Objective To investigate the influence of antiplatelet drugs in patients with coronary heart dis-ease after intervention incidence of no -reflow.Methods 180 cases of coronary artery interventional treatment of coronary heart disease and patients with no -reflow phenomenon as research subjects were randomly divided into ob-servation group and the control group of 90 cases.Observation group after intervention produce given tirofiban hydro-chloride treatment of no -reflow or slow reflow, and the control group received verapamil therapy .Results The final group was injected with drugs Coronary angiography showed TIMI 3 cases number than the control group , and the difference was statistically significant ( p<0.05);After treatment of coronary angiography for the first time , the last observation group was significantly higher level TMPG3, and the difference was statistically significant (p<0.05). Conclusion Compared with verapamil hydrochloride tirofiban in patients with coronary heart disease , intervention can effectively reduce postoperative incidence of no -reflow, which should be spreaded in clinical practice .

OBJECTIVE To discuss the management method of hospital medical waste in nursing activity,prevent from the pollutant proliferation,and avoid the second exposure.METHODS Reinforced the management of the medical waste,established the management network of medical waste,and made the training of all staffs,we drew up a series of effective measures according to the law and regulation.RESULTS Various plan and measure were done, nursing personnel were fully aware of the importance of the environmental protection.(medical) waste(management) was much better than before.The infection which related to the medical waste was not occurred.(CONCLUSIONS) Doing well management of the medical waste is depending on some conditions,which are as(follows:)(1)the leaders pay more attention to;(2)strengthen the training of all staffs;and(3)the management system is sound.

At present, problems in nursing diagnoses include: omission of important diagnoses, inexact diagnoses, irregular writing of diagnoses, unclear differentiation of what is primary from what is secondary in the ordering of diagnoses, improper classification of relevant factors, neglect of psychological and social problems, confusion of problems involving cooperation and potential problems, and lack of conformity between diagnoses and admission evaluation. Measures for solving these problems include: change of concepts, improvement of the overall quality of the nursing personnel, enhancement of the awareness of quality, and reinforcement of assessment and guidance.

Objective To determine the median effective concentration(EC50) of remifentanil by TCI inhibiting the cardiovascular response to the placement of operating laryngoscope performed under propofol anesthesia administered by TCI.Methods Twenty ASA Ⅰ orⅡ patients,aged 20-51 yr,weighing 52-83 kg,undergoing extirpation of vocal cord polyps under general anesthesia with remifentanil-pmpofol administered by TCI.were enrolled in the study.The target plasma concentration (Cp) of propofol was set at 4μg/ml.Operating laryngoscope was placed at 3 min after tracheal intubation.HR and MAP were continuously monitored.When HR or MAP increased by 15%,the candiovascular response was defined as positive.The EC50 was determined by up-and-down technique.The initial Cp of remifentanil was set at 5 ng/ml and was increased/decreased by 20%in the next patient if the cardiovascular response was positive or negative.Results No chest wall stiffness and intraoperative awareness occurred in all the patients.The EC50 of remifentanil TCI inhibiting the cardiovascular response to the placement of operating laryngoscope was 3.50ng/ml with confidence interval(CI) between 3.47-3.60 ng/ml.Conclusion Thee EC50 of remifentanil TCI inhibiting cardiovascular response to the placement of operating laryngoscope is 3.50ng/ml with CI between 3.47-3.60ng/ml.

Objective To investigate the effect of applying web based problem-based learning in the teaching of bilingual curriculum.Methods 2009 grade nursing undergraduate bilingual class (n =57) was taken as control group and traditional teaching method was used.2010 grade nursing undergraduate bilingual class (n =60) was taken as experimental group and bilingual course of introduction to nursing was used to do web based (Blackboard platform) PBL teaching.Teaching process of the grouping-question posing-data gathering-discussion-mid-term feedback-presentation-summary and evaluation was implemented.Result comparison method,network based PBL learning evaluation sheet and content analysis were employed to complete teaching effect evaluation.Data were analyzed by t test and P ＜ 0.05 signifies statistically significant differences.Results Test scores of experimental group were significantly higher than that in control group (P ＜ 0.05).Mean scores of positive items in web based PBL teaching scale were ≥3.84.Electronic learning file content analysis showed that excellent rates of 7 indicators (student participation,thinking ability,inquiry,etc) were ≥66.7％.Conclusion Web based PBL teaching model is good for improving teaching effectiveness in the teaching of bilingual curriculum.

Objective To evaluate the effect of group cooperative learning on the experimental teaching of obstetrics and gynecology nursing.Methods We chose 113 undergraduate nursing students,using the traditional self-learning mode in the experimental teaching of cleaning and disinfection of the vulva and the group cooperative learning mode in the experimental teaching of vaginal douching.Their practical manipulations of the nursing skills by the two teaching modes were compared.A self-designed questionnaire was adopted to investigate the student's attitude to the group cooperative learning.Results The examination achievement by the group cooperative learning was better than that by the traditional self-learning,(Z=-4.986,P<0.001).89.4%of the students approved of the group cooperative learning.Conclusion The group cooperative learning may improve the effects of experimental training,contribute to the cooperative spirits of students,and also make full use of the human resources in teaching.

Objective To explore the negative emotion and self-management of elderly patients with COPD during their community-based rehabilitation.Methods Phenomenological research method of qualitative research was used,12 elderly patients with COPD during their community-based rehabilitation period received in-depth interviews.Results There were three themes sublimated from the patients negative emotions:aloneness and inferiority feeling,self-abasement and guilty feeling,sense of helplessness.Self-management of negative emotions also had three themes:gratitude mood,complying with the disease and distracting attention.Conclusions It is necessary to pay close attention to the negative emotions of elderly patients with COPD during their community-based rehabilitation; the community healthcare services should bear the responsibility of COPD patients' rehabilitation; we should explore practical intervention plan work on gratitude mood of elderly patients with COPD ; mobilize all social resources to do a good job on social support in elderly patients with COPD.

Objective To investigate the effects on pancreas islet function in patients ubdergoing laparoscopic myomectomy during sevoflurane or propofol anesthesia.Methods Forty pa-tients,40-55 years,ASA Ⅰ or Ⅱ scheduled for elective surgery of laparoscopic myomectomy were randomly divided into two groups (n=20 each group).Propofol 2 mg/kg,sufentanil 0.5 μg/kg and rocuronium 0.9 mg/kg were used for induction,BIS was controlled between 40 and 55 during surgery.The anesthesia was maintained with sevoflurane and MAC was maintained with 0.7-1.3 in group S.The anesthesia was maintained with propofol continuous infusion and the plasma concentra-tion of target was set between 2.0 to 5.0μg/ml in group P.Blood glucose,insulin,c-peptide,gluca-gon and cortisol were measured at 3 time points:before induction of anesthesia (T0 ),start of surgery (T1 ),end of surgery(T2 ).Results Compared with T0 ,blood glucose,insulin,c-peptide,glucagon and cortisol in two groups were increased significantly at T1 and T2 (P <0.05).Compared with T1 , blood glucose,insulin,c-peptide,glucagon and cortisol in two groups were increased significantly at T2 (P <0.05).Compared with group S,blood glucose,glucagon and cortisol were increased indis-tinctively and insulin,c-peptide were increased significantly in group P at T1 and T2 (P < 0.05). Conclusion Compared with sevoflurane,propofol could promote the secretion of insulin and c-pep-tide,and inhibit cortisol and glucagon secretion,thus inhibit the rise of intraoperative blood glucose.

Objective To explore the lived study feeling and experience of nursing upgrade students during blended learning model so as to provide the evidence of reforming teaching model of nursing educators.Methods Phenomenological research of qualitative research was used.Four focus groups,25 upgrade nursing students were interviewed in-depth.Results Six themes were sublimated:relief the contradiction between work and study,promote communication in double interaction,improve self-learning ability,improve selfconfidence as learning controllability,online courses lack a sense of belonging,lack of skills support.Conclusions Blended learning model meets students,needs,provides students with personalized learning and improves comprehensive quality.However,the development of blended learning model in China is in the primary stage,we should combine conditions and reference foreign experience to develop it.