Objective To investigate the clinical values of antineutrophil cytoplasmic antibody (ANCA) detection in the diagnosis of rheumatic diseases .Methods 965 patients with rheumatic diseases were taken as rheumatic group ,including 256 cases of SLE , 124 of mixed connective tissue disease(MCTD) ,336 of rheumatoid arthritis(RA) ,166 of Sjogren′s Syndrome(SS) ,45 of systemic sclerosis(SSc) and 38 of dermatomyositis .400 healthy people were served as the control group .Indirect immunofluorescence (IIF) was employed to detect the cytoplasmic ANCA (c-ANCA ) ,perinuclear ANCA (p-ANCA ) .Enzyme-linked immunosorbent assay (ELISA) was utilized to assay the anti-myeloperoxidase(MPO) antibody among patients with positive ANCA .Results Difference of positive rates of serum ANCA of subjects in rheumatic group and control group showed statistical significance (P<0 .01) ,and the differences of positive rates of serum p-ANCA and c-ANCA of subjects with positive ANCA between the two group were also sta-tistically significant(P<0 .01) .The positive rate of serum p-ANCA of patients with SLE was markedly higher than those with MCTD ,RA ,SS ,SSc ,dermatomyositis and healthy people in control group (P< 0 .05) ,while that of patients with MCTD was obviously higher than those with RA ,SS ,SSc ,dermatomyositis and healthy people in control group (P<0 .05) .The positive rate of anti-MPO antibody of 165 patients with positive ANCA in rheumatic group was 58 .4% ,which was significantly higher than that in control group(3% )(P<0 .01) .The positive rate of patients with positive ANCA and impaired renal function in rheumatic group was 55 .4% ,which was obviously higher than those of patients with negative ANCA in rheumatic group (21 .8% ) and control group (6 .25% )(P<0 .01) .Conclusion Serum ANCA detection is of important significance for prevention of nephrotoxic damage in pa-tients with rheumatic diseases .

Objective To study the difference on knowledge-attitude-practice about rational drug use in tumor patients between urban and rural in Shanxi province, and to provide evidence for further development on health education of rational drug use. Methods A questionnaire investigation was conducted among tumor inpatients in Shanxi Cancer Hospital from May 22 in 2014 to May 30 in 2014. Results A total of 990 tumor patients were involved, including 499 urban patients accounting for 50.4 % and 491 rural patients accounting for 49.6 %. The tumor patients′awareness rates of 'the purchase of antibiotics needs a prescription' in urban and rural areas were the highest, 74.9 % (374/499) and 67.0 % (329/491), respectively, and the awareness rates of 'the meaning of OTC on the medicine package' were the lowest, 22.0 % (110/499) and 18.1 % (89/491), respectively. 96.2%(480/499) urban and 92.7%(455/491) rural tumor patients had developed a correct attitude towards 'irrational drug use will affect health and even life-threatening' which ranked the highest, and the rates of correct attitude towards 'adverse drug reaction is the medical accident' were the lowest, 55.5 %(277/499) and 48.1 % (236/491), respectively. The correct behavior rates of 'read the drug instructions' in urban and rural tumor patients were the highest, 97.8% (488/499) and 95.1 % (467/491), respectively, and the correct behavior rates of 'the expired drug recovery to nearby regular pharmacy' were the lowest, 9.2 %(46/499) and 7.5 % (37/491), respectively. Conclusions The knowledge-attitude-practice about rational drug among urban and rural tumor patients in Shanxi province is not optimistic. It should be provided that individual health education in daily work in order to promote rational drug use, prolong survival time and improve the quality of life for tumor patients.

Objective:To investigate the change of microalbuminuria (MA) in patients with RA and its clinical significance.Methods:From January 2018 to December 2019, data of 75 cases of RA patients were collected from outpatient and inpatient wardsof our hospital, and the data of 75 cases of physical examination wascollected as control. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) anti-cyclic citrullinated peptide (CCP) antibody, blood lipid, Homeostasis model assessment for insulin resistance (HOMA-IR), rheumatoid factor (RF), anti-CCP antibodyand MA levels were measured respectively. RA patients were obtained by ultrasound Carotid intima-media thickness (cIMT) and brachial artery flow mediated diastolic function (FMD) were measured. The statistical analysis was carried out with independent t-test, analysis of variance, Pearson correlation analysis and multiple stepwise regression. Results:The MA level of RA patients was significantly higher than that of the healthy control group [(31±5) mg/L vs (25±4) mg/L, t=5.982, P<0.05]. In RA patients, MA level was positively correlated with course of disease ( r=0.327, P=0.015), HOMA-IR ( r=0.576, P<0.01], CRP ( r=0.212, P=0.027), RF ( r=0.585, P<0.01), disease activity score in 28 joints (DAS28) ( r=0.472, P=0.013), cIMT ( r=0.611, P<0.01) and duration of nonsteroidal anti-inflammatory drugs (NSAIDs) use ( r=0.274, P<0.01), and urineMA level( OR=1.763, P<0.01) were independent correlation factors affecting cIMT. Conclusion:The level of MA in RA patients is significantly higher than that in normal controls, and is correlated with disease activity and subclinical atherosclerosis, which could be another important predictor of disease follow-up and early screening of subclinical atherosclerosis in RA patients.

Objective:To explore the quality of life of patients with advanced lung cancer and its influencing factors.Methods:A total of 220 patients with advanced lung cancer in Shanxi Provincial Cancer Hospital from June 2017 to June 2019 were selected. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core-30 (QLQ-C30) and Quality and Life Questionnaire of Lung Cancer (QLQ-LC13) were used to evaluate the quality of life of patients. Combined with the clinicopathological data of the patients, multiple linear regression method was used to analyze the factors affecting the quality of life of patients with advanced lung cancer.Results:A total of 220 questionnaires were issued, and 184 (83.6%) valid questionnaires were returned. There were 102 cases (55.4%) of male and 82 cases (44.6%) of female. Among the 5 functional areas of QLQ-C30, the score of social function was low [(60.2±11.8) points], and the score of cognitive function was high [(78.5±13.4) points]; among the 3 symptom areas, the score of pain was high [(36.8±10.3) points]; among the 6 single items, the lack of appetite was more serious [(58.5±10.5) points]. Among the 10 symptom areas of QLQ-LC13, shortness of breath and cough were more prominent [(34.6±9.5) points and (33.6±6.8) points]. The quality of life of female patients, patients with older age, patients with fewer children, patients with more organ metastases, patients with other diseases and patients with chemotherapy was poor (all P < 0.05), while there was no correlation between smoking status, occupation and education level and the quality of life of advanced lung cancer patients (all P > 0.05). Conclusions:The quality of life of advanced lung cancer patients is closely related to gender, age, the number of children, the number of metastatic organs, with or without diseases and treatment methods. Targeted intervention measures are helpful to improve the quality of life of patients.

Objective:To understand the status quo of post-traumatic growth and family environment of parents of children with hemodialysis and analyze the relationship between them.Methods:From April 2017 to May 2019, parents of 200 children with hemodialysis in Children's Hospital Affiliated to Zhengzhou University were selected as research objects by convenience sampling. The general information questionnaire, Post-traumatic Growth Inventory (PTGI) , Family Environment Scale-Chinese Version (FES-CV) was used for the survey. Pearson correlation analysis and stratified regression analysis were used to explore the relationship between parents' post-traumatic growth and family environment. A total of 200 questionnaires were issued and 183 valid questionnaires were returned, with an effective response rate of 91.5%.Results:The total score of PTGI of 183 parents of children with hemodialysis was (61.95±15.54) , and that of FES-CV was (49.27±7.38) . The total score of PTGI of parents of children with hemodialysis were positively correlated with family environment intimacy, emotional expression, independence, success, culture, entertainment, morality and religion and organizational subscale scores ( P<0.05) , and negatively correlated with scores of environmental contradictions and control subscales ( P<0.05) . The results of stratified regression analysis show that after controlling general data, intimacy and emotional expression in the family environment were the main influencing factors for the post-traumatic growth of the parents of hemodialysis children. Conclusions:The post-traumatic growth of parents of children with hemodialysis is closely related to the family environment. Clinical nurses should take targeted measures to help parents get support from within the family, help them actively cope with diseases and improve post-traumatic growth.

Objective:To explore the application value of perioperative nursing information management system based on mobile applications (APP) in Orthopedic Operating Room.Methods:A total of 55 patients who underwent orthopedic surgery from February 2018 to January 2019 were set as the control group adopting routine perioperative nursing information management. A total of 57 patients who underwent orthopedic surgery from February 2019 to January 2020 were set as the observation group carrying out the perioperative nursing information management system based on mobile APP. We compared the waiting time for consecutive operations, operation time, operation safety check implementation rate, Operating Room nursing quality score, incidence of medical disputes and patient satisfaction of two groups of patients.Results:The waiting time for consecutive operations and operation time of patients in the observation group were shorter than those in the control group with statistically significant differences ( P<0.05) . The operation safety check implementation rate before anesthesia, before operation and before leaving the room in the observation group was higher than those in the control group, and the differences were statistically significant ( P<0.05) . There was no statistically significant difference in the incidence of medical disputes and patient satisfaction between the observation group and the control group ( P>0.05) . Conclusions:The application of perioperative nursing information management system based on mobile APP in Orthopedic Operating Room can effectively improve nurses' work efficiency and nursing quality, and ensure patient safety to a certain extent.

Objective:To discuss the application effect of lean management based on time-action method in Operating Room of General Surgery Department.Methods:A total of 106 patients who underwent surgery in General Surgery Department of Jizhong Energy Xingtai Mining Group General Hospital from April 2018 to March 2020 were selected. According to the admission time, 51 patients admitted from April 2019 to March 2020 were set as the observation group, and 55 patients admitted from April 2018 to March 2019 were set as the control group. The control group adopted routine nursing management, while the observation group accepted lean management based on time-action method on this basis. The quality of Operating Room management, operation efficiency, nursing risk events and occurrence of postoperative infection were observed and compared between the two groups.Results:In the observation group, the scores and total scores of item preparation, sterility, cooperation of nursing staff and equipment management after intervention were respectively (17.94±1.58) , (18.15±1.67) , (25.50±1.86) , (26.74±1.93) and (88.45±5.34) , higher than (16.01±1.33) , (15.92±1.28) , (23.11±1.75) , (24.63±1.81) and (79.71±4.86) in the control group, and the differences were statistically significant ( t=6.821, 7.749, 6.816, 5.809, 8.822; P<0.01) . The preoperative preparation time, time of transporting patients and the overtime of nursing staff in the observation group were respectively (26.35±8.12) , (20.26±5.48) , (134.40±19.84) min, which were lower than (38.56±10.27) , (31.05±9.13) and (209.38±25.96) min of the control group, and the differences were statistically significant ( t=6.755, 7.306, 6.816, 16.611; P<0.01) . The incidence of nursing risk in the observation group was 1.96%, which was lower than12.73% in the control group (χ 2=4.396, P=0.036) . The total incidence of postoperative infection in the observation group was 5.88%, which was lower than 20.00% in the control group (χ 2=4.601, P=0.032) . Conclusions:The use of lean management based on the time-action method for Operating Room of General Surgery Department can improve quality of nursing and operation efficiency, reduce postoperative infections and reduce the incidence of nursing risk events.