Objective To explore the possible factors of early postoperative fluid balance and the influence of early postoperative fluid balance on the prognosis of patients undergoing cardiopulmonary bypass. Methods A retrospective study was conducted on the clinical data of 180 adult patients undergoing cardiopulmonary bypass from January 2012 to December 2015.All the patients were from Sun Yat-sen Memorial Hospital, Sun Yat-Sen University. The data were input and analyzed by SPSS 17.0 software. Results The early postoperative fluid balance of cardiovascular surgery with cardiopulmonary bypass was (540.94 ± 135.86) ml. The value of the early postoperative fluid balance (the difference of the total input amount and the total output amount/body quality) in predicting the major clinical outcome was analyzed by ROC curve. The area under the ROC curve from fluid balance was 0.850 (95%CI 0.736-0.965, P<0.01) and it had the sensitivity of 80.0%, and the specificity was 84.6%. The result showed that the cut off values had a good prediction ability for outcome. The cut off values determined by the biggest Youden index were 28.63 ml/kg, indicated that patients may had better outcome when they had the fluid balance of 28.63 ml/kg. The level of early postoperative fluid balance of patients undergoing cardiopulmonary bypass was correlated with mechanical ventilation time, ICU length of stay, higher risk of acute kidney injury, mixed venous oxygen saturation and clinical outcome (P<0.05). Multivariate analysis indicated that European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE Ⅱ), other types of surgery, body mass index, early postoperative urine output and early postoperative drainage flow were independently associated with postoperative fluid balance of patients undergoing cardiopulmonary bypass. Conclusions Early postoperative fluid balance has a good prediction ability for prognosis of patients undergoing cardiopulmonary bypass. Compared with patients having lower level of fluid balance, the patients with a higher level would be more likely to have longer mechanical ventilation time, longer ICU length of stay, higher risk of acute kidney injury and lower level of mixed venous oxygen saturation. By analysis of ROC curves, the cut-off value for early postoperative fluid balance is 28.63 ml/kg, worse prognosis may be predicted if fluid balance is above 28.63 ml/kg. EuroSCORE Ⅱ, other types of surgery, body mass index, early postoperative urine output and early postoperative drainage flow are independently associated with the postoperative fluid balance of patients undergoing cardiopulmonary bypass.

Objective To determine the optimal suetioning negative pressure based on various sputum viscosity in brain-in-jured patients with tracheotomy. Methods Forty-three traumatic brain-injured patients with traeheotomy were recruited in the study. The negative pressure was determined based on the grade of sputum viscosity. Grade Ⅰ sputum was suetioned with the negative pressure of 13.3kPa,16.0kPa,20.0kPa and 24.0kPa, while Grade Ⅱ sputum with 20.0kPa,24.0kPa,26.TkPa and 29.3kPa,and Grade Ⅲ sputum with 26.7kPa,29.3kPa, 33.3kPa and 37.2kPa. The oxygen saturation(SpO2)was mort-itored before and lmin,3min,5min after endotracheal suctioning. At the same time,the suctioning time and tissue trauma were recorded. The data were analyzed by repeated measures analysis of variance with SPSS 13.0 software. Results The results showed that the optimal negative pressure was 13.3-16.0kPa for grade Ⅰ sputum,24.0-26.7kPa for grade Ⅱ sputum and 33.3kPa for grade Ⅲ sputum,which could ensure the minimum decrease of SpO2 and control the suctioning time within 25s or 30s respectively. Conclusion For traumatic brain-injured patients,varions negative pressure should be selected based on the sputum viscosity by the clinical nurses when suctioning is performed,in order to avoid hypoxemia and tissue trauma caused by suctioning.

The extraction method with organic solvent extraction to detect nitric oxide was improved, and the production of nitric oxide in mice myocardium in vitro was detected with this method. Using organic solvent (DETC)2-Fe2 + -NO complex was extracted from water phase into ester phase, and nitric oxide in sample of large volume can be detected by ESR at room temperature. The extracting ability of several organic solvents such as ethyl acetate, butyl acetate, glycerol triacetate, iso-amy lacetate, and n-butanol, was compared, and it was found that ethyl acetate was a good kind of organic solvent. There was a good linear relationship between the concentration of nitric oxide and ESR intensity within concentration of 20μmol/L, and the detected limit was improved to below 200 nmol/L; (DETC)2-Fe2+ -NO complex is easy to decompose in light but it is very stable in dark at 0～4℃ which, there is only a little change after ten days.

Objective To describe uncertainty in illness of patients with hepatocellular carcinoma intending to undergo transcatheter artery chemoembolization (TACE) and to identify the related factors. Methods A descriptive and correlative design was used. By convenience sampling, 95 patients with hepatocellular carcinoma were recruited from Sun Yat-Sen University Cancer Center in this study. Mishel Uncertainty in Illness Scale was used to assess uncertainty in illness and information needs of patients with hepatocellular carcinoma intending to undergo TACE and the demographic questionnaire and Information Needs Assessment Scale were used to measure demographic data, disease and treatment characteristics and information needs of patients. Results The level of uncertainty in illness in most patients with hepatocellular carcinoma intending to undergo TACE was middle (77.61±9.15) points. The mean score of indeterminacy subscale was (50.16 ± 6.16) points. Uncertainty in illness of patients with hepatocellular carcinoma intending to undergo TACE was affected by the degree of education background, domicile, family economic status, way to pay for the medical expenses, course of diseases, how many times he (she) used to undergo assisted treatments and the level of information needs. Conclusions The level of uncertainty in illness in most patients with hepatocellular carcinoma intending to undergo TACE was middle and it is important to assess patients′uncertainty in illness at clinical work and to take effective interventions to content patients′information needs to decrease the level of uncertainty.

Objective To study the feasibility of using the Orem self-care model in the nursing manpower management of pediatrics,and then summarized the experiences of nursing.Methods Analyzed the nursing points when using the Orem self-care model in the nursing manpower management of pediatrics,evaluated the limitation of children′s self-care,and then allocated nurses reasonable.Results The Orem self-care model was the key in the course of advance the quality of life for children,which can ameliorate the communication between the nurses and the children.Conclusion Using the Orem self-care model in the nursing manpower management of pediatrics can effective advance the nursing efficiency.

Adherence refers to the extent to which a patient′s behavior coincides with medical advice without missing a dose or overdosing and taking drugs at the right time. Good adherence could assure the effect of the therapy and reduce neoplasm metastasis and recurrence as well. In this article, status of oral chemotherapy adherence in cancer patients, impact factors and measurement tools had been reviewed. Adherence of oral chemotherapy in cancer patients and measurement tools of oral chemotherapy adherence needed further study. Besides, nursing should also focus on impact factors of the adherence of cancer patients during the oral chemotherapy, and take effective interventions to improve the adherence, so as to ensure the effect of chemotherapy, and improve the survival rate of cancer patients.

Objective To explore the exercise self-efficacy and its influential factors in patients having undergone total hip or knee arthroplasty.Method The Self-Efficacy Rehabilitation Outcome Scale(SER)and demographic questionnaire were used in the investigation among sixty-five patients recruited by convenient sampling.Results The average score on exercise self-efficacy was(67.94±17.22)and the influential factors included age,family income,types of surgery,whether there were monitors for their exercise and whether there were other patients communicating on exercise methods(all P<0.05).Conclusions The self-efficacy in patients after total hip or knee arthroplasty is at lower level.It is necessary to enhance rehabilitative education to improve their self-efficacy in rehabilitative exercise.

Objective To explore the application of scene simulation teaching combined with research design in the teaching of Community Nursing and evaluate its effects.Methods The scene simulation teaching combined with research design was used in the teaching of Community Health Promotion and Health Education in 68 nursing undergraduate students.The student groups were required to do the scenario case preparation and presentation,and conduct the research design according to specific situations of community health education.The mastery of related knowledge of students before and after the class was compared.Results All the student groups completed the course requirements.After class,the students better grasped the community health education,research design and other related knowledge compared with before class.Sixty-one students (89.71％) regarded the scene simulation teaching combined with research design was suitable for the teaching of Community Health Promotion and Health Education,and over 80％ students regarded this teaching was benefit for the development of their ability of self-learning,teamwork and flexible application of knowledge.Conclusions The scene simulation teaching combined with research design can not only help students master related knowledge,but also focuses on students' ability training,which is suitable for comprehensive application of knowledge.

Objective To understand the influene of inhabited environment on psychological and be-havioral symptom of dementia (BPSD) in patients with Alzbeimer's disease. Methods Nenrepsychiatric in-ventory was used to measure the occurrence of BPSD of 100 home and 100 resthome patients with Alzheimer's disease.Tbe data were analyzed with software SPSS version 13.0. Results The scores of hallucinations, anxi-ety,aberrant motor behavior and sleep disturbance in resthome patients were significant higher than those of home patients.There was significantly difference in the extent of occurrence in aberrant motor behavior, apathy/ indifference, hallucinations, sleep disturbance, anxiety,depression/dysphoria and appetite/eating disorders be-tween home and resthome patients,among which the extent of occurrence in resthome patients was higher except for body weight decreasing and appetite/eating disoniers. Conclusions The occurrence of BPSD is different according to different inhabited environment, symptoms of resthome patients are worse, so families should be ap-pealed as far as possibile to allow AD patients living at home.

Objective To evaluate the effects of acupuncture combined with relaxation training on the pain,anxiety and sleep quality in advanced cancer patients.Methods Seventy-one advanced cancer patients with different severity of pain were included in this study and divided into an experimental group and a control group.Besides treatment of analgesic,patients in experimental group were additionally given treatment of acupuncture and relaxation training,while those in control group were only given analgesic.All subjects were evaluated with questionnaires of Pain Inventory,Self-rating Anxiety Scale(SAS),Pittsburgh Sleep Quality Index(PSQI)and Functional Assessment of Cancer Therapy(FACT-G)before and after treatment.Results Total rate of pain relief in the experimental group was 90.63%,which was significantly lower than that in the control group(84.62%)(P＜0.05),showing that acupuncture combined with relaxation training was more effective for pain relief than analgesic therapy in cancer patients.The scores of sleep indexes and anxiety of PSQI and SAS in experimental group were significantly better than those in control group(P＜0.01).There was no significant difference in the scores of quality of life(QOL)between the two groups.Conclusion Acupuncture combined with relaxation training was more effective for relief of pain and anxiety,and for improvement of sleep quality than analgesic therapy in cancer patients.But short-term intervention had no effect on QOL in advanced cancer patients.