ABSTRACT:Objective To explore the risk factors for maternal adverse pregnancy outcomes.Methods An unmatched case-control study based on hospital was performed.Univariate and multivariate Logistic regression were used to analyze the related factors of maternal adverse pregnancy outcomes,including general condition,history of fertility,abnormal symptoms and diseases during pregnancy.Results Univariate analysis results showed that high education level of gravida might be the protective factors of adverse pregnancy outcomes.The risk factors for adverse pregnancy outcome might include advanced maternal age,intensive workload,frequent pregnancy,history of spontaneous abortion,severe morning sickness,and sickness during pregnancy or progestation.Multivariate Logistic regression analysis showed that high education level of gravida (OR=0.63,95% CI:0.50-0.80)was the protective factor of adverse pregnancy outcomes;severe morning sickness (OR=2 .1 3 ,9 5% CI:1 .6 3-2 .7 9 )and sickness during progestation (OR=2.25,95% CI:1.06-4.77)were the risk factors for maternal adverse pregnancy outcomes.Conclusion The level of maternal education should be improved.We should attach great importance to preventive education and thorough treatment of severe morning sickness. Couples should be encouraged to have physical examination before marriage and pregnancy.Corresponding pregnancy care guidance should be given to pregnant women with different physical conditions so as to effectively reduce the occurrence of adverse pregnancy outcomes.

Objective To increase curative rate of nonoperation treatment for adult blunt splenic trauma.Methods Data of 141 patients with blunt splenic trauma treated in our hospital from March 2010 to October 2014 were retrospectively analyzed in accordance with the spleen injury degree classification issued by the Spleen Surgery Group of Chinese Society of Surgery in 2000.According to the treatment within 6 hours of injury,these patients were divided into operative and nonoperative management groups.Results The proportion of non operation was 69.5％ (98/141) and the success rate was 89.8％ (88/98).43 cases were in operation group:34 cases in grade Ⅲ,9 cases with grade Ⅳ,3 cases died; 98 cases were in non operation group:including 32 cases of grade Ⅰ,50 cases of grade Ⅱ,15 cases of grade llⅢ,1 case with grade Ⅳ.10 cases failed non operation treatment including 1 case with grade Ⅰ complicated by pancreatic and intestinal injury causing peritonitis during the period of observation,1 case of grade Ⅱ complicated by contusion of the liver and secondary bleeding on day 3 after the trauma,7 cases of grade Ⅲ,were converted to surgery because of multiple organ injury and rebleeding secondary to pulmonary complications,and 1 case of grade Ⅳ with multiple organ injury and shock being immediately converted to surgery.In overall there were 2 deaths in nonsurgery group,1 case with grade Ⅲ and 1 case with grade Ⅳ.Condusions Nonoperative treatment of blunt splenic trauma is safe and feasible in grade up to]Ⅱ blund splenic trauma patients.

Objective To investigate the knowledge, belief and practice regarding ICF Generic Set in nurses. Methods 107 nurses from 28 secondary- and tertiary-level hospitals were investigated with self-administered questionnaires. Results In the knowledge dimension, 16.3%~39.4% of the nurses were accurate in each item respectively. The nurses got a middle grade in the attitude dimension and all the sub-dimensions. In terms of practice, 39.4%of hospitals and 44.2%of nurses had never used ICF, and the personal usage of ICF correlated with the scores of the knowledge and perceived susceptibility, perceived benefits, perceived barriers and perceived threat of belief. Conclu-sion The nurses are inadequate in the knowledge and attitude of ICF, and the application of ICF need more promotion.

Objective To explore the influences of health belief model education on training of international classifiction of functioning,disability and health (ICF) generic set in nurses.Methods Eighty-four nurses from 28 hospitals received a set of education of ICF generic set based on health belief model.Nurses' knowledge and belief of ICF generic set were evaluated before and after education.Results The score of ICF generic set knowledge after education was (5.63±0.75) points,which was higher than that of before education 1 (2) points,and there was significant difference (Z=10.092,P＜ 0.05).The scores of ICF generic set belief and perceived susceptibility and perceived barriers dimensions were (63.01±7.04),(11.21±1.45),(13.87±2.68) points after education,and (59.62±6.25),(10.11±3.07),(12.68±3.63) points before education,and there were significant differences(t=3.301,2.986,2.414,P＜ 0.05).Conclusions The heath belief model education can improve the ICF generic set knowledge level of nurses,enhance the nurses' confidence and lower the possible perceived barriers in the application of ICF generic set,and thereby can improve the ICF generic set belief level of nurses.

Building a better performance evaluation system for public hospitals is key to the ongoing health reform. To this end, Beijing Municipal Administration of Hospitals reformed the performance evaluation system of public hospitals in Beijing based on its experiences during 2012 to 2014. This reform integrates the target tasks,day-to-day performance,personalized performance,Party and people management performance,and mandatory plan performance as one evaluation integrity,forming a new public hospitals’performance evaluation system of multi-dimension and multi-level.This approach can effectively integrate diversified performance management objectives and overcome key difficulties in performance management,assisting further promotion of the approach,facilitating government objectives in managing the medical sector,promoting healthy development of hospitals,and exploring how to deepen the public hospital reform in terms of separating ownership from operations.

The role of public hospital performance evaluation has become a roadblock for the current reform of public hospitals.By summarizing the performance evaluation of Beijing municipal hospitals in recent three years,the authors systematically introduced the practice of Beijing Municipal Administration of Hospitals in establishing a public hospital performance evaluation mechanism.In addition,the paper introduced the achievements of the Administration in the evaluation methods of public hospital evaluation,governmental responsibilities in hospital governance,guidance of hospitals’orderly development,and positive interactions between the government and hospitals.This way the paper provided useful references for guiding the hospitals back to public service nature,positive interactions, refined management of hospitals and better performance management.

Objective Examination and evaluation of employee satisfaction index in the hospital performance evaluation.Methods Stratified sampling,field survey and telephone survey were used in customizing a questionnaire for two surveys in July and December 201 5 respectively.Results The standardized score of employee satisfaction was 86.252±1 5.1 53,and the lowest score was found in the canteen environment and food quality.Conclusion Employee satisfaction is found as good overall,and targeted measures are recommended to improve insufficiencies for better employee satisfaction.

OBJECTIVE:To investigate the effects of loading-dose rosuvastain before early percutaneous coronary intervention (PCI) on reperfusion arrhythmias in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI).METHODS:A total of 136 patients with NSTEMI were randomly divided into loading-dose group (68 cases) and control group (68 cases).Both groups who were not given anti-platelet drugs were given loading-dose of Aspirin enteric-coated tablets 300 mg+Clopidogrel sulfate tablets 600 mg immediately after admission.The patients who were given aspirin regularly were given loading-dose of Clopidogrel sulfate tablets 600 mg only once after admission.The patients who were given clopidogrel regularly were given loading-dose of Aspirin enteric-coated tablets 300 mg only once.Those received PCI 12-24 h after medication.After PCI,they took Aspirin enteric-coated tablets 100 mg for life+Clopidogrel bisulfate tablets 75 mg at least 12 months.Loading-dose group was given loading-dose of Rosuvastatin calcium tablets 20 mg orally,12 h before surgery.All patients began to take Rosuvastatin calcium tablets 10 mg,once a day,since the night after the operation.Coronary angiography and the occurrence of reperfusion arrhythmia were observed in 2 groups.The levels of CK-MB and cTnT,major adverse cardiovascular events (MACE) were observed before and after surgery.RESULTS:There was no statistical significance in the number of diseased vessels,culprit vessels,the degree of culprit vessels stenosis or the incidence of MACE between 2 groups (P＞ 0.05).The incidence of reperfusion arrhythmia in loading-dose group was significantly lower than control group,with statistical significance (P＜0.01).There was no statistical significance in the degree of culprit vessels stenosis between 2 groups (P＞0.05).Before surgery,there was no statistical significance in the levels of CK-MB or cTnT between 2 groups (P＞0.05).After surgery,the levels of CK-MB and cTnT in 2 groups were significantly higher than before surgery,but the loading-dose group was significantly lower than the control group,with statistical significance (P＜0.01).CONCLUSIONS:Preoperative loading-dose of rosuvastatin before PCI can reduce the incidence of reperfusion arrhythmias in NSTEMI patients.

DEFENCATH?(taurolidine/heparin)is the first hemodialysis central venous catheter lock solution approved by the FDA.Taurolidine has broad-spectrum antibacterial activity against Gram-negative and Gram-positive bacterium and fungal species and anti-endotoxin and anti-exotoxin activities.Moreover,microbial resistance has not been observed,and the safety is good.Low-dose heparin is effective in anticoagulation and has a low risk of bleeding,and the two complement each other,clinical studies have reported that the catheter lock solution(CLS)effectively reduces the incidence of catheter-related blood stream infection(CRBSI),with good safety and significant clinical value.It will bring benefits to renal failure patients undergoing maintenance hemodialysis.

Objective:To compare the clinical outcomes of endovascular therapy in acute stroke patients with anterior circulation tandem occlusions caused by atherosclerosis or dissection.Methods:A retrospective cohort study. A total of 98 patients with anterior circulation tandem lesions undergoing endovascular therapy in the Wuhan NO.1 Hospital (March 2016 to March 2022) were analyzed. Median age was 64(55,71) years old, and 82.7% (81/98 cases) were males. According to the lesion etiology, the patients were divided into atherosclerosis and dissection groups. The differences in clinical outcomes between the two groups were investigated, including favorable 90-day functional outcome (modified Rankin Scale score of 0-2), successful reperfusion (modified Thrombolysis in Cerebrovascular Infarction score of 2b-3), symptomatic intracranial hemorrhage, stroke-associated pneumonia, 90-day all-cause mortality, and average hospitalization days. Logistic regression analysis was used to adjust for potential confounders affecting functional outcomes in both groups, and to determine odds ratios and 95% confidence intervals.Results:Seventy-one patients were grouped into the atherosclerotic cause and 27 into the dissection cause cohorts. The rate of favorable 90-day functional outcome was 43.7% (31/71 cases) in the atherosclerosis group versus 55.6% (15/27 cases) in the dissection group (adjusted odds ratio=1.339; 95% confidence interval, 0.374-4.798; P=0.654). No significant differences were found in other clinical outcomes between the two groups (all P>0.05). Conclusion:The clinical prognosis of patients with tandem lesions caused by atherosclerotic stenosis or artery dissection was similar after endovascular therapy. Future studies are still needed to verify our results.