Objective To review and analyze the statistics of laboratory critical values in the Department of Cardiovascular Surgery in order to improve the procedures of dealing with these values and provide references for the enhancement of the nursing level. Methods We retrospectively analyzed laboratory critical values of 236 inpatients in the Department of Cardiovascular Surgery from April 2013 to April 2014. General data of the patients including the type of critical values, the critical value, distribution, clinical processing time and complications related to the critical values. Results A total of 208 laboratory critical values of 185 inpatients were analyzed including abnormal blood potassium was involved in 99 (47.60%); abnormal blood glucose was involved in 13 (6.25%); abnormal blood sodium was involved in 11 (5.29%); abnormal blood troponin was involved in 13 (6.25%); and 72 cases had other kinds of critical values (34.62%). A total of 136 critical values were closely related to the Department of Cardiovascular Surgery. Among them, 60 cases had a processing time of 15 minutes or shorter. After re-examination, 16 were confirmed to be fake critical values; and 11 critical values did not need to be treated according to the condition of the patients. There were altogether 27 cases of complications related to critical values, including 23 cases of arrhythmia related to abnormal blood potassium, 2 cases of abnormal muscle strength caused by abnormal blood sodium, and 2 cases of hypoglycemia. After the critical values were handled, related complications disappeared without any recurrence. Conclusions Perfect regulatory regime and process of recording and handling laboratory critical values are important for nurses in our department to carry out more accurate measures in treating these critical values including abnormal blood potassium, blood glucose, blood sodium, and blood troponin, etc. In order to continuously improve medical and nursing quality, nurses should pay more attention to the identification and treatment of laboratory critical values.
目的 提高胸心血管外科患者ICU轉出交接班質量，避免護理差錯和糾紛。 方法 2010年1月－6月，針對患者轉運出現的問題，在查閱文獻及專家咨詢的情況下，設計制定胸心血管外科ICU患者轉出交接單，對患者轉出ICU時的病情、用藥、并發癥等信息進行完善，同時規范交接班簽字手續。采用調查問卷方式，對交接單運用效果進行評價。 結果 轉出交接單的應用，提高了病房護士對ICU護士交接班質量滿意度，除“醫囑單正確執行”、“簽字和藥物交接班清楚”與運用前滿意程度無差異外，其余條目滿意程度均有所增加，增加率波動在3.7%～33.4%。 結論 轉出交接單使用能夠提高ICU患者術后轉運交接質量，預防護理差錯和糾紛，確保證患者安全。
ObjectiveTo summarize clinicopathologic and immunophenotypic features of hepatic epithelioid angiomyolipoma (HEAML) and to explore its diagnostic and differential diagnostic methods.MethodThe clinical and imaging manifestations, pathological morphology and immunohistochemical features of 5 patients with HEAML from August 2011 to December 2017 in this hospital were retrospectively analyzed.ResultsThere were 2 males and 3 females in the 5 patients with HEAML, aged 38–64 years with an average age of 50 years. There were 2 cases of the left lobe tumors and 3 cases of the right lobe tumors. Three cases were diagnosed as the hepatocellular carcinoma and the other two cases were diagnosed as the hepatic hamartoma and (or) hemangioma by the preoperative imaging examination. The diameter of tumors ranged from 1.5 cm to 7.0 cm, with an average of 3.6 cm. Microscopically, the tumors were composed of more epithelioid smooth muscle cells, parenchyma vessels and a small amount of fat. The immunohistochemical results showed that the melan-A, HMB45, and SMA were positive, while the HepPar-1, AE1/AE3, EMA, CD117, Dog-1, CD10, CgA, Syn, and Desmin were negative. The Ki-67 proliferation index was 2%–10%. The patients were all alive without the tumor recurrence after following up for 2–76 months with an average of 31.4 months.ConclusionsHEAML is a rare primary mesenchymal tumor of liver, which should be misdiagnosed for other benign or malignant tumors for influencing clinical treatment. Diagnosis and differential diagnosis can be made by histopathology and immunohistochemical staining.
目的:探討主動脈夾層患者術前血壓控制的護理經驗。方法:回顧性分析了我院2007年1月至2008年1月收治的91例主動脈夾層患者血壓控制的護理措施。結果:本組病例通過密切的觀察和護理,獲得了較好的治療效果。結論:主動脈夾層患者術前血壓控制的過程中,應密切觀察,綜合分析,采取鎮靜、止痛、擴血管等措施,才能有效地控制血壓,為下一步治療贏得時間和機會。
Objective To explore the status of women’s quality of life and analyze risk factors related diminished ovarian reserve (DOR). Methods We applied the method of convenient sampling to investigate 61 patients with DOR (DOR group) and 60 women with normal ovarian reserve function (control group) who visited a reproductive centre of a Triple-A hospital from February to May 2013, using a questionnaire which included basic information table, Menopausal Quality of Life Scale (MENQOL) and SF-36 Health Survey for quality of life, and Kupperman Index Scale (KI) for the degree of clinical symptoms. Then, statistical analysis was performed using SPSS 17.0 software. Results Compared with the control group (43.60±16.82), the level of women’s quality of life in the DOR group (73.42±24.15) was significantly lower (Plt;0.01), while the degree of clinical symptoms was significantly higher (Plt;0.01). There were positive associations between quality of life and degree of clinical symptoms. The risk factors related to DOR were various such as age, weight, quality of sleep, menstrual disorders, number of abortion, age of the first pregnancy, gynecologic surgery, economic income, education, family relationship, unsatisfactory sexual life, and psychological factors. Conclusion In order to improve women’s quality of life, effective treatment should be conducted to relieve clinical symptoms of women with DOR. Good life style, harmonious family relationship, healthy mind and avoiding the risk factors, which could effectively help the prevention and treatment of the disease.
Synchronization analysis of electroencephalogram (EEG) and electromyogram (EMG) could reveal the functional corticomuscular coupling (FCMC) during the motor task in human. A novel method combining Gabor wavelet and transfer entropy (Gabor-TE) is proposed to quantitatively analyze the nonlinearly synchronous corticomuscular function coupling and direction characteristics under different steady-state force. Firstly, the Gabor wavelet transform method was used to acquire the local frequency-band signals of the EEG and EMG signals recorded from nine healthy controls simultaneously during performing grip task with four different steady-state forces. Secondly, the TE of local frequency-band was calculated and the unit area index of the transfer (ATE) was defined to quantitatively analyze the synchronous corticomuscular function coupling and direction characteristics under steady-state force. Lastly, the effect of EEG and EMG signal power spectrum on Gabor-TE analysis was explored. The results showed that the coupling strength in the beta band was stronger in EEG→EMG direction than in EMG→EEG direction, and the ATE values in the beta band in EEG→EMG direction decreased with the force increasing. It is also shown that the difference in TE values of gamma band present a varying regularity as the increase of force in both directions. In addition, EMG power spectrum was significantly correlated with the result of Gabor-TE inspecific frequency band. The results of our study confirmed that Gabor-TE can quantitatively describe the nonlinearly synchronous corticomuscular function coupling in both local frequency band and information transmission. The analysis of FCMC provides basic information for exploring the motor control and the evaluation of clinical rehabilitation.