1.Effect of Yam gruel on postoperative healing in patients with Type Ⅱ diabetes complicated with colorectal cancer
Xiaoqin LIANG ; Shuqin PANG ; Long WANG
Modern Clinical Nursing 2024;23(1):21-27
		                        		
		                        			
		                        			Objective To investigate the effect of Yam gruel on postoperative incision healing in patients with Type Ⅱ diabetes and complicated with colorectal cancer,hence to provide a better diet plan for postoperative incision healing.Methods A convenience sampling method was used to select 92 patients with Type Ⅱ diabetes who were complicated with colorectal cancer and underwent surgery of laparoscopic radical resection for colorectal cancer in a general hospital in Fujian province.IBM SPSS 25.0 software was used to randomly divide the patients into control group and trial group,with 46 patients per group.Conventional postoperative treatment and care was offered to the patients in control group,while patients in the trial group,after anal exhaust,consumed Yam gruel made from Chinese Yam along with the remaining breakfast after deducting an 84 kcal of energy produced by the gruel for 3 weeks.The two groups were compared in terms of the post-intervention healing time,healing grade,incidence of poor incision healing,and changes in blood glucose before intervention,at 1 week and 3 weeks post-intervention.Results Forty-four patients completed the trial in the trial group,with two left at the third week of intervention.A total of 45 patients completed the study in the control group,with one dropped out of the follow-up after 3 weeks of intervention.After intervention,the incision healing time in the trial group was significantly shorter than that of the control group(P<0.05).Additionally,the healing grade was better(P<0.05),and the incidence of incision infections was significantly lower than that of the control group(P<0.05).Repeated measures ANOVA revealed that there were statistically significances in both groups in either main effects on fasting blood glucose and blood glucose at 2 hours after breakfast(all P<0.001).Particularly,at Week 1 and Week 3 post-intervention,the trial group showed both lower fasting blood glucose and blood glucose at 2 hours after breakfast compared with those in the control group(both P<0.01).Conclusion Yam gruel can reduce the time for incision healing,improve the quality of incision healing and regulate blood sugar.
		                        		
		                        		
		                        		
		                        	
2.Incidence of postoperative complications in Chinese patients with gastric or colorectal cancer based on a national, multicenter, prospective, cohort study
Shuqin ZHANG ; Zhouqiao WU ; Bowen HUO ; Huining XU ; Kang ZHAO ; Changqing JING ; Fenglin LIU ; Jiang YU ; Zhengrong LI ; Jian ZHANG ; Lu ZANG ; Hankun HAO ; Chaohui ZHENG ; Yong LI ; Lin FAN ; Hua HUANG ; Pin LIANG ; Bin WU ; Jiaming ZHU ; Zhaojian NIU ; Linghua ZHU ; Wu SONG ; Jun YOU ; Su YAN ; Ziyu LI
Chinese Journal of Gastrointestinal Surgery 2024;27(3):247-260
		                        		
		                        			
		                        			Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.
		                        		
		                        		
		                        		
		                        	
3.Incidence of postoperative complications in Chinese patients with gastric or colorectal cancer based on a national, multicenter, prospective, cohort study
Shuqin ZHANG ; Zhouqiao WU ; Bowen HUO ; Huining XU ; Kang ZHAO ; Changqing JING ; Fenglin LIU ; Jiang YU ; Zhengrong LI ; Jian ZHANG ; Lu ZANG ; Hankun HAO ; Chaohui ZHENG ; Yong LI ; Lin FAN ; Hua HUANG ; Pin LIANG ; Bin WU ; Jiaming ZHU ; Zhaojian NIU ; Linghua ZHU ; Wu SONG ; Jun YOU ; Su YAN ; Ziyu LI
Chinese Journal of Gastrointestinal Surgery 2024;27(3):247-260
		                        		
		                        			
		                        			Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.
		                        		
		                        		
		                        		
		                        	
4.The Integrated Theory of Health Behavior Change in elderly patients with chronic obstructive pulmonary disease
Yanrui JIA ; Chenxi SHI ; Liang DONG ; Yining ZHANG ; Shu DING ; Shuqin WANG ; Yunqing LIU ; Fengli GAO
Chinese Journal of Modern Nursing 2023;29(22):3038-3042
		                        		
		                        			
		                        			Objective:To evaluate the effect of inhaled medication compliance intervention in elderly patients with chronic obstructive pulmonary disease (COPD) based on integrated theory of health behavior change.Methods:A total of 117 elderly COPD patients who visited Respiratory Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University from July to December 2021 were selected by the convenient sampling method. According to the random number table method, they were divided into the experimental group and the control group. 7 cases fell off during follow-up, and a total of 110 cases were finally included in the study, of which 55 cases were in the experimental group and 55 cases in the control group. The control group adopted the conventional health education method, while the experimental group adopted the intervention plan of inhalation medication compliance of elderly COPD patients based on the integrated theory of health behavior change. The accuracy of inhalation device use, inhalant medication compliance, forced expiratory volume in the first second (FEV 1) and Chronic Obstructive Pulmonary Diseases Assessment Test (CAT) scores were compared between the two groups before intervention and 3 months after intervention. Results:After 3 months of intervention, the inhalation device use accuracy, inhalation medication compliance in experimental group were higher than those in the control group, the score of CAT in experimental group was lower than that in the control group, the differences were statistically significant ( P<0.05). There was no statistically significant difference in FEV 1 between two groups ( P>0.05) . Conclusions:The intervention plan for inhalation medication compliance in elderly patients with chronic obstructive pulmonary disease based on the integrated theory of health behavior changes can improve their inhalation medication compliance and improve their quality of life.
		                        		
		                        		
		                        		
		                        	
5.Evidence summary for DVT prophylaxis in critically ill hospitalized patients in internal medicine department
Yu ZHANG ; Chunyan ZHANG ; Shuqin WANG ; Liang DONG ; Na WAN ; Yanrui JIA ; Fengli GAO
Chinese Journal of Modern Nursing 2019;25(36):4698-4703
		                        		
		                        			
		                        			Objective To summarize the best evidence for the prevention of deep venous thrombosis (DVT) in critically ill patients, and to provide a reference for medical institutions and medical staff, so as to reduce the incidence of DVT in critically ill patients. MethodsThe PICO problem was raised for the prevention of DVT in critically ill patients during hospitalization. All evidence concerning the prevention of deep venous thrombosis in critically ill patients were retrieved from PubMed, Cochran Library, BMJ Best Practice, UpToDate,Ovid,Web of Science,Joanna Briggs Institute Evidence-based Health Care Center Database, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), Registered Nurses' Association of Ontario (RNAO) and China Biology Medicine disc (CBMdisc) by computer, which included guidelines, systematic evaluation, evidence summary and original data intimately related to evidence. The literature quality was evaluated and the recommendation level of evidence was determined according to the JBI evidence recommendation level system (2014 edition). ResultsA total of 15 references were included through electronic database retrieval, including 6 guidelines, 5 evidence summaries and 4 systematic evaluations. According to the judgment of comprehensive professionals, totally 21 evidence selected,including the risk assessment of deep venous thrombosis, drug prevention, mechanical prevention, combined prevention and educational management. ConclusionsThis study summarizes the best evidence for the prevention of DVT in critically ill patients, and helps nurses with ICU decision-making, through the application of best evidence, to promote the prevention of deep venous thrombosis in critical internal medicine patients, improve the outcome of patients and elevate the quality of nursing care.
		                        		
		                        		
		                        		
		                        	
6.Nursing care of 4 critically ill pregnant and lying-in women with influenza A
Shuqin WANG ; Chunyan ZHANG ; Na WAN ; Liang DONG ; Xuyan LI ; Bing SUN ; Yanrui JIA ; Zhaohui TONG
Chinese Journal of Modern Nursing 2018;24(14):1624-1626
		                        		
		                        			
		                        			Objective To summarize the nursing experience of 4 cases of pregnant and lying-in women with critical influenza A, so as to provide clinical experience for the observation and nursing for critically ill patients. Methods The clinical data of 4 critically ill pregnant and lying-in women were analyzed, and the clinical characteristics and nursing experience were summarized. Results The pregnant patient of one case discharged from hospital after induction of labor. Another pregnant patient discharged from hospital after the improvement of condition. Due to hypoxia, one pregnant woman caused premature birth of uterine contraction. The pregnant women died respiratory failure, and the fetus died of severe asphyxia. The situation of the lying-in woman was stable, and continuing to rehabilitation. Conclusions The incidence of critical influenza A in pregnant and lying-in women is high, with rapid changes in the condition and high mortality rate. The nursing care for critically ill pregnant and lying-in women with influenza A should pay attention to the dynamic observation of the changes of the disease. Rescue management, targeted nursing of oxygen therapy, antivirotic treatment, obstetric assessment and nursing, and psychological nursing can improve the success rate of treatment of patients.
		                        		
		                        		
		                        		
		                        	
7.Investigation and Analysis on the Effects of 3 New Medication Education Intervention Methods on Patients' Awareness of Rational Drug Use and Compliance in Obstetrics and Gynecology Outpatient Department
Canyang ZHU ; Pingping WU ; Shuqin DENG ; Liang JIAN
China Pharmacy 2017;28(27):3759-3763
		                        		
		                        			
		                        			OBJECTIVE:To provide reference for ensuring safe and effective drug use in obstetrics and gynecology outpatient department.METHODS:Medication education intervention was conducted among some patients in obstetrics and gynecology outpatient department from 4 third grade class A hospitals of our province through making Wechat pushing messages,videos and leaflets.The difference of rational drug use knowledge awareness and compliance was compared before and after intervention by questionnaire survey.RESULTS:A total of 60 questionnaires were distributed,and 60 valid questionnaires were collected with effective recovery rate of 100%.Compared to before intervention,correct rate of 20 questions about the knowledge of rational drug use were improved after intervention in respects of awareness and compliance.The awareness and compliance scores about the knowledge of rational drug use after intervention were higher than before intervention;there was statistical significance in Wechat pushing message group [(53.18 ± 11.51) vs.(88.48 ± 7.12),(55.15 ± 11.82)vs.(86.81 ± 7.69)],in video group [(49.50 ± 17.23) vs.(85.00 ± 11.55),(52.00 ± 17.70)vs.(86.00 ± 6.99)],in leaflets group[(41.47 ± 9.14)vs.(77.05 ± 9.36),(43.23 ± 10.89)vs.(78.82 ± 9.11)] be-fore and after intervention (P<0.05).There was no statistical significance in the improvement of awareness or compliance score among those groups (P=0.992 and P=0.397).CONCLUSIONS:Three intervention methods can effectively improve the awareness and compliance of patients about rational drug use knowledge in obstetrics and gynecology outpatient department.Pharmacists can choose the appropriate medication education intervention based on the patient's different educational levels,preferences and acceptability.
		                        		
		                        		
		                        		
		                        	
8.Clinical study of local application of triamcinolone acetonide in promoting wound healing after granulomatous lobular mastitis operation
Shuqin XIE ; Jie OUYANG ; Zhuohong LIANG ; Aihui LI
Chinese Journal of Postgraduates of Medicine 2017;40(3):233-236
		                        		
		                        			
		                        			Objective To investigate the effect of local application of triamcinolone acetonide in promoting wound healing and recurrence after granulomatous lobular mastitis (GLM) operation. Methods The clinical data of 55 GLM patients with the diameter > 5 cm were retrospectively analyzed, and all patients treated with incision drainage to breast abscess and removal of inflammatory lesions. Thirty - one patients were treated with routine dressing change after operation (control group), and 24 patients were treated with routine dressing change and triamcinolone acetonide injection after operation (experiment group). The wound dressing time, recovery rate and recurrence rate were compared between 2 groups, and hormone related adverse reaction of experiment group was observed. Results The wound dressing time in experiment group was significantly shorter than that in control group:(58 ± 19) d vs. (71 ±25) d, and there was statistical difference (P<0.05). There were no statistical differences in the recovery rate and recurrence rate between experiment group and control group:91.7%(22/24) vs. 83.9%(26/31) and 9.1%(2/22) vs. 15.4% (4/26), P>0.05. The patients of experiment group did not have the hormone related adverse reaction. Conclusions The local application of triamcinolone acetonide after GLM operation can accelerate the wound healing, and it may also contribute to higher recovery rate and lower recurrence rate.
		                        		
		                        		
		                        		
		                        	
9.Effect of loading density of different rigid containers on wet package of orthopedic instruments in the orthopedics department
Shuqin HAO ; Heying DU ; Cong LIU ; Li'e CAI ; Jinxiu LIANG ;
Modern Clinical Nursing 2017;16(6):26-29
		                        		
		                        			
		                        			Objective To explore the effect of loading density of different rigid containers on wet package of orthopedic instruments in the department of orthopedics and to provide the basis for right loading of rigid container so as to ensure the success of the sterilization. Methods About 120 cases of orthopedic exotic instruments for knee surgery were selected from our hospital, according to size and weight of the knee surgery instrument and then evenly divided into Groups A, B, C, 40 pieces in each group. Each group for loading had the same length and width. In Group A, the loading was at 1/2 of the container height, in Group B, the loading was at 2/3 of the container height and in Group C the loading was 4/5 of the container height. The 3 groups were given high pressure steam sterilization, the sterilization temperature, sterilization time and drying time were the same, while biological and chemical monitoring was done. After sterilization, the three groups were compared in terms of the biological and chemical monitoring results as well as the incidence of wet pack. Results There were no significant differences between the 3 groups in the qualification rate of indicator cards and the biological monitoring after sterilization in the 5 kinds of packages among the 3 groups of rigid containers (P>0.05). The incidence of wet package in Group A was significantly lower than that of Group C (χ2=6.80, P=0.009<0.017), but no difference was found between Groups B and C ,Group B and C Group . Conclusions The loading density of different rigid containers affects the incidence of wet package of the orthopedic instruments. Our findings indicate that the loading of the instruments in a rigid container reaches the 2/3~4/5 height of the container, for it can reduce the incidence of wet package of orthopedic instruments.
		                        		
		                        		
		                        		
		                        	
10.Influence of two enteral nutrition injection methods on prognosis of acute cerebral infarction induced pseudobulbar palsy
Wenxiang XU ; Xifang ZHU ; Xiuhua WU ; Shuqin LIANG ; Lihong QU ; Jing SUN
Chinese Journal of Practical Nursing 2016;32(20):1525-1530
		                        		
		                        			
		                        			Objective To investigate two enteral nutrition injection methods on prognosis of patients with acute cerebral infarction (ACI) induced pseudobulbar palsy patients. Methods A total of 86 patients of ACI accompanied with dysphagia were randomly divided into the feeding pump group (n=43) and the traditional nasal feeding group (n=43). Nutritional support for both groups lasted at least more than 14 d through the feeding tube. In the first and fourteenth day data of both groups concerned with body mass index (BMI), triceps skin fold (TSF), upper arm muscle circumference of triceps (MAMC), heamoglobin (Hb), serum prealbumin (Alb), alanine transaminase(ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), creatinine (Cr), incidence of complications, neuro-function score NIHSS and the swallowing function evaluation were collected and analyzed. Results Nutritional index Hb and Alb was (132.6±10.1) g/L and (38.2±1.4) g/L in the group of the feeding pump group, and significantly higher than (122.2±13.2) g/L and (36.3±1.5) g/L in the traditional nasal feeding group in the fourteenth day, the difference was significant (t=12.86, 12.37, P<0.05). The NHISS score was 5.2±1.0 in the feeding pump group, significantly lower than 8.9±1.1 of the traditional nasal feeding group, the difference was significant (t=-26.37, P < 0.05). The improved rate of swallowing function was 81.4% (35/43) in the feeding pump group, significantly higher than 60.5%(26/43) of the traditional nasal feeding group, the difference was significant (χ2=4.568, P < 0.05). Conclusions The use of enteral feeding pump at early stage for ACI patients with pseudobulbar palsy can improve the nutritional status, acute neurological function, swallowing function and lower the incidence of complications which is beneficial for early recovery and short-term prognosis.
		                        		
		                        		
		                        		
		                        	
            
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