Postoperative patients who underwent digestive tract reconstruction have a high risk of malnutrition and absorbing bar-rier. Enteral nutrition support can effectively maintain and improve the nutritional status of the human body, shorten hospital stay, and reduce complications. Therefore, the enteral approach is the preferred postoperative means of nutrition support. This article retrospec-tively summarizes the appropriate time to start enteral nutrition support therapy after digestive tract reconstruction, the proper selection of the mode of enteral nutrition support, the different enteral nutrition preparations, and the treatment of postoperative complications.

Objective To understand the experiences and suggestions for clinical practice training of emergency nurses in suburb of Shanghai City,and to provide theoretical basis for further improving clinical practice training of nurses in emergency department.Methods Using the phenomenological methods and Colaizzi 7 step analysis method to refine the theme,11 interviews were conducted.Results Respondents believed emergency nurses in clinical practice training was important; Training content should follow the training outline and needed appropriate extension according with the demand of the regional students,and help to improve the students' practical ability to work.The students hoped to gain more knowledge.PBL teaching method and situational simulation assessment mode were used.The teachers' solid professional knowledge,skills,and teaching ability and professional dedication were strong.Conclusions We should listen to the voices of training students,adopt relevant suggestions,and gradually improve the clinical practice training of emergency nurses mode.

Objective To evaluate the effectiveness of TR Band hemostat in trans-radial coronary intervention patients.Methods The randomized controlled trials (RCTs) on the application of TR Band hemostat in trans-radial coronary intervention patients were collected through the databases such as the Cochrane Library,OVID,PubMed,CBM,VIP and Wanfang Data.The quality of studies was critically appraised and data were extracted by two reviewers independently,and Meta-analysis was conducted for the included studies.Results Five RCTs involving 5 028 patients were included.Meta-analysis showed that the application of TR Band hemostat in trans-radial coronary intervention patients could shorten the time of hemostasis by compression,reduce the incidence rate of skin lesions,improve the postoperative patients with comfort,but the efficacy was not significant in puncture site bleeding,hematoma and incidence of radial artery occlusion (RAO).Conclusions The application of TR Band hemostat in trans-radial coronary intervention patients can significantly decrease the incidence of oppression hemostasis time and reduce the incidence rate of skin lesions,improve the postoperative patients with comfort.It is worth being popularized.

Objective To investigate the first decompression time of TR Band hemostasis after transradial percutaneous coronary intervention (TRI), provide evidence to support and guidance for clinical nursing practice. Methods By searching Cochrane Library, OVID, PubMed, Chinese biomedical literature service system(CBM),China National Knowledge Infrastructure(CNKI), VIP database(VIP), Wanfang database, the randomized controlled trials (RCTs),controlled clinical trials (CCT) and historical cohort study(HCT) of TR Band hemostasis after coronary artery intervention were collected and analyzed. Two reviewers used bias risk assessment tool according to Cochrane recommendation Handbook 5.0 to evaluate, Meta-analysis was carried out using RevMan 5.1.5 software. Results A total of 1 881 patients in 2 RCTs and 3 CCTs were included.Compared with the first decompression time 30 min, patients in 1 h group with limb swelling and pain incidence were statistically significant difference [ (OR=2.22, 95%CI 1.25-3.93, P<0.01) vs. (OR=1.63,95%CI 1.02-2.59, P < 0.05)], bleeding at the puncture sites or the operative limbnumbness or ecchymosis there was no significant difference [(OR=0.77,95%CI 0.35-1.71, P>0.05) vs.(OR=2.14, 95%CI 0.75-6.12, P>0.05)vs.(OR=11.73, 95%CI 0.64-215.74, P>0.05)];1h compared with 2 h patients with limbs, pain, hemorrhage rate had significant difference [(OR=0.09, 95%CI-0.13--0.05, P<0.01) vs. (OR=2.07, 95%CI 1.24-3.46, P<0.01)]; a comparison between 90 min and 2h, the limb pain and swelling incidence were statistically significant difference [(OR=2.77, 95%CI 1.82-4.23, P<0.01)vs.(OR=2.73,95%CI 1.41-5.28, P<0.01)], the puncture site bleeding, hematoma, ecchymosis rate and the operative limb numbness extent differences were no statistical significance [(OR=0.97,95%CI 0.61-1.54, P>0.05) vs. (OR=0.95, 95%CI 0.52-1.75, P>0.05)vs. (OR=0.96,95%CI 0.54-1.73, P>0.05)]. Conclusions 30 min decompression after TRI can reduce operative limb swelling and pain incidence rate. There is no obvious influence between puncture site bleeding and operative limb numbness.

Objective To explore the application effect of interactive health education in insulin injections of aged patients with type 2 diabetes in the incipient stage of diagnosis and treatment. Methods 100 cases of aged patients with type 2 diabetes were hospitalized into endocrinology department from January 2014 to December 2014, the pen insulin injections were conducted for them at the beginning. They were equally divided into experimental group and control group through random number method. And, the general education guidance was conducted in control group. Meanwhile, the diabetes health education team was established in observation group on the basis of control group. Then, it was educated through the interactive lectures, interviews, teaching, repeated teaching, psychological intervention and individual assessment. Before and after education, the KAP survey of standard insulin injections were used for the patients in two groups to evaluate their degree of proficiency in the knowledge and skills about insulin injections, and the incidence of glucose metabolism level and low blood sugar. Results After intervention, the insulin injection skill in observation group was better than that of in the control group, (64.6%,31/48 vs. 24.5%, 12/149,χ2=16.441, P<0.01), while the level of glycosylated hemoglobin was reduced from (7.95±0.65)%to (6.58±0.62)%(t=7.85, P<0.01). Conclusions In the incipient stage of diagnosis and treatment, the ability of aged patients with type 2 diabetes in learning new knowledge and technology was improved through interactive health education mode. Besides, the insulin injections were standardized. Also, the glucose metabolism was improved, and the incidence of hypoglycemia was significantly reduced to ensure the patients′safety when the insulin was injected outside hospital, which was worth being clinically applied and promoted.

Objective To discuss the application effect of peer support education in improving theself-management ability of old patients with diabetes. Methods A total of 160 cases of old patients with type 2 diabetes who were treated and hospitalized from June 2014 to August 2015 were selected, then equally divided into observation group and control group through using random number method.Finally, 76 cases were studiedin observation group, while 75 cases in control group. The health education guidance of conventional diabetes had been used in two groups for six months, and the peer support education was also conducted for the patients in observation group on the basis of conventional education. The self-management ability, insulin standard injection knowledge-belief and attitude-behavior/practice (KAP) and glycosylated hemoglobin (HbA1c) value of old patients with diabetes were observed before intervention, 3 months and 6 months later, respectively. Also,the hypoglycemia frequency in two groups was compared during intervention. Results After three months of intervention, the score of diet, exercise management, glucose monitoring, foot care, pharmaceutical administration and smoke for self-management ability in observation group was 4.63 ± 0.92, 4.18 ± 0.97, 2.86 ± 0.96, 2.35 ± 0.59, 4.01 ± 1.43 and 0.62 ± 0.29, respectively, while that of these indicators in control group was 3.69 ± 0.83, 3.52 ± 0.67, 1.75 ± 0.67, 1.63 ± 0.72, 3.05 ± 1.39 and 0.59 ± 0.38. Except smoke (P > 0.05), the differences between two groups were statistically significant (t=2.987-5.965, P < 0.05). After six months of intervention, the score of diet, exercise management, glucose monitoring, foot care, pharmaceutical administration and smoke for self-management ability in observation group was 5.86±0.93, 5.37±0.61, 3.97±0.94, 5.06±0.92, 5.81±0.73 and 0.89 ± 0.31, respectively, while that of these indicators in control group was 3.68 ± 0.96, 3.65 ± 0.95, 1.86 ± 0.88, 2.65±0.88, 3.21±1.13 and 0.81±0.39. The difference was statistically significant (t=9.336-15.633, P<0.01), except smoke (P>0.05). Then, the insulin was normally injected in observation group after six months of intervention, the score of knowledge, attitude and behavior was 5.63 ± 1.87, 43.17 ± 6.03 and 16.57 ± 1.59, while that in control group was 3.76 ± 0.83, 23.71 ± 0.59 and 10.16 ± 0.95. The differences between two groups were statistically significant (t= 8.569, 15.623, 6.751, P<0.01). Also, the level of glycosylated hemoglobin was decreased from (8.17 ± 0.32) % to (7.16 ± 0.41) %, and the difference was statistically significant (t=-3.560, P=0.000). Conclusions Peer support education couldenhance the self-management consciousness of old patients with diabetes, standardize the insulin injection, improve the ability of self-management and improve glucose metabolism index so that it is worthy of being clinically popularized and applied.

Objective: To understand the epidemiological characteristics and differences of HIV-positive cases among 15-24 years old in Jiaxing city and provide evidence for the development of targeted prevention and control measures. Methods: A descriptive epidemiological method was used to analyze the data of HIV cases aged 15-24 reported in Jiaxing from 1999 to 2018. Results: A total of 375 cases of young HIV were reported in 1999-2018, with an average age of 21.29±1.90 years, of which 42 were students. The ratio of male to female was 2.47∶1. The proportion of foreign household registration was higher (76%, 285 cases). The proportion of off-campus youth cases in total cases showed a downward trend(χ2=8.26, P=0.00), but the proportion of student cases showed an upward trend(χ2=15.73, P<0.01). Off-campus youth cases were mainly heterosexual transmission(59.16%, 197 cases), and the students’ cases were mainly homosexual transmission(88.10%, 37 cases). There were significant differences in gender, age, household registration, education level, route of transmission, late detection, CD4 level and source of detection among students and off-campus adolescents(P<0.05). Conclusion The prevalence of AIDS in adolescents and students is worthy of attention. The characteristics of adolescents inside and outside the school are different. Targeted prevention measures should be taken to reduce the harm of AIDS to young people.