Objective To develop a curriculum of a training course for oncology nurses in regard to patient education in sexuality for breast cancer patients. Methods Delphi Method was used in the study. Two rounds of questionnaire investigation were conducted among 21 specialists in breast nursing care, sexology, and psychology. The curriculum was developed after revised based on the comments and suggestions brought up in the experts. Results The training curriculum in sexual health of the breast cancer patients for oncology nurse consisted of 5 sections, professional education, sexology, medicine, psychology and practice, which were divided into 45 teaching topics included in 13 courses. The comments of the specialists on the training curriculum were consistent. The coefficients of variation ranged from 0.07 to 0.20. The coordination coefficient was 0.344. Conclusions The current study developed an integral curriculum for oncology nurses in regard to patient education in sexuality for breast cancer patients, which will benefit oncology nurses for their nursing practice.

Objective To explore the hypertensive vulnerability of residents living in Xuzhou City to provide evidence for effective intervention. Methods Based on multi-stage stratified randomized sampling methed,a total of 4980 residents aged 15 to 69 years from 9 counties of Xuzhou City were selected and completed a standard questionnaire. Hypertensive vulnerability was compared by using Chi-square test. Results The prevalence of hypertension was 13.62% among 15 to 69 years old participants. The residents who had no idea of normal level of blood pressure accounted for 45. 26%. The residents who thought it was unnecessary to measure blood pressure every year since 35 year-old accounted for 29. 68%. Those who did not know individual's salt intake per day accounted for 57. 23%. The participants who had no information on hypertension prevention or control accounted for 21.53% and 12. 05%, respectively. The higher hypertensive vulnerability was associated with lower educational level or monthly income per capita; higher hypertensive vulnerability of patients is less than normal crowed. The rates of current smoking, alcohol consumption,salt over-intake and non-blood pressure measurement were 16. 45%, 11.10% ,30. 00%, and 32. 05% respectively. The higher educational level, higher monthly income per capita or older age crowd ,the lower rate of non-blood pressure measurement, the higher rate of alcohol consumption ; salt over-intake was different in different education levels ( χ2 = 23.37, P＜0. 05 ) ; the older age group were in a higher proportion of current smokers;the behavior vulnerabilities were no difference between the patients and normal crowds. Conclusion Hypertensive vulnerability of residents living in Xuzhou City is high. Hypertension education and healthy living style should be improved to effectively prevent the development of hypertension.

Objective To summarize and evaluate the clinical features,therapeutic methods and prognosis of 197 cases with eating crayfish caused rhabdomyolysis in our hospital within July,2016 to August,2016.Methods Using retrospective method,197 rhabdomyolysis cases induced by eating crayfish were admitted into study.Data of epidemiological character,clinical features,therapy protocol and prognosis were collected and analyzed.Results All the patients had the experience of eating crayfish within 12h before the onset.Patients in this cohort had the common symptoms but varying degrees of myalgia,fatigue of the whole body muscles,and urine color change.Laboratory tests revealed:On day 1 of onset,serum myoglobin level had raised up to the peak with average level at (2 135 ± 1 547) μg/L (0-46 μg/L).Creatine kinase with average level at (4 657 ± 2 178) U/L (25-190 U/L);Aspartate transaminase with average level at 264 ± 83 U/L (10-45 U/L);Lactate dehydrogenase with average level at (1 457 ± 673) U/L (313-618 U/L),all these three markers reached peak on day 2,then gradually declined.All the patients recovered and discharged after relaxation,fluid infusion,alkalization of urine and dealing with the complications.Conclusion Timely diagnosis and treatment of the rhabdomyolysis syndrome induced by eating crayfish could indicate favorable prognosis in these patients from July,2016 to August,2016.

Objective To study risk factors for high-normal blood pressure (HNBP) in residents of urban Xuzhou, Jiangsu province, China. Methods A cross-sectional survey was conducted among 17 500 residents in urban area of Xuzhou from June to December 2008 by cluster sampling with self-designed questionnaire to collect their demographic information and measurements of body height, weight and blood pressure. Data were approached to univariate and multivariate non-conditional logistic regression analysis. Results In total, 17 306 residents finished the survey, with an overall response rate of 98.9percent. Results of univariate analysis revealed that 13 variables such as living region, sex, age,occupation, annual average family income, history of dyslipidemia, smoking, alcohol drinking, intake of pork, and vegetables, daily length of sleeping, body mass index (BMI), abdominal obesity, all were related to HNBP ( P ＜ 0. 05 ). Results of multivariate logistic regression analysis showed that living region, sex,age, annual average family income, alcohol drinking, intake of vegetable, BMI, abdominal obesity all associated with HNBP (P＜0. 05). Conclusions Older age, history of alcohol drinking, increased BMI,abdominal obesity all are risk factors to prompt occurrence of HNBP, and intake of large amount of vegetables is its protective factor.

Objective To explore the interaction of sleep quality and depression among patients with type 2 diabetes. Methods With multistage cluster sampling, all the participants were interviewed with self-designed questionnaire, diabetes-specific quality of life scale and self-rating depression scale, and Pittsburgh sleep quality index scale. Chi-square test was used for qualitative data. Risk factors were analyzed by means of multiple linear regression or logistic regression model. The indicator of interaction was calculated according to the delta method. Results There were 944 residents involved in the final analysis, including 365 males and 579 females. The average age was (64. 0 ± 10. 2) years. Compared with patients with type 2 diabetes mellitus( T2DM) who had good sleep quality and no depression symptoms, the risk of quality of life in those with good sleep quality but depression was 2. 75 (95% CI 1. 59-4. 77); and the risk of quality of life in those with poor sleep quality and no depression was 1. 55(95%CI 1. 03-2. 33). The risk of quality of life in those with poor sleep quality and depression was 4. 97(95% CI 2. 34-9. 63). Due to poor sleep quality and depression in patients with T2DM the combined interaction index was 2. 48 (95% CI 1. 44-4. 29), the relative excess risk was 3. 42(95% CI 2. 16-4. 67), and the attributable proportion was 0. 51(95% CI 0. 32-0. 70). Conclusion A combined interaction of poor sleep quality and depression in affecting the quality of life was found in type 2 diabetic patients. When both factors existed at the same time, the interaction effect of these 2 factors was greater than the single one.

Objective To monitor the medication process of advanced lung cancer patients with renal insufficiency .Meth‐ods Pharmaceutical care ,pharmaceutical intervention and medication were offered according to the individual condition of pa‐tient with renal function based on pharmaceutical experience and related literature .Results The patient finished chemotherapy successfully without adverse reaction .Conclusion Clinical pharmacists should keep improving their knowledge and participat‐ing in first‐line clinical treatment activities;the patient‐centered hospital pharmacy service will be founded and the level of ra‐tional medication will be improved when doctors ,pharmacists and nurses could cooperate sincerely .

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

Objective:To explore the changes of levels of coagulation factors at acute phase (within one week) of aneurysmal subarachnoid hemorrhage (aSAH) and their relations with deep venous thrombosis (DVT).Methods:Two hundred and two aSAH patients (aSAH group), admitted to our hospitals from March 2015 to March 2019, were selected in our study, and these patients were divided into a combined DVT subgroup and a uncombined DVT subgroup according to whether they were combined with DVT on the first and third d of onset. One hundred healthy physical examiners whose age and gender matched with those of aSAH group were selected as control group; one, 3, 5, and 7 d after onset, and one d after enrolling of subjects from the control group, thromboelastogram (TEG) was used to detect the R value of TEG (TEG-R) in all subjects. One, two, 3, 4, 5, 6 and 7 d after onset, color Doppler ultrasonography was used to determine whether aSAH patients had DVT.Results:A total of 73 patients (36.14%) were combined with DVT at acute stage of aSAH; 66 were with asymptomatic thrombosis and 7 with symptomatic thrombosis; 59 were with lower extremity intermuscular vein thrombosis and 14 were with intermuscular vein thrombosis. The incidence of DVT (68/73 [93.2%]) peaked on the 1 st-3 rd d of onset. The TEG-R of patients in aSAH group was statistically lower than that of the control group on the 1 st-3 rd d of onset ( P<0.05); the TEG-R of patients in aSAH group on the 1 st-3 rd d of onset was significantly lower than that on 5 th and 7 th d of onset ( P<0.05). The TEG-R of patients in combined DVT subgroup was significantly lower than that of the uncombined DVT subgroup ( P<0.05). Conclusions:Hyperfunction of coagulation factors at acute stage of aSAH is noted within one-3 d of onset; the incidence of DVT is the highest within 3 d of onset, mainly featured as asymptomatic intermuscular venous thrombosis. Whether or not aSAH would combine with DVT is associated with hyperfunction of coagulation factors.

Objective:To observe the 95% effective dose (ED95) of Propofol mono-sedation for successfully inserting the gastroscope in healthy adults by biased coin design up-and-down sequential method.Methods:Using prospective study method, a total of 40 patients proposed for painless gastroscopy in Beijing Friendship Hospital, Capital Medical University from April to May 2021 were selected. There were 15 males and 25 females. American Society of Anesthesiologists (ASA) classification: grade I 26 cases, grade Ⅱ 14 cases. The mean age was (50.80±9.14) years, and the mean body mass index was (24.08±2.65) kg/m 2. Propofol mono-sedation was used in all patients. The initial dose of Propofol was set as 1.6 mg/kg, adjusted with 0.1 mg/kg as a step size. The biased coin design up-and-down sequential method was used in this study. The Propofol dose of subsequent patients was determined by the response to gastroscope insertion of the previous patient. If the gastroscopy insertion reaction of the previous patient was positive, the Propofol dose of the next patient was increased by one level (0.1 mg/kg); if the gastroscopy insertion reaction of the previous patient was negative, the biased coin random was performed, and the Propofol dose used by the next patient was reduced by one level (0.1 mg/kg) with 5% probability and remained unchanged with 95% probability. Changes of mean arterial pressure, heart rate and pulse oxygen saturation were recorded at different time points, and adverse reactions such as perioperative hypotension, bradycardia, tachycardia and hypoxemia were recorded. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between different time points. The ED95 and 95% CI of Propofol in inhibiting the response to gastroscope insertion was calculated by Probit regression analysis. Results:All 40 patients successfully completed the gastroscopy. The calculated ED95 of Propofol mono-sedation for successfully inserting the gastroscope was 2.58 mg/kg with 95% CI of 2.40-3.31 mg/kg. The mean arterial pressure before anesthesia, after propofol injection, at the time of gastroscopy going through throat and immediately after examination was (97.33±13.34) mmHg, (93.15±11.35) mmHg, (78.95±9.30) mmHg, (79.38±9.94) mmHg (1 mmHg=0.133 kPa), respectively. The mean arterial pressure at the time of gastroscopy going through throat and immediately after examination decreased significantly, the difference was statistically significant ( P<0.01). There were no significant differences in heart rate and pulse oxygen saturation compared with those before anesthesia ( P>0.05). Conclusion:The ED95 of Propofol mono-sedation for successfully inserting the gastroscope is determined as 2.58 mg/kg (95% CI: 2.40-3.31 mg/kg) by biased coin design up-and-down sequential method.

Objective To explore the effects of empowerment education combined with family support in management of elderly patients with coronary artery disease combined with renal dysfunction.Methods A total of 100 patients with coronary artery disease combined with renal dysfunction from March 2013 to March 2014 were included and randomly divided into observation group (n =50)and control group (n =50).The same drug treatment was used in both groups,additionally,the routine health education was performed in control group and empowerment education combined with family support was adopted in observation group.The self-care ability, life quality,satisfaction and clinical related indicators were evaluated before interventions and 6 months after interventions.Results After 6 months,there were more patients with medication compliance (72.0%), regular exercise (70.0%),and returning visit on time (70.0%)in observation group than those in control group (P <0.05).The levels of serum creatinine,urea nitrogen and urine protein decreased in both groups, and they decreased more significantly in observation group.The scores of life quality (96.49 ±2.63)and satisfaction (9.09 ±0.88 ) were higher in observation group than those in control group (P <0.05 ). Conclusions The empowerment education combined with family support can improve self-care ability,life quality,satisfaction and clinical related indicators of elderly patients with coronary artery disease combined with renal dysfunction.