Objective To find the application effect of risk management in nursing management in delivery room.Methods 1200 hospitalized parturients in 2011 were selected as the observation group,and 1186 parturients in 2008 were set as the control group.The observation group received risk management and nursing measures,while the control group was given traditional nursing.Nursing defects rates,the rate of post-partum haemorrhage,the incidence of neonatal asphyxia,dystocia rate,nursing disputes and patient satisfaction degree were compared between two groups.Results Neonatal label defects rates,the rate of post-partum haemorrhage,the incidence of neonatal asphyxia,dystocia rate and nursing disputes in the observation group were much lower than that in the control group.The patient satisfaction degree was significandy increased in the observation group.Conclusions Summarizing the risk factors,performing risk management in delivery room can greatly increase the delivery and nursing quality and patient satisfaction degree.

Objective To analyze the characteristics of epidemic situation of HIV/AIDS in Yongzhou from 1993 to 2014,and provide evidence for HIV/AIDS prevention and control strategy.Methods Descriptive epidemiological analysis was conducted on HIV/AIDS epidemic situation in Yongzhou from 1993 to 2014.Results A total of 2 917 HIV/AIDS cases were reported,the reported cases increased year by year;the ratio of male to female cases was 2.30∶1 ;52.04% were aged 20-49 years old,46.76% were aged ≥50 years old,the percentage of population ≥50 years old increased obviously in recent years;the major transmission route was sexual contact (88.48% ),gay transmission accounted for 2.64%.Conclusion The knowledge about AIDS in Yongzhou should be strengthened, intervention in high risk population should be implemented,scope of detection should be expanded,so as to prevent the transmission of AIDS effectively.

Objective To analyse characteristics of military pilot group sandplay work and reveal their psychological status.Methods Using the self-reporting 90-item Symptom Checklist (SCL-90) to test the validity of group sandplay work made by 87 groups of military pilots.Statistical analysis was used to analyse the characteristics of code data in group sandplay work.Results Positive and negative themes in group sandplay work showed negative and positive correlations(r=-0.59,0.59) with symptom factors of SCL-90,respectively.Positive and negative themes scores were 5.37±2.25 and 2.36± 1.85 ,respectively.The secondary theme scores in the positive theme were entirely higher than those in the negative theme.Scores of energy, connection, cooperation, integration, relaxation, and spirituality in the positive theme and threat,limitation, and aggression in the negative theme were relatively high.The overall evaluations of the work include power, integration, enrichment, and fluency.The theme names of the work include life, military, natural and abstract.Conclusion Group sandplay is an effective method in the study of military pilots' psychological health and military pilots are in good mental health.These pilots have strong intrinsic energy,teamwork and communication.However,some pilots have symptoms of anxiety,tension and insecure.

Objective To evaluate the relationship between birth weight and nonalcoholic fatty liver diseases (NAFLD) in Chinese primary school students. Methods A cross-section study was conducted in ifve elementary schools in Gao Hang Town, Shanghai and 2163 students were enrolled in the study (1120 boys/1043 girls). Height, body weight, waist circumference and per-cent of body fat (bioelectrical impedance analysis) were measured by professional nutritionist after training. Birth weight, feeding pattern, height and body weight of parents were obtained by a self-completed questionnaire. NAFLD was diagnosed by ultra-sound. The risk factors of NAFLD were analyzed. Results The prevalence of NAFLD in the study population was 8.9%. The prevalence of NAFLD was signiifcantly higher in boys than that in girls (12.5%vs 5.0%, P<0.01). Logistic regression showed that sex (OR=1.97, 95%CI:1.21-3.21) and percent of body fat (OR=1.12, 95%CI:1.07-1.17) were the risk factors of NAFLD, and normal BMI was the protective factor of NAFLD (OR=0.09, 95%CI:0.04-0.19) in the study population. Conclusions The pre-valence of NAFLD is higher in boys than that in girls. Also overweight, and high percent of body fat are risk factors of NAFLD in children.

Objective:To explore the clinical effect of dual triangular skin flaps for male nipple reconstruction.Methods:From October 2011 to March 2019, we admitted 4 male patients with flat or missing nipples, aged 29 to 45 years old, with an average of 37 years old in Jiangxi Provincial People’s Hospital. Among them, there was 1 case of congenital bilateral flat nipples, 1 case of bilateral nipple loss caused by drug corrosion, and 2 cases of exogenous injury with failure history of bilateral nipple reconstruction. According to the blood supply and elasticity of the skin of the nipple and areola, dual triangular flaps were designed for bilateral nipple reconstruction. The survival of the skin flap was observed and the sensation and shape of the nipple were followed up.Results:Among the 4 patients with 8 nipples, 7 nipples were fully survived symmetrically with no skin flap infection and necrosis. One nipple had local flap necrosis, resulted in wide and flat nipple appearance. During the 12-month follow-up, the reconstructed nipples were soft and felt good. The height of the nipple was 3-4 mm, the diameter was about 5 mm, 7 nipples were in good shape, 1 nipple was slightly small.Conclusions:Dual triangular skin flaps is a good choice for male nipple reconstruction with satisfactory symmetrical appearance and less complication.

Objective:To explore the clinical effect of dual triangular skin flaps for male nipple reconstruction.Methods:From October 2011 to March 2019, we admitted 4 male patients with flat or missing nipples, aged 29 to 45 years old, with an average of 37 years old in Jiangxi Provincial People’s Hospital. Among them, there was 1 case of congenital bilateral flat nipples, 1 case of bilateral nipple loss caused by drug corrosion, and 2 cases of exogenous injury with failure history of bilateral nipple reconstruction. According to the blood supply and elasticity of the skin of the nipple and areola, dual triangular flaps were designed for bilateral nipple reconstruction. The survival of the skin flap was observed and the sensation and shape of the nipple were followed up.Results:Among the 4 patients with 8 nipples, 7 nipples were fully survived symmetrically with no skin flap infection and necrosis. One nipple had local flap necrosis, resulted in wide and flat nipple appearance. During the 12-month follow-up, the reconstructed nipples were soft and felt good. The height of the nipple was 3-4 mm, the diameter was about 5 mm, 7 nipples were in good shape, 1 nipple was slightly small.Conclusions:Dual triangular skin flaps is a good choice for male nipple reconstruction with satisfactory symmetrical appearance and less complication.

Objective To explore the effects of nutritional status investigation combined with WeChat platform intervention on nutritional quality, weight and disease recurrence rate of ulcerative colitis (UC) children. Methods A total of 96 UC children were selected in Affiliated Hospital of Jining Medical University. From January to December 2017, 48 children were included in control group. From January to December 2018, 48 children were included in observation group. Control group carried out routine follow-up. On the basis of that in control group, observation group implemented nutritional status investigation combined with WeChat platform intervention. We compared the disease cognition, children's nutrition cognition, ratio of strictly implementing doctor's advice and correcting the habit of doting on children, family members' nursing satisfaction among children's patients between two groups before intervention and 6 months after intervention. Besides, we observed the nutritional biochemical indexes before intervention and three weeks after intervention, and dietary intake as well as nutritional status, body mass index (BMI), bone mineral density (BMD) before intervention and 6 months after intervention, and disease recurrence rate of children within 6 months. Results A total of 6 months after intervention, the disease cognition, children's nutrition cognition, ratio of strictly implementing doctor's advice and correcting the habit of doting on children, nursing satisfaction among children's patients, and daily protein, fat, sugar as well as energy intake, BMI and BMD in observation group were higher than those in control group with statistical differences (P＜ 0.05). Three weeks after intervention, serum albumin and prealbumin of children in observation group were higher than those in control group with statistical differences (P＜0.05). Conclusions Nutritional status investigation combined with WeChat platform intervention can improve the disease and children's nutrition cognition of UC children's patients, promote them to strictly implement doctor's advice, and improve UC children's nutritional status, weight and growth, and reduce the risk of disease recurrence, and enhance nursing satisfaction which is worth to be used widely in clinical application.

OBJECTIVETo investigate the effects of Xinfeng Capsule (XFC) on pulmonary function and related mechanism in adjuvant-induced arthritis (AA) rats.

METHODSThe rats were randomly divided into five groups: normal control (NC), model control (MC) groups, methotrexate (MTX), tripterygium glycosides tablet (TPT) and Xinfeng capsule (XFC) treatment groups. The adjuvant-induced arthritis model was established by intracutaneous injection of 0.1 mL Freund ' s complete adjuvant in the right paw of rats; the drugs were given 19 d after model establishment. The toe swelling degree (E), arthritis index (AI), pulmonary function, peripheral blood Treg levels, pathological changes of lung tissue and expression of Foxp3, TGF-β1, Smad3, Smad7 proteins in lung tissue were measured 30 d after drug administration.

RESULTSCompared to NC group, the levels of E, AI, alveolitis score, TGF-β1 and Smad3 were significantly increased (P <0.05 or P <0.01); maximum expiratory flow 25% of vital capacity (FEF25),50% maximal expiratory vital capacity flow (FEF50), maximum expiratory flow at 75% of vital capacity (FEF75), maximum mid-expiratory flow (MMF), force peak expiratory flow (PEF), CD4+ CD25+ Treg, Foxp3 and Smad7 were significantly decreased in MC group (P <0.05 or P < 0.01). Compared to MC group,the expression of E, AI, TGF-β1 and Smad3 were reduced, while FEF50, FEF75, MMF, PEF, Treg, Foxp3 and Smad7 were elevated in XFC group (P <0.05 or P <0.01). Compared to XFC group, the level of body mass,FEF25,FEF50, FEF75, MMF and Treg were lower in MTX and TPT groups (P <0.05 or P <0.01).

CONCLUSIONThere are inflamed joints and reduced pulmonary function in rats of adjuvant-induced arthritis. XFC can inhibit paw edema degrees, reduce arthritis response, and improve pulmonary function, which is associated with up-regulating expression of Treg and Foxp3, down-regulating the expression of TGF-β1 and adjusting TGF-β1/Smads signal pathway.

Animals ; Arthritis, Experimental ; drug therapy ; metabolism ; physiopathology ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Forkhead Transcription Factors ; metabolism ; Lung ; drug effects ; pathology ; physiopathology ; Male ; Rats ; Rats, Wistar ; Smad3 Protein ; metabolism ; Smad7 Protein ; metabolism ; T-Lymphocytes, Regulatory ; metabolism ; Transforming Growth Factor beta1 ; metabolism

Jiangsu Provincial People's Hospital takes the reform of DRG payment method as an opportunity,based on the theory of incentive behavior,uses literature research,expert consultation,and key performance indicator methods to develop evaluation indicators,and applies PDCA management tools to establish a continuously improving medical insurance service quality evaluation system.It introduces the process of medical insurance service quality evaluation system construction and its application in medical insurance performance management,and analyzes the implementation effect:DRG operation is improving,disease group structure is optimized,medical quality and efficiency continue to improve,and medical service evaluation scores are improving.

Objective:To establish a multicriteria value assessment index system, so as to provide reference for hospitals access of medical consumables.Methods:In May 2021, based on the paper previously published, the expert consultation method was used to finalize the index structure, index definitions and scoring standards, along with an importance grading of the indexes. And the index weights were calculated using the analytical hierarchy process. Then the assessment scale was designed by way of multi-criteria decision analysis and mini-HTA. With the linear cutting stapler used as an example, six clinicians, three hospital administrators and the medical consumable management committee made an empirical analysis and evaluation of its general value. The coefficient of variation and Kendall coefficient of concordance were used to test the consistency of clinicians′ scores.Results:Three rounds of expert consultations finalized an index structure with 4 level-1 and 11 level-2 indexes, and on such basis a multicriteria value assessment index system for hospital access of medical consumables was established. This system comprised the clinician evaluation scale, hospital administrator evaluation scale and medical consumable management committee evaluation scale. The first two of which were used for preliminary screening, and the third for a full-scale, detailed and quantitative evaluation of those selected, hence a decision was made in the end according to the weighted sum of the three scales. This scale system was used to evaluate a foreign brand and a domestic brand of linear cutting staplers, while the former and the latter scored 90.5 and 75.4 respectively. Statistical analysis of the six clinicians found a coefficient of variation CV<0.25, and the Kendall coefficient of concordance W=0.833, proving good consistency of the evaluation criteria and results. Conclusions:The multicriteria value assessment index system proves highly scientific, comprehensive and practicable, serving a good reference for hospitals to build their value-based mechanism to select medical consumables.