Objective To investigate the infection situation and the gene subtype distribution characteristics of human papilloma-virus(HPV)in Fengxian District of Shanghai to provide the reliable scientific basis for preventing HPV infection and the prevention and treatment of cervical cancer.Methods The PCR combined with reverse dot-blot technique was adopted to analyze the HPV de-tection results among 18 194 women in our hospital from February 2011 to October 2013.Results Among 18 194 cases of sample, 2 986 cases were HPV positive with the total HPV infection rate of 16.41%,in which 21 genotypes were all detected out.Single HPV genotype infection was in 2714 cases,two kinds of HPV genotype infection were in 148 cases(4.96%)and three kinds or more of HPV genotype infection were in 124 cases.The HPV positive rate was 16.88% in the outpatient and 12.76% in the inpa-tients.In the HPV infection,the high-risk type was more than the low-risk type,its detection number was 7.5 times of low-risk type.Most of the high-risk HPV infection were HPV16,52,58;most of the low-risk HPV infection was HPV cp8304,followed by HPV6 and HPV11.Conclusion The HPV prevalence in Fengxian District is generally in line with the Asian population distribution rule,but has its own unique regional characteristics.The infection age peak is 51-65 years old.The high-risk type infection is high-er than the low-risk type infection,which is dominated by the single genotype infection.

Objective To discuss the emergency management and treatment measures of critically severe craniocerebral trauma.Methods A retrospective study was conducted on the emergency management in 82 patients with critically severe craniocerebral trauma admitted to our hospital from September 2005 to May 2011.Results According to the Glasgow Outcome scale ( GOS),there were 10 patients with good recovery (12％),17 with moderate disability (21％),12 with severe disability (20％),four in vegetable status (2％) and 39 deaths (48％).Conclusion The success rate in the treatment of critically severe craniocerebral injury can be enhanced through rapid and effective pre-hospital care,prompt surgical intervention,standardized subsequent therapy,adherence to damage control surgery concept,and emphasis on prevention and cure of secondary brain injury.

Objective To identify the success rate of peripheral indwelling needle puncture in pediatric patients, and analyze its influencing factors. Methods A survey was conducted in a sample of 902 pediatric patients.Personal information table of pediatric patients who receive infusionwas adopted to collect data. Results The success rate of first puncture was 85.37%(770/902), the success rate of two punctures was 95.34%(860/902). The success rate was affected by several factors, such as department, ages of the patients, condition of the veins, years of working as a nurse(OR=1.128, 2.308, 2.351, P <0.05). Conclusions Success rate of peripheral indwelling needle puncture in children still can be improved. When formulate management program, the influencing factors should be considered for management standard.

Objective:To investigated the correlation between vascular remodeling pattern and perforator stroke after stenting in patients with symptomatic intracranial vertebrobasilar artery stenosis.Methods:Patients with symptomatic intracranial vertebrobasilar atherosclerotic stenosis underwent stenting and high resolution magnetic resonance imaging (HR-MRI) from January 2017 to August 2020 were enrolled retrospectively. The data of demography, vascular risk factors, plaque characteristics, operation process and postoperative complications were collected. The plaque characteristics were observed by HR-MRI, and the correlation between vascular remodeling pattern and perforator stroke after stenting was analyzed.Results:A total of 41 patients were enrolled in the analysis. Their age was 60.1±8.8 years (range, 49-77 years). There were 31 males (75.6%). Among them, 21 (51.2%) were positive remodeling, 20 (48.8%) were non-positive remodeling, and 5 (12.2%) had perforator stroke after procedure. The incidence of perforator stroke in the positive remodeling group was significantly higher than that in the non-positive remodeling group (23.8% vs. 0%; P=0.048). The positive remodeling rate of the perforator stroke group was significantly higher than that of the non-perforator stroke group (100.0% vs. 44.4%; P=0.048). Conclusions:Patients with intracranial vertebrobasilar atherosclerotic stenosis and positive vascular remodeling were more likely to have perforator stroke after stenting.

Traditional teaching approach is a method which lack of overall quality cultivation among students. However, the teaching approach which is combined with counter examples can stimulate their study interests, enhance critical thinking ability and promote theory-practice combination. Counter-example teaching approach has been applied in nursing education in these years and It plays an active role in improving nursing educational quality. This paper aims to provide reference to formulate a scheme of cultivating all-round developed nurses through summarizing the advantages and disadvantages, and application process of counter-example teaching approach used in nursing education.

Objective To discuss the effects of SBAR (situation-background-assessmedicine-recommendation) communication in patient hand-over from pediatric emergency ward. Methods SBAR communication mode has been applied in hand-over in the Emergency Department of Children's Hospital of Shanghai from November 2016. The incidence of nursing adverse events, writing error or omission rate of nursing documents and medical staff's satisfaction were compared between before and after intervention, which were from September to October 2016 and from November to December 2016. Results After the implementation of SBAR, the incidence of nursing adverse events was 4.9%, the writing error or omission rate of nursing documents was 3.1%, which were all lower than those of the control group, and the differences were statistically significant (χ2=9.141,10.794;P<0.01). After the implementation, the satisfaction rates on the comprehesiveness, language rationality and the focus of the disease were 95.0%, 97.5% and 95.0%, which were all higher than those of the control group, and the differences were statistically significant (χ2=8.029, 12.131, 4.675; P< 0.05). Conclusions After the SBAR communication mode being applied in patient hand-off in Pediatric Emergency Department, adverse events due to poor communication decreased; nursing documents became more normative; and the satisfaction rate of medical staff involved in hand-over increased. It is therefore worthy of further improving and making wider use of this type of communication.

At present,case management is widely used in the management of chronic diseases and special diseases,but the case management of the special group of high-risk infant needs to be further discussed. This paper summarizes the definition of high-risk infants, the necessity of developing case management, the present situation of implementation of case management of high-risk infants at home and abroad, and probes into the challenges faced when developing case management of high-risk infants in China,in order to promote the application of case management.

Objective:To investigate the status and feasibility of evidence-based nursing practice of pain assessment in pediatric nurses and to analyze its influencing factors.Methods:The convenient sampling method was adopted to select pediatric nurses who met the inclusion and exclusion criteria in Children's Hospital of Shanghai Jiao Tong University from August to December 2018 as the research objects. The Questionnaire on Status of Evidence-Based Nursing Practice of Pain Assessment in Nurses was used to investigate and the influencing factors were analyzed. A total of 300 questionnaires were issued and 265 valid questionnaires were collected, with an effective recovery rate of 88.33%.Results:The evidence-based nursing practice score of pain assessment of 265 pediatric nurses was (114.22±19.81) . The highest score was the dimension of pain screening, and the lowest score was the dimension of communication with patients and their families in pain assessment. Univariate analysis showed that there were statistically significant differences in the total scores of pain assessment evidence-based nursing practice among pediatric nurses in their departments and their doctors' support for pain treatment, whether pain was listed as the fifth vital sign, and whether pain care system was established ( P<0.05) . Multiple linear regression analysis showed that doctors' support for pain treatment, whether the department listed pain as the fifth vital sign and whether the pain care system was established were the influencing factors for pain assessment evidence-based nursing practice of pediatric nurses ( P<0.05) . Conclusions:At present, pediatric nurses in Children's Hospital of Shanghai Jiao Tong University, have a relatively high level of evidence-based nursing practice in pain assessment. However, it is necessary to strengthen communication with patients and their families, establish relevant systems within the department, enhance medical cooperation and promote knowledge transformation of evidence-based nursing for pediatric pain assessment.

Objective:To translate the 16-item version of Quality of Life in Children with Epilepsy (QOLCE-16) into Chinese, and conduct reliability and validity analysis in Chinese children with epilepsy.Methods:The International Functional Assessment of Chronic Illness Therapy (FACIT) translation method was adopted. Three bilingual translators pre-translated the source scale, and another three bilingual translators performed back translation. The QOLCE-16 was adjusted through the cognitive interview and expert consultation. This study was a cross-sectional study. Convenience sampling was used to select 256 children with epilepsy who were admitted to the Department of Neurology of Children's Hospital of Shanghai from June to December 2020. All questionnaires were filled out by long-term caregivers, and 256 copies were finally recovered effectively to analyze the reliability and validity of the QOLCE-16 after cultural adjustment in the evaluation of the health-related quality of life of children with epilepsy. A total of 40 subjects were selected from the sample, and the Chinese version of QOLCE-16 was filled out again at an interval of 2 to 3 weeks. Finally, 32 samples were effectively recovered to evaluate the test-retest reliability of the scale.Results:The Chinese version of QOLCE-16 had 16 items in total, including 4 dimensions of cognition, emotion, social interaction, and physical function. Each item had a good degree of discrimination, and there was a statistical correlation with the total score of the scale ( P<0.05) . The scale-level content validity index ( S- CVI) was 1.00, and the item-level content validity index ( I- CVI) was from 0.89 to 1.00. The KMO value of exploratory factor analysis was 0.909, the eigenvalues of each dimension were 3.482, 3.223, 3.136, 2.955 respectively, and the cumulative variance contribution rate was 79.976%. The Cronbach's α coefficient of the scale was 0.938, and the Cronbach's α coefficient of each dimension was from 0.866 to 0.939. The split-half reliability was 0.814, and the split-half reliability of each dimension ranged from 0.840 to 0.942. The test-retest reliability of the scale was 0.724, and the test-retest reliability of each dimension was from 0.615 to 0.716. Conclusions:The Chinese version of QOLCE-16 has good reliability and validity, and can be used as a simple tool for evaluating the health-related quality of life of children with epilepsy between 4 and 18 years of age.

Objective? To investigate the current situation of the self-efficacy in the main caregivers of pediatric enterostoma patients and its influencing factors, to provide scientific basis for formulating continuing nursing intervention measures for children with enterostomy. Methods? A cross-sectional investigation was carried out. The primary caregivers of the pediatric enterostoma patients who were treated in a ClassⅢ Grade A children's specialized hospital in Shanghai during January 2016 to October 2017 were selected by convenience sampling method. A self-designed general information questionnaire, General Self-Efficacy Scale (GSES), and Hamilton Depression Rating Scale (HAMA) were applied in the investigation. Univariate analysis and multiple linear regression analysis were applied to analyze the influencing factors of self-efficacy. A total of 92 questionnaires were sent out, and 90 were recovered, with a valid rate of 97.83%. Results? The median score of GSES among the 90 primary caregivers of the pediatric enterostoma patients was 24, ranging from 13 to 36, which was at a median to low level. The result of univariate analysis showed that there were significant differences in the distribution of caregivers' self-efficacy scores in terms of education level, residence, family monthly income, health insurance, family structure type and doctor-patient communication level (P＜ 0.01). Multivariate linear regression analysis showed that caregivers' educational level, family type, anxiety level and family monthly income were the main factors affecting their self-efficacy. Conclusions? The self-efficacy level of the main caregivers of children with enterostoma needs to be improved. We should strengthen doctor-patient communication for caregivers with lower education, encourage seeking social support, expand information acquisition, enhance care ability and improve the quality of life of children.