Objective To investigate the actual cost and benefit of stoma nursing at present as a reference for the improvement of stoma care cost management program. Methods A cross sectional study was carried out in gastrointestinal surgery of a tertiary- level hospital in southwestern China from April 2014 to December 2014. The consumption of intestinal stoma care work, the average monthly income/average monthly working hours ratio and other indicators of stoma care nurse specialist were measured by the step cost allocation method, to investigate the actually cost of a single stoma care service which colostomy patients had received and analyze the gap between actually costs and charge standard of Sichuan Province. Results The directly human cost of stoma care expenses were (22.33 ± 3.66) yuan; working fee expenses were (4.18 ± 0.68) yuan;administrative expenses were (1.87 ± 1.32 ) yuan; research and education expenses were (1.87 ± 1.32 ) yuan; the total cost of investment was (29.14 ± 4.76) yuan, which was much higher than the current charge standard of Chengdu Bureau of Commodity Prices (t=119.50, P <0.05). Conclusions There is a difference between the actual cost and charge standard of stoma care. The situation of low pay to labor is not in line with economic laws, and not conducive to the future development of stoma care speciality.

Objective To investigate the clinical application of Morse Fall Scale by primary nurses.Methods Morse Fall Scale was used to assess the falling risk in 21,378 patients by the primary nurses.The application of the Morse Fall Scale, choices of right time for assessment and the occurrence of falls in patients with risks of falling were evaluated by a self-designed questionnaire.Results Among 21,378 patients, 222 patients were at risk of falling.In terms of the items like the history of falls,more than one diagnosis,intravenous injection,the accuracy of assessment was above 91.6%.In terms of the items like aided walking,gait,cognitive state,the assessment accuracy is below 86.0%.The accuracy of assessment timing selection in the situations like admission,the score by Morse fall scale over 24at admission and the accuracy in choosing right time for assessment was was above 90.2% after transferring to other deparments and falling.The accuracy in choosing the right time for fall assessment was below 67.9% under such conditions as apostasies,and oral administration of drugs probably leading to fall. Conclusions It is acceptable that the primary nurses use the Morse fall scale to assess patients with risky falls and for the right choice of assessment.Attention should be paid to strengthen the nurses training to improve the accuracy of the scale,to make sure to choose right time for the assessment so as to prevent the falls of patients to the greatest extent.

Objective To study the interactive debridement methods in treatment and nursing of the wound in patients with abdominal surgical incision infection.Methods In May 2010 to December 2013 in West China hospital of Sichuan University,54 patients with postoperative incision infection accompanied with tissue necrosis after gastrointestinal surgery were divided into two groups,23 cases who accepted interactive debridement treatment were set as the observation group,31 cases with traditional dressing hypertonic saline gauze debridement were named as the control group.The wound debridement completion time,wound healing velocity,wound healing time,dressing change frequency and cost were compared between two groups of patients.Results Compared with those of the control group,in the observation group,the wound debridement completion time was shorter,wound healing velocity was faster,dressing change frequency was longer.Although single dressing change cost was higher in the observation group,but the total dressing change cost was lower compared with the control group.Conclusions The interactive debridement methods used in treatment and nursing of patients with abdominal surgical incision infection showed good effect and safety,which is worthy of wide clinical application.

Objective To investigate the effect of passive exercise on neural functional recovery after peripheral nerve crushed injury.MethodsThe effect of passive exercise on early peripheral nerve regeneration and recovery of motor function were observed with electrophysiological and histological indexes compared with that of the splinting group.ResultsThe nerve conduction of training group was faster than that in the splinting group,and the latency of compound muscle action potentials(CMAP)was shorter(P<0.05).The thickness of myelin sheath,average numbers of myelinated nerve fibera per area and diameter of regenerating axon in training group were larger than those in the splinting group(P<0.05).The wet weight of sural triceps of training group were bigger than that of the splinting group(P<0.01).ConclusionThe passive exercise can improve the early recovery of motor function and neural regeneration after peripheral nerve crushed injury.

Objective To observe the effects of rehabilitation training combined with health education on quality of life and psychological state of elderly patients with chronic obstructive pulmonary disease (COPD).Methods A total of 108 elderly inpatients with moderate to severe COPD in stable conditions were randomly divided into an intervention group and a control group,with 54 patients in each group.The patients in both groups received general respiratory medical therapy.The patients in intervention group also received additional comprehensive rehabilitation training consisting of individualized exercise instructions and health education,while the patients in control group only received online telephone health education and rehabilitation training instruction.Patients in both groups were assessed by using St.George's respiratory questionnaire (SGRQ) and symptom checklist 90 (SCL-90) before and after one year of treatment.Results After treatment,the control group's scores for various SGRQ items were similar to the scores within the group before treatment (P ＞ 0.05).The intervention group's SGRQ scores for symptoms,mobility and impact on life and the total score were (42.12 ± 11.32),(45.17 ± 10.23),(29.98 ± 6.54) and (41.02±9.92),respectively,significantly different from their baseline values and those of the control group after treatment (P ＜ 0.01).After treatment,the intervention group's SCL-90 scores were significantly improved from baseline values and were also significantly different from the control group (P ＜ 0.05).Comparison between the two groups showed that throughout the treatment period,the number of patients with acute attacks and the number of patients' hospitalization due to acute attacks were statistically significantly lower in the intervention group (P ＜ 0.05).Conclusions Rehabilitation training combined with health education can significantly improve quality of life and psychological health of COPD patients.

A case of suppurative meningitis caused by Streptococcus suis infection is reported. The patient was an elderly female with an atypical epidemiological history. The common symptoms included fever, headache and cervicodynia. According to the results of blood bacterial culture and next-generation sequencing of cerebrospinal fluid, the patient was considered purulent meningitis caused by Streptococcus suis. After treatment with the third generation cephalosporins, the symptoms improved significantly. One week after the onset of the disease, herpes labialis occurred, followed by hearing loss about 1 week later. The patient was treated with antiviral and hormone therapy, and was discharged after improvement.

Objective:To explore the application of understanding teaching mode combined with hierarchical training in the standardized training of nurses in gastrointestinal surgery department.Methods:Sixty-three nurses who had standardized training in gastrointestinal surgery department in West China Hospital, Sichuan University from January 2018 to January 2022 were selected as the study objects, among which, 32 nurses from January 2018 to July 2020 were set as the control group, taking regular training method, and 31 nurses from August 2020 to January 2022 were set as the observation group, taking the understanding teaching mode combined with hierarchical training method. The core competence scores of the two groups after training were compared, the scores of basic theory and practical skills of the two groups were compared, and the satisfaction degree of nurses during training was compared between the two groups. SPSS 22.0 was used to perform t-test. Results:After the training, the scores of core competence in the observation group were higher than that in the control group, and the difference was statistically significant ( P < 0.05). The scores of theoretical assessment (96.59±3.22) and practical skills (97.09±2.88) in the observation group were significantly higher than those in the control group (91.52±2.45)(91.14±2.85) ( P < 0.05). The total satisfaction scores of the observation group (93.48 ± 2.52) was higher than that of the control group (86.80 ± 2.22), and the difference was statistically significant ( P < 0.05). Conclusion:It is suggested that understanding teaching mode and joint hierarchical training can improve the core ability and assessment score of nurses in gastrointestinal surgery department, and improve the satisfaction of nurses.

OBJECTIVETo explore the effect of rehabilitation exercise combined with encouragement on the quality of life of patients with chronic obstructive pulmonary disease (COPD).

METHODSA total of 120 inpatients with moderate or severe COPD in stable conditions were randomized equally into experimental and control groups. The patients in both groups received routine treatment for 1 year, and those in the experimental group had additional respiratory muscle and limb exercises with encouragement. The quality of life, 6-min walking distance, lung function, anxiety and depression levels were compared between the two groups before and after the treatments.

RESULTSThe quality of life was improved significantly in the experimental group after the treatments (P<0.01) with obviously increased 6-min walking distance and lowered levels of anxiety and depression in comparison with those in the control group (P<0.05). Compared with the control group, the patients in the experimental group showed also significantly improved lung functions.

CONCLUSIONComprehensive pulmonary rehabilitation training program with exercise combined with encouragement can improve the physical and emotional state, social adapt ability and the quality of life of patients with COPD.

Aged ; Aged, 80 and over ; Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Psychotherapy ; Pulmonary Disease, Chronic Obstructive ; therapy ; Quality of Life ; Treatment Outcome

Objective: To explore the genetic basis for a patient with autism. Methods: High-throughput sequencing was carried out to detect copy number variations in the patient. Results: DNA sequencing found that the patient has carried a 0.11 Mb deletion in distal 2p16.3 spanning from genomic position 50 820 001 to 50 922 000, which resulted removal of exon 6 and part of intron 7 of the NRXN1 gene. The same deletion was not found his parents and brother. Conclusion Partial deletion of the NRXN1 gene may underlie the disease in this patient.

This study was aimed to observe the curative effect and safety of Danzhi Jiangtang Capsule ( DJC ) combined with atorvastatin on carotid artery intima-media thickness (IMT) in diabetes patients without hyper-tension . A total of 196 diabetes patients without hypertension with incrassate carotid artery IMT were randomly divided into the control group ( 98 cases ) and the treatment group ( 98 cases ) . The conventional diabetes thera-py was given to both groups . The atorvastatin of 20 mg/night was given to the control group . And the atorvas-tatin 20 mg/night added with DJC 9 . 0 g/night were given to the treatment group . The treatment course was
12 months . Carotid artery IMT , carotid atherosclerotic plaque area , FPG , FIns , HOMA-IR , HbA1c , blood lipids , hepatorenal function and etc . were examined before and after the treatment respectively . The results showed that there was a significant positive correlation between carotid artery IMT and FIns , HOMA-IR , HbAlc , LDL-C . After 12-month treatment , the total effectiveness is 85 . 87% in the treatment group . And there was significant difference compared with the control group ( P < 0 . 05 ) . The levels of FPG , FIns , HOMA-IR , HbAlc of the treatment group had no difference compared with the control group . Compared with the control group, TC and LDL-C of the treatment group was obviously decreased (P < 0.05). And HDL-C was significantly increased ( P < 0 . 05 ) . The carotid artery IMT of the treatment group decreased from ( 0 . 11 ±0 . 01 ) cm to ( 0 . 08 ± 0 . 01 ) cm . And compared with the control group , there was statistical significance ( P <0 . 05 ) . The carotid atherosclerotic plaque area of 58 cases in the treatment group decreased from ( 0 . 37 ±0.56) cm2 to (0.21 ± 0.25) cm2. However, there was no statistical significance compared to the control group. There were 5 adverse events in the control group and 9 adverse events in the treatment group . And there was no difference between two groups. It was concluded that DJC combined with atorvastatin can regulate lipid metabolism and reduce carotid artery IMT .