Evidence-based nursing practice has received wide attention by scholars both domestically and abroad since it was proposed, and evidence utilization forms the key link of evidence-based practice activities. Promoting action on research implementation in health services framework (PARIHS) has been widely accepted and applied in the innovation of clinical practice. The research team has improved it to i-PARIHS based on years of continuous testing and improvement, as well as feedback from users. This article aims to compare PARIHS and i-PARIHS, and elaborates on basic connotations and core elements of i-PARIHS, so as to provide basis for the innovation of clinical nursing practice in China.
【摘要】 目的 評價青年人頸動脈彩色多普勒超聲檢查的臨床意義，并探討青年人腦梗死與頸動脈粥樣硬化的關系。 方法 2008年2月-2011年3月，對256例青年腦梗死患者進行頸動脈彩色多普勒超聲檢測，選擇性別和年齡匹配的健康青年143例作對照組，比較兩組人群頸動脈彩色多普勒超聲特點的差異。 結果 腦梗死組頸動脈粥樣硬化斑以中等、強回聲斑塊為主，斑塊積分、血管壁內-中膜厚度（ITM值）及斑塊檢出率（34.77%，89例）均明顯高于對照組（Plt;0.01）；腦梗死組頸動脈硬化狹窄率及血栓發生率明顯高于對照組（Plt;0.05，lt;0.01）。 結論 青年腦梗死患者頸動脈粥樣硬化及血栓形成發生率均高，提示青年腦梗死患者的發病主要原因與動脈粥樣硬化有關。IMT值的增加、斑塊的檢出率及形態學特征等是頸動脈病變與腦梗死發生的有意義的檢測指標，在青年人腦梗死的防治中是有參考意義較大的超聲學指標。【Abstract】 Objective To assess the clinical significance of color Doppler ultrasonography in examining carotid arteries of young patients, and explore the relationship between cerebral infarction and carotid arteriosclerosis in young patients. Methods A total of 256 patients with cerebral infarction and 143 people without cerebral infarction diagnosed between February 2008 and March 2011 were assessed by color doppler ultrasonography. The ultrasonic characteristics of the two groups were compared and analyzed. Results Plaques incidence in cerebral infarction group was 81.43% which was higher than that in the control group. The most common sites of plaque formation were common carotid artery (CCA) bifurcate and the initial segment of internal carotid artery (ICA) in young people with cerebral infarction. In the cerebral infarction group, the rate of middle-echoic plaques was higher than that in the control group (Plt;0.05). The rate of low-grade carotid stenosis was higher in the cerebral infarction group than that in the control group (Plt;0.05). Conclusions Cerebral infarction occurrence in young people is closely correlated to carotid artery atherosclerosis. Ultrasonography can provide objective evidences for preventing and treating cerebral infarction.
目的 探討優質護理服務在婦科臨床護理路徑（CNP）實施中的應用效果。 方法 2010年4月－2011年4月納入婦科CNP的住院患者中隨機抽取150例，并選擇同期病區全部17名護士作為對照組；在2011年5月－12月納入婦科CNP并實施優質護理服務的住院患者中隨機抽取150例，并選擇同期病區全部22名護士作為試驗組。比較兩組患者疾病相關知識知曉率、患者及護士工作滿意率、平均住院日的差異。 結果 試驗組患者疾病相關知識知曉率、患者及護士滿意率優于對照組，且平均住院日明顯縮短。 結論 優質護理服務應用于改進CNP管理質量，可提高患者疾病相關知識知曉率和護患滿意率，縮短住院時間，減輕醫療負擔，有利于CNP的實施。
Objective To systematically review the prevalence, clinical characteristics, and prognosis of fulminant type 1 diabetes mellitus (F1DM) in China. Methods The CNKI, WanFang Data, CBM and PubMed databases were searched to collect Chinese F1MD case reports from January 1, 2000 to March 30, 2022. Data analysis was performed using Stata 16.0 software and RevMan 5.3 software. Results A total of 874 cases were included in 233 papers, involving 410 males (46.91%) and 464 females (53.09%). The age of onset was 29.32±1.09 years and the course of disease was 3.74±0.63 days. The BMI was 21.18±0.52 kg/m2, HbA1c was 6.58%±0.08%, the level of fasting C-peptide was 0.04±0.010 ng/mL, level of C-peptide 2 h after meal was 0.09±0.020 ng/mL, the level of blood glucose at the doctor’s office was 34.72±2.89 mmol/L, and the level of arterial blood gas pH was 7.09±0.015. Among them, 734 patients had diabetic ketoacidosis (84.55%), 496 patients had infection of the upper respiratory or digestive tract before onset (56.75%), 4 patients died (0.46%), 78 patients were GADA positive, 11 patients were ICA positive, 13 patients were IAA positive, and 109 were pregnant patients (90 fetal deaths, 82.57%). Conclusion Chinese F1DM is a special but common subtype of diabetes. Its characteristics include a relatively young age of onset, devastating islet damage, and rapid progression, and it is often accompanied by severe metabolic disorders, complications, and grim prognosis. Clinicians should pay more attention to F1DM.
Objective To discuss how to improve organization and management of first-aid nursing during the rescue work. Methods Data about the wounded patients in the Emergency Department of our hospital were collected from 12 to 21 May, 2008. The relevant information concerning the interventions and effects of the organization of first-aid nursing was analyzed. Results In the first ten days after the quake, 1 766 wounded patients were received and treated in the Emergency Department. The results of post-evaluation showed that the rescue work was successful including the first-aid path, rationality of the rescuer dispatch, management of the medical resources, collection of the patients information, and high-quality nursing. Conclusion Effective organization and management of first-aid nursing guarantee the rescue work.