Search

Objective To evaluate the effect of a refined nursing model based on two-way nursing quality feedback on the postoperative mental resilience of patients with facial vascular malformation. Methods A total of 165 patients with facial vascular malformation were randomly divided into control group (n = 82) and study group (n = 83). Routine nursing was used in the control group, while two-way quality feedback nursing was used in the study group. The levels of mental resilience by Connor-Davidson Resilience Scale (CD-RISC), chronic disease stigma by Stigma Scale for Chronic Illness (SSCI) and patient satisfaction by self-made questionnaire were compared between the two groups. Results The score of CD-RISC in the study group was significantly higher than that in the control group (81. 73±2. 48 vs. 64. 15±3. 88, P＜0. 01). The score of SSCI in the study group was lower than that in the control group (44. 88±5. 68 vs. 69. 14±6. 92, P＜0. 01). The score of satisfaction evaluation in the study was higher than that of the control group (95. 01±4. 05 vs. 80. 49±6. 32, P＜0. 01). Conclusion In facial vascular malformation patients, two-way quality feedback nursing model can effectively improve the level of mental resilience, reduce the stigma of chronic illness, and improve patients’ satisfaction, which is worthy of clinical application and promotion. (目的 探讨双向质量反馈护理模式对颜面部血管畸形患者心理弹性的影响。方法 选取颜面部血管畸形患者165例, 随机分为对照组82例和研究组83例。对照组运用科室常规护理, 研究组在常规护理基础上运用双向质量反馈护理模式。采用采用心理弹性量表(CD-RISC)评估患者心理弹性水平, 采用慢性疾病病耻感量表(SSCI)评估患者病耻感, 评价护理满意度。结果 研究组CD-RISC量表评分(81. 73±2. 48)分, 高于对照组的(64. 15±3. 88)分, 差异有统计学意义(P＜0. 01)。研究组SSCI量表评分(44. 88±5. 68)分, 低于对照组的(69. 14±6. 92)分, 差异有统计学意义(P＜0. 01)。研究组满意度评分为(95. 01±4. 05)分, 高于对照组的(80. 49±6. 32)分, 差异有统计学意义(P＜0. 01)。结论 采用双向质量反馈护理模式可有效提高患者心理弹性水平, 降低病耻感, 缓解患者疾病痛苦, 提高患者满意度。)

Objective To investigate the application value of humanistic care for patients with abdominal aortic aneurysm ( AAA ). Methods In this study, 79 patients with AAA were selected from two wards of Vascular Surgery: 38 patients in the first ward ( control group ) were given routine nursing, and 41 patients in the second ward ( Study group ) were given humanistic care on the basis of routine nursing. The hospitalization satisfaction was evaluated by self-made questionnaire, and emotional state of were measured by Self-rating Anxiety Scale ( SAS ) and Self-rating Depression Scale ( SDS ). Results The score of hospitalization satisfaction assessment of the study group after humanistic care was significantly higher than that of the control group (P＜0. 05). The scores of SAS and SDS decreased in both group after intervention, and the scores of SAS and SDS in the study group decreased more significantly compared with those in the control group (P＜0. 05). Conclusion Humanistic care nursing and psychological counseling is implemented in AAA patients, which realizes the perfect combination of psychosomatic nursing, provides patients with satisfactory humanistic medical experience, increases patients’ treatment compliance and treatment effect, improves patients’ quality of life, and promotes patients’ early recovery and community integration. (目的 探讨人文关怀护理在腹主动脉瘤(AAA)患者中的应用效果。方法 79例AAA患者根据病区分为对照组38例和研究组41例。对照组实施常规护理, 研究组在对照组基础上开展人文关怀护理。采用自制量表评价患者护理满意度, 采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估患者焦虑、抑郁情绪状况。结果 研究组满意度评分高于对照组 , 差异有统计学意义(P＜0. 05)。干预后, 两组SAS、SDS量表评分均较干预前降低, 且研究组评分低于对照组, 差异有统计学意义(P＜0. 05)。结论 人文关怀护理注重人文关怀与心理疏导, 能为AAA患者提供人文化就医体验, 缓解患者的焦虑、抑郁负性情绪, 对促进患者早日康复、重返社会有积极作用。)

In recent years, awareness has grown of the vital importance of ecological systems, provoking increased research into how to improve their resilience. Here, one popular new technical/management solution is the creation of greenways along riversides. In practice, however, the practical outcomes of such greenways have sometimes been disappointing due to an excessive focus on technical solutions at the expense of a sufficient consideration of the social impact. This study intends to reflect on the problem by looking at the dynamics of land use for ecosystem functions at the macro scale as well as the relationship between the implementation of greenways and the local demand for diverse everyday activities, in particular, recreation opportunities, at the micro scale. Based on this, it aims to reveal practical solutions to bridge ecological usages and everyday needs that achieve better preservation and services of ecosystems. Taking the greenways along the Yongning River (YRG), which runs through the urban–rural areas and the urban–rural interface of Huangyan-Taizhou, as a case study, GIS analysis and anthropology approaches were applied. The results show that the YRG has systematically improved the riparian ecosystems by better connecting the eco-land use and preserving the waterfront. At the same time, its ability to fulfil the large potential for leisure and recreation services needs to improve. Residents living in different parts of the city had disparate requirements depending on their patterns of daily behaviour. We conclude that the successful implementation of greenways in cities should not only consider technological and nature-based solutions but also consider the socio-cultural background. The diversity of local needs regarding everyday activities and recreation will lead to an equivalent diversity in riparian landscape design. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the safety and efficacy of transbrachial and transfemoral approaches combined with visceral protection for the endovascular treatment of juxtarenal aortoiliac occlusive disease (AIOD) over an average 19-month follow-up period. Methods: In this retrospective analysis, all patients with juxtarenal AIOD at a single institution were reviewed from June 2015 to January 2020. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. The indications for treatment were critical limb threatening ischemia in 12 patients and bilateral claudication in five patients. Percutaneous access via the left brachial artery was first obtained to recanalize the infrarenal occluded lesions. After that, femoral accesses were achieved. A 4-Fr catheter, a 4 mm balloon, or a 6-Fr 90-cm-long sheath was used to complete visceral artery protection. Results: A total of 17 juxtarenal AIOD patients (14 males; mean age, 63.4 ± 8.1 years) underwent endovascular treatment. The technical success rate was 100%. Complete reconstruction was achieved in 15 (88.2%) patients. The infrarenal aorta was reconstructed with kissing covered stent grafts (n = 7), kissing bare-metal stents (n = 2), covered stent grafts (n = 2), bare-metal stents (n = 1), or the off-label use of iliac limb stent grafts (n = 5). Renal embolization was found in 3 (17.6%) patients during intraoperative angiography. There was 1 (5.9%) case of distal runoff embolization after CDT and 1 (5.9%) case of left iliac artery rupture. One (5.9%) death occurred due to acute myocardial infarction 20 days after the operation. The average follow-up period was 19.3 ± 16.7 months (range, 1–54 months) in the remaining 16 cases. The renal artery patency rate was 100%. The estimated cumulative primary patency rates were 92.3% at 12 months and 59.3% at 36 months according to the Kaplan–Meier method. Conclusions: Transbrachial and transfemoral approaches combined with visceral protection offer a safe and effective alternative to open revascularization for the endovascular treatment of juxtarenal AIOD. [ABSTRACT FROM AUTHOR]

Objectives: This study was aimed to evaluate the safety and efficacy of endovascular treatment of extracranial carotid artery aneurysms (ECAAs) using self-expandable covered stent grafts. Methods: All patients with ECAA at a single institution were reviewed from February 2014 to February 2020. Eight consecutive patients (three men, mean age 64.5 years) treated with endovascular repair with self-expandable covered stent graft were retrospectively reviewed. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. Access to ECAA was gained via a femoral approach or a direct puncture of common carotid artery after surgical exposure because of kinking of the aortic arch and common carotid artery. A self-expandable covered stent graft (Viabahn; W. L. Gore, Flagstaff, AZ) was deployed to exclude the aneurysm. Results: Based on imaging features, there were five peudoaneurysms and three true aneurysms. The technical success rate was 100%. Cerebral protection devices were not used in all the patients during the procedures. Immediate absolute obliteration of the ECAA with no endoleak was documented in all the patients. Perioperative complications included one internal carotid-cavernous sinus fistula, one bleeding at the puncture site, and one stroke. The mean follow-up period was 35.5 months (range, 9–72 months). All the patients were alive, with an obligation rate of 100%. No transient ischemia attack, stroke, or reoccurrence of symptoms was identified during the follow-up period. Radiological examinations identified patency of the stent grafts and revealed no endoleaks, stent fracture, stent migration, or aneurysm rupture. Conclusions: Endovascular treatment of ECAAs with self-expandable covered stent grafts appears to be a safe and feasible alternative for traditional open surgery, especially in the challenging anatomy and instable physical conditions. Although cerebrovascular accidents can occur as the result of hemodynamic changes during the perioperative period, the minimal alternative can yield satisfactory midterm follow-up clinical outcomes. [ABSTRACT FROM AUTHOR]