Objective To explore the application value of self-made visual teaching aids in gynecological and obstetrical nursing education. Methods A total of 240 nursing students in grade 2009 from Fujian Medical University and Fujian Health College were selected by cluster sampling and divided by simple randomization into 2 groups (the trial group and the control group). Besides the multimedia combined with traditional teaching adopted in both groups, the visual teaching aids for fetal intrauterine condition was also adopted in the trial group rather than the control group. Questionnaire survey and focus group interview were adopted to appraise the satisfactory degree of all nursing students and the teaching effects evaluation of students in the trial group. Results There were no significant differences between the two groups in education background, and intelligibility evaluation of theoretical study on both the fetal intrauterine condition and the complications in pregnancy and delivery periods (Pgt;0.05), while the difference was statistically significant in the satisfactory degree between different teaching methods (Plt;0.05). 85.0% of nursing students in the trial group thought that visual model could help them to better understand the complications in pregnancy and delivery periods, and the intrauterine condition, 99.17% of students thought that the teaching effect of visual model was better than traditional teaching, and 95.83% of students considered that visual model was favorable for course study. Conclusion The application of self-made visual teaching aids for fetal intrauterine condition makes gynecological and obstetrical nursing education more visual, facilitates students to better understand fetal intrauterine situation and part of the mechanism of pregnancy complications, arouses students’ learning interests, and lays a theory and practice foundation for follow-up internship, so as to enhance the quality of nursing teaching.
【Abstract】ObjectiveTo compare the reliability of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and APACHE Ⅲ to estimate mortality of critical patients in abdominal surgery. MethodsTwo hundred and sixtyone critical patients in abdominal surgery were included in this study. The clinical data of the first day in ICU were collected and evaluated with both APACHE Ⅱand APACHE Ⅲ prognostic systems and statistical analysis were performed. Probability of survival (Ps) was compared with actual mortality. ResultsThe scores of APACHE Ⅱ and APACHE Ⅲ of death group were significantly higher than those of survival group respectively (P＜0.01). The actual mortality of patients whose Ps was no more than 0.5 was higher than that whose Ps was over 0.5 (P＜0.01). With two prognostic systems, the scores and mortality were the highest in pancreatitis patients and the lowest in patients with gastrointestinal malignant tumor. ConclusionAPACHE Ⅱ and APACHE Ⅲ prognostic systems can be effectively applied to the estimation of mortality of critical patients in abdominal surgery. For certain diagnostic categories, APACHE Ⅲ is better than APACHE Ⅱprognostic system.
目的探讨胰十二指肠切除术后并发症与术前状况的关系。方法对67例行胰十二指肠切除术患者的年龄、白蛋白及胆红素水平、糖尿病及其它合并症与术后并发症和病死率的关系进行回顾性分析。结果本组手术并发症发生率为29.8%，死亡率为4.5%。主要并发症为心功能不全、胰瘘、腹腔感染、上消化道出血、肺炎、切口裂开、胆瘘等。年龄大于65岁的患者术后心、肺疾患的发生率明显增高（Plt;0.01）。白蛋白（lt;30 g/L）及总胆红素（gt;171 μmol/L）水平、糖尿病及其它合并症与术后并发症密切相关（Plt;0.05）。结论加强围手术期处理是预防并发症的重要环节。
Objective To compare the clinical value of Acute Physiology and Chronic Health Evaluation ( APACHE) Ⅱ / Ⅲ scoring system in predicting the prognosis of patients complicated with acute kidney injury ( AKI) and multiple organ dysfunction syndrome ( MODS) in ICU. Methods 318 patients with AKI and MODS treated with continuous blood purification in ICU fromJanuary 2004 to June 2010, were evaluated with APACHE Ⅱ and APACHEⅢ and analyzed retrospectively. The area under the receiveroperating characteristic curve ( AUC) and the Lemeshow-Hosmer goodness-of-fit of APACHEⅡ and Ⅲ were assessed. Results Mean scores and predicted hospital mortality of APACHEⅡ and Ⅲ were all significantly lower in the survival group than those in the non-survival group ( P lt; 0. 01) . The AUC were 0. 782 for APACHEⅡ, and 0. 755 for APACHEⅢ, with Youden’s indexes of 46. 4% and 36. 7% , respectively. Hosmer-Lemeshow test showed the calibration of the two systems was reasonable. Conclusion APACHEⅡ and Ⅲ are both good for predicting the severity and prognosis of patients complicated with AKI and MODS in ICU but APACHEⅡ is superior in clinical practice.
Objective To compare the cl inical results between high-flexion and standard cruciate-stabling prostheses in total knee arthroplasty (TKA) by using the 36-item short form health survey (SF-36). Methods Between August 2007 and January 2009, 98 patients (106 knees) underwent TKA with standard cruciate-stabl ing prostheses (standard group), and 46 patients (50 knees) underwent TKA with high-flexion prostheses (high-flexion group). In standard group, there were30 males (32 knees) and 68 females (74 knees) with an age of (70.0 ± 3.5) years, including 78 cases (82 knees) of osteoarthritis (OA) and 20 cases (24 knees) of rheumatoid arthritis (RA) with a disease duration of (14.5 ± 3.3) years; the Hospital for Special Surgery Scoring System (HSS) and the range of motion (ROM) were 56.1 ± 21.6 and (89.0 ± 16.1)°, respectively. In high-flexion group, there were 8 males (10 knees) and 38 females (40 knees) with an age of (68.6 ± 8.9) years, including 44 cases (47 knees) of OA and 2 cases (3 knees) of RA with a disease duration of (13.9 ± 4.1) years; the HSS and ROM were 58.9 ± 25.3 and (91.0 ± 19.3)°, respectively. There was no significant difference in the general data (P gt; 0.05) between 2 groups, so the cl inical data of 2 groups had comparabil ity. Results In standard group, poor wound heal ing and persistent headache caused by cerebrospinal fluid leakage occurred in 1 case, respectively. In high-flexion group, transient common peroneal nerve palsy occurred in 1 case. There was significant difference (P lt; 0.05) in the hospital ization expense between standard group [ (39 000 ± 6 000)] and highflexion goup [ (52 000 ± 8 000)]. The follow-up time was 12-26 months (18 months on average) in standard group (91 cases, 98 knees) and 11-19 months (13 months on average) in high-flexion group (44 cases, 47 knees). The SF-36 showed significant difference in role-physical score (P lt; 0.05), but no significant difference in other 7 indices scores (P gt; 0.05). At the final follow-up, the ROM was (129.1 ± 19.2)° in high-flexion group and (123.6 ± 16.7)° in standard group; showing significant difference (P lt; 0.05). The HSS was 91.2 ± 17.6 in high-flexion group and 92.5 ± 14.5 in standard group; showing no significant difference (P gt; 0.05). Conclusion After TKA, the ROM in high-flexion group is superior to that in standard group, but there is no obvious advantages in terms of the HSS and SF- 36 outcomes.
Objective To investigate the basic condition and psychological health status of children in rural areas of Xibaipo town in Hebei province, learn the psychological problems of the leftover children and their influencing factors, and provide scientific basis for the school and family education for the leftover children. Methods A questionnaire survey was performed on 446 middle and primary school students in Xibaipo town, and the self-designed questionnaire was applied to collect the basic condition, family condition and psychological health status of the children. EpiData 3.0 and SPSS 17.0 were used to perform data entry and data analyses, respectively. Results The survey displayed that the leftover children accounted for 43.5% of the total number of students. The negative emotion of leftover children was significantly ber than that of non-leftover children (χ2=12.484, Plt;0.001), especially for children with both parents living far away. The main factors affecting children’s emotion were their academic performance and whether they were left behind by their parents. Conclusion The psychological health status of the leftover children is poorer than that of non-leftover children, especially for children with both parents working outside and mothers working outside. Being left over and the academic performance are the factors affecting children’s mental condition. More attention should be paid to the physical and mental development of leftover children and vigorous efforts should be exerted to formulate corresponding policies and take countermeasures so as to promote healthy growth of children.
Objective To investigate the impact of genetic factors on mental health status in child and adolescent twins. Methods A total of 102 pairs of twins aged 6 to 16 years were recruited with the support from educational committees and schools. After the guardians of these twins had signed an informed consent form, the Chinese version growth and the state of health evaluation (Development and Well-Bing Assessment, DAWBA) were completed by the parents of these twins to investigate their mental health status. Buccal mucosa samples were collected from all twins for DNA extraction and zygosity identification test. Result A total of 102 pairs of twins were recruited, among whom 93 pairs finished the investigation, including 50 monozygotic pairs and 43 dizygotic pairs. The results of emotional symptoms and behavior symptoms and the impact of symptoms from the DAWBA screening questionnaire showed that the intrapair correlation coeficien of the emotional disorder and the oppositional/conduct disorder and the impact in monozygotic twins were more remarkable than those in dizygotie twins, including separation anxiety (MZ group correlation coefficient (r) = 0.821, Plt;0.01; DZ group r=0.348, Plt;0.01), generalized anxiety (MZ group r=0.546, Plt;0.01; DZ group r=0.309, Plt;0.01), a special terror symptoms (MZ group r=0.849, Plt;0.01; DZ group r=0.726, Plt;0.01 ), and oppositional defiant / conduct disorder (MZ group r=0.237, Plt;0.01; DZ group r=0.163, Plt;0.01), attention deficit - hyperactivity disorder (MZ group r=0.640, Plt;0.01; DZ group r=0.198, Plt;0.01), autistic symptoms (MZ group r=0.680, Plt;0.01; DZ group r=0.372, Plt;0.01). Conclusion Genetic factors play an important role in mental health status of child twins.