Objective To observe the effects of rehabilitation exercises on limb function of patients with cervical spondylotic myelopathy (CSM) after artificial intervertebral disc replacement.Methods 42 CSM patients undergone anterior cervical decompression and Bryan disc prosthesis under microscope were randomly divided into the normal care group (n=20) and rehabilitation exercises group (n=22). All patients of two groups were assessed by JOA scale at 2nd week and 6th month after operation.Results The JOA scores of two groups at 6th month were all higher than that at 2nd week and scores of the rehabilitation exercises group were also higher than that of the normal care group ( P<0.01).Conclusion Rehabilitation exercises after artificial intervertebral disc replacement can improve spine cord function of CSM patient.

The modified early warning score (MEWS), as a rapid assessment and early warning scoring tool, has been widely used in patients in China, which can help nurses to identify potentially critical patients early, but not in all clinical fields. Through the retrieval of the relevant literature of the clinical application of the MEWS in Wanfang Medical Database from 2011 to 2018, the SWOT analysis was used in this paper [strength (S), weakness (W), opportunities (O) and threats (T)] methods, to systematically analyze the advantages, problems existence, implementation opportunities and challenges in the clinical application of the MEWS in our country. The purpose of this study was to obtain the best cut-off value of MEWS in different diseases and to formulate standard early-warning intervention measures for MEWS, which may provide reference for clinical workers to carry out relevant research.

Objective:To select and extract the evidence of delivery mode decision making among repregnancy women with post cesarean section, and summarize the best evidence.Methods:Evidence-based nursing was used to retrieve the evidences on delivery mode decision making among repregnancy women with post cesarean section in the Chinese Guidelines Network, Guidelines International Network (GIN) , National Institute for Health and Clinical Excellence (NICE) , American GuidelineClearinghouse (NGC) , Joanna Briggs Institute Evidence-based Health Care Center of Australia, UpToDate, Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI) , WanFang data, Chinese Biological Medicine (CBM) and Cumulated Index to Nursing and Allied Health Literature (CINAHL) and Excerpta Medica Database (Embase) . The evidences included the guidelines, systematic reviews, evidence summaries, recommended practices, best clinical practice information booklets and primary studies.The retrieval time was from the establishment of the database to 1st May 2019.Results:A total of 13 evidences were included, six guideline, one expert consensus and six systematic reviews, which involved 15 best evidences in four aspects, trial of labor after cesarean section (TOLAC) /vaginal birth after cesarean (VBAC) population, VBAC/uterine rupture influencing factors, delivery mode management and the delivery decision making tools.Conclusions:Evidences of clinical practice should be recommended according to the resource of medical institutions, promotion and barrier factors when medical staff apply evidences, reasonable judgments of clinician, clinical data provided by delivery women, will of delivery women and their family members. Users should continuously update evidences since the best evidences update over time to solve the problems of delivery mode decision making among repregnancy women with post cesarean section by scientific method so as to improve the nursing quality.

Objective To compare the value of Modified Early Warning Score (MEWS) and MEWS combined with blood glucose score in the evaluation of prognosis in patients with acute diabetic complications. Methods An analysis was conducted in 419 patients with acute complications of diabetes in the Endocrinology Department of Pingdingshan the Second People's Hospital. All the patients were evaluated with MEWS and MEWS combined with blood glucose score and divided into survival group and death group from admission to discharge. The prediction accuracy in patients' prognosis of MEWS and MEWS combined with blood glucose score were compared between the two groups. Results The score of MEWS and MEWS combined with blood glucose score of the death group were (4.43±1.39) and (8.32±7.41) respectively, while those of the survival group were (2.77±2.41) and (4.11±7.26) respectively. The differences were statistically significant (t=-3.338, -2.755; P<0.01). Using death as the predictor, the area under the receiver operating characteristic curve (AUC) of MEWS was 0.875 (95%CI: 0.840-0.905), with medium resolution, and the optimal cut-off value was more than 4; Youden index was 0.640 3, the sensitivity was 78.43%; specificity was 85.60%; the positive predictive value was 43.01%, and the negative predictive value was 96.63%. The AUC of MEWS combined with blood glucose score was 0.982 (95%CI: 0.964-0.992), with high resolution, and the optimal cut-off value was more than 7; Youden index was 0.897 7; the sensitivity was 94.12%; the specificity was 95.65%;the positive predictive value was 75.00%, the negative predictive value was 99.15%. Conclusions MEWS combined with blood glucose score can better predict diabetes outcomes in patients with acute complications, and it is worthy of clinical application.

Objective To survey the utilization of basic public health service among hypertensive and diabetic patients in communities.Methods A survey on the utilization of basic public health service was conducted between October 2014 and November 2014,1 511 patients with hypertension and 1 508 patients with type 2 diabetes aged ≥35 years were randomly selected for the survey from 18 communities in 2 cities and 4 townships of Shandong and Jiangsu provinces in China.Results The survey showed that 87.0％ (1 314/1 511) of hypertensive patients and 88.5％ (1 334/1 508) of diabetic patients visited community hcalth services within the year,and the blood pressure/blood glucose elevation were found in community health services in 68.5％ (1 035/1 511) of the hypertensive patients and 53.3％ (804/1 508) of the diabetic patients,respectively.The proportion of participants in community health education was higher in rural areas than that in urban areas [hypertension 73.2％ (556/760) vs.60.3％ (453/751),x2 =48.48,P ＜ 0.01;diabetes 77.8％ (591/760) vs.62.6％ (468/748),x2 =43.73,P ＜ 0.01].The proportion of outpatients who were followed up for more than 4 times was higher in rural areas than that in urban areas [hypertension 61.3％ (466/760) vs.48.4％ (363/751),x2 =79.31,P ＜ 0.01;diabetes 58.8％ (447/760) vs.50.5％ (378/748),x2 =17.78,P ＜0.01].The self-test rate of blood pressure and blood glucose in the urban was higher than that in rural areas [hypertension 41.8％ (314/751) vs.17.8％ (135/760),x2=104.59,P＜0.01;diabetes41.7％ (312/748) vs.11.3％ (86/760),x2=179.28,P ＜ 0.01].The proportion of patients with hypertension who did not take medication was higher in rural areas than in that in urban areas [36.7％ (279/760) vs.24.0％ (180/751),x2 =70.88,P ＜ 0.01],and the proportion of patients with diabetes who did not take medication was not statistically significant between rural and urban areas [20.8％ (156/760) vs.19.8％ (148/748),x2 =1.95,P ＞ 0.05].The control rates of hypertension and diabetes were 39.8％ (602/1 511) and 39.6％ (597/ 1 508),respectively.82.5％ (1 247/1 511) hypertensive patients and 75.6％ (1 140/1 508) diabetic patients selected community clinics for treatment and disease management,and satisfaction rate with primary health care in community clinics were 82.1％ (1 077/1 312) and 82.5％ (1 101/1 334) respectively.Conclusions High percentage of community clinic choice and visit was found,and most of the patients got the recommendation about health life style.But difference existed between the practice of self-monitoring of blood pressure and fasting blood glucose and control of blood pressure and blood glucose and plan of chronic disease prevention and control.