Objective To investigate the causes of the complications occurred after repeated embolization therapy for huge cerebral arteriovenous malformations and to discuss their nursing interventions. Methods A total of 54 embolization procedures were performed in 17 patients with huge cerebral arteriovenous malformations. The clinical data were retrospectively analyzed. The causes of complications were carefully examined and the preventive measures were discussed. The prompt and necessary nursing interventions were formulated in order to prevent the complications or serious consequences. Results Among the total 17 patients, one patient gave up the treatment because of the cerebral hemorrhage which occurred two months after receiving 3 times of embolization therapy. One patient experienced cerebral vascular spasm during the procedure, which was relieved after antispasmodic medication and no neurological deficit was left behind. Two patients developed transient dizziness and headache, which were alleviated spontaneously. One patient presented with nervousness, fear and irritability, which made him hard to cooperate with the operation and the basis intravenous anesthesia was employed. No complications occurred in the remaining cases. Conclusion The predictive nursing interventions for the prevention of complications are very important for obtaining a successful repeated embolization therapy for huge cerebral arteriovenous malformations, which will ensure that the patients can get the best treatment and the complications can be avoided.

Objective To observe the effects of insulin caliper for blood glucose control on glycemic central tendency, fluctuation and incidence of hypoglycemia, etc., in emergent and critical patients to evaluate its application value.Methods A prospective single-blinded randomized parallel controlled intervention study was conducted. One hundred patients with severe hyperglycemia requiring treatment with insulin infusion admitted to emergency department and intensive care unit (ICU) of the First Hospital of Jiaxing from November 2015 to November 2017 were enrolled, and they were divided into the caliper group (used patented product insulin calipers for blood glucose control to adjust insulin dose for blood glucose control) and the conventional group (used paper-based insulin dose modification scheme to adjust insulin dose for blood glucose control) on average by random number table, 50 in each group. The gender, age, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), sequential organ failure assessment (SOFA), the principal diseases, main factors affecting blood glucose (hepatic and renal insufficiency, hypoglycemic drugs, glucocorticoids, mechanical ventilation, enteral nutrition, parenteral nutrition, intravenous glucose use, etc.), blood glucose levels at each time node (once every 2 hours after insulin use and once every 4 hours after 16-72 hours), glycemic coefficient of variance (CV), glycemic lability index (GLUGLI) and mean amplitude of glycemic excursion (GLUMAGE), insulin dose, incidence of hypoglycemia, proportion of achieving the glucose control target at each time point, the length of ICU stay and hospitalization cost per patient were recorded and compared between the two groups.Results After excluding those with incomplete data and withdraw in the midway, 92 patients were enrolled in the analysis finally,47 in caliper group and 45 in conventional group. There were no significant differences in the incidence of the gender, age, APACHEⅡ, SOFA, presence of infection at admission, previous diabetes history, glycosylated hemoglobin level, blood glucose at admission, proportion of patients after surgery, major diseases at admission and major factors affecting blood glucose between the two groups. A total of 1379 blood glucose measurements were obtained in the caliper group and 1332 blood glucose measurements were obtained in the conventional group. The glycemic measurements in caliper group were significantly lower than that in conventional group at each time point from 6-72 hours. Compared with conventional group, GLUGLI and GLUMAGE were significantly decreased in the caliper group [GLUGLI: 12.96 (8.73, 19.58) vs. 23.27 (13.07, 44.61), GLUMAGE (mmol/L): 0.66±0.22 vs. 0.87±0.28, bothP< 0.01]; there was a tendency towards decreasing incidence of hypoglycemia in the caliper group [8.51％ (4/47) vs. 15.56％ (7/45)], but no statistical difference was found (P > 0.05); the proportion of achieving the glucose control target was significantly increased in the caliper group [41.99％ (579/1379) vs. 27.18％ (362/1332),P < 0.01]. There were no significant differences in glycemic CV, insulin dose, proportion of hypoglycemic measurements in total measurements, and the length of ICU stay, the length of hospital stay, incidence of nosocomial infection, patient prognosis and cost between the two groups.Conclusion For emergent and critical patients, insulin caliper for blood glucose control presents favorable application value for achieving glucose control target, reducing glycemic fluctuation, and lowering the incidence of hypoglycemia.Clinical trial registration China clinical trial registration center, ChiCTR1800015024

Objective To be investigated the morphology of colorectal small flat adenoma and the expressions of p53 , p21, ER and PR. Methods Colonoscopy ( Olympus CF 240) and microscopy ( Olympus BV 41) were used to observe 50 cases of colorectal small flat adenomas. The expressions of p53 , p21 , ER, and PR were detected by the two steps of immunohistochemistry in 50 cases of small flat adenomas and the surrounding mucosa, 26 cases of colorectal carcinomas, while 15 cases of the normal colorectal mucosa as control group. Results These lesions were distributed throughout the large bowel, the prevalence in order was transverse colon, sigmoid and rectum. The small flat adenoma was round, flat, or sessile in shape, and sized

Objective:To explore the effect of clinical nursing teacher training mode guided by deep learning theory.Methods:The clinical nursing teacher training mode was constructed under the guidance of deep learning theory and in combination with the characteristics of clinical nursing teachers, led and implemented by the university teacher development center. The questionnaire guided by Kirkpatrick Model was used to investigate clinical nursing teachers who had completed the five-stage training. The effects and differences in reaction, learning, behavior, and result levels were compared between the training objects in six training sessions. A total of 138 questionnaires were collected, of which 129 questionnaires were valid, with a response rate of 93.48%. The SPSS 22.0 was used to conduct analysis of variance or chi-square test.Results:On the reaction level, there were significant differences in the satisfaction of trainees in training time, examination form, and organization management ( P<0.05); on the learning level, the trainees had different opinions on the effect of training on promotion and improvement of clinical nursing quality ( P<0.05); on the behavior level, the training objects had different tasks in undergraduate classroom teaching and in hospital and medical association education and training ( P<0.05); on the result level, the clinical nursing teachers who completed the training all participated in different types of nursing teaching. Conclusion:The clinical nursing teacher training mode based on deep learning theory can significantly improve the teaching ability of clinical nursing teachers and promote their professional development.