Objective To evaluate the effectiveness of discharge planning and home care for patients with peritoneal dialysis (PD).Methods A total of 60 PD patients were randomly divided into the intervention group and control group,30 cases in each group.Discharge planning and home care were carried out in the intervention group, while routine nursing and telephone follow -up service after discharge were implemented in the control group.The patientsˊscores of Zung Self -Rating Anxiety Scale(SAS),Self -Rating Depression Scale(SDS),Self management ability of patients undergoing peritoneal dialysis,complication rate and readmission rate were compared between the two groups at the next day admission,discharge,lth month and 3th after discharge.Results The scores of SAS and SDS in the intervention group were significantly lower than that in the control group at 3th month after discharge,the difference was statistically significant(tSDS =5.263,tSAS =3.812,P <0.05).The Self management ability of patients undergoing peritoneal dialysis was significantly higher than that of the control group at lth and 3th month after discharge,the difference was statistically significant (t =6.845,t =7.231,P <0.05).No significant difference in the re -admission rate (16.67%,6.67%)was found between the two groups (χ2 =0.387,P >0.05).The complication rate in the intervention group was significantly lower than in the control group at 3th month after discharge(χ2 =5.124,P <0.05).Conclusion Discharge planning and home care can effectively relieve depression and anxiety in patients with peritoneal dialysis and improve the abilities of daily life.It is worth promoting and applying in clinic.

Objective To investigate the regulatory effect of Fuling Xingren Gancao granules(FXG)on macrophage polarization in atherosclerosis(AS)model mice.Methods ApoE-/-mice were used to construct an AS model and RAW264.7 macrophages were used to construct a polarized cell model.The total area of aortic plaques and the degree of aortic stenosis were detected by Oil red O and hematoxylin and eosin staining,respectively.Expression levels of the M1 polarization factors inducible nitric oxide synthase(iNOS)and chemokine ligand 2(CCL2),as well as the M2 macrophage factors Arg-1,YM1,and CD206,and the phosphorylation levels of signal transducer and activator of transcription(STAT3)in vitro and in vivo were detected by polymerase chain reaction and Western blot.Results FXG significantly reduced the total area of aortic plaques in ApoE-/-mice,decreased the expression levels of the M1 macrophage polarization factors iNOS and CCL2,and increased the expression levels of the M2 macrophage polarization factors Arg-1 and YM1(P＜0.05).STAT phosphorylation levels were decreased in the model mice and M1 macrophages,but were upregulated after FXG intervention(P＜0.05).The STAT3 inhibitor Stattic partially eliminated the regulatory effect of FXG on iNOS and Arg-1(P＜0.05).Conclusions FXG has an inhibitory effect on the progression of AS,via targeting STAT3 to regulate macrophage polarization.

Objective:To explore the effects of peer support-based rehabilitation on symptom burden and resilience of lung cancer patients undergoing chemotherapy, so as to provide reference for relieving the symptoms of patients during chemotherapy.Methods:A total of 90 lung cancer patients who undergoing chemotherapy in Nanjing First Hospital, Nanjing Medical University were assigned to the experimental group and the control group according to the enrolled time, with 45 cases in each group. The patients from January to November 2018 in the control group recieved routine chemotherapy care and rehabilitation, the patients from January to November 2019 in the experimental group implemented peer support-based rehabilitation based on the routine chemotherapy care. The symptom burden and resilience on admission and discharged from hospital were assessed by Chinese version of the MD Anderson Symptom Inventory (MDASI-C) and Connor-Davidson Resilience Scale (CD-RISC), respectively.Results:There was no significant difference in the scores of MDASI-C, CD-RISC on admission between the two groups( P>0.05). At discharge, the symptom distress scores and life influence scores in MDASI-C were (6.19 ± 1.72), (5.72 ± 1.45) points in the experimental group, significantly lower than those in the control group (7.23 ± 2.02), (6.75 ± 1.67) points; the tenacity, power, optimism dementions socres and total scores of CD-RISC were (28.12 ± 4.33), (20.88 ± 5.64), (10.69 ± 3.00), (59.69 ± 8.25) points in the experimental group, significantly higher than those in the control group (24.57 ± 4.14), (17.83 ± 4.09), (9.39 ± 2.58), (51.82 ± 5.84) points. The differences were statistically significant ( t values were 2.18-5.13, all P<0.05). Conclusions:Peer support-based rehabilitation can effectively alleviate symptom burden and promote resilience of lung cancer patients undergoing chemotherapy.

Objective:To observe and compare the teaching effects of problem-based learning (PBL) and case-based learning (CBL) combined with problem-originated clinical medicine curriculum (PCMC) on standardized training of nurses in the department of respiratory medicine.Methods:Thirty-one standardized training nurses from the Department of Respiratory Medicine, Nanjing Hospital Affiliated to Nanjing Medical University/Nanjing First Hospital during April 2019 to March 2020 were taken as the control group, and CBL combined with PCMC was used for teaching. Another 31 nurses from April 2020 to March 2021 were taken as the observation group, using PBL combined with PCMC teaching. Both teaching period lasted for 3 months. The examination results, their work ability before and after training and their recognition of teaching methods were compared between the two groups. SPSS 25.0 was used for t test and chi-square test. Results:The scores of academic and practical evaluation were significantly higher in the observation group than the control group[(92.58±5.25) vs. (86.80±6.74); (90.05±6.27) vs. (85.64±7.23)]. After the training, the scores of leadership, clinical nursing, education and consultation, interpersonal relationship, legal and ethical practice, and professional development, critical thinking and scientific research and the total scores of working ability were significantly improved than before the training ( P<0.05), and the scores of the above dimensions of the observation group were significantly higher than those of the control group ( P<0.05). In addition, the observation group's recognition scores of teaching methods to clarify the learning focus, mobilize learning enthusiasm, broaden knowledge, enhance group collaboration, improve nurse-patient communication skills, cultivate critical thinking, and promote teacher-student communication were significantly higher than those of the control group ( P<0.05). Conclusion:The application of PCMC combined with PBL in the standardized training of nurses in the department of respiratory medicine not only helps to improve the assessment results, but also enhances their working ability and is recognized by them.

Objective:To explore the effect of silent therapy combined with character strengths-based intervention on the sleep quality and psychological resilience of lung cancer patients undergoing chemotherapy.Methods:From January 2018 to November 2020, the convenient sampling method was used to select 88 lung cancer patients who received chemotherapy in the Nanjing First Hospital of Nanjing Medical University. According to the odd and even number of wards, patients were divided into control group and study group, each with 44 cases. The control group was given routine nursing, and the patients in the study group were treated with silent therapy combined with character strengths-based intervention on the basis of the control group. The differences in sleep quality and psychological resilience between the two groups of patients were observed before and after the intervention for 4 weeks.Results:Before the intervention, there was no statistically significant difference in the scores of sleep quality factors and psychological resilience between the two groups ( P>0.05) . After the intervention, the study group's scores of sleep latency, sleep disturbance, sleep efficiency, drug application, sleep quality, daily function, and sleep duration were all lower than those of the control group, and the psychological resilience score was higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The silent therapy combined with character strengths-based intervention applied to the nursing of patients undergoing chemotherapy for lung cancer can effectively improve the sleep quality of patients, increase their psychological resilience, which is worthy of clinical application.

OBJECTIVE：To investigate the situ ation and characteristics of ADR reports in the elderly patients （≥65 years old ） of Sichuan province ，and to provide reference for guaranteeing the safety of drug use. METHODS ：ADR reporting data of elderly patients collected by spontaneous reporting system of Sichuan ADR monitoring center from 2013 to 2019 were collected ，and then analyzed in respects of report types ，reproting institution ，relationship，patienst’age，gender，nationality，drug type ，organ/system invovled. RESULTS & CONCLUSIONS ：In the past seven years ，175 431 cases spontaneous ADR were collected by Sichuan ADR monitoring center ，and the annual proportion of “general”ADR reports decreased from 78.93％ in 2013 to 60.50％ year by year ； the annual proportion of “new general ”and“serious”ADRs increased year by year ，among which that of “new general ”ADR increased more obviously. The main reporting institutions were medical institutions ，accounting for 92.79％-98.87％ of the total annual reports. The enthusiasm of enterprises and individuals to report ADR needed to be improved ；8 031 cases（4.58％）were “positive”relationship，21 283 cases（12.13％）were“likely”，146 117 cases（83.29％）were“possible”. Except that the gender of 272 cases were not reported ，there were 88 176 male cases and 86 983 female cases ；most of them were 65-74 years old （104 962 cases，59.83％）. The reports covered 19 nationalities，among which the re were 166 752 cases（98.72％）of Han nationality. The distribution of ADR related drug categories in elderly patients of Yi ， Tibetan and Qiang nationalities was significantly different from that of Han nationality （P＜0.01）. The top three drug categories in the total frequency were anti-infective drugs （31.10％），traditional Chinese medicine com （18.27％），and central nervous system drugs （9.99％）. The injection route was the most likely to cause ADR （72.12％）. ADR mainly involved s kin and its appendants （21.47％）， gastrointestinal system （19.61％）and central and peripheral nervous system （18.55％）. Aminophylline injection was the only dr ug in the top 10 drugs leading to “new general ”ADR for consecutive 7 years. Cefotaxime sodium for injection ，Ceftriaxone sodium for injection ，Cefoperazone sodium and sulbactam sodium for injection were the top 10 drugs causing “severe”ADR in consecutive 7 years，which should be paid more attention in clinic.