1.Discussion of stroke unit management in nursing based upon international standards in neurology department
Qunli XU ; Lijun FENG ; Xiuhua RAO
Chinese Journal of Practical Nursing 2013;29(30):73-75
Objective To discuss the practice of nursing management model of stroke unit based upon the international standards implemented in the neurological unit.Methods The experiences of the stroke unit management were summarized and applied to instruct the clinical practice.Results After the implementation,the average hospitalization days,the proportion of drugs,medical cost,and mortality rate decreased.The satisfactory degree of patients with the stroke unit increased.Conclusions The nursing management model of stroke unit not only improved the quality of nursing service to stroke patients,but also decreases the mortality and disability rate,shortened the length of hospital stay,and enhanced the satisfaction degree of patients and their family members.
2.The risk factors and the etiology analysis of early infection in recipients following liver transplantation
Xiuhua XIE ; Yingjun JIANG ; Man XIE ; Xinjuan KONG ; Wei RAO ; Yunjin ZANG ; Tingting WANG
Chinese Journal of Organ Transplantation 2017;38(4):200-205
Objective To explore the risk factors,the distribution of etiology and drug resistance status of patients with early infection (3 months) after liver transplantation,and to provide reference for clinical diagnosis and treatment.Methods The clinical data of 112 recipients from February 2014 to December 2015 were collected,and logistic regression analysis was performed on the risk factors of early postoperative infection in liver transplant patients.The independent risk factors of infection after liver transplantation were screened out.At the same time,the results of pathogen culture and drug sensitivity test were statistically described.Results The independent risk factors for infection at 3th month after liver transplantation included the operative time ≥600 min [P =0.003,odds ratio (OR) =9.996,95 % confidence interval (95 % CI),2.221-44.981],intensive care unit (ICU) ≥6 days (P =0.010,OR =6.306,95% CI =1.563-25.437),Child-Pugh grade of C (P =0.023,OR =6.298,95% CI =1.294-30.659).Of the 112 liver transplant recipients,59 had an infection (52.68%),and 168 stains of pathogens were isolated.The positive rate of the specimens was highest in sputum,followed by bile,ascites,drainage and catheter end,blood,deep vein catheter,middle urinary,pleural effusion and peripherally inserted central catheter (PICC).The detectable rate of gram-negative bacteria,gram-positive bacteria,fungi and viruses was 46.43% (78 strains),29.76% (50 strains),18.45% (31 strains),and 5.36% (9 strains) respectively.Infection occurred mainly within 1 month after surgery,accounting for about 80.36% (135 strains),especially at 1st week after surgery,accounting for about 34.52% (58 strains).Gram-positive bacteria had a higher drug resistance rate,including penicillins,macrolides,aminoglycosides,quinolones,linamides,etc.especially in the highest rate of Enterococcus faeciurr.Gram-negative bacteria were individualized based on the different strains of the bacteria,and they were relatively low in the resistance of the carbapene.Conclusion Infection is one of the most common complications after liver transplantation.To reduce the incidence of infection after liver transplantation,efforts should be made to shorten the duration of operation and ICU stay time,improve the basic nutritional status of recipients,and enhance monitoring of the recipient's infection after liver transplantation,to further increase the survival rate of postoperative liver transplantation recipients and improve the quality of life.
3.Management of a colon cancer patient complicated with COVID-19.
Ziqi YE ; Yun HONG ; Xiuhua WU ; Dongsheng HONG ; Yanfang ZHANG ; Xihao DONG ; Yuefeng RAO ; Xiaoyang LU
Journal of Zhejiang University. Medical sciences 2020;49(2):245-248
OBJECTIVE:
To explore the feasibility of radical resection for cancer patients complicated with coronavirus disease 2019 (COVID-19).
METHODS:
The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed.
RESULTS:
The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice.
CONCLUSIONS
The case indicates that radical resection can be performed in SARS-CoV-2 patients with twice-negative SARS-CoV-2 nucleic acid testing results.
Betacoronavirus
;
isolation & purification
;
Colonic Neoplasms
;
complications
;
surgery
;
Coronavirus Infections
;
complications
;
therapy
;
Disease Management
;
Humans
;
Pandemics
;
Pneumonia, Viral
;
complications
;
therapy
;
Treatment Outcome
4.Management of a colon cancer patient infected with corona virus disease 2019.
Ziqi YE ; Yun HONG ; Xiuhua WU ; Dongsheng HONG ; Yanfang ZHANG ; Xihao DONG ; Yuefeng RAO ; Xiaoyang LU
Journal of Zhejiang University. Medical sciences 2020;49(1):245-248
OBJECTIVE:
To explore the feasibility of surgical treatment for cancer patients complicated with corona virus disease 2019 (COVID-19).
METHODS:
The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed.
RESULTS:
The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice.
CONCLUSIONS
The case indicates that it may feasible to undergo radical tumor surgery for cancer patients with COVID-19 after the virus nucleic acid testing turns negative and more studies are needed to confirm this conclusion.
Antiviral Agents
;
therapeutic use
;
Betacoronavirus
;
Clinical Laboratory Techniques
;
Colonic Neoplasms
;
complications
;
surgery
;
virology
;
Coronavirus Infections
;
complications
;
diagnosis
;
drug therapy
;
Fever
;
Humans
;
Nucleic Acid Amplification Techniques
;
Pandemics
;
Pneumonia, Viral
;
complications
;
diagnosis
;
drug therapy