Objective To provide guide for prevention and cure of peritonitis in peritoneal dialysis(PD) by comparing the causative organisms and clinical outcome of PD related peritonitis in younger and elderly patients in our center.Methods All patients who developed PD related peritonitis between January 2006 and December 2013 in Wuhan NO.1 hospital were included.According to their age,episodes were divided into younger patients group (＜ 65 years) and elderly patients group (≥65 years).The microbiology and clinical outcome of PD related peritonitis were compared,and the related risk factors of the treatment failure were analyzed.Results Three hundred and sixty-six episodes of peritonitis occurred in 258 patients during the study period.The overall rate of peritonitis was 1 episode in 76.8 patient-months.Elderly patients had higher incidence of peritonitis (1 episode every 56.4 months vs 1 episode every 88.7 months,P=0.001),higher incidence of fungus infection (9.6％ vs 3.9％,P=0.026) and higher mortality (46.2％ vs 14.0％,P=0.001) than that in younger patients.Cox regression analysis showed that longer duration of PD treatment and fungal peritonitis were both risk factors of the treatment failure.Conclusion Elderly patients had higher incidence of peritonitis,higher incidence of fungus infection and higher PD-related mortality than younger patients.

Objective To investigate health knowledge awareness , attitude and practice of caregivers of CHD ( Congenital Heart Disease ) children treated with aid fund , so as to provide theoratical basis for suitable nursing strategies .Methods 102 caregivers of CHD children treated with aid fund were surveyed by self-designed questionaries . Reasons were analyzed and nursing strategies were discussed .Results Average awareness rate of the caregivers on health knowledge was 13.31%.Average possession rate of health care attitude was 68.23%.Average formation rate of health behavior was 18.4%.Conclusions Among the caregivers , awareness of health care knowledge and average formation rate of health behavior were low , while their health care attitude was high .Systematic health education should be carried out , so as to improve overall health knowledge of caregivers of CHD children and caring ability of the family , to establish healthy life style and to help the CHD children rocover soon and have a better future .

Objective To investigate the status quo of nurses' awareness on respiratory exercise and practice in surgical departments and surgery-related ICU in several hospitals in China.Methods On December 28th, 2015, all of the 93 students in the ICU specialist training course were selected by convenience sampling and surveyed by a self-designed questionnaire. Among the 98, 42 nurses in surgical departments and surgery-related ICU were selected and surveyed about their awareness on respiratory exercise and practice in clinic. Factors influencing the clinical practice were also analyzed.Results 92.8% of nurses in surgical and surgery-related units believed respiratory exercise as useful or very useful. However, only 16.7% evaluated themselves as "taking respiratory exercise very seriously" in their work, while 11.9% evaluated their co-workers as "taking respiratory exercise very seriously" in their work. When evaluating themselves and their peer staff in practice of respiratory exercise, percentage of those who guided their patients with respiratory exercise after surgery regularly were only 19% and 16.7%. Only 7.1% of the nursing staff considered clinical practice of respiratory exercise as well done. Investigation on the nurses' comprehension on approaches of respiratory exercise and application showed what most nurses master and do in practice was non-assisted respiratory exercise. It was put forward by the nurses that the primary reason for insufficient clinical practice of respiratory exercise was lack of professional physiotherapist (92.9%).Conclusions There is a big gap between the nurses' awareness and clinical practice of respiratory exercise. The nurses' awareness and application of respiratory exercise are limited, which leads to an unsatisfactory practice in clinic. Therefore, clinical practice of respiratory exercise to surgical patients can be promoted by training professional physiotherapists, developing necessary training program, setting formal standards, and many other aspects.

Objective To investigate the nursing effects of Sanyrene in the drug extravasation induced by intravenous drip of potassium chloride in adults. Methods A total of 72 patients with drug extravasation caused by intravenous drip pf potassium chloride in Chinese PLA General Hospital from April 2016 to April 2017 were selected as study objects and divided into the control group and the experimental group according to the order of admission, 36 cases respectively. Patients in the control group were treated with magnesium sulfate, while patients in the experimental group were treated with Sanyrene. After the treatment, both groups were given comprehensive nursing intervention. The total clinical therapeutic efficiency, incidence of complications and patients' nursing satisfaction rate were compared between two groups. Results The total clinical therapeutic efficiency and patients' satisfaction rate in the experimental group were significantly higher than those in the control group (P< 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (P<0.05). Conclusions The application of Sanyrene in the treatment of drug extravasation induced by intravenous drip of potassium chloride in adults has significant therapeutic effect. The combination of Sanyrene with comprehensive nursing intervention can help to shorten the clinical symptom remission time, improve nursing satisfaction, and reduce the incidence of complications of patients, which is worthy of clinical promotion.

Objective This study described our experience on perioperative nursing care for hybrid revascularization by endoscopic robotic coronary artery bypass on the beating heart with percutaneous coronary intervention ( PCI) in a staged approach .Methods Patients undergoing hybrid coronary revascularization from January 2007 to September 2013 were included in the study .The progressive patient care was different compared with conventional coronary artery bypass graft surgery ( CABG ) , so the health education and specific nursing were of great importance in different phases .The preoperative angina pectoris attacks therapy and pulmonary function training were necessary , and the hemodynamic monitoring , hemorrhage volume record , lung caring, pain therapy and anticoagulation after robotic assisted CABG were also important .At the same time, the intensive anticoagulation before PCI and renal injury , arterial hemorrhage prevention after PCI needed much attention.Results There was no death patients during the study phase . After the hybrid coronary revascularization, patients were stable and no severe complication was occurred .After 2 days of surgery, patients could take a walk at bedside .The mean time of ICU stay was (37.8 ±5.6) hours.After PCI, no bypass vascular stenosis occurred .Conclusions The comprehensive perioperative nursing care is necessary for patients received hybrid coronary revascularization surgery .

Objective:Guiding hospitals to strengthen the emphasis on clinical medical research, promote hospital discipline construction, to improve the quality of medical services and clinical innovation capacities.Methods:Starting from different user groups, combines the experience of the knowledge base of the library construction institution of Grade-A Tertiary Hospital and the cooperation experience with various functional departments, this paper analyzes the functional structure of the institutional repository according to the problems faced in the actual work to explore the difficulties during the construction process.Results:The construction of the Institutional Repository of hospitals for different users is imminent. In addition to the use of Institutional Repository to improve the utilization of intelligence and information resources, the construction of institutional repository on the evaluation of science and technology influence can also promote the development of hospital disciplines.Conclusions:A solution method is proposed, based on the background of scientific and technological influence evaluation, the future construction direction of the institutional repository.

ObjectiveTo systematically evaluate the safety of Chinese medicines combined with Tripterygium wilfordii polyglycoside tablets/Tripterygium wilfordii tablets （TWPT/TWT） in the treatment of rheumatoid arthritis （RA）， and to explore the network regulatory mechanisms of enhancing efficacy and reducing toxicity of commonly used combination regimes. MethodThe literature involving the adverse reactions of TWPT/TWT in treating RA was searched and collected from three Chinese databases （CNKI， Wanfang Data， VIP） and three English databases （PubMed， Cochrane Library， Embase） from the inception of the databases to July 2021. All studies were assessed by the Cochrane risk of bias tool， and the data were extracted and analyzed by Stata 15.0. Furthermore， Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine 2.0 （TCMIP v2.0，http：//www.tcmip.cn/） was used to construct a "drug target-symptom gene of efficacy and toxicity" interaction network， to explore the underlying network regulatory mechanisms of enhancing efficacy and reducing toxicity of common T. wilfordii preparation combinations. ResultA total of 2 132 articles on Chinese medicines combined with TWPT/TWT in the treatment of RA were retrieved， and 18 of them were finally included. The systematic review showed that the adverse reactions of TWPT/TWT against RA mainly occurred in the digestive system， blood system， and reproductive system， of which digestive system had the highest incidence of damages. However， the combination with Chinese medicines effectively alleviated the adverse reactions caused by TWPT/TWT ［RR （95% CI）=0.45 （0.30， 0.66）， P<0.01］. In addition， the subgroup analysis indicated that the age of RA patients， course of disease， combination regimen， medication dosage and duration of treatment all affected the occurrence of adverse reactions of TWPT/TWT. It was found in clinical studies that total glucosides of paeony （TGP） and TWPT/TWT was most widely combined， and the effect of TGP in reducing TWPT/TWT-induced hepatotoxicity was also more significant than that of other Chinese medicines. Moreover， taking this combination regime as an example， this paper explored the "efficacy-toxicity" association mechanisms of TGP-TWPT/TWT against RA. The "drug target-symptom gene of efficacy and toxicity" interaction network revealed that the core network targets of TGP-TWPT/TWT enhanced efficacy and reduced toxicity mainly through regulating immunity-inflammation-related pathways， metabolic pathways and cell signal transduction. Especially， interleukin-4 （IL-4） and interleukin-13 （IL-13）， which were involved in the "immunity-inflammation" module， were the common targets of TGP-TWPT/TWT to enhance efficacy and reduce toxicity. The endogenous sterols， bile acids and bile salts， insulin secretion and other metabolic pathways in the "body metabolism" module were closely associated with the mechanisms of TWPT/TWT inducing hepatotoxicity and TGP reducing hepatotoxicity. While cell function regulation pathways， such as stem cell factor （SCF）/tyrosine kinase receptor （KIT） signaling pathway and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）signaling pathway were involved in both anti-RA effects and hepatotoxicity of TWPT/TWT. ConclusionClinical application of suitable Chinese medicines combined with TWPT/TWT in the treatment of RA can effectively improve the rheumatism and reduce the adverse reactions of TWPT/TWT， and TGP-TWPT/TWT has the most significant toxicity-reducing effect. Further biological network-based investigation indicates that the toxicity-reducing mechanism of TGP-TWPT/TWT may be related to the regulation of interleukin signaling pathway and bile acid metabolism pathway， and the synergistic efficacy-enhancing effect of the combination may be achieved by acting on interleukin signaling pathway and cell function regulation pathway.