Objective To investigation the present situation of full‐time bachelor and upgraded clinical nurses ,in order to provide effective basis for the reasonable nursing hierarchical management and job arrangement .Methods Using cluster sampling method ,the working status of clinical nurses self‐designed questionnaire survey for 566 clinical nurses from 13 three level of first‐class hospitals of Nanning city were investigated by self‐designed questionnaire survey .Results The total score of full‐time bache‐lor and upgraded clinical nurses working status showed low satisfaction;the total score of working status of the upgraded nurse was higher than full‐time bachelor nurses .The upgraded clinical nurse in 4 dimensions of welfare treatment ,nursing working character‐istics and identity ,the work to be recognized ,interpersonal relationship scored higher than full‐time bachelor nurse(P<0 .05);in the dimension of scientific research and teaching opportunities scored lower than full‐time bachelor nurses(P<0 .05);in 3 dimen‐sions of scheduling ,job autonomy ,personal professional development opportunities ,the difference was not statistically significant (P>0 .05) .Conclusion The overall performance of working statute of full‐time bachelor nurses is worse than upgraded nurses ,and some aspects including the occupation identification need to be further strengthened .The nursing managers need to increase the nursing hierarchical using of strength ,promote the rationalization process of job responsibility and arrangement of the high degree of clinical nurses ,in order to reduce the flow loss rate .

Objective To investigate the level and characteristics of working satisfaction of nurses, explore the role of top-up continuing education in clinical nursing work,and provide effective basis for the reasonable nursing post arrangement for nursing administrators. Methods Using cluster sampling method, the general information and the self-designed working satisfaction of clinical nurses questionnaire survey for 926 nurses from 22 three level of first-class hospitals of Guangxi Zhuang Autonomous Region. Results The total score of working satisfaction of the upgraded nurses was higher than that of the junior college nurses. The scores comparison of 6 dimensions which were nursing working identity, the work to be recognized, job autonomy, interpersonal relationship, scientific research and teaching opportunities, personal professional development were (29.25±6.27) points vs. (21.39±5.72) points, (21.96±4.73) points vs. (18.22±3.79) points, (16.67±5.21) points vs. (13.16±4.28) points, (17.83±3.56) points vs. (13.37±4.21) points, (21.32±4.63) points vs. (15.73±5.16) points, (20.51±3.52) points vs. (15.17±4.22) points, the difference was statistically significant (t=3.936, 2.762, 2.936, 3.323, 7.616, 6.215, P<0.05). There was no statistical difference between them in 2 dimensions which were scheduling situation, welfare treatment (P>0.05). Conclusions After upgraded continuing education, the comprehensive quality of nurses has been improved,and the working satisfaction has been improved significantly.

Objective: To investigate efficacy of operation and non-operation treatment for hip fractures patients complicated with pulmonary embolism. Methods: A retrospective case control study was conducted to analyze the clinical data of 18 hip fracture patients complicated with pulmonary embolism admitted to Dongyang People's Hospital from May 2017 to January 2019. There were 11 males and seven females, aged 59 to 96 years[(80.0±9.3)years]. There were 10 patients with intertrochanteric fractures, one with femoral subtrochanteric fracture and seven with femoral neck fractures. After diagnosis of pulmonary embolism, the patients were given anticoagulant therapy with low molecular weight heparin for at least one week. The re-examination showed that pulmonary embolism absorption improved and D-dimer did not increase. Eleven patients chose surgical treatment (operation group) with intramedullary nail internal fixation or artificial hip replacement. Seven patients chose non-surgical treatment (non-operation group) with skin traction. The Harris score of hip function was compared between the two groups. Visual analogue scale (VAS) was used to evaluate hip joint pain. At the last follow-up, fracture healing, prognosis of pulmonary embolism and mortality within 3 months were recorded. Results: All the patients were followed up for 3-22 months [(11.2±6.0)months]. At last follow-up, the Harris score was (92.1±2.2)points in the operation group and (28.8±18.8)points in the non-operation group (P<0.01); the VAS was 0 point (0-1 point) in the operation group and 3 points (1-3 points) in the non-operation group (P<0.01). At the last follow-up in the operation group, five patients obtained fracture healing after internal fixation, and among the six patients receiving artificial joint replacement, five patients recovered well except for one deceased patient. At the last follow-up, pulmonary embolism was absorbed and no recurrence of pulmonary embolism was found. None of the patients died within 3 months in operation group, while 14% of the patients (1/7) in the non-operation group died within 3 months. Conclusions For hip fracture patients complicated with pulmonary embolism, compared with non-operation treatment, operation treatment is more beneficial to restore hip function and relieve pain, with lower mortality rate within 3 months. Operation treatment is feasible for patients who showed improved absorption of pulmonary embolism and no secondary increase of D-dimer after one to two weeks of full anticoagulation treatment before operation.

Objective To investigate the status of hospitalized cancer patients sense of hopelessness.Methods 508 cancer patients in the Affiliated Tumor Hospital of Guangxi Medical University were recruited and divided into the youth group and the middle aged group.Beck Hopelessness Scale (BHS) was assessed to compare the depression degree between the youth group and the middle aged group.Results In general,without a sense of hopelessness in 182 patients (40.9％),mild hopelessness in 178 patients (40.0％),moderate hopelessness in 68 patients (15.3％),severe hopelessness in 17 patients (3.8％).However,no statistical difference was significantly different on the depression degree between the youth group and the middle aged group,while significat difference existed between patients with different dwelling places and treatment time.Conclusions Most cancer patients have different degree of hopelessness.Duration of treatment,dwelling conditions and other factors can affect the patients sense of hopelessness.

Objective To investigate the suicide related psychological status of cancer patients in hospital. Methods 508 cancer patients in the Affiliated- Tumor- Hospital- of- Guangxi- Medical- University were recruited and using the hospital anxiety and Depression Scale (HADS) and Beck Hopelessness Scale (BHS) for evaluating cancer patients′anxiety, depression, hopelessness. According to age, the patients were divided into three groups, comparing the differences in three groups′scores of anxiety, depression, hopelessness. Results Of all the respondents, there were 38.7% (172/445) patients with anxiety, and 26.3% (117/445) patients with depression, and 59.1% (263/445) patients with different degrees of hopelessness. In the comparison of three groups of patients, anxiety scores existed differences (U=7.083,P < 0.05), the average score of anxiety in patients below 40 years was 6.84±3.73, 40-49 years old patients with anxiety average score was 7.17±3.75, 50-60 years old patients with anxiety average score was 6.14±3.79. But depression scores and despair scores had no statistic difference among the three groups(U=2.417 and 0.166, P > 0.05). Conclusions Many people have anxiety / depression in cancer patients, most cancer patients have varying degrees of hopelessness. The health care workers should get attention to these suicide related psychology, take appropriate intervention, in order to avoid the occurrence of hospitalized cancer patients committing suicide.

BACKGROUND: Total isoflavones of pueraria (TIP) possesses estradiol-like structures and has inhibition effect on bone loss or osteopenia in ovariectomized rats. However, studies have demonstrated that the prevention and treatment effect of TIP on osteoporosis in ovariectomized rats is poor, especially in single utilization. OBJECTIVE: To investigate the combination effect of TIP and vitamin D on the treatment of osteoporosis in ovariectomized rats. METHODS: Totally 81 female sprague-drawly (SD) rats of 3-month-old were randomly assigned into 9 groups. Exception those in the sham-surgery group, all rats were prepared for ovariectomized models. Vitamin D or low-, middle- and high-dose TIP or low-, middle- and high-dose TIP combined with vitamin D were intragastric administrated in the vitamin D, TIP or combination groups, respectively. There was no drug medication in the model and sham-surgery groups. The uterus coefficient was calculated at 3 months after medication. The serum alkaline phosphatase (ALP) activity, calcium, phosphonium, bone gla protein, estradiol levels, as well as bone mineral density of femur was determined. RESULTS AND CONCLUSION: Compared with the model group, the uterus coefficient and estradiol level was obviously increased in the middle- and high-dose TIP groups and all combination groups (P < 0.05); the ALP and bone gla protein levels significant decreased (P < 0.05); and the bone mineral density of central and distal femur were notably increased (P < 0.05); in particular, the result was more manifest in the high-dose combination group. TIP and vitamin D presented with synergism in uterus coefficient, estradiol, ALP, bone gla protein levels and bone mineral density of distal femur, but the effect was not significant in the calcium and phosphonium levels in the TIP and/or vitamin D groups. The findings demonstrated that Tip combined with vitamin D can induce synergism on prevention and cure of osteporosis in ovariectomized rat.

Objective:To construct the rehabilitation strategy of anterior cruciate ligament reconstruction based on the evidenced method and evaluate the effectiveness in clinic.Methods:The rehabilitation strategy was firstly built based on evidenced method. And then 80 patients from Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing University Medical School Affiliated Drum Tower Hospital from January to August, 2019 were randomly and equably sent to experiment group and control group. Patients in experiment group or control group were accepted the evidenced method or regular method as treatment strategy, respectively. The visual analogue scale (VAS), thigh circumference, motion range of knee joint and Lysholm score were recorded before and after surgery.Results:Six papers met the inclusion criterion and were been screen out from 1 535 papers, and then the evidenced rehabilitation strategy of anterior cruciate ligament reconstruction was made. The VAS scores in 12 and 24 h were 1(0-2), 1(1-3) in experiment group and 2(1-3), 3(1-3)in control group, the differences were significant between two groups( Z values were 4.955, 6.489, P<0.001). The motion ranges of knee joint in 2, 4, 6, 12 weeks after operation were (61.6±5.1)°, (85.3±6.6)°, (114.6±5.2)°, (127.6±3.4)° in experiment group and(54.9±4.6)°, (71.0±8.8)°, (105.1±5.9)°, (115.8±4.0) °in control group, the differences were significant between two groups( t values were 6.209-14.138, P<0.001). The Lysholm scores at 6,8,12 weeks after operation were 58.8±3.7, 71.1±3.1, 84.3±3.7 in experiment group and 56.0±3.4, 65.4±4.3, 75.6±3.0 in control group, the differences were significant between two groups( t values were 3.511, 6.867, 11.439, P<0.001). Conclusions:This evidenced rehabilitation strategy of anterior cruciate ligament reconstruction in this study was helpful to alleviating the pain, improving motion range of knee joint after anterior cruciate ligament reconstruction.

Objective To explore the safety and efficacy of the Wingspan stenting of basilar artery atherosclerosis stenosis though the analysis of single center massive clinical data. Methods Ninety one consecutive patients received Wingspan stenting because of basilar artery stenosis in our center from July 2007 to April 2013. The patients were classified into three groups:early term (n=30), middle term (n=30), and late term (n=31) according to the operation time in our center. The basic clinical data and the factors which may affect the ischemic events were retrospectively analysed, t test and Chi?Square test were used to analyze the factors related to the periprocedural ischemic complications. Results All of patients were stented successfully and the technical success rate was 100%(91/91). The mean stenosis was reduced from (82.2 ± 5.8)% to (15.9 ± 5.7)%; strokes or death happened in 13 cases within 30 days, including perforator stroke in 8 patients(8.8%, 8/91), thrombosis in 4 patients(4.4%, 4/91), subarachnoid hemo rrhage in 1 patient(1.1%, 1/91), 2 patients with disabling or fatal strokes. Lesions involving in the middle segment of basal artery (P=0.049), long?segment disease (P=0.002), severe stenosis (P=0.001) may be a risk factor affecting perioperative ischemic stroke, and the surgeons' surgical technique was not risk factors for ischemic complications (P=1.000). Seventy seven patients (84.6%, 77/91) had the clinical follow?up and the mean follow?up period was (31.3±15.1) months. Four patients suffered from posterior circulation strokes during the clinical follow?up , one of them (1.3%, 1/77) had disabling stroke, another 3 patients (3.9%, 3/77) suffered from TIA. The 2?year accumulate probability of stroke (any stroke or death within 30 days and stroke in the territory of the qualifying artery beyond 30 days)was 16%(95%CI, 8.2%to 23.8%). Forty six patients had the imaging follow?up and the mean follow?up period was(9.5±8.3)months, 6 patients(13.0%,6/46) had in?stent restenosis (ISR) and 2/6 patient had the symptomatic ISR. Conclusions The stroke or death rate of symptomatic basilar atherosclerosis Wingspan stenting within 30 days is high, but the disabling or fatal stroke rate is low. The middle segment of basilar artery involved, the long stenosis, the severe atherosclerosis may be the factors related to the periprocedural ischemic strokes. The incidence of disabling or fatal strokes was low following Wingspan stenting.

Objective To investigate the application value of combined detection of antikeratin (AKA) antibody,anti-cyclic citrullinated peptide(anti-CCP) antibody,anti-RA33 antibody,RF and ESR in the diagnosis of rheumatoid arthritis(RA).Methods One hundred cases of RA and 60 cases of suspected RA in our hospital from June 2014 to May 2015 were collected.One hundred and twenty cases of non-RA other autoimmune diseases served as the control group.The indirect immunofluorescence assay (IFA) was used to detect anti-KA antibody,anti-CCP antibody and anti-RA33 antibody were detected by using ELISA.The rate scatter turbid assay was used to detect RF.The Westergren method was used to detect ESR.The diagnostic performance of each diagnostic indicator was evaluated.Results The detection rates of anti-KA antibody,anti-CCP antibody,anti-RA33 antibody,RF and ESR in the RA group were in turn 64%,75%,44%,84% and 51% respectively,the detection rate(sensitivity) of 5-indicator parallel detection were 97%, the specificity of 5-indicator series detection was 89.2%;in the suspected RA group,the detection rates of 5-indicator were in turn 16.7%, 31.7%,13.3%,20%,15% respectively,which in the control group were in turn 0.8%,2.5%,1.7%,0.8% and 5.8% respectively.The detection rates of 5-indicator in the RA group was significantly higher than that in the suspected RA group,showing extremely significant difference (P<0.001),the detection rate of 5-indicator had extremely significant difference between the suspected RA group and control group (P<0.001),the sensitivity of five-indicator parallel detection was 97%,which was significantly higher than that of single indicator detection (P<0.05),the detection specificity of 5-indicator series detection was up to 100%,which was also significantly higher than that of single indicator detection (P<0.05),the missed diagnosis rate of parallel detection was minimal,while the negative predictive value was highest,the misdiagnosis rate of series detection was lowest,the positive predictive value was highest,the Youden index of parallel detection was largest.Conclusion The single detection of anti-CCP antibody and RF have good sensitivity and specificity, but 5-indicator combined detection has higher sensitivity and specificity,which can better reduce the missed diagnosis rate and misdiagnosis rate,can greatly improve the efficiency of diagnosis,and has an important clinical significance for the early diagnosis of RA.

Objective To provide the effective references for reasonable arrangement of nursing post by comparison on the core competence level and characteristics between the upgraded and the fulltime bachelor nurses.Methods Questionnaire survey based on the basic demographic data and the Competency Inventory for Chinese Registered Nurse for 391 clinical nurses from 13 three level of firstclass hospitals.Results The core competence score of the upgraded and the full-time bachelor nurses showed a moderate degree of satisfaction; the full-time bachelor nurses' total scores were higher than those of the upgraded nurses,and there were statistically significant differences among 6 dimensions included critical thinking and scientific research ability; there was no significant difference in clinical nursing dimension.Conclusions The full-time bachelor nurses' core competence is higher than that of the upgraded nurses in general,but no significant difference exists in clinical nursing dimension.