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Exploration of the reasons for the replacement of central venous catheter dressing in ICU patients and their proper care

Jing LIU ; Xiao-ping SHAO

Journal of Navy Medicine.2014;(1):43-45. doi:10.3969/j.issn.1009-0754.2014.01.016

Objective To explore the reasons for the replacement of central venous catheter dressing and improve nursing in ICU patients.Methods Retrospective analysis was made on the reasons for the replacement of central venous catheter dressing in patients of the conventional group .By using integrated nursing method ,"menu-care"procedures were designed and implemented for the replacement of central venous catheter dressing, and patients applying the same nursing methods in the same period next year were used as the control.Results The reasons for the replacement of central venous catheter dressing in ICU patients were: looseness of the adhesive membrane, oozing of blood and oozing of fluid.Days of dressing maintenance for the conventional group were(2.35 ± 0.89)d, which were obviously fewer that those of the "menu-care"group (3.43 ±0.52) d, with statistical significance(P<0.05).CRBSI of the conventional group was 13.0%, which was higher than that of the"menu-care"group, also with statistical sig-nificance(P<0.05).Conclusion Proper nursing methods could increase the days of dressing maintenance and decrease the infection rate of CRBSI .

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Effects of nursing intervention on pre-surgical anxiety in 286 patients having elective surgery

Min HUANG ; Hou-cheng LI

Journal of Navy Medicine.2014;(1):41-42. doi:10.3969/j.issn.1009-0754.2014.01.015

Objective To explore the effects of comprehensive nursing intervention measures on the prevention of pre -surgical anxiety in patients having elective neurosurgery .Methods In accordance with different nursing methods , 286 patients, who received neurosurgical treatment in the Neurosurgery Department of our hospital from Jan , 2011 to May, 2012, were divided into 2 groups:the experimental group (150 cases) and the control group (136 cases).The patients in the control group received routine nursing care , be-fore elective neurosurgical surgery .In addition to routine nursing care , the patients in the experimental group received intensified psy-chological care plus comprehensive nursing interventions , such as musical therapy , massage, graphic beckoned card and better commu-nications between patients and nurses .Then, anxiety values were compared between the 2 groups.Results Pre-surgical anxiety value of the patients in the experimental group was (46.0 ±5.1), which was lower than (61.0 ±7.0) of the control group.And statistical significance could be seen, when comparisons were made between them (P<0.01).Conclusion Comprehensive nursing intervention could significantly decrease pre-surgical anxiety of elective surgical patients and proved to be helpful to the performance of surgery and recovery of patients .

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Safety and efficacy of oral lactulose coupled with bifico as pre-surgical bowel preparation in patients with primary liver cancer

Jieqiong ZHAO ; Hongling WANG ; Jing XU ; Xueqing SHAO

Journal of Navy Medicine.2015;(1):34-36. doi:10.3969/j.issn.1009-0754.2015.01.013

Objective To study the safety and efficacy of oral lactulose coupled with bifico as pre-surgical bowel preparation in patients with primary liver cancer .Methods With the knowledge and consent of the patients , a total of 80 patients were randomly divided into 2 groups, the experimental group and the control group , each consisting of 40 patients.The experimental group received o-ral lactulose plus bifico and the control group was given oral polyethylene glycol electrolytes as pre -surgical bowel preparation before sur-gery.Then, patients′tolerance, acceptance, adverse reactions, bowel cleansing and post-surgical bowel movement recovery were ob-served and compared between the 2 groups.Results No statistical significance in bowel cleansing could be observed , following imple-mentation of the drugs for the two groups (P>0.05).The texture and acceptance of the drugs for the experimental group were obviously superior to those of the control group, with statistical significance(P<0.05).With the exception of allergic reaction, no statistical difference could be noted in adverse reactions to pre-surgical bowel preparation for both groups (P>0.05).The incidence of other ad-verse reactions for the experimental group was lower than that of the control group , with statistical significance(P<0.05).Following pre-surgical bowel preparation , frequency of defecation and recovery of liver function for the experimental group were superior than those of the control group, also with statistical significance, when comparisons were made between the 2 groups (P<0.05).Conclusion Lactulose coupled with bifico as pre-surgical bowel preparation was safe and feasible , which could not only improve the sense of comfort for the patients, but increased their compliance , and decreased medical cost as well .

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The application of wound-bed preparation sequential plan in the treatment of postsurgical unhealed wound following tibiofibula open fracture

Da TENG ; Jing HAN ; Xueyuan DENG ; Yan YAN ; Shuhua WU

Journal of Navy Medicine.2015;(1):31-33. doi:10.3969/j.issn.1009-0754.2015.01.012

Objective To explore the effect of wound-bed preparation sequential plan on wound healing following tibiofibula open fracture .Methods Forty-six patients with postsurgical unsealed wound following tibiofibula open fracture , who were admitted into the Navy General Hospital from May 2011 to May 2014 were selected for our study .With the knowledge and consent of the patients , the patients were randomly divided into 2 groups:the wound-bed preparation sequential plan group ( or simply the sequential plan group ) (n=23) and the control group (n=23).Evaluation indicators included:improvement of wound surface, total time of wound surface healing and standard wound surface healing time .Results No.of days when fresh granulation appeared for the sequential plan group were (4.30 ±1.49) d, which were shorter than those of the routine treatment group (6.00 ±2.31) d, with statistical significance (P=0.001).Total time of wound surface healing and standard wound surface healing time for the sequential plan group were respec -tively (36.00 ±12.74) d and (2.01 ±0.69) d/cm3 .However, for the routine treatment group , total time of wound surface healing and standard wound surface healing time were respectively (51.70 ±16.45) d and (2.60 ±1.03) d/cm3 , and statistical significance could be noted, when comparisons were made between the 2 groups(P=0.001, 0.027).Conclusion When used in the treatment of postsurgical unsealed wound following tibiofibula open fracture , the standard wound-bed preparation sequential plan was beneficial to the improvement of wound bed , enhancement of granulation and acceleration of wound healing .

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Relationship between adiponectin and abnormal lipid metabolism in new onset of type 2 diabetes

Hongyan WANG ; Zhusen LIN

Journal of Navy Medicine.2015;(1):28-30. doi:10.3969/j.issn.1009-0754.2015.01.011

Objective To Explore the relationship between abnormal lipid metabolism and serum adiponectin level .Methods With the knowledge and consent of the patients and following the signing of the letter of agreement , 70 new onset of type 2 diabetic patients without macrovascular complications were divided into 2 groups, group A and group B, each consisting of 35 patients.Group A received the therapy of lowering plasma glucose and blood pressure , and group B received the therapy of lowering plasma glucose , blood pressure and lipid reduction as well .Changes in serum adiponectin concentration were monitored after 7 months of treatment .The open treatment phase lasted one year , then, changes in serum adiponectin concentration were measured again .Results Serum adiponectin concentrations in type 2 diabetic patients without macrovascular disease , who received the therapy of lowering plasma glucose , blood pressure and lipid, significantly increased [the level of adiponectin before treatment:(5.01 ±1.96)mg/L, the level of adiponectin after treatment:(5.65 ±2.33)mg/L].Conclusion Improvement in lipid metabolism could increase adiponectin level and prevent the de -velopment of macrovascular disease in patients with type 2 diabetes mellitus .

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Clinical effects of BiPAP combined with tiotropium bromide in the treatment of chronic obstructive pulmonary disease with acute exacerbation

Hongxia ZHAO ; Shilin XU ; Anshan ZHUO ; Yushu CAO ; Wanning TONG

Journal of Navy Medicine.2015;(1):24-27. doi:10.3969/j.issn.1009-0754.2015.01.010

Objective To observe the clinical effects of bi-level positive airway pressure ( BiPAP) combined with tiotropium bromide in the treatment of chronic obstructive pulmonary disease ( AECOPD) with acute exacerbation .Methods Sixty cases of AECO-PD with acute exacerbation were randomly divided into group A and group B , each consisting of 30 cases, and clinical analyses were made on them .The patients in both groups were given routine treatment , including oxygen breathing , spasmolysis , expectoration , anti-infection and BiPAP.At the same time, the patients in group B were administered with the above treatment couple with BiPAP inhala-tion agent, with a dosage of 18μg, once a day.Symptoms, pulmonary functions and blood-gas analysis were performed to see the effects and adverse reactions , and hospitalization days were also recorded accordingly .Results Total effective rate for group A was 73.33%, while the rate for group B was 93.33%, and statistical differences could be seen , when comparisons were made between them ( P<0.05 ) .Following treatment , symptom scores , pulmonary functions and results of blood gas analysis in the patients of both groups signif -icantly improved, as compared before treatment (P<0.05).The conditions of the patients in group B were obviously superior to those of the patients in group A, with statistical significance (P<0.05).For the average length of stay at the hospital , the patients in group B were obviously superior to those of the patients in group A (P<0.05).The incidence of adverse reactions for the patients in group B was low, with minor symptoms.Conclusion The effects of BiPAP combined with tiotropium bromide in the treatment of chronic ob-structive pulmonary disease with acute exacerbation were obviously superior to that by simple BiPAP therapy .Furthermore, the former was safer and more effective , which was worth further clinical extension .

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Value of different assessment criteria of midnight serum cortisol in the diagnosis of Cushing′s syndrome

Wei ZHANG ; Zheng ZHANG ; Erli XU

Journal of Navy Medicine.2015;(1):20-23. doi:10.3969/j.issn.1009-0754.2015.01.009

Objective To explore the value of different assessment criteria of midnight serum cortisol in the diagnosis of Cushing′s syndrome (CS).Methods Seventy-four patients were diagnosed to have CS in No .411 hospital, CPLA, from 2007-2012. Serum cortisol levels at 08:00 and 24:00, urinary free cortisol level ( UFC) at 24 h and the levels of adrenocorticotropic hormore (ACTH) and potassium at 08:00 were detected in the said 74 cases of Cushing′s syndrome.Then, the obtained results were compared with those of the 75 overweight/obesity cases without CS and 84 non-overweight cases ( control group ) .Blood samples were collected at midnight for the detection of serum cortisol in the sleeping mode and awake status .Results (1) In the patients with CS, the levels of serum cotisol and urinary free cortisol detected at 8:00 and 24:00 in sleeping mode were higher than those overweight /obesity cases and the control group .In these same patients , the levels of serum cotisol and urinary free cortisol detected at 8:00 and 24:00 in the awake mode were also higher than those overweight/obesity cases and the control group .Serum cortisol level detected at 24:00 in the patients of the overweight/obesity group was higher than that of the control group .(2) When serum cotisol levels detected in the sleeping mode at 24:00 were respectively 50, 138, 207, 229 and 331 nmol/L, the detection sensitivity to CS was 100.0%, 97.1%, 85.7%, 77.1%and 68.6%, while the detection specificity was 24.1%, 75.9%, 86.1%, 92.4%and 98.7%.On the other hand, the de-tection sensitivity to CS in the awake status , was respectively 100.0%, 97.4%, 92.3%, 84.6%and 71.8%;and the detection specific-
ity was 11.3%, 67.5%, 82.5%, 87.5% and 96.3%.Conclusion The serum cortisol level of 207 nmol/L detected at 24:00 in the sleeping mode and the level of 207 nmol/L or 229 nmol/L detected in the awake status displayed better sensitivity and higher specificity .

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Effects of vacuum-assisted closure on the healing of radioactive ulcer in rabbits

Zhenyu GONG ; Xiaoyan FENG ; Ruihua XIONG ; Qiu ZHAN ; Xiaolong LI

Journal of Navy Medicine.2015;(1):16-19. doi:10.3969/j.issn.1009-0754.2015.01.008

Objective To observe the effects of vacuum-assisted closure ( VAC) on the healing of the radioactive ulcer in rabbits.Methods The rabbit radioactive ulcer model was established , and the animals were divided into 2 groups:the control group treated with conventional wound dressing and the experimental group treated with VAC .Observations were made on various indicators at 5 different time points:i.e.before surgery, 3, 7 and 14 days after surgery, and after wound healing.Results Wound swelling and se-cretions for the animals of the experimental group were significantly improved , when they were compared with those of the control group . Removal of necrotic tissue and growth of granulation tissue were significantly accelerated .Average healing time was significantly short-ened [(16.3 ±2.6)d比(20.4 ±3.7)d)] (P<0.05).The expression levels of MMP-1 and MMP-2 mRNA in the wound tissue were significantly decreased, 3, 7 and 14 days after surgery (P<0.05), while the expression levels of TIMP-1 and TIMP-2 mRNA were sig-nificantly increased (P <0.05).The expressions of bFGF and VEGF in the serum were increased considerably (P <0.05). Conclusion Vacuum-assisted closure displayed a positive effect on the healing of radioactive ulcer of rabbits .

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Protective effects of Qijia oral liquid on hematopoiesis in irradiated mice

Ying TANG ; Qingmin WANG ; Lina LIU ; Wenbin CHEN

Journal of Navy Medicine.2015;(1):13-15. doi:10.3969/j.issn.1009-0754.2015.01.006

Objective To study the protective effect of Qijia oral liquid on hematopoiesis in mice with radiation injury . Methods Fifty mice were randomly divided into the control group , the model group, the low, moderate and high dosage of Qijia oral liquid groups (100, 200, 400 mg/kg).The animals were irradiated with 60Co gamma ray with an absorbed dosage of 6.0 Gy.The number of white blood cells , spleen index , the number of endogenous spleen nodules , bone marrow nucleated cells and DNA content were measured and analyzed .Results Nine days after gamma ray exposure , the number of nucleated cells , DNA content, the number of white blood cells , spleen nodules and spleen index in all the drug groups were increased significantly , as compared with those of the model group (P<0.01 or P<0.05).Conclusion Qijia oral liquid presented a protective effect on the hematopoietic system in mice with radiation injury .

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Investigation and analysis of fatigue among the ship crew of a certain naval vessel

Wei DING ; Wei WANG ; Hui YANG ; Junqin WANG ; Fengfeng MO

Journal of Navy Medicine.2015;(1):10-12. doi:10.3969/j.issn.1009-0754.2015.01.005

Objective To analyze and evaluate the fatigue status of the ship crew , as well as the air quality of the ship cab-ins, and to find out influencing factors for the fatigue among the ship crew , so as to provide theoretical evidence and guidance for the maintenance and improvement of the health of the ship crew during prolonged deployment at sea .Methods Investigation and analysis on the fatigue status among the ship crew both before and after deployment were made by using the questionnaire of 《the Subjective Fa-tigue Symptom Checklist》.Air quality of the ship cabins was analyzed by using Gasmet DX 4035 FT-IR multi-component air analyzer and assessed in accordance with Indoor Air Quality Standards .Results (1) One week after deployment , fatigue symptoms in all the shipboard personnel deteriorated significantly , and three fatigue factors including "somatic", "mental"and "neurosensory"factors were all considerably increased .(2) The levels of formaldehyde and SO 2 in some cabins exceeded the permissible limits .Conclusion The fatigue status among the ship crew after deployment at sea obviously deteriorated , as compared with that before deployment .The levels of harmful gases in some cabins exceeded the limits as specified in the standards , which could worsen the fatigue status among the ship crew.

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