Objective To establish an appraisal system of clinical comprehensive competence for nursing undergraduates.Methods The level construction tree model was established by questionnaire survey based on Delphi method,and the weights of each indicator in three grades were calculated.Results The appraisal system of clinical comprehensive competence for nursing undergraduates was ultimately established which contained 6 first-level indicators,21 second-level indicators and 69 third-level indicators.In third-level indicators,the indicators with the highest weight value was The students can use the communication skills when assessing,carrying out,evaluating and giving health education,the indicators with the lowest weight value was The research point had some value. and The research novelty met needs.Conclusions The appraisal system is scientific and reliable,and can provide basis for appraising the clinical comprehensive competence for nursing undergraduates.

Objective To evaluate the reliability and validity of Bowel Function Index applied to assess the constipation induced by strong opioid drugs for patients with cancer pain.Methods 126 patients with constipation induced by strong opioid drugs for pain caused by cancer were selected.BFI,Patient Assessment of Constipation Symptoms(PAC-SYM) and clinical observations were used to collect data which were conducted for reliability analysis,correlation analysis and tests for several independent samples to evaluate the reliability and validity.Results The internal consistency determined by Cronbach αt was 0.86 for the total BFI score.Significant correlations were found among BFI,PAC-SYM and clinical observations.The BFI total score and each item scores of three groups all showed significant differences.Conclusions The Chinese version of BFI is a simple,valid and reliable,clinically relevant tool to assess the constipation induced by strong opioid drugs for pain caused by cancer.

Objective To investigate the effects of artificial airway cuff pressure at different monitoring intervals on ventilator associated pneumonia (VAP) in critical patients. Methods About 56 patients treated with mechanical ventilation from January 2015 to December were grouped by ward numbers:32 patients in the south ward were in the experiment group and 24 in the north ward were in the control group. The two groups were given the same routine care, e.g., mechanical ventilation by endotracheal intubation. In the experiment group, the cuff pressure was controlled to 30cm H2O every six hours and the control group was every 4h. The two groups were compared in terms of the incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation and mortality. Result The incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation, and mortality showed no significant differences between the two groups (P>0.05). Conclusions For mechanically ventilated patients, the cuff pressure controlled to 30cm H2O every 6h can not increase the incidence of VAP, duration of mechanical ventilation and mortality. It can reduce the nursing workload.

Objective To develop the Quality of Life Questionnaire with traditional Chinese medicine characteristics for patients with ulcerative colitis.Methods The pool of entries were initially formed by using literature review,theoretical analysis and interviews.Delphi technique was used to formulate.quality of life questionnaire for patients with ulcerative colitis through a two-round expert consultation among 22 experts in 9 provinces.Results In two-round surveys,the rates of questionnaire retrieve were 95.7％ and 100.0％,respectively.The authoritative coefficients was 0.85,the coordination coefficients were 0.288 and 0.290,respectively,P＜ 0.01.The preparation of the primary scale consisted of physical,psychological,independence and social function of 4 dimensions and 48 items.Conclusions A reliable and valid questionnaire with traditional Chinese medicine characteristics for evaluation of quality of life for patients with ulcerative colitis was developed.It can be used to provide reference for the evaluation of the quality of life for patients with ulcerative colitis in China.

Objective To explore the effect of auricular plaster therapy on associated symptoms and quality of life in patients with constipation induced by strong opioid drugs for pain.Methods A total of 60 patients selected were randomly divided into the intervention group and the control group with 30 cases in each group.The intervention group was treated with auriculotherapy based on the pattern/syndrome differentiation after detecting the auricular sensitive acupoints' distribution in patients with opioid-induced constipation after receiving opioid therapy.BFI,self-made scale on symptoms accompanied by constipation and PAC-QOL were used to collect data about constipation symptoms and the level of quality of life before or after the intervention,and still with a subset of the intervention group followed for more than two weeks.Results The BFI and PAC-QOL scores of the intervention and control group were lower after intervention,and the decline score of the two groups showed significant difference.But for the self-made scale,the score of each item was slightly lower compared with that before treatment,which showed no statistically significant difference between groups.A follow-up of 2 weeks showed that the long-term efficacy of auricular plaster therapy was significantly lower than before,but was less desirable than short-term.Conclusions Scientific and reasonable choice of acupoint prescription according to syndrome differentiation can effectively improve symptoms accompanied by constipation and patients' quality of life.

Objective: To explore the possible types of patients with gastric cancer undergoing chemotherapy based on their experience with the symptom cluster of pain, fatigue, sleep disturbance. Methods: Totally 161 gastric cancer patients were investigated by the demographic and clinical characteristics questionnaire, the Numeric Rating Scale (NRS), the Brief Fatigue Inventory (BFI), the Pittsburgh Sleep Quality Index (PSQI), Quality of Life Questionnaires (QLICP-ST). Cluster analysis using SPSS 22.0 version was performed to categorize patients. Results: Four different types of patients were got through cluster analysis. Type Ⅰ patients showed all low symptoms (23 cases accounted for 14.3%), Type Ⅱ patients showed low pain and moderate fatigue (43 cases accounted for 26.7%), Type Ⅲ patients showed low pain and high fatigue (62 cases accounted for 38.5%), Type Ⅳ patients performed moderate-to-high on all symptoms (33 cases accounted for 20.5%). Their education status, chemotherapy cycle sand KPS score were the main factor influencing the classification of pain-fatigue-sleep disorder symptoms in patients with gastric cancer undergoing chemotherapy after operation (χ²=13.873, 26.442, F=3.193, P<0.05 or 0.01). Type Ⅳ tended to have higher education level, lower KPS score and later stage of chemotherapy. Furthermore, patients in moderate-to-high class had significantly lower quality of life score than all low class (F=10.552, P <0.01). Conclusion In this research, patients with gastric cancer undergoing chemotherapy were divided into 4 types based on their experience with the symptom cluster of pain, fatigue and sleep disturbance. It could provide basis for effectively screening and implementing measures for symptoms management.

OBJECTIVETo observe the efficacy difference between scrapping therapy combined withDecoction and the single application ofDecoction for perimenopausal syndrome (PMS) with pattern of fire excess fromdeficiency.

METHODSEighty patients were assinged into an observation group and a control group, 40 cases in each one. Patients in the control group were treated with oral administration ofDecoction to clear heart heat and nourish kidney. One dose of the decoction was taken by two times within one day. Based on the treatment of the control group, patients in the observation group were additionally treated with scrapping therapy along the urinary bladder meridian of foot-, heart meridian of hand-and kidney meridian of foot-; the scrapping therapy was performed at Back-points, Shenmen (HT 7), Yongquan (KI 1), Taixi (KI 3), Zhaohai (KI 6), Sanyinjiao (SP 6), Zusanli (ST 36), etc.; the treatment was given once every week. Four weeks of treatment were taken as one course in two groups, and totally 2 courses were given. The modified Kupperman score, menopausal quality of life (MENQOL), level of serum estrogen (E), follicle stimulating hormone (FSH) and luteinizing hormone (LH) before and after treatment as well as the clinical efficacy were valuated between the two groups.

RESULTSAfter treatment, each item score and total score of modified Kupperman were reduced apparently in the two groups (<0.01,<0.05) except dyspareunia score in the control group. The score of hot flash and sweating, paresthesia, depression, fatigue, arthralgia, palpitation, formication, urinary symptoms and total score in the observation group were superior to those in the control group (<0.01,<0.05). After treatment, the total score and each dimension score of MENQOL were obviously decreased in the two groups (all<0.01), and the scores of vasomotor symptoms, psychosocial condition and physical condition in the observation group were significantly lower than those in the control group (<0.01,<0.05). There were no significant differences of serum hormone levels before and after treatment between the two groups (all>0.05), however, after treatment, the serum Elevel had the tendency to raise and serum LH, FSH levels had the tendency to decrease in the observation group. The total effective rate was 97.4% (37/38) in the observation group, which was higher apparently than 81.1% (30/37) in the control group (<0.01).

CONCLUSIONSThe scrapping therapy combined withDecoction or the simple application ofDecoction can both improve PMS symptoms and the quality of life, delay the ovary recession; the combination of scrapping therapy andDecoction achieve superior efficacy on PMS syndrome to the simple application ofDecoction.

OBJECTIVETo compare the difference in the therapeutic effect on post-infectious cough differentiated as wind-cold retention in the lung between the combined therapy of scraping anddecoction and the simple application ofdecoction.

METHODSEighty patients were randomized into a combined therapy group and a Chinese herbal medicine group, 40 cases in each one. In the Chinese herbal medicine group, the oral administration ofdecoction was used. The main ingredients included,,,,,,,, etc., one dose a day, twice a day. In the combined therapy group, on the basis of the treatment as the Chinese herbal medicine group, scraping therapy was added and applied to the bladder meridian of foot-, the lung meridian of hand-, the conception vessel and the governor vessel, focusing on Tiantu (CV 22), Baihui (GV 20), Dazhui (GV 14), Feishu (BL 13), Fengmen (BL 12), Taiyuan (LU 9), Lieque (LU 7) and Fengchi (GB 20), once a week and one-week treatment as one session. Totally, the continuous two sessions were required in the two groups. The cough symptom score, cough remission time, relapse, TCM syndrome score, the score of Leicester cough questionnaire (LCQ), SP concentration in the supernatant of the induced sputum before and after treatment as well as clinical efficacy were observed in the two groups.

RESULTSThe cough symptom score, TCM symptom score and SP concentration in the supernatant of the induced sputum were all apparently reduced after treatment in the patients of the two groups (all<0.01). The scores in the combined therapy group were reduced in the higher amplitude as compared with those in the Chinese herbal medicine group (all<0.01). The total effective rate was 95.0% (38/40) in the combined therapy group, better than 87.5% (35/40) in the Chinese herbal medicine group (<0.05). Regarding the cough remission time and relapse rate, the results in the combined therapy group were better than those in the Chinese herbal medicine group[(5.3±1.2) d vs (7.4±1.5) d,<0.01; 0% (0/19) vs 62.5% (5/8),<0.01]. The scoreo of LCQ was all apparently improved in the patients of the two groups (both<0.01), and the score in the combined therapy group was higher than that in the Chinese herbal medicine group (<0.01).

CONCLUSIONSScraping therapy combined withdecoction and the simple application ofdecoction all relieve the symptoms of post-infectious cough and improves the living quality. The therapeutic effects of the combined therapy are superior to the oral administration ofdecoction.