Objective To discuss the diagnosis and management of adrenal cortical carcinoma. Methods 12 cases of adrenal cortical carcinoma were evaluated with regard to clinical,pathologic characteristics and prognosis.Of the 12 patients,6 were male and 6 were female with an average age of 37.The tumor was functional in 4 and nonfunctional in 8.The tumor was on the right side in 10 and on the left in 2.The diameter of the tumor was 3～30 cm.3 cases were Sullivan stage Ⅰ,3 stage Ⅱ,2 stage Ⅲ and 4 stage Ⅳ. Results Tolal ablation of the tumor has been conducted in 11 and biopsy only in 1.Estrogen receptor expression was positive in 5 out of 7 as deteted by immunohistochemistry assay.Five patient died within 1.5 years after operation whereas the other 7 are still surviving including 5 administered with tamoxifen. Conclusions Adrenal cortical carcinoma may be an estrogen-dependant tumor,so tamoxifen is an effective adjuvant drug in the treatment.Tumor size and stage appear to be strongly correlated with prognosis,larger size and higher stage are associated with a poor prognosis.

Objective To explore indexes supposed to be covered in nursing quality evaluation in Neurology Department in children′s hospital. Methods Through literature review and expert interviews, basic framework on the evaluation index system of nursing quality in neurology department was preliminarily established. Formal expert consultation questionnaire was formed by combining pre-investigation by self-designed questionnaire and expert opinion. With Delphi method, a two-round questionnaire survey was done to 21 experts for their opinion and argument on indexes of several levels, settings of entries, etc. of the preliminarily-constructed evaluation standard system. Basing on opinions of the experts, evaluation indexes of nursing quality were set up, with index weight determined by analytic hierarchy process.Results Evaluation indexes of nursing quality were set up after the two-round investigation. The index system had three levels, with three first class indexes, eleven second class indexes and forty-nine third class indexes. After the two-round consultation, cooperation index of the index system was 0.306 1. The authority coefficient of experts was 0.835 7. Return rates of the two-round consultation were 87. 50% and 100. 00%, with 72. 86% of the experts bringing up opinions. Index weight of various levels was determined by analytic hierarchy process, with Yaahp 0. 6. 0; CR value of index of various levels was all less than 0. 10. Conclusions A relatively reasonable evaluation index system of nursing quality has been preliminarily established.

Objective:To analyze the relationship between healthy behavioral capability, psychological resilience and breastfeeding self-efficacy in primiparas.Methods:Totally 140 primiparas who delivered in Children's Hospital Affiliated of Zhengzhou University from September 2018 to March 2019 were selected by convenient sampling and investigated with the Demographic Information Questionnaire, Self-rated Abilities for Health Practices Scale (SRAHP) , The Connor-Davidson Resilience Scale (CD-RISC) and Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) . The relationship between healthy behavioral capability, psychological resilience and breastfeeding self-efficacy in primiparas was then analyzed based on the data. Totally 140 questionnaires were distributed in this study, and 137 valid questionnaires were collected, accounting for an effective recovery rate of 97.86%.Results:The total SRAHP score of the 137 primiparas was (68.25±13.85) , whose total average score of the different items of this scale was (2.43±0.92) . The total CD-RISC score of the 137 primiparas was (57.41±13.82) , whose total average score of the different items of this scale was (2.30±1.22) . The total BSES-SF score of the 137 primiparas was (48.83±10.87) , whose total average score of the different items of this scale was (3.87±1.26) . Pearson correlation analysis showed that there were positive correlations between the dimensions of healthy behavioral capability, the dimensions of psychological resilience and the scores of breastfeeding self-efficacy in primiparas ( P<0.01) . Healthy behavioral capability showed a mediating effect between psychological resilience and breastfeeding self-efficacy in primiparas, accounting for 37.19% of the total effect. Conclusions:There is a positive correlation between breastfeeding self-efficacy and the level of healthy behavioral capability and psychological resilience, and the level of healthy behavioral capability plays a mediating role between psychological resilience and breastfeeding self-efficacy. Therefore, enhancing psychological resilience and the level of healthy behavior can significantly improve the self-efficacy of breastfeeding, which has a significant effect on the breastfeeding rate of primiparas.

Objective To investigate fatigue in children with acute lymphoblastic leukemia (ALL) during chemotherapy,and influencing factors.Methods From Feburary 2014 to August 2016, 216 children with ALL,from 5 to 15 years old,treated in a Grade III,Level A children's hospital in Zhengzhou,were surveyed by Peds QLTM multidimensional fatigue scale (Chinese version) and Questionnaire on discomfort in ALL children during chemotherapy.Results During chemotherapy,total scores of fatigue in the ALL children were (31.71±16.66) ,with fatigue of the whole body (11.67±6.29),of sleeping (10.99±5.57),and of cognition (9.10±6.84);during chemotherapy,incidence of fatigue of the whole body was 90.74%,of sleeping 95.83%, and of cognition 81.94%. Main influencing factors of fatigue of the whole body were weight loss,appetite loss and lack of energy,accounting for 72.8% of fatigue variation;that of sleeping were weight loss and irritability, accounting for 51.2% of fatigue variation;and that of cognition were difficulty in concentration and oral ulcer, accounting for 44.2% of fatigue variation.Conclusions During chemotherapy,fatigue in ALL children is common and is below average level. When managing fatigue symptoms in ALL children,nurses should actively treat the symptoms,so as to reduce the level of fatigue.

Objective:To explore the application effect of early nursing intervention based on NNN-link in social disorders of children with autism spectrum disorders (ASD) .Methods:A total of 126 hospitalized children with ASD in the Rehabilitation Center of Henan Children's Hospital from January to May 2023 were selected as research subjects by convenience sampling. They were randomly divided into an intervention group ( n=63) and a control group ( n=63) using a random number table. The control group received routine care, while the intervention group received early nursing intervention based on NNN-link in addition to routine care. The Social Disorder-related Nursing Diagnosis Outcome Scales and the Childhood Autism Rating Scale (CARS) scores were compared between the two groups before and after intervention. Results:After the early nursing intervention, the scores for family atmosphere, participation in leisure activities, participation in play, social skills, and social participation were higher in the intervention group compared to the control group, the differences were statistically significant ( P<0.05). The CARS scores of the intervention group were also lower than those of the control group, the differences were statistically significant ( P<0.05) . Conclusions:Early nursing intervention based on NNN-link can effectively improve the social disorder conditions of children with ASD, reduce their autism symptoms, and promote recovery.

Objective To observe the effect of oral massage combined with trial feeding on dysphagia in neonates with hypoxic- ischemic encephalopathy (HIE). Methods We enrolled 30 hospitalized newborns who were diagnosed moderate to severe HIE with dysphagia in the NICU of our hospital from January 2016 to December 2017. According to the random number table method, these newborns was divided into control group and study group. Oral massage combined with trial feeding were given in the study group, nasogastric feeding in the control group and family participatory care and the treatment of nutritional neurodrugs were also given in two groups. To campare the oral milk remnant, feeding time and sucking action after the flow of milk and swallowing, oral feeding time, gastric tube indwelling time and length of stay in two groups. Results After 5 days intervention, the clinical manifestations of dysphagia in two groups were compared, and there were 6 cases, (8.50 ± 1.05)ml, (36.40 ± 2.87)min and 10 cases of oral milk remnant, feeding time and sucking action after the flow of milk and swallowing respectively in the study group, and 15 cases were 15 cases, (10.80 ± 0.39 )ml, (42.29 ± 1.60) min, 3 cases in the control group, respectively. The difference between the two groups was statistically significant ( χ2=12.86, t=7.52, 6.93, χ2=6.66, P<0.05). The oral feeding time, gastric tube indwelling time and hospitalization time of the study group were (15.60±1.35) d, (11.73±1.39) d, and (21.47±2.03)d, and the control group were (17.00±0.65) d , (14.13±0.99) d, (23.27 ± 1.16) d, respectively. The difference between the two groups was statistically significant (t=3.61, 5.45, 2.98, P<0.05). Conclusions For children with dysphagia, oral massage and combined feeding before each feeding can promote the improvement of oral motor nerves in children, and improve feeding effect, and promote rehabilitation of children.

Objective:To explore the emotion regulation belief and work alienation of pediatric nurses in Zhengzhou and to analyze the correlations between them.Methods:From January to February 2019, this study selected pediatric nurses at Children's Hospital Affiliated to Zhengzhou University and Henan Province People's Hospital as subjects by convenience sampling. All of nurses were investigated with the general information questionnaire, the Chinese Version of Emotion and Regulation Beliefs Scale (ERBS) and Work Alienation Scale for Nurses. This study analyzed the current status of emotion regulation belief and work alienation of pediatric nurses, and analyzed the influences of general information and emotion regulation belief on work alienation. This study sent out 235 questionnaires and 233 valid of them were collected with 99.15% for the effective rate.Results:Among 233 pediatric nurses, the total score of ERBS was (50.65±8.92) . The total score of work alienation scale was (35.02±5.97) . There were statistical differences in the scores of work alienation among pediatric nurses with different genders, ages and titles ( P<0.01) . Multiple linear regression analysis showed that the main influencing factors of work alienation of pediatric nurses included the genders, titles and emotion regulation belief with statistical differences ( P<0.05) . Conclusions:Pediatric nurses have a low level of emotion regulation belief and a high level of work alienation. Emotion regulation belief has a negative correlation with the alienation of nursing work. Hospital managers should increase nurses' emotion regulation belief to lower the alienation of nursing work.

Objective? To investigate and analyze the relationship between relocation stress,family function and coping strategy in parents of children transferred from Intensive Care Uni(t ICU). Methods? Using the method of cross-sectional study, the parents of children transferred from ICU to general ward in Children's Hospital Affiliated to Zhengzhou University from October 2018 to March 2019 were selected as the subjects of study by convenience sampling. General Information Questionnaire, Family Relocation Stress Scale (FRSS), Feetham Family Functioning Survey(FFFS),and the Coping Health Inventory for Parents(CHIP) were used to evaluate the relocation stress level and analyze the relationship between scores of FRSS, FFFS, and CHIP. A total of 200 questionnaires were distributed and 179 valid ones were retrieved, yielding an effective recovery rate of 89.5%. Results? The total score of FRSS of the 179 ICU-transferred children's parents was (34.52±8.46), which was in a high level of stress; the total average score of FFFS was (1.27±1.14); the total score of "coping style use frequency" was (144.57±13.57) in CHIP, and the total score of "coping style effect"was (78.20±14.83); correlation analysis showed that each dimension and total score of FFFS was negatively correlated with the level of relocation stress of parents (P＜0.05), and positively correlated with the "frequency and role of coping styles" (P＜0.05). Conclusions? The relocation stress of ICU-transferred children's parents is serious. Family function and coping style are closely related to the level of relocation stress. Medical staff should pay attention to the adaptation of families in the process of transfer, encourage parents to adopt more positive ways to cope with diseases and improve the overall health of children and families.

Objective To understand the intelligence and safety behavior in clinical nurses and to explore the correlation between them so as to provide a basis for standardizing nurses' safety behavior. Methods From February to April 2019, we selected clinical nurses at Children's Hospital Affiliated to Zhengzhou University and the third affiliated hospital of Zhengzhou University by convenience sampling as subjects. The investigation was carried out with the Safety Behavior Scale (SBS) and Chinese version of Resourcefulness Scale (RS). A total of 414 questionnaires were sent out and 411 valid questionnaires were collected with 99.28% for the valid recovery rate. Results Among 411 clinical nurses, the total scores of SBS and RS were (53.04±8.37) and (95.56±18.26) respectively. Single factor analysis showed that there were statistical differences in the scores of SBS among nurses with different ages, work lives, professional titles and education levels (P＜0.05). Hierarchical regression analysis showed the influencing factors of safety behavior of nurses were work lives, professional titles and education levels. After controlling general information, individual intelligence was the influencing factor of safety behavior in clinical nurses. Conclusions The higher the clinical nurse's intelligence is, the more standardized the patients' safety behavior is. Nursing managers should improve clinical nurses' intelligence by various measures and further standardize nurses' safety behavior.

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.