Objective To systematically review the effect of cluster-based nursing for prevention of deep venous catheter-related bloodstream infection.Methods We searched the domestic literature,using RevMan5.2 software for statistical processing.Results A total of 13 qualified literature was included.Its combined OR=0.33,95％CI=(0.26,0.43),indicating that the cluster-based nursing could significantly reduce deep venous catheter-related bloodstream infection rate.Conclusions Cluster-based nursing is a practical nursing intervention,which should be promoted in clinical practice.

Objective To evaluate the efficacy of entecavir treatment in chronic hepatitis B virus ( HBV ) infected patients with mild hepatic dysfunction and marked pathological injury.Methods One hundred and fifty five chronic hepatitis B ( CHB) patients with HBV DNA>1.0 ×104 U/mL admitted in Lishui People’ s Hospital during January 2008 to October 2011 were enrolled in the study.Patients were divided into three groups: those with serum ALT <2 ×ULN and liver inflammation injury ≥G2 and/or fibrosis stage≥S2 were in observation group ( n=75 ); patients with ALT ( 2-5 ) ×ULN were in control group 1 (n=38);patients with ALT>5 ×ULN were in control group 2 (n=42).All patients were given entecavir (0.5 mg, 1/d, p.o) treatment.ALT normalization rates, HBV DNA negative rates, HBeAg negative conversion rates and seroconversion rates at 12-, 24-,48-, 96-and 144-week were observed and compared among groups.Variance analysis andχ2 test were performed for measurement data and numeration data, respectively.Results ALT normalization rates in observation group were 86.7%, 90.7%, 90.7%, 92.0%and 96.0%at 12-, 24-, 48-, 96-and 144-week, which were higher than those in control group 1 (χ2 =2.04, 2.15, 2.78, 2.69 and 2.47, P <0.01), but no statistically significant difference was observed between observation group and control group 2 (χ2 =2.53,2.42,2.09,2.24 and 2.32,P>0.05) . HBV DNA negative rates in observation group were 70.7%, 78.7%and 82.7%at 12-, 24-and 48-week, which were higher than those in control group 1 (χ2 =4.56, 4.23 and 4.28, P<0.05), but no statistically significant difference was observed between observation group and control group 2 (χ2 =2.75, 2.62 and 2.98, P>0.05).HBeAg negative conversion rates in observation group were 6.6%, 21.3%and 25.3%at 48-, 96-, and 144-week, which were higher than those in control group 1 (χ2 =4.68, 4.78 and 5.01, P<0.05), but no statistically significant difference was observed between observation group and control group 2 (χ2 =2.24, 2.57 and 2.13, P>0.05).HBeAg seroconversion rate in observation group was 4.0%at 24-week, which were higher than that in control group 1 (χ2 =2.87, P <0.05), but the seroconversion rates at 96-and 144-week were lower than those in control group 2 (χ2 =2.92 and 3.14, P<0.05).Conclusion The efficacy of entecavir treatment for HBV infected patients with mild hepatic dysfunction and marked pathological injury is satisfactory.

It was the honor to participate in the exchange program between University of Malta and Soochow University focusing on Dementia care;gerontology and elderly rehabilitation care from September 2016 to January 2017. During those 5 months, as a nursing graduate student, the experience which made me a deeply impression is the point of view ofperson-centred carefrom the medical care I′ve seen in Malta. This essay combined with the exchange experience through clinical observation and practice at hospitals in Malta, is going to highlight the point of view of person-centred care. That can reflect on some shortages of domestic in the medical care environment in China, hoping for a morehumane, moreperson-centred, andperson in heartmedical care environment.

Objective To evaluate the effect of Angio-Seal vascular closure device by the femoral artery hemostasis.Methods Relative literature was searched by computer,according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software.Results A total of four studies of randomized controlled trial were brought into this research,the total sample size was involved in 3 191 cases,the sample size of the intervention group and the control group respectively was 1 583 and 1 608.The analysis results showed,Angio-seal vascular closure device can significantly shorten the time of hemostasis after femoral artery interventional therapy in patients and the limb braking time.The sensitive analysis results showed that the results stability were high and the conclusions were reliable.Conclusions Application of Angio-seal vascular closure device can significantly shorten the interventional therapy in patients with bleeding time and braking time.

Objective To evaluate the effect of early nursing interventions on the dysphagia of strok e patients.Methods The randomized controlled trials (RCT) on early nursing interventions were collected using the database such as Chinese Science and Technology Periodical Database (VIP),China national knowledge internet (CNKI) and Wanfang Database.The results were analyzed with RevMan5.2 Software.Resuits Six studies were included in the study.The dysphagia recovery rate was significandy increased in the intervention group.Conclusions Early nursing interventions can effectively promote the dysphagia function recovery of stroke patients.

Abstract With the increasing prevalence of overweight and obesity in children, the influence of overweight and obesity on pubertal timing has attracted the attention of scholars. This paper reviewed the correlation and mechanism between childhood obesity and pubertal timing, especially for earlier pubertal timing, and found that the regulation of hypothalamic-pituitary-gonadal axis function by nutrition and metabolic signals might under lie those associations. Obesity in girls was positively correlated with early pubertal timing, while the conclusions in boys were inconsistent. Overweight in boys was related to early pubertal timing, obesity in boys could lead to both earlier and later onset of puberty, which warrents further investigation.

OBJECTIVETo compare the efficacies ofentecavir and adefovir in patients with chronic hepatitis B (CHB) and cirrhosis when administered as monotherapies using a 240-week course.

METHODSNinety patients diagnosed with CHB and cirrhosis (compensated or decompensated) were randomly divided into two treatment groups for administration of either entecavir (0.5 mg/day, oral; n =38) or adefovir (10 mg/day, oral; n =52) for 240 weeks. All participants underwent B-ultrasound and were tested for levels of HBV-DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen, creatinine, alpha-fetoprotein (AFP) and various serological markers of the hepatitis B virus at baseline and at treatment weeks 24, 48, 96, 144, 192, and 240. Instances of drug-related complications and adverse reactions were recorded. Patients who did not achieve complete virological response by treatment week 48 or who experienced virological breakthrough at any time during the study course were recorded and started on an appropriate combination therapy regimen. Statistical analyses were carried out using the t-test, chi-square test, and Cox regression modeling.

RESULTSThe dropout rate in the entecavir group was 2.6% and in the adefovir group was 13.5%. At treatment week 240, significantly more patients in the entecavir group had undetectable serum HBV-DNA (91.9% vs. adefovir group: 57.8%; x2=10.362, P=0.001), a negative conversion rate of hepatitis B e antigen (HBeAg) (46.2% vs. adefovir group: 24%; x2=5.055, P=0.025), and rate of HBeAg seroconversion (23.1% vs. adefovir group: 8%, P=0.047).The entecavir group and the adefovir group showed no significant differences upon per-protocol analysis and intention-to-treat analysis, nor in the rates of hepatocellular carcinoma development (entecavir group: 8.1% vs. adefovir group: 6.7%; x2=0.000, P=1.000) or mortality (entecavir group: 8.1% vs. adefovir group: 4.4%; x2=0.051, P=0.821). The possibility of achieving undetectable serum HBV-DNA was 2.761 times higher in the entecavir group than in the adefovir group (95.0% CI: 1.630 to 4.679). The possibility of HBeAg seroconversion was 0.192 times higher for males than for females (95.0% CI: 0.046 to 0.806).

CONCLUSIONCompared to adefovir, entecavir provides high efficiency and rapid viral suppression as a monotherapy for CHB patients when administered in a 240-week course.

Adenine ; analogs & derivatives ; Aged ; Alanine Transaminase ; Antiviral Agents ; Aspartate Aminotransferases ; Biomarkers ; Carcinoma, Hepatocellular ; Female ; Guanine ; analogs & derivatives ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Liver Neoplasms ; Male ; Organophosphonates ; Time Factors ; alpha-Fetoproteins

Objective To explore the effect of using smart products (including smart phones, computers and other electronic products),as well as having hobbies on their cognitive function in pension agency elderly people,and analyze if there is certain protective effect on cognitive function by using smart products and having hobbies.So as to reduce the risk of mild cognitive impairment in the future. Methods By convenience sampling, 160 residents living in the nursing home of suzhou city (mean age 60 or higher) were selected, and demographic data were collected by using a homemade questionnaire, their cognitive function was investigated by using the Montreal Cognitive Assessment Scale. Results Single factor analysis showed that the score of the elderly who often use smart products in every cognitive field and overall cognitive function were superior to those who could not use smart products,the difference was statistically significant(t=-4.47--2.15,all P<0.05).The scores of the elderly with hobbies were higher in the overall cognitive function and the other six areas except the orientation, than those who had no hobby,and the differences were statistically significant(t=-6.80--1.81,all P<0.05).After adjusting for age,gender,body mass index(BMI),cultural level,often using smart products in total cognitive function in the elderly(t=4.842,P<0.01)and executive function(t=4.008,P<0.01),attention(t=3.045,P=0.003), abstract(t=2.135,P=0.034),delayed recall(t=3.759,P<0.01),the directional(t=2.866,P=0.005)of the five areas showed significant correlation. The total cognitive function of the elderly with hobbies (t=3.496, P = 0.001) and the visual spatial execution function (t=3.316, P = 0.001), naming (t=3.241, P =0.001), abstract (t=2.643, P = 0.009), and delayed recall (t=2.073, P= 0.04) were all significantly correlated.Conclusions Often using smart products and having certain hobbies are protective factors of cognitive function,build corresponding intervention plans for the future,by cultivating the elderly hobby, guiding the elderly using intelligent products and other measures to achieve successful aging, slow the cognitive decline,thus reducing the risk of mild cognitive impairment.

With the increasing burden of hypertension in Chinese adults， the detection rate of hypertension among children and adolescents continued to rise， drawing increasing attention to the impact of pubertal timing on blood pressure. In recent years， many scholars have evaluated the association between pubertal development and blood pressure at different stages using various methods of assessing pubertal timing. To understand the correlation between pubertal timing and blood pressure in adolescents， this study reviews the associations between pubertal timing and blood pressure and their underlying mechanisms. The relationship between earlier female pubertal development and the risk of hypertension in adulthood shows positive， negative， and U-shaped correlations， with varying results. Earlier female pubertal development may lead to a higher detection rate of hypertension during adolescence. Most of the studies focus on the correlation between pubertal timing and adult blood pressure， with less research on adolescent blood pressure， indicating a need for further research to reveal underlying patterns.

Objective To investigate the level of glycosylated albumin (GA) in liver cirrhosis patients with different Child-Pugh classes and its application value in predicting liver function. Methods A total of 486 patients with liver cirrhosis who were hospitalized in Tianjin Third Central Hospital from January 1 to December 31, 2019, were enrolled, among whom 227 patients had liver cirrhosis without diabetes and 259 patients had liver cirrhosis with diabetes. The patients were divided into groups according to Child-Turcotte-Pugh (CTP) score, and fasting blood glucose, glycosylated hemoglobin, and percentage of GA (GA%) were measured. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between three groups, and the Dwass-Steel-Critchlow-Fligner test was used for further comparison between two groups. Scatter plots and fitting curves were plotted for CTP score and GA% to evaluate the association between them and calculate the cut-off value. Results For the cirrhosis patients without diabetes, there were significant differences between the patients with different Child-Pugh classes in GA% ( χ 2 =24.809, P < 0.001), fasting blood glucose ( χ 2 =11.899, P =0.003), and glycosylated hemoglobin ( χ 2 =13.607, P =0.001); further pairwise comparison showed that there was a significant difference in GA% between Child-Pugh class A/B liver cirrhosis patients without diabetes and Child-Pugh class C liver cirrhosis patients ( P < 0.05), Child-Pugh class A patients had a significantly higher level of fasting blood glucose than Child-Pugh class B patients ( P < 0.05), and Child-Pugh class A patients had a significantly higher level of glycosylated hemoglobin than Child-Pugh class B/C patients ( P < 0.05). For the patients with liver cirrhosis and diabetes, there were significant differences between the patients with different Child-Pugh classes in GA% ( χ 2 =10.734, P =0.005) and fasting blood glucose ( χ 2 =16.295, P < 0.001); further pairwise comparison showed that Child-Pugh class C liver cirrhosis patients with diabetes had a significantly lower GA% than Child-Pugh class A/B patients ( P < 0.05) and Child-Pugh class A patients had a significantly lower fasting blood glucose level than Child-Pugh class B patients ( P < 0.05). The fitting curve showed that GA% increased with the increase in CTP score in the liver cirrhosis patients without diabetes, reached the highest value at the CTP score of 6.5, and then started to decrease, with the lower value at the CTP score of 11.5, which showed a curvilinear relationship; in the liver cirrhosis patients with diabetes, GA% first increased and then decreased with the increase in CTP score, with a cut-off value of 8. Conclusion GA% first increases and then decreases along with the progression of liver cirrhosis. There is a significant difference in GA between liver cirrhosis patients with different Child-Pugh classes, suggesting that the reduction in GA is closely associated with liver function decompensation in end-stage liver cirrhosis.