Objective To evaluate the effectiveness of blood gas analysis in samples from two regions.Methods 112 patients with APACHE Ⅱ scores 27 ～ 43 were taken arterial blood from dorsalis pedis artery and femoral artery respectively. Compare the clinical effect of the samples. Results There is no statistically significant difference between results of two blood collection methods ( P ＞ 0. 05 ), While there is statistically significant difference in puncture success ( 110 vs 100, χ2 = 14.23, P ＜ 0. 05 ), vein mistaken injury, hematoma formation, thrombosis, and compression time ( 12 vs 1,7 vs 0,6 vs 0,5.5 ±0.7 vs 2.5 ±0.5 ;χ2 =9.32,5.99,4.85,t = 38. 06, P ＜ 0. 05 ). Conclusions Blood collection method should be determined by the different situation of critically ill patients. Femoral artery blood sample should be taken with caution in order to prevent complication and improve quality of nursing care.

Objective To evaluate the effectiveness of oropharynx airway in post-thoracotomy patients with sputum drainage difficulties. Methods 96 post-thoracotomy patients with sputum drainage difficulties were divided randomly into control group and test group: expectoration through oropharynx airway group and expectoration through nasal cavity group. Heart rate, blood pressure, PO2, SpO2, sputum suction time,successful intubation rate, effect of sputum suction and pulmonary associated complications before and after sputum aspiration between two groups were analyzed. Results There are significant differences in SpO2,PO2 , sputum suction time, successful intubation rate, effect of sputum suction and pulmonary associated complications before and after sputum aspiration between two groups ( t = 11. 16,11. 15, 15.20,8.18,6. 10,6.56,16.70,4.89 ;x2 = 5.76,4.44; P ＜ 0. 05 ), while there are no significant differences in HR and BP (P ＞0. 05 ). Conclusions Sputum suction through oropharynx airway is benefit to keep airway clean,improve respiration and relieve hypoxia.

Objective To discuss the effect of phased reward behavior therapy on rehabilitation of patients with chronic schizophrenia.Methods 60 patients were randomly divided into treatment group (30 cases) and control group (30 cases) according to admission time.The treatment group received reward behavior therapy on the basis of drug treatment and traditional nursing care,while the control group received conventional work entertainment treatment activities.Brief Psychiatric Rating Scale (BPRS),Scale for Schizophrenia Positive Symptoms (SAPS),Negative Symptoms Scale (SANS) and the efficacy of inpatient rehabilitation of mental patients rating scale (IPROS)were used to evaluate the deficiency level of social function,degree of remission and rehabilitation of the patients before and 6 months after the treatment.Results The total average score of BPRS and IPROS of the treatment group were lower than the control group and the differences were significant [(8.81 ±6.41) vs (11.10±8.5),(19.15 ±14.11 ) vs (31.14 ± 16.10 ) ;t =3.18,7.61 ;P ＜ 0.01 ].SAPS and SANS scores of the treatment group were lower than the control group,the differences were significant [ (7.31 ± 1.51) vs ( 10.16 ± 2.10),( 12.32 ± 2.16) vs ( 15.65 ±1.48) ;t =3.62,3.12;P＜0.01].Conclusions Reward behavior therapy could help reduce some of the symptoms of chronic schizophrenia,improve self-care ability,prevent deterioration and regain mental function.

Objective To redesign the clinical nursing post by scientific method and formulate a post description for ICU nurses. Methods The methods of data analysis, observation and interview were used to make a questionnaire for ICU nurses′ post in one general tertiary-level hospital, opinions of 15 experts were filtered by Delphi method from two rounds of questionnaires. Results Finally, 9 types nursing posts had been confirmed, and we studied out 9 post job descriptions. The experts′authority coefficient was 0. 84 while the had a good expert′s opinion coordination coefficient with 0. 36 (P<0. 05). Conclusions Experts′ opinions on the description of ICU clinical nursing post were concentrated and had high re liabilities in this study. It is consistent with the clinical practice and can provide foundations which includes work training, post evaluation and performance evaluation for ICU staffs.

Objective To investigate the health education effect of self-efficacy intervention on schizophrenia patients with diabetes mellitus.Methods Sixty patients were divided according to their hospitalized order,with odd number for the experimental group (n =30) and even number for the control group (n =30).The experimental group received self-efficacy intervention for 10 weeks in addition to drug treatment,while the control group received general preaching health education pattern and conventional nursing method,and each patient was provided with a health education handbook including knowledge about schizophrenia and diabetes,and diabetes monitoring record sheet.Self-designed health knowledge questionnaire and social function flaw screening meter (SDSS) was used to evaluate patients ' cognition about diabetes and social function improvement.Automatic biochemistry analyzer was also used to monitor the control condition of patients' fasting blood-glucose (FPG) and 2-hour postprandial blood-glucose (2 hPG).Results Ten weeks later,patients' knowledge about the cause of disease,drug compliance,notice in drug-taking,complication management,self examination,diet calculation and comprehensive management ability was higher in the experimental group than that in the control group,and the difference was statistically significant (t =2.810,3.843,3.617,2.841,2.741,4.281,3.867,respectively; P ＜ 0.05).Factors in SDSS including social withdrawal,ward activity,personal care,interests in outer world,responsibility and tradition of planning were all lower in the experimental group than those in the control group,and the differences were statistically significant (t =3.640,2.802,2.953,3.241,2.915,respectively ;P ＜ 0.05).The FPG and 2 hPG were also lower in the experimental group than those in the control group,and the differences were statistically significant (t =3.74,3.57,respectively ; P ＜ 0.01).Conclusions Health education based on self-efficacy intervention can improve the symptoms and saccharometabolism of schizophrenia patients with diabetes,thus to further improve patients' social function and quality of life.

Objective To explore the effect of the extended nursing services model on coping style and life quality of patients with depression .Methods Sixty patients were admitted by the community street living into the group, the patients in Beitang district were assigned to the observation group (n=30), and the patients in Nanchang district were assigned to the control group ( n=30 ) .The patients received health education and rehabilitation during hospitalization , health guidance in the discharge , and were followed up for 12 months.The patients in the observation group were transferred to the research system on the integration of community -based rehabilitation , were given the extended nursing services , and were established the service extension file .The coping style and life quality of patients were assessed by the simplified coping style assessment scale ( SCSQ ) and WHO quality of life BREF ( WHOQOL-BREF ) , and the relapse rate was analyzed between two groups . Results No significant differences were found in the scores of SCSQ and the life quality before intervention (P>0.05).The scores of positive and negative response factors were respectively ( 1.79 ±0.37 ), (1.38 ±0.35) in the observation group 12 months after follow-up, and were respectively (1.25 ±0.42), (1.69 ±0.38) in the control group, and the differences were statistically significant ( t =3.53, 3.16, respectively;P <0.01).The scores of physical, psychological, social relations and environmental fields in WHOQOL-BREF scale were respectively (67.58 ±5.76), (75.57 ±5.32), (57.48 ±6.06), (62.26 ± 6.23) in the observation group12 months after follow-up, and were significantly higher than (64.52 ±7.51), (68.61 ±6.43), (53.59 ±6.12), (59.35 ±7.27) in the control group, and the differences were statistically significant (t=2.88, 3.67, 2.78, 2.36, respectively;P<0.01).The relapse rate was 10.7%(3 cases) in the observation group 12 months after follow-up, and was 43.3% (13 cases) in the control group, and the difference was statistically significant (χ2 =7.714, P<0.01).Conclusions The extended nursing services model is helpful to improve the patients ’ coping style , reduce the relapse rate and increase the quality of life .

Objective To discuss the effect of “six preventions” risk assessment form in psychiatry to reduce the accidents occurrence among inpatients .Methods By the time of admission , 233 inpatients were divided into control and intervention group ,from May 2011 to December 2012 as the control group (116 cases), from March 2012 to December 2012 as intervention group ( 117 cases ) .After the patients were admitted to hospital in the intervention group , psychiatric nursesusedself-designed “six preventions” risk assessment form ( impulsion prevention ,running-outprevention , hiding medicine prevention , self-abandonprevention , falling down prevention , and choking prevention ) to assess the risk , divided into high , medium and low risk level according to the rating results , and then implemented tiered nursing intervention , while the control group received routine treatment and nursing .Results Comparing the number and rate of accidents occurrence in the two groups ,the intervention group had three cases with a rate of 2.56%, and the control group had 24 cases with a rate of 20.69%.The difference was statistically significant (χ2 =18.67, P<0.01).For the intervention group, the comparison of the rate of accidents between different types and durations showed no statistical significance ( P>0.05).For the control group, the comparison of the rate of accidents between different types and durations showed a statistical significance (χ2 =14.63,7.79,respectively;P<0.05).Schizophrenia and duration less than 1 year contributed the higher rate of accidents occurrence with a statistical significance (χ2 =23.62, 23.45, respectively;P<0.01).Conclusions Adopting psychiatric risk assessment form of “six prevention” to stratify inpatients can effectively reduce the rate of accidents occurrence .

BACKGROUND: We examined changes in hepatitis B core-related antigen (HBcrAg) during the four sequential phases of chronic hepatitis B virus (HBV) infection: hepatitis B e antigen (HBeAg)-positive chronic infection (EPCI) and hepatitis (EPCH), followed by HBeAg-negative chronic infection (ENCI) and hepatitis (ENCH). We compared the performance of serum HBcrAg, hepatitis B surface antigen (HBsAg), and HBV DNA in predicting EPCH and ENCH. METHODS: We enrolled 492 consecutive patients: 49 with EPCI, 243 with EPCH, 101 with ENCI, and 99 with ENCH. HBcrAg was detected by chemiluminescent enzyme immunoassays. HBsAg and HBeAg were detected by chemiluminescent microparticle immunoassays. HBV DNA was detected by real-time PCR. Predictive performance of HBcrAg, HBsAg, and HBV DNA was evaluated using ROC curves. RESULTS: Areas under ROC curves (AUCs) of HBcrAg, HBsAg, and HBV DNA for predicting EPCH were 0.738, 0.812, and 0.717, respectively; optimal cutoffs were ≤1.43×105 kU/mL, ≤1.89×104 IU/mL, and ≤3.97×107 IU/mL, with sensitivities and specificities of 66.3% and 77.6%, 65.0% and 93.9%, and 60.5% and 79.6%, respectively. AUCs of HBcrAg, HBsAg, and HBV DNA for predicting ENCH were 0.887, 0.581, and 0.978, respectively; optimal cutoffs were >26.8 kU/mL, >2.29×102 IU/mL, and >8.75×103 IU/mL, with sensitivities and specificities of 72.7% and 95.1%, 86.9% and 39.6%, and 89.9% and 92.1%, respectively. CONCLUSIONS: HBsAg and HBV DNA were the best predictors of EPCH and ENCH, respectively. HBcrAg is an important surrogate marker for predicting EPCH and ENCH.
Area Under Curve ; Biomarkers ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Real-Time Polymerase Chain Reaction ; ROC Curve

Objective To investigate the attributable risk(AR)of Acinetobacter baumannii(AB)infection in criti-cally ill patients.Methods A multicenter retrospective cohort study was conducted among adult patients in inten-sive care unit(ICU).Patients with AB isolated from sterile body fluid and confirmed with AB infection in each cen-ter were selected as the infected group.According to the matching criteria that patients should be from the same pe-riod,in the same ICU,as well as with similar APACHE Ⅱ score(±5 points)and primary diagnosis,patients who did not infect with AB were selected as the non-infected group in a 1:2 ratio.The AR was calculated.Results The in-hospital mortality of patients with AB infection in sterile body fluid was 33.3％,and that of non-infected group was 23.1％,with no statistically significant difference between the two groups(P=0.069).The AR was 10.2％(95％CI:-2.3％-22.8％).There is no statistically significant difference in mortality between non-infected pa-tients and infected patients from whose blood,cerebrospinal fluid and other specimen sources AB were isolated(P＞0.05).After infected with AB,critically ill patients with the major diagnosis of pulmonary infection had the high-est AR.There was no statistically significant difference in mortality between patients in the infected and non-infec-ted groups(P＞0.05),or between other diagnostic classifications.Conclusion The prognosis of AB infection in critically ill patients is highly overestimated,but active healthcare-associated infection control for AB in the ICU should still be carried out.

ObjectiveTo explore the regulatory effect of Gouqi chewable tablets on innate and adaptive immunity in normal mice and its antioxidant activity in vitro and in vivo. MethodThe effects of low-， medium-， and high-dose groups （0.25， 0.5， 1.5 g·kg^-1） on the immune function of normal mice were observed by carbon clearance test， immune organ index test， serum hemolysin test， ConA-induced splenic lymphocyte proliferation test， and natural killer cell （NK cell） activity test. The effects of Gouqi chewable tablets on the antioxidant capacity in vivo were determined by detecting the content of superoxide dismutase （SOD）， glutathione peroxidase （GSH-Px）， and malondialdehyde （MDA） in mice serum. The in vitro antioxidant activity of Gouqi chewable tablets was detected by 2，2'-azino-bis（3-ethylbenzothiazoline-6-sulfonic acid） diammonium salt （ABTS）， 2，2-diphenyl-1-picrylhydrazyl （DPPH）， and hydroxyl radical scavenging tests. ResultCompared with the blank control group， the low-， medium-， and high-dose groups of Gouqi chewable tablets improved the viability of NK cells， the proliferation of splenic lymphocytes， and the level of serum hemolysin antibody in mice （P<0.05）. The high-dose group increased the thymus index， spleen index， and phagocytic function of macrophages （P<0.05， P<0.01）. As compared with the blank control group， the activity of GSH-Px in mice serum in the medium-dose group was increased （P<0.05）， and the content of MDA in mice serum in the high-dose group was decreased （P<0.05）. In in vitro antioxidant tests， the median inhibitory concentration （IC₅₀） values of Gouqi chewable tablets were 1.64±0.20， 2.04±0.03， and 10.27±0.03 g·L^-1 by the DPPH， ABTS， and OH^- free radical method， respectively. Those results indicated that Gouqi chewable tablets have good antioxidant effects in vitro. ConclusionGouqi chewable tablets can enhance the immune function of mice with good antioxidant effects.