Objective To observe the effect of foam dressing and polyurethane gel pad in prevention of pressure ulcer for surgical patients.Methods 140 patients in neurosurgery department were randomly divided into the control group and the experimental group with 70 patients in each group.The control group received foam-rubber cushion for conventional nursing,the experimental group used foam dressing and polyurethane gel pad to prevent pressure ulcer.Instantly after the operation and 30 min later,the situation of skin pressure ulcer was recorded respectively,the maximum diameter of erythema was measured and the process was put into phases.24 hours after the operation,patients of the above two groups were visited and the situation of skin pressure ulcer was recorded.The skin pressure ulcer and the maximum diameter of erythema were compared between the two groups.Results Cases with phase Ⅰ and phase Ⅱ pressure ulcer in the experimental group were less than those of the control group at three time points,which were instantly after the operation,30 min and 24 hours later.The diameter of erythema at three time points was also less than the control group.Conclusions Foam dressing and polyurethane gel pad could effectively prevent or alleviate pressure ulcer after operation and therefore is worthy of clinical application.

Objective To use the method of Meta-analysis to evaluate the effect of the evidencebased nursing in preventing the deep vein thrombosis after orthopaedic surgery,to provide the basis for clinical prevention of DVT.Methods The randomized controlled trials (RCT) on the evidence-based nursing in preventing the DVT were collected using the databases of China National Knowledge Infrastructure (CNKI),Wanfang Periodical Databases,Chinese Science Technology Periodical Databases (VIP) and PubMed and analyzed by RevMan 5.2 software.Results Nine RCTs were included in the study.The results of Meta-analysis revealed that the incidence of the DVT could be effectively prevented by evi-dencebased nursing.Conclusions The evidence-based nursing can reduce the incidence of the DVT after orthopaedic surgery.

BACKGROUND:With the development and improvement of liver transplantation technology, patients waiting for or undergoing liver transplantation have continued to increase in number. Due to their fears and concerns about post-transplantation rehabilitation, patients are under physical and mental stress, most of whom are shown to have a variety of mental disorders that affect rehabilitation. At present, mental problems of liver transplant patients are more concentrated in post-transplantation research, while patients waiting for liver transplantation do not get enough mental assessment and intervention.
OBJECTIVE:To investigate the suitable mode of cognitive-behavioral therapy for liver transplant recipients waiting for donor liver and to evaluate the effect to improve patient’s physical and mental state.
METHODS:Twelve liver transplant patients who underwent pre-transplantation assessment were randomly divided into experimental group and control group, each group with six cases. The control group received conventional treatment. The experimental group received cognitive-behavioral therapy in addition to conventional treatment. Self-rating anxiety scale (SAS) and vital signs were measured in the two groups on admission, 1 week and 3 weeks after admission.
RESULTS AND CONCLUSION:The SAS score of the experimental group was lower than that of the control group at 1 and 3 weeks after admission, and SAS score decreased as the intervention extended. The systolic blood pressure of the experimental group was lower than that of the control group at 3 weeks after admission, but there was no significant difference in diastolic blood pressure between two groups. The heart rate of the experimental group was lower than that of the control group at 1 and 3 weeks after admission. The respiratory rate of the experimental group was lower than that of the control group at 3 weeks after admission. Cognitive-behavioral therapy can reduce the level of anxiety and keep vital signs stable with good feasibility and effectiveness in patients waiting for liver transplantation.

White matter hyperintensities (WMHs) is a magnetic resonance imaging phenotype of cerebral small vessel disease,which is manifested as diffuse or confluent subcortical white matter.There is usually no clinical manifestation in the early stage of WMHs,and its pathophysiological mechanism has not been fully elucidated.Studies have shown that a variety of factors are associated with WMHs.The article reviews the risk factors for WMHs.

Objective To study the risk factors and to provide preventive measures of pulmonary infection for patients with severe brain injury.Methods A total of 320 patients with severe brain injury were analyzed with hospital-based case-control study method.A total of 101 patients complicated with lung infection were set as the experimental group.Another 101 patients with no pulmonary infection according to the proportion of 1:1 choice over the same period were set as the control group.The related factors were analyzed with the univariate analysis and the multiple factors Logistic regression analysis.Results Univariate analysis showed that the occurrence of pulmonary infection of patients with severe brain injury was closely related to the old age,low GCS score,long time stay in the bed,long time hormone application,long time antibiotic application,the combined underlying disease,use of mechanic ventilation,long-term smoking history and indwelling gastric tube.Multivariable Logistic regression analysis showed that the application of mechanic ventilator,the combined underlying disease and long time stay in bed were the independent risk factors for pulmonary infection of patients with severe brain injury,but GCS score was a protective factor.Conclusions The occurrence of lung infection were related to the ventilator application,the combined underlying disease,long time stay in bed and low GCS score.Considering these risk factors,the medical staffs should take preventive measures early to control lung infection.

Objective To evaluate the impact of programmed nursing intervention based on MEWS for potential accidents in critical patients.Methods The randomized controlled trials (RCT) on programmed nursing intervention based on MEWS for potential accidents in critical patients were collected using the databases of PubMed,Medline,FMJS,CNKI,Wanfang database,VIP.Data were analyzed with RevMan5.0 software.Results Four RCTs were included in the study.All were Chinese articles.The incidence of accidents in the intervention group was significandy lower than that of the control group,the difference was statistically significant.Conclusions Programmed nursing intervention based on MEWS can effectively reduce the potential accidents happened in critical patients.

Objective To evaluate the effect of the bundle of care interventions in preventing ventilator-associated pneumonia (VAP) in the mechanic ventilated patients.Methods The randomized controlled trials (RCT) on the bundle of care interventions in preventing ventilator-associated pneumonia (VAP) were collected using the databases of PubMed,Medline,Embase,Cochrane library,China National Knowledge Infrastructure (CNKI),Wanfang Periodical Databases and Chinese Science and Technology Periodical Databases (VIP),data were analyzed by RevMan5.0 software.Results Ten RCTs were included in the study.The results of Meta-analysis revealed that the incidence of ventilator associated pneumonia,mechanical ventilation time,ICU length of hospital stay and the mortality rate in the intervention group were different from the control group,the difference had statistical significance.Conclusions The bundle of care interventions can reduce the incidence of ventilator-associated pneumonia,mechanical ventilation time,ICU length of hospital stay and the mortality rate.

Objective To discuss the application effect of evidence-based nursing in preventing the phlebitis using the method of Meta analysis,and provide basis for clinical prevention of phlebitis.Methods The randomized controlled trials (RCT) on the evidence-based nursing in preventing the phlebitis were collected using the databases of China National Knowledge Infrastructure(CNKI),Wanfang Periodical Databases,Chinese Science Technology Periodical Databases (VIP) and PubMed which were analyzed by RevMan 5.0 software.Results Seven RCTs were included in the study.The results of meta-analysis revealed that the incidence of the phlebitis was effectively prevented by evidence-based nursing.Conclusions The evidence-based nursing can reduce the incidence of the phlebitis.

Objective To analyze the characteristics of early cognitive impairment in leukoaraiosis (LA) patients and fractional anisotropy (FA) changes by diffusion tensor imaging (DTI) in various regions of interest (ROIs), and explore the relationship between FA values and cognitive impairment. Methods A total of 38 chronic ischemic LA patients, admitted to our hospital from August 2015 to August 2016, and 20 healthy elderly controls were chosen in our study. Comprehensive assessment of cognitive functions, and MRI and DTI examinations were performed in subjects from these two groups. The cognitive functions, and FA values in ROIs were compared between the two groups;the FA values in ROIs of mild, moderate, and severe ischemic LA patients were compared. The correlations between FA values in ROIs and cognitive functions in LA patients were analyzed. Results As compared with the healthy control group, the patient group had significantly lower Mimi Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores, statistically longer time of Stroop test C, lower scores of verbal fluency test (VFT), digit span (DS)-inverted sequence, word similarity test in Chinese Revision of Wechsler Intelligence Scale for Children (WISC-CR), auditory verbal learning test (AVLT), clock drawing test and block testing, and significantly longer time of Trail Marking Test A (TMTA) and Stroop test B (P<0.05), suggesting that the overall cognitive function, executive function, memory, visual-spatial ability, information processing capability of LA patients decreased greatly. Significantly decreased FA values in bilateral anterior horn of lateral ventricle, left superior frontal gyrus, left inferior frontal gyrus, bilateral frontal orbital gyrus, right deep temporal lobe, right cingulate gyrus, and genu of corpus callosum in the LA patient group were noted as compared with those in the control group (P<0.05). In mild, moderate and severe LA patients, the FA values of these ROIs decreased in turn, with statistically significant differences (P<0.05). In the LA patient group, correlation analysis showed that the scores of auditory verbal learning test were positively correlated with FA values in the brain regions of left anterior horn of lateral ventricle, bilateral frontal orbital gyrus, deep white of right temporal lobe, right cingulate gyrus, and genu of corpus callosum (P<0.05), and negatively correlated with FA values in left inferior frontal gyrus (P<0.05); the scores of trail making test A were negatively related with FA values in right anterior horn of lateral ventricle (P<0.05); the Stroop test B scores were negatively correlated with FA values in deep white matter of the right temporal lobe (P<0.05); the Stroop test C scores were negatively related with FA values in left orbital frontal cortex, deep white of right temporal lobe, right cingulate gyrus, and genu of corpus callosu (P<0.05); and the block testing scores were positively related with FA values in left frontal orbital gyrus, right temporal lobe deep, and genu of corpus callosu (P<0.05). Conclusions The early cognitive impairment and decreased FA values are noted in LA patients. FA values are related to cognitive impairment. DTI contributes to diagnose early cognitive impairment in LA patients.