Objective To study the level and influencing factors of sense of coherence (SOC) among elderly patients with Parkinson's disease (PD).Method Totally 118 elderly patients with PD were investigated by a self-designed demographic questionnaire,sense of coherence-13 (SOC-13) and social support rating scale (SSRS),and to explore the level and influencing factors of SOC among the patients.Results The total score of SOC-13 was (52.27±9.30),and it was at a low level.Multiple regression analysis showed that educational level,severity of the disease,family economic status and social support were the influencing factors of SOC.Conclusion SOC of elderly patients with PD is at a low level,which is influenced by individual factors,nurses should take targeted measures to improve the patients' SOC status by the influencing factors.

Objective To explore the effects of different exercise modes of ball-holding on preventing peripherally inserted central catheter (PICC) related thrombus, so as to provide a basis for formulating scientific nursing intervention. Methods From June to November 2017, this study selected 86 cancer patients with chemotherapy through PICC of Oncology Department in First Affiliated Hospital of PLA General Hospital by purposive sampling. All of the patients from two wards of Oncology Department were divided into the experimental group and the control group by tossing a coin. Patients of the experimental group carried out ball-holding 25 times to 30 times after 3 meals each day with clenching for 10 seconds, loosening 10 seconds and grip strength according to that the ball was compressed to one half. Patients of the control group accepted conventional nursing that ball-holding was implemented 3 times, a total of 500 times. Color Doppler ultrasound was used to dynamically observe the blood flow velocity, incidence, formation position, formation time and classification of thrombus as well as other complications after indwelling catheter. The SAS 9.4 was used to statistical analysis. Results This study involved 42 patients in the experimental group and 41 patients in the control group after removing missing patients. The maximum velocity of axillary vein of patients in experimental group before and 1, 3, 7, 14, 21, 28 days after indwelling catheter was (16.12±3.62), (15.83±3.07), (15.69±3.01), (15.05±2.49), (14.46±3.85), (15.47±2.95) and (14.75±2.91) cm/s respectively. There was no significant difference in blood flow velocity before indwelling catheter between two groups (t=-0.54, P=0.594 5). But, there were significant differences in blood flow velocity 21 and 28 days after indwelling catheter between two groups (t=-5.00,-4.69; P<0.000 1). The difference of the maximum velocity in interaction between groups and different time points was significant (F=22.23, P<0.000 1). The average velocity per unit time of axillary vein of experimental group before indwelling catheter and 1, 3, 7, 14, 21, 28 days after indwelling catheter was (9.97±3.01), (9.69±2.61), (9.72±2.49), (8.88±1.47), (8.55±2.20), (9.48±2.71), (9.26±2.73) cm/s respectively. There was no significant difference in average velocity before indwelling catheter between two groups (t=0.07, P=0.945 9). After indwelling catheter, there were significant differences in average velocity 21 and 28 days after indwelling catheter between two groups (t=-4.60,-4.48; P<0.000 1). There was also a significant difference in average velocity per unit time of axillary vein among the interaction between groups and different points (F=9.84, P<0.000 1). The flow velocity of axillary vein of two groups declined over time 14 days before indwelling catheter. The flow velocity of experimental group gradually rose over time 14 days after indwelling catheter and was with a fall after rise 21 days after reaching peak value; the flow velocity of control group remarkably slowed over time. A significant difference was found in incidence of catheter related thrombus between two groups (P<0.05). The incidence of thrombus of control group constantly rose over time (χ2=6.158, P=0.013). There was also significant difference in incidence of other catheter related thrombus complications between two groups (χ2=5.760,P=0.016) . Conclusions The modes of ball-holding of experimental group can make the flow velocity of axillary vein in a high level and be propitious to prevent blood stagnation, reduce the incidences of thrombus and other catheter related thrombus complications. It is worth to be used in clinical application.

Objective The Nuss procedure is a minimally invasive pectus repair.The aim of this study was to explore the changes in quality of life in patients who underwent a Nuss procedure.Methods 96 patients,who underwent a Nuss procedure in our institution,were interviewed at preoperation,1 year after operation with the bar in place,and before the planned bar removal.The Nuss Questionnaire modified by George Krasopoulos et al,which evaluates psychosocial and physical well-being,was independently used by patients.Results Most of the scoring of the individual questions and the total score of individual patients revealed a significant improvement,both in preoperation vs.1 year after operation and 1 year after operation vs.before the planned bar removal.Conclusion The Nuss procedure has been shown to improve the quality of life in patients with pectus excavatum deformity in the short term.

Objective:To explore the relationship between resilience and self-efficacy or social support in elderly hemiplegic patients after stroke. Methods:A total of 106 elderly hemiplegic patients after stroke were investigated by a self-designed demographic questionnaire, Connor-Davidson Resilience Scale (CD-RISC), self-efficacy scale for chronic (SSC) and Social Support Rating Scale (SSRS) . Results:The total score of CD-RISC was (56.52 ± 10.61), the SSC was (4.82 ± 1.63), and the SSRS was (34.69±6.11) . Pearson correlation analysis showed that resilience was positively related to self-efficacy and social support (r=0.441, 0.429, P<0.01) . Conclusion:Resilience of elderly hemiplegic patients after stroke is low, nurses can improve it by enhancing the patients’self-efficacy and social support.

Objective To explore the influence of repeatedly PICC catheterized on catheter tip position. Methods We analyzed the catheter tip position of patients who located PICC in one level three class-A hospital in Beijing from May to October in 2014. A total of 381 effective medical records were collected and divided into having the history of catheterization group and having no history of catheterization group depending on patients whether catheterized before. The patients having the history catheterization were divided into ipsilateral catheter group(B1 group)and no ipsilateral catheter group(B0 group),the catheter tip position was compared. Results The best catheter tip position for patients having the history of catheterization was 30. 79% , which was lower than patients having no history group of 52. 66%(χ2 = 17. 565,P < 0. 01),and the patients of having catheterization history group had the incidence rate of shallow catheterization(47. 74% )higher than 35. 40% in the no catheterization history group(χ2 = 5. 817,P < 0. 05). The patients of having catheterization history group happened the incidence of catheter tip position acquired dystopia of venae subclavia higher than patients having no catheterization history group(P < 0. 05). The best catheter tip position had lower rate in the B1 group comparing with B0 group,but the patients acquired dystopia of venae subclavia in the B1 group was lower than the patients in the B0 group(P < 0. 05). Conclusions Multiple PICC catheterization reduces the accuracy of catheter tip position,and impacts the safety and reservation of PICC. We should minimize the non-planned extubation incidences. If patients require re-catheterizaiton,we should select the opposite limbs to catheterize without catheterizaiton contraindication to ensure the safe of PICC catheterization.

Objective:To investigate the prevalence, risk factors and outcomes of diastasis recti abdominis (DRA) in multiparas after the second delivery.Methods:From June 2017 to September 2019, 300 multiparas with an average age of (31.7±4.0) years (26 to 43 years) after the second delivery were recruited at 6 weeks postpartum from two hospitals in Wenzhou. There were 171 multiparas with two natural births,36 multiparas with one natural birth and one caesarean delivery, and 93 multiparas with two caesarean deliveries. The interrectus distance (IRD) was measured with palpation at 6 weeks, 6 months and 12 months after delivery. Data on age, height, weight before pregnancy and delivery, baby′s birth weight, abdominal circumference before pregnancy and delivery, fetus number, delivery mode and occupation type were collected. Strength and endurance of abdominal muscle was assessed using manual muscle testing and curl-ups, low back pain was assessed using Oswestry disability index(ODI), urinary incontinence was assessed with International Consultation on Incontinence guestionnaire-incontinentia urinae (ICIQ-UI) short form (ICIQ-SF), and quality of life was assessed using 36-item short form health survey (SF-36).Results:Prevalence of DRA was 51.7%(155/300), 39.3%(116/295) and 27.7%(80/289) 6 weeks, 6 months and 12 months after delivery, respectively. Logistic regression analysis indicated that age ( OR=1.39, 95 %CI:1.02-1.91, P=0.38), abdominal circumference ratio ( OR=2.31, 95 %CI:1.23-4.33, P=0.01), twins ( OR=11.41, 95 %CI:2.15-60.76, P<0.01), and cesarean section ( OR=1.44, 95 %CI:1.06-1.95, P=0.02) were the risk factors of DRA at 12 months after delivery. At 12 months after delivery, the multiparas with DRA had weaker strength and endurance of abdominal muscle ( Z=-3.62, P<0.01; Z=-8.91, P<0.01), more serious low back pain ( Z=-2.10, P=0.04), and lower quality of life on physical health ( t=-3.34, P<0.01) than the multiparas without DRA. No difference in prevalence and severity of urinary incontinence and quality of life on psychological health was found when comparing multiparas with and without DRA (χ 2=0.66, P=0.42; Z=-1.18, P=0.24; t=0.91, P=0.36). Conclusion:Multipara after the second delivery has great likelihood for DRA.Age, abdominal circumference ratio, twins, and cesarean section are the risk factors of DRA. DRA is related to abdominal muscle dysfunction, low back pain, and quality of life.

Objective:To explore the safety and efficacy of radiofrequency in the treatment of overactive bladder(OAB).Methods:A prospective, multicenter, non-randomized controlled trial was conducted. Eligible patients were divided into test group and control group in Zhejiang Provincial People’Hospital, The First Affiliated Hospital of Wenzhou Medical University, and Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from March 2019 to June 2020. Inclusion criteria: patients diagnosed with OAB, and bladder capacity>100ml. Exclusion criteria: pregnant and lactating women; patients with secondary OAB symptoms such as urinary tract obstruction; patients with uncontrolled urinary tract infection within 1 week; patients in stable stage by using other treatment methods; patients implanted with any nerve stimulator, cardiac pacemaker or implantable defibrillator; patients with malignant tumors, serious cardiovascular, cerebrovascular diseases, renal insufficiency or received BTX treatment in recent 12 months. The patients were allocated to test group and the control group in a ratio of 2∶1 according to the time sequence of the visit. The patients in the test group were treated with radiofrequency treatment. After entering the group, they were treated for 4 times at the 1st, 2nd, 7th and 8th week respectively. In the control group, the energy was turned off during the radiofrequency treatment. The patients were followed-up every week until the end of the 12th week. The treatment success rate [the average frequency of urination in 24 h was reduced more than 50% from the baseline or returned to the normal (≤8 times/day) or the average frequency of urgent urination in 24 h was reduced more than 50% from the baseline], the frequency of urination, urgent urination and nocturnal urination before and after treatment, the residual urine volume of the bladder, the quality of life (QOL) score and the occurrence of catheter related adverse events in two groups were compared.Results:114 patients were enrolled in the study, including 76 patients in the test group and 38 patients in the control group. There were no significant differences in the age [(44.2±12.8) vs. (41.7 ± 12.1) years old], male female ratio (13/63 vs. 4/34), average course of disease [2.0(1.2, 5.0) vs. 2.0 (1.0, 4.0) years], the frequency of urination[12.8 (10.6, 16.8) vs. 12.8 (10.3, 17.0) times], urgency urination [11.8(9.3, 15.8) vs. 11.8 (9.0, 17.0) times], nocturia [2.7 (1.3, 3.7) vs. 2.3(0.7, 3.3) times], residual urine volume of bladder [12.0 (3.0, 28.0) vs. 14.0 (3.7, 20.0) ml ] and the QOL score [5.0(4.0, 5.0) vs. 4.0(4.0, 5.0)]before the treatment between the two groups ( P>0.05). The treatment success rate in the test group was 76.3% (58/76), while 26.3% (10/38) in the control group, with a statistically significant difference ( P<0.01). There were significant differences between the test group and control group in the frequency of urination [9.7 (7.7, 12.0) vs. 12.9 (9.6, 15.7) times], urgent urination [7.3 (5.0, 10.0) vs. 11.7 (7.3, 15.3) times], nocturia [1.3 (0.7, 2.0) vs. 1.7 (1.0, 3.0) times] and the QOL score of the patients[3.0(1.0, 3.0) vs. 4.0(3.0, 4.5)]after the treatment(all P<0.05). The frequency of urination, urgency urination, nocturia, the residual urine volume and the QOL score in the test group were significantly improved ( P<0.05) after the treatment.The frequency of urination, nocturia, residual urine volume and the QOL score in the control group were improved ( P<0.05) after the treatment. 13 (11.4%) patients had catheter related adverse events. In the test group and the control group, there were 7 cases of macroscopic hemorrhage caused by the placement of instruments (5/76 vs. 2/38), 5 cases of acute urinary tract infection within 3 days (3/76 vs. 2/38), and 1 case of instrument breakage (catheter breakage) (0/76 vs. 1/38). There were no significant differences in the adverse events between the two groups ( P> 0.05). Conclusions:Radiofrequency treatment of OAB can effectively improve the symptoms of patients, improve the QOL of patients, and has low incidence of adverse events, with good efficacy and safety.