Although heart transplantation remains to be the optimal treatment for advanced heart failure, its use has been largely limited due to shortage of available donor organs. Over the past two decades, left ventricular assist device (LVAD) has been significantly modified in size, durability and hemocompatibility. In addition to the bridge to transplantation, LVAD has become an attractive alternative to heart transplantation for end-stage heart failure as destination therapy for unsuitable candidates. Although the performance of LVAD has been improving greatly in recent years, there are still great challenges in the management of device complications and low quality of life after implantation. This review will summarize the types of LVAD, indications for implantation, postoperative management and adverse events.
目的 調查規范化培訓護士的職業自我概念現狀，以期為其培訓方案提供參考依據。 方法 2010年10月－11月采用護理專業自我概念量表對某三甲綜合醫院2009級、2010級175名規范化培訓護士進行面對面問卷調查。 結果 88.37%規范化培訓護士職業自我概念積極，5個維度得分從高到低分別是溝通交流、技能、靈活性、領導、滿意度。2010級規范化培訓護士職業自我概念總得分（t=?2.027，P=0.044）及領導維度得分（t=?3.258，P=0.001）高于2009級者，而技能（t=2.120，P=0.036）、靈活性（t=2.054，P=0.042）維度得分低于2009級；有職業興趣的規范化培訓護士其領導維度得分高于無職業興趣的規范化培訓護士（t=2.063，P=0.043）。 結論 護士規范化培訓中除注重技能培訓外還應加入情感教育課程，建立領導能力評價體系等。
目的 了解接受胰島素治療的糖化血紅蛋白＞7.5%的2型糖尿病患者自我血糖監測現狀及存在的問題，為幫助患者建立健康行為提供理論依據。 方法 對2008年12月－2011年2月住院治療的128例符合納入標準的患者進行問卷調查。調查內容包括患者一般資料、血糖控制情況、自我監測相關知識及技能等內容。 結果 共發放問卷128份，收回128份，其中有效問卷122份。糖尿病患者血糖自我監測知識獲取渠道單一，且相關知識匱乏；不能制定正確血糖自我監測方案，不能對檢測結果進行正確記錄和匯報；血糖檢測操作不正確，檢測頻率達不到標準要求。 結論 接受胰島素治療的2型糖尿病患者自我監測現狀并不容樂觀，患者自我監測行為缺乏。為此，提高糖尿病患者健康教育水平，幫助其建立并維持健康行為，是糖尿病教育工作的重點和挑戰。
Objective To study the effect of PBL teaching method which was applied in the clinical practice of diabetes nursing, and to analyze its advantages and shortages. Methods Seventy-seven undergraduates in major of nursing were randomly grouped into two: one as an experimental group was taught with PBL teaching method, while the other as a control group was taught with traditional teaching method. The questionnaire and final examination were adopted to analyze the teaching effect. Results The effect of PBL teaching method was better in the experimental group for stimulating learning motivation, helping students to closely combine the theory and practice, and promoting communication ability. However, there was no statistical difference in final examination between the two groups (Pgt;0.05). Conclusion PBL teaching method is much better than traditional teaching method in clinical nursing practice of internal medicine, for it can guide students to get the approaches for solving problems and cultivate their integrated diathesis and other abilities.
Objective To explore the correlation between blood glucose and self-management behaviors in patients with type 2 diabetic mellitus before initial basal insulin therapy. Methods A convenient sample of 200 patients with type 2 diabetic mellitus who were hospitalized in a tertiary hospital from February to August 2016 were enrolled in the study on a voluntary basis. Patients’ demographic information, fast blood glucose, glycosylated hemoglobin, and scores of diabetes self-care activities were gathered through questionnaires. Results A total of 193 valid questionnaires were recovered. Before starting basal insulin therapy, the mean blood glucose and the mean glycosylated hemoglobin of the 193 patients were (12.22±3.95) mmol/L and (10.01±2.38)%, respectively, with 12 patients (6.22%) meeting the goal of fasting blood glucose ≤7 mmol/L and 18 patients (9.33%) meeting the goal of glycosylated hemoglobin <7%, respectively. The total score of self-care activities was 26.76±14.77, in which 3 patients (1.55%) performed well. Spearman analysis demonstrated that the total score of self-care activities was negatively correlated with fast blood glucose ( r=–0.401, P<0.001) and glycosylated hemoglobin (r=–0.227, P=0.028). Conclusions The blood glucose levels and self-management behaviors in diabetic patients at the beginning of initial basal insulin therapy are not optimistic. Enhanced management of type 2 diabetic patients with initial basal insulin therapy is the prerequisite to promote diabetes self-care activities.
The evaluation of student performance is an important but difficult part of the implementation of problem-based learning (PBL). This article introduces the background to the reform of evaluation in PBL, analyzes the principles of such evaluation, and gives a critical review of the methods applied in the reform of student evaluation in PBL, so as to help medical schools adopt practical and efficient evaluation methods.
Objective To explore the model and significance of medical and surgical nursing teaching reform, so as to promote the development of academic disciplines and the quality-oriented education.Methods With the method of cluster sampling, the reform object of four-year nursing undergraduates of Grade 2006 and 2007 of Sichuan University, the reform content of the neurological system recorded in both medical and surgical nursing taught in the semester of Autumn 2008 and Autumn 2009, and with the pilot reform of neuropathies nursing teaching, the integration of medical and surgical nursing teaching reform was performed through lesson preparations, theoretical classroom instruction and clinical probation. Results The medical and surgical nursing teaching reform obtained a significant result. Compared with the undergraduates without integration reform of Grade 2004 and 2005, the students of Grade 2006 and 2007 were more satisfied (92.25 vs. 72.97; χ2=19.806, P=0.000) with both the increased real benefited academic hours and the double-increased clinical probation hours without any change of the total teaching hours. Conclusion The integration teaching of both medical and surgical nursing can promote the cultural convergence, and is conducive in fostering students’ holistic thinking and in integration and effective uses of resources.
ObjectiveTo review and analyze the clinical manifestations of common aortitis in cardiac surgery. MethodsWe screened 41 552 patients who were hospitalized in the Department of Cardiac Surgery of Zhongshan Hospital, Fudan University from 2010 to 2020, analyzed the patients' clinical data, and classified according to the type of diseases. Then we summarized all their clinical manifestations. ResultsIn our center 145 patients were operated for aortitis diseases, including 75 males and 70 females, with the age of 24-76 (45.6±11.3) years. There were 61 patients of Takayasu's arteritis, 51 patients of Behcet's disease, 8 patients of syphilitic aortitis, 8 patients of systemic lupus erythematosus, 2 patients of Kawasaki disease, 4 patients of ankylosing spondylitis, 10 patients of dry syndrome, and 1 patient of scleroderma. ConclusionAortitis is not uncommon in cardiac surgery, and awareness of the disease should be enhanced. So that we can distinguish various types of aortitis and to make proper management to improve patients' prognosis.
Objective To investigate the current situation of self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes mellitus (T2DM) in Sichuan province, and to analyze the influencing factors of SMBG, so as to provide evidence for improving the level of SMBG. Methods By the convenience sampling method, 410 patients with T2DM for more than 1 year were selected from 17 hospitals and community health service centers in 7 cities across Sichuan province, and their SMBG was investigated with a questionnaire. Results Among 410 eligible patients, the average frequency of SMBG was 7.3 times per month. There were 268 patients (65.4%) performed SMBG less than 4 times per month, 94 (22.9%) performed 4-15 times per month, 29 (7.1%) performed 6-29 times per month, and 19 (4.6%) performed over 30 times per month. Just 234 patients (57.1%) monitored the HbA1c in the past 6 months. FPG, 2-hour PPG and HbA1c were negatively correlated with the frequency of SMBG. The influencing factors of SMBG were insulin treatment and education. Conlusion The SMBG status in D2TM patients is relatively poor in Sichuan province, and the compliance of SMBG is expected to be improved by enhancing diabetic education.