ObjectivesTo investigate the present status of clinical nurses' attitude towards patient safety and its influencing factors.MethodsA total of 2 290 clinical nurses in 10 large general hospitals in Anhui Province were investigated by general data and patient safety attitude questionnaire (SAQ).ResultsThe total score of the nurse's patient safety attitude was 112.57±11.83, in which the 6 dimension scores arranged from high to low were management recognition, working conditions, job satisfaction, team cooperation, safety climate, and pressure perception. Nurses who were female, marriage, college degrees, head nurse, and receivded patient safety education had higher total scores.ConclusionsScores of nurses of tertiary 3A hospitals in Anhui Province are overall above average. The influencing factors of nurses’ safety attitude are gender, marital status, education level, length of service, whether being head nurse, and whether being received safety education.
In recent years, with the development of positive psychology, resilience has gradually become a research hotspot and has been applied to the study of mental illness. This paper introduced the concepts, theoretical models and measurement tools of resilience, reviewed the level of resilience of patients with bipolar disorder and its related influencing factors, and further research were suggested based on existing problems. It is expected to provide scientific basis for formulating systematic, efficient and personalized interventions for patients with bipolar disorder.
Objective To investigate current situation of medical service and management in Gaozha Central Township Health Center (GzC), so as to provide baseline data for township health centers in both key techniques research and product development of drugs allocation and delivery. Methods A questionnaire combined with a special interview was carried out, which included the general information, human resources, medical service and management, and the practice of essential medicine list. Results a) The hardware condition of GzC was not good enough, and the economic status of the service recipients was lower than the average level of both Wuzhong City and China mainland; b) The constituent ratio of general practitioner (GP) and nurse, and GP and laboratorian were all lower than those of national level, while, the constituent ratio of GP and technician was a little bit higher. GzC was in short of medical technical personnel and, especially, the professional pharmacists. The logistics technical workers were as the same proportion as the nurses. The medical technical personnel without professional education background accounted for 3.4%, and about 38% of the staff members had no college degree, about 86.2% had at most primary profession titles. There was no personnel turnover of GzC in recently years; c) The bed utilization ratio was lower than national level (46.4% vs. 60.7%), while the average duration of stay and the in-patient and out-patient service workload of GP were longer or heavier than national level (8 vs. 4.8, 9 vs. 8.3, 4 vs. 1.3); d) The out-patient service in 2010 decreased 26.9% compared to 2009; and the in-patient service in 2010 decreased 42.4%; e) The average medical expense per outpatient and per inpatient increased 127.3% and 56.2%, respectively in 2010 compared to 2009; and f) Essential medicine list was put into practice in April 1st of 2010 and there was only 195 species available in GzC, which has not met the requirements of the national essential medicine list. Conclusion In order to meet the standards of general rural township health center in western China, GzC needs to cope with challenges of insufficient hardware conditions, short of staff, unreasonable personnel structure, low educational background and professional title of the staff, none human resources flow and low technical level of medical service. GzC dose well in drug expenses control, and the hospitalization costs are lower than those of the national level. However, it increases rapidly in 2010. The management of GzC may be influenced by zero-profit sale of the essential drugs, and appropriate subsidy and policy support are necessary to maintain its service quality. And it is required to complement the medicine based on the evidences, to carry out staff training and usage guidance of essential medicine, and to finally guarantee the safe and reasonable use of medicines.
ObjectiveTo investigate the effect of electroacupuncture on the apoptosis of hippocampal neurons in C57BL/6J mice with status epilepticus by observing the changes of hippocampal subtle neuron pathology and apoptosis.MethodsMale C57BL/6J mice were used to prepare epileptic status models of lithium-pilocarpine mice, and then 7-day electroacupuncture stimulation (Baihui, Fengfu) were given to the mice model. Open field experiment and new object recognition experiment were performed to observe the changes of cognitive abilities. The pathological changes of hippocampal neurons were detected by HE staining. Hippocampal apoptosis protein (Caspase-3) and microtubule-associated protein (MAP-2) were detected by immunohistochemistry. Effect of electroacupuncture on apoptosis of hippocampal neurons in C57BL/6J mice with status epilepticus were recorded.Results① Compared with the control group, the vertical movement, modification times, and number of crossings of the model group all decreased significantly (P<0.000 1,P<0.000 1,P<0.000 1), and their cognitive ability decreased significantly (P<0.01). Compared with the model group, vertical movements, modification times, and number of crossings were increased in the electroacupuncture (EA) group (P<0.01,P<0.05,P<0.05), and the cognitive ability of new objects was increased (P<0.01). ② HE staining showed that the model group had significant damage to the hippocampal neurons of mice, and the cells swelled, nuclear collapsed and vacuoles appeared. In the EA group, the injury of hippocampal neurons was alleviated, and cell edema and vacuolization were alleviated. ③ Immunohistochemistry showed that compared with the control group, the IOD of the Caspase-3 positive cells in the hippocampus of the model group increased significantly (P<0.000 1), and the IOD of the MAP-2 positive cells decreased significantly (P<0.01); Compared with the electroacupuncture, the IOD of the Caspase-3 positive cells in the hippocampus of the mice decreased (P<0.05), and the IOD of the MAP-2 positive cells increased (P<0.05).ConclusionsElectroacupuncture can improve the pathological changes of hippocampal neurons in C57BL/6J mice with status epilepticus, promote cytoskeletal repair, reduce neuronal apoptosis in hippocampus, and antagonize the damage of hippocampal neurons induced by status epilepticus.
Objective To understand the current status of nosocomial infection management in secondary and higher medical institutions in the city to find out the problems and put forward countermeasures. Methods According to the standard of " 19. Nosocomia Infection Management” in the evaluation standard of Sichuan Provincial General Hospital of 2011, the nosocomial infection management of 18 hospitals at or above grade 2 was supervised and evaluated on site. Results The average score of the 18 hospitals was 84.88±2.58. Organization and management had the highest pass rate (83.33%), while the catheter room had the lowest (33.33%). Concusion The 18 hospitals’ nosocomial infection management has been led to different degrees of attention, to build a hospital management organizational structure, developed a more comprehensive rules and regulations and work processes. But in key sectors and key links, the pass rate is still low, it needs to timely update the management concept, increase the necessary facilities and equipment for sensing and controlling, refine the control measures, formulate the pre-plan process and quality assessment standards and effectively implement.
Status epilepticus (SE) is one of the most common neurological emergencies. Prolonged seizures can cause permanent neuronal death in the central nervous system, necessitating early recognition and timely intervention. Although there is some consensus on the diagnosis and treatment of SE, the high heterogeneity of SE patients presents a significant challenge for standardized management and prognosis prediction. This review summarizes the current research progress on the diagnosis, treatment, and prognosis of SE, aiming to provide references for early diagnosis, early treatment, and early prediction of prognosis.
ObjectiveTo observe the dynamic changes of neuroglobin (NGB) expression in hippocampus after status epilepticus(SE) in rats, and to explore the role of NGB in epileptic seizures.Methods40 healthy male Sprague Dawley rats were randomly divided into two group according to random number table method:control group (n=5) and epilepsy model group(n=35).Epilepsy model group according to observation time was divided into:0h, 1h, 3h, 12h, 24h, 10d and 30d.Intraperitoneal injection Lithium-pilocarpine (20 mg/kg~127 mg/kg, Li-PC) to establish the rat model of SE.Observe the behavioral changes in rats with epilepsy.Nissl staining was used to detect the neuronal damage in hippocampus. Streptavidin-biotin-peroxidase complex immunohistochemical method was used to detect the expression level of NGB in hippocampus;ResultsAfter SE, the neurons in hippocampus were severely damaged with the progress of epileptic seizures, the number of surviving neurons in CA1, CA3 regions showed a near linear decline.Among them, the number of surviving neurons in (12h, 24h, 10d, 30d)CA1, (0h, 12h, 24h, 10d, 30d)CA3 and(12h, 24h, 10d, 30d) DG area were significantly lower than that of the control group (P < 0.05).The expression level of NGB in CA1, CA3 and DG region of hippocampus were increased after SE, and both of CA1 and DG were reached peak in 24h after SE, but was still higher than the control group.And the CA3 area showed a continue rising trend.Among them, CA1(24h, 10d, 30d), CA3(24h, 10d, 30d) and DG(12h, 24h, 10d, 30d) were higher than that of control group significantly (P < 0.05).In addition, it was found that there was a positive correlation between the number of surviving neurons in CA3 area and the expression level of NGB (R=0.306, P=0.011).ConclusionUp-regulation of NGB expression in hippocampus after status epilepticus, and was positively correlated with the number of neurons in the CA3 area, suggesting that up regulation of NGB expression may be a compensatory protective mechanism of ischemic injury induced by seizures, and participate in the protection of epilepsy related neuronal damage.
Objective To investigate the financial burden of in-patients with thyroid diseases in the West China Hospital in Chengdu, Sichuan province, from January 2011 to December 2012, so as to provide baseline data for further research. Methods The data of in-patients (who had been discharged from the department of endocrinology and metabolism or discharged after being transferred to other departments for diagnosis and treatment in the West China Hospital in 2011) were collected from the Hospital Information System (HIS) of the West China Hospital, including basic information, initial diagnosis when the patients were discharged, hospital costs, the information about whether the patients had been registered the insurance in hospital, etc. We classified diseases according to ICD-10 based on the initial diagnosis when the patients were discharged on the first page of case reports. The data were input using Excel 2010 software, and statistical analysis was performed using SPSS 13.0 software. Results The results showed that: a) in 2011, 205 person-times were hospitalized in the department of endocrinology and metabolism, of which, 84 were male and 121 were female, with mean age of 45.3±15.7 years; b) for patients with thyroid diseases, median hospital stay was 10 days, the average cost of hospital stay for each patient was RMB 2 881.43 yuan, most of which was for lab tests and examination; c) the person-times of patients with hyperthyroidism was 162, accounting for 79.5% of the total of thyroid diseases, median hospital stay was 10 days, and the average cost of hospital stay was RMB 2 958.36 yuan; and d) there was no association between the number of hyperthyroidism complications and hospital stay and costs. Conclusion Thyroid diseases are a commonly-seen disease in the department of endocrinology and metabolism, of which, hyperthyroidism accounts for the most. There is no association between the number of hyperthyroidism complications and hospital stay/costs.
ObjiectiveTo explore the efficacy and safety of ketogenic diet therapy (KDT) in the rapidly progressive stage of childhood developmental epileptic encephalopathy Dravet syndrome (DS). Methods The clinical data of all patients who added KDT in the Children’s Hospital of Fudan University from 2011 to 2022 were retrospectively collected, and the age of <6 years was used as the criterion for the rapid progression of the disease. The clinica data, genotype and the efficacy of KDT were analyzed in DS patients who met the criteria. Results A total of 32 patients met the criteria for rapid disease progress, including 22 males and 10 females. The age at onset was (5.69±2.10) months. All patients had multiple seizure phenotypes and monthly seizures despite reasonable Antiseizure medications treatment. After 3, 6, 12, and ≥24 months, 93.8% (30/32), 87.5% (28/32), 53.1% (17/32), 34.4% (11/32) remained on the KDT, while 76.7% (23/30), 75.0% (21/28), 70.6% (12/17), 54.5% (6/11) showed >50% reduction in seizure. Status epileptius (SE) was reduced by 100% at 3 months, 71.0% at 6 months, 86.0% at 12 months. After 12 months, 14 patients experienced efficacy degradation. After 3 months, the EEG background rhythm showed improvement in 75.0% patients, interictal epileptic discharges was decreased in 54.5% patients and cognitive function was improved in 78.6% patients. At the initial stage of KDT, 62.5% (20/32) patients had transisent adverse reactions, including diarrhea, vomiting, fatigue, lethargy, hypoglycemia, and metabolic acidosis, but no mid- and long-term adverse reactions were found. ConclusionKDT is an efficective and safe treatment for DS. KDT can effectively control seizures, reduce the incidence of Status SE and shorten the duration of SE. With the prolongation of the KDT course, some patients experienced a degraded effect. KDT can improve abnormal EEG and cognitive function in DS patients. Pharmoco-resistant DS patients are suggested to receive KDT in the early stage of disease progression.
Objective To investigate the disease constitution and drug application of inpatients in Yong’an Central Township Health Center (YaC) in Shuangliu County of Sichuan province in 2009, so as to provide baseline data for further research. Method Questionnaire and focus interview were carried out, case records and drug application information of YaC inpatients in 2009 were collected. The diseases were classified according to ICD-10 based on first diagnose. Drug application was analyzed based on pharmaceutical dosage form, pharmaceutical effect, cost, and clinical departments. Data including general information of the inpatients, discharge diagnosis, hospitalization expenses, and drug cost etc. were rearranged and analyzed by Excel software. Result a) The total number of inpatients was 4 335 and the female/male was 55.59% vs. 44.1%, their disease spectrum included 18 categories, which accounted for 85% of disease classes of ICD-10; b) The inpatients suffered from top 5 systematic diseases were 3 531, accounted for 81.45%, which included the respiratory, digestive, urinary tract and urogenital, circulatory systems, as well as trauma and toxicosis. Except the trauma and toxicosis, the female was more than the male in all the rest main systematic diseases; c) The top 15 single diseases were chronic bronchitis in acute stage, acute upper respiratory infection, pneumonia, acute gastroenteritis, chronic bronchitis, urinary stone, acute appendicitis, chronic gastritis, acute gastritis, vertebrobasilar ischemia, cesarean section, fracture, acute urticaria, and meniere disease; d) The total inpatients with top 15 single diseases accounted for 59.81%, including 6 chronic diseases and 9 acute diseases. The patients’ average costs of chronic disease were higher than that of acute disease; and e) The proportion of western medicine cost accounted for 80% to 90% of total cost, and the cost of anti-microbial drugs and drugs of humoral regulation ranked as the top two. Conclusion a) The inpatients in 2009 are mainly in age of 25 to 59, and over 60 years old as well. The top two diseases mainly attacked are in respiratory and digestive systems, acute diseases are more than the chronic; b) Except for pneumonia, urinary stone, uroschesis, urinary stone, trauma, and toxicosis, the female inpatients are more than the male for complaining all other diseases; c) The number of inpatients received hysterotomy is as 4.24 times as that of natural labor, and the rationality should be paid attention to; d) The commonly used drugs, according to the costs, involve in 4 kinds of drugs and 1 kind of vaccine, which are in accordance with the main burden of the diseases; e) Supervision should be focused on the drugs of high cost or the one most frequently used; and f) The 0.9% Sodium chloride injection, Glucose injection and Cefuroxime listed in the EML (2009) satisfy the needs of treatment for YaC inpatients in 2009.