BACKGROUND: There are some cytokines like interleukin-6, tumor necrosis factor-alpha as well as neurohormones such as norepinerphrine in serum of patients with congestive heart failure. However, whether they influence the occurrence and development of congestive heart failure is uncertain.OBJECTIVE: To explore the changes and significance of interleukin-6,tumor necrosis factor-alpha and norepinerphrine in order to provide basis for assessing the severity of heart failure and its prognosis.DESIGN: A case control study.SETTING: Department of Cardiology, Shidong Hospital of Shanghai City.INTERVENTIONS: A total of 58 patients with congestive heart failure admitted to Department of Cardiology, Shidong Hospital of Shanghai City from January 2000 to October 2001 were chosen as patient group with 33 males and 25 females. According to NYHA heart function classification,there were 12 cases of level Ⅱ, 32 cases with level Ⅲ and 14 cases of level Ⅳ. Thirty healthy volunteers who took physical examination during the same time were chosen as control group with 18 males and 12 females.ELISA was used to assay the levels of interleukin-6, tumor necrosis factoralpha and norepinerphrine in serum while two-dimension echocardiography was used to test the left ventricular ejection fraction in order to observe the relationship between cytokines and heart function.RESULTS: ① The levels of interleukin-6 [(367.6±78.6), (569.7±117.3)ng/L], tumor necrosis factor-alpha [(395.3±82.4), (583.1±124.8) ng/L] and norepinerphrine [(396.5±85.3),(675.9±136.2) ng/L] in patients with level Ⅰ-Ⅱ, Ⅳ heart function was remarkably higher than those of patients with level Ⅱ heart function and people in control group[(221.5±58.4), (170.2±42.7)ng/L; (205.4±59.2), (180.3±43.8) ng/L; (227.4±65.6),(163.8±41.5) ng/L] (P ＜ 0.05). Compared patients of level Ⅱ heart function with people in the control group, there was no difference on the above indicators (P ＞ 0.05).②There was highly negative correlation between interleukin-6, tumor necrosis factor-alpha, norepinerphrine and left ventricular ejection fraction (r=-0.63, P＜ 0.01; r=-0.54, P＜ 0.05;r=-0.58,P ＜ 0.01). The more severe the heart failure, the higher the levels of interleukin-6, tumor necrosis factor-alpha and norepinerphrine. There was obviously positive correlation between tumor necrosis factor-alpha and norepinerphrine as well as between interleukin-6 and norepinerphrine (r=0.57,P ＜ 0.01;r=0.51,P ＜ 0.05). The more severe the heart failure, the higher the level of interleukin-6 and tumor necrosis factor-alpha and that there was positive correlation between them (r=0.39, P ＜ 0.05).CONCLUSION: The tumor necrosis factor-alpha and interleukin-6 levels in patients with congestive heart failure all increased, especially in patients with moderate or severe congestive heart failure, and represented negative correlation with left ventricular ejection fraction. It suggests that the levels of interleukin-6, tumor necrosis factor-alpha in serum can be used as indicators to assess the severity and prognosis of congestive heart failure and provide assessment basis for quantitative evaluation of rehabilitation interventions.

ObjectiveTo observe the clinical effect of low molecular weight heparin calcium in the treatment of chronic obstructive pulmonary disease combined with pulmonary heart disease.MethodsA total of 64 patients with chronic obstructive pulmonary disease combined with pulmonary heart disease from December 2008 to December 2010 were enrolled in this study and divided into treatment group and control group by random digits table with 32 cases each.The control group was given routine treatment and the treatment group was given low molecular weight heparin calcium for 7 days at the basis of routine treatment.ResultsThe total effective rate in treatment group[ 90.6％ (29/32) ] was significantly higher than that in control group [ 68.8％ (22/32) ] (P ＜ 0.05 ).In treatment group,the levels of arterial carbon dioxide tension (PaCO2) and arterial oxygen tension (PaO2) after treatment [(54.64±9.63),(74.21 ± 11.76) mm Hg (1 mm Hg =0.133 kPa)] were significantly decreased compared with before treatment [(78.66 ± 11.22),(53.42 ± 8.84 ) mm Hg ] (P ＜ 0.01 ).In control group,the levels of PaCO2 and PaO2 after treatment [ (61.10 ±7.24),(65.07 ± 8.21 ) mm Hg] were significantly decreased compared with before treatment[ (79.52 ± 12.54),(51.35 ± 7.31 ) mm Hg ] (P ＜ 0.05 ).After treatment the levels of PaCO2 and PaO2 in treatment group were better than those in control group (P ＜ 0.05).ConclusionsThe low molecular weight heparin calcium in treatment of chronic obstructive pulmonary disease combined with pulmonary heart disease can effectively improve the clinical manifestation.It is worth the clinical promoted application.

Objective To analyze the falls of female inpatients with the psychotics diseases and summarize effective nursing intervention. Method Two hundred and eighty-nine psychiatric female inpatients from April 2014 to August 2014 were collected, and the reasons of falls cases during this period were analyzed and nursing methods were formulated. Result Nine patients fell, with an incidence of 3.11%(9/289) including the reason of lack of risk dynamic evaluation, lack of fall prevention measures and shortage of nursing personnel. Conclusions The reasons for the falls of the hospitalized psychiatric female patients include lack of risk dynamic evaluation, lack of fall prevention measures, shortage of nursing personnel. The nursing countermeasures include risk assessment of dynamic management and the implementation of the fall prevention measures , strengthening training and health education so as to prevent and reduce the occurrence of falls and ensure patients'safety.

H type hypertension is essential hypertension complicated elevated plasma homocysteine level ,which ac-counts for about 75% in Chinese adults with hypertension and is closely related to cerebral stroke and other cardio-vascular diseases .Lowering homocysteine level in patients with hypertension possesses important significance for preventing stroke .

Objective:To explore the application method and effect of mind mapping in the practice teaching of psychiatric nursing students.Methods:A total of 31 undergraduate nursing students from June to December in 2018 were selected as the experimental group, and 32 interns from April to July in 2019 were selected as control group. The experiment group adopted the mind mapping method to carry out the teaching while the traditional teaching method was used for teaching in control group. The changes of the critical thinking ability, the evaluation on the teaching method, and the performances of the theoretical and operational assessments were compared between the two groups of nursing students before and after the practice teaching. SPSS 20.0 was used for t-test, Chi-square test, and rank sum test. Results:The experimental group improved significantly in the score of the critical thinking ability scale. It was raised to (331.03±14.31) points from (248.09±24.45) points before teaching. The score of experimental group was significantly higher than that in control group ( P<0.05). The affirmative evaluation of each item in the experimental group was more positive than that in the control group, and the difference was statistically significant ( P<0.05). The theoretical scores were (88.35±7.71) points and the operational scores were (86.45±5.03) points in experimental group after the practice; the theoretical scores were (74.41±10.27) points and the operational scores were (81.02±6.64) points in control group after the practice teaching. There were significant differences between the two groups ( P<0.05). Conclusion:The use of mind mapping method in clinical teaching has improved the enthusiasm of psychiatric nursing students. The method of learning changes from passive to active. At the same time, this method has also promoted the cultivation of nursing students' critical thinking ability, which is worthy of clinical promotion.

Objective:To explore the status quo of mental health specialist nurses' awareness of suicide of inpatients.Methods:Totally 58 mental health specialist nurses from general and specialized hospitals in a city in Jiangsu Province from July 2018 to July 2019 were selected by convenient sampling, and investigated with the self-designed questionnaire for Mental Health Specialist Nurses' Awareness of Suicide Prevention.Results:TheMental Health Specialist Nurses' Awareness of Suicide Prevention scoreof 58 nurses was (13.19±2.05) ; there were no statistically significant differences in the acquisition channel of suicide prevention knowledge between nurses who scored 14 or above and those who scored less than 14 ( P>0.05) . The single factor analysis showed that the difference in the suicide knowledge scores of nurses in different departments was statistically significant ( P<0.05) . There were statistically significant differences between the general knowledge of suicide and the total score of suicide knowledge between psychiatric nurses and nurses in neurology / internal medicine and other departments ( P<0.05) . Conclusions:Mental health specialist nurses' awareness of suicide and suicide prevention related nursing behaviors are not ideal. Nursing managers should carry out suicide prevention knowledge training to improve their awareness and prevention of suicide.

Objective:To understand the status of readiness of returning to work for schizophrenic patients during rehabilitation, and to analyze the influencing factors.Methods:A convenient sampling method was used to select 300 patients with schizophrenia during rehabilitation period who were admitted to a Class ⅢGrade A psychiatric hospital in Jiangsu Province from April 2018 to March 2019. They were surveyed using the Social Disability Screening Schedule (SDSS) and the Readiness for Return-to-work Scale (RRTW) .Results:The RRTW scores of the 300 schizophrenia patients who returned to work during the rehabilitation period from high to low were as follows: the contemplation dimension was (3.18±1.24) , the precontemplation dimension was (2.85±1.07) , the prepared for action-self-evaluative dimension was (2.74±1.03) , the prepared for action-behavioral was (2.14±0.82) . The distribution of the number of people in each dimension from high to low is as follows: contemplation (209 cases) , precontemplation (43 cases) , prepared for action-self-evaluative (37 cases) , prepared for action-behavioral (11 cases) .The results of Pearson correlation analysis show that social disability and social withdrawal, social activities outside the family, activity inside the family, family functions, interest and concern for the outside world, responsibility and planning are negatively correlated with readiness to return to work ( r=-0.222--0.442, P<0.05) . Conclusions:The readiness of schizophrenic patients to return to work during rehabilitation is at a low level. Psychiatric nursing staff should take targeted intervention measures to improve the readiness of patients with schizophrenia to return to work according to the influencing factors of their readiness to return to work.

Objective:To systematically evaluate the medication experience and needs of patients with oral anticancer drugs at home, providing reference for the formulation and implementation of home supervision measures for these patients.Methods:PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, CNKI, Wanfang database, VIP database and Chinese biomedical literature database were searched by computer to collect qualitative studies on medication experience and needs of patients with oral anticancer drugs at home. The retrieval period was from the database construction to May 1, 2021. The quality of the literature was evaluated by the Australian JBI qualitative research quality evaluation criteria for evidence-based health care centres, and the results were integrated by the pooled integration method of Meta-integration.Results:A total of 11 studies were included, 52 results were extracted, 13 categories were summarized and 4 integrated results were obtained: heavy negative psychological experience; undergo physical trials; a desire for outside support; adjust to the disease.Conclusions:According to the four aspects of experience and needs of patients with oral anticancer drugs at home, medical staff should guide them to establish health belief, improve disease perception and coping ability, and take measures to meet patients′ needs for knowledge, communication and social support through multiple channels.

Objective:To explore the inner experience of self-management of adverse drug reactions in patients with oral chemotherapy at home, so as to provide a basis for medical staff to better implement home supervision of patients.Methods:This study was a qualitative study. The purposive sampling method was used to select 12 patients with gastrointestinal tumors who were admitted to Department of Oncology of a ClassⅢ Grade A hospital in Nanjing from April to May 2021 and were required to take oral chemotherapy drugs at home for semi-structured in-depth interviews. Colaizzi's 7-step analysis method was used to analyze and summarize the interview data.Results:A total of 3 themes and 7 sub-themes were extracted from the inner experience of self-management of adverse drug reactions in patients with oral chemotherapy at home. Theme one was the perception of self-management of adverse drug reactions in patients undergoing oral chemotherapy at home. This included anxiety and fear in the face of adverse reactions and ambivalence in seeking to communicate with medical staff. The topic two was the attitude and behavior of self-management of adverse drug reactions in patients with home-based oral chemotherapy drugs. This included insufficient attention to active review of adverse effects of myelosuppression and a lack of ability to identify adverse drug reactions. The topic three was the motivation and needs of self-management of adverse drug reactions in patients with home-based oral chemotherapy. The family's careful care provided strong support, the convenience of mobile communication relieved the patient's troubles and there was a need for information and knowledge of the adverse reactions of oral chemotherapy drugs.Conclusions:Medical staff need to strengthen drug knowledge education and psychological care for gastrointestinal tumor patients taking oral chemotherapy drugs at home and build a mobile information platform to improve their self-management capabilities.

Objective:To explore the correlation between lateral violence, leadership empowering, psychological capital and work alienation among nurses in Oncology Department.Methods:From July to September 2022, a survey was conducted on 327 nurses of Oncology Department in Jiangsu Province using the Nurse Lateral Violence Scale, Chinese version of Empowering Leadership Scale, Chinese version of Psychological Capital Questionnaire and Nurse Work Alienation Questionnaire. The PROCESS program was used to analyze the moderated mediation model.Results:The lateral violence of nurses in Oncology Department had a positive predictive effect on work alienation, and the difference was statistically significant (β=0.339, P<0.01) . Leadership empowering had a partial mediating effect on the correlation between lateral violence and work alienation with a statistical difference, the effect value was 0.071, accounting for 20.94% of the total effect. Psychological capital had a moderating effect on the second half of the mediating effect of leadership empowering, and the difference was statistically significant (β=-0.360, P<0.01) , and the impact of lateral violence on work alienation increased with the increase of psychological capital level. Conclusions:The lateral violence among nurses in Oncology Department can affect work alienation through leadership empowering. The mediating model of psychological capital regulating the correlation between leadership empowering and work alienation is established.