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Objective To evaluate the comprehensive nursing program based on Delphi method for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods Totally 106 patients with AECOPD were randomly divided into control group (n=48, 5 cases were lost to follow up) and intervention group (n=47, 6 cases were lost to follow up). The control group was given routine nursing before discharge from hospital, and the intervention group was given comprehensive nursing interventions based on Delphi method. The readmission rate, quality of life and self-management ability of the two groups were compared one month and six months after discharge from hospital. The rate of readmission between the two groups one and six months after discharge from hospital was compared. The quality of life, 6-minute Walk Test (6MWT) and self-management ability of patients were evaluated before and after intervention. Results There was no significant difference in the rate of readmission between the two groups one month after intervention (P＞0. 05), and the rate of readmission in the intervention group after six months was significantly lower than that of the control group(P＜0. 05). The St George's Respiratory Questionnaire (SGRQ) score, respiratory symptoms, activity restriction and disease influence were significantly lower than those in the control group (P＜0. 05), and the self-management ability and 6MWT were significantly higher than that of the control group (P＜0. 05). Conclusion The comprehensive nursing programe based on Delphi method can significantly reduce the rate of readmission of patients with AECOPD , improve their quality of life and improve their self-management ability. (目的 探讨基于德尔菲法构建的综合护理方案在慢性阻塞性肺疾病急性加重(AECOPD)患者中的应用。方法 106例AECOPD 出院患者随机其分为对照组48例(脱落 5例)和干预组47例(脱落 6例)。对照组给予常规出院护理, 干预组采用基于德尔菲法构建的综合护理干预。比较2组出院后1个月和6个月的急性加重和再入院情况, 观察2组干预前后生活质量、6分钟步行试验(6MWT)以及自我管理能力。结果 2组出院后1个月的急性加重和再入院情况比较, 差异无统计学意义(P＞0. 05)。干预组6个月内急性加重次数及再入院次数均低于对照组, 差异有统计学意义(P＜0. 05)。干预后, 干预组SGRQ评分下降明显, 与对照组比较, 差异有统计学意义(P＜0. 05)。干预后, 2组6MWT均有提高, 且干预组优于对照组, 差异有统计学意义(P＜0. 05)。干预后, 2组自我管理量表评分均升高, 且干预组评分高于对照组, 差异有统计学意义(P＜0. 05)。结论 基于德尔菲法构建的综合护理方案对改善患者出院后病情, 降低再入院率, 提升患者生活质量和自我管理能力有显著作用。)

Acute liver failure (ALF) is characterized by rapid liver cell destruction. It is a multi-etiological and fulminant complication with a clinical mortality of over 80%. Therapy using mesenchymal stem cells (MSCs) or MSCs-derived exosomes can alleviate acute liver injury, which has been demonstrated in animal experiments and clinical application. However, similar to other stem cells, different cell sources, poor stability, cell senescence and other factors limit the clinical application of MSCs. To achieve mass production and quality control on stem cells and their exosomes, transfecting umbilical cord mesenchymal stem cell (UCMSC) with lentivirus overexpressing human telomerase reverse transcriptase (hTERT) gene, the hTERT-UCMSC was constructed as an immortalized MSC cell line. Compared with the primary UCMSC (P3) and immortalized cell line hTERT-UCMSC at early passage (P10), the hTERT-UCMSC retained the key morphological and physiological characteristics of UCMSC at the 35th passage (P35), and showed no signs of carcinogenicity and toxic effect in mice. There was no difference in either exosome production or characteristics of exosomes among cultures from P3 primary cells, P10 and P35 immortalized hTERT-UCMSCs. Inoculation of either hTERT-UCMSC (P35) or its exosomes improved the survival rate and liver function of ALF mice induced by thioacetamide (TAA). Our findings suggest that this immortalized cell line can maintain its characteristics in long-term culture. Inoculation of hTERT-UCMSC and its exosomes could potentially be used in clinics for the treatment of liver failure in the future. [ABSTRACT FROM AUTHOR]