Objective To explore the application and clinical effects of nursing procedure of in the patients of Ebola virus dis-ease (EVD).Methods We went on nursing assessments to the 5 EVD patients by applying nursing procedure and made the nursing diagnosis based on the results of nursing assessments.Then we analyzed the possible reasons of common nursing problems and made anticipated goals and carried out the nursing strategies.We evaluated the efficiency of nursing eventually.Results We carried out nursing procedures in 5 EVD patients.No complication was occurred in all patients.Three patients fully recovered and dis-charged from our hospital.We got a good treatment results and achieved good social benefits.Conclusion System nursing to EVD patients,which accords to nursing procedure,helps us reducing the nursing complications,and decreasing the mortality of patients.

Objective To evaluate the validity of shifts management by group schedule comprising doctors,nurses and sanita-ry cleaners simultaneously on the basis of echelon allocation in Ebola Treatment Unit(ETU)of China.Methods According to the characteristics of Ebola infectious disease prevention and control,working schedule was designed basing on the medical staff compo-sition,working duration and job responsibilities.The validity of this schedule was evaluated by hospital admission time,discharge time,PPE supplies consumption,the error frequence of PPE wearing or uncoating and staff satisfaction.Results Through this mode of shift management,hospital admission time and discharge time were shortened,PPE supplies consumption and the error fre-quence of PPE wearing or uncoating were decreased,the satisfaction degree were improved among doctors,nurses and sanitary cleaners(P <0.01).Conclusion The application of this new style working schedule could ensure the nursing services to be procee-ded safely and smoothly.

Objective To explore the expression of heparanase(HPA)and its correlation with the clinical pathological features and angiogenesis in bladder transitional cell carcinoma.Methods HPA mRNA level was detected with RT-PCR and its protein level was determined by immunohistochemical staining in 68 cases of bladder cancer and 24 cases of adjacent tissues of bladder cancer.Results The positive rate of HPA mRNA was 60.3%(41/68)in bladder cancer,4.2%(1/24)in the adjacent tissues of bladder cancer.The expression of HPA mRNA had statistically significant correlation with pathological stage,clinical staging and lymphonode metastasis(P

Objective To establish core competence evaluation index system of orthopaedic specialized nurse .Methods Alto‐gether 35 experts from Class Ⅲ Grade Ⅰ hospital in Chongqing ,Beijing ,Jiangshu were consulted by a three‐round delphi survey ,and finally established the core competence evaluation index system of orthopaedic and the weight of each index .Results The core com‐petence evaluation indexes of orthopaedic specialized nurse included 4 first class indexes ,14 second class indexes and 72 third class indexes .The expert authority coefficient was 0 .833 ,the familiar coefficient was 0 .794 ,the determination coefficient was 0 .872 ,The coordination coefficient of primary and secondary and third indicators were 0 .390 ,0 .324 ,0 .308 ,respectively ,and there were statis‐tically significant differences (P< 0 .05) .Conclusion The expert opinions for the core competence evaluation indexes are consist‐ent ,the results are objective and scientific .It can provide quantitative standards for training ,examining and evaluation of orthopaedic specialized nurse .

Objective To modify the existed transfer trolley for collection and distribution so as to enhance cleaning and disinfection.Methods The existed transfer trolley was added with an intake pipe,a spray nozzle,a drilled divider,a drainage pipe and etc for perfusion rinse,and equipped with auxiliary mechanisms such as a protective support and preserver.Omnidirectional cleaning and disinfection of the trolley were executed by the intake pipe,nozzle and high-pressure irrigation machine.Results The trolley prevented the disinfection solution from spitting,ensured the safety of the staff and environment,and had the qualified rate of disinfection being 100％.Conclusion The modified transfer trolley gains advantages in environmental protection,energy saving and practicability,and thus is worthy promoting clinically.

Objective To investigate the methods and effects of multimodal and phased protective training for medical staff against Ebola.Methods The 4 stages of the protective training include the theoretical teaching,track type simulative process train-ing,simulative ward training,on-site training.We combined the 4 protective training stages and made 4 protective skills assessments in sequence.Results The average scores and qualified rates of the medical staff in the second,third,fourth assessment increased significantly comparing with that in the first assessment.The qualified rate reached 100% in the fourth assessment and we realized zero infection during the mission.Conclusion Multimodal phased protective training reinforced the protective skills of medical staff.Zero infection of medical staff needed seamless supervision in work time eventually.

Multidisciplinary cooperation (MDC) chronic disease management model is a new care model, which is widely used in the specialty area of chronic kidney disease. However, there are still many problems in clinical practice, such as the lack of systematic and specific operating instructions. In this paper, we reviewed and summarized the practices of MDC in chronic kidney disease management in China. We also explained the concept of the MDC, composition, and division of labor in chronic kidney disease management, the specific operating model, intervention methods, clinical effects, and existing problems. This review provided references for the application of MDC in continuous care of chronic kidney disease cases management.

Objective:To investigate the effect of hemoglobin (Hb) volatility on cardiovascular prognosis in peritoneal dialysis (PD) patients.Methods:Retrospective cohort study was designed. Patients undergoing stable PD for more than 3 months and followed up regularly for at least 1 year were enrolled from May 1, 2013 to October 31, 2014 in the General Hospital of Ningxia Medical University. According to the Hb variation based on the mean changes in Hb standard deviation at 1 month, 3 months, 6 months, 12 months over baseline Hb, all patients were divided into low volatility group (≤10 g/L), moderate volatility group (>10-20 g/L) and high volatility group (>20 g/L), and baseline information were compared among these groups. Kaplan-Meier survival analysis and Cox regression equation were used to analyze the relationship between Hb variation and cardiovascular mortality and all-cause mortality. Besides, the patients were divided into qualified group (Hb≥110 g/L) and substandard group (Hb<110 g/L) by the Hb level at the study endpoint (cardiovascular death and all-cause death) according to KDIGO guidelines and relevant literature. Cox regression analysis was used to analyze the relationship between Hb variation and cardiovascular death in qualified group or substandard group. Multivariate linear regression analysis was used to analyze the related factors of Hb fluctuation in PD patients.Results:A total of 267 patients were enrolled. There were 160 males (59.93%) in this study. The age was (52.66±13.72) years old, and the median dialysis age was 37(21, 61) months. The patients' baseline Hb (before dialysis) was (80.16±14.89) g/L and at the end of the study Hb was (105.34±22.08) g/L. Body mass index and baseline Hb levels in the high volatility group were lower than those in low volatility group and moderate volatility group (all P<0.05). Both moderate and high volatility groups had lower estimated glomerular filtration rate than that in low volatility group, and high volatility group had higher urea nitrogen level than that in low volatility group (all P<0.05). The amount of erythropoietin usage in the high volatility group was higher than that in moderate volatility group ( P<0.05). The Kaplan-Meier survival analysis results showed that there was no significant difference in survival rate for all-cause death (Log-rank χ2=0.735, P=0.693) and cardiovascular death (Log-rank χ2=2.961, P=0.228) in different Hb volatility groups. Cox regression analysis showed that after adjusting for age, sex, serum creatinine, and blood albumin, higher Hb volatility was associated with a lower risk of cardiovascular death ( HR=0.972, 95% CI 0.947-0.999, P=0.040). After adjusting for related confounding factors, higher Hb volatility was still a protective factor for cardiovascular death in the substandard group ( HR=0.946, 95% CI 0.903-0.992, P=0.022), but there was no significant correlation between Hb fluctuation and all-cause death. Multivariate linear regression analysis results showed that the fluctuation level of Hb was positively correlated with Kt/V ( B=4.682, 95% CI 2.480-6.884, P<0.001) and erythropoietin dosages ( B=0.001, 95% CI 0-0.001, P=0.003), and negatively correlated with baseline Hb ( B=-0.554, 95% CI -0.651--0.457, P<0.001). Conclusions:High Hb variability is a protective factor for cardiovascular death in PD patients with lower Hb level (substandard Hb). Adopting a reasonable program to correct anemia timely to reach the standard level has a greater impact on reducing risk of cardiovascular death in PD patients than Hb variation in anemia treatment.

Objective:To investigate the correlation between the distribution of traditional Chinese Medicine (TCM) constitution and the syndrome of TCM and the performance under gastroscope in patients with hiatal hernia(HH).Methods:A total of 300 HH patients diagnosed in the Department of Gastroenterology, the Second Affiliated Hospital of Shandong University of TCM from January 2016 to December 2018 were enrolled in this study.The clinical information was collected to complete TCM constitution, TCM syndrome type and gastroscopic performance classification.Results:The composition ratio of TCM constitution in 300 patients with HH was not exactly the same(χ 2=88.140, P<0.05). From high to low, the order was: Qi stagnation(58 cases), Qi deficiency(56 cases), damp heat(51 cases), phlegm dampness(45 cases), Yang deficiency(27 cases), Yin deficiency(21 cases), peace(17 cases), blood quality(17 cases), special quality(8 cases). There was a significant attribute association between TCM syndrome type and TCM constitution classification(χ 2=129.753, P<0.05), among which: the syndrome of liver and stomach stagnation heat corresponded to damp heat and Yin deficiency; the syndrome of spleen and stomach dampness heat corresponded to phlegm dampness syndrome; the syndrome of spleen and stomach deficiency cold corresponded to Yang deficiency and Qi deficiency; the syndrome of Qi stagnation and phlegm corresponded to blood sputum and Qi stagnation; Qi deficiency and blood stasis syndrome corresponded to Qi deficiency.There was significant attribute association between gastroscopic performance and TCM constitution(χ 2=123.189, P<0.05), among which: no esophagitis corresponded to Yang deficiency, Qi deficiency, peace and phlegm dampness; the grade A reflux esophagitis corresponded to the dampness heat and the Qi stagnation; the grade B corresponded to the dampness heat and the Qi stagnation, the grade C had no obvious correspondence, the grade D corresponded to the Yin deficiency. Conclusion:The TCM constitution of HH patients is mainly characterized by Qi stagnation, Qi deficiency, damp heat and phlegm dampness, and there is a significant correlation between constitution classification and TCM syndromes type and gastroscopic performance.

Nurse's professional identity is a positive evaluation of nursing profession by the nurses themselves,which directly affects the outcome of patients and nurses.Nursing practice environment can not only affect the formation of nurses' professional identity,but also affect the safety of patients and the development of hospitals through the influence of nurses.The research on professional identity and positive working environment of nurses in China started late and is still in the exploratory stage.This study analyzed the overview,research progress and relationship of nurses' professional identity and practice environment,and provided reference for nurses' professional identity training and the construction of positive nursing practice environment in China.