Objective To discuss the recent effect of professional instruction on patients with type 2 diabetes mellitus. Methods 200 patients with type 2 diabetes mellitus were divided into the observation group and the control group. The observation group received professional instruction while the control group only got doctors'simple advice about the characteristic, results and attentions of diabetes mellitus. Various in dices were determined before and 3 months after intervention and patients compliance was evaluated 3 months after intervention. Results The indices such as blood glucose,glycosylated hemoglobin, urine trace protein, blood lipid, weight index, blood pressue and waistline were different between the two groups(P＜0.05) after intervention although no difference was seen between them before intervention(P＞0.05).The patients compliance in the observation was better compared with the control group(P＜0.01). Conclusion Application of professional instruction proved to be an effective method to alleviate the symptoms of patients with type 2 diabetes mellitus.

Objective　To study the predictability, stability and safety of laser in situ keratomileusis (LASIK) for myopia.Methods　 Five hundred and Sixty-five eyes ( 293 patients ) were treated with the SCMD corneal shaper and laser sight Compak - 200 excimer laser and followed up for more than 6 months. These eyes were divided into 4 groups according to the degrees of myopia: Group Ⅰ:-1.50～-5.75D,120 eyes; Group Ⅱ:-6.00～-9.75D,230 eyes; Group Ⅲ:-10.00～-14.75D,148 eyes and croup Ⅳ:-15.00～-26.00D,67 eyes.Results　Six months post-operatively, mean uncorrected visual acuity of each group was 1.15±0.20, 0.92±0.22, 0.69±0.24 and 0.44±0.22 respectively; The uncorrected visual acuity of 0.5 or better was 100%, 94.6%, 85.8% and 47.7% respectively; And 1.0 or better was 91.7%, 56.7%, 18.0% , 0% respectively. Mean spherical equivalent of each group was -0.14D±0.61D, -0.43D±1.20D, -0.57D±1.47D and -1.79D±2.57D respectively. There were no serious complications. Conclusion　 LASIK is an effective and safe method for reducing myopia. But the potential complications should be noticed.

Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.

Objective To investigate the clinical effect of alprostadil in the treatment of coronary heart disease and its effect on myocardial microcirculation and hemorheology.Methods From January 2015 to October 2017,100 patients with coronary heart disease admitted to the First People's Hospital of Wenling were randomly divided into two groups according to the digital table,with 50 cases in each group.The control group was treated with routine therapy.The observation group was treated with alprostadil on the basis of routine treatment.The clinical efficacy,myocardial microcirculation index and hemorheology index were compared between the two groups.Results The total effective rate of the observation group was 96％ (48/50),which was higher than 82％ (41/50) of the control group,and the difference between the two groups was statistically significant (x2 =5.005,P ＜ 0.05).After treatment,the cardiac troponin Ⅰ and myocardial troponin T in the observation group were (0.023 ±0.014)μg/L,(0.012 ±0.006)μg/L,respectively,which in the control group were (0.037 ± 0.015) μg/L,(0.019 ± 0.008) μg/L,respectively,the differences between the two groups were statistically significant (t =4.825,4.950,all P ＜ 0.05).The erythrocyte hematocrit,plasma viscosity,erythrocyte sedimentation rate,erythrocyte electrophoresis time in the observation group were (25.69 ± 3.87) ％,(293.42 ± 12.73) s,(15.21 ± 4.59) mm/h,(1.29 ± 0.37) mp/s,respectively,which in the control group were (32.54 ± 4.52) ％,(326.17 ± 18.65) s,(21.85 ± 5.93) mm/h,(1.76 ± 0.43) mp/s,respectively,the differences between the two groups were statistically significant (t =8.140,10.256,6.261,10.256,all P ＜ 0.05).Conclusion Alprostadil in the treatment of coronary heart disease can improve the clinical efficacy and improve the patients'myocardial microcirculation and hemorheological indicators.

Focusing on the field of palliative care，the Rodgers evolutionary concept analysis method was used to analyze the literature related to good death in the context of Chinese culture.The development history and application，definition and characteristics，influencing factors and their impacts，measuring indicators and tools of the concept of good death were elaborated，and further discussions were conducted.Good death refers to an individual’s peaceful and painless journey towards death，without subjective pain or concern，and calmness under the premise of sufficient longevity，while receiving care and companionship during the process of death from family，especially children and grandchildren，as well as achieving moral fulfilment and transcendence.The characteristics of good death in the context of Chinese traditional culture include the indirect expression of physical and mental pain being “understood” and properly handled，the construction of dying dignity based on virtue rather than autonomy，the emphasis on filial piety and emotional connections in the family，making after-death arrangements and realizing intergenerational inheritance，as well as the emphasis on achieving the integrity of life at the moment of death，which have distinct Chinese cultural characteristics.In the future，the connotation and extension of the concept of good death should be further explored，so as to assist in the development of localized theory and practice systems of good death.

From the perspective of hospice care,focusing on the entire process before and after the occurrence of a death event,taking the interpretation of the concept of death value in hospice care as the starting point,this paper explored the value connotation implied in the process of death from the perspectives of the terminal person,caregivers,and social culture,as well as summarized the characteristics of the death value.Meanwhile,in the current social context of the difficulty in achieving good death due to the shallow understanding of death,this paper analyzed the great significance of the construction of the death value concept in hospice care for improving the personal death quality of the terminal person,promoting the quality of end-of-life,and accelerating the formation of a social environment of good death,with a view to stimulating academic attention to the construction of the death value of terminal person,and providing conceptual reference for improving the quality of hospice care services.

Objective: To investigate the clinical significance of scheduled diclofenac sodium in gynecological hysteroscopic surgery. Methods: A total of 125 patients undergoing hysteroscopic surgery were divided into observation group(64 cases) and control group(61 cases) according to the operation date.The observation group received diclofenac sodium(50mg) 30min before operation and after operation.The control group was anesthetized with propofol 2mg·kg^-1·h^-1.The pain at 1h and 2h postoperatively, the incidence of adverse reactions within 12h after operation, the time from operation to bed ambulation, anesthetic cost and comfort of patients were compared between the two groups. Results: The pain scores of VAS in the observation group at 1h and 2h postoperatively were (3.23±1.75)points and (1.84±1.36)points, respectively, which were significantly lower than those in the control group[(5.07±1.73)points and (2.75±1.60)points, t=-5.875, -3.435, all P<0.05]. The incidence of nausea and vomiting in the observation group within 12h after operation was less than that in the control group(5 cases vs.27 cases)(χ²=12.175, P<0.05). The time spent on ambulation of the observation group[(11.17±2.18)min]was significantly shorter than that of the control group[(17.84±3.42)min](t=-12.933, P<0.05). The anesthetic cost of the observation group was significantly lower than that of the control group (1.24 CNY vs.71.30 CNY, t=18.130, P<0.05). Conclusion The diclofenac sodium plan anal preoperative analgesic effect in patients undergoing gynecological hysteroscopic surgery is better, so that out of bed activities ahead of time, can reduce the anesthesia costs, gynecological hysteroscopy can be used as the preferred method of anesthesia.

Objective To explore the effectiveness of ADDIE instruction model(Analyse,Design,Develop,Implement,Evaluate)in the on-the-job training for neonatal transfer nurses to improve the comprehensive ability in life-saving as well as to ensure the safety of neonates during the transfer.Methods The pre-and post-control study in self-trained comparison was conducted with 35 neonatal nurses in our hospital.Thirty-five neonatal nurses in our hospital were included in a special training group for neonatal transport.According to the ADDIE instruction model,the training needs of nurses were analysed,special training protocols were designed and developed,training rules were implemented and the effects of training on the nurses were evaluated.Scores in professional theoretical knowledge,practical and various skills and teamwork and communication abilities in neonatal transfer were compared before and after the implementation of the ADDIE instruction model.Results All of the 35 nurses had completed the training and responded to the survey.The scores in professional theoretical knowledge,practical skills and teamwork and communication abilities in the neonatal transfer nurses were all significantly increased after the training with ADDIE instruction model(P＜0.001).Conclusions On-the-job training of ADDIE instruction model among the neonatal transfer nurses can effectively enhance the professional knowledge and practice skills,enable the nurses to play a leading role in the process of treatment and improve abilities in teamwork and communication of the neonatal transfer nurses.The ADDIE instruction model provides valuable insights in the training of neonatal transfer nurses.

Objective:To retrieve, evaluate and summarize the evidence of prevention of venous thromboembolism in gynecological cancer patients during perioperative period, so as to provide scientific basis for clinical practice.Methods:We systematically searched the Chinese and English databases, the guide website, and the professional association website for evidence on the prevention of venous thromboembolism in gynecological cancer patients during perioperative period, including the guideline, evidence summary, recommended practice, systematic review, and expert consensus. The retrieval time limit was from the establishment of the database to February 19, 2022. Two evidence-based trained researchers selected corresponding evaluation tools according to different types of articles to evaluate the quality of the articles, including the extraction, translation and integration of recommendations.Results:A total of 18 articles were included, including 9 guidelines, 1 evidence summary, 2 recommended practices, 5 systematic reviews, and 1 expert consensus. Finally, 20 pieces of evidence were formed from 6 aspects: risk factors, admission assessment, deep venous thrombosis screening, prevention of venous thromboembolism, duration and health education.Conclusions:This study summarizes the best evidence for prevention of venous thromboembolism in gynecological cancer patients during perioperative period, in order to reduce the incidence of venous thromboembolism in patients through early prevention, screening and identification, and provide evidence-based basis for clinical nurses.

OBJECTIVETo understand the coverage of HIV related intervention and antiviral treatment among HIV-positive men who have sex with men (MSM) and to examine factors of initiating antiretroviral treatment.

METHODSA total of 501 HIV-positive MSM were recruited by "snowballing" sampling in Chengdu (160), Chongqing (168) and Guangzhou (173) from January to June, 2013. Participants who were older than18 years, had sex with men, HIV-infected, were living in these 3 cities when survey was conducted were eligible for subjects of this survey. The data were collected by computer assisted survey, including social demography, the coverage of HIV related follow-up intervention and ART, related knowledge level, sexual behaviors in the last 6 months, as well as notification to sexual partners and family. We analyzed the influence factors for initiating ART by Multiple Unconditioned Logistic Regression.

RESULTSAmong 501 HIV-positive MSM, the ratio of CD4 counting and HIV viral load testing were 90.8% (455) and 19.4% (97), respectively. The percentage of the latest CD4 counting not more than 350 per µl was 33.0% (150/455). The coverage of initiated ART among the participants who met the qualification was 56.0% (84/150). The multivariable Logistic regression analysis showed that the possibility of not on ART among participants who were migrants increased to 5.21(2.33-11.66) times of the local residents and the possibility among participants who were diagnosed STD in the last year increased to 2.70(1.12-6.55) times of those who were not infected STD, the possibility of not on ART among participants who had sex with male occasional or commercial partner in the last 6 months increased to 2.16(1.03-4.50) times of those who hadn't, and the possibility among participants who had anal sex with condom use in the past 6 months increased to 2.68(1.10-6.50) times of those who couldn't insist using condom.

CONCLUSIONThere were low coverage of series of HIV/AIDS related intervention services among HIV-positive MSM in Chengdu, Chongqi and Guangzhou. Migrants, had sex with male occasional or commercial partner, had anal sex with condom use in the past 6 months, not infected STD in the last year may be the independent risk factors for HIV-positive MSM to not initiating ART.

Anti-Retroviral Agents ; therapeutic use ; CD4 Lymphocyte Count ; China ; Cities ; Condoms ; Demography ; Emigrants and Immigrants ; Follow-Up Studies ; HIV Infections ; drug therapy ; epidemiology ; Health Knowledge, Attitudes, Practice ; Homosexuality, Male ; Humans ; Logistic Models ; Male ; Risk Factors ; Risk-Taking ; Safe Sex ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires