Objective To investigate the effect of mindfulness-based stress reduction on job burnout of nurses.Methods By convenience sampling method,a questionnaire survey was conducted among 90 nurses in a third-grade and level-A general hospital in Zhengzhou.The nurses were randomly divided into the control group and the intervention group with 45 nurses in each group.Nurses in the intervention group were intervened under the mindfulness-based stress reduction,but nurses in the control group received psychological guidance and research method courses.The job burnout level of both groups of nurses was assessed before the treatment and 8 weeks after the treatment respectively.Results After the intervention,the factor scores of emotional exhaust,depersonalization decreased and personal achievement score increased.The incidence rate of job burnout significantly decreased.Conclusions The mindfulnessbased stress reduction therapy can relieve nurses' job burnout.

Objective To explore the effects of health education employing health belief model on health behavior of population with high risk of stroke.Methods 92 people with high risk of stroke were randomly divided into the control group(47 cases) and the intervention group(45 cases).The intervention group received health education employing health belief model while the control group got routine health education.The health behavior of both groups were assessed before the treatment and after six-month treatment.Results The health behavior of the intervention group was significantly better than that of the control group after intervention except the domain of nutrition and spiritual growth.Conclusions Health belief model can improve health behavior of the population with high risk of stroke.

Objective To explore the effect of the combination of video feedback and telephone intervention on postdischarge rehabilitation in patients receiving artificial total hip replacement.Methods A total of 60 patients receiving artificial total hip replacement were divided into intervention group and control group with 30 cases each by random digits table method.The combination of video feedback and telephone intervention was conducted in intervention group,and conventional discharge guidance and telephone follow-up on a regular basis in control group.In intervention group,the patients or their family member were asked to record the video of the exercises and daily living when patients were at home according instructions and researchers assessed the condition of patient's joint and muscle function and provided individual education and instructions to the patients on the basis of the feedback video through telephone.Harris hip function rating scale and Functional Independence Measure (FIM) were investigated at discharge and 1,3,6 months after discharge.Results There were no significant differences in Harris hip function rating scale and FIM score at discharge between 2 groups,P＞0.05.Harris hip function rating scale score were (72.70± 11.65),(83.11±5.12),(94.83±3.08) scores at 1,3,6 months after discharge in intervention group,and (63.20±14.96),(77.00±11.62),(87.50±7.94) scores in control group,there were significant differences,P＜0.05 or ＜0.01.FIM score were (96.30±4.63),(108.76±3.28),(125.79±1.19) scores at 1,3,6 months after discharge in intervention group,and (78.23±5.09),(86.43±6.30),(96.54±5.35) scores in control group,there were significant differences,P＜0.01.Conclusion The combination of video feedback and telephone intervention could help to promote the postdischarge hip function for patients receiving artificial total hip replacement.

Objective To explore the effects of family empowerment model on medication adherence in youth patient with cerebral infarction.Methods By convenience sampling,a questionnaire survey was conducted among 84 patients and families of neurology department in a third-grade and a-level general hospital in Zhengzhou.The patients and families were randomly divided into the control group and the intervention group,each group consisted of 42 patients and families.Patients and families in the control group got routine health education,but patients and families in the intervention group were intervened under family empowerment.The medication adherence of the patients were compared between the two groups before and after health education.Results The medication adherence in both groups were higher after health education than that before health education,the diffidence in the comparison of medication adherence was statistically significant between the two groups after health education.Conclusions The family empowerment model can improve the medication adherence in youth patient with cerebral infarction.

OBJECTIVETo investigate the capability of semi-quantitative and quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict the response to concurrent chemoradiotherapy( CCRT) in patients with non-small cell lung cancer (NSCLC).

METHODSA total of 24 patients with stage III or IIIB NSCLC, who underwent 3.0T DCE-MRI before CCRT, were enrolled in this study. Semi-quantitative and quantitative parameters were calculated by Funtool and Omnikinetics software. The relationship between these obtained parameters and tumor response was evaluated by Spearmen' s correlation analysis. The patients were classified into two groups according to the tumor regression rate after treatment, as response group (group A) and non-response group ( group B). Mann-Whitney U test was used to compare the parameters of responders and non-responders. The value of the parameters on predicting response was calculated by receiver operating characteristic curve (ROC).

RESULTSThe tumor regression rate after treatment was negatively correlated with time to peak (TTP) and the extravascular-extracellular volume fraction (Ve), and was positively correlated with signal enhancement ratio (SERmax) and volume transfer constant (Ktrans) (P < 0.05 for all). Statistical significant differences were found between group A and group B both in semi-quantitative and quantitative parameters (P < 0.05). Group A had a lower TTP value [(34.66 ± 16.37) s vs. (44.09 ± 17.41) s] and Ve value [(0.19 ± 0.03) vs. (0.25 ± 0.05)] than group B, whereas group A had a higher SERmax [(166.50 ± 44.95)% vs. (113.57 ± 46.62)%] and Ktrans [(0.41 ± 0.17) min(-1) vs. (0.28 ± 0.12) min(-1)] than group B (P < 0.05 for all). The ROC analysis indicated that when setting the threshold of Ve on ≤ 0.21 for predicting response, the specificity, sensitivity and accuracy were 85.7%, 80.0% and 83.3%, respectively, with an area under curve of 0.875 (P < 0.001).

CONCLUSIONSBoth the semi-quantitative and quantitative DCE-MRI parameters are helpful for predicting the response after CCRT of NSCLC. Quantitative parameters seem to be more meaningful than semi-quantitative parameters.

Carcinoma, Non-Small-Cell Lung ; pathology ; therapy ; Chemoradiotherapy ; methods ; Contrast Media ; Humans ; Lung Neoplasms ; pathology ; therapy ; Magnetic Resonance Imaging ; methods ; ROC Curve ; Remission Induction ; Sensitivity and Specificity ; Time Factors

To explore the long-term effects of L-T4 treatment on physical and intellectual development in neonatal congenital hypothyroidism(CH) patients during adolescence and adulthood.14 out of 15 patients,aged 15-31 years old,including 9 males and 6 females,were diagnosed by neonatal screening for congenital hypothyroidism.(1) By treatment for 10 years until adolescence,return visit ages were 12.6-18.1 years old,the height of patients were normal in 14 cases,weight normal in 8 cases,and overweight in 6 cases.Only the first patient of neonatal screening for congenital hypothyroidism height 154 cm,weight of 43.5 kg,which were below the standard.Bone age by X-ray showed 9 normal,1 case of rapid development,4 cases with left wrist bone age retardation.IQ combined Raven's test(CRT) showed 3 cases excellent,7 cases normal,3 cases borderline,and 2 cases low.(2)Treatment for more than 20 years to adulthood,9 cases of return visits (8 cases were screened out) by 23-31 years of age,with 5 males and 4 females,height and bone age were all normal,normal weight,only 2 cases BMI slightly overweight.As to IQ,good were in 7 cases,mild retardation in 2 cases.7 patients received above average education;they were all employed except one.The employed patients were all capable for their jobs.In summary,screening out of 8 patients,1 case were of mild mental retardation (12.5％);while 7 patients(87.5％),both in physical and intellectual levels were as those of the normal population.

Objective? To explore the status quo of chief nurse's integrity leadership behavior perceived by nurses and nurses' work restriction and to discuss the correlation between the two. Methods? Nurses from 5 internal medicine departments, 5 surgery departments, the emergency department, the intensive care unit, the obstetrics and gynecology department and the operation room from a ClassⅢ Grade A hospital in Zhengzhou were selected by hierarchical sampling, between October and December 2016, and investigated with the Integrity Leadership Questionnaire and the Work Restriction Questionnaire for Nurses. Pearson correlation analysis was used to analyze the relationship between the two. Totally 300 questionnaires were distributed, and 280 questionnaires were collected, with a recovery rate of 93.3%. Results? The total scores chief nurse's integrity leadership behavior and work restriction in the 280 nurses were (32.26±4.13) and (40.23±10.06), respectively. The 4 dimensions of chief nurse's integrity leadership behavior were negatively correlated with the total score of nurse's work restriction (P＜0.05). Conclusions? Chief nurse's integrity leadership behavior and nurses' work restriction at a medium level. Nurses' working efficacy may be improved by improving chief nurse's integrity leadership behavior.

Objective To search and summarize the best evidence about the management of dysphagia in stroke domestic and abroad. Methods Computer retrieval of American guide network, BMJ best clinical practice, Scottish inter college guide network, Canadian clinical practice guide database, JBI evidence-based health care center of Australia, Ontario Registered Nurses Association of Canada, medical pulse guide network, PubMed, Ovid, EMBASE, web of science, CNKI and Wanfang database, etc, with the retrieval time limit from January 2010 to June 2019. Search for guidelines and systematic reviews related to dysphagia after stroke, evaluate and summarize the best evidence. Results A total of 11 clinical practice guidelines and 39 systematic evaluations were selected. After evidence extraction and summary, 6 categories and 32 best evidences related to dysphagia disorders of stroke were extracted, including screening, evaluation, treatment, complication prevention (oral care and nutrition risk screening), health education and training. Conclusions In order to ensure the quality of medical care and the safety of patients, medical staff should use the evidence related to dysphagia disorders of stroke according to the relevant level of evidence-based medical evidence.

Objective: To analyze the clinical characteristics and prognosis of 34 cases of acute myeloid leukemia (AML) with FLT3 internal tandem duplication (FLT3-ITD) and MLL gene rearrangement. Methods: The clinical data of 34 AML patients with FLT3-ITD and MLL gene rearrangement was compared and analyzed for the therapeutic efficacy, prognostic factors when treated with chemotherapy, chemotherapy combined with targeted therapy or allogenic hematopoietic stem cell transplantation (allo-HSCT). Results: Of the thirty-four cases with median age 41 (4-71) years old, 63.6% presented with white blood cells (WBC) greater than 30×10⁹/L, 39.4% greater than 50 × 10⁹/L respectively on admission. M₅ (35.3%) made up the highest proportion. The cytogenetic abnormality reached 61.8%, of which the complex cytogenetic abnormality accounted for 11.8%. Eleven patients (32.35%) had both FLT3-ITD and MLL gene abnormalities. In addition to FLT3 and MLL abnormalities, 23 patients (67.6%) had one or more other gene abnormalities (multiple gene abnormalities). Of the 34 cases, 29.4% patients went into complete remission (CR) after two courses of chemotherapy. 20.6% (7 patients) went into CR after 3 or more courses of chemotherapy. The rate of early relapse in the CR group was 52.9%. Patients with WBC>50×10⁹/L or multiple gene abnormalities had a lower remission rate (7.7%, 5.4%) after two courses of chemotherapy. CR rate for the patients with more than three gene abnormalities was 0. The total 2-year overall survival (OS) in the 34 patients was 28.8% (95% CI 13.5%-46.0%) and the disease-free survival (DFS) was 27.1% (95% CI 12.5%-44.0%). Of the 18 patients treated with chemotherapy alone or chemotherapy combined with targeted therapy, 17 cases died within 2 years and 1 lost follow-up after giving up treatment. For the 16 patients received allo-HSCT, the 3-year OS was 43.4% (95% CI 13.7%-70.4%) and DFS 42.7% (95% CI 13.4%-69.7%). Conclusion AML patients with FLT3-ITD and MLL gene rearrangement often presented with M₅, accompanied by hyperleukocytosis, cytogenetic or multiple gene abnormalities. Those patients were observed to have low response rate and high early relapse when treated with chemotherapy without allo-HSCT. Patients had multiple gene abnormalities may be an important poor prognostic factor. Allo-HSCT is an effective treatment which could significantly improve the prognosis and survival of AML patients with FLT3-ITD and MLL gene abnormalities.