Objective To explore the effect of pain management by anesthesia nurses on labor analgesia. Methods A total of 100 parturient women in the Affiliated Hospital of North China University of Science and Technology between July and August 2015 were randomly divided into two groups: analgesia group and control group with 50 in each. Both two groups accepted labor analgesia routine maternity nursing. Analgesia group accepted maternal perinatal term pain management in addition to the routine nursing. Then we compared degree of pain during the production process, labor time and perineal injury between the two groups of women. Results The number of women with a labor pain degree of 0-Ⅲ in the analgesia group was respectively 36 (72%), 12 (24%), 2 (4%) and 0 (0%), and the number in the control group was respectively 23 (46%), 17 (34%), 8 (16%), and 2 (4%). The above difference between the two groups was statistically significant (Z=–2.908, P =0.004). The number of women with intact perineum, perineal injury of lateral and median cut, and Ⅰ-Ⅲ degree laceration in the analgesia group was respectively 31 (62%), 7 (14%), 8 (16%), 4 (8%) and 0 (0%); and the number in the control group was respectively 21 (42%), 12 (24%), 10 (20%), 7 (14%) and 0 (0%), also with significant difference between the two groups (Z =–2.028, P =0.043). The first and second labor stage of the analgesia group was (462.32±101.27) and (63.58±10.38) minutes, and was (568.27±113.28) and (76.92±11.24) minutes in the control group, with significant differences between the two groups (P<0.001). There was no statistically significant difference between the two groups in the third labor stage (5.78±3.02) and (5.97±2.96) minutes, (P=0.654). Conclusions The implementation of pain management by anesthesia nurses on labor analgesia can significantly reduce maternal labor pain, shorten the time of labor, and the condition of the perineal injury is mild and easily acceptable. It is worthy of clinical promotion.
ObjectiveTo summarize the significance of laboratory examinations in diagnosis of ulcerative colitis (UC). MethodsLiteratures at home and abroad were searched to review the clinical significance of laboratory examinations indexes in diagnosis of UC. ResultsAnti-neutrophilcytoplasmicantibodies (ANCA) had some value in diagnosis of UC, but it was limited in evaluation of UC in active patients. The positive rate of anti-intestinal goblet cell antibody (GAB) in patients with UC was higher than that of patients with Crohn's disease (CD), so it could be used as identification indexes of the two diseases, but it could not reflect the severity of the disease. Anti-saccharomyces cerevisiae antibodies (ASCA) and anti-pancreatic antibody (PAB) were mainly used in the differential diagnosis of UC and CD, but they had no significant advantages in diagnosis of UC. Fecal calprotectin (FCP) played a positive role in evaluation of recurrence and activity in UC. Although lactoferrin, M2-pyruvate kinase (M2-PK), and S100A12 were not as effective as FCP, but if combined with related indicators, they were also important. ConclusionsOf the relevant indexes of laboratory examination in the diagnosis of UC, FCP plays an importent role in the evaluation of recurrence and activity of UC.
ObjectiveTo systematically review the clinical efficacy and safety of glucocorticoids, acetaminophen and antimicrobial drugs in the treatment of intrapartum fever in labor analgesia. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, CBM, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of glucocorticoids, acetaminophen, and antimicrobial drugs for intrapartum fever in labor analgesia from inception to June 30, 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was then performed by using RevMan 5.4 software. ResultsA total of 10 RCTs involving 1 337 women were included. Meta-analysis showed that the use of glucocorticoids reduced the incidence of intrapartum fever in women with labor analgesia compared with the control group (OR=0.52, 95%CI 0.33 to 0.82, P<0.01). But there was no statistically significant difference between acetaminophen or antimicrobial drugs and the control group. ConclusionCurrent evidence shows that the use of glucocorticoids can reduce the incidence of intrapartum fever in labor analgesia, but the use of acetaminophen and antimicrobial drugs cannot reduce the incidence of intrapartum fever. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To assess the effectiveness and safety of local versus systemic application of opioids for labor analgesia. Methods We searched PubMed (1966 to January 2008), EMBASE (1980 to January 2008), The Cochrane Library (Issue 1, 2008), CBM (1978 to January 2008), CNKI (1979 to January 2008) for randomized controlled trials (RCTs) involving local versus systemic application of opioids for labor analgesia. Quality assessment and data extraction were conducted by two reviewers independently. Meta-analyses were conducted with The Cochrane Collaboration’s RevMan 4.2.10 software. Results A total of 12 trials involving 5909 participants met the inclusion criteria. Meta-analyses showed that local application of opioids was superior to systemic application in terms of maternal satisfaction with pain relief during labor (RR 1.63, 95% CI 1.27 to 2.09). No significant difference was found between the two groups in the incidence of low neonatal Apgar score at 5 minutes (RR 0.63, 95% CI 0.40 to 1.01). Conclusion Local application of opioids for labor analgesia appears to be more effective than systematic use in reducing pain during labor. But as for safety concerns, maternal and neonatal adverse effects are observed in both groups. Thus, more high-quality and large-scale RCTs are needed.
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.
Objective To evaluate the teaching effect of case-based learning (CBL) combined with team-based learning (TBL) pedagogy in laboratory diagnostics education. Methods The data of the undergraduate clinical-medical students who completed the laboratory diagnostics course between September 2021 and July 2023 at West China School of Medicine of Sichuan University were retrospectively collected. Among them, the undergraduates of grade 2020 adopted the CBL+TBL combined pedagogy, while the undergraduates of grade 2019 assumed the traditional lecture-based learning (LBL) teaching method. Based on the cluster sampling method with the whole grade as the sampling unit, comparative effectiveness was assessed via examination scores and questionnaire feedback. Results A total of 303 students received the CBL+TBL teaching method (CBL+TBL group), while 289 students received the LBL teaching method (LBL group). Compared with the LBL group, the CBL+TBL group had higher scores on the clinical case discussion (90.28±4.05 vs. 88.39±5.19, P<0.001) while lower scores on the theoretical quiz (83.89±12.55 vs. 88.77±10.46, P<0.001). The overall performance of the CBL+TBL group was worse than the LBL group (61.28±3.83 vs. 61.98±3.98, P=0.028). A total of 161 valid copies of questionnaire were collected from the CBL+TBL group. Among them, more than 70% of the students believed that CBL+TBL pedagogy could improve learning motivation, independent learning ability, and team communication and assistance ability. Compared with the LBL teaching mode, 74.5% of the students preferred the CBL+TBL pedagogical approach. Conclusion The CBL+TBL pedagogy can help to improve autonomic learning, teamwork, and problem-solving ability, and a combination with LBL teaching may be utilized to enhance theoretical scores.