[Objective] To investigate the application effects of nursing hierarchical management model in modern hospital.[Methods] By using the “quality nursing demonstration project”activities launched by the hospital as an opportunity,the nursing shift reform in the emergency department was carried out from March 2011,the hierarchical management of group nursing model was implemented.The management effect was observed.[Results] After nursing hierarchical management,nursing knowledge,nursing attitude scores of 14 nurses were higher than before.Assessment indicators of quality of nursing were improved,the sense of competition,service and responsibility of nurses were enhanced.[Conclusions] Nursing hierarchical management model in the modern hospital includes workforce management,responsibilities management and assessmcnt management.It can improve nursing knowledge and attitudes,enhance the sense of competition,service and sense of responsibility of nurses,which should be widely apphed.

Objective To investigate the job burnout status of emergency nurses and its related factors.Methods Maslach Burnout Inventory-General Scale (MBI-GS) and Nurse Stressor Scale were used to investigate job burnout and job stress conditions by selecting 21 nurses from the emergency department,21 nurses from the big medicine systems and 21 nurses from the big surgical systems.Results The emotional exhaustion,depersonalization,reduced personal accomplishment scores of the emergency nurses were significantly different from the big medicine systems and the big surgical systems.The major source of pressure for emergency nurses were time allocation,workload,working environment and equipment,patient care,management and interpersonal relationship.Conclusions Nurses in the emergency department face a variety of stressors,easily to produce burnout syndrome.Managers should take effective means to alleviate the pressure on nurses to maintain their physical and mental health.

Objective To investigate the influence of support and intervention technique with multi-dimensions on uncertainty in illness for cancer children′s parents. Methods With convenience sampling method, a total of 74 cases of hematological malignant and solid tumor patients′ parents in Hematology and Tumor Centre of Children′s Hospital of Fudan University were selected. There were 35 cases in the intervention group, which were given multi-dimension-support and intervention technique for 8 weeks as well as regular chemotherapy and nursing care. There were 39 cases in the control group, who were only given regular chemotherapy and nursing care. The level of uncertainty in illness in both groups were evaluated after 8 weeks of the base-line investigation. Results The scores of uncertainty in illness reduced over time in both groups (F=95.402,P<0.01). After 8 weeks, the scores of the intervention group were lower than those of the control group (F=24.079,P < 0.01). Conclusions The all-round, multi-dimension and real-time techniques of support and intervention could decrease the level of uncertainty in illness for cancer children′s parents.

Objective To understand the current status of paediatric medication safety,identify the existing problems on nursing research of paediatric medication safety and supply reference for paediatric medication safety.Methods 268 requested research papers published from 2003 to 2013 were retrieved from CNKI and CBM databases,and were analyzed by quantitative methods.Results Among 268 literatures,60.1％ were experience summaries and discussion.72.0％ didn't use any analyzing methods.64.6％ adopted qualitative analysis.Nine categories of these studies contents were concluded,among these,literatures dealing with medication management and medication safety education for parents came the first,accounting for 31.0％ and 15.3％; while those elaborating about information technology and medication safety education of nurses were the least,accounting for 4.1％ and 3.0％.Conclusions Most of the studies were qualitative comments and experience summaries which lack of rigorous designs and statistical methods.The research contents were scattered and difficult to be used in clinical environment.It is strongly recommended that studies on paediatric medication safety should be enhanced.Furthermore,nursing guideline should be constructed by evidence-based methodology to promote domestic paediatric medication safety.

Objective To formulate job evaluation index system for clinical nurse specialist in comprehensive children′s hospital. Methods A total of 19 experts were consulted by two-round Delphi method to ensure the item of index system, the order and weight of each index was determined by hierarchy analysis. Results The evaluation index system included 5 level-1 dimensions, 13 level-2 dimensions and 30 level-3 items. The authority of the expert advisory coefficient was 0.84, determine coefficient was 0.91, familiarity cofficient was 0.77. The coordination coefficient of one, two, three indexes were 0.44, 0.52, 0.51, with statistical significance (P < 0. 05). Conclusions The job evaluation index system is reliable and valid, which can provide basis on job management.

OBJECTIVETo evaluate the methods for collection of peripheral blood stem cells (PBSC) in children.

METHODSPeripheral blood stem cells were collected from 20 child patients and 11 donors. The patients treated with chemotherapy, received G-CSF or GM-CSF and the donors received G-CSF for mobilization. When the peripheral blood (PB) leukocyte count reached to 5 X10(9)/L,the hematopoietic stem cells were collected with CS-3000 Plus, COM TEC or COBE Spectra blood cell separators from patients and donors. For children whose weight <20 kg,HCT <24% or TBV <1 100-1 650 ml,blood cell separators were pre-injected with the same type RBCs irradiated by 25 Gy of gamma-ray and with low flow rate (10-30 ml/min). The number of CD34(+) cell was detected by flow cytometry. The relationship of number of CD34(+) cell with mononuclear cell (MNC) and processed blood volume was analyzed.

RESULTSSuccessful collection of the PBSCs with the CS- 3000 Plus (n=10), the COM TEC (n=3) and the COBE Spectra (n=18) was achieved in all the 31 cases with 1-5 aphereses used. Number of CD34(+) cells was (7.9 ±2.9) X 10(6)/kg and that of MNCs was (7.4 ±3.1) X 10(8)/kg. The total CD34(+) cell count was correlated with MNCs before aphaeresis and processed blood volume.

CONCLUSIONFor collection of high quality PBSCs, the appropriate methods should be chosen according to the body weight, TBV, mobilization of child patients/donors.

Adolescent ; Child ; Child, Preschool ; Cytapheresis ; methods ; Female ; Hematopoietic Stem Cell Mobilization ; Hematopoietic Stem Cells ; Humans ; Infant ; Male

Objective:To explore the relationship between the expression of angiopoietin 1 (ANGPT1) and Smadhomolog 9 (Smad9) genes in cancer tissues and tumor metastasis, invasion behavior and prognosis in patients with lung adenocarcinoma.Methods:Sixty patients with lung adenocarcinoma in Chengwu Hospital Affiliated to Shandong First Medical University from October 2018 to December 2019 were selected as the research objects. The expressions of ANGPT1 and Smad9 mRNA in cancer tissues and adjacent tissues were compared, as well as the expressions of ANGPT1 and Smad9 mRNA in cancer tissues of patients with different tumor metastasis and invasion behaviors. The relationship between ANGPT1 and Smad9 mRNA expression and tumor metastasis and invasion behavior of lung adenocarcinoma were analyzed, and the 1-year survival rate of patients with lung adenocarcinoma was calculated. The 1-year survival rate of patients with different ANGPT1 and SMAD9 mRNA expression levels were compared.Results:The relative expression of ANGPT1 mRNA and Smad9 mRNA in cancer tissues were lower than those in adjacent tissues: 2.45 ± 0.26 vs. 11.18 ± 0.93, 4.23 ± 0.31 vs. 7.58 ± 0.65, the differences were statistically significant ( P<0.05). There were significant differences in the relative gene expression of ANGPT1 and Smad9 mRNA in different clinical stages, tumor diameter, degree of differentiation, lymph node metastasis and pleural invasion ( P<0.05). Spearman correlation analysis showed that the expression of ANGPT1 and Smad9 mRNA were negatively correlated with clinical stage, tumor diameter, lymph node metastasis and pleural invasion ( r = - 0.517, - 0.539, - 0.606, - 0.679, P<0.05), and positively correlated with the degree of differentiation ( r = 0.628, P<0.05). The 1-year survival rate of 58 patients was 72.41%. Kaplan-Meier curve analysis showed that the 1-year survival rate of patients with low expression of ANGPT1 and Smad9 mRNA in cancer tissues were were lower than those in patients with high expression ( P<0.05). Conclusions:Down-regulation of ANGPT1 and Smad9 genes in cancer tissues will accelerate the metastasis and invasion behavior of lung adenocarcinoma. Up-regulating the expression of both genes can be a potential way to improve survival.