ObjectiveTo explore the impact of continuous quality improvement on the quality of life and complications in end-stage hemodialysis patients. MethodWe reviewed the clinical data of 128 end-stage renal disease patients undergoing hemodialysis from January 2013 to January 2014. The patients were divided into observation group and control group randomly with 64 patients in each. Patients in the control group received routine nursing only during hemodialysis, while those in the observation group received extra continuous quality improvement nursing on the basis of routine one. Quality of life of the two groups of patients was evaluated by World Health Organization Quality of Life Scale-brief before and after intervention. Adverse reactions during hemodialysis were also observed in these two groups. ResultsThe incidences of hypotension, malnutrition, thrombosis, infection and arrhythmia in the observation group were significantly lower than those in the control group (P<0.05). Psychological dimension, social dimension, physiological adaptability and total scales of quality of life in the observation group were significantly better than those in the control group (P<0.05). ConclusionsContinuous quality improvement of nursing reduces the rates of complications and improves patients' quality of life.
ObjectiveTo explore the relationship between pregnancy-associated plasma protein-A (PAPP-A) and different types of coronary heart disease (CHD) in Chinese. MethodsThe papers about the relationship between the PAPP-A level and coronary heart disease in Chinese published before December 2013 were searched from electronic databases, including PubMed, EMbase, China National Knowledge Infrastructure, Wanfang and VIP. Statistical analysis was carried out using Stata 12.0 software. ResultsA total of 44 papers were included in this meta-analysis. The number of cases was 3 628, including 1 137 stable angina pectoris (SAP) patients, 1 368 unstable angina pectoris (UAP) patients and 1 123 acute myocardial infarction (AMI) patients. The number of control was 1 177. This meta-analysis indicated that the levels of PAPP-A were higher in different types of CHD patients than those in the control group[SAP group:SMD=0.38, 95% CI (0.25, 0.50), P < 0.001; UAP group:SMD=2.84, 95% CI (2.36, 3.32), P < 0.001; AMI group:SMD=3.31, 95% CI (2.78, 3.85), P < 0.001, respectively]. The levels of PAPP-A were higher in AMI group than UAP group[SMD=0.56, 95% CI (0.33, 0.80), P < 0.001]. At the same time, the levels of PAPP-A in patients with disease of one, two and three coronary arteries were higher than those in the control group[SMD=2.40, 95% CI (1.49, 3.31), P < 0.001; SMD=2.27, 95% CI (1.44, 3.09), P < 0.001; SMD=2.30, 95% CI (1.35, 3.24), P < 0.001, respectively]. The levels of PAPP-A were higher in patients with disease of two arteries than in those of one artery[SMD=0.29, 95% CI (0.01, 0.58), P=0.042], but there was no significant difference between patients with disease of three arteries and those of 1 or 2 arteries(P > 0.05). ConclusionsThe levels of PAPP-A are significantly higher in CHD patients and are positively related with the severity of CHD. The levels of PAPP-A can be regarded as the indicator for judging the severity of CHD