红细胞分布宽度与心搏骤停患者预后的回顾性队列研究

目的探讨入住ICU时的红细胞分布宽度(red cell distribution width, RDW)与心搏骤停(cardiac arrest, CA)患者全因病死率的关系。方法本研究是一项回顾性队列研究(2001—2012年), 从美国重症监护医学信息数据库(MIMIC-Ⅲ, v1.4)中提取首次入住ICU的成人(年龄≥18岁)CA患者的临床资料。按照90 d是否死亡进行分组, 将所有患者分为生存组和死亡组, 并比较两组临床特征。同时, 按照四分位数间距法将RDW分成四组。采用Kaplan-Meier生存曲线分析各组患者28 d和90 d累积生存率变化情况, 并采用log-rank检验加以检验。运用多因素Cox回归分析揭示RDW和CA患者全因病死率之间的关系。结果依据纳入排除标准, 最终纳入853例成人CA患者。整体人群年龄(67.26±15.84)岁, 男性为534例(62.60%), SOFA评分(6.13±3.70)分。与存活组(n=410)比较, 死亡组(n=443)患者年龄、SOFA评分、RDW、阴离子间隙、肌酐以及血磷值较高, 慢性阻塞性肺疾病、急性肾损伤和脓毒症的比例...     

中性粒细胞与淋巴细胞比值联合红细胞分布宽度与血小板计数比值在急诊老年脓毒症患者中的应用价值

目的探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte rate, NLR)联合红细胞分布宽度与血小板计数比值(red blood cell distribution width to platelet count ratio, RPR)对急诊老年脓毒症患者病情和预后的评估价值。方法采用前瞻性研究方法选取2020年1月到2022年2月于首都医科大学宣武医院急诊科就诊的169例老年脓毒症患者临床资料, 入院后给予血常规、胸部电子计算机断层扫描、生化全项、降钙素原、病原学检查等, 根据24 h最差值给予急性生理与慢性健康状况评估(acute physiology and chronic health evaluation, APACHE Ⅱ)评分, 随访28 d, 根据患者预后分为生存组125例和死亡组44例。比较两组患者白细胞计数(white blood cell count, WBC)、NLR、降钙素原、RPR和APACHE Ⅱ评分的差异, 探讨NLR和RPR与APACHE Ⅱ评分的相关性。比较RPR、NLR及二者联合和降钙素原预测老年脓毒症患者死亡的受试者...     

中国部分地区人群和动物中肠出血性大肠埃希菌O157∶H7分布特征

自20世纪90年代以来,中国大部分省、市、自治区相继开展了人群和动物的肠出血性大肠埃希菌O157∶H7病原监测.监测结果显示:①在不同的地区和时间,人群中O157∶H7的感染率/带菌率不同;②动物中O157∶H7的带菌率存在地区、时间及种群的差异;③人群O157∶H7的感染与动物带菌存在关联.提示,加强人群和动物的病原监测、揭示O157∶H7在人群和动物中的流行规律、降低动物的感染或带菌率对预防与控制人群肠出血性大肠埃希菌O157∶H7的感染具有重要意义.     

中、美《护理学基础》教材先进性的比较研究

目的通过中美两国教材的比较研究,为提高我国护理学科教材建设的先进性提供借鉴。方法采取比较研究为主,附以文献回顾和理论研究的方法。结果美国护理学科教材内容更新快,更能反映社会现实,同时扩展了学科内容的奠基作用,内容更趋科学化。在立体的教材建设中,中国注重学科内容的配套,而美国则注重教材形式的配套。结论中美两国在体现护理学科教材先进性上各具特色。美国由于经济以及科技上的优势,在某些特定环节上更加完善,高科技运用更加广泛、灵活,这为完善我国护理学科教材先进性建设提供了借鉴。     

Sources and symptoms of stress among nurses in the first Chinese anti-Ebola medical team during the Sierra Leone aid mission: A qualitative study

ObjectiveThis study investigated the sources of stress, corresponding symptoms, and stress relief among nurses of the first Chinese anti-Ebola medical team during the Sierra Leone aid mission.MethodA purposive sampling method was used and 10 nurses were selected from the first Chinese anti-Ebola medical team that was dispatched to Sierra Leone. Data were collected via phone and semi-structured interviews, then analyzed using Colaizzi's seven-step method.ResultsThe data showed three major themes: (1) The causes of stress during the Sierra Leone aid mission mainly related to unsafety, responsibility, and unfamiliarity; (2) Physical, cognitive, emotional, and behavioral symptoms were documented; (3) Nurses experienced relief from stress after the mission.ConclusionTargeted measures, proper responses and good community support can effectively lower stress among nurses on anti-Ebola missions.     

Technique and Practical Problems: The Tourniquet Test the Influence of Age or Hemorrhagic Disorders on the Distribution and Size of Petechiae

Mulder H, Koster J, Hackeng WHL, van der Schaar H. Normocalcaemic hyperparathyroidism after parathyroidectomy: a retrospective study. Scand J Clin Lab Invest 1993; 53: 607-610.

Forty-eight patients with proven hyperparathyroidism underwent parathyroidectomy. All patients were post-operatively normocalcaemic and free of symptoms due to their pre-operative hypercalcaemic state. However, 20 (42%) post-operative patients still had increased serum PTH and low serum phosphate levels.     

Evaluating a community nursing service: listening to the voices of clients with an intellectual disability and/or their proxies

The aim of this study was to evaluate a specialist nursing service programme for people with an intellectual disability residing in the community. It is important to correct the imbalance in the literature that has neglected the voices of the clients themselves or denied expression by their proxies. The aim of the study was to gain a better understanding of matters of importance for clients and their families and to involve them in the evaluation of a service that directly affects their care. Only three clients were able to participate; however, 17 parents (next of kin) agreed to be interviewed. In-depth interviews were audio-taped, transcribed and analysed relating to the questions asked and were checked against the domains of the nursing practice in the disability area: continuity of care, advanced nursing practice, education and credentialling, personal and professional attributes, primary health care, and normalization. The findings confirm the high regard in which the programme is held. Service evaluation is crucial in providing evidence for programme funders. The favourable outcome of this evaluation meant that the programme gained funding for another few years.     

Nationally funded health management projects for older adults in China and the United States: Comparative analysis based on data from two principal institutions

ObjectivesTo systematically summarize and compare the health management projects on the aged population funded by the National Institutes of Health (NIH) in the US and the National Natural Science Foundation of China (NSFC) in China.MethodsAll elderly-related projects from 2007 to 2022 were retrieved by searching the project titles, abstracts, and keywords such as “older adults,” “elderly,” “aged,” “health management,” and so on. Python, CiteSpace, and VOSviewer were used to extract, integrate, and visualize the relevant information.ResultsA total of 499 NSFC projects and 242 NIH projects were retrieved. For both countries, prestigious universities and institutions received the most funded projects; the projects that got the most funds were longitudinal studies. Both countries attach great importance to investment in the health management of the aged population. However, different focuses existed in health management projects for older adults in the two countries due to distinct national conditions and development levels.ConclusionsThe analysis results of this study can provide a reference for other countries with similar challenges of population aging. Effective measures should be taken to promote the transformation and implementation practice of the project achievements. Nurses can benefit from these projects and facilitate the translation of relevant research findings into clinical practice to improve nursing quality for older adults.