Objective? To explore the effects of phased discharge process for ICU patients on separation anxiety of their family members. Methods? From October 2018 to December 2018, we selected 136 family members of patients discharged from ICU at Xinxiang Central Hospital by convenience sampling as subjects. Family members were randomly divided into group of routine discharge (n=66) and group of phased discharge (n=70). Group of routine discharge carried routine discharge process. Group of phased discharge process implemented phased discharge process which divided discharge process into four stages including after condition stabilizing, 24 hours before discharge, on the discharge day and 24 hours after discharge and provided different nursing keys. The separation experience and depression as well as anxiety were evaluated with the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) and Hospital Anxiety and Depression Scale (HADS) before and after intervention. Results? After intervention, the scores of PDEQ of two groups decreased compared with those before intervention (t=-11.763, -27.172); besides, the score of PDEQ in group of phased discharge was lower than that in group of routine discharge (t=-28.441); the ratios of family members with the scores of PDEQ＜ 1.20 and ranged from 1.20 to 2.00 in group of phased discharge were higher than those in group of routine discharge respectively. After intervention, the scores of HAD-A and HAD-D and total score in HADS between two groups all decreased compared with those before intervention;the dimension scores and total score of group of phased discharge were lower than those of group of routine discharge (t=-6.881, -8.806, -9.111). The differences were all significantly statistical (P＜ 0.05). Conclusions? Phased discharge process can relieve separation experience in family members of ICU discharged patients, lower their anxiety and depression and improve their care ability.

Objective To explore the consistency of different physicians in diagnosis of malignant breast lesions with breast CEUS predictive model.Methods Totally 953 patients with solitary breast nodule from multicenter who underwent ultrasound and CEUS were collected.The research team was composed by the initial group (one junior physician from each hospital),check group (one or two physicians who had at least two-year experience of CEUS examination from each hospital),research group (two senior physicians from Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital) and cross-blinded group (one or two vice directors or chief physicians from each hospital).At first,the lesions were classified according to the breast imaging reporting and data system (BI RADS) by the initial group and the check group,then new BI RADS classifications were performed by research group and cross blind group with breast CEUS predictive model.The consistency of different physicians in diagnosis of malignant breast lesions was analyzed.Results Among 953 patients,benign lesions were found in 451 patients (451/953,47.32％),malignant lesions were found in 435 patients (435/953,45.65％),and precancerous lesions were found in 67 patients (67/953,7.03％).The accuracy of the initial group,check group,research group and cross-blinded group was 71.67％(683/953),74.92％(714/953),80.17％ (764/953) and 83.42 ％ (795/953),respectively.The consistency of different physicians for diagnosis of malignant breast lesions between initial group and check group was good (Kappa =0.82,P＜0.001),while between initial group and crossblinded group,initial group and research group were both moderate (Kappa =0.56,0.41;all P＜0.001).The consistency of different physicians for diagnosis of malignant breast lesions between cheek group and cross-blinded group,between check group and research group were both moderate (Kappa =0.68,0.51;all P＜0.001).The consistency between research group and cross-blinded group with breast CEUS predictive model was moderate (Kappa =0.74,P＜ 0.001).Conclusion The consistency of different physicians in diagnosis of malignant breast lesions with breast CEUS predictive model was moderate.