Objective To investigate the state of thyroid hormones and thyrotropin level in different gestation periods. Methods FT3, FT4, TSH and hCG were measured in 623 patients by ACS-180 automatic chemiluninescence analyzer. The urinary iodine was random measured by the use of iodine catalytic reaction mechanism of Arsenic-Cerium, rapid urinary iodine was detected with cold digestion method of quantitative detection. Result Serum FT3,FT4 ,and hCG levels in the first and second trimester were higher than in the third trimester ( F =53. 19,78.00,58.77, P ＜0. 05) ,and TSH levels were lower than in the third trimester ( F =5.68, P ＜0.05). The incidence of thyrotropin level disorder was 7. 54%, there were no significant differences in the gestation periods ( χ2 = 3.92, P ＞ 0. 05 ). The incidence of subclinical hypothyroidism,subclinical hyperthyroidism, hypothyroidism and hyperthyroidism were 3.53%, 2. 57%, 1.12% and 0. 32%, respectively. The incidence of subclinical hypothyroidism in the first and third trimester was high, while the incidence of subclinical hyperthyroidism in the second trimester was high. Conclusions Thyrotropin level in the third trimester was lower than that of the first and second trimester. HCG changes were not the main reason that caused the thyrotropin level disorder during the pregnancy.

Objective The article aimed to investigate the effect of application of phase learning teaching method in teaching of clinical nursing skills.Methods A total of 97 undergraduate nursing students in grade 2008 were grouped as the experimental group,these students adopted phase learning teaching method,which divided clinical nursing skills course into three stages.A total of 103 undergraduate nursing students in grade 2008 were set as the control group,the students were given traditional teaching method.The teaching effect was compared between two groups.Results Compared with the control group,theoretical knowledge,practical skills,professional emotion and critical thinking were better in the experimental group,the difference was significant,t value was-4.566,-6.332,-2.371 and-4.308.Conclusions The phase learning teaching method is an effective and practical method to improve the teaching effect of clinical nursing skills.

Objective To examine the systemic lupus erythematosus ( SLE) and its nursing knowledge in SLE child and their parents, in order to provided reference for intervening clinical health education, promoting attitudes change and establishing healthy life style. Methods A convenience sample of 58 SLE children and their parents were recruited from Paediatrics Department in Peking Union Medical College Hospital. A questionnaire was used to measure the SLE and its nursing knowledge of the children and their parents. Results The overall 58 SLE children acquired average score of the disease (23. 57 ± 4. 54), with high score in the disease general knowledge and low score in immunization and vaccination, exercise, hormone leading to increasing of cholesterol and supplement of vitamin D. Conclusions SLE children and their parents have certain SLE and its nursing knowledge , but some key knowledge exits shortcomings; hence, we should do the personalized teaching plan in clinical job to provided family-based education mode for further improvement of SLE and its nursing knowledge in SLE children and their parents.

Objective To explore the current situation of stressor,job burnout and anxiety of pediatric nurses of Class Ⅲ Grade A hospitals and to analyze the correlation between stressor and job burnout as well as stressor and anxiety.Methods From January to February 2017,a total of 233 pediatric nurses of 5 Class Ⅲ Grade A hospitals of Beijing were selected by convenience sampling as subjects.All of the pediatric nurses were investigated with the Nurse Job Stressor Scale (NJSS),Maslach Burnout Inventory-Human Services Survey (MBI-HSS),Self-Rating Anxiety Scale (SAS).Results Among 233 pediatric nurses,two dimensions of NJSS with high scores included time allocation and workload (2.69 ± 0.87) as well as patient care(2.54 ± 0.70).Two items of NJSS with high scores contained that the wages and other welfare treatment was low (3.04 ± 0.93) as well as worrying about mistakes and accidents in work (2.97 ± 0.97).The emotion exhaustion dimension of MBI-HSS was with 22.7％ for the severe level.Patients with low scores of sense of personal achievement accounted for 41.2％.The score of SAS was (38.38 ± 7.47) significantly higher than Chinese model (t=17.57,P ＜ 0.01).There were 10.7％ of nurses with the moderate-severe level of anxiety.The correlation analysis among stressor,job burnout and anxiety of pediatric nurses showed that except for time allocation and workload as well as sense of personal achievement,other dimensions of NJSS had positive correlations with dimensions of MBI-HSS and SAS (r=0.169-0.527,P ＜ 0.05).Conclusions Pediatric nurses are with high working pressure.Policy makers and managers should consider characteristics in pediatric nursing,reduce nurses' stressors as well as the level of nurses' job burnout and improve their mental health,so as to ensure the quality of pediatric nursing.

Objective To explore the effects of hemodialysis on patients' coagulation function and to analyze its rea-sons. Methods Blood samples of 68 patients before and after hemodialysis who took maintenance hemodialysis in our hospital from January 2012 to April 2014 were selected. Flow cytometry was applied to test P-selectin on platelet sur-face. Indirect enzyme linked immunosorbent assay was applied to test ultra-sensitive C-reactive protein, endothelial von Willebrand factor and D-dimer. Through the observation on patients, arrangement of patient data, and measurement of dialyzer blood volume after hemodialysis, reasons and analysis for changes of coagulation function for patients taking hemodialysis were retrospectively analyzed. Results All patients were discharged from hospitals after the treatment, and PT and FIB values after the treatment were significantly lower than those before the treatment (P<0.05). APTT and TT values were not statistically different from those before the treatment (P>0.05). Positive rate of D-dimer was 50%before the treatment and 0.0% after the treatment, and the difference compared before and after the treatment was statistically significant (P<0.05). Results of P-selectin on platelet surface, ultra-sensitive C-reactive protein, endothelial von Wille-brand factor and D-dimer after hemodialysis were significantly higher than those before hemodialysis, and the differ-ences were statistically significant. Factors affecting changes of patients' coagulation function included individual health quality, doctors' inaccurate assessment, inappropriate anti-coagulation, insufficient usage of heparin and inappropriate operation techniques by nurses. Conclusion Medical staff should enhance their knowledge of anti-coagulation, improve the assessment and testing of coagulation status for patients taking hemodialysis, provide anti-coagulation protocol timely and properly, and practice operation techniques. Meanwhile, although heparin is used during treatment, patients may still be highly coagulated. Therefore, regular monitoring of coagulation indicators is able to effectively reduce co-agulation during hemodialysis.

Objective To explore the medical compliance behavior among systemic lupus erythematosus (SLE) children so as to provide a basis for implementing targeted nursing intervention. Methods From November 2015 to October 2017, we selected 124 SLE children of Department of Pediatrics of Peking Union Medical College Hospital as subjects in by convenience sampling. The self-designed SLE Children Medical Compliance Behavior Questionnaire was used to the investigation. A total of 124 questionnaires were sent out and 116 valid questionnaires were collected. Results Among 116 children, the mean of total score of medical compliance behavior was (105.91±10.62) along with the highest score (4.91±0.43) in the term of"I will not presume to reduce the dose" belong to the dimension of medication and review. Conclusions SLE children have the high level of compliance in medication and review. Health care providers should continue to carry out sunscreen, choose appropriate diet, pay attention to the details of infection prevention and develop a regular exercise habit for children along with their patients so as to improve long-term prognosis and quality of life of SLE children.

Objective:To understand the change trend and influencing factors of fecal calprotectin(FC) in very low birth weight(VLBW) infants, and to explore the application value of FC detection in the diagnosis of necrotizing enterocolitis(NEC) in VLBW infants.Methods:VLBW infants hospitalized in the neonatal department at Quanzhou Children′s Hospital from June 2018 to May 2019 were selected as research object for a prospective study.Fecal samples from the 1st, 7th, 14th, 21st, 28th and 35th days after birth and fecal samples from the acute and recovery stages of NEC were collected continuously.The content of FC was determined quantitatively by immunofluorescence assay.Results:(1) The FC level of non NEC VLBW infants from 1 to 35 days after birth was 143.5(47.8, 391.2) μg/g.Univariate analysis showed that the level of FC fluctuated with the postnatal age, the level of FC was the highest at 21 days, and then decreased.The level of FC increased significantly in formula feeding, premature rupture of membranes, neonatal sepsis, feeding intolerance and pregnant mothers without glucocorticoid before delivery( P< 0.05). (2) Multivariate covariance analysis showed that prenatal application of glucocorticoid( F=10.550, P=0.001), premature rupture of membranes( F=13.311, P<0.001), neonatal sepsis( F=8.001, P=0.005), feeding intolerance( F=4.751, P=0.030) and NEC( F=54.566, P<0.001) had significant effects on FC level.After controlling the effects of prenatal corticosteroid, premature rupture of membranes, neonatal sepsis and feeding intolerance, the levels of FC in NEC group and non-NEC group were 3 162.3(1 412.5-7 244.4)μg/g and 141.3(125.9-162.2)μg/g, respectively.In NEC group, the levels of FC in acute stage and recovery stage were 3 166.9(1 745.1, 6 806.4)μg/g and 130.9(97.4, 273.9)μg/g, respectively, with significant difference( t=10.304, P<0.001). While the levels of FC were 2 347.9(1 404.4, 5 893.4)μg/g in the mild NEC and 4 114.7(2 764.5, 9 208.4)μg/g in the moderate or severe NEC, respectively, with no significant difference( t=1.131, P=0.280). Conclusion:The levels of FC fluctuate with postnatal age and it is affected by multiple factors.FC maybe a useful marker for the diagnosis and evaluation of efficacy of NEC in VLBW infants.

Objective To evaluate the effectiveness of family-centered educational intervention on disease-related knowledge, health behavior and subsequent visit compliance among children with systemic lupus erythematosus (SLE). Methods From October 2014 to June 2015, a total of 62 children with SLE from a class Ⅲ grade A hospital of Beijing were selected as the research object by convenient sampling method. They were divided into control group with 32 cases and observation group with 30 cases in chronological sequence. No children were withdrawn from the observation group, and 2 cases in the control group had not been followed up for 3 months after discharge. A total of 60 children had completed the study for 6 months. Children in the intervention group were given family-centered educational intervention, while children in the control group were given conventional treatment and nursing in ward. We assessed their disease-related knowledge and health behaviors before the intervention, 3 months after discharge, and 6 months after discharge, and evaluated their subsequent visit compliance before the intervention and 6 months after discharge. Results The disease-related knowledge level of children in intervention group was significantly higher than that of children in control group at 3 and 6 months after discharge (F=4.513, 5.412;P<0.001);For the health behavior, there was no significant difference between two groups of children at 3 months after discharge (F=1.948,P=0.057), but at 6 months after discharge, the intervention group was higher than the control group (F=3.399,P=0.001); There was a significant difference in the compliance of the two groups of children in the 6 months after discharge (χ2=6.667,P=0.021). Conclusions Family-centered educational intervention can rapidly improve the level of disease-related knowledge in children with systemic lupus erythematosus. It can improve children's health behavior and improve their subsequent visit compliance.

Alzheimer's disease(AD)is the most common cognitive disorder in the elderly and manifests primarily as progressive cognitive function decline, neuropsychiatric symptoms and multiple functional impairments.Obstructive sleep apnea(OSA)is a common type of respiratory disorder.Studies have found that AD and OSA are connected in many ways, including the risk of developing these diseases, biomarkers and neuroimaging features.These connections may result from a variety of mechanisms, such as neuropathological protein deposition, exacerbated immune-mediated inflammation, oxidative stress abnormalities, impaired mitochondrial function, and disturbed neurotransmitter systems, among others.This article reviewed the relationship between AD and OSA, the mechanisms linking them and their treatment.

In recent years, the oral feeding readiness for preterm infants has been paid more and more attention, and there are various assessment tools for the oral feeding readiness. The professionals in various countries have been constantly improved and adjusted according to the national and clinical conditions, but up to now, no unified standard has been formed. This paper reviews the assessment tools of preterm infant′s oral feeding readiness at home and abroad, and provides reference for the unified evaluation standard of preterm infant's oral feeding readiness, so as to establish more standardized and effective intervention strategies and enhance the effect of preterm infant′s oral feeding nursing.