Objective To investigate the diagnostic value of a double action MR contrast agent——gadobenate dimeglumine (Gd-BOPTA) for focal liver lesion and biliary system disease.Methods Articles about Gd-BOPTA in CNKI and PubMed for the past few years were searched and the value of Gd-BOPTA in the diagnosis of focal liver lesion and biliary system disease was summarized.Results For focal liver lesion,Gd-BOPTA not only can reveal blood supply of the lesion,but also reveal the hepatocellular functional status in the lesion.For biliary system,biliary excretion of Gd-BOPTA can be used to evaluate the anatomic structure of bile duct,function of gallbladder and biliary system disease.Conclusions Gd-BOPTA has an important value in the diagnosis of focal liver lesion and biliary system disease.Gd-BOPTA may have wider applications in the future.

Objective To explore the experiences of internship in nursing homes among college students of elderly service and management major. Methods Descriptive phenomenological methodology was adopted in this study, a semi-structured interview was conducted with 10 college students of elderly service and management major. Data were analyzed based on Colaizzi' s phenomenological research method. Results Six themes were extracted including: sense of worthlessness;heavy burden of work;respond actively and continuous learning;sense of satisfaction and achievement;the future is mixed;eager to pursue further study. Conclusions College students of elderly service and management major have heavy burden of work and feel worthlessness, they worry about the future, so educators in colleges, managers of nursing homes and national policy-makers should take targeted measures to stable talent team of old-age service.

Objective To investigate the effect of physician guidance on cigarette cessation in current smokers with chronic obstructive pulmonary disease(COPD).Methods Cigarette cessation education and routine telephone follow-up was provided for 70 COPD patients.Pulmonary function and exhaled carbon monoxide level were detected every 3 months.Results After 6 months' follow-up,28 participants(40.00%) successfully quitted cigarette smoking.Seventeen subjects (24.28%) experienced relapse,with mean cessation time(3.08±0.33) months.Once receiving physician guidance,5 re-attempted to quit cigarette smoking,and 12 reduced tobacco consumption. Sixteen subjects(22.86%) did not quit smoking,although the mean cigarette consumption per day was decreased by 60%.Nine participants (12.86%) showed no change in smoking habit. Conclusion Physician guidance could impreve the rate of cigarette cessation in COPD patients.Intensive intervention may be correlated with successful smoking cessation.

Objective:To determine the dose-effect relationship of nalbuphine preventing injection pain of medium plus long chain triglyceride propofol in pediatric patients undergoing gastroenteroscopy.Methods:Pediatric patients, aged 3-8 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective gastroenteroscopy, were enrolled in the study.The doses of nalbuphine were determined by up-down sequential allocation, nalbuphine 0.2 mg/kg was injected intravenously in the first child, and 5 min later medium plus long chain triglyceride propofol 2.5 mg/kg was given intravenously.Ambesh 4-point method was used to evaluate the injection pain of propofol.When the prevention of injection pain was ineffective, the dose of nalbuphine was increased in the next patient, otherwise the dose was reduced, and the difference between the two successive doses was 0.01 mg/kg.This process was repeated until the 7th turning point occurred.The ED 50 and ED 95 of nalbuphine and 95% confidence interval (CI) preventing injection pain of propofol were calculated by Probit regression. Results:The ED 50 and ED 95 (95% CI) of nalbuphine preventing medium plus long chain triglyceride propofol injection pain were 1.57 (1.50-1.62) and 1.71 (1.64-2.05) mg/kg, respectively. Conclusion:The ED 50 and ED 95 of nalbuphine preventing injection pain of medium plus long chain triglyceride propofol are 1.57 and 1.71 mg/kg, respectively, in pediatric patients undergoing gastroenteroscopy.

Objective To explore the correlations between work engagement and transformational leadership among PICC specialized nurses.Method A total of 176 PICC specialized nurses recruited from Shandong Province by convenience sampling method were involved in the study by the Utrecht work engagement scale (UWES-9) and transformational leadership scale.Results The average scores of work engagement and transformational leadership were (39.21±11.56) and (89.68±23.52).Work engagement dedication and absorption were positively correlated to transformational lendership (P＜0.05).Conclusion Hospital administrators should plan a clear direction for the development of the PICC specialized nurses to enhance their work engagement.

Objective To investigate the construction of PICC catheterization nurses in Shandong province. Methods A total of 235 hospitals were investigated from PICC maintenance network in Shandong province with self-designed questionnaire through internet survey. Results 179 hospitals established intravenous (IV) nurse team(76.17%). 86.92%(93/107) of the tertiary hospitals established Ⅳ nurse team, which was higher than 67.19% (86/128) of the secondary hospitals, the difference was statistically significant(χ2=12.50,P<0.01). There were 1335 trained and certificated nurses while 1382 nurses engaging in PICC catheterization, and there were more PICC catheterization nurses in tertiary hospitals than secondary hospitals, the difference was statistically significant(t=7.23,P<0.01). 22.98%(54/235) of the hospitals had more PICC catheterization nurses than trained and certificated nurses, 11.49%(27/235) of the hospitals had more trained and certificated nurses than PICC catheterization nurses. 7.81%(108/1382) of the PICC catheterization nurses worked full-time and 31.91%(441/1382) had a manager position. 51.06% (120/235) of the hospitals had set up clear selection criteria for PICC catheterization nurses, mainly focusing on education background, professional tittle and (or) work experience. Organization in PICC training was diversified, giving priority to nursing association in provinceand nursing association in city. PICC catheterization nurses in only 20.43% (48/235) of the hospitals would accept training annually, 31.49%(74/235) of the hospitals would re-certificate PICC nurses. Conclusion PICC nurse team has been preliminarily established in Shandong province, but nursing staff deployment was unevenness, and primary hospitals should be further reinforced. The position role of PICC nurses should be further clarified. The selection criteria of PICC nurses should be further standardized. And the training space of PICC nurses should be further promoted.

OBJECTIVE:To provide reference for vancomycin-induced neutropenia adverse reactions/adverse events in clinical diagnosis. METHODS:With a case of children with neutropenia treated by long-course and large-dose vancomycin,PubMed and CNKI were retrieved to collect related literature and the literature was analyzed. RESULTS:Neutropenia may be associated with vancomycin,based on causality criterion of adverse reaction in China. CONCLUSIONS:Vancomycin-induced neutropenia in chil-dren is most likely associated with prolonged exposure induced by infusion,vancomycin dosage should be reduced or stopped,and routine blood and plasma concentration should be closely monitored.

Liver cancer is a malignant tumor. The current operation or chemoradiotherapy cannot achieve a satisfactory effect, and relapse and metastasis are always big problems in the treatment of liver cancer. According to the recent theory of liver cancer stem cells, the genesis, development, relapse, metastasis, and prognosis of liver cancer are all related to liver cancer stem cells. If the liver cancer stem cells are treated by targeted therapy, which would reduce the number of or destroy the stem cells, the relapse, metastasis, and drug resistance after tumor resection may be reduced or eliminated. The progress in targeted therapy for liver cancer stem cells is reviewed here. Although there are many types of targeted therapies for liver cancer stem cells, it is still a key problem that the targeting is not strong enough, which needs to be solved urgently. Whether the dual- or multi-targeting would solve this problem still needs to be confirmed by further experimental studies.

Objective To explore the experiences of family caregivers of children with tumor of PICC-line. Methods A semi- structured interview was conducted with 16 family caregivers of children with tumor of PICC- line. Data were analyzed based on Colaizzi′s phenomenological research method. Results Five themes were extracted including lack of knowledge and skills of family care, heavy psychological burden, weakness of social support system, to face calmly and respond actively, sense of achievement brought by gaining nursing experience. Conclusions Understanding the experiences and problems of family caregivers can help nurses provide professional family care education and psychological counseling to alleviate their psychological burden and satisfy their needs.

Objective To explore the effectiveness of using WeChat platform to assist health education for patients with PICC-line. Methods A total of 129 patients with PICC-line were divided into two groups according to the visiting order,64 patients in control group and 65 patients in treatment group. The patients in the two groups received routine education.In addition,the patients in the treatment group received WeChat-based health education for one month. The patients self-management, hope, catheter-related complications and unplanned extubation were compared between the two groups. Results The score of self-management and hope in the treatment group were(144.55±8.27),(38.28±3.18)points,while the score in the control group were (137.08 ± 6.47), (38.34 ± 4.60) points, which had the statistically difference in the score of self-management (t=-5.712, P<0.01). The incidence of catheter-related complications and unplanned extubation in the treatment group were 9.2%(6/65) and 1.5%(1/65), while the incidence in the control group were 29.7%(19/64) and 10.9%(7/64), which had the statistically difference (χ2=8.637, 4.898, P<0.01 or 0.05). Conclusions WeChat-based health education for patients with PICC-line achieves good effectiveness and simple and practicable and is worthy of promotion.