In nursing teaching,it is necessary to adopt the idea of developmental teaching,innovate the traditional teaching method,make the students be active and learn autonomously and in the meantime make the exploration of developmental evaluation,in order to improve the students' integrative quality and promote their individual development and strengthen their competence of autonomous learning.

Objective To observe the effect of prevention of infection using a modified type of povidone-iodine for bowel preparation after transrectal ultrasound-guided prostate biopsy.Methods Collecting 318 casesdiagnosed of suspected prostate cancer were divided into two groups by random digital table method.The control group underwent routine bowel preparation,with the concentration of 1％ povidone iodine 300 ml in half an hour before the puncture and keeping 5-10 minutes;the experimental group underwent modified povidone iodine bowel preparation,with the concentration of 3％ povidone-iodine 50 ml in 10 minutes before the punctureand keeping 10 minutes.All patients were used sensitive antibiotics in 2 hours after prostate biopsy to prevent infection,then compared the two group's infection rates.Results The incidence of infection in the experimental group was 1.25％ (2/160),which was significantly lower than 7.59％ (12/158) in the control group,the difference was statistically significant (x2=7.604,P ＜ 0.01).Conclusions The modified povidone iodine intestinal preparation can prevent postoperative infection of transrectal ultrasound-guided prostate biopsy effectively and can be used in clinical.

Objective To build learning evaluation system and indicators connotation of problem-based in small-group teaching model.Methods Delphi technique was used to build learning evaluation system of problem-based for course of nursing education through a two-round expert consultation among 30 experts in Zhejiang province.Results The experts' authority coefficient was 0.89,determination coefficient was 0.90,and familiar confficient was 0.88.The finally learning evaluation system of problem-based for course of nursing education consisted of 3 first-level indicators,14t second-level indicators and 41 third-level indicators.The coordination coefficients of first-level indicators and second-level indicators were 0.37 and 0.31,respectively,there was significant difference,P＜0.01.Conclusion This project has a rigorous and reliable construction process with strong theoretical and practical significance,and could be used as a guidance and reference for problem-based in small-group teaching for course of nursing education.

Objective To discuss the importance of balloon occlusion test before interventional treatment of the intracranial giant intemal carotid artery aneurysms and to sum up the nursing experience in assisting the procedure. Methods Proper perioperative nursing measures were carried out for 12 patients, who suffered from intracranial giant internal carotid artery aneurysm and underwent spring coil occlusion treatment. Nursing measures included mental care, observation of the vital signs, prevention of the complications, etc. Results Neither death nor exacerbation of the condition occurred in all the 12 patients. The patients were discharged from the hospital with a mean hospitalization of nine days. During a follow-up period ranged from 4 months to one year, seven patients had no disagreeable feeling, one patient complained of discomfort but no abnormality was found on follow-up DSA, and disappearance of the aneurysm was observed in 4 patients. Conclusion The monitoring of the vital signs, the prevention of the complications and the standard nursing care are the key points for ensuring a successful operation in treating intracranial giant intemal carotid artery aneurysms with spring coil occlusion.

Objective To explore the status and influencing factors of competency among undergraduate nursing interns. Methods A total of 285 undergraduate nursing students from Huzhou University were investigated with competency by a self-designed questionnaire. Results The total score of competency was (157. 61 ± 16. 73) among the involved students. Scores of professional quality, personal effectiveness, clinical nursing ability and professional development ability were (3. 97 ± 0. 47), (3. 76 ± 0. 49), (3. 67 ± 0. 47) and (3. 53 ± 0. 51). Major influencing factors of professional development included the hospital level and practical experience before practice. Major influencing factors of clinical nursing ability, professional quality and personal effectiveness was practical experience. Conclusions Nursing students should try to choose a high-level hospital during the internship. Clinical teachers should carry on individual multi-leveled training according to the characteristics of nursing students, especially focus on the ability of professional learning, plan execution, coordinated strain and so on. They should also establish the index system of competence among undergraduate nursing students to promote the professional development of them.

OBJECTIVETo study the prevention and treatment of HBV reinfection after liver transplantation.

METHODSTotal 19 cases of chronic fulminant hepatitis B, the end-stage of liver cirrhosis and liver carcinoma complicated with HBV cirrhosis. Were performed liver transplantation and given anti-viral drugs pre and post transplantation. Famciclovir was administered in 4 cases, lamivudine in 13 cases and lamivudine+HBIG in 2 cases. The serum HBVM and liver biopsy immunohistochemistry were performed.

RESULTSFour cases given famciclovir developed reinfection. Serum HBsAg, HBeAg and HBV DNA were positive in 3 cases. Liver biopsy immunohistochemistry showed HBsAg and HBeAg phenotype. Classical viral hepatitis in 1 case occurred, three cases died. In the lamivudin group 7 cases showed positive for HBsAg, 2 cases positive for HBV DNA, 4 cases HBsAg or HBcAg phenotype. One case showed positive for serum anti-HBc the other negative for HBVM, and liver biopsy immunohistochemistry was negative too.

CONCLUSIONSThese date suggest that anti-virus prevention and treatment in pre and post liver transplantation with HBV infected correlative disease is necessary, feasible and effective.

2-Aminopurine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; Biopsy ; methods ; DNA, Viral ; analysis ; Drug Combinations ; Female ; Hepatitis B ; prevention & control ; Hepatitis B Surface Antigens ; blood ; Hepatitis B e Antigens ; blood ; Humans ; Immunoglobulins ; therapeutic use ; Lamivudine ; therapeutic use ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Postoperative Care ; methods ; Preoperative Care ; methods ; Recurrence

Objective:To observe the clinical efficacy of sacubitril-valsartan combined with Haikun Shenxi in the treatment of chronic left heart failure with renal insufficiency.Methods:A total of 80 patients with chronic left heart failure and renal insufficiency who were admitted to Dalian Municipal Central Hospital from October 2019 to October 2020 were selected as the research objects. They were divided into two groups by random digits table method, 40 cases in each group. The control group was treated with sacubitril-valsartan. The observation group was based on the control group plus Haikun Shenxi Capsule, and N-terminal pro-brain natriuretic peptide (NT-proBNP), heart function indexes, kidney function indexes, blood gas indexes and quality of life in two groups were compared.Results:NT-proBNP, serum creatinine and blood urea nitrogen in the observation group were significantly lower than those in the control group after treatment: (1 034.27 ± 87.33) μg/L vs. (1 421.46 ± 105.54) μg/L, (240.53 ± 45.26) μmol/L vs. (284.52 ± 52.47) μmol/L, (12.05 ± 1.87) mmol/L vs. (15.79 ± 1.87) mmol/L, the difference was statistically significant ( t = 17.88, 4.01 and 8.62; P<0.01); left ventricular end-diastolic dimension (LVEDD) after treatment in the observation group was significantly lower than that in the control group: (46.12 ± 1.05) mm vs. (48.81 ± 1.74) mm, left ventricular ejection fraction (LVEF) and cardiac index (CI) were significantly higher than those in the control group: (49.95 ± 2.17)% vs. (45.24 ± 3.22)%, (2.98 ± 0.55) L/(min·m 2) vs. (2.45 ± 0.73) L/(min·m 2), the difference was statistically significant ( t = 7.67, 8.38 and 3.66; P<0.01); the blood gas index arterial partial pressure of carbon dioxide (PaCO 2) in the observation group after treatment was significantly lower than that in the control group: (46.34 ± 3.52) mmHg (1 mmHg = 0.133 kPa) vs. (51.63 ± 4.25) mmHg, arterial partial pressure of oxygen (PaO 2), oxygen saturation of haemoglobin (SO 2), pH, HCO 3-, base excess (BE) were significantly higher than the control group: (69.35 ± 5.12) mmHg vs. (62.45 ± 4.86) mmHg, (90.46 ± 4.02)% vs. (85.36 ± 4.32)%, 7.32 ± 0.12 vs. 7.22 ± 0.15, (23.1 ± 2.0) mmol/L vs. (21.5 ± 1.9) mmol/L, (-1.57 ± 0.67) mmol/L vs. (-2.15 ± 0.85) mmol/ L, the differences were statistically significant ( t = 6.06, 6.18, 5.47, 3.33, 3.67 and 3.39; P<0.01); the quality of life scores PD, ED, OD and TS in the observation group after treatment were lower than those in the control group: (17.80 ± 3.11) scores vs. (22.35 ± 2.72) scores, (12.28 ± 2.10) scores vs. (15.74 ± 1.73) scores, (18.27 ± 1.69) scores vs. (25.54 ± 2.33) scores, (46.68 ± 3.15) scores vs. (62.17 ± 3.63) scores, the differences was statistically significant ( t = 6.97, 8.05, 15.30 and 20.38; P<0.01). Conclusions:The sacubitril-valsartan combined with Haikun Shenxi in the treatment of chronic left heart failure with renal insufficiency has a significant clinical effect. It could effectively improve the patient's heart and kidney function and blood gas indicators, and further improve the patient's quality of life.

Objective To investigate clinical nursing teaching competency of teachers and develope selection criteria, professional training of clinical nursing teachers and refinement of teachers, so as to improve the quality of clinical teaching. Methods By using determination of clinical nursing teachers competency scale to investigate three tertiary hospitals of 125 clinical nursing teachers with competency level in Huzhou city, and to analyze scores of cultivation level and its influencing factors. Results The final score of teachers′competency was (3. 69 ± 0. 29) at below average levels, while the highest score was professional quality (3. 81 ± 0. 28), the lowest score was professional competence (3. 59 ± 0. 35), followed by teaching ability to lower scores (3. 62 ± 0. 40). Conclusions Competence of clinical nursing teachers is in the lower-middle level, so the nurse managers should pay attention to the scientific selection of teachers and strengthen the training of professional competence and teaching ability.

Adult ; Aged ; Alcohol Drinking ; China ; ethnology ; Fatty Liver, Alcoholic ; etiology ; Female ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires

Objective:To analyze the levels of T lymphocyte subsets (CD3, CD4, CD8 and CD4/CD8) in patients with paraquat poisoning, and to explore the relationship between the changes of T lymphocyte subsets and the prognosis of pulmonary fibrosis.Methods:In October 2019, a total of 47 patients with oral 20% paraquat low water solvent poisoning in Guangzhou 12th people's Hospital from June 2018 to June 2019 were selected as the research objects. Patients were divided into early death group (16 cases died within 2 weeks) and non early death group (31 cases survived more than 2 weeks) . The non early death group was divided into pulmonary fibrosis group (23 cases) and normal lung group (8 cases) . 20 healthy people in the same period were randomly selected as the control group. The neutrophils (N) , C reaction protein (CRP) , alanine aminotransferase (ALT) , creatinine (Cr) , amylase (aAMY) , creatine kinase isoenzyme (CKMB) , pH, HCO 3-, blood oxygen saturation (SO 2) and lactic acid (Lac) of patients poisoned within 3 d were examined every day. Independent sample t-test was used for inter group comparison, and paired sample t-test was used for intra group comparison. Results:Compared with non early death group, the levels of N, CRP, ALT, Cr, aAMY, CKMB and Lac in early death group increased ( P<0.05) , while pH and HCO 3- decreased ( P<0.05) . Compared with the control group, the levels of CD3, CD4 and CD4/CD8 were decreased on the first day in the early death group and non early death group ( P<0.05) , and the levels of CD3, CD4 and CD4/CD8 were decreased on the 15th day in the pulmonary fibrosis group ( P<0.05) . Compared with the normal lung group, the levels of CD3, CD4 and CD4/CD8 in the pulmonary fibrosis group decreased on the 15th day ( P<0.05) . Conclusion:The persistent low cellular immune function in patients with paraquat poisoning is related to the progress of pulmonary fibrosis, which is an important factor affecting the prognosis of patients with pulmonary fibrosis.