Objective To investigate the application of the mini nutritional assessment (MNA)in the malnutrition risk eval-uation of elderly inpatients with cardiovascular disease(CVD).Methods The MNA method was adopted to detect the MNA scores in 316 elderly inpatients with CVD.The inpatient′s nutritional status was evaluated according to the MNA scores.Results Among 316 cases,52 cases(16.46%)were malnutrition,60 cases (18.99%)had the malnutrition risk and 204 cases (64.56%)were in a good nutritional status;the occurrence rate of malnutrition and malnutrition risk in the female elderly patients were higher than those in the male patients,the differences were statistically significant(P <0.01);the occurrence rate of malnutrition and malnutri-tion risk in the elderly inpatients(≥80 years old)were higher than those in the low age patients(60~<80 years old),but the differ-ences had no statistical significance(P >0.05);the occurrence rate of malnutrition and malnutrition risk in the rural patients were higher than those in the patients lived in city,the differences were statistically significant(P <0.05).Conclusion Elderly inpatients with CVD have the higher prevalence of the malnutrition risk,the MNA can be applied in elderly inpatients with CVD for conduc-ting the nutritional status monitoring and early screening the malnutrition risk.

Objective To explore the related infection factors of the internal jugular vein indwelling central venous catheter , and make prevention countermeasures according to the infection factors of central venous catheter infections .Methods A total of 564 patients admitted in liver and gallbladder surgical ward with external jugular vein indwelling central venous catheter were se‐lected ,extract the relevant hospital infection data in patients by the XingLin hospital infection real‐time monitoring system ,and SPSS15 .0 statistical analysis was conducted .Results The infection rate of 564 cases of patients was 4 .07% .The rate of gram‐neg‐ative bacteria infection was 43 .5% ,the gram positive bacteria infection accounted for 34 .8% ,fungi accounted for 21 .7% ,including multiple drug‐resistant bacteria infection accounted for 52 .1% .Catheter indwelling 14 d or more infection rate was 8 .5% ,14 d fol‐lowing infection rate was 2 .1% ,and infected patients for more advanced cancer and patients with severe acute pancreatitis .Pipe joint respectively with heparin cap and needle positive pressure infusion joint connections ,infection rate was statistically different (P<0 .05) .Conclusion The infection of internal jugular vein indwelling central venous catheter should not be ignored ,and the oc‐currence of catheter‐related infection of patients is closely related to state of an illness ,the time of catheter insertion ,and the joint device and so on .

Objective To establish an audit team at the Clinical Trial Institution and explore the feasibility of a new model involving clinical pharmacists in auditing clinical trial projects in hospitals.Methods The audit team consists of 6 clinical pharmacists trained as clinical trial auditors by the National Medical Products Administration Institute of Executive Development and specialized coaching by experts from other hospitals.Results The audit team completed a total of 16 audit reports and identified 189 problems,including 128 general problems,58 important problems and 3 serious problems.The institution,sponsors,investigators and subjects were all involved.Conclusion Based on the actual situation of our hospital,the mode of clinical pharmacists establishing audit teams in medical institutions can effectively improve the quality management level of drug clinical trial projects.

Objective To analyze the influencing factors of pressure ulcers in bedridden patients from the view of caregivers.Methods We used convenience sample method to investigate primary the caregivers of 306 bedridden patients from January 2015 to June 2015.General information questionnaire,self-efficacy scale of caregivers for preventing pressure ulcers and scale of preventing pressure ulcers were used in this investigation.Patients were divided into the group with pressure ulcers (n =57) and the group without pressure ulcers (n =249).General data,self-efficacy and score of preventing pressure ulcers of caregivers in two groups were compared,and losgistic regression analysis was used to analyze the influencing factors of pressure ulcers in bedridden patients.Results The Braden score was (12.07±2.07) points in the group with pressure ulcers,and was (12.94±2.44) points in the group without pressure ulcers (t=2.34,P＜0.05).The scores of self-efficacy and preventing pressure ulcers of caregivers in the group with pressure ulcers were (57.23 ±8.01) points and (3.38±0.40) points,while those in the group without pressure ulcers were (53.53±8.46) points and (3.01± 0.37) points (t =2.87,5.18;P＜ 0.05).Logistic regression analysis showed that the influencing factors of pressure ulcers were the score of caregivers' measures to prevent pressure ulcers,whether caregivers received training about preventing pressure ulcers and the Braden score of patients (P＜ 0.05).Conclusions It is suggested that the nursing staff should be united with community to educate the caregivers for preventing pressure ulcers,and improve caregiver's prevention behavior,so as to reduce the incidence of pressure ulcers.

Objective To explore the behavior intention of home blood pressure monitoring in hypertension patients, analyze the influence factors and provide the emphasis of health education and reference for formulating individual intervention. Methods A total of 156 hypertension patients from February 2016 to August 2016 in the outpatient department of Fuling Center Hospital of Chongqing were surveyed using self-designed behavior intention of home blood pressure monitoring and influence factors questionnaire. One-way ANOVA and multiple stepwise regression analysis were performed to analyze the factors affecting behavior intention of home blood pressure monitoring in hypertension patients. Results The average score of home blood pressure monitoring intention in hypertension outpatients was (3.9±1.1). The scores of attitude, subjective norm and perceived behavior control were (111.7±8.0), (62.5±6.9) and (84.9±23.1). There were significant differences in the behavior intention score of patients with different educational levels (F=5.377,P=0.005). The factors affecting the behavior intention of home blood pressure monitoring in hypertension patients were attitude, subjective norm and perceived behavior control (β=0.682,0.114, 0.070;P<0.01). Influence factors of home blood pressure monitoring intention explained 58.1% of the variance (R2=0.581).Conclusions Patients′behavior intention of home blood pressure monitoring is positive. Perceived behavior control, subjective norm and attitude affect the behavior intention of home blood pressure monitoring in hypertension patients. The nursing intervention should focus on improving patients′execute ability, providing positive evaluation on the behavior of home blood pressure monitoring and increasing patients′knowledge of home blood pressure monitoring.

Objective To investigate fatigue in children with acute lymphoblastic leukemia (ALL) during chemotherapy,and influencing factors.Methods From Feburary 2014 to August 2016, 216 children with ALL,from 5 to 15 years old,treated in a Grade III,Level A children's hospital in Zhengzhou,were surveyed by Peds QLTM multidimensional fatigue scale (Chinese version) and Questionnaire on discomfort in ALL children during chemotherapy.Results During chemotherapy,total scores of fatigue in the ALL children were (31.71±16.66) ,with fatigue of the whole body (11.67±6.29),of sleeping (10.99±5.57),and of cognition (9.10±6.84);during chemotherapy,incidence of fatigue of the whole body was 90.74%,of sleeping 95.83%, and of cognition 81.94%. Main influencing factors of fatigue of the whole body were weight loss,appetite loss and lack of energy,accounting for 72.8% of fatigue variation;that of sleeping were weight loss and irritability, accounting for 51.2% of fatigue variation;and that of cognition were difficulty in concentration and oral ulcer, accounting for 44.2% of fatigue variation.Conclusions During chemotherapy,fatigue in ALL children is common and is below average level. When managing fatigue symptoms in ALL children,nurses should actively treat the symptoms,so as to reduce the level of fatigue.

Objective To explore the predictors of reperfusion arrhythmia (RA) after PCI in patients with acute myocardial infarction (AMI) using Meta-analysis, and to provide evidence for clinical diagnosis and treatment of RA.Methods Firstly, the inclusion and exclusion criteria were restricted and the search strategy was planned. The clinical trials that related to emergency PCI treatment in AMI patients and published before 31st December 2016 were included by two researchers in this study by searching PubMed, CINAHL Database, MEDLINE, Web of Science, Cochrane Libraray, CBM, VIP, CNKI and Wanfang Database. After evaluating the quality of the literature, the Review Manager 5.3 software was used for Meta-analysis.Results A total of 10 studies including 13923 participants were enrolled. The Meta-analysis showed that the risk factors for RA after PCI in AMI patients included: smoking (OR=1.73; 95％CI 1.17-2.56;P<0.01), TIMI0 flow grade (OR=2.74; 95％CI 2.15-3.49;P<0.01), inferior MI (OR=4.52; 95％CI 2.47-8.42;P<0.01), right coronary artery infarction (OR=3.19; 95％CI 1.07-9.58;P=0.04), multi-vasculopathy (OR=3.05; 95％CI 1.83-5.09;P<0.01), renal failure (OR=2.81; 95％CI 1.45-5.43;P< 0.01), time from symptom onset to PCI≤6 h (OR=2.41; 95％CI 1.43-4.07;P<0.01), and duration of operation >1 h (OR=4.03; 95％CI 1.60-10.15;P<0.01). The protective factors included hypertension history (OR=0.76; 95％CI 0.63-0.93;P<0.01) and pre-infarction angina (OR=0.20; 95％CI 0.13-0.30;P<0.01). There were no significant differences in age (OR=1.03; 95％CI 0.95-1.11;P=0.48), history of diabetes (OR=1.26; 95％CI 0.29-5.47;P=0.75), and Killip grade>1 (OR=2.22; 95％CI 0.90-5.48;P=0.08).Conclusions The risk factors for RA after PCI in AMI patients include smoking, TIMI0 flow grade, inferior MI, right coronary artery infarction, multi-vasculopathy, renal failure, time from symptom onset to PCI ≤6 h, and duration of operation >1 h. The hypertension history and pre-infarction angina are protective against RA after PCI in AMI patients.

Objective? To construct a risk assessment scale for patients with acute myocardial infarction (AMI) and reperfusion arrhythmia after percutaneous coronary intervention (PCI) by Delphi expert consultation at home and abroad. Methods? From 1st January 2017 to 31st December 2017, we preliminarily drew up risk factors related to patients with AMI and reperfusion arrhythmia after PCI by retrieving and analyzing the heart surgery related risk assessment scale at home and abroad; and we confirmed the weight of risk factors by two rounds of expert consultation on scientific nature, suitability and operability of risk factors with the method of Delphi method and the expert evaluation method. Results? The recovery rates of questionnaire were 90% and 95% respectively in two rounds of expert consultation, and the authority coefficient was 0.89 and 0.93. The risk assessment scale constructed for patients with AMI and reperfusion arrhythmia after PCI included 3 first-level risk factors, 13 second-level risk factors. Among weight of risk factors by two rounds of expert consultation, the variation coefficients were all less than 0.2, and the coordination coefficient ranged from 0.20 to 0.34. Conclusions? All the experts participating in the investigation are positive with the high consistency of expert opinion, good coordination, professional representativeness and high authority. The constructed risk assessment scale can effectively assess the risk of AMI patients after PCI, reduce the processing time of reperfusion arrhythmia, enhance the ability of nurses to predict the reperfusion arrhythmia of those patients so as to early decrease the incidence of reperfusion risk.

Objective:To investigate the current status of discharged patients at risk of pressure injury and analyze risk factors of pressure injury.Methods:Using the convenient sampling method, 54 medical alliance units of Chongqing Fuling Central Hospital were selected for a cross-sectional survey. Patients at risk of pressure injury when discharged from the hospital and their caregivers were selected as the research objects from August 2019 to June 2020. The general demographic data sheet, clinical test data sheet, Braden Pressure Ulcer Risk Assessment Scale, Barthel index, and Family Caregiver Task Inventory (FCTI) were used for investigation. In this study, a total of 409 questionnaires were issued and 409 were effectively received, with an effective recovery of 100%.Results:There were 224 patients (54.8%) at light risk of pressure injury, 74 patients (18.1%) at moderate risk, 89 patients (21.8%) at high risk and 22 (5.4%) patients at extreme risk. The differences in general demographic data, clinical test data and self-care ability grade of 409 patients were statistically significant ( P<0.05) . The FCTI scores of caregivers for patients with different risk levels were compared, and the difference was statistically significant ( P<0.05) . The results of ordered logistic regression analysis showed that white blood cell count ( OR=1.103, 95% CI: 1.006-1.209, P=0.035) , care ability of caregivers ( OR=1.060, 95% CI: 1.017-1.104, P=0.005) , fecal incontinence ( OR=14.112, 95% CI: 2.505-79.497, P=0.003) , indwelling catheter ( OR=3.111, 95% CI: 1.332-7.269, P=0.009) , severe dependence ( OR=15.705, 95% CI: 2.655-92.918, P=0.002) were risk factors for the risk of pressure injury in discharged patients. Conclusions:Among discharged patients with Braden score less than or equal to 18 points, there are 45.2% (185/409) patients with moderate risk of pressure injury and above. It is necessary to focus on discharged patients with high levels of white blood cells, weak care ability of caregivers, indwelling catheters and self-care ability of heavy dependence grade to prevent pressure injuries.

Background and objectiveEpidermal growth factor receptor (EGFR) and KARS must be detected mu-tation status before patients of lung cancer use targeted drugs. The aim of this study is to elucidate the signiifcance ofEGFR and KARS mutation in ifne needle aspiration (FNA) cytology suspension specimens of non-small cell lung carcinoma.Methods EGFR gene exons 18-21 andKARS codons 12, 13 of exons 2 were performed by Real-time PCR methods in ifne needle aspira-tion cytology suspension specimens of lymph nodes.Results 85 metastasis lymph nodes were detected in ifne needle aspira-tion cytology samples of lung cancer.EGFR mutation rate was 37.3%.KARS mutation rate was 7.2%. 19 formalin ifxed paraffn-embedded tissue specimens were available and match cytology specimens. Analysis ofEGFRmutation status in those samples revealed agreement with the results obtained in cytological samples (kappa=1.0). Clinical follow-up was available for 13 who presented with stage IV disease. Based on the identiifcation of such mutations, these patients received subsequent therapy with a TKI in clinic. We observed two cases complete remission (16.7%) and 8 cases partial remission (66.7%) and three had ongo-ing stable disease.ConclusionFine-needle aspiration cytology samples were detectedEGFR andKARS mutation. The meth-od which collects samples was easier, simple and convenient. This method has higher application value in clinical treatment.