Objective To investigate maternal risk factors for fetal congenital heart diseases (CHD). Methods A case-control study was conducted on 16 645 pregnant women who underwent cardiovascular malformation screening for fetal cardiovascular system,whose pregnancy outcomes were recorded,and whose newborns were scanned by an echocardiography in Peking University People's Hospital,Haidian,Changping,Mentougou and Daxing Maternal and Child Health Hospital from Nov.2006 to Oct.2009.One hundred and twelve pregnant women whose babies were found to be CHD (40 severe CHD and 72 simple CHD) before or after delivery were taken as study group.Women in control group (n =304) were randomly selected from those pregnant women who had infants without CHD.Logistic regression analysis and x2 test were used to analyze the maternal risk factors for fetal CHD. Results (1) The average age of women whose infants had severe CHD was 28.3 years (21-40 years),and it was 29.9 years (22-39 years) for women whose infants had simple CHD.There were no significant differences between the control group (29.5 years,20-44 years) and the above two groups (t=1.511 and -0.826,P=0.138 and 0.410 respectively).(2) Single factor analysis:during first trimester,the rate of upper respiratory infection (18/39,46.2 ％) and exposure to certain chemicals (13/40,32.5％) of severe CHD group were higher than those of control group [(14.9％ (45/303) and 2.0％ (6/304)] (x2 =22.399 and 62.678,OR=4.895 and 23.753,95％CI:2.419-9.905 and 8.358-67.506,P =0.000 respectively).Compared with control group (0.0％,0/304),the rate of pregnant women with CHD family history in simple CHD group was significantly higher (4.2％,3/72)(Fisher exact test,P=0.007).(3) Logistic regression analysis:maternal upper respiratory infections (OR =5.120,95％CI:2.340-11.206,P =0.000) and exposure to certain chemicals (f)R=23.030,95％CI:7.506-70.665,P=0.000) during first trimester were risk factors for fetal severe CHD. Conclusions Upper respiratory infection and exposure to certain chemicals during first trimester might play important roles in the occurrence of fetal severe CHD.Maternal family history of CHD might associate with fetal simple CHD.

Objective? To explore the effects of home visit directed by Peplau interpersonal relationship model on negative emotions and medication adherence in elderly bronchial asthma patients. Methods? From May 2015 to May 2017, we selected 90 elderly bronchial asthma patients in the First Affiliated Hospital of Zhengzhou University as subjects by convenience sampling. All of the patients were divided into observation group and control group with the method of random number table, 45 cases in each group. Observation group carried out home visit nursing based on the Peplau interpersonal relationship model for elderly bronchial asthma patients. Control group adopted routine follow-up care. The medication adherence and disease cognition of patients both groups were recorded with the Medication Adherence Report Scale for Asthma (MARS-A) as well as Insight and Treatment Attitude Questionnaire (ITAQ), and the anxiety and depression of patients both groups before and after intervention were assessed with the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). We also observed the incidence of bronchial asthma acute attack in patients one year after discharge. Results? When home visit was completed and one year after discharge, the medication adherence of observation group was higher than that of control group, and the score of ITAQ was higher than that of control group and that at discharge with statistical differences (P＜ 0.05). One year after discharge, the incidence of bronchial asthma acute attack of observation group was lower than that of control group with a statistical difference (P＜ 0.05). When home visit was completed and one year after discharge, the scores of HAMA and HAMD of observation group were lower than those of control group with statistical differences (P＜0.05). Conclusions? Home visit directed by Peplau interpersonal relationship model help to reduce the incidence of acute attack of elderly bronchial asthma patients external hospital, relieve the negative emotions and improve disease cognition as well as medication adherence.

Objective? To explore the application of three-dimensional quality assessment model of structure-process-outcome in continued nursing care for elderly patients with lung cancer after operation. Methods? By purposive sampling, 48 elderly patients discharged after radical resection of lung cancer from January to December 2016 were taken as control group and received routine continuous nursing care. Another 51 elderly patients discharged after radical resection of lung cancer from June 2017 to June 2018 were taken as the observation group. Continuous nursing program based on structure-process-outcome quality assessment model was applied for the observation group. The effect of intervention was assessed by using Strategies Used by People to Promote Health (SUPPH) and Quality of Life Questionnaire-30(QLQ-30). Results? At 6 months after discharge, the scores of each dimension of SUPPH scale in the observation group were statistically higher than those in the control group (P＜ 0.05). In the observation group the scores of "physical function", "role function", "social function" and "overall health" of QLQ-30 scale were higher than the control group, the scores of "fatigue", "pain", "insomnia", "lack of appetite", "constipation", and "diarrhea" were all lower than the control group with statistical significance (P＜0.05). Conclusions? The continuous nursing care based on the three-dimensional quality assessment model of structure-process-outcome for elderly patients with lung cancer can help to improve their sense of self-efficacy and quality of life.

Objective To explore the application effects of nursing team in patients with acute multiple trauma in multiple disciplinary team (MDT) model. Methods A convenient sampling method was used to select 82 patients with multiple injuries who were treated since the establishment of the trauma center in the First Affiliated Hospital of Zhengzhou University from July 2016 to June 2018. From July 2014 to June 2016, a total of 55 patients with multiple trauma before the establishment of the trauma center were seclected as the control group. The experimental group was used MDT model for rescue, and the control group was used traditional model for rescue. The doctors' arrival time, emergency examination time, emergency stay time, rescue success rate and postoperative complication rate of the specialists in the two groups were compared. Results The doctors' arrival time in the experimental group was (16.80±3.57) min, the time of emergency examination was (22.36±3.49) min, and the time of emergency stay was (38.19±8.18) min, which was shorter than those of the control group (23.27±5.76), (45.69±7.75), (55.49±13.67) min, the differences between the two groups were statistically significant (P＜0.01). The successful rescue rate of the treatment group was 96.3% (79/82), which was higher than 87.3% (48/55) of the control group. The difference between the two groups was statistically significant (P＜ 0.05). The postoperative complication rate was 3.7% (3/82) in the experimental group and 12.7% (7/55) in the control group, the difference between the two groups was statistically significant (P＜ 0.05). Conclusions Patients with multiple trauma received treatment with MDT model can effectively shorten the time of doctors' arrival, emergency examination time, emergency stay time, improve the success rate of treatment, and reduce the incidence of postoperative complications.

Objective:To explore the effect of positive reinforcement theory-based nursing in patients with acute myocardial infarction undergone percutaneous coronary intervention (PCI) .Methods:Convenience sampling was used to select 107 patients with acute myocardial infarction after PCI in the First Affiliated Hospital of Zhengzhou University from July 2018 to June 2020 as the research object. The patients were divided into the experimental group ( n=54) and the control group ( n=53) by random number table method. The control group was given routine nursing after PCI, while the experimental group was given nursing based on positive reinforcement theory on the basis of the control group. After six months of follow-up, the scores of the Self-management Scale for Patients Undergone Coronary Artery Stent Implantation, the Coronary Revascularization Outcome Questionnaire for Determination of Quality, and the incidence of cardiovascular adverse events were compared between the two groups before and after the intervention. Results:After intervention, The total score and the scores of each dimension of the Self-management Scale for Patients Undergone Coronary Artery Stent Implantation and the scores of each dimension of the Coronary Revascularization Outcome Questionnaire for Determination of Quality of the experimental group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The incidence of cardiovascular adverse events in the experimental group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Positive reinforcement theory-based nursing can help improve the self-management ability of patients with acute myocardial infarction undergone PCI, reduce the incidence of adverse cardiovascular events, and improve the quality of life of patients.