Objective To investigate the current status of self-management action of patients with chronic kidney disease (CKD) during early-mid stage and its influencing factors. Methods 80 patients were recruited in a tertiary hospital in Beijing from March to June 2011.They were surveyed with a self-designed self-management action questionnaire of patients with CKD. Results The total score of self-management action in patients with CKD was(69.10±5.63 ).1.25％ patients with CKD had bad self-management ability and 88.75％ patients had moderate self-management ability,only 10.00％ patients had good self-management ability.Patients of younger age,with higher education level,ever attending lectures or having inpatient experience had better self-management ability.And the methods of payment also had significant influence on the self-management of patients with CKD. Conclusions When taking care of patients with CKD,health care providers should be more individual case-based,especially paying more attention to those who are older,with low education degree,never have attended health education lectures and do not have inpatient experience,in order to increase patients' self-management ability and help them improve their health status.

Objective To probe the difference of MSCT features between clear cell renal cell carcinoma (ccRCC)and renal oncocytoma (RO),to improve the diagnostic accuracy.Methods 31 cases of ccRCC and 16 cases of RO which were confirmed by pathology were analyzed retrospectively,and the difference in some CT features including the morphology and CT value of plain scanning and three phases of enhancement scanning were analyzed.Results The diameter of the tumor of the ccRCC group was (5.04 ± 1.9 1 4)cm,meanwhile that of the RO group was (3.5 9±2.1 6)cm,exhibiting statistically significant difference in the diameter which was bigger in ccRCC group than that in RO group (P＝0.023).There were 90.32% (28/31)of cases with cystic necrosis in the ccRCC group and 18.75%(3/16)in the RO group,which was statistically significant that the patients with cystic deterioration in the ccRCC group were more than those in the RO group (P＜0.001).35.48% (11/31)of cases with peritumoral or intratumoral neovascularization in the ccRCC group and no cases in the RO group were found,and there was a statistically significant difference (P＝0.009).The enhancement degree in the ccRCC group was greater than that in the RO group in cortical phase and excretory phase,but lower in parenchy phase.However, there was no significant difference in the enhancement degree and the enhancement index in three phases of enhancement scanning (P＞0.05). Conclusion MSCT can demonstrate the renal tumor with or without cystic necrosis and neovascularization around or inside the tumor,which is helpful to differentiate ccRCC from RO.

Objective? To explore the distribution of Myers and Briggs Types Indictor(MBTI) personality type and status quo of professional identity in senior nursing undergraduates. Methods? Totally 230 full-time nursing undergraduates from 4 medical universities in Beijing were selected by convenient sampling between March and July 2017 and investigated with the general information questionnaire, MBTI-M Personality Type Scale and Professional Identity Scale for Nursing Undergraduates. Totally 230 questionnaires were distributed and 201 valid questionnaires were collected. Results? The professional identity score of the 201 senior nursing undergraduates was (83.40±10.47). Multivariate linear regression analysis revealed that registered county household, first choice, choice of nursing for personal love, positions of class or university and ESFJ personality had effects on professional identity of senior nursing undergraduates (P＜ 0.05). Conclusions? The professional identity of senior nursing undergraduates remains at an average level. The professional identity of nursing students with ESFJ personality is higher than that of nursing students with other personality types. Nursing educators should pay attention to the difference of professional identity caused by nursing students' personality type, improve the professional identity of nursing undergraduates, and stabilize the nursing team with targeted measures.

Head and neck osteosarcoma is a rare tumor. Its clinical features and recurrence pattern are different from those of osteosarcoma in other parts. Osteosarcoma of the head and neck occurs late with a high local recurrence rate and a low distant metastasis rate. Local recurrence is the main cause of death. Surgery is the main treatment. Postoperative radiotherapy is recommended for patients with positive surgical margin, proximal incisional margin and uncertain surgical margin. The role of chemotherapy remains controversial. Effective molecular targeted therapeutics need to be further explored for recurrent, metastatic and unresectable osteosarcoma, .

Background:China's accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts.This study reported the detailed development and evaluation of an international consulting training for global health workforce.Methods:Based on Kirkpatrick's model,a mixed-methods approach was used to evaluate the effectiveness of the training.Quantitative and qualitative data on participants' reaction,learning,and application of the learned knowledge and skills were collected by a training evaluation survey at the ending of training and a follow-up interview in three months after the training.Results:Thirty-six participants attended the training and 34 of them completed quantitative investigation.The training satisfaction evaluations were positive,for which participants rated the training program highly and over 90％ of them agreed with the usefulness of the training.About knowledge and skills change,participants showed improved consulting knowledge and skills from pre-to post-training (P ＜ 0.001).A total of 23 participants accepted follow-up interview,and most participants applied knowledge and skills learned from the training in their daily work or study.However,only 30.4％ of participants applied their learning in the consulting program.The largest barrier of application was the lack of consulting opportunities.In addition,almost all the participants reported that they would be glad to attend more training courses in the future.Conclusion:The international consulting training program was well-received,and was feasible to improve the consulting service competence of global health professionals.According to participants' feedback,it is essential to develop and expand consulting training in the field of global health.

Objective    To evaluate the relationship between four classic inflammatory biomarkers, including C-reactive protein (CRP), white blood cell (WBC), IL (interleukin family), tumor necrosis factor-α (TNF-α), and postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) and valve replacement (VR) surgeries. Methods    We searched PubMed, EMBase, the Cochrane Library, Ovid, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, VIP database and WanFang database from the inception to April 2020. Studies on the relationship between POAF and the above four inflammatory biomarkers were analyzed. Two researchers independently reviewed the literature, extracted data and evaluated the quality of the literature. RevMan 5.3 software was used for meta-analysis. Results    A total of 47 articles were included, covering 10 711 patients. The levels of preoperative CRP (SMD=0.38, 95%CI 0.14-0.62, Z=3.12, P=0.002) and postoperative CRP (SMD=0.40, 95%CI 0.06-0.74, Z=2.33, P=0.02), IL-6 (SMD=1.34, 95%CI 0.98-1.70, Z=7.26, P<0.001) and TNF-α (SMD=−0.33, 95%CI −0.65-−0.01, Z=2.02, P=0.040) were related to POAF, while preoperative IL-8 (SMD=−0.05, 95%CI −0.28-0.18, Z=0.42, P=0.68) and TNF-α (SMD=−0.43, 95%CI −1.22-0.36, Z=1.07, P=0.28), postoperative WBC (WMD=1.16, 95%CI −0.09-2.42, Z=1.82, P=0.07) and IL-10 (SMD=0.21, 95%CI −0.35-0.77, Z=0.73, P=0.46) were not related to POAF. The relationships between preoperative WBC and IL-10, postoperative IL-8 and POAF were inclusive, which needed further verification. Furthermore, the relationship between postoperative CRP and POAF were not consistent, as they were not significantly correlated in sub-group analysis. Conclusion    The inflammatory substrate before the surgery and inflammatory reaction induced by the operation is related to the occurrence and maintenance of POAF. Compared with preoperative inflammatory status, postoperative inflammatory factors may have a greater predictive value for POAF. Preoperative CRP, postoperative IL-6 and TNF-α levels are reliable biomarkers of POAF.

Objective To explore the differences in MRI signs between traumatic and non-traumatic rotator cuff tears and their correlation with the degree of rotator cuff tears.Methods A retrospective analysis was conducted on the clinical data and MRI man-ifestations of 82 patients in the trauma group and 80 patients in the non-trauma group with rotator cuff tears confirmed by arthroscopy.MRI indicators included 10 parameters:the degree of rotator cuff tear,tendon kinking-sign,tendon retraction,muscle edema,fatty degeneration,muscle atrophy,long head of the biceps tendon injury,acromion type,acromio-humeral distance(AHD),and lateral acro-mion angle(LAA).The clinical data and MRI indicators of the two groups were compared,and the correlation between MRI indica-tors and the degree of rotator cuff tears was analyzed.Results There were no significant difference in age and gender between the trauma group and the non-trauma group(P＞0.05),but the onset time of symptoms was significantly shorter in the trauma group compared to the non-trauma group(30 d vs 135 d,P＜0.001).Muscle edema,tendon kinking-sign,and long head of the biceps tendon injury were more common in the trauma group(P＜0.05),while fatty degeneration and type Ⅲ acromion were more common in the non-trauma group.The average AHD was smaller in the non-trauma group compared to the trauma group(P＜0.001).In addition,type Ⅲ acromion was more commonly seen in full-thickness rotator cuff tears,and AHD value was negatively correlated with the degree of rotator cuff tears(P＜0.05).Conclusion Muscle edema,tendon kinking-sign,and long head of the biceps tendon injury on MRI are highly suggestive of traumatic rotator cuff tears,while fatty degeneration,type Ⅲ acromion and smaller AHD indicate non-traumatic rotator cuff tears.Type Ⅲ acromion and decreased AHD increase the risk of full-thickness rotator cuff tears.

Objective? Based on the clinical nursing ability and the needs of nurses, a network information platform for standardized training of nurses is constructed, which is practical, comprehensive, scientific and reasonable. Methods? Using semi-structured interview method to construct the questionnaire of the functional requirements of the standardized training network information platform module for nurses, using the questionnaire to investigate the standardized training nurses, clinical teachers and nursing managers to obtain the functional requirements of the standardized training network information platform module for nurses. Two rounds of Delphi expert consultation were used to determine the modules and functions of the network information platform for standardized training of nurses, and a multidisciplinary information platform team was established to initially build the network information platform. In August 2015 and August 2016, 90 new openly recruited nurses from a ClassⅢ Grade A hospital were set as the control group, and 98 new openly recruited nurses in August 2017 were set as the observation group. The control group used the traditional training method, and the observation group used the network information platform for training. Questionnaire survey was used to compare the two groups' clinical nursing ability, academic achievement and professional skill achievement. Results? According to the demand, the standardized training network information platform for nurses was designed into four parts:basic module, specialized module, humanistic module and assessment module. The scores of self-evaluation, leadership of peer review, critical patients′ monitoring, teaching and cooperation, planning and evaluation, communication and professional development in the observation group were significantly higher than those in the control group (P＜ 0.05). The professional theoretical results and professional skills results of the observation group were higher than the control group and the difference was statistically significan(t P＜0.05). Conclusions? Based on the clinical nursing ability, the network information platform for standardized training of nurses is constructed, and the platform is used for standardized training of nurses, which can improve the clinical nursing ability,the academic examination results and the professional skill examination results of the trained nurses.

Objective To explore the occurrence regularity and risk factors of new-onset atrial fibrillation in early stage after brain and spinal surgery of Neurosurgery Department so as to provide a basis for carrying out predictive nursing for high-risk population. MethodsFrom March to June 2019, we selected 107 patients with brain or spinal surgery of Neurosurgery Department at a Class Ⅲ Grade A hospital in Beijing by convenience sampling. Data were collected including electrocardiogram of patients 12 hours after surgery, general information and clinical data. We analyzed the incidence and characteristics of atrial fibrillation, hospital stay as well as incidences of complications. Logistic regression model was used to analyze the risk factors. ResultsA total of 107 patients were included. The incidences of new-onset atrial fibrillation in early stage after surgery and persistent atrial fibrillation were 16.80%(18/107) and 1.87%(2/107) respectively. The average onset time of new-onset atrial fibrillation after surgery was 261.00 (87.00, 419.00) min after surgery. The incidence (50.00%) of atrial fibrillation within 4 h after surgery was the highest, and decreased progressively after that. The average duration of atrial fibrillation every time was 3.00 (1.50, 8.30) min, and the total duration was 5.50 (3.00, 11.25) min. The risk factors of new-onset atrial fibrillation after surgery of Neurosurgery Department included the high levels of blood phosphate and lymphocyte percentage before surgery, lesion located in brainstem or insular lobe as well as a low level of fasting blood glucose after surgery(P＜ 0.05). ConclusionsNew-onset atrial fibrillation after brain and spinal surgery of Neurosurgery Department mostly occurred within 8h after surgery. Pay attention to heart rhythm after surgery of patients with high levels of blood phosphate and lymphocyte percentage before surgery, lesion located in brainstem or insular lobe as well as a low level of fasting blood glucose after surgery.

With the aggravation of global aging, home care has become a new concept of health care for the aged. How to provide continuous, practical, economical and convenient home care services for the elderly has become the goal of long-term care system reform in various countries. At present, internationally representative home care system includes private and social insurance co-paying and private organizations providing services (American mode) , government paying and private organizations providing services (Canadian mode) , government and individuals co-paying and diversified service providers (Australian mode) and insurance paying and diversified service providers (Japan mode) . This article summarizes home care modes represented by the United States, Canada, Australia and Japan, expounds the core elements of home care and analyzes its characteristics, advantages and disadvantages. It is suggested that China should learn from advantages of home care in other countries and create a home care mode in line with national conditions by combing characteristics of social system and economic level in China