Background:At present, evidence of the role of oral hygiene in ICU-related pneumonia is rare. The study aimed to evaluate the effectiveness of toothbrush-based oral care in preventing ventilator-associated pneumonia (VAP) in patients with mechanical ventilation in the ICU. Methods:Ten databases were searched for randomized controlled trials (RCTs) evaluating toothbrush-based oral care for preventing VAP in patients with mechanical ventilation in ICU. Quality assessment and data extraction were independently performed by 2 researchers. The meta-analysis was performed using RevMan 5.3 software. Results:Thirteen RCTs with 657 patients were included. Tooth brushing + 0.2%/0.12% chlorhexidine was associated with reduced incidence of VAP compared to chlorhexidine (OR = 0.63, 95% confidence interval [CI]: 0.43-0.91, P = .01) or tooth brushing + placebo (OR = 0.47, 95% CI: 0.25-0.86, P = .02) in patients with mechanical ventilation in ICU, but was similar to cotton wipe with 0.2% or 0.12% chlorhexidine (OR = 1.33, 95% CI: 0.77-2.29, P = .31). Conclusions:Tooth brushing combined with chlorhexidine mouthwash can prevent VAP in patients with mechanical ventilation in ICU. There is no advantage of tooth brushing combined with chlorhexidine mouthwash over cotton wipe with chlorhexidine mouthwash for preventing VAP in these patients.

目的:探讨热敏灸对H型高血压患者脑卒中及其危险因素的影响.方法:选取福建省人民医院2018年9月-2019年6月收治的H型高血压患者140例,采用随机数字表法分为观察组和对照组,每组70例.对照组行常规治疗,观察组行热敏灸治疗,记录两组干预前、4、8周后血压、Hcy水平、血脂水平、新增脑卒中及脑卒中后并发症的发生率.结果:随访3个月内,观察组患者新增脑卒中及脑卒中后并发症的发生率均低于对照组(P<0.05),干预4、8周后两组患者危险因素(血压、Hcy水平)均有下降,观察组低于对照组,差异均有统计学意义(P<0.05);干预4周后,两组血脂水平差异均无统计学意义(P>0.05),干预8周后,观察组血脂水平均优于对照组,差异均有统计学意义(P<0.05).结论:热敏灸治疗H型高血压患者,有利于降低脑卒中发生率,并影响其危险因素.

Objective The aim of the study was to investigate the effectiveness and safety of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) in patients with poststroke aphasia. Method We comprehensively searched for eligible studies from 11 electronic medical databases from their inception to February 20, 2019. Randomized controlled trials reporting the effectiveness of LF-rTMS for patients with poststroke aphasia were included. The primary outcome was language ability. The secondary outcomes were functional communication and adverse events. The methodological quality of the randomized controlled trials was evaluated by the Cochrane Back Review Group Risk of Bias Assessment Criteria. Results Of the 567 records retrieved, 18 studies with a total of 536 participants were included. All the included studies were of relatively acceptable methodological quality. All studies but one used LF-rTMS + speech and language therapy (SLT), not LF-rTMS alone. The meta-analysis showed that LF-rTMS had beneficial effects for patients with aphasia after a stroke in terms of naming, repetition, comprehension, written language, and functional communication. The subgroup analyses of language performance showed positive effects of LF-rTMS among stroke patients with chronic aphasia and acute aphasia. LF-rTMS + SLT had effects on language performance that were superior to the sham rTMS + SLT and SLT alone. A shorter LF-rTMS duration benefited language performance more than a longer duration. Additionally, 20 min of LF-rTMS per session produced a positive effect on language ability for patients with aphasia after a stroke. No adverse events were reported. Conclusions LF-rTMS + SLT is an effective and safe method for patients with poststroke aphasia to improve their language performance. Additionally, the most commonly used LF-rTMS protocol for patients with aphasia after a stroke was 90% of the resting motor threshold 20 min per day, 5 days per week, for 2 weeks.

Objectives:Acoustic analysis is a kind of objective assessment of speech-sound which can offer a relatively simple and visual way to examine production of a vowel.Mandarin Chinese is a tone language in which the same phonetic segment carries a different meaning when produced at different lexical tones.Previous studies have examined American English vowels produced by native adult speakers.The aim of the present study was to establish the vowel formant space by examining the formant frequencies associated with Mandarin vowels pro-duced by Chinese young adults aged 23 to 33 years old and identify the characteristics of vowels in Mandarin Chi-nese at 4 different lexical tones.Methods: Acoustic signals of the six Mandarin vowels (/a/,/?/,/e/,/i/,/u/,/y/) produced by native young adult speakers of Mandarin Chinese (n=11) were recorded,and the participants were in-structed to produce all the speech samples using a comfortable loudness level and speech rate.The speech samples were produced was randomly.The first two formants were analyzed by using a professional acoustic measurement system (Multi-Speech,KayPentax,USA).Multi-Speech provides a time-domain waveform and a frequency-do-main wide-band spectrogram (filter bandwidth=300 Hz).Results:The results showed that,generally speaking,the vowel /a/ exhibited the highest mean F1 value whereas vowel /i/ had the lowest F1.The vowel /i/ showed the high-est F2 while /u/ showed the lowest F2 value.The vowel of /?/ and /e/ with different four tones in F1 and F2 had significant differences (P<0.05).However,no significant differences (P>0.05) in F1 and F2 were observed in the other vowels across tones,like /a/,/i/,/u/,/y/.Conclusion: An acoustic vowel space was established in which /i/,/u/,and /a/ were corner vowels,and /?/ and /e/ were found centrally,contributing to the generally triangular vowel space associated with these six core vowels of Mandarin Chinese.The investigation of the first two formant fre-quencies of vowels across tones shows significant differences were found in the vowels /?/ and /e/ with different tones in F1 and F2.When /?/ was produced with level tone,the tongue was more advanced and depressed than with other three tones.For /e/ with rising tone the tongue was more retracted,compared to the tongue for /e/ with dipping tone.

目的 采用Meta分析方法评价强化躯干肌训练对脑卒中偏瘫患者平衡功能的影响.方法 严格按照循证医学系统评价方法,采用计算机检索中国知网数据库、万方数据库、中国生物医学文献数据库(CBMdisc)、维普数据库、PubMed、Cochrane Library、Medline数据库.检索时限均为从建库至2018年12月.检索所有躯干肌训练对脑卒中偏瘫患者平衡功能影响的临床随机对照试验文献.根据资料提取表提取的数据,按照Cochrane系统评价手册中的文献质量评价标准对纳入的文献进行评价,采用Rev Man 5.0软件进行Meta分析.结果 最终纳入文献16篇,共1208例研究对象.Meta分析结果显示,Berg平衡量表(BBS)平衡功能结局指标中,试验组的强化躯干肌悬吊训练法、躯干肌强化训练法、核心肌群训练法改善脑卒中偏瘫患者平衡功能的效果显著高于对照组[强化躯干肌悬吊训练法:WMD =8.92,95％CI (6.38,11.45),Z=6.90,P＜0.000 01;躯干肌强化训练法:WMD =2.23,95％ CI(1.33,3.12),Z=4.88,P＜0.000 01;核心肌群训练法:WMD=5.57,95％CI(2.60,8.55),Z=3.67,P=0.0002].Fugl-Meyer 躯体评定量表中的平衡量表(MPP)平衡功能结局指标中,试验组的强化躯干肌训练法改善脑卒中偏瘫患者平衡功能的效果高于对照组[躯干肌训练:WMD=2.24,95％CI(0.50,3.98),Z=2.52,P=0.01].结论 强化躯干肌悬吊训练法、躯干肌强化训练法、核心肌群训练法均可改善脑卒中偏瘫患者的平衡功能.

认知功能障碍泛指各种原因导致的各种程度的认知功能损害,从轻度认知功能损害到痴呆〔1〕. 认知功能障碍又称为认知功能衰退、认知功能缺损或认知残疾. 我国人口老龄化速度逐渐加快〔2〕,人口老龄化加快了轻度认知功能障碍( MCI)和阿尔茨海默病( AD)患病率的上升. MCI是一种常见的老年综合征〔3〕,具有高发生率、高致残率、低知晓率、低就诊率的特点〔4〕.

Objective To explore the effect of discharge planning service on the self-care ability and quality of life of stroke patients. Methods A total of 42 patients met the inclusion criteria of stroke were randomly divided into control group and experimental group, 21 cases of each group. The control group received routine care of cerebral vascu-lar disease, while the experimental group was given discharge planning services based on the conventional cerebrovascu-lar disease. Two groups of patients were observed and analyzed with self-care ability ( Barthel Index) and quality of life ( SF-36) . Results In the fourth week after discharge, the BI index of the experimental group was significantly higher than that in the control group, and the difference was statistically significant (P<0. 05) . The emotional function of life quality was higher in the experimental group than that in the control group, and the difference was statistically signifi-cant ( P<0. 05 ) . Conclusions The discharge planning service is helpful to improve the self-care ability of patients with stroke and improve their quality of life.

目的 探讨老年2型糖尿病患者肠道双歧杆菌生长与血糖的相关性,从肠道菌群角度为2型糖尿病的防治与研究提供新的途径.方法 根据纳入和排除标准,抽取2015年4月-10月福建某三甲医院糖尿病健康教育俱乐部的2型糖尿病患者90例,收集其粪便和血液标本,检测患者肠道双歧杆菌以及血糖状况,采用Spearman等级相关法分析两者之间的相关性.结果 老年2型糖尿病患者肠道长双歧杆菌、短双歧杆菌、青春双歧杆菌、婴儿双歧杆菌和双歧杆菌总菌的定量结果分别是(0.0001±0.0006)、(4.405±8.475)、(4.752±2.779)、(0.003±0.005)和(8.069±8.206) logN/g.空腹血糖和早餐餐后血糖分别为(8.638±1.913)、(9.763±1.910) mmol/L.相关分析显示:青春双歧杆菌和婴儿双歧杆菌与早餐后2h血糖呈现负相关(r=-0.213、-0.217,P＜0.05),但相关性不显著;双歧杆菌总菌与空腹血糖和早餐后2h血糖有负相关关系(r=-0.302、-0.559,P＜0.01).结论 老年2型糖尿病患者肠道内双歧杆菌数量减少,血糖与肠道双歧杆菌的数量呈负相关,尤其是早餐后2h血糖,其相关机制有待进一步研究.

Objective To discuss the requirements of continuing education based on competency in rehabilitation nursing staff.Methods:Through literature review of relevant theories,the competency was used as the benchmark to develop the questionnaire of continuing education requirement for the rehabilitation nursing staff and the Delphi method was used for correspondence.Results:After two-round consultation,the experts opinions tended to be consistent,and the expert authority coefficient and Kendall's W coefficient were 0.87 and 0.301 respectively.Then constructed 62 secondary indexes to surround 5 competency dimensions.Conclusion:The study of continuing education requirements based on competency in rehabilitation nurses has high scientificity and reliability through Delphi method,which has great important meaning to cultivate rehabilitation nursing staff and rehabilitation nursing education.

Objective We conducted a meta-analysis to evaluate the efficacy of cognitive training on post-stroke cognitive impairment.Methods Randomized controlled trials (RCTs) comparing cognitive training with no cognitive training in addition to either medicine or rehabilitation were identified from Database.Meta-analyses were conducted for the eligible RCTs.Results Seven trials with a total of 368 patients met inclusion criteria.Pooled random-effects estimates of the change in the Mini-Mental State Examination were calculated for the comparison of cognitive training with no cognitive training in addition to medicine or rehabilitation.Following intervention with cognitive training, the merged mean difference (MD) was 5.42 (95% CI [3.16,7.68],P<0.005).For the comparison of cognitive training with no cognitive training in addition to medicine or rehabilitation groups, the Barthel Index MD was 11.17,95% CI=(4.40,17.94),(P<0.05).Overall, the study quality was rated as moderate based on the Cochrane Handbook for Systematic Reviews of Intervention:Part 2:8.5.Conclusion This meta-analysis suggests that cognitive training had positive effects on cognitive function and Activities of daily living of post-stroke cognitive impairment patient.

目的 探讨出院准备服务对脑卒中患者日常活动能力的影响.方法 将符合纳入标准的脑卒中患者42例随机分成对照组与实验组各21例.对照组施行脑血管疾病常规护理,实验组在脑血管疾病常规护理基础上施行出院准备服务,观察两组患者日常活动能力(Barthel指数)评分并分析.结果 出院后4周,实验组患者Barthel指数(80.00±16.047)高于对照组(61.67±23.417)分,差异有统计学意义(P<0.05).结论 出院准备服务可改善脑卒中出院后的日常生活能力.

[目的]调查厦门市脑卒中患者中医体质特点.[方法]采用便利抽样的方法对厦门市162名符合条件的脑卒中患者进行中医体质调查,描述不同体质类型分布情况,按不同的年龄、性别对体质类型进行比较.[结果]①厦门市脑卒中患者中医体质类型为平和质6人,偏颇体质156人;其中气虚质54人(33.3%),痰湿质48人(29.6%),湿热质18人(11.1%).②年龄<60岁患者以痰湿质最为常见,≥60岁则以气虚质最为多见;不同年龄的脑卒中患者对其气虚质的构成差异有统计学意义(P<0.05).③男性患者中常见体质类型(>20%)为气虚质,女性患者中常见体质类型(>20%)为痰湿质和气虚质.不同性别患者平和质、气虚质、痰湿质及血瘀质的构成差异有统计学意义(P<0.05).[结论]厦门市脑卒中患者中医体质类型以气虚质、痰湿质及湿热质为多见;不同性别、年龄的患者,其中医体质类型分布也有所不同.

This paper discusses how to construct an evidence -based self-management education program for COPD and gives a brief description of how to evaluate the program locally and how to evaluate its adaptability.This approach combines systematic reviewm/eta -analysis,content validity evaluation,ex-periment and qualitative interview together .Researchers who are interested in this field can refer to this idea and develop disease -specific non-drug inter-vention programs.

[目的]探讨Seminar教学法在本科《康复护理学》教学中的应用效果.[方法]将福建中医药大学2012级甲班护理本科生103人作为对照组(采取传统教学法),2012级乙班护理本科生106人作为实验组(采取Seminar教学法).采用理论考核及一般自我效能感量表进行评价.[结果]实验组的理论成绩及一般自我效能感总分均高于对照组(P＜0.05).[结论]在康复护理学的教学过程中,应用Seminar教学法有利于提高教学效果及护理本科生一般自我效能感.

目的:探讨脑卒中后尿失禁患者的膀胱管理现状及影响因素.方法:釆用便利抽样的方法,从福州、厦门某两所三甲医院神经内科抽取100例脑卒中急性期、恢复期、后遗症期住院患者为调查对象,采用郭丽的脑卒中尿失禁情况调查问卷进行调查.结果:脑卒中后尿失禁总发生率为48%,48名患者都有不同程度的漏尿,且都没有进行过尿动力学检查,膀胱管理中使用防护用品、记录排尿日记、执行饮水计划、进行膀胱训练、接收健康宣教、盆底肌锻炼总是或者经常的比例分别只有77%、10.4%、20.9%、22.9%、38.6%、0%,性别、照顾者、BMI指数、卒中类型、吸烟史、饮酒史等可能是影响脑卒中后尿失禁的相关因素.结论:脑卒中后尿失禁发生率高,尿失禁患者的膀胱管理仍需进一步加强与完善,脑卒中后尿失禁危险因素的确立有待进一步研究,医护人员应重视此类患者并寻找适当的措施使患者的身心健康得到最大程度的恢复.

Objective:To explore the effective method of relieving the pain of middle aged and elderly patients with rheumatoid arthritis by observing the effect of timing ginger moxibustion on the governor meridian. Methods:Seventy eight cases of middle aged and elderly patients with rheumatoid arthritis were randomly divided into a control group and a treatment group,39 cases in each.The control group were given routine treatment and health guidance,while the treatment group were given timing ginger moxibustion on the governor meridian from 17:00 to 19:00 for 21 days on the basis of the treatment for the control group.The changes of pain in the two groups were evaluated by the visual analogue scales(VAS),the number of joint tenderness and the duration of pain relief.Results:After treatment,the VAS pain score,the number of joint tenderness and the duration of pain decreased compared with those before treatment,and the difference was statistically signiifcant (P< 0.01).After the treatment,the VAS pain score,the number of joint tenderness and the duration of pain were less or lower than those of the control group,and the difference was statistically signiifcant (P< 0.01).Conclusion:Timing ginger moxibustion can effectively alleviate the pain of rheumatoid arthritis in middle aged and elderly patients.

目的 翻译中文版护士交接班评估量表(NASR),并对其进行信度、效度检测.方法 遵循Brislin双人翻译与回译原则,利用专家咨询法进行文化调适,形成中文版NASR量表.在130名临床护士调查中评价其信度与效度.结果 中文版NASR量表共有17个条目,因子分析共提取5个因子,累积贡献率为88.420％.该量表Cronbach'sα系数为0.840,各因子Cronbach's α系数为0.855～0.975,重测信度为0.803,各因子重测信度为0.804～0.950.中文版NASR量表的内容效度(CVI)为0.92,各维度间的相关系数为0.331～0.562,各维度与量表总分之间的相关系数为0.551～0.702,且均有统计学意义(P＜0.01).结论 中文版NASR量表具有良好的信效度,可作为护士对交接班效果评估工具,实现护理交接班质量的优质改进.

目的 评价患者及护士对标准化床边交接班的满意度.方法 选取5个外科护理单元,依据SBAR标准沟通模式实施标准化床边交接班.分别在实施前和实施6个月后调查患者、护士对床边交接班的满意度.结果 实施后患者及护士对交班满意度部分条目显著高于实施前(P＜0.05,P＜0.01).结论 标准化床边交接班的实施,有利于提高患者满意度,保证患者安全.在床边交接班取得积极效果的基础上,护理管理者应关注患者及交接班护士的主观感知,从根本上提高床边交接班质量.

目的 分析护理本科生专业认同感、精神压力与自尊三者之间的关系,为专业思想教育提供客观依据.方法 采用护理本科生专业认同调查问卷(QBNS)、精神压力量表(PSQ)与自尊量表(SES)对403名护理本科生进行调查.采用多元逐步回归分析法,分析自尊和精神压力对专业认同感的影响.结果 以第一志愿录取的学生专业认同感得分高于其他专业调剂的学生(P＜0.01),因自己喜欢就读护理专业的学生专业认同感得分高于其他原因就读护理的学生(P＜0.01)；2008级学生精神压力高于2007级学生(P＜0.05)；其他志愿录取的学生自尊水平高于第一志愿和其他专业调剂的学生(P＜0.05)；自尊与专业认同感呈显著正相关(P＜0.01),与精神压力呈显著负相关(P＜0.01).回归分析显示,自尊和精神压力是专业认同感的有效预测因子.结论 自尊不仅可以影响精神压力,而且与精神压力共同预测专业认同感.

Objective To analyze the relationship among the general self-efficacy,self-esteem and professional identification of nursing baccalaureate students and to provide some suggestions for educational practice. Methods A total of 403 nursing baccalaureate students in traditional Chinese medicine colleges were recruited. They were investigated with general self-efficacy scale (GSES), Rosenberg self-esteem scale(SES)and questionnaire for baccalaureate nursing students (QBNS). The relationship among general self-efficacy,self-esteem and professional identification was analyzed by multiple stepwise regression analysis. Results The mean score of general self-efficacy was 23.81± 5.27. There were significant differences in the score of general self-efficacy among different grades and enrollment methods (P<0.01). The nursing students,general self-efficacy was positively correlated with self-esteem,professional identification,professional emotion and professional skills(r=0.11-0.50, P<0.05). Conclusions Nursing educator should pay attention to the cultivation of self-esteem and professional identity in the training of nursing student in order to improve the self-efficacy of nursing students.