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 .

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 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.

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 This article aimed to investigate the treatment adherence of patients with hypertension and examine determinants of adherence.Methods A longitudinal design was adopted to test the treatment adherence and correlated factors of patients with hypertension twice from 2009 to 2012.The influencing factors of treatment adherence in patients with hypertension were analyzed.Results A total of 520 patients finished the first investigation,and 331 patients completed the second investigation.The comparison of demographic characteristics between patients who participated the second investigation or not showed no significant difference except for the education degree (x2=9.38).The incidences of symptoms and complications,systolic blood pressure and diastolic blood pressure of hypertensive patients and the laboratory indexes such as serum creatinine (SCr),total cholesterol (TC),low density lipoprotein (LDL),high density lipoprotein (HDL),fasting blood-glucose and postprandial blood sugar in the second investigation were lower than those of the first investigation,but the difference showed no statistical significance.The scores of treatment adherence,self-efficacy,social support,quality of life were higher in the second investigation than those of the first investigation.The multiple regression analysis found that treatment adherence,social support,education degree and duration of disease course were significant predictors in the first investigation entered the equation,accounting for 26％ of the total variance,among which treatment adherence explained 15％ of the variance,social support 7％,education degree 3％ and duration of disease course 1％.Conclusions The treatment adherence of hypertensive patients improved over one year follow-up.Healthcare providers should pay attention to adherence behavior at initial phase of disease development,and effective strategies targeted patients at risk are suggested to be necessary and should be designed according to the factors affecting adherence.

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.

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 explore the current situation of knowledge,beliefs and behavior of elderly patients with COPD during their community-based rehabilitation.Methods Phenomenological research method of qualitative research was used,14 elderly patients with COPD during their community-based rehabilitation period received in-depth interviews.Results There were three themes and corresponding subthemes sublimated from the patients:self-management knowledge and skills,self-management beliefs and attitudes and self-management behavior.Conclusions It is necessary to pay close attention to spreading disease related health information,especially for patients with low health literacy.During the process of COPD self-management projects,we should focus on negative beliefs and negative attitudes on their selfmanagement behavior choice,which is as important as strengthening the patients' self-efficacy.

Objective To research the applications of resting-state functional MRI in conjunction with voxel-based morphometry on cerebral functions and structures in patients with schizophrenia. Methods Thirty-two patients with schizophrenia and 32 healthy people underwent resting state functional magnetic resonance imaging (Rs-fMRI)and sagittal scanning T1WI with 3D FFE Pulse Sequence. Rest1.8 software was applied to calculate the differences of amplitude of standardized low-frequency fluctuation(ALFF)between the two groups,then the voxel-based morphometry(VBM)data of abnormal brain regions were evaluated to compare the differences of grey matter intensity. Finally,combining with ALEF and VBM,we explored the changes of cerebral functions and structures. Results As compared to the control group ,the ALFF-elevated regions were the right putamen ,the left orbital frontal cortex extending to the left putamen and left dorsal-lateral superior frontal gyrus;the ALFF-decreased regions were the right inferior tempotalgyrus,the left posterior cingulated gyrus and the left angular gyrus(P<0.05). No elevated regions of grey matter intensity were found in the patient group. Conclusions Extensive abnormal active regions of the brain under resting state could be found in patients with schizophrenia ,the grey matter intensity of abnormal regions also decreased generally. They are in accordance with the glutamate-hypothesis of schizophrenia ,which involves extensive impairments of neurons ,disorders of neurotransmitter′s circulations and balances.