目的 调查安置永久性人工心脏起搏器的老年患者术前焦虑状况，为制订护理对策提供依据。 方法 2004年7月-2008年7月收治需安置永久性人工心脏起搏器的心脏病患者78例，术前采用焦虑自评量表（SAS）对其进行问卷调查，并采用自制一般情况问卷调查了解情况。 结果 植入永久性心脏起搏器的老年患者术前SAS得分高于国内常模（Plt;0.05）。根据自制调查问卷结果，差异有统计学意义（Plt;0.05）的项目:老年患者随年龄增长焦虑量表评分降低；丧偶者焦虑评分高于有配偶者；完全公费、部分公费、自费的焦虑量表评分依次增高；老年患者对起搏器知识了解程度越少，焦虑评分越高；无家人陪伴者比有家人陪伴者焦虑评分高。而性别、文化水平差异无统计学意义。 结论 植入永久性起搏器的老年患者术前多数存在焦虑情绪，且焦虑与年龄、婚姻、费用支付方式、有无家人陪伴、相关知识等有一定关系，医护人员应针对性地做好患者术前护理，帮助患者面对现实，以积极的心态接受手术治疗。
目的 了解成都市卧床老年人的抑郁发生情况及影响因素。 方法 对2009年12月－2011年2月卧床时间＞1个月的325例卧床老年人采用老年抑郁量表、焦虑自评量表、生活满意度指数A进行调查，并对影响的抑郁的相关因素进行统计分析。 结果 成都市卧床老年人抑郁的发生率为57.5%。不同病情、生活自理能力、焦虑情况、社会交往情况、生活的满意度和家庭功能的老年人，其抑郁评分差异有统计学意义（P＜0.05）。多重线性回归分析发现影响老年人抑郁的主要因素有病情、卧床分级、焦虑、社会活动、满意度、文化程度，其中对生活满意、有社会活动、文化程度高是保护因素，而焦虑、病情较重、卧床等级高是抑郁的危险因素。 结论 卧床老年人的抑郁发生率较高，应加强对卧床老年人，特别是病情重、焦虑、大部分或者全天卧床、低文化的卧床老人抑郁发生的关注，鼓励老年人增加社会活动、提高老年人对生活的满意度和增进他们的心理健康。
ObjectivesTo systematically review the efficacy of intra-articular injection of sodium hyaluronate for kashin-beck disease. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), CBM, VIP, WanFang Data, and CNKI were electronically searched from inception to January 2016 to collect randomized controlled trials (RCTs) about sodium hyaluronate in the treatment of kashin-beck disease. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 6 RCTs involving 1 276 patients were included. The result of metaanalysis suggested that the sodium hyaluronate group was significantly superior to the control group in clinical effect (OR=5.89, 95% CI 4.10 to 8.47, P < 0.000 01) and the Lequesne index (SMD=-1.66, 95% CI-2.14 to-1.13, P < 0.000 01). ConclusionIntra-articular injection of sodium hyaluronate is helpful in the improvement of kashin-beck disease in clinical effect and the Lequesne index. Due to the limited quality and quantity of the included studies, more high quality studies are need to verify the above conclusion.
Methods To explore the level of delirium knowledge of geriatric nurses in Sichuan province and analyze the factors, so as to provide the basis for systematic and targeted knowledge training on delirium and clinical management. Methods Using the self-designed “the Questionnaire of Elderly Delirium Knowledge”, geriatric nurses from 22 hospitals in Sichuan province were investigated through a convenient sampling method from September 2018 to February 2019. Results A total of 475 geriatric nurses were investigated. The average delirium knowledge score of the 475 geriatric nurses was 69.51±12.42. Multiple linear regression analysis showed that the main factors affecting the score of delirium-related knowledge were the education of nurses (P=0.037), technical title (P<0.001), years of working in the geriatric department (P=0.001), and the level of working hospital (P=0.001). Conclusions The level of delirium knowledge of geriatric nurses is low and can not meet the needs of clinical work. Nursing managers should carry out delirium knowledge training according to the different characteristics of nurses.
ObjectiveTo assess the comparative efficacy of all kinds of selenium supplementation in the treatment of patients with Kashin-Beck disease (KBD) by network meta-analysis. MethodsWe searched seven electronic databases including PubMed, EMbase, The Cochrane Library (Issue 7, 2016), CBM, VIP, WanFang Data and CNKI databases up to July 2016. All randomized controlled trials (RCTs) assessing the effect of selenium supplementation on KBD were included. Two reviewers independently screened literatures, extracted data and assessed the risk bias of included studies, and then meta-analysis was performed by using Stata13.1 software. ResultsA total of 16 RCTs involving 2 883 participants were included. Direct meta-analysis comparison showed that:Compared with placebo or blank group, sodium selenite (OR=5.00, 95%CI 3.21 to 7.78), selenium supplement salt (OR=7.60, 95%CI 2.34 to 24.67), and combination of sodium selenite and vitamin E (OR=11.05, 95%CI 2.61 to 46.80) had higher metaphysis X-ray improvement (P < 0.05). Ranking on efficacy indicated that combination of sodium selenite and vitamin E were highest, followed by selenium supplement salt, sodium selenite, sodium selenite plus vitamin C, vitamin C, and placebo/blank. ConclusionBased on the results of network meta-analysis, selenium supplement (sodium selenite, combination of sodium selenite and vitamin C, combination of sodium selenite and vitamin E, as well as selenium salt) is more effective than placebo or no treatment in promoting the repairement of metaphysis impairment. The effect of combination of sodium selenite and vitamin E are highest.
Acute diarrhea has a high incidence in children. Pediatric tuina has been widely used in children with acute diarrhea in China. However, there is no guideline on the treatment of tuina for children with acute diarrhea. This guideline was developed following evidence-based principles and the World Health Organization handbook for guideline development. The linked systematic review was conducted following the Cochrane handbook. The quality of evidence and the strength of recommendations were evaluated using the GRADE approach. The reporting followed the RIGHT statement. Seven clinical questions (2 foreground questions and 5 background questions) were identified by literature review and expert consensus. Based on the linked systematic review and through comprehensive consideration of the balance of benefit and harm, quality of evidence, patient preferences, and other resources, we formulated the recommendations using Delphi expert consensus. We suggested combination of a weak recommendation for tuina with Western medicine usual care to treat children with acute diarrhea. This guideline can be used by clinicians and nurses in the department of traditional Chinese medicine pediatrics, and department of pediatric tuina, and can also be used as a reference for relevant clinicians of Western medicine and is also applicable to all institutions that practice tuina treatment.