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Effect of Tourniquet Modified Strapping on Venipuncture in Tumor Patients

Modern Hospital.2017;17(5):778-780. doi:10.3969/j.issn.1671-332X.2017.05.049

Objective To investigate the effect of tourniquet modified strapping on venipuncture in tumor patients.Methods 120 tumor patients whose veins were exposed hard in radiotherapy department from October 2016 to March 2017, randomly divided into the control group and the observation group equally.The control group was treated with the traditional single strapping tourniquet to have venipuncture and the observation group with tourniquet modified strapping.Results The venous filling degree, the success rate of first puncture, and the satisfaction of the patients in the observation group were significantly higher than those in the control group (P<0.05).Conclusion The use of tourniquet modified strapping in tumor patients whose veins were exposed hard can significantly improve the venous filling degree, the success rate of puncture, the satisfaction of patients and the quality of nursing service, and thus it is worthy of clinical promotion.

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Value of ABCD2 Score in Predicting Medium-and Long-Term Prognosis in Patients with Ischemic Stroke

Feng LAI ; Yunfeng LAI ; Feng OUYANG ; Kuangsheng HUANG ; Weijin CHENG

Modern Hospital.2017;17(5):770-771. doi:10.3969/j.issn.1671-332X.2017.05.046

Objective To discuss the value of ABCD2 score in predicting medium and long-term prognosis in patients with ischemic stroke.Methods 184 patients with ischemic stroke admitted to department of neurology from March 2014 to December 2014 were selected as the research object.According to the ABCD2 score points prior to admission, the patients were divided into 3 groups: 40 cases in the low risk group, 76 in the moderate group and 68 in the high risk group based on whether or to what extent he was able to do self care.The phone call reviews were made for the clinical symptoms of patients discharged from the hospital after six months..According to the modified Rankin scale classification standard, the patients discharged from the hospital after six months were divided into 2 groups: 126 cases in the self-care group and 56 cases in care-needing group.The groups were compared in terms of conditions.Results The self-care rate in the low risk group was 90.00%, the moderate group 77.63% and the high-risk group 45.59%.The care needing rates in the three groups was 5%, 19.74% and 48.53%, respectively.The care needing rate in the low risk group was obviously lower than that in the moderate-risk group and the high risk group (P<0.05).The care needing rate in the moderate risk group was obviously lower than that in the high risk group (P< 0.05).The self-care rates in the low risk group and the moderate group were higher than that in the high risk group (P<0.05).Conclusion The ABCD2 score has a higher predictive value for medium and long-term prognosis in patients with ischemic stroke.

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Diagnostic Value of FFDM Combined with DBT in Breast Diseases

Huaxiu YE ; Yuxing CAI ; Weimin XU ; Yuanbi LIN ; Le MA

Modern Hospital.2017;17(5):764-766,769. doi:10.3969/j.issn.1671-332X.2017.05.044

Objective To explore the diagnostic value of full-field digital mammography (FFDM) combined with digital breast tomosynthesis (DBT) in breast diseases.Methods 506 patients receiving mammary gland molybdenum target inspection from January 1, 2014 to December 31, 2014 were selected.The images from FFDM and DBT were analyzed, respectively.The breast imaging reports and pathological results were compared to investigate the sensitivity, specificity and accuracy of FFDM, DBT alone and combined use of DBT and FFDM.Results The results of preoperative mammography in the 506 women (bilateral breast) were as follows: FFDM combined with DBT detected 202 benign cases (39.9%) and 304 malignant cases (60.1%);FFDM alone detected 194 benign cases (38.3%) and 312 malignant cases (61.7%);DBT alone detected 187 benign cases (37.0%) and 319 malignant cases (63.0%).Pathologically, 214 benign cases (42.3%) were detected and 292 malignant cases (57.7%).In terms of the sensitivity, specificity and accuracy, The combined use of DBT combined with FFDM was the best, followed by FFDM alone and DBT alone.Conclusion The sensitivity, specificity and accuracy of FFDM combined with DBT for diagnosis are better than those of FFDM alone or DBT alone.

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Myocardial Protection Effect of Dexmedetomidine in Patients Undergoing Open-heart Surgery under CPB

Qiugu ZENG ; Dafeng LI ; Xiangru CEN ; Yiyou YANG ; Xianqin CHEN ; Baoliu LIN ; Yuexian TAN

Modern Hospital.2017;17(5):752-754. doi:10.3969/j.issn.1671-332X.2017.05.041

Objective To observe the myocardial protective effect of dexmedetomidine in patients undergoing open-heart surgery under cardiopulmonary bypass (CPB).Methods 50 patients of open-heart surgery under CPB were randomly divided into two groups equally, namely observation group and control group.Observation group was treated with injection of dexmedetomidine at 0.5 μg/kg for 15 min, and then maintained at 0.4 μg/kgoh.The control group was given equal volume of normal saline.Concentrations of IMA and cTnI were determined before anaesthesia (t0), after 30 minutes of CPB (t1) and after surgery (t2).Results IMA and cTnI concentrations of t1 and t2 in the observation group were significantly lower than those in the control group (P<0.05).Conclusion Dexmedetomidine has obvious protective effect on myocardium, which can reduce open-heart surgery of patients with myocardial ischemia reperfusion injury (MIRI).

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Clinical Observation of Nasal Continuous Positive Airway Pressure Ventilation in the Treatment of Neonatal Respiratory Failure

Qiwei WANG ; Jinhua CHEN ; Zhilong LIAO

Modern Hospital.2017;17(5):735-736,739. doi:10.3969/j.issn.1671-332X.2017.05.035

Objective To explore the clinical efficacy of nasal continuous positive airway pressure ventilation and conventional mechanical ventilation in the treatment of neonatal respiratory failure (NICU).Methods 68 cases of neonatal respiratory failure in our hospital from June, 2014 to June, 2016 in neonatal intensive care unit, according to the random number table method were divided into two groups: The observation group involved 34 patients with nasal continuous positive airway pressure, the control group 34 patients with conventional mechanical ventilation treatment.The changes of arterial blood gas analysis, clinical effect and complication were compared between the two groups.Results The PCO2 of the two groups was significantly decreased (P<0.05), and the observation group was higher than the control group (P<0.05).There was no significant difference in PO2 between the two groups (P>0.05).However, pH value was significantly increased, and the observation group was smaller than the control group (P<0.05).The total effective rate was 94.12% in the observation group and 67.65% in the control group (P<0.05).The time of ventilation and incidence of comorbidities in the observation group was significantly shorter than that in the control group (P<0.05).Conclusion Nasal continuous positive airway pressure ventilation for treatment of neonatal respiratory failure can more significantly improve the efficacy than conventional mechanical ventilation, shorten the time on the machine and reduce the relevant complications.So it is worth promoting.

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Expression of ELMO1 in Hepatocellular Carcinoma and its Effects on Cell Migration

Wenjin HUANG ; Hongli XI ; Xiaodan LIN ; Hongwei YU ; Tongchong ZHOU

Modern Hospital.2017;17(5):718-721. doi:10.3969/j.issn.1671-332X.2017.05.029

Objective To investigate the expression of engulfment and cell motility protein 1 (ELMO1) in hepatocellular carcinoma(HCC) and its effects on cell migration.Methods The expression of ELMO1 in HCC cell lines and HCC tissues was assessed by Western blot.We used transient transfection with an ELMO1 expressing vector to over-express ELMO1 protein in SK-HEP-1 cells.Over-expression of ELMO1 was confirmed by Western blot.siRNAs specific to ELMO1 (ELMO1 siRNA) were used to knockdown ELMO1 expression.Rho Family Small GTPase Activation Assay, Western blots, transwell assay were used to determine the migration potential of cells.Student's test was employed for statistical analysis.Results The expression of ELMO1 protein was obviously up-regulated in HCC tissues and cell lines (P<0.05).Over-expression of ELMO1 promoted cell migration in SK-HEP-1 cells, while knock-down of ELMO1 showed the opposite effect.Conclusion ELMO1 up-regulation significantly correlates with cell migration in hepatocellular carcinoma.

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Intervention Effect of Evidence-based Nursing on Health Behavior of Elderly Patients with Hypertension in the Community

Fengyun WU ; Cuimei HAN ; Wanying HUANG ; Huiyi CHEN

Modern Hospital.2017;17(5):695-699. doi:10.3969/j.issn.1671-332X.2017.05.022

Objective To explore the intervention effect of evidence-based nursing on the health behavior of elderly hypertensive patients in the community.Methods 187 elderly hypertensive patients who were hospitalized in December 2015 and met the inclusive criteria were divided into observation group (n=93) and control group (n=94).The observation group received evidence-based nursing according to the evidence-based medical system evaluation while the control group was given regular nursing both for 6 months.The clinical efficacy of two nursing modes was observed and the differences between pre-intervention and pose-intervention and groups were recorded and analyzed with a self-designed questionnaire, drug compliance questionnaire and health behavior scale.Results In the observation group, the blood pressure was effectively controlled or reduced, treatment compliance was significantly increased and body mass index (BMI) was within the ideal range 6 months later.Scores of unhealthy behaviors such as those in living habits and mental stress were lower than those in the control group, which showed significant difference (P<0.05).There was no significant difference in activity participation between the two groups (P>0.05).Conclusion Evidence-based nursing intervention can effectively control the hypertension, improve the treatment compliance of the community elderly hypertension patients and help lead them to a more positive and healthier life style.

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Implementation and Management of Socialized Outsourcing of the Electromechanical and Property Maintenance Services in General Hospitals

Manshan CHEN ; Naiji LIANG ; Zhanxin MO ; Ziliang LI

Modern Hospital.2017;17(5):673-675,678. doi:10.3969/j.issn.1671-332X.2017.05.015

The steps and process of the socialization of outsourcing the electromechanical and property maintenance in a provincial general hospital in South China were introduced to discuss about socialized management modes and provide references for promotion and management of outsourcing such services.

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Hospitalization Expenses of Patients with Type 2 Diabetes and their Influencing Factors

Yanjie ZHANG ; Chao SHI ; Lixu MA ; Nan WANG ; Jin LI

Modern Hospital.2017;17(5):670-672. doi:10.3969/j.issn.1671-332X.2017.05.014

Objective To conduct an empirical analysis of constitutes and changes of type 2 diabetes patients′ hospitalization expenses and find out the differences and influencing factors so as to provide hospitals and related departments with the decision basis of controlling medical costs, arranging medical resources and optimizing systems.Methods Information of type 2 diabetes patients who had been admitted to a certain first-class grade one hospital in Ningxia from 2013 to 2016 were collected and categorized.Hospitalization costs and influencing factors of the patients were comprehensively analyzed through descriptive statistics, variance analysis and regression analysis.Results The medicine and examination costs as the constitutes of hospitalization expenses were too high.Gender, length of stay, age and diabetic complications were main contributory factors of type 2 diabetes patients′ hospitalization expenses.Conclusion The costs of hospitalization of patients with type 2 diabetes are unreasonable and need to optimize.Type 2 diabetes patients′ hospitalization expenses should be effectively controlled and medical resources should be reasonably used through standardizing treatment behavior, shortening length of stay, intensifying publicity and education, enhancing prevention and reinforcing follow-ups, expanding health insurance coverage and upgrading its level.

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Construction of Disease Settlement Standard System from the Cost Generation Process

Haiying XU ; Jieyi HUANG ; Liping ZENG

Modern Hospital.2017;17(5):666-669. doi:10.3969/j.issn.1671-332X.2017.05.013

This paper explores the reasonable construction of disease settlement standard system based on production process and source of costs, charging standards and the quantitative relationship between disease and settlement, putting forward clinical path minimum settlement standard and regulate a major guideline for settlement standard for local diseases by excluding the excessive service from patient's wills, high value consumables and high-priced drugs based on clinical path cost variation coefficient measured by disease typing and actual cost variation coefficient determined by class of hospital.

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