Objective To establish a risk indicator evaluation system on ladder-typed coordination between man and machine.Methods Using Delphi method,40 experts were inquired by letters for two rounds,the risk indicators and weights on ladder-typed human-machine coordination were identified.Results A risk indicator evaluation system was formed by 5 first-level indicators,17 secondary indicators and 22 tertiary indicators.Conclusions This research has a high degree of participation and authority from experts with an excellent coordination,forming a risk indicator evaluation system on laddertyped coordination between man and machine,which can provide a standard principle on man-machine coordination measures for mechanical ventilation patients.

Objective To explore the effects of sequential nursing care on patient- ventilator inter-action after cardiovascular surgical procedure. Methods thirty-six patients after cardiovascular surgical procedure in ICU from July 2006 to July 2007 were enrolled, they were randomly divided into the experi-mental group and the control group with 18 patients in each group.The experimental group adopted sequen-tial nursing care, while the control group received conventional nursing care. The condition of patient- venti-lator interaction after cardiovascular surgical procedure was observed and underwent t test. Results Gen-erally, there were significant differences in inspiratory trigger pressure(P-T), inspiratory delay time(D-I), inspiratory trigger time (D-T). The index of arterial blood gas at 4,8,12 hours after patients regain con-sciousness completely was better and the time of mechanical ventilation after operation,the time of ward-ship,the hospi-tal stay time were also significantly shorter in the experimental group than those in the con-trol group. Conclusions The patient-ventilator counteraction can be reduced,and the patient-ventilator synchreny can be alleviated by sequential nursing care.

Objective To study the effect of various treatments for the Budd-Chiari syndrome (BCS). Methods The clinical data of different treatments in 260 BCS patients were analysed retrospectively. Results Of the 260 patients,273times of BCS underwent interventional treatment?operative treatment or the combination of operation and interventional therapy, including percutaneous transluminal angioplasty(PTA) or/and stenting of the inferior vena cava(IVC)in 149 cases (160 times), percutaneous transhepatic angioplasty or/and stenting of the hepatic venous in 15 cases (17 times ),the combination of the two methods in 10 cases,radical resection in room temperature in 8 cases, mesocaval shunt in 16 cases,mesojugular shunt in 5 cases,mesoatriumr shunt in 8 cases,IVC-atrium shunt in 6 cases,splenopneumoexy in 18 cases, mesocaval shunt combined with PTA and stenting of the IVC in 17 cases, and transcardic membranotomy combined with PTA and stenting of the IVC in 8 cases . Two patients died in the operation:One died of cardiac tamponade,and the another died of operrative hemorrhagic shock.During the follow-up period of 3 months～6 years,20 patients recurred,of whom 7 died of hepatic failure,the other patients recovered satisfacorily. Conclusions The interventional treatment is the first choice for BCS.For patients unable to get interventional treatments or failure for interventional treatments, operation or operation combined with interventional therapy should be considered.

Objective To explore the standard sequential classification intervention in patients with acute myocardial infarction affected the timing of ICU stay and prognosis. Methods A total of 141 patients were divided into observation group (n=70) and control group (n=71) by random number table. The patients of observation group underwent standard classification methods which an officer physician and charge nurse took care of patients based on the assessment results of the patient′s heart function, circulation volume state, the initial plan of care, and cardiac ischemia grading with the different levels of nursing interventions. The patients of control group received routine nursing of Cardiology Department. We compared the differences of admitted rate of ICU, rate of invasive mechanical ventilation, ICU fatality rate and severe arrhythmia between two groups. Results The admitted rate of ICU in the observation group was 10%, rate of invasive mechanical ventilation 1. 4%, ICU fatality rate 2. 9%, that all were lower than those of the control group (χ2 =2. 213,2. 117,2. 013;P < 0. 05). Ventricular premature beats (VPB) rate was 25. 3%, ventricular tachycardia or ventricular fibrillation 7. 0%,Ⅱ or Ⅲ degree heart-block 5. 6%, sinus arrest rate 4. 2% in the observation group higher than those of the control group (χ2 =2. 707,2. 115,2. 012,2. 003; P<0. 05). Conclusions The standard Sequential intervention can significantly improve the classification of acute MI prognosis, and contribute to health care professionals to master the timing of ICU stay.

Objective To build prenatal health education programs for primiparities and their spouses based on the concept of flipped classroom.Methods Expert questionnaires for prenatal health education programs for primiparities and their spouses based on the concept of flipped classroom were prepared by searching for original literatures from international and domestic databases. The Delphi method was used to investigate a total of 50 obstetrics experts from 18 ClassⅢ hospitals from Shandong province for two rounds. Results The concentration degree of these experts' opinions was high with an authority coefficient of 0.956 and a familiarity coefficient of 0.958, the determination coefficient was 0.954; the coordination coefficients for primary, secondary and tertiary indicators were 0.617, 0.423 and 0.391, respectively. The final health education program included 2 primary indicators, 11 secondary indicators and 55 tertiary indicators. Conclusions The experts' opinions on the prenatal education program for primiparities and their spouses are consistent. The program is highly scientific and reliable, which provides reference for prenatal health education for primiparities and their spouses based on flipped classroom.