Objective To describe the current status and existing problems on the specialist nurse in China and provide references for nurse management.Methods The following databases were searched:Chinese Biomedical Literature Database (SinoMed),China Academic Journal database,Chinese Science and Technology journals database,using the key words specialty nurse,clinical nurse specialist and advanced practice nurse.Strict inclusion and exclusion criteria were applied.Results Seven hundred and eighteen papers were eligible for inclusion.The earliest paper was published in 1992,then the number increased yearly.Most of the papers were reviews or summaries of experience,and the hotspot were about the nurse specialist in ICU,operating room,emergency,oncology and diabetes department.Conclusions The attempt about nurse specialist have been carried out in the whole country,but further improvement and practice are needed to solve the existing problems such as the definition,training,certification and nurse management,and it is urgent for us to explore a suitable way for the development of specialist nurse in China.

The rise of advanced nursing practice in the developed countries promotes the development of nursing science, nursing postgraduate education arises at the historic moment. Professional nursing postgraduate education started late in our country and its development is not mature, there exists some problems in the training plan and professional positioning, such as training process not realizing the training objectives, unreasonable curriculum setting and evaluation system, unclear professional direction, disconnection of vocational orientation and the professional qualification and specialist nurse certification. Therefore, nursing professional degree graduate education mode needs further exploration and unity.

Objective To explore the current research status and existing problems in severe burn nursing by reviewing relevant literature of severe burn nursing published in 6 kinds of nursing core journals. Methods Search 6 kinds of nursing core journals using the following key words: severe burn critical burn serious burn large area burn intensive burn and nursing. Applying bibliometrics to conduct descriptive analysis of the external and internal characteristics of these papers. Results Two hundred and nine papers were included;the main literature research type of thess articles was clinical experience summary, the content of these literature was extensive. Conclusions Severe burn nursing research focus on clinical symptomatic nursing; clinical nurse scientific research ability needs to be strengthened, and subject aspects should be paid more attention to children, the elderly, and clinical nurse physical and psychological conditions.

Objective To study the efficacy and safty of low dose rituximab therapy in elderly patients with chronic refractory immune thrombocytopenia(ITP) .Methods 36 elderly patients with chronic refractory ITP were collected from Xingtai People′s Hospital of Hebei ,the patients were given intravenous injection of intravenous rituximab at the dose of 100 mg once weekly for 4 consecutive weeks ,observing the efficacy and adverse reaction and following up for 12 months .Difference of platelet (PLT ) ,white blood cell (WBC) ,cluster differentiation 8 + (CD8 + ) ,CD19 + eukomonocyte number and immunoglobulin (IgG ,IgM ,IgA )were compared before and after treatment .Results The responses of complete remission (CR)were 17 casese(47 .2% ) ,remission (R) were 11 casese (30 .6% ) and no remission (NR) 8 casese (22 .2% ) respectively ,2 patients experienced mild dizziness and chest tightness ;PLT were significantly increased ( P = 0 .001) after treatment ,CD19 + lymphocyte count decreased significantly (P =0 .001) ,WBC ,CD8 + lymphocyte and serum immunoglobulin IgG ,IgM ,IgA showed no significant difference before and after treat-ment(P> 0 .05) .Conclusion Low dose rituximab had better clinical efficacy for the treatment of elderly patients with chronic re -fractory ITP ,low dose rituximab may be a effective treatment in elderly chronic refractory ITP patients with minor adverse reac -tions .

Objective To investigate the effects of a mobile application-based continuous breastfeeding intervention program for gravidas. Methods Pregnant women who received prenatal care and delivered at First Maternity and Infant Hospital Affiliated to Tongji University were enrolled in this quasi-experiment from April 1 to May 31, 2017. Those women who met the inclusion criteria in the Eastern and Southern campuses of the hospital were recruited as intervention group (n=100) and control (n=100) group, respectively. In addition to the routine breastfeeding support which the control group was offered only, the intervention group also received mobile application-based continuous breastfeeding intervention, namely a questionnaire was sent through WeChat official account where the pregnant women had free access to continuous breastfeeding support based on their survey results, such as understanding the benefits of breastfeeding at the first trimester, relationships between breastfeeding and immunity at the second trimester, breast care at the third trimester, treatment of milk spillage/spit during labor, and iron and vitamin supplementation at puerperium. Basic information about the participants, results of Breastfeeding Knowledge Questionnaires administered at the first, second and third trimesters and during labor and the puerperium, responses to Self-efficacy of Breastfeeding Questionnaires during labor and the puerperium, and exclusive breastfeeding rates at discharge and 42 d postpartum were compared between the two groups using two independent sample t-test and Chi-square test. Results There were 83 and 80 pregnant women in the intervention group and control group finally analyzed, respectively. No statistical difference in the scores of the Breastfeeding Knowledge Questionnaire at the first trimester was observed between the intervention group and control group (13.4±1.9 vs 13.3±1.9, t=0.133, P=0.895). However, the scores at the second and third trimesters and during labor and the puerperium in the intervention group were higher than those in the control group (14.1±1.3 vs 13.5±2.0, 14.7±1.1 vs 14.2±1.3, 15.3±1.7 vs 14.4±1.2 and 15.7±1.5 vs 14.9±1.0; t=2.160, 2.435, 4.104 and 3.946; all P<0.05), respectively. The scores of Self-efficacy of Breastfeeding Questionnaires during labor and the puerperium were also higher in the intervention group (123.5±4.7 vs 118.5±5.7 and 128.4±4.2 vs 119.0±6.5, t=6.170 and 10.959, both P<0.01). Compared to the control group, the intervention group had higher exclusive breastfeeding rate at discharge and on 42 d after delivery [78.3% (65/83) vs 61.2% (49/80), χ2=5.641; 57.8% (48/83) vs 38.8% (31/80), χ2=5.938; both P<0.05]. Conclusions The mobile application-based continuous breastfeeding intervention program may effectively improve breastfeeding outcomes.