Combination of Intravenous and Topical Application of Tranexamic Acid in Primary Total Knee Arthroplasty: A Prospective Randomized Controlled Trial

This study was aimed to determine the efficacy and safety of combined intravenous (IV) and topical application of tranexamic acid (TXA) in unilateral total knee arthroplasty (TKA) compared with the IV-TXA. One hundred eight-four patients were enrolled. Participants received either 3 g of IV-TXA or 1.5 g topical TXA combined with 1.5 g IV-TXA. The results revealed that compared with the 3 g IV-TXA, adding 1.5 g topical TXA to 1.5 g IV-TXA in unilateral TKA can have the similar effectiveness in reducing transfusion rate and total blood loss without sacrificing safety. The most important is that by adding topical TXA, patients can gain a smaller maximum decline of hemoglobin (Hb), less drainage volume, less postoperative knee pain, less knee swelling, shorter length of hospital stays and higher short-term satisfaction.     

Urinary netrin-1 and KIM-1 as early biomarkers for septic acute kidney injury

Background: Acute kidney injury (AKI) during sepsis is associated with poor outcome. However, diagnosis of AKI with serum creatinine (SCr) level change is neither highly sensitive nor specific. Therefore, identification of novel biomarkers for early diagnosis of AKI is desirable. Aims: To evaluate the capacity of combining urinary netrin-1 and human kidney injury molecule type 1 (KIM-1) in the early diagnosis of septic AKI. Methods: We prospectively recruited 150 septic patients from Jun 2011 to Jun 2013 at Zhejiang Provincial People's Hospital, China. SCr, urinary netrin-1, and KIM-1 levels were recorded at 0, 1, 3, 6, 24, and 48?h of ICU admission and compared between AKI and non-AKI patients. In addition, we investigated the prognostic value of netrin-1 and KIM-1 between non-survivors and survivors in septic AKI patients. Results: SCr levels started to show elevation after 24?h of ICU admission. However, netrin-1 levels increased significantly as early as 1?h, peaked at 3–6?h and remained elevated up to 48?h of ICU admission in septic AKI patients. KIM-1 increased significantly by 6?h, peaked at 24?h and remained significantly elevated until 48?h of ICU admission. Furthermore, we observed significant higher urinary KIM-1 levels at 24?h and 48?h in non-survivors compared to survivors in AKI patients. Conclusions: Our results suggest that both netrin-1 and KIM-1 are clinically useful as early biomarkers in the diagnosis of septic AKI. In addition, persistent elevation of urinary KIM-1 level may be associated with poor prognosis.     

Point prevalence of pressure ulcers in three second‐level hospitals in Mexico

Pressure ulcers (PU) are the source of multiple complications and even death. To our knowledge, there is no available data about PU prevalence in Mexico. The objective of this study was to determine the point prevalence of PU in three second‐level hospitals in Mexico. Every adult hospitalised patient was included in each hospital. Age, gender, hospitalisation ward, Braden score, and the number, location and stage of the ulcers encountered were recorded, as well as any pressure relief measures. In total, 294 patients were examined (127 were male); of these, 63 were considered to be at risk. The average age was 48·6 years. The overall prevalence of the PU was 17%. The service with the highest prevalence was the ICU. The most frequent stage was II (32%) and they were most commonly found in the sacrum (74%). The average Braden score of the patients with ulcers was 10, and 21·4% of the patients obtained moderate‐ to high‐risk Braden scores. Of them, 60·3% had ulcers and only 46% had any preventive measures. The prevalence of PU in three hospitals in Mexico is 17%. The most common stage is II and the most commonly affected site is the sacrum. Only 46% of patients with PU had at least one pressure release measure.     

手术治疗甲状腺疾病980例护理体会

目的:总结手术治疗甲状腺疾病的经验。方法:回顾分析980例患者的临床资料,讨论术中及术后处理的要点。结果:囊内结扎切除法使喉返神经损伤率明显降低;细管负压引流可保持切口清洁,使引流更加彻底;切口皮内缝合法或医用胶粘合法增强了美容效果并可缩短住院时间。结论:手术治疗甲状腺疾病可获得良好效果。     

国外药典与中国药典的无菌检查用真菌培养基的灵敏度比对

微生物培养基是微生物生长繁殖需要的一种生物营养物质。无菌试验用培养基是药品无菌检验的重要手段，中国药典无菌检查法中检查真菌用的培养基改良马丁培养基是用于检查样品是否污染真菌。而BP、EP、USP、JP等国家药典用大豆-酪蛋白消化培养基检查此项。进口药品的药品标准及厂报标准大多都参照国外药典制定，为了与国际接轨，了解大豆-酪蛋白消化培养基能否替代改良马丁培养基，我们参照中国药典培养基灵敏度检查法对中国药典改良马丁培养基与大豆-酪蛋白消化培养基进行了比对试验。现报告如下.     

饮食干预在门诊肿瘤化疗病人中的应用研究

[目的]探讨饮食干预对提高门诊肿瘤化疗病人生活质量的影响。[方法]将187例门诊肿瘤化疗病人随机分为两组,A组(93例)进行饮食干预,B组(94例)进行常规指导,两组病人均给予一定的止吐药物。[结果]对病人进行饮食干预后生活质量有明显的提高,两组病人在顺利完成化疗计划有统计学意义(P<0.01)。[结论]对门诊化疗病人实施有计划、针对性饮食干预,提高了病人的生活质量,保证了化疗计划的顺利完成,从而提高生存质量。     

1例静脉注射古拉定致过敏反应病人的护理

古拉定为维持细胞生物功能有重要作用,加速自由基的排泄,有助于减轻化疗、放疗的毒副反应,很少致过敏反应,现就1例我院静脉注射古拉定致过敏反应的病人介绍如下。1病例介绍病人,女,44岁,因“间断浮肿6年,加重20d”于2006年3月9日入院治疗。入院诊断:肾病综合征,肾性高血压。既往无过敏史。查体:体温36.5℃,脉搏86/min,呼吸18/min,血压20.88/13.03kPa(157/98mmHg)入院后给予5%葡萄糖溶液150mL+20mL+古拉定1.8g,当输古拉定液体滴入约100mL时病人突然主诉咽部痰多,胸闷,观察病人面色通红,呼吸费力,呼吸26/min血氧饱和度88%考虑为古拉定所致的…     

护理本科生职业生涯规划状况的调查分析

[目的]探讨护理本科生职业生涯规划的状况。[方法]2007年5月采用问卷调查法对我市568名在校护理本科生进行职业生涯规划影响因素以及相关知识的调查。[结果]学校、年级、性别、母亲职业对职业生涯规划有显著影响；45．8％的学生对职业生涯规划了解一些，30、3％的学生只是听说过，而非常了解的只有0．7％；45．4％的学生对护理专业比较满意，但是也有30．5％的学生期望今后从事与医学无关的职业；57．6％的学生完全赞同开设职业生涯规划课程，51．8％的学生认为非常有必要进行职业生涯规划。[结论]护理本科生职业生涯规划教育环节薄弱，护理管理者与教育者应给予重视。