1.Readiness assessment and influencing factors analysis of evidence-based practice for prevention and management of urinary retention after cervical cancer radical operation
Yongli LYU ; Mengna WANG ; Qianru LIU ; Li GENG ; Can XIANG ; Yinglu WAN
Chongqing Medicine 2024;53(11):1656-1660
Objective To understand the readiness of gynecological wards in conducting the evidence-based practice for the prevention and management of urinary retention after cervical cancer radical resection,and to analyze the influencing factors.Methods The 190 nursing staffs in the gynecological oncology wards of this hospital in June 2020 were selected as the study subjects.The assessment of readiness for evidence-based nursing practice (CREBNA) and general information questionnaire were used to conduct the questionnaire survey,single factor and multiple factor stepwise regression to analyze the influencing factors.Results The score of CREBNA was (135.94±17.83) points,the evidence subscale was (52.41±7.88) points,the organi-zational environment subscale was (40.58±5.01) points and the promoting factors subscale was (42.67±6.24) points.The results of univariate analysis showed that the total score of CREBNA was related to the ed-ucational background,professional title,position,scientific research experience,understand degree on evidence-based and necessity of conducting evidence-based (P<0.05).The multiple stepwise regression analysis showed that the understanding degree on the evidenced-base and necessity of conducting evidence-based were the influencing factors of CREBNA scale (P<0.05).Conclusion The readiness of the evidence-based nursing practice in this study is good and has good feasibility.
2.Pelvic floor holistic theory guided complete rectal prolapse manegement
Bingbing LYU ; Yongli CAO ; Ming LI ; Siyuan WANG ; Dong WEI
Chinese Journal of General Surgery 2022;37(6):439-442
Objective:To evaluate pelvic floor holistic theory used in the treatment of complete rectal prolapse (CRP).Methods:Forty-two CRP patients at No. 989 Hospital between Oct 2015 and Jun 2019 were divided into group A ( n=23) treated by laparoscopic rectopexy associated with the procedure for PPH, and group B ( n=19), by Altemeier precedure. The degree of rectal prolapse, Wexner fecal incontinence score and Wexner constipation score were evaluated before operation and at the 6th,12th and 24th months after operation Results:The operation time of the two groups were (53±6) and (90±9) min; intraoperative blood loss was (14±5) and (80±19) ml; the hospital stay was (8.9±1.7) and (13.5±2.1)d, all P<0.05. There was no significant difference in postoperative recurrence between the two groups ( P>0.05). The degree of rectal prolapse in group A and B were (9.5±1.7) and (8.7±1.5)cm; the 6 th, 12 th and 24 th months after operation were [(-1.0±1.6), (-0.2±1.8)cm; (-1.0±1.3), (-0.3±1.5)cm; (-0.8±1.2), (-0.5±1.6)cm], all P<0.05. The preoperative constipation in group A and group B was (6.4±1.7) and (6.4±1.5) respectively; the 6 th, 12 th and 24 th months after operation were [(2.8±1.0) vs. (3.0±1.3); (2.6±1.1) vs. (2.8±1.3); (2.0±0.9) vs. (2.3±1.1)], all P<0.05. The preoperative fecal incontinence score of group A and group B were (7.6±1.7) vs. (7.1±1.5); the 6 th, 12 th and 24 th months after operation were [(3.7±1.7) vs. (3.4±1.2); (3.5±1.8) vs. (3.1±1.1); (3.4±1.9) vs. (2.6±1.3)], all P<0.05. Conclusion:Pelvic floor holistic theory help improve the treatment of complete rectal prolapsed.
3.Relationship between the level of anti Mullerian hormone and antral follicle count and oocytes number in patients undergoing in vitro fertilization
Lina PAN ; Yongli HUANG ; Jing LYU ; Xi LUO ; Jie WANG ; Zhuo CHEN
Journal of Chinese Physician 2022;24(9):1363-1367
Objective:To investigate the relationship between the level of anti Mullerian hormone (AMH) and antral follicle count (AFC) and oocytes number in patients with in vitro fertilization (IVF). Methods:372 patients with primary infertility who received IVF and embryo transfer (IVF-ET) treatment in the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2020 were prospectively selected as the study subjects. According to the oocytes obtained, the patients were divided into low ovarian response group (LOR group, the number of oocytes obtained ≤5, n=37), normal group (NOR group, the number of oocytes obtained was 6-15, n=292) and high ovarian response group (HOR group, the number of oocytes obtained >15, n=43). The levels of AMH and AFC in the three groups were observed. The relationship between AMH, AFC with LOR and HOR was observed by multivariate logistic analysis. The sensitivity, specificity, optimal cut-off value and area under the curve (AUC) of AMH and AFC for predicting LOR and HOR were calculated by receiver operating characteristic (ROC) curve. Results:There were significant difference in AMH, AFC and oocyte number among the three groups (all P<0.05). The AMH, AFC and oocyte number in NOR group were higher than those in LOR group, and AMH, AFC and oocyte number in HOR group were higher than those in LOR and NOR group (all P<0.05). The results of binary multivariate analysis showed that AFC and AMH were protective factors of LOR (all P<0.05), while AFC and AMH were risk factors of HOR ( P<0.05). The sensitivity and specificity of AMH and AFC in predicting LOR were 83.8% and 75.7%, 65.7% and 84.2%, respectively. The sensitivity of AMH or AFC positive as the standard for predicting LOR was 94.6%, and the specificity of AMH and AFC was 91.6%. The sensitivity and specificity of positive AMH and AFC in predicting HOR were 69.8% and 74.4%, 69.6% and 83.6%, respectively. The sensitivity of AMH or AFC positive as the standard for predicting HOR was 93.0%, and the specificity of AMH and AFC positive as the standard for predicting HOR was 93.0%. Conclusions:AMH and AFC are significantly correlated with oocyte number in patients with primary infertility. Flexible application of AMH and AFC is beneficial to better predict the number of oocytes obtained, which provides a reference for clinical development of individualized ovarian stimulation program.
4.A case of severe ethylene glycol poisoning treated successfully by V-V ECMO combined with blood purification
Yongli PAN ; Shijin LYU ; Zhenhong JIANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(12):947-949
Ethylene glycol, also known as glycol, is a common low-temperature antifreeze used in automobiles. It is a colorless, odorless, volatile, low-sweet, sticky liquid at room temperature. Ethylene glycol is easily decomposed and absorbed through the digestive tract. Toxic metabolites cause serious clinical symptoms such as central nervous system inhibition, metabolic acidosis, cardiopulmonary symptoms and renal insufficiency, and even death. Misuse and oral suicide are the main causes of ethylene glycol poisoning. This article reports a case of severe ethylene glycol poisoning admitted to the emergency department of the Affiliated Hospital of Hangzhou Normal University in December 2021. After treatment with V-V ECMO combined with blood purification, the patient was improved and discharged from hospital.
5.A case of severe ethylene glycol poisoning treated successfully by V-V ECMO combined with blood purification
Yongli PAN ; Shijin LYU ; Zhenhong JIANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(12):947-949
Ethylene glycol, also known as glycol, is a common low-temperature antifreeze used in automobiles. It is a colorless, odorless, volatile, low-sweet, sticky liquid at room temperature. Ethylene glycol is easily decomposed and absorbed through the digestive tract. Toxic metabolites cause serious clinical symptoms such as central nervous system inhibition, metabolic acidosis, cardiopulmonary symptoms and renal insufficiency, and even death. Misuse and oral suicide are the main causes of ethylene glycol poisoning. This article reports a case of severe ethylene glycol poisoning admitted to the emergency department of the Affiliated Hospital of Hangzhou Normal University in December 2021. After treatment with V-V ECMO combined with blood purification, the patient was improved and discharged from hospital.
6.Quantitative computed tomography-derived abdominal visceral adipose tissue and cardiometabolic risk in a large-scale population
Shengyong DONG ; Xiaojuan ZHA ; Limei RAN ; Yongli LI ; Shuang CHEN ; Jianbo GAO ; Shaolin LI ; Yong LU ; Yuqin ZHANG ; Xiao MA ; YueHua LI ; Xigang XIAO ; Xiangyang GONG ; Zehong YANG ; Wei CHEN ; Yingying YANG ; Bairu CHEN ; Yingru LYU ; Yan WU ; Jing WU ; Kaiping ZHAO ; Xiaoxia FU ; Xia DU ; Haihong FU ; Xiaoguang CHENG ; Qiang ZENG
Chinese Journal of Health Management 2021;15(5):425-431
Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.
7.Applying structural equation model to construct the index of influencing factors of clinical nursing teaching quality
Li ZENG ; Li GENG ; Zhuoya ZHANG ; Yongli LYU
Chinese Journal of Practical Nursing 2021;37(5):390-396
Objective:to construct and test the structural equation model of influencing factors of clinical nursing teaching quality, and analyze the influencing factors and strength of clinical nursing teaching quality.Methods:Based on the literature, 20 indexes influencing the quality of clinical nursing teaching were selected. In July 2019, clinical nursing teachers of a third class a medical institution were selected for convenient sampling survey. Through factor analysis, 20 indexes were classified into 6 dimensions, namely, teaching environment, teaching attitude, teacher quality, teacher behavior, teaching management and teaching quality.Results:The structural equation model of influencing factors of clinical nursing teaching quality was constructed. The fitting index of the model reached the standard value, and the model had a good fit.Conclusion:With the help of this model, the nursing administrators can find out the factors and intensity that affect the quality of clinical nursing teaching, which is helpful to put forward the improvement strategies of improving the quality of clinical nursing teaching, to improve the effect of clinical nursing teaching, to improve the quality of clinical nursing teaching, and to provide reference for the research of similar clinical nursing teaching quality.
8.Application of medical science popularization competition in nursing interns from the perspective of healthy China
Zhuoya ZHANG ; Li GENG ; Li ZENG ; Yongli LYU ; Jiao YANG ; Ying HU
Chinese Journal of Practical Nursing 2021;37(13):1027-1031
Objective:To explore the application effect of medical science competition in nursing interns whocontribute to "healthy China" , and to improve their health education awareness, ability, method and self-confidence.Methods:A total of 205 nursing interns who worked in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from 2019 to 2020 were selected as the research objects. They were divided into the control group (105 cases) and the experimental group (100 cases) according to whether they participated in the medical science competition. The control group learned the form and method of health education in clinical rotation according to the traditional practice teaching plan. The experimental group volunteered to participate in the medical science competition, which required the dissemination of health knowledge through various forms. Before and after the competition, the health education ability assessment scale was used for comparison.Results:Before the medical science competition, there was no significant difference in the total score of assessment, planning, implementation, evaluation and health education between the control group and the experimental group ( t values were 0.765 - 1.749, all P>0.05). After the medical science competition, the total scores of assessment, planning, implementation, evaluation and health education ability of nursing interns in the experimental group were (24.38 ± 4.72), (17.98 ± 3.98), (25.16 ± 5.36), (12.57 ± 2.96) and (80.09 ± 15.65) respectively, while those in the control group were (22.45 ± 6.29), (16.61 ± 4.77), (23.04 ± 6.55), (11.31 ± 3.46) and (73.41 ± 19.69).The differences between the two groups were statistically significant ( t values were 2.226 - 2.795, all P<0.05). Conclusions:The medical science competition can improve the health education ability of assessment, planning, implementation, evaluation of nursing interns and contribute to "healthy China" .
9. In vitro fertilization-embryo transplantation combined with ovarian malignant tumor cause analysis and nursing
Chinese Journal of Practical Nursing 2019;35(10):754-757
Objective:
The causes of ovarian malignant tumors after in vitro fertilization and embryo transplantation were analyzed retrospectively, and the preventive measures were put forward and the corresponding nursing measures were taken.
Methods:
For confirmed after in vitro fertilization and embryo transplantation combined with ovarian malignant tumor in 5 patients with psychological care, perioperative observation and complications prevention treatment, chemotherapy nursing, health guidance, etc.
Results:
Five patients were treated and treated with appropriate clinical care, including 4 cases of continuous pregnancy, 1 case of termination of pregnancy.
Conclusions
By analyzing the causes of such diseases and taking preventive measures, the occurrence of complications can be reduced and the multidisciplinary cooperation among gynecology, obstetrics and neonatology can be improved to improve the relevant nursing level.
10.The diagnostic value of endoscopic ultrasound-guided fine needle aspiration for mediastinal and abdominal lymphadenopathy
Jiaying CHEN ; Wen GUO ; Qingyu DING ; Yang LYU ; Wei ZHU ; Yongli YAO ; Fachao ZHI ; Side LIU ; Tianming CHENG
Chinese Journal of Digestive Endoscopy 2017;34(8):568-572
Objective To study the diagnostic value and clinical efficacy of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA ) for mediastinal and abdominal lymphadenopathy. Methods Thirty patients who underwent EUS-FNA for mediastinal or abdominal lymphadenopathy between May 2009 and December 2015 were reviewed. The clinical efficacy of EUS-FNA was evaluated by pathological results and the follow-up. The EUS-FNA effect on clinical decision was also analyzed. Results Lesions were located in the mediastinum in 10 cases and in the abdomen in 20 cases. The total diagnostic accuracy, sensitivity, specificity, positive predictive value ( PPV) and negative predictive value ( NPV) of EUS-FNA were 96. 7%, 94. 7%, 100. 0%, 100. 0% and 91. 7%, respectively. Of all the 30 cases, 20 lymph glands were of unknown origin. The diagnostic accuracy, sensitivity, specificity, PPV and NPV of EUS-FNA in these lesions were 95. 0%, 88. 9%, 100. 0%, 100. 0% and 91. 7%, respectively. The combination of cytological and histological examination had higher accuracy ( 96. 7% VS 73. 3%, P=0. 026) and sensitivity ( 94. 7%VS 57. 8%, P= 0. 019 ) than cytological examination only. Immunohistochemistry stains were performed in 12 neoplastic cases, and 11 ( 91. 7%) were confirmed. The diagnosis by EUS-FNA had positive impact on clinical decisions in 27 patients ( 90. 0%) . Conclusion EUS-FNA is an effective approach for mediastinal and abdominal lymphadenopathy, and the result has a positive impact on clinical decisions. The combination of cytological and histological examination and application of ancillary techniques, such as immunohistochemistry stains, can improve the diagnostic efficacy of EUS-FNA.

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