Non-valvular atrial fibrillation is associated with the incidence of thromboembolism. Current guidelines recommend preferential use of novel oral anticoagulants (NOAC) in patients with nonvalvular atrial fibrillation. Oral anticoagulation medication adherence rate was relatively low among discharged patients with non-valvular atrial fibrillation.To investigate the effects of the anticoagulation programs based on the theory of planned behavior and nudge strategy among patients with non-valvular atrial fibrillation.130 patients with non-valvular atrial fibrillation were randomized to the intervention group or control group, 72 patients in the intervention group, and 58 patients in the control group with a 6-month follow-up. Medication adherence, intention, attitude, perceived behavioral control and subjective norm and quality of life were assessed.There were significantly differences in the intention, attitude and subjective norm between the two groups at one month, three months and six months follow-up (P <0.01). There were significantly differences in the perceived behavioral control between the two groups at three months and six months follow-up (P <0.01). The medication adherence scale score was higher in the intervention group than in the control group at three months and six months follow-up. However, there were no differences in quality of life between the two groups at one month, three months and six months follow-up.The program based on the theory of planned behavior and nudge strategy can improve medication adherence in patients with non-valvular atrial fibrillation.
Objective
To compile and evaluate the questionnaire of knowledge, belief and practice of perioperative nurses in the prevention of deep venous thrombosis (DVT) in order to provide a tool for further investigation of the status quo of nursing care in the prevention of DVT during perioperative period.
Methods
Based on the theoretical model of knowledge, belief and practice, a questionnaire item pool was established by literature reading and semi-structured interviews, and an initial questionnaire was formed by Delphi expert inquiry. It was convenient to select 197 nurses engaged in surgery and operating room nursing in Qingdao Municipal Hospital Affiliated to Qingdao University to carry out the pre questionnaire, and to carry out the differentiation levels,relevance coefficient analysis and reliability and validity test were used to form a formal questionnaire.
Results
After two rounds of Delphi expert inquiries, three items with lower assignment value and four items with modified contents were deleted to form the initial questionnaire. The positive coefficients of experts in two rounds of inquiry were 85.00% and 100.00%, respectively; the Kendall's harmonious coefficients of experts were 0.195 and 0.204 (P<0.01); and the authoritative coefficients of experts were 0.836 and 0.849. Four items were deleted from 197 pre-survey questionnaires by discriminatory analysis, correlation coefficient analysis and reliability and validity test. The Item Level Validity (I-CVI) of the total questionnaire was 0.800-1.000, and the Scale Level Validity (S-CVI) was 0.825. In the structural validity analysis, the KMO value of each item was 0.824, the Bartlett spherical test value was 3170.304, P < 0.01. Twelve common factors with eigenvalues greater than 1 were extracted, and the cumulative variance contribution rate was 66.11%. The intrinsic consistency Cronbach a coefficient of the total questionnaire was 0.859, and the retest reliability was 0.706. Finally, a formal questionnaire with 40 items in 15 knowledge dimensions, 10 belief dimensions and 15 behavior dimensions was formed.
Conclusion
The reliability and validity of the questionnaire are well evaluated, and it can be used as a tool for investigating the knowledge, belief and practice of perioperative nurses in preventing deep venous thrombosis.
Key words:
Perioperative period; Deep vein thrombosis; Prevention; Questionnaire; Operating room nurses
This study aimed to investigate the serial-multiple mediation effect of professional identity, psychological capital (PsyCap), work-related stress, and work-related wellbeing among intensive care unit (ICU) nurses in China. The cross-sectional survey was conducted from January 2017 to May 2017 in two Grade III A general hospitals (with more than 2000 beds) in Jining, Shandong Province, China. Cluster sampling was used to recruit participants from the two hospitals. A total of 330 ICU nurses participated in the study. The nurses’ work stress scale, Chinese nurse’s professional identity scale, the PsyCap questionnaire, and Chinese work-related wellbeing scale were used to collect the data. Descriptive analysis, independent-samples t- test, one-way analysis of variance, Pearson correlation analysis, linear regression analysis, and structural equation modeling were used to analyze the data ( P < 0.05 was considered statistically significant). The average score for the work-related wellbeing of ICU nurses was 85.91 ± 13.94. Work-related stress, professional identity, and PsyCap correlated significantly with work-related wellbeing. The major predictors of work-related wellbeing were PsyCap, work-related stress, professional identity, and monthly salary. The serial-multiple mediation effects of professional identity and PsyCap in the relationship between work-related stress and work-related wellbeing were statistically significant. Positive professional identity and PsyCap were sequentially associated with decreased work-related stress, which in turn was related to increased work-related wellbeing among ICU nurses. Therefore, this study aims to explore the impact of ICU nurses’ work-related stress on work-related wellbeing, as well as the mediating effect of professional identity and PsyCap. It is hoped that hospital care managers will pay attention to the mental health of ICU nurses, increase their professional identity, and reduce work-related stress to improve the quality of the ICU nursing service and stabilize nursing work.
Lower back pain (LBP) is a common and remitting problem. One of the primary causes of LBP is thought to be degeneration of the intervertebral disc (IVD). The aim of the present study was to investigate the role of the myeloid differentiation primary-response protein 88 (MyD88)‑dependent Toll‑like receptor 4 (TLR4) signal pathway in the mechanism of IVD degeneration. IVD nucleus pulposus cells isolated and cultured from the lumbar vertebrae of Wistar rats were stimulated by various doses of lipopolysaccharide (LPS; 0.1, 1, 10 and 100 µg/ml) to simulate IVD degeneration. Cells were rinsed and cultured in serum-free Dulbecco's modified Eagle's medium/F12. Reverse transcription-quantitative polymerase chain reaction was used to determine the levels of TLR4, MyD88, tumor necrosis factor α (TNFα), and interleukin‑1β (IL‑1β) mRNA expression after 1, 3, 6, 9 and 12 h of incubation. Additionally, western blot and enzyme‑linked immunosorbent assay analyses were used to determine the levels of TLR4, MyD88, TNFα, and IL‑1β protein expression after 24, 48 and 72 h of incubation. The levels of TLR4, MyD88, TNFα and IL‑1β mRNA all increased in the cells stimulated by 10 µg/ml LPS at 3, 6 and 9 h (all P<0.001). Furthermore, the levels of TLR4, MyD88, TNFα and IL‑1β protein all increased at 24, 48 and 72 h (all P<0.001). Additionally, the mRNA and protein levels of TLR4, MyD88, TNFα and IL‑1β increased significantly in the cells stimulated by 1, 10 and 100 µg/ml LPS compared with the control group, and reached a peak in the 10 µg/ml LPS group (all P<0.001). These results suggest that the MyD88-dependent TLR4 signal pathway is a target pathway in IVD degeneration. This pathway is time phase‑ and dose-dependent, and when activated can lead to the release of inflammatory factors that participate in IVD degeneration.
Constipation is one of the most common non-motor symptoms in PD patients, and the constipation, can appear before motor symptoms. Incorrect treatment of constipation in PD patients can result in colonic volvulus and pseudo intestinal obstruction, as well as a reduction in the therapeutic effect of anti-PD drugs due to absorption issues. There is, however, no comprehensive and scientific nursing intervention plan for PD patients' constipation who are constipated.A multi-disciplinary nursing research group of five people was established to construct the first draft of intervention plan through literature review. We chose 15 experts from 7 universities and tertiary hospitals spread over 5 provinces (cities), including 4 neurologists, 9 clinical nursing specialists in neurology, 1 dietician, and 1 rehabilitator. Two rounds of consultations were held from April to July 2022 with 15 experts to screen and revise the indicators at each level, confirming their importance and feasibility at each level.There were three primary indicators (pre-intentional stage, intentional stage, and action stage) in the two rounds of expert correspondence, nine secondary indicators (disease risk perception, adverse consequence expectation, self-efficacy and intention of action; action plan, coping plan and coping self-efficacy; produce healthy behaviors, maintain healthy behaviors, recover behaviors and recover self-efficacy), and 22 tertiary indicators.After the implementation of two rounds of Delphi method, the final formed constipation intervention program for PD patients provides the basis for clinical nursing practice, which has the characteristics of convenience, comprehensiveness, dependence, scientific and feasibility. Therefore, it has application and promotion value.
Objective To explore the molecular types of methicillin-resistant Staphylococcus aureus (MRSA) strains present in major hospitals in Qingdao area, using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) methods, trying to find out the epidemiological characteristics of these MRSA isolates. Correlation of the PFGE types with microbiological phenotypes and clinical data was also studied. Methods 360 isolates of MRSA were procured during 2003 to 2007 from major hospitals in Qingdao. PFGE technology was applied to comparatively analyze the chromosomal DNA digested with endonuclease Sma Ⅰ . Comparison of DNA fragments patterns from each MRSA strain and cluster analysis were performed with the Bionumericus version ' 2.0' software. A dendogram was generated using PFGE macrorestriction fragments on gel images. Data was used to predict the possibility of each PFGE type via SPSS software version 11.0, using the variables as predictors including groups on patient's age, gender, source and the site where MRSA was isolated. Antibiotic sensitivity patterns of these MRSA isolates were determined by K-B tests, and a correlation between these patterns and PFGE types was investigated. Housekeeping genes were amplified with PCR and sequenced in representative strains of variant PFGE types to identify their allelic profile. Results 5 types of PFGE patterns (M0-M4) were identified with MI being the predominant and M2 next to it which was significantly correlated to the isolates from wounds. M3 type strains were mainly isolated from ICU wards and there were a few cases complied with M4 type with no correlated variant factors found in this study. A unique pattern of MRSA isolates with its M0 distinct from other types had not been reported. No significant association was found between PFGE individual types,gender or age groups. M1 and M2 types were the major proportional PFGE patterns among different hospitals. No vancomycin-resistant isolates were detected among 360 MRSA strains. No significant association was found between individual antibiotic resistance and specific PFGE types. Data from MLST analysis showed that the aUelic profiles of M1 and M3 type strain had the same ST239 linage which was commonly present in China. For M2 and M4 representative strains, the allelic profiles were ST5 and ST240, respectively. ST45 and ST398 were corresponding to two PFGE patterns clustered as M0 type. Conclusion Nosocomial infection due to MRSA was evenly distributed among different age groups and no gender bias was observed. The PFGE types of MRSA strains isolated in major hospitals in Qingdao were highly correlated with the sources of isolates and ST239 isolate seemed the prevalent and widespread one. Strategies should be designed to further monitor and prevent or minimize the spread of ST5 MRSA isolates and the like, in Qingdao area.
Key words:
Methicillin-resistant Staphylococcus aureus; Molecular typing; Nosocomial infection
Objective
To understand the status quo of perception control, self-management and cancer-related fatigue (CRF) in breast cancer patients receiving chemotherapy, and to investigate the impacts of perception control and self-management on CRF.
Methods
In this study, 246 breast cancer patients undergoing chemotherapy from Shandong Cancer Hospital and Institute were investigated by means of cross-sectional survey. Cancer experience and efficiency scale was used to evaluate the patients′ perception control; cancer patients′ self-management scale was used to assess their self-management; and Piper Fatigue Scale was used to evaluate their CRF. Finally, the scores of CRF among the patients with different demographic data were compared, and the effects of perception control and self-management behavior on CRF were analyzed.
Results
In univariate analysis, there were statistically significant differences of CRF scores resulting from different educational backgrounds (F=3.392, P=0.019), sources of medical cost (F=4.368, P=0.005), disease stages (F=4.376, P=0.005), chemotherapy periods (F=3.865, P=0.010) and courses of disease (F=3.094, P=0.028). The differences in each dimension of perceived control cancer experience (F=7.248, P=0.001), control efficacy (F=96.595, P<0.001), self-management level of cancer patients (F=65.009, P<0.001) and CRF (F=130.973, P<0.001) were statistically significant. Cancer experience in perception control was positively correlated with CRF (r=0.467, P<0.001); control effectiveness and self-management of cancer patients were negatively correlated with CRF (r=-0.505, P<0.001; r=-0.564, P<0.001). Multiple linear regression showed that source of medical expenses (setting commercial insurance as the reference group), chemotherapy cycle (setting chemotherapy cycle ≥ 6 cycles as the reference group), cancer experience, control effectiveness, and self-management were entered in regression models, which could explain 55.5% of the total variation in CRF scores, and there was a significant linear relationship (F=17.100, P<0.001).
Conclusion
Medical staff should focus on CRF in patients at their own expense and in the 2-5 chemotherapy cycles. Cancer experience is positively correlated with CRF. Control effectiveness and self-management behavior are negatively correlated with CRF.
Key words:
Breast neoplasms; Fatigue; Analysis of influence factor; Perception control
Objective
To investigate the feasibility of human umbilical vein endothelial cells (hUVECs) and human bone marrow mesenchymal stem cells (BMSCs) forming vascular network like structure in three-dimensional co-cultured system.
Methods
Green fluorescent protein and red fluorescent protein to were used to transfect the 4th generation human umbilical vein endothelial cells and the 4th generation bone marrow mesenchymal stem cells respectively, which were implanted into typeⅠ rat tail collagen to co-culture in the dish including a volume fraction of 5% extracellular matrix (ECM) fatal bovine serun (FBS) medium 1 ml. Through confocal laser scanning microscope, the state and development of two cells form network structures and both growth after co-cultured 2 d, 4 d, 7 d were observed. MetaXpress software system was used to calculate the length of the vascular network like structure and analyze cell viability using DNA extraction method by DNA extraction.
Results
2 days later, BMSCs started stretching, growing fusiform and showing no aggregation between cells. hUVECs did not dramatically stretch, only a few cells slightly stretched.4 days later BMSCs continued stretching and aggregating, while hUVECs stretched considerably and had started to gather, but there was no obvious link between the two cells.7 days later two cells stretched and aggregated. Both interlaced and formed tubular structure and vessel-like structures extendingobviously. Determination of DNA content displayed the number of cell proliferation in 7 days significantly, as well as the mRNA and protein level of vascular endothelial growth factor (VEGF).
Conclusion
The labeled hUVECs and BMSCs maintain their fluorescence and survive in type Ⅰ rat tail collagen. They both can grow and extend free in this three-dimensional co-culture system. They show significant interaction to form vascular network like structure 7 days after co-culture. The results of the present study suggest that this co-cultured system is effective and feasible, and it also affirms the importance of hUVECs and human BMSCs in the process of forming vascular network like structure.
Key words:
Human umbilical vein endothelial cells; Human bone marrow mesenchymal stem cells; TypeⅠ rat tail collagen; Vascular network like structure
[Objective] To investigate the Effect of Xianzhong(XI) Injection on Histomorphology of Knee and Interleukin-1β(IL-1β) 、Prostaglandin E2(PGE2) in Rabbits with Early Stage Osteoarthritis(OA).Mothods One Handred and twenty rabbits were randomly divided into 5 groups,the blank group,the model group treated with 0.5ml normal saline once a week,the positive control group treated with0.5ml hyaluronate once a week,and the XI 1 group and XI 2 group with 0.5ml XI once and twice a week,respectively,all the medicineswere medicated via intra-articular injection.The Patholoyical charge of histomorghology of cartilage and synovial were observed by Mallo-ry staining 8 weeks after modeling, and Interleukin-1β and Prostaglandin E2 content in synovia were detected as well.Result Histomor-phology examination showed there was no calcifiction in all the layers of cartilage in the positive control group and the XI 1 group withcomplete cartiaginuous bluish-green collagen preserved.The Makin grading Indicating the effection that in the XI 1 group was equivalentto that in the positve control group(P0.05),and that were better in the two XI groups and the positive control group than that in the modelgroup(P0.05).The content of Interleukin-1β and Prostaglandin E2 decreased in synovia in the postive control group and the two XI groupas compared with that in the model group(P0.05).[Conclusion] XI can repair the degenerative cartilage in early OA.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)