1.Prone position-cardiopulmonary resuscitation in adults: a scoping review
Xuhong LAN ; Longfei GUO ; Hongfang ZHOU ; Hengyang WANG ; Qian WANG ; Donghui JIA ; Wenjuan YUAN ; Yuchen WU ; Zhigang ZHANG ; Caili PENG
Chinese Critical Care Medicine 2024;36(10):1049-1055
Objective:To comprehensively search the relevant literature on prone position-cardiopulmonary resuscitation (PP-CPR) in adults at home and abroad, analyze the content, summarize the evidence, and provide reference for clinical health care professionals.Methods:Systematic search of CNKI, China Biomedical Literature Service System (SinoMed), Wanfang Data, VIP database, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochran Library, Web of Science, Scopus literature database and other Chinese and English databases was conducted. The search period was from inception to June 15 in 2024. The contents of PP-CPR from randomized controlled trial (RCT), non-RCT (prospective or retrospective), cohort studies and case reports were extracted and systematically analyzed. The search results were standardized by the method of scoping review.Results:A total of 523 articles were obtained through preliminary search, and 14 references and gray literature were retrieved, totaling 537 articles. After strict screening by two researchers, a total of 26 literatures were included, 3 were non-RCT and 23 were case reports, involving 12 countries, including 3 in Chinese, 19 in English, 2 in French, 1 in German, and 1 in Korean. Three non-RCT demonstrated that compared with standard cardiopulmonary resuscitation (CPR), PP-CPR could produce higher pressure, and provide good respiratory and circulatory support. A total of 25 adult patients were included in the 23 case reports, of which 17 reported total recovery time and 13 reported PP-CPR time ≤ 5 minutes, all of which recovered spontaneous circulation, indicating the effectiveness of PP-CPR technology. In terms of final outcome, 4 patients (16.0%) died and 21 patients (84.0%) survived, indicating that PP-CPR technology could provide timely blood circulation and improve clinical outcomes for prone cardiac arrest patients. Among the 11 patients who reported complications after resuscitation, no neurological damage was found in the short-term outcomes, indicating that PP-CPR technology had a certain level of safety.Conclusions:PP-CPR can provide timely blood circulation for patients with cardiac arrest who are unable to lie supine quickly, and win "golden time" for defibrillation and further treatment. In clinical practice, medical staff need to evaluate the emergency environment, the number of rescuers and the specific condition of the patient, and implement first aid as soon as possible, so as to reduce the time of no blood flow in the vital organs of patients with cardiac arrest in prone position, and improve the clinical prognosis.
2.Perioperative nursing care of a newborn with bacterial corneal ulcer undergoing corneal transplantation
Huan WANG ; Jingjing WANG ; Wenyan DOU ; Xuhong WU
Chinese Journal of Nursing 2024;59(4):465-468
To summarize the perioperative nursing experience of a newborn with bacterial corneal ulcer undergoing corneal transplantation.Preoperative nursing points:to strengthen eye observation and protection to avoid corneal perforation;to properly administer systemic and eye medication to control infection.Postoperative nursing points:to closely observe the condition of corneal grafts to prevent postoperative complications;to provide eye drops on time after surgery to ensure medication safety;to emphasize pain management and provide nutritional support;to provide targeted health education to parents to ensure that the patient receives continuous care.Through multidisciplinary team collaboration,meticulous treatment and care,the corneal graft of the patient was clear,the suture was not loose,and there was no bleeding in the anterior chamber after 1 week of corneal transplantation.The vital signs were stable,and the patient was discharged from the hospital,and ophthalmic follow-up was conducted.After 7 weeks of surgery,the suture was successfully removed and the corneal transplantation was successful.
3.Observation on the Effect of Buzhong Yiqi Decoction(补中益气汤)in the Treatment of 36 Mechanically Ventilated Cases of ICU-acquired Weakness with Spleen Qi Deficiency Syndrome
Boling WU ; Xuhong TAN ; Yongsheng HU
Journal of Traditional Chinese Medicine 2024;65(23):2450-2456
ObjectiveTo analyze the efficacy and safety of Buzhong Yiqi Decoction (补中益气汤, BYD) in the treatment of mechanically ventilated patients of intensive care unit acquired weakness (ICU-AW) with spleen qi deficiency syndrome. MethodsSeventy-two patients eligible for mechanical ventilation ICU-AW and spleen qi deficiency were selected and randomly divided into routine ICU basic treatment and nursing combined with nasal feeding or oral administration of normal saline 3 times a day, 50 ml per time as control group, and routine ICU basic treatment and nursing combined with BYD 3 times a day, 50 ml per time as treatment group, with 36 cases in each group. The treatment cycle was 7 days. Traditional Chinese medicine (TCM) syndrome score, Medical Research Council (MRC) score, diaphragm mobility, diaphragm thickness at the end of inspiration and expiration, diaphragm thickness rate, time to successfully remove the tracheal tube, superoxide dismutase (SOD) and malondialdehyde (MDA) levels of patients were measured before and after treatment, and the efficacy of TCM syndrome was evaluated. ResultsThe total effective rate regarding TCM syndrome was 88.89% in the treatment group, which was higher than 66.67% in the control group (P = 0.033). After treatment, the main symptom score, secondary symptom score and total score of TCM syndrome, diaphragm mobility and MDA level significantly decreased in both groups, while MRC score, diaphragm thickness rate and SOD level increased (P<0.01), with more improvement in the treatment group than in the control group (P<0.05 or P<0.01). The number of successful tracheal intubation removal within 7 days after treatment in the treatment group (28/36 cases, 77.78%) was higher than that in the control group (19/36 cases, 52.78%). ConclusionBasic treatment combined with oral administration of BYD can improve the MRC score, general condition, diaphragm contraction, and antioxidant capacity of patients with mechanical ventilation in ICU-AW with spleen qi deficiency, thereby improving the success rate of extubation with sound safety.
4.Analysis of research hotspots and frontiers in the training of health management talents in China based on knowledge mapping
Qian WANG ; Shan WU ; Yunrui BAI ; Xuhong GE ; Jieyi HU ; Lu WANG ; Song LENG
Chinese Journal of Health Management 2023;17(8):603-607
Objective:To analyze the research hotspots and frontiers in the training of health management talents in China based on knowledge mapping.Methods:The literature related to talent training in health management was retrieved from the databases of CNKI, Wanfang Data, and VIP Journals from 2007 to 2022. The keywords used for retrieval included “health management” “curriculum system” “health manager” “evaluation system” “health service and management” and “talent training”. The time distribution of the literature was analyzed using Excel. Bibliometric analysis was conducted to visually analyze the research in health management talent training, focusing on authorship and collaboration, research institutions, high-frequency keywords, and research hotspots. A knowledge map was created to outline the research framework.Results:A total of 378 journal articles were retrieved. Over the past decade, there has been an overall increasing trend in the number of research publications related to health management talent training. The highest number of articles was published in 2021 (63 articles). In terms of spatial distribution, highly productive authors were relatively concentrated, and research institutions were mostly universities, with Hangzhou Normal University having the highest number of publications (14 articles). The research hotspots included health managers, practice teaching modes, cross-cultivation, and discipline construction. The research frontiers concentrated on talent training modes, health service and management professions, talent demand, and curriculum system construction.Conclusions:In the past decade, health management talents training in China has received more attention and importance. However, there is limited exchange and cooperation among authors and research institutions, and the research hotspots continue to extend in the direction of specialization and diversification. The transformation from vocational education to academic education and strengthening professional construction are the frontiers of the research.
5.Analysis of the Characteristics of Microbial Flora in Pharmaceutical Water Systems and Discussion on Their Cultivation
ZHANG Xuhong ; ZHENG Xiaoling ; GONG Wanzi ; WANG Yinhuan ; LI Jue ; ZHANG Xinping ; WU Jiequn
Chinese Journal of Modern Applied Pharmacy 2023;40(18):2608-2616
Pharmaceutical water is the most widely used raw material and solvent in the process of pharmaceutical products, which is widely used in the cleaning and disinfecting process of appliances, equipment, facilities and systems, and is involved in the whole process of pharmaceutical products. Pharmaceutical water is one of the main sources of microbial contamination of pharmaceutical products, so the microbial safety of pharmaceutical water is crucial for pharmaceutical quality. This paper mainly introduces the characterization of the pharmaceutical water system, and conducts biofilm analysis. Due to the characteristics of oligotrophic and slow-growing of microorganisms in the pharmaceutical water system, this paper also further discusses the microbiological testing and culture methods of pharmaceutical water, so as to provide reference for the establishment of a scientific and reasonable microbiological testing system, as well as provide an important theoretical basis and new ideas for further research on hard-to-culture microorganisms.
6.Meta-synthesis of qualitative research on parents' needs of premature infants in Neonatal Intensive Care Unit
Jingjing WANG ; Xuhong WU ; Xuehong ZHONG ; Juan WANG
Chinese Journal of Modern Nursing 2023;29(10):1294-1301
Objective:To integrate the needs of parents of premature infants during hospitalization in Neonatal Intensive Care Unit (NICU) , so as to provide basis for formulating targeted interventions.Methods:From the establishment of the database to June 3, 2022, the qualitative research on the needs of parents of premature infants in the NICU was retrieved by computer in MEDLINE, Web of Science, CINAHL, Embase, PsycINFO, China Biology Medicine disc, China National Knowledge Infrastructure, VIP and WanFang Data. After screening, the two researchers used the quality evaluation criteria for qualitative research of Australia Joanna Briggs Institute Evidence-Based Health Care Center for quality evaluation. The research results finally included were integrated through Meta-synthesis.Results:A total of 12 researches were included, 62 research results were extracted, summarized into 6 categories, and 4 integrated results were formed, including the need for medical and nursing staff, the need for family members, the need for other parents of premature infants, and the need for government and medical institutions.Conclusions:During the hospitalization of premature infants in NICU, parents have needs for medical and nursing staffs, family members, other parents of premature infants, government and medical institutions. Medical and nursing staff should carry out corresponding intervention and guidance according to their needs, so that they can cope with the emergency of premature delivery.
7.Association between remnant cholesterol levels and incident diabetic retinopathy in middle-aged and older patients with diabetes
Rong YU ; Xuhong HOU ; Xiangning WANG ; Lili JIA ; Xinhua DU ; Qiang WU ; Yuqian BAO ; Weiping JIA
Chinese Journal of Internal Medicine 2023;62(12):1430-1435
Objective:To investigate the association between remnant cholesterol (RC) and the risk of diabetic retinopathy (DR) in middle-aged and older individuals with diabetes.Methods:Based on the Shanghai Nicheng Cohort Study database, the data of 1 255 individuals with diabetes aged 55-70 years at baseline (2013-2014) with complete fundus photographs and serum cholesterol data in Nicheng, Shanghai, were analyzed. Multinomial logistic regression models were used to evaluate risk ratios ( RRs) and their 95% confidence intervals ( CIs) between baseline RC level and incident DR. Results:The median age of the subjects was 61.9 years, and 60.4% were women. After a 4.6-year follow-up, 79 (6.3%) patients developed DR, including 50 (4.0%) mild non-proliferative DR and 29 (2.3%) referable DR (RDR). Multivariable logistic regression showed that each mmol/L increase of RC was associated with a 40% higher risk of RDR ( RR=1.40, 95% CI 1.03-1.90). Compared with the lowest tertile of RC (<0.63 mmol/L), the risk of RDR in the highest tertile (≥0.85 mmol/L) increased by 4.59 times ( RR=5.59, 95% CI 1.51-20.73). Conclusion:The RC level may help identify individuals at high risk of incident RDR in middle-aged and older Chinese adults with diabetes.
8.Correlation between postpartum pelvic floor dysfunction and vaginal microecological imbalance in late pregnancy.
Chunxia CHENG ; Boyang GUO ; Ruizhen LI ; Wen WU ; Chunmei MI ; Xuhong LI
Journal of Central South University(Medical Sciences) 2022;47(11):1608-1614
OBJECTIVES:
Pelvic floor dysfunction (PFD) seriously affects women's physical and mental health. Pregnancy and childbirth are recognized as high-risk factors for PFD, and studies have shown that vaginal microenvironmental disorders can promote the development of pelvic organ prolapse. In this study, we intend to investigate whether the changes in vaginal microecology during pregnancy affect the pelvic floor function and participate in the development of postpartum PFD, and provide a basis for the prevention and treatment of PFD.
METHODS:
A total of 358 full-term mothers who delivered in Third Xiangya Hospital, Central South University from November 2019 to April 2020 were selected and underwent review 6 to 8 weeks after delivery. The pelvic floor structures were examined using pelvic floor ultrasound, and ultrasound values were measured at rest and at maximum Valsalva maneuver. One hundred and seventy women with PFD were assigned in a PFD group, and 188 women without PFD were assigned in a control group. The clinical data of all mothers were collected, and the clinical data and the results of microecological testing for vaginal secretions after 36 weeks of gestation and before delivery were compared between the 2 groups. The correlation of PFD with leucorrhoea cleanliness, lactobacillus level, bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC) was analyzed, and logistic regression analysis was used to screen for independent risk factors for PFD.
RESULTS:
The incidences of VVC, BV, Lactobacillus vaginalis deficiency, and leucorrhoea cleanliness ≥III° were all higher in the PFD group than those in the control group (P<0.05). Among them, leukocyte cleanliness ≥III°and lack of Lactobacilli in the vagina were independent risk factors for the development of PFD, while VVC and BV were not independent risk factors for the development of PFD.
CONCLUSIONS
Postpartum PFD is related to vaginal microecological imbalance in late pregnancy, among which Lactobacillus vaginalis deficiency and leucorrhoea cleanliness ≥III° are independent risk factors for the occurrence of PFD. Therefore, pregnant women with Lactobacillus vaginalis deficiency and leucorrhoea cleanliness ≥III° in late pregnancy should pay attention to the occurrence of postpartum PFD, and early diagnosis and effective intervention of postpartum PFD should be enhanced.
Pregnancy
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Female
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Humans
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Pelvic Floor
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Mothers
9.The clinical value of the logistic regression model with a combination of three-dimensional CT quantitative and qualitative parameters in predicting the invasiveness of pure ground glass nodules
Xuhong MIN ; Qilong SONG ; Yongqiang YU ; Biao SONG ; Bin WANG ; Yuan LI ; Zhaohua WANG ; Wu CHEN ; Xu WANG
Chinese Journal of Radiology 2021;55(1):34-39
Objective:To explore the value of the logistic regression model with three-dimensional CT quantitative parameters in combination with qualitative parameters in predicting the invasiveness of pure ground glass nodules (pGGN).Methods:The clinical data and image features of 191 patients (196 lesions) with pGGN on CT confirmed as lung adenocarcinoma by pathology from April 2019 to December 2019 in Anhui Chest Hospital were retrospectively analyzed. Totally, 196 lesions were divided into atypical adenomatous hyperplasia (AAH)+adenocarcinoma in situ (AIS)+minimally invasive adenocarcinoma (MIA) group ( n=128) and invasive adenocarcinoma (IAC) group ( n=68). CT quantitative parameters included the maximum diameter, volume, average CT value and quality of pGGN, and the qualitative parameters included the intrinsic vascular changes, abnormal air-bronchogram, lobulated signs, bubble-like sign, pleura-traction sign, and fuzzy tumor-lung interface sign. The Mann-Whitney U test was used to compare the quantitative parameters and the Pearson χ 2 test was used to compare the qualitative parameters between two groups. The independent predictors of IAC and predictive probability value were screened by univariate analysis in combination with multivariate logistic regression analysis. The ROC curves were drawn to compare the diagnostic probability of logistic regression prediction probability and each single parameter. Results:There were statistically significant differences in maximum diameter [0.92(0.77,1.14) cm vs. 1.41(1.12, 1.93) cm, Z=-7.366, P<0.001], volume[0.31(0.20, 0.53) cm 3 vs. 0.88(0.41, 2.00) cm 3, Z=-6.254, P<0.001], average CT value[-571.5(-637.2, -477.0) HU vs. -418.1(-532.4, -338.5) HU, Z=-5.882, P<0.001], quality[0.14(0.09, 0.25) g vs. 0.42(0.26, 1.21) g, Z=-7.438, P<0.001], intrinsic vascular changes(23 vs. 49, χ2=55.906, P<0.001), abnormal air-bronchogram(13 vs. 30, χ2=29.908, P<0.001) and pleura-traction sign(39 vs. 32, χ2=5.291, P=0.021) between the two groups. The logistic regression analysis showed that the maximum diameter, average CT value, intrinsic vascular changes and abnormal air-bronchogram were the independent risk factors of IAC, and the odds ratio value(95%CI) were 10.624(1.275-88.522), 1.004(1.000-1.008), 3.424(1.458-8.043) and 2.993(1.114-8.043), respectively. The ROC curve demonstrated that the area under the curve, sensitivity and specificity of the logistic regression model were 0.899, 0.912, and 0.711 respectively, which were better than separate analysis results from each single parameter. Conclusion:The logistic regression model with a combination of three-dimensional CT quantitative and qualitative parameters can predict the invasiveness of pGGN better.
10.A national baseline survey of clinical practice of arterial blood gas collection in newborn infants
Lili LIU ; Bin QU ; Guangyu LI ; Yanan WANG ; Xuhong WU ; Linqi ZHANG
Chinese Journal of Modern Nursing 2021;27(31):4216-4220
Objective:To investigate the clinical practice status of neonatal arterial blood gas collection in Class Ⅲ Grade A children's hospitals in China, so as to provide a reference for further standardizing neonatal arterial blood gas collection operating standards.Methods:From July to September 2020, convenience sampling and self-designed Neonatal Arterial Blood Gas Collection Technology Practice Questionnaire were adopted to conduct a cross-sectional survey on the technical operation of 824 nurses of Neonatology Department in 15 ClassⅢ children's hospitals, general hospitals, and maternal and child health hospitals across the country. A total of 824 questionnaires were distributed, 791 were retrieved, and 747 valid questionnaires were collected.Results:The most common site for neonatal arterial blood gas collection was the radial artery, accounting for 98.80% (738/747) , followed by the brachial artery 47.79% (357/747) . The radial artery was often selected below the place where the pulsation was strongest (46.86%, 350/747) , and the most needles were inserted at an angle of 15° to 30°. The brachial artery was often selected below the place where the pulsation was strongest (58.77%, 439/747) , and the most needles were inserted at an angle of 30° to 45°. The more common complications after arterial blood gas collection were bruising, bleeding, and hematoma. A total of 390 (52.21%) nurses received uniform training in arterial blood gas collection in the past year. There was a statistically significant difference in the incidence of needle stick injuries in the collection of nurses of Neonatology Department who received uniform training or not ( P<0.05) . Conclusions:The operating standards for neonatal arterial blood gas collection are not uniform, and it is necessary to standardize the collection process and management. Although the training for nurses has been carried out in clinical practice, the incidence of needle stick injuries among nurses still needs to be further reduced, especially the targeted training of arterial blood gas collection and operation skills. The collection tools should be improved to increase the success rate of arterial blood collection, reduce the occurrence of complications, and ensure the safety of nurses.


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