99∓3.71 ml, significantly smaller than that of the right one (11.86∓4.05 ml, P<0.01). The physiochemical indices of the patients, including the voiding volume, semen pH, liquefaction time and sperm concentration, were normal or similar with those of the healthy volunteers (P>0.05). Almost all the patients sperm motility and viability were significantly lower than those of the healthy volunteers (P<0.05). In addition, no significant difference was found in the sperm density, motility or viability between the patients with unilateral and bilateral varicocele (P>0.05).

CONCLUSIONVaricocele may decrease the testicular volume. Both unilateral and bilateral varicocele may have an effect on the bilateral testes to cause possible functional impairment of the testes manifested by decreased sperm motility and viability.

Adolescent ; Adult ; Child ; Humans ; Infertility, Male ; etiology ; Male ; Middle Aged ; Retrospective Studies ; Semen ; Sperm Count ; Sperm Motility ; Testis ; physiopathology ; Varicocele ; complications ; physiopathology ; Young Adult

Objective To explore the clinical efficacy of early combined application of parenteral nutrition and enteral nutrition among patients in neurosurgical intensive care unit(NICU).Methods Two hundred fifty-five patients with severe neurological diseases were admitted to NICU of Shanghai Tenth People's Hospital from January 1 to August 31 in 2018.The patients were divided into two groups:traditional enteral nutrition group (control group,n=170),who were treated with enteral nutrition management at the early stage,and early combined application of parenteral and enteral nutrition group (experimental group,n=85),who were at first treated with parenteral nutrition since admission and then enteral nutrition management 72 hours later.The differences of Glasgow outcome scale (GOS),incidence of individual adverse reactions,daily average enteral nutrition,human albumin supplement,daily average fluid supplement,pulmonary infection rate,infection time and albumin level during hospitalization between the two groups were compared.The relationship among the course of enteral nutrition,nutrient content,pulmonary infection and serum albumin level in the experimental group were also discussed.The GOS was predicted by decision tree,random forests,nearest neighbor algorithm,adaboost and bagging.Results There was no significant difference between baseline scores after 1∶2 propensity score matching.The dominance ratio of GOS between the two groups was 1.853 (95％CI:1.018-3.385) (P=0.043).The change of albumin level was not related to the choice of nutritional regimen,but was related to the level of consciousness after admission and the level of basic albumin before admission.The level of consciousness in the experimental group was higher than that of the control group,and the fluid infusion volume was decreased while the daily average enteral nutrition and albumin supplementation were increased,the types of adverse reactions occurred more and earlier (P＜0.05).The misjudgment rate of GOS prediction models ranged from 0.482 to 0.606.Conclusions Compared with traditional early enteral nutrition therapy,early combined parenteral nutrition and enteral nutition can improve the prognosis of patients with severe neurological diseases.

To deeply explore the load experience of primary caregivers of colorectal stoma patients, analyze their psychological load, understand their load experience when caring for patients, so as to provide theoretical basis for promoting patients’ home rehabilitation and continuous nursing. A semi-structured interview was conducted with the primary caregivers of 10 patients with permanent stoma in a tertiary hospital in Xi’an using a phenomenological research method, and the data were summarized and refined by Colaizzi 7-step analysis. A total of four themes were extracted: complex emotional reactions, lack of knowledge about stoma care, a huge care load on the shoulder, and social and financial support needed. The primary caregivers of colorectal stoma patients have a certain degree of care load in the daily care of the patients. Health care professionals should pay attention to the psycho-emotional changes of these individuals and take targeted interventions to reduce the psychological load of the caregivers and improve the quality of life of the patients and their caregivers.

To deeply explore the load experience of primary caregivers of colorectal stoma patients, analyze their psychological load, understand their load experience when caring for patients, so as to provide theoretical basis for promoting patients’ home rehabilitation and continuous nursing. A semi-structured interview was conducted with the primary caregivers of 10 patients with permanent stoma in a tertiary hospital in Xi’an using a phenomenological research method, and the data were summarized and refined by Colaizzi 7-step analysis. A total of four themes were extracted: complex emotional reactions, lack of knowledge about stoma care, a huge care load on the shoulder, and social and financial support needed. The primary caregivers of colorectal stoma patients have a certain degree of care load in the daily care of the patients. Health care professionals should pay attention to the psycho-emotional changes of these individuals and take targeted interventions to reduce the psychological load of the caregivers and improve the quality of life of the patients and their caregivers.