1.Research on the application of holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy
Chen MA ; Yajuan YAN ; Yue HE
China Medical Equipment 2017;14(9):100-102
Objective:To investigate the effect of holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy. Methods: 80patients with cervical cancer were divided into observation group (40cases) and control group (40cases), and patients of control group received routine nursing modein perioperative period while patients of observation group received holistic nursing mode in the same stage. The complication of the two groups were compared and analyzed, and the satisfaction degree for nursing mode was investigated.Results: Under the intervention of holistic nursing, the number of complication of observation group was significantly lower than that of control group (x2=8.205,P<0.05). And the satisfaction degree for nursing of observation group was significantly higher than that control group(x2=5.000,P<0.05).Conclusion: The holistic nursing intervention in perioperative nursing for patients underwent radical hysterectomy under laparoscopy can significantly improve the life quality of patients, and reduce the occurrence of complication, and enhance the satisfaction degree of patients for nursing.
2.Cytological features of cerebrospinal fluid in 170 the patients with modified ZeiM-Neelsen positive tuberculous mengningitis
Yajuan LIU ; Junying HE ; Hui BU ; Dan HE ; Yueli ZOU
Chinese Journal of Nervous and Mental Diseases 2017;43(4):215-219
Objective To investigate the features of the cerebrospinal fluid (CSF) in the modified ZeiM-Neelsen (MZN) positive tuberculous mengningitis (TBM).Methods We retrospectively reviewed the clinical data of 170 patients with tuberculous meningitis confirmed by MZN stain from December 2012 to July 2015.The purpose of the present study was to investigate the relationship of MZN staining and CSF cytology.Results Among 170 patients with TBM confirmed by MZN staining,128 cases had first detectable acid-fast bacillus (AFB) in earlier stage.The cytology included 15.5% mixed cellular cytology,58.5% lymphoid cytology,19.5% neutrophilic cytology and 6.5% normal cytology.Twenty-four cases had first detectable AFB within 1-2 months following disease onset.The cytology included 13.1% mixed cellular cytology,56.6% lymphoid cytology,21.7% neutrophilic cytology and 8.7% normal cytology.Eighteen cases had first detectable AFB 2 months after disease onset.The cytology included 26.7% mixed cellular cytology,46.7% lymphoid cytology,20.0% neutrophilic cytology,6.6% normal cytology.There was no significant difference in median time of first detectable AFB among those four types of cytology (P=0.812).There was significant difference in median time of first detectable AFB between patients with and without anti-TB therapy [21.5 (12.3,37.8) days vs.8.5 (6.0,16.3)days,P<0.001].There was no significant difference in median time MZN stain turning negative between patients with and without anti-TB therapy [11 (5.75,19.25) days vs.6(4.25,10.75)days,P=0.230].Conclusions AFB can be detectable within a month after the onset of TBM in most of cases.(MZN) positive staining is not associated with the major type of cytology.Anti-TB therapy may delay the first detectable time of AFB.
3.Research on influence of intravenous infusion by double-lumen PICC on continuous dynamic CVP monitoring
Haiyan HE ; Yucun LIU ; Wenfeng TANG ; Yajuan CHEN
Chongqing Medicine 2014;(25):3275-3277
Objective To investigate the influence of intravenous infusion by double-lumen peripherally inserted central catheter (PICC)on continuous dynamic central venous pressure(CVP)monitoring.Methods In the patient undergoing the double-lemon PICC,continuous dynamic CVP monitoring was performed by a lumen and the intravenous infusion was conducted by another lu-men.Whether the simultaneous venous infusion affecting the values of continuous dynamic CVP monitoring was observed.Results Intravenous infusion through double-lumen PICC had no influence on simultaneously continuous dynamic CVP monitoring (P>0.05),which could influence the values of CVP monitoring when simultaneously using the intravenous infusion pump(P<0.05). The speed of pumping fluid had no influence in a shout time(10 min),with significant difference(P>0.05).The CVP values could recovered to the status before infusion when continuously infusing after stopping using the infusion pump.Compared with before in-fusion,the CVP values after stopping intravenous infusion had no obvious change(P>0.05).Conclusion Intravenous infusion by double-lumen PICC has no influence on continuous dynamic CVP monitoring.But simultaneously adding infusion pump has certain influence on the CVP monitoring values.
4.Clinical Application of Balloon Bionic Midwifery in 832 Cases
Hongying LI ; Junfeng YU ; Xia MA ; Xuemei DING ; Litao WU ; Meizhen HE ; Yajuan SHEN
Journal of Kunming Medical University 2016;37(10):104-107
Objective To investigate the effect of the balloon Bionic midwifery on the delivery outcomes and to analyze the clinical value.Methods 1 683 parturients from June 2014 to May 2015 were selected.They were randomly divided into observation group (832 cases,applied balloon Bionic Midwifery) and control group 851 cases.We compared the labor,the postpartum hemorrhage,the outcomes of pregnancy and the rate of survival of neonates of the two groups.Results The first and second stage as well as the total stage of labors of the observation group were lower than the control group (P<0.01);Also,the rate of cesarean delivery and the hemorrhage together with the asphyxia of neonates were lower than the control group (P<0.01).However,the rate of vaginal delivery was higher than the control group (P <0.05).The differences between them had a great statistical significance.Conclusions The balloon bionic midwifery technology has an advantage in reducing the rate of cesarean delivery and the maternal pain of pregnant women as well as the maternal complications.It is an effective and safe midwifery technology.So it has a great value of spreading in clinical trials.
5.Application of Xpert MTB/RIF for early diagnosis of tuberculous meningitis
Yueli ZOU ; Wei SUN ; Li GUO ; Yanan TIAN ; Hui BU ; Yajuan LIU ; Junying HE
Clinical Medicine of China 2015;31(9):782-784
Objective To explore the diagnostic significance of Xpert MTB/RIF in cerebrospinal fluid,and evaluate the application for early diagnosis of tuberculous meningitis(TBM).Methods Sixty cases of TBM and 30 cases of non-TBM patients were selected as our subjects.Xpert MTB/RIF and modified Ziehl-Neelsen stain were performed in cerebrospinal fluid.The detection rate of the system and the resistance of the patients were analyzed.Results Eleven cases were diagnosed as the positive cases in 60 cases with TBM,and 0 case was diagnosed as TBM in control group.Sensitivity and specificity of Xpert with TBM were 18.33% and 100%,respectively.The difference of the two groups was statistically significant (P =0.014).The positive rate of definite group was 23.68%(9 cases),18.18%(2 cases) in probable group and 0% in possible group,and the difference of the three groups was statistically significant(x2 =3.070,P>0.05).The resistance rate was 36.36% (4/11).Sensitivity of the modified Ziehl-Neelsen staín was 63.33% (38/60).Eleven cases were detected positive by Xpert MTB/RIF,9 cases were positive with modified acid fast staining,and the positive rate was 18.33%,and the difference of the two methods was statistically significant (P =0.000).Conclusion Xpert MTB/RIF test is simple and rapid diagnostic method.The combination of Xpert MTB/RIF and modified ZiehlNeelsen stain will improve the efficiency of the early diagnosis of TBM.
6.Clinical characteristics of neonatal hemolytic disease of anti-M or Rhesus system
Song GU ; Yajuan WANG ; Ying LIN ; Caiyun YANG ; Yan ZHONG ; Jianping HE ; Huixin WANG ; Xuefang YANG
Chinese Journal of Perinatal Medicine 2016;19(4):284-288
ObjectiveTo analyze the clinical manifestation of hemolytic disease of the newborn (HDN) due to anti-M and Rhesus system.MethodsClinical information was collected and analyzed for three cases with HDN due to anti-M and 64 with Rhesus hemolytic disease, who were admitted to Department of Neonatology, Beijing Children's Hospital Affiliated to Capital Medical University from February 2011 to January 2015, as well as another 28 cases of HDN due to anti-M with complete information retrieved from literature in Wanfang and China National Knowledge lnfrastructure (CNKI) Database from 1992 to 2014.Chi-square test was performed for statistical analysis.ResultsTwo out of the 64 Rh hemolytic babies gave up therapy due to kernicterus and another two out of the 31 MN hemolytic babies, obtained from literature, died 24 h after birth because of anemia or edema, while the rest survived. Although more babies were the first child of the family in HDN due to anti-M than those of Rh hemolytic disease [26%(8/31) vs 9%(6/64),χ2=4.487, P=0.034], but lower incidence of jaundice [81%(25/31) vs 98%(63/64),χ2=9.686,P=0.002], less proportion of presentation of jaundice within 24 h after birth [29% (9/31) vs 64%(41/64),χ2=10.279,P=0.001] and lower positive rate of direct antiglobulin test [39%(12/31) vs 100%(64/64), Fisher exact test,P=0.000] were shown in HDN due to anti-M. No significant difference was found in the incidences of hyperbilirubinemia [58%(18/31) vs 66%(42/64),χ2=0.513], severe hyperbilirubinemia [23%(7/31) vs 36%(23/64),χ2=1.724], anemia [81%(25/31) vs 89%(57/64),χ2=1.253] and severe anemia [29%(9/31) vs 34%(22/64),χ2=0.271] between HDN due to anti-M and Rh hemolytic babies (allP>0.05).ConclusionsHDN due to anti-M and Rhesus hemolytic disease can cause severe pathological jaundice and/or anemia in newborns. Indirect antiglobulin test should be offered when direct antiglobulin test is negative which is helpful in the diagnosis of HDN due to anti-M.
7.A study of therapeutic efficacy of mycophenolate mofetil in the treatment of multiple sclerosis ;and neuromyelitis optica
Yajuan XIANG ; Yang HE ; Tingting YANG ; Donghui AO ; Hong JIANG ; Yangyang WANG ; Xuguang GAO ; Guangzhi LIU
Chinese Journal of Postgraduates of Medicine 2016;39(9):779-782
Objective To assess the efficiency and safety of mycophenolate mofetil (MMF) in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO). Methods Twenty-seven patients with MS or NMO were selected, and the patients were divided into 2 groups:MMF group (MMF combined with glucocorticoid treatment group, 10 cases) and glucocorticoid group (only glucocorticoid treatment group, 17 cases). There were 5 cases with MS and 5 cases with NMO in MMF group. There were 13 cases with MS and 4 cases with NMO in glucocorticoid group. The therapeutic efficacy 6 months after treatment, expanded disability status scale (EDSS) before treatment and 6 months after treatment, and annualized relapse rate (ARR) were compared; and the safety was observed. Results There was no statistical difference in efficacy rate 6 months after treatment between MMF group and glucocorticoid group: 9/10 vs. 11/17, P>0.05. The EDSS scores 6 months after treatment in MMF group and glucocorticoid group were significantly lower than those before treatment: (2.41 ± 2.05) scores vs. (3.40 ± 2.05) scores and (1.17 ± 0.92) scores vs. (2.38 ± 1.28) scores, and there were statistical differences (P<0.05), particularly for the patients with MS. The ARR 6 months after treatment in MMF group was significantly lower than that before treatment: 0 time/year vs. 0.75 times/year, and there was statistical difference (P<0.05). The difference of ARR before and after treatment in MMF group was significantly higher than that in glucocorticoid group: 0.75 times/year vs.- 0.46 times/year, and there was statistical difference (P<0.01), particularly for the patients with MS. Only 1 female patient had myalgia when taking higher dosage of MMF, and the symptom tended to relieve after the dosage was reduced. Conclusions MMF is effective in the treatment of MS and NMO. MS can improve the neurological function and reduce the recurrence of the disease;and the safety is high.
8.Influence of overall responsibility system nursing for patients with mumps combined with meningitis
Yan LIN ; Yajuan HE ; Qian YANG
Journal of Clinical Medicine in Practice 2017;21(2):122-124
Objective To observe the influence of overall responsibility system nursing for patients with mumps combined with meningitis.Methods A total of 124 cases with mumps combined with meningitis were randomly assigned to routine group and primary nursing group,respectively given routine nursing and overall responsibility system nursing.Fever duration,parotid gland swelling duration,therapeutic effect and related sequel were analyzed.Results The therapeutic effect of overall responsibility system nursing group was better than routine group.Primary nursing group had less fever duration and parotid gland swelling duration compare with routine group.Both groups didn't occur serious complications,but it showed no statistical significant difference (P > 0.05).Conclusion Overall responsibility system nursing for patients with mumps combined with meningitis can effectively reduce fever duration and parotid gland swelling duration,and improve therapeutic effect.
9.Effect of transitional care for asthma children in acute attack period
Yan LIN ; Yajuan HE ; Qian YANG
Journal of Clinical Medicine in Practice 2017;21(4):152-154
Objective To explore the effect of transitional care for asthma children in acute attack period.Methods A total of 86 asthma children in acute attack period were randomly divided into two groups.Patients in control group were given general care and patients in intervention group were given transitional care.The attacks of disease after discharge,unconformity and life quality after intervention were compared between two groups.Results Times of acute attack and readmission in the intervention group were significantly lower than that in the control group (P < 0.05),while intervals of attacks was significantly longer than the control group (P < 0.05).Scores in unconformity,unpredictability,complexity,and the lack of information,and the total score of MUIS were significantly lower than the control group (P < 0.05).After nursing intervention,the physical scores,psychological scores,environmental scores,social field scores and total scores of life quality scale were significantly higher than that of intervention before in two groups (P < 0.05),and the control group was significantly lower than the intervention group after intervention (P < 0.05).Conclusion Transitional nursing can effectively reduce the frequency of asthmatic attack after discharge,reduce times of readmission,improve confidence and adherence to treatment,and improve the patient's quality of life.
10.Influence of overall responsibility system nursing for patients with mumps combined with meningitis
Yan LIN ; Yajuan HE ; Qian YANG
Journal of Clinical Medicine in Practice 2017;21(2):122-124
Objective To observe the influence of overall responsibility system nursing for patients with mumps combined with meningitis.Methods A total of 124 cases with mumps combined with meningitis were randomly assigned to routine group and primary nursing group,respectively given routine nursing and overall responsibility system nursing.Fever duration,parotid gland swelling duration,therapeutic effect and related sequel were analyzed.Results The therapeutic effect of overall responsibility system nursing group was better than routine group.Primary nursing group had less fever duration and parotid gland swelling duration compare with routine group.Both groups didn't occur serious complications,but it showed no statistical significant difference (P > 0.05).Conclusion Overall responsibility system nursing for patients with mumps combined with meningitis can effectively reduce fever duration and parotid gland swelling duration,and improve therapeutic effect.