简介：Palliativecareisthereliefofsymptomswithoutdealingwiththeunderlyingcause,e.g.useofanalgesia,torelievepain.Theuseofsuchanagentalleviatesthesymptomswithoutcuringtheunderlyingdisease.Thisisthetypeofcareforpatientswithseriousillnesses.Itfocusesonimprovingqualityoflife,notjustinyourbody,butalsoinyourmindandspirit.Thereisathinlinebetweenpalliativecareandhospicecare.

简介：Objective:Toevaluatetheeffectofmultidisciplinarycollaborativecare(MCC)inpatientswithbothacutecoronarysyndrome(ACS)anddepressionand/oranxietydisorderscomparedwithusualphysiciancare(UPC).Methods:Depressionand/oranxietywerescreenedbyusingSDSandSAS,ACSpatientswithdepressionand/oranxietydisorderswererandomizedintoMCCandUPCgroups.Thecardiacoutcomesandthelifequalitywereevaluatedat1yearfollow-up.Results:Overall,30.19%(96/318)patientshadpositivescreenresults.At1year,CardiacoutcomemeasuresforpatientsinMCCgroupweresignificantlybetterforcompositeeventsofcardiacdeathandnon-fatalMI(6.12%vs23.40%,p=0.016),cardiacfunction(NYHAfunctionalclassificationIIIorIV,0%vs25%,p=0.05),andanginapectoris(21.28%vs85%,p<0.0005),thanpatientsinUPCgroup;thelifequalitywereimprovedinpatientsinMCCgroup.Conclusion:AfterACS,30.19%ofpatientshaddepressionand/oranxietydisorders,MCChadbettereffectsoncardiacoutcomesandqualityoflifeinACSpatientswithPsychiatricdisorders.

简介：INTRODUCTIONPulmonaryarteriovenousfistula(PAVF)isararecongenitalpulmonaryvascularmalformationwiththeincidenceof2-3/100,000.Itistheabnormalcommunicationbetweenthepulmonaryarteryandpulmonaryvein.Theclinicalmanifestationsofthisdiseasearevarioussothatitiseasytobemisdiagnosed1.Atpresent,DSAisthegoldstandardforthediagnosisof

简介：BackgroundThevideo-assistedthoracoscopicsurgicaltechniquesarewidelyusedinthetreatmentofpatientswithcongenitalheartdiseaseswithgoodoutcomes.However,thefeasibilityandsignificanceofnursebasedearlycardiacrehabilitationincardiacintensivecareunit(ICU)forpatientswithtotallythoracoscopiccardiacoperationhasbeenseldomstudied.MethodsThirty-sixpatientswithtotallythoracoscopiccardiacoperationundertheconditionofthecardiacICUinGuangdongGeneralHospitalwererandomallocatedtotheinterventiongroupandthecontrolgroupbetweenJanuary2012toDecember2014.Thecontrolgroupreceivedstandardnursingcare,andtheinterventiongroupreceivedearlycardiacrehabilitationnursingcareinadditiontostandardcare.Theoutcomemeasuresincludedtheoxygensaturation(SpO2%),vitalcapacity,forcedexpiratoryvolumein1second(FEV1),andpaininthethoracicwound(visualanaloguescale,VAS),whichweremeasuredatthebaselineandwithin2-dayafter4-weeknursingcare.Forsafetyreason,wealsomonitoredtherateofperceivedexertion(RPE),heartrate,systemicbloodpressure.ResultsTherewerenon-significantdifferencesbetweenthegroupsinage,sex,totalnumberofcomorbidconditions,totalnumberofmedications,surgicaltime,andanesthetictime(P>0.05).Following4weekstreatment,thecardiopulmonaryfunctionsandVASscorewereimproved(P<0.05)inallgroups.Inaddition,theimprovementsweremoreintheearlycardiacrehabilitationnursecaregroupthaninthecontrolgroup(P<0.05).ConclusionTheearlycardiacrehabilitationnursingcareincardiacICUissafe,feasibleandbeneficialforpatientswithtotallythoracoscopiccardiacoperation.

简介：BackgroundAcuterespiratorydistresssyndrome(ARDS)causedbyH7N9influenzainpregnantwomanisalife-threateningeventwithanincreasedriskformaternalandbaby'sdeath.Theaimofthisstudywastoevaluatetheimpactofpoint-of-careultrasonography(POCUS)onthemanagementandprognosisofthesepatients.MethodsAcaseof31-yr-oldpregnantwomaninourhospital,whowasunderwentPOCUSforevaluatingcardiopulmonaryfunctions,volumestate,fluidresponsivenessandultrasound-guidedprocedureswasadmittedtoIntensiveCareUnit(ICU).Weperformedultrasonographydailyformonitoringorganfunctions.Reviewofrelatedliteratureswasalsoconducted.ResultsWiththehelpofPOCUS,wemadequicklydiagnosisofseverepneumoniaandARDScausedbyH7N9influenza.ThetherapieshadalsobeenchangedafterPOCUSexaminations,suchasrestrictfluidadministrationrelyingontheassessmentsoftheinferiorvenacava(IVC)toestimatepreloadandlungultrasoundmonitoringtoidentifytheearlypresenceofextravascularlungwater(EVLW)andavoidfluidoverresuscitation,ultrasound-guidedrecruitmentmaneuvertoimprovedrespiratorydistresssyndrome,andsoon.ConclusionsPOCUShasasignificantimpactondecision-makingandtherapeuticmanagementandshouldbecomeaclinicalroutineinthemanagementofARDSpatientscausedbyH7N9influenzainpregnancy.

简介：BackgroundAdvancedpracticenursetransitionalcarehasbeenproofedtobeimportantforolderadultswithchronicconditions.However,sucheffectivenesshasneverbeenstudiedinthemanagementofappropriateWarfarinuseinclinicalpractice.MethodsAtotalof97patientswererandomlydistributedintocontrolgroupwhoreceivedusualcare,andinterventionalgroupwhoreceivedtransitionalcareprovidedbyAPNs.A12-monthobservationofbothgroupswererecordedbyphysiciansandAPNsandtheimpactofAPNsonthemanagingofWarfarintherapywasalsoevaluatedbasedontimeinthetherapeuticrange(TTR).ResultsAPNstransitionalcaresignificantly(P<0.01)improvedpatients’adherence,increasedTTRandhighTTRratiocomparedwithcontrolgroup.Re-admissionduetostrokewassignificantly(P<0.01)reducedbyAPNstransitionalcare.ConclusionAPNstransitionalcareimprovespatients’knowledgeonAFandreducesstrokerisk.ThecurrentresearchstronglysuggestthenecessityofAPNstransitionalinterventionalinmanaginganticoagulationtherapyinAFpatientsinChina.