Objective To research the effects of establishing core system key risk index in reducing adverse events. Methods Analyzed the causes of the 147 adverse events in 2014. Including the core system implementation of the reasons for the end of the adverse events caused, the data of fundamental reasons in adverse events and the high risk link that because nurses don′t practice the core system. In 2015, randomly checked the 29 nursing units, including 27 wards and emergency outpatient transfusion room, ICU. Contains the implement rates of the core system in transfusion treatment, day and night shifts, doctors′ advice and patients′ identification. In order to quarterly analysis the index and pertinently improve the results, assessors of quality administration council, head nurse in endemic area and attendant watch keeper are chosen to gather index data. Results After one year of management, the key aspects of the core system execution qualified rate has reached 95%, the check of the implementation of the system, the total pass rate compared with before had increased 6.94%, orders execution system implementation of a qualified rate had increased 9.33%, patient identification system implementation of qualified rate had increased 4.29%, the qualified rate of change of comparison the differences were statistically significant (P<0.05). After the establishment of the core system key risk index management, the adverse events had decreased 11.06%(P < 0.05). Conclusion The establishment of the core system key risk index management can effectively improve the implement rates and reduce the nurse adverse events.

Objective To study the sonographic features of fetal lung in normal and preeclampic pregnancies,with follow-up on the occurrence of neonatal respiratory distress syndrome (NRDS),as well as,examine the effects of preeclampsia (PE) on fetal lung maturity (FLM).Methods We collected data from 140 cases during the early pregnancy period (29 to ＜34 weeks),100 cases during the late pregnancy period (34 to 39 weeks),as well as 240 cases of normal pregnancies with the same gestational ages for the contwl group.Data included the parameters of fetal lung maturity measured by ultrasound and the incidence of NRDS postpartum.We analyzed the effects of PE on fetal lung maturity.Results The right fetal lung from the early onset PE group was significantly smaller than that of the normal group.There was no difference in the right lung area between the PE group and the normal group of the same gestational age.Compared with the normal group of the same gestational age,the LHR group had no difference in the early and late PE groups.The acceleration time/ejection time of the main pulmonary artery in the early and late PE group was significantly higher than that of the normal group.There was no difference in the incidence of NRDS among all the groups of the same gestational age.Conclusion PE has no significant effect on fetal lung function or maturation of the pulmonary tissues.Lung maturation may precede the same gestational age without PE.

Objective To investigate clinical value of right ventricular morphology in children with congenital heart disease associated pulmonary hypertension. Methods From October 2014 to October 2017, 37 children with congenital heart disease without associated pulmonary hypertension ( resting pulmonary systolic pressure ≤30 mmHg,1 mmHg＝0. 133 kPa) were selected as group A. Thirty-seven children with congenital heart disease and associated pulmonary hypertension (resting pulmonary systolic pressure＞30 m) . were in group B,and 37 healthy children were in control group. Echocardiography was performed to compare the results of right ventricular morphology and systolic function in three groups. Results ( 1 ) Right ventricular morphology indexes:right atrium upper and lower diameter((56. 8±4. 0) mm),right atrium left and right diameter((49. 2± 3. 3) mm),right ventricle basal segment inner diameter(( 43. 7± 2. 5) mm), right ventricle medial diameter((41. 7±3. 9) mm),right ventricle long axis distance((73. 4±6. 2) mm), sternum sidelines right ventricular outflow tract proximal end diameter((37. 8± 2. 4) mm),short axis view right ventricular outflow tract distal internal diameter (( 33. 6 ± 2. 1) mm),main pulmonary artery internal diameter((30. 5± 2. 5) mm), right ventricle end diastolic area (( 31. 6 ± 1. 8) cm2 ), right ventricle end systolic area((19. 0± 2. 7) cm2 ) in group B were higher than those in group A((46. 2± 3. 1) mm,( 40. 4 ±2. 8) mm,(34. 6±2. 2) mm,(32. 5±2. 6) mm,(65. 1±4. 7) mm,(30. 2±2. 0) mm,( 29. 4±1. 8) mm, (23. 0±1. 6) mm,(22. 5±1. 1) cm2,(11. 6±1. 2) cm2)and control group((45. 3±2. 6) mm,(39. 5±1. 7) mm,(34. 0±1. 9) mm,(31. 8± 2. 0) mm,(63. 2± 3. 8) mm,( 29. 6± 1. 7) mm,(28. 9± 1. 5) mm,(22. 4 ±1. 4) mm,(22. 1±1. 0) cm2,(11. 3±0. 9) cm2),( F＝140. 26,147. 47,223. 08,130. 46,43. 56,183. 33, 74. 71,209. 94,587. 99,221. 34, all P＜0. 01 ) . ( 2) Right ventricle contractile function indexes : right ventricular area change rate((40. 1±1. 6)%),three tricuspid ring systolic displacement((2. 2±0. 2) cm), tricuspid valve peak systolic flow velocity((13. 8±0. 9) cm／s)in group B were lower than those in group A ((46. 3±1. 7)%,(2. 5±0. 3) cm,(16. 7±1. 2) cm／s)and control group((46. 8±1. 5)%,(2. 6±0. 3) cm, (17. 2±1. 4) cm／s),the difference was statistically significant(F＝200. 81,21. 86,88. 85,all P＜0. 01 ) . Conclusion Children with congenital heart disease associated pulmonary hypertension have right ventricle morphological changes and right ventricular systolic function decreasing. Right ventricular morphological examination has important clinical value.

OBJECTIVETo analyze the status of maternal health behaviors and it's risk factors for Yi-nationality women in poor rural areas of Sichuan province.

METHODSIn 2012, multi-stage stratified cluster sampling method was used to select 14 villages of two poor counties in Liangshan Yi-nationality autonomous prefecture Sichuan province. At least 10 women who have infants aged 0-12 months were selected in each simple villages, a total of 284. The structured questionnaire was developed on the basis of the theory of reasoned action. Yi-nationality female college students were trained as investigators. Research indicators included prenatal care rate, hospital delivery rate, postpartum examination rate, socio-demographic characteristics, maternal health care knowledge. χ² test was used to compare the differences of above indicators among different groups. The structural equation model were used to statistical analyze.

RESULTSIn the 284 subject women, 51.7% (147/284) women owned more than 2 children, 41.6% (118/284) women were more than 30 years old, 87.3% (248/284) women were illiteracy. The prenatal care rate was 69.7% (197/284), the hospital delivery rate was 26.8% (76/284), and the postnatal check rate was 22.9% (65/284). The influence factors of maternal health behaviors included the number of children, age and education (χ² were 10.92, 13.24, 9.58; P values were 0.027, 0.004, 0.008, respectively).The structural equation model analysis results showed that the maternal health behaviors were directly or indirectly affected by subjective norms (β = 0.236, P < 0.001), women's cognition (β = 0.226, P = 0.020) and women's attitudes on maternal health behavior (β = 0.157, P = 0.001). Among subjective norms, women have high compliance to their husbands (β = 0.850, P < 0.001), their peers (β = 0.708, P < 0.001), and their mothers-in-law (β = 0.636, P < 0.001).

CONCLUSIONThere were still serious problems in maternal health behaviors for Yi-nationality women in poor rural areas. The main factors included not only the women's cognition and attitudes for maternal health, but also the attitudes of important social relationships.

Child ; China ; Ethnic Groups ; Family ; Female ; Health Behavior ; ethnology ; Humans ; Infant ; Maternal Health ; ethnology ; Maternal Health Services ; Postpartum Period ; Pregnancy ; Prenatal Care ; Risk Factors ; Rural Population

Objective: To verify the applicability of the theory of planned behavior(TPB) in the physical exercise behaviors of rural adolescents in Sichuan Province, and to explore the possible influencing factors of physical exercise behaviors, and to provide a theoretical basis for further effective intervention measures. Methods: A total of 2 302 students were selected from grade seven and grade ten of two rural middle schools in Zizhong, Sichuan Province. The survey was conducted with a structured questionnaire. Using TPB as the research framework and basis, the structural equation model was constructed for analysis. Results: Lack of physical exercise was 1 527(66.3%).Physical exercise behavior was statistically different among schools, grades(t=-7.40，-2.90，10.90,P<0.05)， and genders. Based on TPB, the structural equation model was established and corrected to obtain the revised model, and the fitting index GFI=0.93, CFI=0.94, NFI=0.94, TLI=0.93, IFI=0.94,RMSEA=0.07, indicating the model fitted good. Exercise intention directly affected exercise behaviors. The standardized effect was 0.45(95%CI=0.39-0.52). Subjective norms and perceived power were the main two mediators of the relationship between value evaluation and exercise intention. The standardized effect values were 0.66(95%CI=0.57-0.73), 0.23(95%CI=0.16-0.93)(P<0.01). Conclusion There is serious lack of physical exercise in rural adolescents in Sichuan Province. TPB has a good applicability for physical exercise in rural adolescents in Sichuan Province. Subjective norm is the most important factors to promote exercise intentions.