Objective To explore clinical practice value of Disease Severity Evaluation Scale (DSAS), and divide patient's nursing level according to the results of DSAS. Methods The assessment group was set up for evaluation of the scale, DSAS was used to determine the nursing level of 3 713 hospitalized patients (age > 18 years old) from 17 clinical departments, from April to May 2014. Results Nursing level determined by DSAS was compared with the standard nursing level, kappa coefficient was 0.72, P < 0.05, suggesting that the consistency was better. According to the kappa coefficient, 17 clinical departments could be divided into three categories, namely the applicability of DSAS were different in different departments. Conclusions DSAS can be used as a objective basis for division of nursing level and has a certain clinical significance. But in order to make it guide clinical work better, scoring system with department characteristic should be developed on the basis of DSAS.

Objective To determine the normal range of minimal erythema dose (MED) for ultraviolet A (UVA) and B (UVB) in volunteers from Urumqi region.Methods One hundred and twenty-seven volunteers including healthy subjects and patients with noninflammatory skin disorders were enrolled in this study.SUV-1000 type UV simulator was used as the light source to determine MED of UVA and UVB in these subjects.Results These subjects included 48 persons with Fitzpatrick skin type Ⅲ,79 with Fitzpatrick skin type Ⅳ,51 males and 76 females.The median MED value for UVA and UVB was 38.1 J/cm2 and 31.8 mJ/cm2 respectively in subjects with skin type Ⅲ,59.16 J/cm2 and 48.00 mJ/cm2 respectively in subjects with skin type Ⅳ.Significantly lower median MED values of UVA (both P ＜ 0.01) and UVB (both P ＜ 0.05) were observed in the male and female subjects with skin type Ⅲ compared with those with skin type Ⅳ.The male subjects showed a significantly higher median UVA-MED value (59.16 J/cm2 vs.41.10 J/cm2,P ＜ 0.05),but a similar UVB-MED value (39.60 mJ/cm2 vs.35.55 mJ/cm2,P ＞ 0.05) compared with the female subjects.No significant difference was observed in the median value of UVA-or UVB-MED in subjects with skin type Ⅲ or Ⅳ between Han and Uygur nationality (all P ＞ 0.05).Also,no correlation was found in the median value of UVA-or UVB-MED with age or duration of outdoor exposure in the male or female subjects (all P ＞ 0.05).The lower reference limit was 33.38 J/cm2 for UVA-MED and 27.90 mJ/cm2 for UVB-MED in the population in Urumqi region.Conclusion Skin phototype may be an important determinant of MED.

Objective To investigate the main risk factors of respiratory complications in patients with cervical spinal cord injury so as to provide reference for early nursing assessment and personalized nursing intervention model. Methods A retrospective case series study was conducted on the clinical data of 303 patients with cervical spinal cord injury admitted to the Third Hospital of Hebei Medical University between January 2015 and September 2016. There were 248 males and 55 females, aged (44.9 ±13.8)years (range, 14-70 years). There were 109 cases at fracture site C14 and 194 cases at C5-8. According to ASIA classification, 131 cases were grade A, 26 cases grade B, 42 cases grade C, and 104 cases grade D. The duration from injury to operation was (23.2 ± 69.9) hours (range, 6-48 hours). Univariate analysis was performed on the risk factors of respiratory complications, including gender, age (14-54, 55-65, and 66-70 years old), occupation, hospital stay, smoking history, previous history, ASIA grade (grades A to D), injury cause, complications (abdominal distension, hyponatremia, hypoproteinemia, and anemia). Multivariate logistic regression was used to analyze the significant risk factors in the univariate analysis so as to further identify risk factors associated with respiratory complications. Results Univariate analysis showed that age (55-65 and 66-70 years), ASIA grade A, ASIA grade B, smoking history, injury cause, complications (abdominal distension, hyponatremia, hypoproteinemia, and anaemia) were related to respiratory complication of patients with cervical spinal cord injury (P ＜0.05). The gender, occupation, length of hospital stay, and previous history were not associated with respiratory complications of patients with cervical spinal cord injury (P＞0.05). Logistic regression analysis showed that age between 55 and 65 years (OR = 3.989, P ＜ 0.05), age between 66 and 70 years(OR =0.301, P＜0.05), AISA grade A (OR=30.300, P＜0.05), ASIA grade B (OR =5.784, P ＜0.05), smoking history (OR=5.238, P ＜0.05), abdominal distension (OR = 1.975, P＜0.05), hypoproteinemia (OR =6.212, P ＜ 0.05), and hyponatremia (OR =3.233 ＜0.05) were independent risk factors for respiratory complications in patients with spinal cord injury. Except for ASIA classification, other factors might be easily ignored by doctors and nurses, leading to poor prognosis of patients. Conclusions Age (above 55 years), ASIA grades A and B, smoking history, abdominal distention, hypoproteinemia, and hyponatremia are the risk factors of respiratory complications in patients with cervical spinal cord injury. Based on the results, early nursing assessment can be carried out and personalized nursing measures can be taken to reduce the incidence of respiratory complications. It can also provide reference for constructing standardized nursing intervention model.

Objective To analyze the risk factors of acute pressure ulcer in liver transplantation patients after operation to look for the nursing method.Methods Ninety-five liver transplantation patients from January 2005 to September 2013 were chosen,and their basic information were collected,and the indicator associated with the occurrence of pressure ulcer before,during and after the operation were recorded and the risk factors were analyzed,and the effect of medical factors on the incidence of pressure ulcer in patients with liver transplantation were evaluated.Results Thirty patients had the pressure ulcers within three days after operation,and the fourteen cases(46.67％) occurred on the day of operation,and nine (30.00％),five (16.67％),two (6.66％) respectively occurred on the first,second and third day of operation.The cases of pressure ulcers occurred in the sacral and heel area were respectively nineteen (63.33％) and nine cases (30.00％).The differences were found in the incidence rate of pressure ulcers in patients with different the score of Braden,the level of serum total protein,the operative time,the blood loss,the first time to get out of bed and compliance behavior (x2/Z =6.338,7.787,4.005,12.960,4.163,6.257,respectively; P ＜ 0.05).The maximum cases of pressure ulcers caused by the lack of cognition were twelve cases (40.00％),followed by seven cases (23.33％) which caused by the less frequency evaluation.Conclusions The occurrence of acute pressure ulcer is closely related to the score of Braden,the level of serum total protein,the operative time,the blood loss,the first time to get out of bed and compliance behavior,and nursing measures should be taken according to the risk factors to reduce the incidence of pressure ulcer after operation.

Objective To develop a satisfaction scale in orthopaedic inpatient and test the reliability and validity.Methods A research team was founded in March 2015.The primary items were obtained through literature review and semi-structured interview with orthopaedic inpatients.After expert consultation,the pretesting scale was developed.212 patients with orthopedic in the Third Hospital of Hebei Medical University were recruited in the study to finish the questionnaire from May to November 2015.After the test of reliability and validity,the final scale was developed.Results The final scale consisted of five dimensions and forty nine items.The Cronbach's α coefficient was 0.987 for the total scale and the dimensions were ranged from 0.874 to 0.928.The split-half reliability was 0.929.The item-content validity index (I-CVI) was 0.786-1.000.The scale-content validity index (S-CVI) was 0.893.The CVI of dimensions was 0.83-0.93.Exploratory factor analysis totally extracted five common factors,and the load value of each entry factor was 0.480-0.480.The cumulative variance contribution rate was 70.625％.Conclusions The orthopaedic inpatient satisfaction scale has good reliability and validity.It can be used as the evaluation tool for the satisfaction in orthopedic hospitalized patients and it also can provide references for the interventions in effect evaluation of satisfaction.

This paper elaborated and analyzed the characteristics, clinical application and limitations of risk assessment tools for venous thromboembolism at home and abroad so as to provide a reference for improving and selecting assessment tools, and an early risk warning for patients with the risk of venous thromboembolism to carry out effective individualized prevention.

Objective:To observe the impacts of different postures on the hemodynamics of lower extremity vein.Methods:In this single center non-randomized controlled study in 15 healthy female volunteers, the hemodynamic changes in the common femoral vein were detected by color Doppler ultrasound at 10 different postures: supine position, slope positions with bed end elevated at 15°, 30° and 45°, trapezoidal positions with bed end elevated at 15°, 30° and 45°, and positions with bed head elevated at 30°, 45° and 60°.Results:Different postures resulted in significant differences in the velocity of blood flow in the common femoral vein ( P<0.05), with slope position at 45°> slope position at 30°> slope position at 15° = trapezoidal position at 30°> trapezoidal position at 15° = trapezoidal position at 45°> supine position> position with bed head elevated at 30°> position with bed head elevated at 45° = position with bed head elevated at 60°. Conclusions:In the postures observed in this study, the slope position with bed end elevated at 45° can promote the most effectively the blood reflux in the lower extremity vein, the trapezoidal positions with bed end elevated may not facilitate the distal blood reflux in the lower extremity vein, and positions with bed head elevated may hinder the blood reflux in the lower extremity vein.

Objective To explore the application of compound sequential technology on sputum exclusion for patients with cervical spinal cord injury. Methods A total of 86 patients with cervical spinal cord injury ( CSCI) were divided into intervention group and control group from January 2011 to December 2013 in our hospital on average. The patients of intervention group adopted compound sequential technology on sputum exclusion, while the patients in the control group underwent conventional nursing measures. We evaluated the occurrence of pulmonary infection and atelectasis, and the usage of artificial airway. Results In the intervention group, the incidence of lung infection and atelectasis (9. 3%) was lower than that of the control group (37. 2%), and the difference was statistically significant (χ2 =9. 382,P< 0. 05). The cure time in the intervention group was shorter that of the control group (t = -6. 339,P <0. 05). Utilization rate of artificial airway in the intervention group was 7. 0% compared with 30. 2% in the control group (χ2 =7. 679,P<0. 05). The length of carrying tube in the intervention group was lower than that of the control group (t = -5. 490,P <0. 05). Conclusions The compound sequential technology can improve the effect of sputum exclusion in patients with CSCI, decrease pulmonary infection and atelectasis, shorten the time of carrying tube, and enhance cure rate.

Objective To investigate the application results of standardization care process in the primary treatment of patients with pelvic fracture hemorrhage. Methods A total of 38 patients, who received the standardized processes for treatment during the period from January 2013 to October 2014 ( after the standardization care process established ) , were selected as observation group, while 38 patients, who only received the rescue based on nurse′working experience during the period from January 2011 to December 2012 ( before the standardization care process established) , were taken as control group. Rescue time, success rate and the medical cooperation satisfaction rate were compared between two groups. Results The rescue time of observation group was shorter than that in the control group (t= -3. 546,P<0. 05);the rescue success rate of observation group (89. 5%) was higher than that of the control group (71. 1%) (χ2 =4. 070,P <0. 05);medical cooperation satisfaction rate of observation group ( 92. 5%) was higher than that in the control group (77. 4%) (χ2 =4. 740,P<0. 05). Conclusions The application of rescue standardized processes on pelvic fracture hemorrhage can enhance the coordination between doctors and nurses, shorten the time in saving patients, and improve the success rate and medical cooperation satisfaction rate. The standardization care process is in favor of quick rescue, orderly and overall conduction and implementation of clinical care;hence it should be promoted in future clinical nursing work.

Objective To explore the influence of extubation time of urinary catheter on post-operational urination and comfort degree of patients with orthopedic surgery, so as to and make clear the best extubation time of urinary catheter for them. Methods 900 patients treated with operation in Department of Orthopaedics in the Third Hospital of Hebei Medical University from April to June in 2016 were selected by convenience sampling and divided, according to extubation time of urinary catheter, into group A, B and C, each with 300 cases. For patients in group A, urinary catheters were removed in the morning the day after the operation(12~24 h after operation), while in group B, 6 h after, and in group C, 2 h after. Rate of successful urination after extubation of urinary catheter, bladder discomfort, incidence rate of acute urinary retention and comfort degree of indwelling catheter in the three groups were compared. Results Difference in rate of successful urination and incidence rate of frequent micturition, urgent urination, micturition pain and acute urinary retention of patients in the three groups showed statistic significance (P<0.05). It was shown in pairwise comparison that rates of successful urination in group A and B were higher than that in group C, while incidence rates of acute urinary retention were lower (P < 0.05), and that incidence rate of frequent micturition, urgent urination and micturition pain in group A was higher than that in group B and C (P<0.05). Difference in comfort degree of indwelling catheter in the three groups showed statistic significance (P < 0.05). Incidence rates of discomfort in degree Ⅱ in group B and C were less than that in group A, while incidence rate of discomfort in degree Ⅲ in group C was less than that in group A and B (P<0.05). Conclusions For orthopedic patients,the best extubation time of urinary catheter is 6 h after the operation, which helps to raise rate of successful urination, lower urethra irritative symptoms due to cathetering, and reduce bladder discomfort after extubation.