1.Application of Workshop in training nurses' prevention of falls of hospitalized patients
Jun YANG ; Xintong LIU ; Fu DING ; Yueping ZHU ; Xizhen HE
Chinese Journal of Medical Education Research 2015;(1):104-106
Objective Through adverse event reporting module in hospital nursing manage-ment system, research group screened out the fall incidence higher departments to explore the effect of workshop mode in tralning nurses' prevention of falls of hospitalized patients. Methods A tralning team was set up under the guidance of hospital nursing department, to determine the content of the project and implementation process. 176 registered nurses were received tralning of fall-prevention by workshop mode, compared the differences in fall prevention knowledge level of nurses before and after tralning. Likert's 5-points were used in the investigation for satisfaction of participants. Results Aver-age score of after tralning was (18.66 ±1.32). The previous increase was (2.42 ±2.06). The differences was statistically significant (P=0.000). The comprehensive evaluation of the tralning mode from the participants was over 92.00%, except for the tralner was 89.77%. Participants were satisfied with the workshop mode . Conclusion Application of workshop in tralning program can improve nurses' knowledge of fall-prevention and guarantee patient safety.
2.Research of gerontological nurse practitioner training curriculum
Xintong LIU ; Xiuwen CHI ; Fu DING ; Yueping ZHU ; Xizhen HE ; Jun YANG
Chinese Journal of Medical Education Research 2015;(5):530-533
Objective To explore the theory of curriculum contents for gerontological nurse practitioner training which is suitable for the situation of our country. Method Delphi technique was used in this research to build content indicators of gerontological nurse practitioner training curricu-lum, and calculate the variation coefficient. Results The theory training curriculum includes founda-tions of gerontological nursing, geriatric syndrome, facilitating physiological balance and general gero-tological care modules and 41 core indexs. Every coefficient of variation is less than 20 percent [(4.35±0.71), (4.63±0.57), (4.55±0.57), (4.67±0.55)]. The mean values of the importance (4.54± 0.622) and general characteristics are more than four. Conclusion The content setting of the geron-tological nurse practitioner training theory course not only highlights the training characteristics of the geriatric care, but also has comprehensive and systematic content, reflects humanistic care spirit and pays attention to developing nurses’clinical practice ability. Therefore, it is worthy of reference and promotion.
3.Clinicopathological Characteristics of Tumor Infiltrating Lymphocytes in Ovarian Serous Adenocarcinoma
Xizhen HU ; Jie DING ; Changyan LIANG
Journal of Practical Obstetrics and Gynecology 2017;33(10):764-768
Objective:To investigate the clinicopathological characteristics and immunohistochemical features of tumor-infiltrating lymphocyte(TIL) in ovarian serous adenocarcinoma,and their clinical value.Methods:The immunohistochemistry was used to observe 68 ovarian serous adenocarcinomacases'immunohistochemical features,and their correlations with clinicopathological characteristics were analyzed.Results:There were 43 cases with a large amount of TIL infiltrating in the 68 cases of serous adenocarcinoma,account for 63.24%.There were significant differences on the with or without a large amount of TIL infiltrating among the different tumor grade,different clinical stage,and different CA125 level (P < 0.05).The numbers of CD3 +,CD4 + and CD8 + TIL in the cancer nest were significantly less than those in the stroma,with significantly statistical difference (P < 0.05),Meanwhile the ratio of CD4 +/CD8 + in the cancer nest was significantly less than that in the stroma(P<0.05).The ratio of CD4 +/CD8 + in the cancer nest and stroma at stage Ⅲ and with poor differentiation was significantly lower than in those at stage Ⅰ-Ⅱ and with good differentiation(P<0.05).Meanwhile the ratio of CD8 +/FoxP3 + Treg in the cancer nest was less than that in the stroma(P<0.05).The ratio of CD8 +/FoxP3 + Treg in the cancer nest at stage Ⅲ and with poor differentiation tumor was significantly lower than in those at stage Ⅰ-Ⅱ and with good differentiation(P<0.05).The expression of GzmB in the cancer nest at stage Ⅲ and with poor differentiation tumor was significantly lower than that in the cancer nest at stage Ⅰ-Ⅱ and with good differentiation tumor(P<0.05).Conclusions:With or without a large amount of TIL is related to tumor grade,clinical stage,and CA125 level inovarian serous adenocarcinoma.The numbers of TIL in ovarian serous adenocarcinoma increase considerably,but mainly in the stroma,and which may be related to several factors such as tumor cell differentiation and clinical stage.
4.A nonlinear relationship between the hemoglobin level and prognosis of elderly patients with sepsis: an analysis based on MIMIC-IV.
Penglei YANG ; Jun YUAN ; Qihong CHEN ; Jiangquan YU ; Ruiqiang ZHENG ; Lina YU ; Zhou YUAN ; Ying ZHANG ; Wenxuan ZHONG ; Tingting MA ; Xizhen DING
Chinese Critical Care Medicine 2023;35(6):573-577
OBJECTIVE:
To investigate the correlation of hemoglobin (Hb) level with prognosis of elderly patients diagnosed as sepsis.
METHODS:
A retrospective cohort study was conducted. Information on the cases of elderly patients with sepsis in the Medical Information Mart for Intensive Care-IV (MIMIC-IV), including basic information, blood pressure, routine blood test results [the Hb level of a patient was defined as his/her maximum Hb level from 6 hours before admission to intensive care unit (ICU) and 24 hours after admission to ICU], blood biochemical indexes, coagulation function, vital signs, severity score and outcome indicators were extracted. The curves of Hb level vs. 28-day mortality risk were developed by using the restricted cubic spline model based on the Cox regression analysis. The patients were divided into four groups (Hb < 100 g/L, 100 g/L ≤ Hb < 130 g/L, 130 g/L ≤ Hb < 150 g/L, Hb ≥ 150 g/L groups) based on these curves. The outcome indicators of patients in each group were analyzed, and the 28-day Kaplan-Meier survival curve was drawn. Logistic regression model and Cox regression model were used to analyze the relationship between Hb level and 28-day mortality risk in different groups.
RESULTS:
A total of 7 473 elderly patients with sepsis were included. There was a "U" curve relationship between Hb levels within 24 hours after ICU admission and the risk of 28-day mortality in patients with sepsis. The patients with 100 g/L ≤ Hb < 130 g/L had a lower risk of 28-day mortality. When Hb level was less than 100 g/L, the risk of death decreased gradually with the increase of Hb level. When Hb level was ≥ 130 g/L, the risk of death gradually increased with the increase of Hb level. Multivariate Logistic regression analysis revealed that the mortality risks of patients with Hb < 100 g/L [odds ratio (OR) = 1.44, 95% confidence interval (95%CI) was 1.23-1.70, P < 0.001] and Hb ≥ 150 g/L (OR = 1.77, 95%CI was 1.26-2.49, P = 0.001) increased significantly in the model involving all confounding factors; the mortality risks of patients with 130 g/L ≤ Hb < 150 g/L increased, while the difference was not statistically significant (OR = 1.21, 95%CI was 0.99-1.48, P = 0.057). The multivariate Cox regression analysis suggested that the mortality risks of patients with Hb < 100 g/L [hazard ratio (HR) = 1.27, 95%CI was 1.12-1.44, P < 0.001] and Hb ≥ 150 g/L (HR = 1.49, 95%CI was 1.16-1.93, P = 0.002) increased significantly in the model involving all confounding factors; the mortality risks of patients with 130 g/L ≤ Hb < 150 g/L increased, while the difference was not statistically significant (HR = 1.17, 95%CI was 0.99-1.37, P = 0.053). Kaplan-Meier survival curve showed that the 28-day survival rate of elderly septic patients in 100 g/L ≤ Hb < 130 g/L group was significantly higher than that in Hb < 100 g/L, 130 g/L ≤ Hb < 150 g/L and Hb ≥ 150 g/L groups (85.26% vs. 77.33%, 79.81%, 74.33%; Log-Rank test: χ2 = 71.850, P < 0.001).
CONCLUSIONS
Elderly patients with sepsis exhibited low mortality risk if their 100 g/L ≤ Hb < 130 g/L within 24 hours after admission to ICU, and both higher and lower Hb levels led to increased mortality risks.
Humans
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Male
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Female
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Aged
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Retrospective Studies
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Sepsis/diagnosis*
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Critical Care
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Intensive Care Units
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Prognosis
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Hemoglobins
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ROC Curve