OBJECTIVETo establish a rapid determination method with gas chromatography-mass spectrometer (GC-MS) for thiodiglycolic acid (TDGA), a vinyl chloride (VCM) biomarker.

METHODSA high- sensitivity determination method was established using a moderate methyl esterification instead of methyl esterification of highly toxic diazo reaction.

RESULTSThe standard curve regression linear equation of the method was: y=8460.5x-4758.2, the linear coefficient was 0.999 7, the minimum quantity concentration was 2.0 µg/L, the range of precision value was 0.81%-2.38%, and the average recovery of standard addition was 99.0%-102.9%.

CONCLUSIONThis method reduces the risk of traditional methyl esterification, improves the determination sensitivity compared with the GC-FPD method, and meets the determination requirement of TDGA.

Objective To investigate the clinical value of continuity nursing model in caring patients with malignant obstructive jaundice treated with percutaneous transhepatic biliary drainage (PTBD).Methods A total of 120 patients with malignant obstructive jaundice treated by PTCD were enrolled in this study.The patients were divided into the control group (n=60) and the observation group (n=60).Routine discharge guidance and health education was conducted for the patients of control group,while for the patients of observation group,in addition to conventional discharge education,the continuity nursing was executed by the responsible nurse.Continuity nursing was meant to continue the service,to guide the observation of the wound and dressing change,the observation of the quantity and quality of drainage solution,to teach the knowledge of the management of PTCD catheter as well as its complications,to guide patient's diet and rest,and to establish the continuity nursing records.Results The patients of both groups were followed up for 3 months.The patients' awareness rate of the knowledge related to PTCD tube in the observation group was significantly higher than that in the control group.The wound infection rate,the rate of PTCD tube prolapse or blockage,and the tube-related re-hospitalization rate in the observation group were strikingly lower than those in the control group (P＜0.05).Conclusion The continuity nursing model can significantly improve patients' awareness rate about the knowledge related to PTCD tube,reduce the incidences of biliary tract infection,PTCD tube prolapse or blockage,wound infection,and tube-related re-hospitalization,therefore,the quality of life can be surely improved.

Objective To investigate the curative effect of bronchoalveolar lavage with fiberoptic bronchoscopy combined with vibration sputum drainage in the treatment of severe pneumonia patients undergoing mechanical ventilation (MV).Methods A prospective randomized controlled trial was conducted. 286 severe pneumonia patients undergoing MV admitted to intensive care unit (ICU) of Hunan People's Hospital from January 2014 to July 2016 were enrolled, and they were divided into control group and observation group according to random number table, with 143 patients in each group. Patients in both groups received sensitive antibiotics for anti-infection, etiological treatment, and calefacient and humidifying treatment. The patients in the control group received bronchoalveolar lavage with fiberoptic bronchoscopy, and those in the observation group received bronchoalveolar lavage combined with vibration sputum drainage. The parameters of respiratory function and inflammation before and after treatment, curative effect, and prognosis were compared between the two groups.Results ① There were no significant differences in respiratory function parameters between the two groups before treatment, 2 hours after treatment, the parameters were improved in both groups. Moreover, oxygenation index (PaO2/FiO2) in observation group was significantly higher than that of control group [mmHg (1 mmHg = 0.133 kPa): 379.1±20.2 vs. 351.8±24.7], and arterial partial pressure of carbon dioxide (PaCO2) and airway resistance (Raw) were significantly lower than those of the control group[PaCO2 (mmHg): 36.5±5.8 vs. 45.3±6.9, Raw (cmH2O, 1 cmH2O = 0.098 kPa): 12.9±0.6 vs. 13.1±0.8, allP < 0.01]. ② There were no significant differences in inflammation parameters between the two groups before treatment, 24 hours after intervention, which were significantly decreased in both groups. Moreover, white blood cell count (WBC), procalcitonin (PCT) and C-reactive protein (CRP) in the observation group were significantly lower than those of the control group [WBC (×109/L): 8.2±1.7 vs. 12.8±3.7, PCT (μg/L): 15.4±2.4 vs. 21.8±3.1, CRP (mg/L): 37.1±6.1 vs. 67.2±7.2, allP < 0.01]. ③ Compared with the control group, the treatment efficiency of observation group was improved [95.1% (136/143) vs. 87.4% (125/143)], the quantity of sputum excretion was increased (mL: 49.2±12.5 vs. 36.9±11.0), duration of MV and length of ICU stay were significantly shortened (days: 6.4±3.6 vs. 9.4±2.1, 8.6±5.7 vs. 12.4±4.6, bothP < 0.01), however, there was no significantly statistical difference in 28-day mortality between control group and observation group [2.8% (4/143) vs. 2.1% (3/143),P > 0.05].Conclusion Compared with bronchoalveolar lavage with fiberoptic bronchoscopy alone, the treatment of bronchoalveolar lavage combined with vibration sputum drainage is more effective in sputum excretion for severe pneumonia patients undergoing MV, which could improve the respiratory function, reduce infection, shorten the duration of MV and the length of ICU stay, and improve the recovery.

An introduction to the Basic service module featuring holistic,full flow and seamless connection built by the hospital.Authors described their experiences in achieving homogenous clinical nursing care,and pointed out that integrating medical humanistic care into the daily nursing process,can improve doctor-patient relationship and patients satisfaction,thus raising medical service quality and efficiency.

Air Pollutants, Occupational ; analysis ; Butylene Glycols ; analysis ; Chromatography, Gas ; Workplace

Objective To evaluate the effects of Massive Open Online Course (MOOC) on standardized training of nurses.Methods The 148 new nurses from August 2015 to July 2016 were selected as the control group, and trained in traditional teaching mode. The 150 new nurses from August 2016 to July 2017 were recruited as the observation group, and trained with MOOC on the basis of traditional teaching mode. The scores of core ability, including the theoretical and operational assessment, critical thinking and clinical nursing were compared between the two groups.Results After one year of training, the scores of theoretical and operational assessment of the observation group were (97.16±1.92) and (96.56±1.87) respectively, which were better than those of the control group, and the difference were statistically significant (t=12.091, 7.895;P<0.001). The scores critical thinking / academic research ability and clinical nursing ability of the observation group were (25.66±5.12) and (25.12±4.42) respectively, which were better than the control group, and the differences were statistically significant (t=2.191, 2.030;P<0.05).Conclusions The application of MOCC with traditional teaching mode on the new nurse standardized training is helpful to improve new nurses' theoretical and operational knowledge, enhance the satisfaction of clinical departments, and to cultivate new nurses critical thinking, ethical practice and other core competencies.

Objective? To explore the effects of Internet + home care platform on continued nursing care for peripherally inserted central catheterization (PICC) in cancer patients. Methods? Totally 173 cancer patients who were hospitalized and received PICC in Hu'nan People's Hospital between March and December 2017 were selected using convenient sampling and divided into the control group (n=92) and the home care group (n=81). Patients in the control group received conventional continued nursing care, while patients in the home care group received continued nursing care via the home care platform by following the WeChat account, including on-site catheter maintenance and personalized health education. The cases and frequency of catheter maintenance, patient's knowledge about daily PICC maintenance and the incidence of PICC-related complications from catheterization to catheter removal were compared between the two groups. Results? The incidence rate of complications was lower in the home care group than in the control group, the difference was statistically significant (χ2=5.210, P＜ 0.05); the number and frequency of missing catheter maintenance in the home care group were lower than that of the control group, while the knowledge levels about daily PICC maintenance at home in the home care group were higher than those of the control group, and the differences were all statistically significant (P＜ 0.05). Conclusions? Continued nursing care based on the Internet +home care platform for cancer patients receiving PICC is practical and feasible, and patients can enjoy safe, homogeneous and continued PICC nursing care at home. Therefore, it is worth promoting in clinical practice.

Objective To explore the effects of nurse-patient horizontal communication on medical compliance behavior and postoperative complications in patients with benign prostatic hyperplasia ( BPH ) . Methods A total of 218 patients with BPH were recruited in the department of urology of Hunan Provincial People′s Hospital from March 2014 to December 2015. They were divided into control group ( n=109, routine nursing) and experimental group ( n=109, routine nursing+personalized horizontal communication model ) according to the order of admission. After intervention, patient compliance, the length of hospital stay, postoperative complications and patient satisfaction were evaluated between two groups. Results The patient compliance behavior on medication, reasonable diet and relaxation, giving up smoking and drinking of patients in experimental group were better than those in control group. Besides, the length of hospital stay and the number of patients with gross hematuria, enuresis or lower urinary tract symptoms in experimental group were less than those in control group. Moreover, the patient satisfaction of experimental group was better than that of control group. There were significant differences in those aspects between two groups ( P < 0. 05 ) . Conclusions The nurse-patient horizontal communication will be propitious to improve the patient compliance, reduce the length of hospital stay, decrease the incidence of complications and increase the patient satisfaction.

Objective To explore the effects of MiniQuest teaching model on critical thinking ability in nursing students. Methods From September to October 2016, we selected 172 nursing students as subjects by purposive sampling. All of the students were divided into the observation group (n=88) and the control group (n=84). Students of the control group accepted conventional lecture methods. Otherwise, students of the observation group were taught with MiniQuest teaching model. Students were evaluated with the Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) before and after intervention. Results After intervention, the total score and scores of five dimensions of CTDI-CV including truth-seeking, open-mindedness, analyticity, self-confidence and maturity of nursing students of the observation group were higher than those of the control group with significant differences (P< 0.05). Conclusions The MiniQuest teaching model is conducive to improving critical thinking ability of nursing students.

Objective To compare the replacement time of normal and anti-reflux disposable drainage bag for the risk of infection in patients with biliary T-tube drainage, and to explore the most suitable frequency which patients can get the most benefits.Methods Totals of 144 patients with routine T-tube drainage and the negative culture results of biliary bile were randomly divided into three groups by random number table method. Group A and group B used ordinary disposable drainage bag, while group A changed it every day and group B changed it once a week.Group C used the disposable anti-reflux drainage bag and replaced it once a week.The extraction of bile from drainage bag was used to do the bacteriological monitoring and the results were compared among the three groups.Results There was no significant difference in the bacterial culture among the three groups at the 5th day and 10th day after the drainage (χ2 =0.51, 1.64, respectively;P >0.05).The replacement frequency of the three groups were statistically significant (F=1 379.17,P<0.01).The cost of changing drainage bag in three groups had statistically significant difference ( F =229.19, P <0.01 ). Conclusions Patients with biliary T-tube, who use the ordinary disposable bags and change it weekly have similar infection rate as the anti-reflux drainage bag, what’ s more, it can reduce the costs of patients and the workload of nurses.