BACKGROUND: It has been shown that patients managed with hemodialysis experience decrease of quality of life. But there are a few reports about the relationship between the self-management behavior such as dietary behavior, taking medicine, management behavior of physical sign etc and health-related quality of life (HRQOL) in hemodialysis patients.OBJECTIVE: To study the relationship between self-management behavior and HRQOL in Chinese hemodialysis patients,especially potential association of self-management behavior variables with indicators of HRQOL in order to improve their quality of life (QOL).DESIGN: Sampling investigation based on hemodialysis patients.SETTING: Nursing department and dialysis center in a university hospital. PARTICIPANTS: This research was completed in the Nursing Department of First Hospital Affiliated to China Medical University. Totally 120hemodialysis patients,63 males and 57 females,aged 19 -79 years old with the mean age of(52 ± 12),were selected from the First and Second Hospital Affiliated to China Medical University,the First Affiliated Hospital of Dalian Medical University,the Central and the Second Hospital of Shenyang Medical College,from July to September 2003. Inclusion criteria: Patients above 18years old,dialysis history more than 3 months with twice or three times every week,understanding the questionnaires and being volunteers. Exclusion criteria: Patients with acute disease and mental disorder.METHODS: Self-administered questionnaire was used to measure self-management behavior and short-form 36 health survey(SF-36) was used to measure HRQOL of patients with hemodialysis. Correlation and multivariate regression analysis were used to test the relationship between self-management behavior and HRQOL.MAIN OUTCOME MEASURES: Self-management behavior and HRQOL.RESULTS: Totally 107 questionnaires were available. Multivariate regression analysis indicated that management of physical,psychosocial activity was the significant factor of.physical component summary(regression coefficient = 2.709,R2 =0. 150,P<0.01),and management of physical sign,psychosocial behavior was the significant factor of mental component summary(regressioncoefficient=1.126,R2=0.041,P<0.05).CONCLUSION: Improving hemodialysis patients' management of physical,psychosocial activity and management of physical sign could help hemodialysis patients to raise their HRQOL.

Objective To investigate the relationship between brain natriuretic peptide (BNP)and heart function in elderly patients with acute myocardial infarction.Methods All data were taken from the hospitalized cases with acute myocardial infarction from December 2008 to August 2010.100 patients aged from 60 to 97 were enrolled.The data were divided into 4 groups (group 1,24 cases; group 2,32 cases,group 3,23 cases; group 4,21 cases) respectively according to Killip's classification.Left ventricular function was measured by echocardiography.Plasma BNP was determined with enzyme immunoassay.Results Compared with non heart failure group and normal group,heart failure group had much higher plasma BNP concentrations.The plasma BNP level had positive correlation with left ventricular end diastolic diameter (r =0.27,P ＜ 0.01) and left ventricular end-diastolic dimension (r=0.37,P＜0.01),while,had a negative correlation with left ventricular ejection fraction (r =-0.38,P ＜ 0.01).Conclusions Plasma BNP level was significantly elevated which could evaluate the heart function in elderly patients with acute myocardial infarction.

With the deeply thought of military hospital reform and medical support system,the analysis and suggestions for present situation are put forward.

Objective To discuss the teaching method and effect of teaching-learn-do integration mode in the Basic Nursing Technology.Methods Students of two classes of grade 2010 and two classes of grade 2011 in our nursing college were randomly divided into the experimental group and the control group,they respectively adopted teaching-learn-do integration teaching mode and first-theory-after-practice traditional teaching method.The teaching effect of the two groups by theory and skills testing was compared.Results The experimental groups were better than the control groups in two grades in skill examination results.For the theoretical examination results,the experimental group of grade 2011 was better than the control group,while the two groups of grade 2010 were undifferentiated in theoretical examination.Conclusions Teaching-learn-do integration mode can not only improve students' operating skills,but also promote the theoretical learning,and improve the students' learning ability of independent innovation,suitable for practical and technical-strong course teaching in Basic Nursing Technology.

Objective To understand the practical application of drug intervention in elderly patients with chronic heart failure (CHF) for providing evidences and data for a standard treatment. Methods The elderly CHF patients aged at least 60 years who were hospitalized from July 1973 toJuly 2007 in the Second Hospital of Tianjin Medical University and from January 1983 to December 2002 in Tianjin First Center Hospital were enrolled. The age, gender, etiology, heart function and drug therapy were retrospectively analyzed. The patients were divided into 4 groups: group 1973-,group 1980-, group 1990- and group 2000-2007. And the data were collected and analyzed by SPSS 13.0 software. Results A total of 4704 cases were enrolled, of which there were 2430 (51.7%)male and 2274 (48. 3%) female. Mean age was (71.3±-7. 1) years. The patients aged 80 years andover accounted for 12.8% (603/4704). The first three ranking causes were pulmonary heart disease,coronary heart disease and rheumatoid heart disease in group 1973- and 1980-. And those were coronary heart disease, pulmonary heart disease and rheumatoid heart disease in group 1990 and 2000-2007. The combined uses of angiotension converting enzyme inhibitors(ACEI) and β-receptor blocker,and of ACEI, β-receptor blocker and aldosterone antagonist were also increasing year by year. Patients with coronary heart disease, rheumatoid heart disease, pulmonary heart disease and dilated cardiomyopathy had a higher proportion of multiple drugs cotreatment. The differences in the frequency of all drugs use among four groups of CHF had a statistical significance (p＜0.05). The usage of ACEI combined with β-receptor blocker and aldosterone antagonist, and ACEI combined withβ-receptor blocker, diuretic and digitalis was increasing along with the heart function becoming serious. The patients with a heart function of New York Heart Association (NYHA) Ⅱ or Ⅲ class received more β-receptor blocker. And ACEI was used at most in patients with NYHA Ⅲ class. The angiotension Ⅱ receptor blockers(ARB) was used at most in NYHA Ⅲ or Ⅳ class. Conclusions Nitrate, diuretic and digitalis are the main therapeutic agents in hospitalized patients with CHF in some regions of Tianjin. ACEI, β-receptor blocker and ARB are used in a rapid increment. There are still some problems such as standardizing the heart failure treatment and prevention in the elderly.

Objective To obtain the information of therapies with beta blocker in patients with heart failure in our hospital. Methods 408 hospitalized cases in 2004 and 213 outpatients from April to July in 2005 with chronic heart failure from the cardiology department were collected. Results In hospitalized cases,of 54.9% patients were prescribed beta blocker,and only 4% of them arrived at target dosage and 24.9% of them arrived at half of target dosage. 86.1% of them were given metoprolol. The maximum dosage was (54.25?34.26) mg/d,the mean was equal to the 36.17% of target dosage. Among outpatients,77.5% were taken beta blocker,and only 2.5% of them reached the target dosage and 26.6% of them reached half of target dosage; and 89.7% of them were frequently given the metoprolol,the average dosage was up to 35% of the target dosage. Conclusions There was a great gap between the clinical practice and guideline of beta blocker therapy in patients with chronic heart failure. The prescribed dose of beta blocker was lower than the target dosage.

Objective To explore the relationship among emotional resilience,stress and school adjustment.Methods Adolescent life events check-list,adolescent emotional resilience scale and school adjustment scale of middle school students were conducted among 394 junior high school students.Results (1)The emotional resilience score and emotion recovery score of male junior high school students(46.07±8.56,24.43±5.80) were higher than that of female ones(44.39±8.39,23.27±5.37),and the differences were statistically significant(t=1.97,2.05,P＜0.05).The total score of emotional resilience(45.46±8.50,44.83±8.56) was not statistically related with whether they were the only children(t=0.68,P=0.50).The emotional resilience score and positive emotion score of rural junior high school students(44.04±8.53,20.63±5.35)were lower than that of urban ones (46.46± 8.34,22.15 ±4.72),and the differences were statistically significant(t=-2.86,-2.99,P＜0.01).The total score of emotional resilience (47.23±7.82,44.63±8.45,43.00±8.97) in different grades was statistically significant (F=8.86,P=0.00),and the first grade students were higher than the second and third year students.(2)Psychological stress was negatively related with emotional resilience and school adjustment(r=-0.23～-0.35,P＜0.01),and emotional resilience was positively correlated with school adjustment(r=0.12 ～ 0.29,P＜0.01).The relationship between stress and school adjustment were mediated by positive emotion and emotional recovery (the mediating effect were 11.11％,21.15％).Conclusion Frotional resilience plays a mediating role between psychological stress and school adjustment.

Objective To investigate the telomerase activity and abnormality of p16 gene in liver metastatic tumors of colorectal carcinoma. Methods Telomerase activity was detected by a non isotopic PCR based TRAP assay (Telomeric repeat amplification protocol) and the homozygous deletions of p16 gene was detected by a semiquantitative multiple PCR in tissue samples from 24 liver metastases of colorectal carcinoma. Results Telomerase activity were observed in 19 (79 2%) out of the 24 colorectal carcinoma patients. There was no correlation hetween the telomerase activity, the number of metastasis, differentiation, liver fibrosis and HBsAg status of the patients. Homozygous deletions of p16 gene were found in 9 out of 24 (37 5%) patients, and homozygous deletions of p16 gene was significantly correlated with telomerase activity.Conclusion The abnormality in telomerase activity and homozygous deletions of p16 gene may be important for elucidating in liver metastases of colorectal carcinoma.

Objective To compare drug therapy in patients suffering from chronic heart failure between Tianjin and Kashi region of Xinjiang autonomous region and to analyse their disparities in drug uses by guideline between the two regions.Methods All data were retrospectively taken from the hospitalized chronic heart failure cases from June 2005 to June 2006 in the 2nd Hospital of Tianjin Medical University and the 2nd People's Hospital of Kashi in Xinjiang respectively.The heart functions level NYHA Ⅱ-Ⅳ were recorded for analysis of drug use in the two regions.Results 749 cases were enrolled,491 from Tinajin and 258 from Kashi of Xinjiang.The average age of group Tianjin[(70.39±10.84)yrs]was older than that[(62.91±12.54)yrs]of group Kashi(t=8.488,P＜0.01).The distribution of≥165 cases in the group Tianjin(75.6%)was higher than that of group Kashi(51.2%)(X2=45.642,P＜0.01).The male cases in group Tianjinwere 264(53.8%)andthatwere 134(51.9%)in group Kashi with no significant differences in sex distribution between the two groups(P＞0.05).The first three etiological diseases were coronary heart disease(84.9%),rheumatic heart disease(5.9%)and dilated cardiomyopathy (3.3%)in group Tianjin,and that were coronary heart disease(63.2%),pulmonary heart disease(19.8%)and dilated eardiomyopathy(6.6%)in group Kashi respectively.The proportions of level NYHA Ⅱ,Ⅲ,Ⅳ on admission were 29.7%,39.1%and 31.2%in group Tianjin respectively,and that were 15.5%,39.5%and 45.0%in group Kashi respectively,with significant difference in heart function levels between the two groups(X2=22.770,P＜0.01).Theusages of nitrides and β-blockers in group Tianjin were more than that in group Kashi(both P＜0.01).The usages of diuretics,digitalis was more in group Kashi(all P＜0.01).There was no difference in ACEI usages between the two groups.The dosages of drugs in group Tianjin achieved the target dosages by the guideline and the dosages in group Kashi did not achieve the targets.The use frequency of β-blockers was more in male cases and＜65yrs respectively of group Tianjin.The usage frequency of uretics and aldosterone antagonist were more in＜65yrs cases of group Kashi and the usages of nitrides,ACEI,B-blockers,calcium antagonists,aldosterone antagonist of male cases were more than that of female cases(all P＜0.05)in this group.The usages of uretics,digitalis,aldostemne antagonist increased following the grading of heart function of the two groups(P＜0.05).Moreover the usage of ACEI decreased following the worsen heart function in group Tainjin and this was not the same in group Kashi.Conclusion There are differences in drug medications for chronic heart failure between Tianjin and Kashi.The majority of treatment drugs in Tianjin is approaching the guideline and there is a gap from guideline in Kashi of Xinjiang,especially on the dosage.

Pathology is an important basic course in higher vocational nursing,with a wealth of humanistic education.But in the actual teaching process,the humanistic education is often ignored because of too much basic knowledge teaching.Our teaching and research section used questionnaire to find the gaps between current situation,goal of humanistic education and students' needs.By enhancing teachers' humanistic awareness and discovering the entrance to humanistic education,we targeted to professional ideological education,guided students to pay attention to humanistic education and helped them to cultivate humanistic caring capability,and students all had good evaluation on it.It helped to solve the problem of both teaching and education to students in short time under pressure.