Objective Observe the curative effect of Ginkgo Leaves Tablets in combination with Amlodipine Besylate Tablets,Irbesartan Tablets in the treatment of hypertension.Methods Randomly divide 98 old hypertensive patients into the control group and the observation group,the control group shall orally take Amlodipine Besylate Tablets and Irbesartan Tablets; the observation group shall add Ginkgo Leaves Tablets on the basis of the treatment of the control group, observe the antihypertension of these two groups of cases and the improvement of the clinical symptoms.Results The changes in blood pressure,chest distress,dizziness and ECG of the observation group is remarkably different from that of the control group(P<0.01). Conclusion Ginkgo Leaves Tablets in combination with Amlodipine Besylate Tablets,Irbesartan Tablets can effectively lower the blood pressure,improve the clinical symptoms,and is worthy of clinical popularization in the treatment of hypertension.

Core human resource serves as the principal capital of carrier of knowledge and skills of a hospital,which is the most decisive factor of a hospital' s competitiveness and adaptability for its initiative and creativity.Their stability and development plays a key role in hospital development.This study analyzed the characteristics and capacity demand of such human resource,and proposed that their management should differ from the rest,recommending reforms in their job description,development and training,performance appraisal,remuneration design and incentive mechanism.

Objective To explore the influence of group B Streptococcus screening during pregnancy and the incidence of the ear‐ly‐onset GBS disease for newborns .Methods Totally 47 cases of pregnant women with premature rupture of membranes (PROM ) , which were GBS positive and accepted antibiotic treatment ,who were chosen as the experimental group .While 73 cases of pregnant women with premature rupture of membranes (PROM) ,which were not accept GBS screening and antibiotic treatment ,were chosen as control group .The neonatal clinical manifestations were observed .The swab specimens were collected from throat and detected of GBS by using PCR method .Results The experimental group showed no occurrence of neonatal group B streptococcal infection , dyspnea ,cyanosis and fever .Totally 7 cases of the control group had group B Streptococcus infection .Totally 2 cases had dyspnea and 2 cases had cyanosis .Totally 4 cases had fever .The neonatal research indicators of these two groups were statistically signifi‐cant differences (P<0 .05) .Conclusion The group B Streptococcus screening during pregnancy would effectively reduce the inci‐dence of neonatal infection of group B Streptococcus .

Objective To investigate the nurses′experience of participating in job training, in order to provide the basis for further higher qualified training.Methods Twelve psychiatric nurses worked in Minhang and Baoshan mental health center of Shanghai during April to October, 2013 were selected by the purpose sampling method.The in-depth interviews were conducted by semi-structured interviews.The data were analyzed using the phenomenological analysis method.Results The workers training experience could be summarized in 5 themes:realizing the importance of job knowledge training, expanding psychiatric expertize, updating the service concept, strengthening the security cautionary and eager for getting communication skills.Conclusions The job knowledge training can develop nurses′professional qualities, enhance their nursing responsibility and promote their connotation.Nursing managers in mental health center should pay more attention to the training, and try to satisfy the nurses′inner needs and improve their comprehensive qualities, so that they would ensure sustained increase of the nursing safety and quality.

Objective To improve the psychiatric nursing training and the workers′ quality through investigating the level of psychiatric nurses′ job knowledge. Methods Considering of both theoretical and practical needs, we designed the “Questionnaire of Psychiatric Care Workers′ Job Knowledge”. A total of 97 people in two mental health centers of Shanghai who were working as care workers from September 2012 to March 2013 were selected. The questionnaire was surveyed before training and 6 months′after training. The level of psychiatric care knowledge was compared. Results After the training and mentoring, 8 nurses (8. 25%) were excellent;44 nurses (45. 36%) were fine;42 nurses (43. 30%) were passed;3 nurses (3. 09%) were not passed, which were significantly higher than those before the training (H=121. 09,P<0. 01). After training, the score of job responsibility was (18. 03 ± 1. 54);the score of crisis coping method was (16. 21 ± 1. 63);the score of basic medicine was (15. 33 ± 2. 34);the score of safe maintenance knowledge was (17. 57 ± 1. 77);the score of basic nursing knowledge was (13. 01 ± 2. 39) and the mean score was (80. 20 ± 7. 96), which were significantly higher than those before the training ( t = 12. 98, 11. 38, 17. 10, 18. 57, 12. 00, 19. 01, respectively;P<0. 01 ). Conclusions Phased, diverse education and training is helpful with improving psychiatric care workers′ job knowledge, which may contribute to the team building and professional skills′development of psychiatric nurses. It also can improve the patients′satisfaction for the care workers.

Objective:To investigate the perioperative complications and risk factors of postoperative death in patients with acute Stanford type A aortic dissection (ATAAD).Methods:The perioperative data of 228 patients with ATAAD who underwent continuous surgery in the Affiliated Hospital of Jining Medical University from January 2013 to July 2021 were retrospectively analyzed. The complications were analyzed. According to the survival within 30 days after surgery, they were divided into death group (24 cases) and survival group (204 cases). The risk factors of postoperative death were analyzed by univariate and multivariate logistic regression. The receiver operating characteristic (ROC) curve was drawed to evaluate the predictive efficacy of various risk factors on postoperative death of ATAAD patients.Results:The first three complications before operation were hypoxemia (10.1%, 23/228), pericardial tamponade (7.9%, 18/228), renal insufficiency (5.3%, 12/228), the first three complications after surgery were hypoxemia (75.8%, 173/228), renal insufficiency (26.8%, 61/228) and liver insufficiency (26.3%, 60/228). A total of 24 patients died, the fatality rate was 10.5%(24/228). Logistic regression analysis showed that age≥55 years old ( OR=7.733, 95% CI: 1.986-30.111, P=0.003), preoperative pericardial tamponade ( OR=5.641, 95% CI: 1.546-20.577, P=0.009), cardiopulmonary bypass time (CBP)≥200 min ( OR=1.008, 95% CI: 1.002-1.014, P=0.007) and postoperative renal insufficiency ( OR=5.875, 95% CI: 1.927-17.907, P=0.002) were independent risk factors for early death after ATAAD. The area under the ROC curves of joint prediction was 0.905 (95% CI: 0.820-0.950, P<0.01). The sensitivity and specificity of joint prediction were 88.4%, 76.5%, respectively. Conclusions:ATAAD has many perioperative complications and high mortality. Age≥55 years old, preoperative pericardial tamponade, CPB time≥200 min, and postoperative renal insufficiency were independent risk factors for postoperative death in ATAAD patients.

Objective:To understand the current situation of psychological crisis vulnerability among elderly individuals with multimorbidity and analyze the factors that influence it, to provide insights for improving their coping abilities.Methods:A cross-sectional survey design was conducted at Renmin Hospital of Wuhan University from May 1 to November 30, 2022.The attitudes toward aging, sense of meaning of life, and vulnerability to psychological crisis were analysed among outpatients and inpatients.Statistical analysis was performed on the questionnaire results, and the influencing factors of vulnerability to psychological crisis in elderly patients with co-morbidities were analyzed using one-way linear regression and multivariate linear regression.Additionally, the correlation between aging attitudes, sense of meaning of life, and vulnerability to psychological crisis was examined using Pearson correlation analysis.Results:A total of 685 questionnaires were distributed, and 602 valid questionnaires were collected, resulting in a valid recovery rate of 87.9%.The total score for the sense of meaning of life in elderly co-morbid patients was(39.2±8.3), while the total score for aging attitudes was(80.2±13.5).The total score for psychological crisis vulnerability was(69.4±12.8), indicating a medium-high level of vulnerability.The results of multiple linear regression analysis revealed that the factors influencing psychological crisis vulnerability in elderly multimorbidity, in descending order, were residence status, economic situation, marital status, age, type of chronic disease, and hospitalization history in the past six months.Psychological crisis vulnerability in elderly multimorbidity showed a negative correlation with the sense of meaning of life and the attitude of aging( r=-0.315, -0.264, both P<0.01), while the attitude of aging exhibited a positive correlation with the sense of meaning of life( r=0.515, P<0.01). Conclusions:The vulnerability of elderly individuals with multimorbidity to psychological crises is influenced by several factors.Healthcare professionals should prioritize individuals who are elderly, residing in nursing institutions, widowed, financially disadvantaged, experiencing multiple illnesses, and not currently hospitalized.

BACKGROUND:Reducing the rate of abnormal fertilization is an effective approach to improving the efficacy of in vitro fertilization and reducing patients'financial strain.However,the current research on abnormal fertilization has focused on exploring the types of prokaryotic nuclei and their generation mechanisms,as well as analyzing embryos formed by abnormal fertilization,chromosomal ploidy and utilization value.There is a lack of clinical prediction models for abnormal fertilization based on retrospective studies. OBJECTIVE:To construct a nomogram model to predict abnormal female factors in in vitro fertilization. METHODS:A total of 5 075 patients undergoing treatment for conventional in vitro fertilization at Nanxishan Hospital of Guangxi Zhuang Autonomous Region from March 2017 to March 2022 were retrospectively analyzed.The male confounders were calibrated on a 1:1 propensity score with a match tolerance of 0.02,and 1 672 cases were successfully matched.According to the Vienna Consensus,patients with≥60%normal fertilization capacity were included in the normal fertilization group(n=836)and those with<60%normal fertilization capacity were included in the abnormal fertilization group(n=836).The model and validation groups were obtained by random sampling at a ratio of 7:3.Factors related to the occurrence of abnormal fertilization following conventional in vitro fertilization in the model group were screened using univariate analysis and the best matching factors were selected using the Least Absolute Shrinkage and Selection Operator(LASSO)and included in a multifactorial forward stepwise Logistic regression to identify their independent influencing factors and plot a nomogram.Finally,the prediction model was validated for discrimination,accuracy and clinical application efficacy using receiver operating characteristic curves,calibration curves,clinical decision curves and clinical impact curves. RESULTS AND CONCLUSION:The univariate analysis indicated the factors influencing the occurrence of abnormal fertilization were age,controlled ovarian hyperstimulation protocol,number of assisted pregnancies,years of infertility,infertility factors,anti-mullerian hormone,sinus follicle count,basal luteinizing hormone,luteinizing hormone concentration on the human chorionic gonadotropin day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).LASSO regression further identified the best matching factors,including age,microstimulation protocol,number of assisted pregnancies,years of infertility,anti-mullerian hormone,luteinizing hormone level on human chorionic gonadotropin injection day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).Multifactorial forward stepwise Logistic regression results showed that age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day were independent influencing factors for the occurrence of abnormal fertilization following conventional in vitro fertilization.The receiver operating characteristic curves showed an area under the curve of 0.761(0.746,0.777)for the model group and 0.767(0.733,0.801)for the validation group,indicating that the model has good discrimination.The mean absolute error of the calibration curve was 0.044,and the Hosmer-Lemeshow test indicated that there was no significant difference between the predicted probability of abnormal fertilization and the actual probability of abnormal fertilization(P>0.05),indicating the prediction model has good consistency and accuracy.The clinical decision curves and clinical impact curves showed that the model and validation groups had the maximum net clinical benefit at valve probability values of 0.00-0.52 and 0.00-0.48,respectively,and there was a good clinical application efficacy in this valve probability range.To conclude,the nomogram model has good discrimination and accuracy as well as clinical application efficacy for predicting the occurrence of abnormal fertilization in women undergoing conventional in vitro fertilization based on age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day.

Objective:To investigate personal exposures to nitrogen oxides(NOX)and nitrogen di-oxide(NO2)and the influence of baseline personal characteristics,living environment and daily activity patterns of the participants on the exposures among adults over 35 in Tianjin and Shanghai.Methods:In this panel study,91 healthy nonsmoking adults aged over 35 from Tianjin and Shanghai participated in our study.The study was conducted in summer and winter.The participants were followed for three times with an interval of at least two weeks.Only participants in Shanghai were followed once in winter because of the COVID-19 pandemic.Twenty-seven participants completed follow-up visits in both seasons.We measured their 24 h personal exposures to NOX and NO2and collected their baseline and time-activity in-formation through questionnaire/diary.The linear mixed model was used to analyze the associations be-tween potential influencing factors and personal NOX and NO2 exposure levels.Results:There were 349 follow-up visits with valid 24 h personal NO2 and NOX exposure measurements in the two cities.The ave-rage 24 h personal exposures to NO2 and NOX(volume fraction)in Tianjin participants were 18.0 x 10-9 and 26.2 × 10-9 in summer,and 31.0 x 10-9 and 54.9 x 10-9in winter,respectively;and the average 24 h personal exposures to NO2 and NOX in Shanghai participants were 38.7 x 10-9and 100.0x10-9in summer,and 45.5 x10-9 and 139.2 x 10-9 in winter,respectively.The results of univariate regression analysis showed that their personal NOX exposure levels were significantly associated with city,season,gender,average daily cooking times,and ambient NO2 concentrations measured at fixed-site monitoring stations.In addition to the above factors,the personal NOX exposure levels were also significantly associ-ated with educational level and the personal NO2 exposure levels were also significantly associated with passive smoking,average daily home time,cooking energy type,residential distance from main traffic road,and use of kitchen ventilators.Multivariate regression analysis showed that the personal exposure levels of NO2 and NOX were significantly lower in Tianjin than that in Shanghai,were significantly lower in summer than that in winter,and were significantly and positively associated with ambient NO2 concen-trations measured at fixed-site monitoring stations.In addition,personal NOX exposure levels were signifi-cantly lower in females than in males,and personal NO2 exposure levels were significantly positively asso-ciated with average daily cooking times and significantly inversely associated with average daily home time.For every interquartile range(IQR)increase(12.7 × 10-9)in ambient NO2,the personal NO2 exposure levels increased by 27.5％(95％CI:17.0％-38.9％),and personal NOX exposure levels in-creased by 16.1％(95％CI:7.1％-25.8％).Conclusion:Season,city and ambient NO2 concentra-tions are significant influencing factors of personal exposure levels of NO2and NOX At the same time,the personal exposures levels of NO2 are also affected by lifestyle factors.Our study provides scientific evi-dence for making precise air pollution control decisions and reducing the exposure levels of NOX in the population.