Objective To investigate the evaluation of professional image of practical nurses in hospi -talization patients, and put forward consideration and recommendation of the professional image construction of practical nurses. Methods A total of 580 in - patients from 2 hospitals were surveyed by self- administrated questionnaires, to understand the professional image of practical nurses in them. Results 25.2% of patients thought that the practice nurses' service qualities didn't meet the standards expected. Most patients considered that the training of nursing technique, language communication and occupational etiquette for nurses should be strengthened. Conclusions There is a gap between professional image of practical nurses and the patients' expectations. Practical nurses need to culture the professional level, language communication skills and professional etiquette.

Objective To explore the effect of task-driven teaching methodology based on the action research on cardiopulmonary resuscitation training. Methods The 80 nurses recruited in 2011 were assigned in the control, receiving routine training while another 80 nurses recruited in 2012 were in the study group, where task-driven teaching methodology was used based on the action research. The two groups were compared in terms of results of theoretical and operational examinations. Result The study group was significantly better than the control group in the scores of theoretical and operational examinations ( P < 0 . 05 ) . Conclusion The task-driven teaching methodology based on the action research not only increases the examination results, but also improves the effect of teaching.

Objective To evaluate the effectiveness of moderate aerobic exercise intervention for patients with Alzheimer's disease. Methods Randomized Clinical Trials(RCTs) that assessed the effectiveness of aerobic exercise intervention for patients with Alzheimer's disease were reviewed using multiple electronic databases systematically. Data were analyzed by RevMan 5.2.0 version. Results Eight RCTs were included. Meta-analysis indicated that moderate aerobic exercise could improve the score of MMSE(WMD=1.58,95%CI:0.63~2.53,P<0.01),reduce the score of Alzheimer's disease assessment scale-cognitive subscale(ADAS-Cog)(WMD=-4.06,95%CI:-6.83~-1.28,P<0.01) and the score of Neuropsychiatric Inventory(WMD=-3.97,95%CI:-5.69~-2.25,P<0.01). Conclusion Moderate Aer-obic exercise can improve cognitive function of Alzheimer's patients,and improve their neuropsychiatric symptoms.

Objective To investigate and analyze the patients′needs of nurses′ professional image, in order to promote the harmonious development of nurse-patient relationship. Methods We selected 500 patients by convenient sampling method who were hospitalized in Department of Respiratory Medicine more than 3 days from July 2010 to June 2012, and the patients were surveyed by the demands of nurse′s professional image questionnaire. Results A total of 500 questionnaires were distributed and 494 of them collected with effectively collective rate 98. 8%. Among 494 patients, 70. 45% of them did not accept nurses eating snakes during work;60. 12% of patients preferred to receive treatment from the same nurse; 77. 51% of them believed the communication just required to understand the meaning when nurses provided services;99. 80% of them did not agree with nurse′s heavy makeup during working time; 74. 29% of them accepted nurse wearing not too exaggerated accessories; 80. 57% of them accepted treatment from nursing interns; 93. 39% of them did not have conflicts with nurses;45. 35% of them believed nurse′s words with out any doubts;54. 05% of them asked for smile when nurses provided services. Conclusions The nurse′s professional image should be enhanced, and nurses should pay attention to building up a good professional image, so as to enhance the nurse′s integral professional image and reduce the nurse-patient conflicts and the social pressure of nursing staffs.

Objective To systematically evaluate the clinical effect and safety of repaglinide and metformin for treating diabetes mellitus (MD) of secondary failure of sulfonylurea (SFS).Methods The randomized controlled trials (RCT) at home and abroad on the comparison of effect and safety of repaglinide and metformin in treating MD with SFS were retrieved.The modified Jadad scale was employed to evaluate the literature quality.The RevMan5.3.1 software was used for conducting the meta analysis.Results A total of 10 RCT were included.The meta-analysis results showed that compared with metformin for treating MA with SFS,repaglinide decreased the fasting blood glucose effectively (MD=-2.30,95 ％ CI:-2.53--2.06,P＜0.01),increased the fasting C-peptide (MD=0.06,95％CI:0.02-0.11,P=0.01),reduced the postprandial 2 h blood glucose (MD=-2.17,95 ％CI:-2.44-1.89,P＜0.01) and decreased glycosylated hemoglobin (MD=-2.60,95％CI:-3.21--2.00,P＜0.01) as well as the adverse reactions (RR=0.05,95％CI:0.02-0.09,P＜0.01).However,there was no statistical difference in fasting insulin between the repaglinide and metformin groups (MD=0.18,95％CI:-0.18-0.54,P=0.32).Conclusion Currently evidences suggest that repaglinide is superior to metformin for treating MD with SFS.

Objective: To investigate the status of immunization of National Immunization Program (NIP) and its adverse reaction rate in children with tuberous sclerosis. Method: Questionnaire survey was adopted to identify the vaccination coverage and its adverse events; 72 cases of children with tuberous sclerosis and 78 normal controls (healthy children completing age-appropriate NIP) admitted to Chinese People′s Liberation Army General Hospital from December 2014 to November 2015 were involved into this study. Result: The age-appropriate NIP coverage rate of tuberous sclerosis was 36%(26/72). The coverage rate of bacillus calmette-guerin (BCG), hepatitis B vaccine 1^st to 3^rd doses (HepB1-3), oral poliovaccine 1^st dose (OPV1), diphtheria, pertussis and tetanus 1^st dose (DPT1), DPT1-3, meningococcal polysaccharide vaccine group A (MPVA), measles amd rubella vaccine/measles vaccine 1^st dose (MRV/MCV1), and Japanese encephalitis vaccine 1^st dose (JEV1) were 100%(72 cases), 75%(51 cases), 97%(66 cases), 91%(62 cases), 82%(56 cases), 66%(45 cases), 69%(42 cases), and 61%(37 cases) respectively. The reasons why the children did not complete the vaccination plan were that parents were concerned about vaccination-induced seizures or seizures had not been controlled. Among 72 children with TSC, the rate of adverse events or suspected adverse events after vaccination was 17% (12 cases), which was higher than the normal control children (2 cases, 3%) (χ²=8.799, P<0.05). The main adverse events were seizure events, which accounted for 92%(11 cases). Conclusion The age-appropriate NIP coverage rate among children with tuberous sclerosis is low. The high incidence of adverse events may be associated with a fact that there are some nervous system abnormalities in cases with tuberous sclerosis. TSC children vaccination is relatively safe, with no serious adverse events.

Objective To assess the efficacy and safety of mammalian target of rapamycin (mTOR) inhibitor rapamycin in treatment of children with cardiac rhabdomyoma,associated with tuberous sclerosis complex (TSC).Method The clinical data of children with cardiac rhabdomyomas,who had received a diagnosis of TSC previously,were collected between September 2011 and November 2015 from Pediatric Department of the People's Liberation Army General Hospital.Patients in line with the inclusion criteria received long-term treatment with sirolimus.The starting doses of sirolimus was 1 mg/ (m2 · d),and the plasma concentration was maintained at 5-10 μg/L.The size and number of cardiac rhabdomyomas were analyzed after treatment with rapamycin,and the efficacy and safety were assessed.The Wilcoxon test was used to analyze data.Result All the 51 children met the inclusion and exclusion criteria,including 30 males and 21 females.The median age for rapamycin treatment was 15.0 months (7.0-35.0 months).Tumors disappeared in 26 (51％) children,decreased by more than 50％ (including 50％) in 15 (29％)children,decreased by less than 50％ in 5 (12％) children,and had no change or progressed in 4 (8％)children.The number of tumors decreased by 77 (72％).The median maximum diameter of tumor was 8.7(5.9-11.3) mm before treatment,0.0 (0.0-4.0) mm after treatment,and the median decrease of tumor size were 6.7 (3.9-10.0) mm (Z =-8.817,P ＜ 0.01).The median disappearance time was 3.26 (2.92-5.37) months.Among different age groups,after treatment by rapamycin,the rate of tumor's disappearance was 50％ (12/24) in 0-1 years group.Tumors disappeared in 10 of 16 patients in ＞ 1-3 years group and in 4 of 11 patients in ＞ 3 years group.The rate of tumor's disappearance was the highest after 3 months of treatment as compared with 6 and 12 months of treatment.Ten children had adverse event that was related to rapamycin.Canker sore was reported in one child and dyslipidemia was reported in 9 children.Conclusion Rapamycin is efficacious and well tolerate in treatment of cardiac rhabdomyomas associate with TSC,and lead to a reduction in tumor size and number,in addition,significantly shorten the duration of cardiac rhabdomyoma.

Objective To explore the influencing factors of type 2 diabetes mellitus(T2DM)merging with diabetic peripheral neuropathy(DPN),and to construct and verify a prediction model based on random forest algorithm.Methods 512 T2DM patients who were hospitalized in our hospital from January 2019 to December 2021 were divided into simple T2DM group(n=292)and T2DM combined with DPN group(DPN,n=220)based on whether or not DPN was present.The general data and biochemical indicators of the two groups were compared.Logistic regression analysis was conducted to identify the influencing factors of DPN in T2DM patients.A random forest model was constructed.Results Compared with the T2DM group,the DPN group showed an increase in weight loss rate,incidence of diabetic retinopathy(DR),WBC and HbA1c(P<0.05),with decrease in DM duration≥10 years,TG and HDL-C(P<0.05).Logistic regression analysis showed that age≥60 years,HbA1c,TG,HDL-C,rate of weight loss,DR were influencing factor for T2DM combined with DPN.The random forest model showed that when the number of trees was 387,the error rate was the lowest.The importance ranking of the influencing factors of T2DM combined with DPN were the rate of weight loss,TG,DR,HDL-C,HbA1c and age≥60 years.Conclusions Age≥60 years,HbA1c,TG,HDL-C,rate of weight loss and DR are influencing factors for T2DM combined with DPN,that can be used for early clinical diagnosis and treatment.

Epilepsy is a common disease in central nervous system;most patients with epilepsy after regular anti-epilepsy drug treatment can be controlled,but drug treatment in about 20％-30％ of patients is invalid,known as refractory epilepsy.With the development of imaging techniques,PET/MRI emerge and they combine anatomical and functional imaging,which makes the imaging more clear,enjoying more accurate anatomical structure.Thus,PET/MRIplay important roles in the process of pathogenesis,diagnosis and preoperative assessment of epilepsy.We mainly introduce the concepts of PET/MRIand the comparison with other imaging technology,and describe the application of PET/MRI in preoperative assessment ofrefractory epilepsy.