Duck circovirus(DuCV),a potential immunosuppressive virus,was investigated in Southern China from March 2006 to December 2009 by using a polymerase chain reaction(PCR)based method. In this study,a total of 138 sick or dead duck samples from 18 different farms were examined with an average DuCV infection rate of～35%. It was found that ducks between the ages of 40～60 days were more susceptible to DuCV. There was no evidence showing that the DuCV virus was capable of vertical transmission. Farms with positive PCR results exhibited no regularly apparent clinical abnormalities such as feathering disorders,growth retardation or lower-than-average weight. The complete genomes of 9. strains from Fujian Province and 1 from Zhejiang Province were sequenced and analyzed. The 10 DuCV genomes,compared with others genomes downloaded from GenBank,ranged in size from 1988 to 1996 base pairs,with sequence identities ranging from 83.2% to 99.8%. Phylogenetic analysis based on genome sequences demonstrated that DuCVs can be divided into two distinct genetic genotypes,Group I(the Euro-USA lineage)and Group II(the Taiwan lineage),with approximately 10.0% genetic difference between the two types. Molecular epidemiological data suggest there is no obvious difference among DuCV strains isolated from different geographic locations or different species,including Duck,Muscovy duck,Mule duck,Cheery duck,Mulard duck and Pekin duck.

Objective To know the research status and the tendency of development about the catheter depth of retention enema.Methods All the clinical studies about the catheter depth of retention enema were searched in China national knowledge internet (CNKI),VIP,Chinese biological medical disc and WanFang database from January 26th 2016.Bibliometric analysis was used to analyze these articles from the distribution of the year,periodical,region,work unit,fund,study type and the characteristics of included studies.Results A total of 76 articles were included and the number of published articles was stable in recent years.The majority was journal articles and was published in nursing journals.Most of the published articles were from Shandong,Guangdong and Sichuan province.Most of the authors were work in hospitals.Funding source was poor.58 (76.3％) articles were about random control trails (RCTs).The catheter depth in the experimental group was 3-60 cm;the number of samples included in the study was 15-560,while none was estimated.8 studies reported the inclusion criteria,and 6 studies reported the exclusion criteria.Baseline comparability was reported in 50 studies.Conclusions Although the number of clinical studies on the catheter depth of retention enema is at the stable stage,the study design and methodological quality still need to be further improved.Researchers should follow the principle of randomization,control and blinding in the future researches;specify the strict inclusion and exclusion criteria;and set up a reasonable control to ensure the authenticity and reliability of the findings.

Objective:To systematically evaluate effects of auricular acupoint pressing on improving perimenopausal insomnia.Methods:The randomized controlled trials of auricular plaster therapy to improve perimenopausal insomnia was searched by computer in domestic and foreign databases, and the search time was from the establishment of each database to October 25, 2018. Two researchers independently screened the literature, extracted data and evaluated the risk of bias in the included literature and RevMan 5.3 analysis software was used for data analysis.Results:A total of 6 Chinese literatures were included. Meta-analysis results showed that there was no statistically significant difference in Pittsburgh Sleep Quality Index (PSQI) score reduction by auricular acupoint pressing compared with estazolam ( WMD=-0.06, 95% CI: -0.96-0.84, P=0.90) .Auricular acupoint pressing was better than Anshen Buxin capsule in reducing PSQI score ( WMD=-5.16, 95% CI: -7.37--2.95, P<0.000 01) . Auricular acupoint pressing could effectively improve perimenopausal insomnia, and the difference was statistically significant ( RR=1.19, 95% CI: 1.08-1.31, P=0.000 4) . Auricular acupoint pressing with beans combined with oral modified Huanglian Ejiao Decoction was better than oral modified Huanglian Ejiao Decoction alone in reducing Athens Insomnia Scale (AIS) scores ( WMD=-2.60, 95% CI: -4.42--0.78, P=0.005) . Compared with modified Chaihu Guizhi Longgu Muli Decoction treatment, auricular acupoint pressing combined with modified Chaihu Guizhi Longgu Muli Decoction could effectively reduce the modified Kupperman score ( WMD=-4.07, 95% CI: -6.36--1.78, P=0.000 5) . In terms of reducing the scores of the social support scale, there was no statistically significant difference between the auricular acupoint pressing with beans and estazolam ( WMD=-0.16, 95% CI: -1.26-0.94, P=0.78) . Conclusions:Auricular acupoint pressing has advantages in improving the total effective rate, reducing PSQI score and AIS score and improving Kupperman score. Limited by the quantity and quality of the included literatures, more large-sample high-quality studies with long-term follow-ups are needed for verification.

This paper reviews the literature about the common complications, evaluation tools and intervention measures of free flap repair for tongue cancer patients at home and abroad, summarizes the current research status, and points out that the nursing plan of free flap repair for tongue cancer patients needs to be further standardized, and needs to carry out evidence-based clinical research.

With the construction and development of head and neck tumor, diagnosis and treatment technology and survival rate of patients have been improved in different degrees. Nurses play an important role as managers and practitioners in the treatment and rehabilitation of patients with head and neck tumors, and it is very important to evaluate and manage the treatment and prognosis of head and neck tumor patients scientifically. In this context, the American Cancer Society launched the Head and Neck Cancer Survivorship Care Guideline in 2017 and was endorsed by the American Society for Clinical Oncology. This paper mainly discusses the forming process of the guidelines, the main points of the consensus of experts, the guiding role of the guidelines in clinical work and the obstacles and limitations of the guidelines.

Objective To analyze and provide reference for developing clinical practice guidelines of ostomy care suitable for the domestic health care settings. Methods Content analysis method was used to analyze clinical practice guidelines searched from the Internet. Results A total of 13 clinical practice guidelines were included. All the guidelines were published between 2005 to 2016 without update. Four of them were evidence-based guidelines, the rest were not. A total of 21 items were identified as being related to ostomy care. Conclusions Although the existing clinical practical guidelines are instrumental to guiding clinical ostomy care practice, most of them were not evidence-based guidelines without high methodological quality. Meanwhile, some guidelines lack specific and updating recommendations for ostomy care, which may cause problems in ostomy care practice. What′s more, some recommendations may not suit for China because they were made in the foreign circumstance. Researchers and clinical nurses should develop local practice guidelines of ostomy care with consideration of the actual medical conditions in China and the best evidence.

Objective To cross-cultural adapt and test the reliability and validity of Humanistic Relationship Experience Scale (HRES) made by Boscart. Methods Cross-culture Adaptation was carried out by following American Academy of Orthopaedic Surgeons Evidence Based Medicine Committee (AAOS). A convenience sampling was conducted among 180 patients with chronic disease, and then assessed the reliability and validity of HRES. The internal consistency coefficient and the test-retest were used to assess the reliability of HRES, and the content validity index (CVI) and construct validity were used to assess the validity of HRES. Results In order to understand the purpose and content of the scale easily, the Chinese version title of HRES was revised to"Nursing Humanistic Care Experience Scale-Noninfectious Chronic Disease Patients Version (NHCES-NCDP)" after soliciting experts′ advice. The CVI of the scale was 1;factor analysis got three factors, which could explain 67.897％of the total variance. A 0.965 Cronbachαof total scale was obtained, and for each dimension range was 0.876-0.948;the test-retest reliability was 0.710 for the overall scale. Conclusion NHCES-NCDP is reliable and valid, which can be used to assess the experience of nursing humanistic care for patients with chronic diseases, and to explore nurses′implementation of nursing humanistic care.

Objective:To systematic review the efficacy and safety of external application of traditional Chinese medicine on treatment of breast cancer related lymphedema.Methods:CNKI, Wanfang Data, VIP, Sino-Med, The Cochrane Library, PubMed, Web of Science were searched for related randomized controlled trials, the retrieval time was from inception to May 25, 2020. Two researchers independently screened and evaluated the included studies. Meta-analysis was performed by RevMan 5.4 software.Results:A total of 16 studies involving 1 315 patients with breast cancer related lymphedema were included, and the methodological quality of the included studies was not high. Compared with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment had advantages in improving the total efficiency( P<0.01) and quality of life( P<0.01), reducing pain( P<0.01) and improving upper limb function( P<0.01), without obvious adverse reactions( P>0.05), but there was no improvement in depression( P>0.05). Compared with conventional treatment, external application of traditional Chinese medicine could improve the total efficiency( P<0.01). Compared with placebo sticker combined with conventional treatment, external application of traditional Chinese medicine combined with conventional treatment can reduce circumference( P<0.05) and reduce pain( P<0.01), without obvious adverse reactions( P>0.05). Conclusions:Available evidence suggests that external application of traditional Chinese medicine may be a potential treatment method for breast cancer related lymphedema. Due to the poor methodological quality of the included studies, high-quality randomized controlled trials are still needed.

Objective:To study the effect of experiential teaching combined with literature salon on the teaching quality of neurosurgery standardized training.Methods:A total of 120 trainees having standardized training in the Department of Neurosurgery of Southwest Hospital, Army Medical University from January 2018 to January 2020 were selected in the study, and they were divided into study group ( n=67) and control group ( n=53) according to the time of admission. The control group received traditional clinical teaching, and the study group was given experiential teaching combined with literature salon. The assessment results (scores of theoretical examination, clinical practice skill and case analysis skill), problem analysis skills and self-confidence of critical thinking were compared between the two groups before and after teaching, and the teaching satisfaction of the two groups was compared. SPSS 20.0 was performed for t test and chi-square test. Results:After teaching, the theoretical examination score, clinical practice skill score and case analysis ability score of the two groups were significantly increased compared with those before teaching, and the clinical practice skill score and case analysis ability score of study group were significantly higher than those of control group ( P<0.05). After teaching, the scores of problem analysis ability and self-confidence of critical thinking of the two groups were significantly higher than those before teaching, and the scores of problem analysis ability and self-confidence of critical thinking were significantly higher in study group than those in control group ( P<0.05). The teaching satisfaction of trainees in study group (91.04%, 61/67) was significantly higher than that in control group (73.58%, 39/53) ( P<0.05). Conclusion:Experiential teaching combined with literature salon teaching can significantly improve the quality of clinical teaching in department of neurosurgery, and it is helpful to improve the clinical practical ability and enhance the teaching satisfaction of students with standardized training.

Objective:To investigate the implementation procedures and dosimetric verification of the first patient treated with total body irradiation (TBI) based on volumetric modulated arc therapy (VMAT).Methods:Two sets of CT images were acquired under the head-in first and foot-in first to contour the planning target volume (PTV) of the cranial and caudal segments to accomplish the treatment of the whole body length, on which two interrelated plans of 5 subsequent isocenters with a total of 15 VMAT fields were performed to cover all PTVs. The plans were prescribed to ensure 90% PTV dose coverage with a total dose of 12 Gy in 6 fractions. Firstly, a dose optimization was performed on the caudal CT images, then the cranial CT images were optimized based on the dose distribution of the caudal CT images. The evaluation of the final treatment plan was carried out based on a plan sum of both two sets of images. The parameters of PTV and organs at risk (OARs) were measured by dose volume histograms from the accumulated plan. The quality assurance comprised the verification of the VMAT plans for each individual isocenter via Delta4 phantom. The dose distribution in the overlapped region between two adjacent central fields was verified with EBT3 film. The absolute dose at the overlapped region between two images was measured via Pinpoint chamber. In vivo dosimetry on the patient′s skin was monitored by MOSFET dosimeters. The results of planning parameters and treatment duration were analyzed. Results:The mean doses of two segments of PTVs were 12.45 Gy and 12.37 Gy. The mean dose for the lung was 10.8 Gy. The machine unit (MU) and mean treatment delivery time were 2 883 MU and 24.3 min, and the mean total time per fraction was 121 min. The mean 3%/3 mmγ-analysis pass rate for each isocenter VMAT plan was (99.74±0.42)%, and the mean 5%/5 mmγ-analysis pass rate for the overlapped region was (90.11±2.72)%. The average deviation of absolute dose in the overlap region of the caudal and cranial images was (3.6±0.4)%. In vivo measurement of 8 points on the patient showed that the dose of each region was ranged from 1.57 Gy to 2.04 Gy. Conclusion:According to the results of dosimetric verification, TBI based on multi-isocenter VMAT can be applied in clinical practice, which remains to be improved in terms of dose distribution, measurement results and clinical efficiency.