Objective To study the effect of cooperative network on in-job training of nurses. Methods 80 randomly selected nurses with length of service from 1 to 5 years participated the written examination with alternation of the network test monthly. Self- designed questionnaires were sent out to survey the nurses about the recognition of the two testing modes. Department of Nursing compared and analyzed the exam results. Results The network test was popular among nurses, besides, it was economical, convenient, could save human resources, contribute to remarkable learning effect. Conclusions Application of cooperative network test in in-service training of nurses is convenient and practical, and can improve collaboration and team spirit of nurses.

Objective To explore a practicable method for analyzing the cost losses of residents' health impact induced by environmental pollution and evaluate the cost losses of local residents' health impact in arsenic contaminative area. Methods The data on residents' health were obtained in an arsenic polluted area as the basis analysis of economic loss. Additionally, the data on the sizes of local population, GDP, the annual personal income, the annual prevalence of acute diseases, absence due to sickness and patients' nursing care, the annual prevalence of chronic diseases in 1985. Local residents' age specific death rates and sizes of population in 1985-1995 were collected also. 3 mumerable indexes were screened for estimating the cost losses of residents' a health impact in arsenic contaminative area based on the data mentioned above and combined with abridged life table. Results Based on the calculated GDP and personal average income in 1995, the cost losses of residents due to arsenic pollution consisted of 3 sections: the first included GDP losses of 50.52 yuan/(person-year) and personal income loss of 43.71 yuan/(person-year) attributed to the reduced life expretancy of the residents living in arsenic-polluted area. The second was an excess of the annual medical expenditure of 56.30 yuan/(person-year) for residents living in arsenic-polluted area compared with that of control group. The third included GDP loss of 74.14 yuan/(person-year) and income loss of 64.23 yuan/(person' year) attributed to the health life days of residents in arsenic-polluted area during the period of number of working years. The total economic loss of 3 section mentioned above make the total GDP reduction of about 180.96 yuan/(person-year) and average income loss of about 164.27 yuan/(person-year) including excessive medical costs. Conclusion The analytical method could be applied to the estimation of economic loss of environmental pollution-attributable health impact.

Objective:To analyze the correlation of serum homocysteine(Hcy)levels with hematoma absorption and cognitive function in elderly patients with cerebral hemorrhage.Methods:Clinical data of 80 elderly patients with cerebral hemorrhage admitted to our hospital from January 2017 to July 2019 were retrospectively analyzed.According to serum levels of Hcy(normal range: <15 μmol/L), 21 patients with serum Hcy<15 μmol/L were included in Group A, and 59 patients with Hcy≥15 μmol/L were included in Group B. General data(gender, age, hypertension, diabetes, bleeding part, bleeding volume, etc.), hematoma absorption and cognitive function were recorded and compared between the two groups.The correlation of serum Hcy levels with hematoma absorption and cognitive function in elderly patients with cerebral hemorrhage was analyzed by using Spearman correlation analysis.Results:There was no statistical difference in gender, age, hypertension, diabetes, bleeding location and bleeding volume between the two groups.The speed of hematoma absorption and scores of Montreal Cognitive Assessment(MoCA)were higher in Group A than in Group B[(0.4±0.1)ml/d vs.(0.3±0.1)ml/d, (19.6±4.6)points vs.(16.3±3.3)points, t=3.935 and 3.532, both P=0.000]. Spearman correlation analysis showed that serum Hcy level was negatively correlated with hematoma absorption and cognitive function in elderly patients with cerebral hemorrhage( r=-0.372 and-0.311, P=0.000 and 0.005), indicating that hematoma absorption and cognitive function were worse with the higher serum Hcy levels in elderly patients with cerebral hemorrhage. Conclusions:Serum Hcy levels change in elderly patients with cerebral hemorrhage.As serum Hcy levels increase, the risk for adverse events such as slow hematoma absorption and unsatisfactory improvement in cognitive function in patients increases accordingly.Serum Hcy levels play an important role in the occurrence and development of diseases in elderly patients with cerebral hemorrhage and can be used to evaluate the condition and prognosis of patients with cerebral hemorrhage.

Objective:To assess the differences of the 2016 and 2009 edtion guidelines on diastolic dysfunction in sepsis patients.Methods:A single-center, prospective study was conducted. The relevant information of sepsis patients in Intensive Care Unit (ICU) were analyzed from October 2016 to January 2019. Patients’ transthoracic echocardiography at the first 24 h and 3rd day of their admission and left ventricular diastolic dysfunction were stratified according to the 2009 and 2016 edition guidelines. Patients’ characteristics, arterial blood gas analysis, and blood biochemical indexes were recorded at the first 24 h of the ICU admission. Additionally, the following information were retrieved during ICU stay: site of infection, frequency of adrenaline and dobutamine, maximal dose of norepinephrine, use of hydrocortisone, invasive mechanical ventilation and renal replacement therapy. The rank-sum test of two independent samples was used to compare the differences in the diagnosis of left ventricular diastolic dysfunction.Results:A total of 196 patients with sepsis or septic shock were screened, and 86 patients were excluded. Finally, clinical data of 110 patients were included in the analysis.The median time of the first ultrasound examination in ICU was 17 h. Among the patients with different diastolic function severity in baseline data analysis, only age was significantly different. According to the 2016 edition guidelines, 43 (39%) of 110 patients had diastolic dysfunction and another 30 (27%) had indeterminate diastolic dysfunction within 24 h of ICU admission. According to the 2009 edition guidelines, 40 (36%) patients had diastolic dysfunction and 58 (53%) patients had indeterminate diastolic dysfunction. The diagnosis of left ventricular diastolic dysfunction of different grades was significantly different between the 2016 and 2009 edition guidelines ( Z=4.92, P<0.01). According to the 2016 edition guidelines at the 3rd day of ICU admission, 52 (47%) patients were diagnosed with diastolic dysfunction and 18 (18%) were diagnosed with indeterminate diastolic dysfunction; According to the 2009 edition guidelines, 50 (46%) of these patients were diagnosed with diastolic dysfunction and 45 (41%) had indeterminate diastolic function. Similarly, there was a large difference in diagnosis ( Z=4.60, P<0.01). Subgroup analysis of patients with normal systolic function (ejection fraction > 50%) showed that the diagnosis of left ventricular diastolic dysfunction were significantly different at the first 24 h and the 3rd day of ICU admission ( Z=4.34, P<0.01 and Z=5.71, P<0.01). Conclusions:The 2016 edition guidelines identify a significantly higher incidence of dysfunction in patients with severe sepsis and septic shock compared to the 2009 edition guidelines. Although the 2016 edition guidelines seem to be an improvement, issues remain with the application of guidelines using traditional measures of diastolic dysfunction in this cohort.