Objective To analyze if the increasing the dose and time of vancomycin will increase the renal toxicity risk in patients with resistance to toluene penicillin Staphylococcus aureus (methicillin-resistant Staphylococcus aureus, MRSA) and blood drug concentration significance in the course of treatment.Methods We enrolled 105 patients, mean age (58.0 ±5.8) years;59 males (61.9%) treated in our hospital with MRSA.Patients’ age, sex, serum creatinine (SCr), creatinine clearance rate (CrCl), serum vancomycin concentrations, duration of treatment, acute physiology and chronic health evaluation II score were analysed.The definition of renal toxicity is that SCr is higher than the baseline 0.5 mg/dL, or according to the measurement results of a series SCr:SCr elevation≥50%.The relevant data in patients with renal toxicity and non toxicity were compared.Results 45 (42.9%) had renal toxicity.Vancomycin concentration was significantly higher in renal toxicity patients than non toxicity [(20.9 ±9.8)μg/mL vs. (14.2 ±6.6)μg/mL, P<0.001), serum drug concentration≥15μg/mL (67.8% vs 40.3%; P =0.01) and vancomycin treatment duration (14 days) ( 46.0% vs 21.4%; P =0.011 ) has obvious different scale between two groups. Regression analysis showed that: vancomycin serum concentration≥15μg/mL and prolonged treatment were independent predictors of renal toxicity ( adjusted likelihood ratio =2.83; 95%CI, 1.03 ~7.72, P=0.045).Conclusion The increase of vancomycin dosage and treatment time was the risk of nephrotoxicity.

Objective:To explore the effect of phased nursing based on the compliance curve in pelvic floor function rehabilitation training for patients with stress urinary incontinence.Methods:From January 2019 to June 2020, convenience sampling was used to select 70 patients with stress urinary incontinence in the Urology Surgery, the Second Affiliated Hospital of Zhejiang Chinese Medical University as the research object. Patients were randomly divided into the control group and the intervention group with the random number table method, each with 35 cases. The control group conducted conventional nursing, and the intervention group carried out phased nursing based on the compliance curve on this basis. The treatment effects of the two groups after intervention were compared, and the self-efficacy and quality of life of the two groups of patients before and after the intervention were compared through the Pelvic Floor Muscle Training Self-Efficacy Scale and the Incontinence Quality of Life Questionnaire (I-QOL) .Results:After the intervention, the treatment effect of the intervention group was better than that of the control group, and the difference was statistically significant ( P<0.05) . After the intervention, the self-efficacy score of patients in the intervention group was (1 328.8±276.8) , which was higher than that (1 150.5±324.8) of the control group, and the difference was statistically significant ( P<0.05) . After the intervention, the total score and the scores of each dimension of the I-QOL of the intervention group were higher than those of the control group, and the differences were statistically significant (all P<0.05) . Conclusions:The phased nursing based on the compliance curve applied to the pelvic floor function rehabilitation training for patients with stress urinary incontinence can improve the treatment effect, self-efficacy and quality of life of the patients.