Objective To investigate the effect of narrative medicine mode in perioperative medical and nursing care for patients underwent radical nephrectomy. Methods A total of 124 patients received radical nephrectomy from February 2014 to October 2016 were selected and divided into experimental group and control group by block randomization grouping method with 62 cases each. Narrative medical treatment and care was applied in experimental group while control group received conventional treatment and care. The psychological status and social support of the patients were evaluated by Zung Self-rating Anxiety Scale(SAS), Self-rating Depression Scale (SDS) and social support rating scale(SSRS), as well as rehabilitation indexes including complications, first feeding time, hospitalization time, costs, etc. Results Anxiety and depression status were existed in both experimental and control groups before operations, and there were no significant difference in all pre-operative scales between two groups (P>0.05). The score of SAS, SDS, SSRS was (44.71 ± 4.67), (40.84 ± 4.05), (43.21 ± 3.60) points after operation and (54.98 ± 5.93), (46.52 ± 5.07), (31.87 ± 3.22) points before operation in experimental group. The score of SAS, SDS, SSRS was (53.24±5.97), (44.63±4.37), (32.61± 2.72) points after operation and (54.92 ± 5.83), (46.53 ± 4.89), (32.16 ± 2.48) points before operation in control group. Significant differences were found between before and after operation in experimental group (t=18.73, 8.85, 18.18, all P<0.01). However, no significant difference could be found between before and after operation in control group (t=1.590, 1.400, 1.910, P>0.05). After operation, the complications, first feeding time, hospitalization time and costs was 22.58%(14/62), (2.50±0.92) d, (11.16±3.72) d, (24.6±4.0) thousand yuan in experimental group, which was 48.39%(30/62), (3.98 ± 1.44) d, (15.48 ± 5.44) d, (40.2 ± 3.1) thousand yuan in control group. Significant differences were found between experimental group and control group (χ2=9.02, t=2.07, 8.06, 3.93, P<0.05 or 0.01). Conclusions Narrative medicine mode can provide medical care filled with respect, empathy, and humanistic concern, andimprove patients′psychological status, thus promoting rehabilitation.

Objective To investigate postoperative psychological experiences of patients underwent kidney transplant donated by his/her parent,and to discover mental signs and psychological journey in individual growth.Methods Semi-structured in-depth interviews were conducted among 17 patients underwent kidney transplant donated by his/her parent,and Giorgi analysis method was used to analyze data.Results The postoperative psychological experiences of patients mainly contained 4 aspects:posttraumatic growth,rebuilding meaning of life,being grateful for experience,coexisting of hope and challenge.Conclusion The patients have complex psychological experiences,having positive aspects derived from rehabilitation and improved quality of life,as well as negative aspects derived from concerning health of the donor,fear for complication and rejection,and lack of sound supporting system.Medical staff should guide patients to adjust cognitive and behavioral patterns and face life events directly,integrate medical/social support resources and enhance patients' psychological capital to face future life.

Objective To study the relationship between the exposure time of puncture needle of infusion bottle stopper and microbial contamination during clinical intravenous transfusion. Methods A total of 600 cases from November 1, 2014 to January 31, 2015 who have received the clinical intravenous transfusion for investigation were selected.When replacing the infusion bottle (bag), inserting the puncture needle slowly across the bottle stopper and making the needle tip be canted to the transfusion bottle mouth (bag) of the rubber plug, gently squeezing the Murphy's tube until solution was not dripping, recording down the exposure time in the air of the needle tip from medicine droplet to the end. To dip the lower part with sterile swabs and culture the swabs in nutrient broth medium. Meanwhile, to replace the next bottle of medicine and get the remaining 2 ml of liquids into the culture broth medium, after 48 h, both of which medium were switched to blood plate culture cultivation for observing the general situation of the bacteria growth. Results Among the 600 cases of clinical transfusion, 24 cases were positive for sterile swabs microorganisms culture, positive rate was 4.0%, among which microorganisms, 15 cases were gram-positive coccus, 3 cases were gram-negative bacillus, 3 cases were gram-positive bacillus and 3 cases were fungi. Correspondingly, 3 cases were positive for liquid broth culture, positive rate was 0.5%as the gram-positive coccus. The exposure time and broth microbial culture result was statistically significant, while the exposure time and medicinal broth microorganisms culture result possesses had no statistical significance. Conclusions Inserting the puncture needle across the bottle stopper could successfully reduce the liquid drug residues in the infusion bottle (bag), however, which might also cause time-dependent microbial contamination during the exposure process in the air.

Objective To explore the application of culture construction on nursing unit management. Methods We educated nurses with hospital's outstanding culture and carried out a variety of multicultural learning based on the need of patients, in order to construct comfortable nursing culture atmosphere which could improve the professional level. We also organized group cultural activities by quality control circle ( QCC) to make the nursing quality management more scientific. Results Nursing culture construction developed the comprehensive capabilities of nurses, and improved the nursing quality as well. The patients'satisfactions were 98. 9% and 99. 0% in 2013 and 2014 respectively according to the investigations conducted by the third party. Conclusions The nursing culture construction established a vigorous, enthusiastic and comfortable working atmosphere, promoted the growth and progress of nurses as well as the development of specialized nursing.

Robotic assisted laparoscopic radical prostatectomy (RALP) is a perfect combination of modern remote information technology, intelligent engineering technology and minimally invasive surgical technique, with less hemorrhage and damage as patients getting good prognosis. In the past 10 years, the development of RALP has improved in our country rapidly. In this review, the progress of nursing researches of RALP were discussed, including preoperative therapeutic communication and comprehensive geriatric assessment, intraoperative anesthesia and heat preservation, and postoperative observation and fast recovery.

Objective To investigate the effects of early ambulation on general comfort of patients undergoing retroperitoneal laparoscopic adrenalectomy. Methods From July 2013 to September 2014, 153 patients in our hospital, who underwent retroperitoneal laparoscopic adrenalectomy were randomly divided into control (n=78) and experimental groups (n=75). Early ambulation intervention was taken in the experimental group. Concretely, the patients were educated with early ambulation knowledge before operation, then they were evaluated for early ambulation 6 hours post operation. Finally, the qualified patients received early ambulation intervention and executed the corresponding ambulation program 8-24 hours after operation. Whereas, patients in the control group could decide their ambulation time all by themselves. Simultaneously, the time of first ambulation was compared between two groups and general comfort questionnaires ( GCQ ) were applied to evaluate the comfort status of the patients. Results The time of first ambulation was ( 12. 8 ± 5. 0 ) h in experimental group while it was (27. 9 ± 11. 8)h in the control group (t=10. 233,P<0. 01). The GCQ score post surgery in the experimental group was (89. 2 ± 12. 4), which was significantly higher than (73. 5 ± 10. 4) in the control group ( t = 8. 498, P < 0. 01 ). Conclusions Early ambulation of patients undergoing retroperitoneal laparoscopic adrenalectomy can effectively improve their general comfort status and promote their rapid recovery.