Objective To develop a scale for measuring CHD patients' health belief and to rectify its reliability and validity.Methods The primary items were obtained through reviewing literature and semi-structured interviewing with CHD patients.After team discussion and experts evaluation,the pretesting scale was developed.Two hundred and sixty subjects were recruited in the first study to finish the questionnaire by convenience sampling.The reliability and validity of this scale were tested by exploratory factor analysis,reliability analysis and correlation analysis.Results It was found that eight common factors extracted by exploratory factor analysis.Factor loading of each item ranged between 0.489 and 0.850.The 8 factors explained for 60.698％ of total variance.The correlations between the subscales and the total scale were ranging from 0.811 to 0.876.The correlations between the subscales of the scale were ranging from 0.330 to 0.732.The Cronbach's α coefficients of the total scale was 0.802,and the subscales Cronbach's α coefficients were ranging from 0.684 to 0.834.Test-retest reliability was 0.880,and that of subscales were 0.673～0.841.Conclusions The newly developed coronary artery disease health belief scale has showed acceptable reliability and validity,which can be used as a useful tool for the assessment and intervention of patients' health belief.

Objective: To explore the application and choice of latissimus dorsi musculocutaneous flap and thoracodorsal artery perforator flap in different wound repair. Methods: From March 2012 to February 2018, 8 cases of different wounds were repaired with island latissimus dorsi myocutaneous flap pedicled with dorsal thoracic artery, free latissimus dorsi myocutaneous flap, or thoracodorsal artery perforator flap combined with scapular flap. The patients includes 4 cases of trauma, 2 cases of tumor and 2 cases of osteomyelitis. Among them, 5 cases received pedicled grafting, 2 cases had anastomotic vascular free grafting combined with antibiotic bone cement chain bead, 1 case had thoracodorsal artery perforator flap combined with scapular flap. Results: All 9 flaps of 8 patients survived. The size of the flaps ranged from 22.0 cm×7.5 cm to 28.0 cm×21.0 cm. All the donor and recipient areas healed well. After 2 months to 2 years follow up, all flaps have good blood supply, and the limbs′ function was normal. The appearance of flaps were satisfactory, with fully treated osteomyelitis, and no recurrence of the tumor was observed. Conclusions According to wound characteristics, selective application of thoracodorsal artery perforator flap, pedicled or free latissimus dorsi myocutaneous flap is effective for the repair of muscle, skin and soft tissue defects, as well as osteomyelitis, after tumor resection.

Objective To explore the effect of auricular-plaster therapy combined with aromatherapy on anxiety and quality of life in patients with colorectal surgery.Methods A total of 135 patients with colorectal surgery were randomly divided into group A (auricular-plaster therapy combined with aromatherapy),group B(auricular-plaster therapy),group C (aromatherapy),group D(blank).Anxiety and life quality levels of four groups were determined by using self-rating anxiety scale(SAS),quality of life instruments for cancer patients (QLICP-CR)and were compared between four groups before and after intervention.Results The SAS and QLICP-CR scores of group A were lower than those of group B,group C and group D after intervention.The SAS and QLICP-CR scores of group B and group C were lower than that of group D after intervention.There were no statistical significant differences in SAS and QLICP-CR scores between group B and group C after intervention.Conclusions Auricular-plaster therapy combined with aromatherapy can effectively alleviate anxiety of patients with colorectal surgery and improve their quality of life,and the effect is better than that of auricular-plaster therapy and aromatherapy.

Objective To translate the English version of the Nursing Profession Self-Efficacy Scale into Chinese,and to test the reliability and validity of the Chinese version. Methods The reliability and validity of the Chinese version of scale was tested among 480 nurses from Tianjin First Central Hospital. Results The revised Chinese version of the Nursing Professional Self-Efficacy Scale contained 19 entries, the Cronbach′s α coefficient was 0.95, the test-retest reliability was 0.91. Conclusions The revised Chinese version of the Nursing Profession Self-Efficacy Scale has acceptable reliability and validity. It can be used to measure the Nursing Profession Self-Efficacy among nurses in China.

Objective To establish a learning evaluation indexes systen of flipped teaching method,and provide the basis for evaluating academic performance of each student who majors in nursing.Methods The indexes were determined by Delphi method of two rounds of consultation involving 15 experts,and the weight of every index was set up by analytic hierarchy process.Results The response rates of questionnaire investigation for the two rounds of consultation were 13/15 and 12/13 respectively.The authority value of experts was 0.847.The Kendall concordance coefficients for the indexes of first-level,second-level and third-level were 0.373,0.258 and 0.595 respectively,P＜0.05.Finally,the evaluation indexes system including 3 first-level indexes,5 second-level indexes,and 6 third-level indexes was set up.Conclusions The results of the two rounds of expert consultation are reliable.The consistency of expert opinions is good.The study provides a scientific and systematic evaluation tool for evaluating nursing undergraduates' performance under flipped teaching.

Objective To systematically evaluate the effects of prone position ventilation on newborn with respiratory distress syndrome.Methods We searched databases including PubMed,EMBASE,Cochrane Library,Web of Science,CBM,CNKI,Wanfang and VIP.We included all randomized controlled trials and randomized crossover trials of neonatal respiratory distress syndrome.Studies were selected according to inclusion and exclusion criteria,extracting data and assessing quality.Then RevMan 5.3 software was used to analyze the data.Results Ten studies included seven randomized controlled trials and three randomized crossover trials,and 500 patients were included.The results of meta-analysis showed that in prone position ventilation group SaO2[MD=2.41,95％CI(0.87,3.95),P=0.002],PaO2[MD=5.20,95％CI(3.04,7.36),P＜0.001],Pa2//FiO2[MD=24.40,95％CI(8.35,40.44),P=0.003],the risk of pneumothorax [RR =0.10,95％ CI (0.01,0.76),P=0.03] and intracranial hemorrhage [RR =0.41,95％ CI (0.20,0.83),P=0.01]and duration of mechanical ventilation [MD=-23.22,95％CI(-38.30,-8.14),P=0.003] compared with supine positiongroup had significantly statistical difference;however there was no significant difference in ventilator-associated pneumonia[RR=0.72,95％CI(0.48,1.09),P=0.12] between two groups.Conclusion Prone position ventilation is effective to improve SaO2,PaO2 and PaO2/FiO2,shorten duration of mechanical ventilation and reduce the risk of pneumothorax and intracranial hemorrhage in newborn with respiratory distress syndrome.While it could not effectively reduce incidence of ventilator-associated pneumonia.Due to the limitations of the quality of studies included,multi-centered randomized controlled trials with large sample size are needed in the future to evaluate the effects of prone position ventilation on neonatal respiratory distress syndrome.

Non-valvular atrial fibrillation is a common arrhythmia and a major risk factor for cardioembolic stroke. Small cerebral vascular disease is a syndrome of clinical, cognitive, imaging, and pathological manifestations caused by intracranial small vascular lesions. The imaging findings on cranial magnetic resonance usually shows recent subcortical small infarction, vascularised lacunae, white matter hypersignal, perivascular space enlargement, cerebral microhemorrhage, and brain atrophy. It is a major cause of neurological loss and cognitive function decline in the elderly. Current studies suggest that atrial fibrillation may increase the imaging load of cerebral small vessel disease through a series of mechanisms such as microembolization, hypoperfusion, inflammation, endothelial dysfunction, and lymphoid system dysfunction. The imaging of cerebral small vessel disease with atrial fibrillation has a potential relationship with cognitive function decline and is related to the occurrence and prognosis of stroke, even more has a potential role in suggesting the etiology and secondary prevention strategies of ischemic stroke.
Aged ; Atrial Fibrillation/epidemiology* ; Cerebral Small Vessel Diseases/complications* ; Cognitive Dysfunction/etiology* ; Humans ; Magnetic Resonance Imaging ; Stroke/etiology*

Objective To evaluate the efficacy and safety of heated gel mattress(HGM) for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods Systematic searches on PubMed, EMBASE, Cochrane Library, Web of Science CBM,CNKI,Wanfang and VIP were performed for randomized controlled trials or quasi-randomized control trials which explored the effects of HGM on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria,extracting data and assessing quality. Then, Meta-analysis and trial sequential analysis were performed by using RevMan 5.3 and TSA v0.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results This systematic review included 10 studies which comprised 7 randomized controlled trials and 3 quasi-randomized control trials, encompassing 773 patients. The results of Meta-analysis showed that in HGM group admission temperature on neonatal intensive care unit (standardized mean difference was 0.63, 95% confidence interval was 0.40-0.87, P=0.00), incidence of hypothermia (relative risk was 0.73, 95% confidence interval was 0.57-0.93, P=0.01) and hyperthermia (relative risk was 1.82, 95% confidence interval was 1.31-2.54, P=0.00) compared with the control group had significantly statistical difference;however, there was no significant difference in admission temperature on EM or TWM group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage III/IV between two groups. TSA confirmed that the pooled results of admission temperature on NICU and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusions HGM is an effective rewarming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia but not decrease the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever and complications. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, high-quality research.

Objective To translate the English version of Type 2 Diabetes Stigma Assessment Scale(DSAS-2) into Chinese,and to test the reliability and validity of the Chinese version of DSAS-2. Methods The DSAS-2 was translated and adapted according to Chinese culture following the translation and back-retranslation procedure.The reliability and validity of the Chinese version of DSAS-2 was tested among 294 patients with type 2 diabetes. Results The Chinese version of DSAS-2 included three subscales: Treated Differently (6 items), Blame and Judgment (7 items), and Self-stigma (6 items) and contained a total of 19 items.The Cronbach α coefficient of the Chinese version of DSAS-2 was 0.879,the Cronbach α coefficient of three factors was 0.832,0.815 and 0.844,respectively;the test-retest reliability was 0.835. The content validity index was 0.916. The scores of DSAS-2 correlated with the scores of Rosenberg Self-esteem Scale, Patient Health Questionnaire 8- Item Scale and Generalized Anxiety Disorder 7-Item Scale (r =-0.452, 0.443, 0.412, P<0.01). Three factors were extracted by exploratory factor analysis and could explain 55.75% of the total variance. Conclusions The Chinese version of DSAS-2 has acceptable reliability and validity,which can be used to evaluate stigma among patients with type 2 diabetes in China.

OBJECTIVETo systematically observe the clinical effect on chronic obstructive pulmonary disease (COPD) at the stable stage, differentiated as cold phlegm blocking the lung type, treated with acupoint sticking therapy during the dog days and the three nine-day periods after the winter solstice so as to propose the latest clinical idea and theoretic evidence for the treatment of COPD.

METHODSOne hundred and fifty cases of COPD at stable stage, which were in accordance with the inclusive standard were randomly divided into three groups, named group A (treatment in dog days and the three nine-day periods after the winter solstice), group B (treatment in dog days) and group C (treatment in the three nine-day periods after the winter solstice), 50 cases in each group. The ingredients (Semen Brassicae, Euphoribia Kansui, Asarum, Rhizome Corydalis, Cinnamon, ginger juice) and doses of herbal medicine plaster were same in each group. The herbal plaster was applied to Feishu (BL 13), Shenshu (BL 23), Dazhui (GV 14), Tiantu (CV 22), Danzhong (CV 17) and Zhongfu (LU 1). In group B, the treatment was given once on the 1st day of each dog-day period, totally 3 treatments were included. In group C, the treatment was given once on the 1st day of each nine-day periods after the winter solstice, totally, 3 treatments were involved. In group A, the treatment was given once on the 1st day of each dog-day period and each nine-day periods after the winter solstice separately, totally 6 treatments were required. The therapeutic effect was evaluated in 4 aspects, named comprehensive clinical efficacy, survival quality (the scores for symptoms, activity limitation and influence on daily life), the attach frequency and pulmonary function.

RESULTSThe total effective rate was 88.0% (46/50) in group A, which was superior to 76.0% (38/50) in group B and 70.0% (35/50) in group C separately (P < 0.01, P < 0.001). The results of the attack frequency, clinical symptom score and pulmonary function indices after treatment were all improved apparently as compared with those before treatment in each group (all P < 0.01). All the above indices in group A were improved much apparently as compared with the other two groups (P < 0.01, P < 0.001). Except for the level of forced vital capacity (FVC), the results of clinical symptom score and the other pulmonary function indices in group B were all improved significantly as compared with group C (P < 0.05, P < 0.001).

CONCLUSIONAcupoint sticking therapy during different season of the year achieves a superior clinical efficacy for the patients with COPD at stable stage. This therapy can reduce the attack frequency and improve the survival quality and pulmonary function for the patients. It is concluded that the efficacy of the treatment in dog days and the three nine-day periods after the winter solstice is superior to simple dog-day treatment and the treatment in the three nine-day periods after the winter solstice, and the efficacy of dog days treatment is better than that in the three nine-day periods after the winter solstice.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Lung ; metabolism ; physiopathology ; Male ; Middle Aged ; Mucus ; chemistry ; metabolism ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; metabolism ; physiopathology ; Seasons ; Vital Capacity