Objective To investigate radiation doses to examinees undergoing computed tomography (CT) scanning of different body parts (the head, chest, and abdomen) in medical institutions of Shijiazhuang, China, and to provide a reference for optimizing radiation protection for examinees in medical institutions. Methods March 2021 to March 2022, eleven medical institutions of radiation monitoring in Shijiazhuang were surveyed for the basic information, scanning parameters, and dosimetric data of a total of 930 adults and children who received CT examinations. The dosimetric data of the subjects were analyzed and compared with the domestic and international diagnostic reference levels and the results of other cities in China. Results In the above hospitals, the CTDI_vol(P₅₀) of CT subjects in children's group were 17.42-50.45 mGy, 2.13-14.01 mGy and 3.58-28.20 mGy, respectively. DLP(P₅₀) ranges from 228.87 to 966.97 mGy·cm, 33.20 to 296.03 mGy·cm, and 74.90 to 926.53 mGy·cm, respectively. In the adult group, the CTDI_vol(P₅₀) in the head, chest and abdomen of CT subjects were 37.28-54.05 mGy, 6.43-14.99 mGy and 8.28-18.75 mGy, respectively. DLP(P₅₀) ranges from 372.81 to 630.56 mGy·cm, from 219.77 to 467.93 mGy·cm, and from 313.86 to 689.87 mGy·cm, respectively. The distribution of radiation doses in different-grade hospitals varied greatly. The abdomen dose of the children's hospital was higher than other hospitals. Especially the primary hospitals were significantly higher than the recommended diagnostic reference level (DRL). Conclusion In some secondary and primary hospitals, the setting of CT scanning parameters was simplified, not specific to the subjects’ age and body types. They should strictly comply with the principal of optimizing radiation protection to strengthen radiation dose optimization and supervision, reducing the radiation dose of examinees in future examinations .

With the rapid development of information and communication technology and the internet, the application of telemental health services has become more and more extensive. This paper introduces the concept and development of telemental health, and expounds the mode and setting of telemental health services abroad. This paper focuses on the review of the implementation methods and application effects of foreign telemental health services in the rehabilitation of stroke patients, so as to provide a reference for the clinical development of telemental health services in China to promote the rehabilitation of stroke patients.

Objective:To evaluate the rehabilitation efficacy of early mobilization based on collaboration care model for patients with laparoscopic colorectal surgery.Methods:Cluster sampling method was used in the department to recruit colorectal cancer patients with laparoscopic surgery. The control group (49 cases) received routine perioperative care and exercise, and the intervention group (47 cases) received the coordinated early mobilization combined with routine perioperative care and exercise, from January to March 2019. Primary outcome were health status and the proportion of patients returning to preoperative functional walking capacity (6-min walk test) at 4 weeks after surgery. The in-hospital mobilization (time out-of-bed), time to achieve discharge criteria, time to recover gastrointestinal function and complication rate were explored.Results:In intervention group,89.4%(42/47) of patients achieved mobilization target on 4 days after surgery compared with 42.6%(20/47) on the day of surgery. Time out of bed were greater in the intervention group compared with the control group, and there were differences between the two groups( Z values were -8.437--7.381, P<0.01). Time to recover gastrointestinal function and the recovery of energy on 3 days after surgery were (58.74±17.41) h, (59.02±9.46) points in the observation group, and (71.82±21.53) h, (62.61±7.68) points in the control group, and there were significant differences between the two groups ( t values were -3.263, -2.046, P<0.05). But other outcome measures were not different between the two groups ( P>0.05). Conclusions:For colorectal laparoscopic surgery patients, the coordinated early mobilization improved the adherence to ambulation, in-hospital mobilization, time to recover gastrointestinal function and recovery of energy to promote rehabilitation.

Objective:To explore the real return-to-work experiences and expectations of young and middle-aged stroke patients in community, in order to provide reference for the formulation of the support plan for returning to work from the perspective of patients, and further promote their return to work.Methods:Using the phenomenological method of qualitative research, 11 young and middle-aged stroke patients in Zhengzhou community from April to May, 2019 were interviewed in a semi-structured way, then the interview data were analyzed and the theme was extracted.Results:The community young and middle-aged stroke patients return-to-work experiences and expectations included the following five themes: uncertain return-to-work belief, limited work-related ability, complex inner feelings in the process of returning to work, insufficient external support and expectation of returning to work after stroke (The desire to return-to-work, expectation to get support and help related to returning to work).Conclusions:In order to promote young and middle-aged stroke patients in community to return to work, the three-way interaction mode of community-society-workplace should be considered from the aspects of patients' personal and external support to help patients recover actively, establish beliefs, reduce negative emotions, and further promote patients to return to work.

Objective To explore the impact of WeChat-assisted follow-up on self-administer medication capability of stroke survivors.Methods Seventy patients were recruited from a tertiary hospital and randomly divided into intervention group (n=35) and control group (n=35).Patients in intervention group were given WeChat-assisted follow-up including health education program and behavior guidance,and patients in control group received regular discharge care.The effects of WeChat-assisted follow-up and regular care on self-administer medication ability,cognitive and behavior level were assessed.Results After three months' follow-up,the scores of self-administer medication capability (38 (32,42)),experience (25 (20,28) and the integral level (87 (71,92)) in intervention group were significantly higher than those in control group (capability 25(16,38),experience 21 (8.75,27),total score 68 (38,87)) (Z=-2.511,-2.033,-2.209,P＜0.05).The self-administer medication experience,cognitive,capability and total scores increased significantly in intervention group after intervention(Z=-4.525,-4.610,-3.806,-4.718,all P＜ 0.01),while only the cognitive level increased slightly in control group (18 (10,24) vs 13 (11,18),Z =-1.794,P=0.073).Conclusions Follow-up intervention based on WeChat platform can improve the stroke patients' self-administration medication capability,however,the long-term effects on cognitive level and further reform need to be strengthened.

Objective: To investigate the situation and influencing factors of bowel cleansing in patients before colonoscopy, and to provide reference for guiding patients′ bowel preparation. Methods: The clinical data of 421 patients undergoing electronic colonoscopy in the endoscopy center of the second people′s hospital of Lu′an city in Anhui Province from April to September 2018, Prospective collection by systematic sampling, including general data of patients, clinical data of bowel preparation and score of Boston bowel preparation scale. Univariate analysis and logistic regression analysis were performed on the relevant factors of bowel preparation. Results: Among the 421 patients, 52 cases were not eligible for intestinal cleaning, and the unqualified rate was 12.35%(52/421). Logistic regression analysis showed that: Total amount of drinking water prepared for intestinal tract before colonoscopy (OR=1.674, P=0.018),The total times of defecations after taking the drug (OR=1.270, P=0.014), the characteristics of last stool before colonoscopy (OR=2.211, P=0.042), the diet the day before colonoscopy (OR=0.553, P=0.006) , body mass index (OR=1.111, P=0.042), and intestinal diseases (P=0.022), were all intestinal clearance independent influencing factors of cleaning effect; While took laxative type (mannitol/PEG), drunk water speed (within 3 hours), first defecation time, the site of drinking bowel-clearing drugs, daily activity, none of the above factors affected the bowel preparation effect (P>0.05) . Conclusion Before colonoscopy, there were many factors affecting the cleaning effect of the intestine. The total water intake of intestinal preparation was less than 2 000 ml, the total number of defecation after taking medicine was less than 5 times, the last defecation contained residue, the day before the examination was strictly fasting, the body mass index was less than 18.5 kg/m², and colitis, enterelcosis and occupying lesion are independent risk factors for intestinal cleaning. Attention should be paid to the comfort care and guidance of intestinal preparation, and prospective intervention can effectively improve the cleaning effect of intestinal tract.

Objective To investigate the curative effect of Zhizhukuanzhong capsule combined with Deanxit in the treatment of functional dyspepsia ( FD) of spleen -deficiency and qi -stagnation.Methods Seventy -six patients with FD were randomly divided into three groups .A group (24 cases)_was given Zhizhukuanzhong combined with Deanxit,B group (26 cases) was given Zhizhukuanzhong ,C group (26 cases) received trimebutine dispersible tablets treatment.After treatment for 8 weeks,the symptoms of indigestion,depressive state and therapeutic effect were observed.Results Before treatment,there were no statistically significant differences in the symptoms of dyspepsia (all P>0.05).After treatment,the symptoms of dyspepsia were improved in different degree ,the effective rates of A, B,C three groups were 91.6%,65.4% and 42.3%,respectively,there was no statistically significant difference between A group and B group(χ2 =1.579,P=0.209);there was statistically significant difference between A group and C group(χ2 =13.549,P=0.000);there was no statistically significant difference between B group and C group (χ2 =2.786,P=0.09).The FD patients complicated with varying degrees of anxiety and depression ,there was no statistically significant difference among the three groups before treatment (P>0.05).After treatment,comparison of HAMA and HAMD scores among the three groups:there were statistically significant differences between A group and B group (tHAMA =6.839,tHAMD =4.607,all P<0.05),A group and C group (tHAMA =20.069,tHAMD =15.342,all P<0.01),B group and C group (tHAMA =11.951,tHAMD =12.071,all P<0.01).After treatment,the HAMA,HAMD scores of A group and B group were significantly decreased compared with before treatment ( A group tHAMA =52.758,tHAMD=49.970,B group tHAMA =30.230,tHAMD =17.151,all P<0.01).Those in C group had no statistically significant decline compared with before treatment (tHAMA =7.845,tHAMD =3.530,all P>0.05).The adverse reactions of A group were mainly weakness ,dizziness,drowsiness,which were alleviated within 2 weeks.The adverse reactions of B group were slight stomach disease and stool frequency increased ,which not affected the treatment.The adverse reactions of C group were digestive tract symptoms ,which lasted for more than 2 weeks.Conclusion Zhizhukuanzhong capsule combined with Deanxit in the treatment of FD of spleen -deficiency and qi -stagnation can obtain good curative effect,it is safe,convenient,and with minor side effects,good compliance.

OBJECTIVEOn the basic therapy, to assess the clinical effects of dynamic scalp acupuncture, scalp acupuncture combined with proprioceptive neuromuscular facilitation (PNF) therapy and simple PNF therapy for upper limb motor impairment in ischemic post-stroke spastic hemiplegia.

METHODSA total of 90 cases were randomly assigned into a PNF group, a dynamic scalp acupuncture group and a scalp acupuncture group, 30 cases in each group. Basic therapy and PNF therapy were applied in the three groups. PNF therapy was used during scalp acupuncture in the dynamic scalp acupuncture group. PNF therapy was applied after scalp acupuncture in the scalp acupuncture group. The points were the upper 1/5 and middle 2/5 of (MS 6) and (MS 7) at the lesion side, the hemiparalysis contralateral side. The treatment was given for 6 months, once a day and 1 month as a course. The modified Ashworth scale (MAS), the Fugl-Meyer motor assessment (FMA) and Barthel index (BI) were observed before treatment and 2 weeks, 1 month, 3 months, and 6 months after treatment.

RESULTSThe MAS 1 month, 3 months and 6 months after treatment were improved compared with those before treatment in the three groups ( all <0.05), and the MAS results in the dynamic scalp acupuncture group were better than those in the PNF and scalp acupuncture group (all <0.05). The FMA and BI scores 1 month, 3 months and 6 months after treatment were higher than those before treatment (all <0.05). The FMA Scores in the 3 time points and after treatment in the dynamic scalp acupuncture group were higher than those in the other two groups (all <0.05).

CONCLUSIONPNF therapy during scalp acupuncture can relieve the spasmodic condition of patients with upper limb motor impairment in ischemic post-stroke spasmodic hemiplegia, and improve the limb function and life activity, which is better than PNF therapy after scalp acupuncture and simple PNF therapy.

Acupuncture Therapy ; Brain Ischemia ; complications ; rehabilitation ; Combined Modality Therapy ; Hemiplegia ; rehabilitation ; therapy ; Humans ; Scalp ; Stroke ; complications ; Stroke Rehabilitation ; Treatment Outcome

Objective To understand caregivers concerning on the nutritional status of patients with esophageal cancer after operation and to provide reference for esophageal cancer patients with postoperative rehabilitation guidance, to help nurses providing targeted health education for esophageal cancer patients. Methods A phenomenological approach was used to conduct unstructured interviews with 8 caregivers of patients with esophageal cancer in the cancer hospital.Data Data were analyzed by Colaizzi's phenomenological procedure. Results Through reading, analysis, reflection, classification and extraction,there were 3 themes: lacking of esophageal cancer related nutrition knowledge, but the belief of active acquisition is strong and behavior compliance is poor. Caregivers are positive about dietary nutrition;Caregivers have poor compliance and professionalism on behavior of dietetic care. Conclusions Doctors and nurses need to carry out elaborate diet instruction for caregivers of patients with esophageal cancer, to meet their nutritional knowledge needs, to provide a variety of effective and authoritative counseling channels, and to supervise their care behavior and promote patients rehabilitation as soon as possible.

Objective To establish a nursing shared governance model and compare the difference of structural empowerment level between participants and non-participants. Methods Convenient sampling method was used and a total of 583 clinical nurses were investigated by structural empowerment questionnaire. Results Independent sample t test showed no difference in gender, age, and working years between observation group(228) and control group(355) (P>0.01); Pre-test showed no difference between two groups, after one year application, structural empowerment level showed significant difference between observation group (3.73 ± 0.66) and control group(3.10 ± 0.56) (t=3.624,P<0.01). Structural empowerment level increased in both groups(t=-3.482,-14.346, P<0.01). Conclusions Shared governance model is effective in evaluating nurses′structural empowerment level.