Objective To evaluate the influence of preoperative quitting time on coronary artery bypass grafting (CABG) patients with postoperative hypoxemia incidence.Methods 151 patients with coronary bypass surgery and preoperative history of smoking who preparation of CABG in hospital were recruited from September 2011 to September 2013.According to the preoperative smoking cessation time patients were divided into five groups:0 days,1-30 days,31-60 days,61-90 days,more than 90 days.Single factor regression and Logistic analysis were used to analyse the influence of preoperative quitting time on CABG patients with postoperative hypoxemia incidence.Results Age,weight,smoking habit,quitting time,hypertension,diabetes mellitus were risk factors of hypoxemia after coronary artery bypass grafting.Logistic regression analysis showed that age,body weight,smoking habit,smoking time were independent risk factors of hypoxemia after coronary artery bypass grafting.The incidences of hypoxemia of the five groups 0 days,1-30 days,31-60 days,61-90 days and more than 90 days were 55.56％ (15/27),59.26％ (16/27),27.58％ (8/29),22.73％ (5/22),15.63％ (5/32).The incidence of hypoxemia had significant difference (x2=19.212,P ＜ 0.05).Conclusions Age,weight,smoking habit,quitting time were independent risk factors of hypoxemia after CABG.With the quitting time increase,hypoxemia after CABG overall downward trend.Difference quitting time before the operation,the hypoxemia occurred difference rate influence,On the preoperative smoking CABG patients were smoking cessation intervention timely helps to reduce the occurrence of postoperative hypoxemia.

Objective To discuss the nursing care for patients with advanced hepatocellular carcinoma (HCC) who are receiving transcatheter arterial chemoembolization (TACE) combined with sorafenib. Methods A total of 23 consecutive patients with advanced HCC who met the inclusion criteria were enrolled in this study. TACE was carried out in all patients. Three-five days after TACE the patients started to orally take sorafenib. During the treatment course, the patients were kept under close observation for adverse reactions and complications. After leaving the hospital the patients were followed up by the extended care team members, and health education as well as appropriate nursing intervention was carried out. Results All patients with advanced HCC took sorafenib orally after TACE. The major adverse events and complications were gastrointestinal adverse reactions (n = 22) and transient liver dysfunction (n = 23). After leaving the hospital all the patients received regular follow- up examination and extended nursing care. Conclusion Usually, the incidence of adverse reactions is higher in patients with advanced HCC after TACE combined with sorafenib treatment. Careful in-hospital observation and extended out-hospital nursing can reduce the incidence of adverse reactions and thus improve the patient’s quality of life.

Objective To investigate feasibility and clinical application value of improved percutaneous transhepatic biliary internal-external drainage (PTBIED).Methods Consecutive patients from April 2007 to April 2010 with malignant obstructive jaundice were diagnosed by medical imaging or pathological confirmation whenever possible.The patients with proximal malignant biliary obstruction and intact inferior common bile ducts ＞ 3 cm in length,and a bilirubin of 70 μmol/L or higher,were included in the experimental group.The control group included patients with low malignant biliary obstruction,and those who met the criteria for the experimental group but refused to receive the altered method of PTBIED.The patients underwent traditional PTBIED in control group.The patients in the experimental group received the procedure as following:according to percutaneous transhepatic cholangiography,a biliary external drainage catheter was modified by adding side-holes.Then under fluoroscopic guidance,the loop tip of the modified biliary drainage catheter was positioned in the inferior common hepatic duct/common bile duct,while the additional side-holes were located in the expanded hepatic duct.Technical success rate,complications,hepatic function and white cell count (WBC) were recorded pre- and post-procedure.All patients were followed-up until death.A t-test was used to compare continuous variable data changes,the Chi-square test was used to compare categorical variable data in two groups,and survival time was assessed using the Kaplan-Meier method.Results Forty-six patients were included in the study,with 21 in the experimental group and 25 in the control group.The procedures were successfully performed in all patients in the two groups.There was no procedure-related death in the two groups.Symptoms were improved similarly after procedures in the two groups.The mean quantity of drained bile per day [experimental group (521 +136) ml/d,control group (606 + 159 ) ml/d,t =1.930,P ＞ 0.05],decrease of the serum total bilirubin after the procedures [ experimental group (87 ± 51 ) μmol/L,control group( 105 ± 66 ) μmol/L ( t =1.061,P ＞ 0.05 ) ] and the median survival time ( experimental group 7.7 months,control group 6.9 months,x2 =0.610,P ＞0.05 ) of the patients showed no statistically significant difference between two groups.The mean WBC amount of patients was higher after the traditional procedure [ ( 10.9 ±5.2) × 109/L] than before the procedure [ (7.8 ±2.9) × 109/L] in the control group ( t =3.606,P ＜ 0.05 ),but the converse change occurred in the experimental group [ pre-procedure (8.2 ± 3.4) × 109/L ],post-procedure [ (7.4 ± 2.6) × 109/L] ( t =2.649,P ＜ 0.05 ).No reflux of duodenal juice was observed in all patients of the experimental group,and 1 patient had infection of biliary tract.The reflux was observed in 11 patients of the control group after conventional PTBIED.Of them,8 patients had infection of biliary tract.Incidence rate of infection of biliary tract in the control group was higher than that in the experimental group( x2 =5.381,P ＜ 0.05 ).Conclusions Improved PTBIED is convenient and feasible,and compared with traditional PTBIED,it can reduce the complications of infection of biliary tract.

Objective:To retrieve, evaluate, and integrate the best evidence of general anesthesia health education for adult patients undergoing elective surgery, so as to provide a basis for clinical health education guidance.Methods:Evidence-based questions were established based on the population, intervention, professional, outcome, setting and type of evidence (PIPOST) model. All evidence on general anesthesia health education for adult patients undergoing elective surgery were retrieved from databases or professional association websites such as Cochrane Library, British Medical Journal (BMJ) Best Practice, UpToDate, Agency for Healthcare Research and Quality, Guidelines International Network, National Institute for Health and Clinical Excellence, Clinical Guidelines Library, PubMed, China National Knowledge Infrastructure, WanFang Data, Medlive, American Society of Anesthesiologists, and Society of Anesthesiology of the Chinese Medical Association. The search period was from database establishment to June 18, 2023. Two researchers screened and evaluated the quality of the included literature, extracted and integrated the evidence to form the best evidence for general anesthesia health education in adult patients undergoing selective surgery.Results:A total of 10 articles were included, including four guidelines, three clinical decision-making, and three expert consensus. A total of 41 pieces of evidence on general anesthesia health education for adult patients undergoing elective surgery were extracted, including six aspects of anesthesia overview, pre-anesthesia evaluation, pre-anesthesia preparation, anesthesia process and cooperation, anesthesia recovery period management, and postoperative management.Conclusions:The best evidence of general anesthesia health education for adult patients undergoing selective surgery summarized can provide a basis for comprehensive and systematic education of anesthesia health educators.

Objective To discuss the health education effect of a self-made health education video for patients with hepatic carcinoma who are receiving transcatheter arterial chemoembolization (TACE)therapy.Methods Based on the needs of patients,a TACE health education video was designed and produced,which was input into the tablet personal computer,such as iPad,to let patients watch.A total of 451 patients with liver cancer,who were admitted to the Department of Intervention,First Affiliated Hospital of Henan University of Technology and Science,China,to receive TACE during the period from June 2014 to June 2016,were included in this study.By using the random number table method,the patients were divided into the observation group (n=226) and the control group (n=225).The self-made health education video together with regular education was used to educate the patients of the observation group,while routine oral and written education was executed for the patients of the control group.The cognition to TACE-related knowledge,the compliance with postoperative treatment and nursing,and the patient's satisfaction were assessed and the results were compared between the two groups.Results The cognition in the following three aspects,including TACE-related knowledge,perioperative education and discharge education,in the patients of the observation group was significantly higher than that in the patients of the control group (P＜0.05).The compliance with postoperative treatment and nursing in the patients of the observation group was remarkably higher than that in the patients of the control group (P＜0.01).The patient's satisfaction in the patients of the observation group was strikingly higher than that in the patients of the control group (P＜0.01).Conclusion Health education by using a self-made health education video can improve liver cancer patient's cognition to TACE as well as the patient's compliance with postoperative treatment and nursing.The health education in the form of watching video can significantly improve health education effect and the satisfaction of the patients.Thus,it is worthy of clinical application.