An indexing system is constructed,based on the implementation of prevention and control technology for chronic non-communicable diseases in community health service institutions,using both literature review and Delphi method,and using the Analytic Hierarchy Process (AHP) to calculate the weight of the indexing system.The system comprises three level-1 indexes,8 level-2 indexes and 33 level-3 indexes.The research proposed a transition from emphasis of therapeutic means to prevention,and emphasis on prevention and control technologies to the high-risk population in the prevention and control technology of chronic non-communicable diseases,along with development of techniques and measures to encourage behavioral changes of the population with chronic diseases.

Objective To systematically analyze the current situation of case‐control studies published on Chinese nursing ac‐ademic journals and provide references for future researches .Methods All literatures related to case‐control studies published on Chinese nursing academic journals were retrieved from CNKI ,CBM ,Wangfang databases ,and VIP by computer .The literatures were analyzed by bibliometrics method .Results Totally 77 literatures published in 17 journals were retrieved .The number of liter‐atures revealed an increasing tendency .T he content of these literatures involved 11 nursing fields ,such as medicine nursing ,surgery nursing ,and fundamental nursing .29 .9% of studies were supported by research grants .On the other side ,authors were located in 18 provinces ,autonomous regions and municipalities .Meanwhile ,most of them were from developed regions and worked in medical institutions .Conclusion The method of case‐control studies have gradually gained recognition of Chinese nursing researchers . However ,the number of case‐control studies were still small .Nursing researchers should be encouraged to conduct case‐control studies actively and apply this kind of method in more extensive fields of nursing .

OBJECTIVE:To provide ideas for revise and improve the standard and related method of the quality control of ben-zalkonium chloride in Chinese Pharmacopoeia (2015 edition,Ⅱ). METHODS:The standards and related methods of the quality control of benzalkonium chloride in Chinese Pharmacopoeia(2015 edition,Ⅱ),British Pharmacopoeia(2013 edition),European Pharmacopoeia (7.0 edition) and United States Pharmacopoeia (36 edition) were comprehensively compared. RESULTS:Com-pared with Chinese Pharmacopoeia(2015 edition,Ⅱ),the standards abroad provided the component and the ratio of the benzalko-nium chloride substituted homolog,the method for ammonia compound test had higher sensibility,it also added the test for benzyl alcohol,benzaldehyde and benzyl chloride impurity,as well as the component ratio test and average relative molecular mass calcu-lation. CONCLUSIONS:The standard and related method of the quality control of benzalkonium chloride in Chinese Pharmacopoe-ia(2015 edition,Ⅱ)still need to be further improved.

Objective To investigate the effect of lung ischemic preconditioning (IP) on the expression of aquaporin-1 (AQP1) during lung ischemia-reperfusion (I/R) induced by cardiopulmonary bypass (CPB) in dogs.Methods Twelve adult mongrel dogs,weighing 15-20 kg,were randomly divided into 2 groups (n =6 each):lung I/R (group I/R) and ischemic preconditioning group (group IP).The left pulmonary artery was occluded at 10 min of off-pump CPB and mechanical ventilation was stopped in the left lung,60 min later occlusion was released,and mechanical ventilation was recovered to establish the model of left lung ischemia-reperfusion injury induced by CPB.In group IP,lung ischemic preconditioning was induced by 2 cycles of 5 min ischemia followed by 5 min reperfusion before occlusion of the left pulmonary artery.Before CPB (T1),immediately after occlusion of the left pulmonary artery (T2),at the end of CPB (T3),and at 2 h after the end of CPB (T4),pulmonary specimens were collected for determination of wet to dry lung weight ratio (W/D ratio) and expression of AQP1 and for examination of the pathological changes of lungs which were scored.Respiration index (RI),oxygenation index (OI),and alveolar-arterial oxygen tension difference (P(A-a)O2) were calculated at T1,T3 and T4,and the left pulmonary alveolar fluid clearance (AFC) was calculated at T4.Results Compared with group I/R,P(A-a) O2 and RI were significantly decreased,OI was increased,W/D ratio and pathological scores were decreased,the expression of AQP1 was up-regulated,and the AFC was increased at T3 and T4 in group IP.The pathological changes of the lung were significantly attenuated in group IP as compared with group I/R.Conclusion The mechanism by which lung ischemic preconditioning mitigates lung I/R injury induced by CPB is related to upregulation of the expression of AQP1 in dog lung tissues.

Objective To investigate the present situation of midwifery and the appropriate technical application of midwifery in Henan Province.Methods Using convenience sampling method,questionnaire survey was conducted among 32 tertiary hospitals,47 secondary hospitals and 11 primary hospitals via the platform of midwifery section of Henan Province nursing association.Results For hospitals of different levels in Henan Province,the training rate of midwives was (19.55±20.28)％,80.2％ of the hospitals mentioned there was a need to increase midwives,the rates of natural delivery and perineal side cutting were (50.84±12.16)％ and (40.14±21.15)％,and there were significant differences in the rates of natural delivery and perineal side cutting among hospitals of different levels(P＜0.05).The proportion of application of appropriate techniques of midwifery was as follows:Doula delivery was 49.4％,labor in liberal position was 35.8％,epidural anesthesia was 56.8％,water birth was 4.9％,Lamaze breathing was 60.5％,and music therapy was 24.7％;the main reason for no Doula delivery was the shortage of midwives (75.6％),and the reasons for no labor in liberal position were the midwife had not been trained(57.7％) and there was safety hazard (57.7％).Conclusion The rate of standardized training for midwives was low,and there was a need of increasing midwives in hospitals of all levels in Henan Province.The appropriate technologies of midwifery need to be popularized,and the hospital should strengthen the training of related knowledge and skills for midwives in order to improve work ability,pronote natural delivery,and enhance application of appropriate techniques of midwifery.

Objective:To explore the preventive effects of group personalized nursing intervention based on IMB model in high-risk population of gestational diabetes mellitus (GDM) .Methods:Totally 130 high-risk patients with GDM who created medical files and planned to labor in the Third Affiliated Hospital of Zhengzhou University from November 2018 to January 2019 were selected by convenient sampling. Excluding 2 patients with threatened abortion, 9 who did not labor in our hospital, and 3 with invalid questionnaires, finally 116 pregnant women were included, who were divided into the observation group ( n=57) and the control group ( n=59) according to the random number table. Pregnant women in the control group received routine care based on IMB model, while pregnant women in the observation group were divided into several subgroups, including overweight/obesity, advance age, GDM history, and family history groups, with 6-10 cases in each subgroup. Personalized nursing intervention for high-risk factors and lifestyles were provided for different subgroups. The self-made GDM Knowledge Questionnaire, incidence of GDM, oral glucose tolerance test (OGTT) results, weight gain during pregnancy, and pregnancy outcome were used to compare the effects of intervention between the two groups. Results:There was no significant difference in GDM knowledge scores between the two groups before intervention ( P>0.05) , while there was statistically significant difference in GDM knowledge scores between the two groups after intervention ( P<0.01) . The weight gain of the observation group was (13.03±5.58) kg, which was lower than (16.02±4.92) kg of the control group, and the difference was statistically significant ( t=3.068, P=0.003) . The incidence of GDM in the observation group was 12.28%, lower than 28.81% in the control group, and the difference was statistically significant ( P<0.05) . After the OGTT, there was no statistically significant difference in fasting blood glucose between the two groups ( P>0.05) ; there was statistically significant difference between the blood glucose values of the two groups 1 and 2 hours after taking sugar ( P<0.05) . There was no statistically significant difference in the incidence of cesarean section, premature delivery, gestational hypertension, premature rupture of fetal membranes, giant infants, and neonatal hypoglycemia between the two groups ( P>0.05) . Conclusions:Group personalized nursing intervention based on the IMB model is helpful to improve the knowledge level of high-risk population of GDM, and reduce the incidence of GDM and weight gain during pregnancy, and its effects on pregnancy outcome need to be further explored.

Androgen insensitivity syndrome (AIS) is a recessive single gene disease of X chromosome, which is rare clinically and has a very low incidence in newborn boys. This is mainly due to the abnormal pathway in which androgens play a role, resulting in sexual differentiation disorder in patients. A pair of identical twins were admitted to our hospital, and a new pathogenic mutation site of the androgen receptor gene was found, resulting in an androgen insensitivity phenotype.

Objective:To evaluate the influence on the results and safety of double-balloon enteroscopy (DBE) at different combination time.Methods:Patients who received combined DBE procedures in Nanjing Drum Tower Hospital from April 2019 to August 2020 were divided into the one-day combination group and the non-one-day combination group. The complete enteroscopy rate, time of anterograde approach, time of retrograde approach, total time of combined approach, adverse events, hospital stay and cost were compared.Results:Among 119 patients who received DBE, 23 patients were excluded due to small intestinal stenosis. The complete enteroscopy rate was 92.9% (39/42) in the one-day group and 74.1% (40/54) in the non-one-day group, showing significant difference ( χ2=4.390, P=0.036). There were significant differences in the time of retrograde approach (35.59±23.29 min VS 55.10±19.04 min, t=-4.080, P<0.001), total time of combined approach (89.10±27.82 min VS 114.20±24.55 min, t=-4.254, P<0.001), hospital stay (9.24±3.76 d VS 11.76±4.41 d, t=-2.599, P=0.011) between the two groups. There were no significant differences in the time of anterograde approach, hospital cost or adverse events between the two groups. Conclusion:Combined DBE on one day yields a higher complete enteroscopy rate, less examination time and less hospital stay, which is worth of clinical application.

Objective:To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects of forefoot with the help of the three dimensional computerized tomography angiography(3D-CTA).Methods:From November 2013 to February 2018, 19 patients with anterior foot defects were treated in the Yidu Central Hospital of Weifang. There were 12 males and 7 females. The patients ranged from 16 to 45 years old, with an average age of 29.6 years. Preoperative 3D-CTA examination of the ipsilateral foot was performed to find out the blood vessels in the donor site, to determine the location, course, length of the superficial branch of the medial plantar toe artery and its relationship with the surrounding tissues, and to design the medial saphenous nerve nutrient vessel skin flap for retrograde repair of the skin and soft tissue defect at the front of the foot. Sensitive recovery were evaluated according to Swanson evaluation of clinical effect of peripheral nervous impairment.Results:Preoperative three-dimensional CT angiography showed that the superficial branches of the medial plantar toe artery were detected, and the perforating vessels during the operation were basically consistent according to the result of the examination. The 19 cases of forefeet skin detects were successfully reconstructed with the reverse saphenous nerve neurocutaneous flaps. All patients were followed up with the mean of 8 months. All flaps survived totally without diabrosis and swelling. The walking and weight-bearing were normal and the blood supply of foot were good. The functional recovery of foot and ankle was excellent in 8 cases, good in 10 cases and middle in 1 case. The sensory recovery of the forefoot: S4 5 feet, S3 10 feet, S2 4 feet; R4 3 feet, R3 9 feet, R2 7 feet.Conclusions:Preoperative 3D-CTA examination can confirm the anatomy of the superficial branch of the medial toe base artery in the donor site and guide the design of the medial saphenous nerve nutrient vessel flap for retrograde repair of skin and soft tissue defects of the distal foot. The blood supply is reliable, the wound is small and the effect is satisfactory.

Objective:To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects of forefoot with the help of the three dimensional computerized tomography angiography(3D-CTA).Methods:From November 2013 to February 2018, 19 patients with anterior foot defects were treated in the Yidu Central Hospital of Weifang. There were 12 males and 7 females. The patients ranged from 16 to 45 years old, with an average age of 29.6 years. Preoperative 3D-CTA examination of the ipsilateral foot was performed to find out the blood vessels in the donor site, to determine the location, course, length of the superficial branch of the medial plantar toe artery and its relationship with the surrounding tissues, and to design the medial saphenous nerve nutrient vessel skin flap for retrograde repair of the skin and soft tissue defect at the front of the foot. Sensitive recovery were evaluated according to Swanson evaluation of clinical effect of peripheral nervous impairment.Results:Preoperative three-dimensional CT angiography showed that the superficial branches of the medial plantar toe artery were detected, and the perforating vessels during the operation were basically consistent according to the result of the examination. The 19 cases of forefeet skin detects were successfully reconstructed with the reverse saphenous nerve neurocutaneous flaps. All patients were followed up with the mean of 8 months. All flaps survived totally without diabrosis and swelling. The walking and weight-bearing were normal and the blood supply of foot were good. The functional recovery of foot and ankle was excellent in 8 cases, good in 10 cases and middle in 1 case. The sensory recovery of the forefoot: S4 5 feet, S3 10 feet, S2 4 feet; R4 3 feet, R3 9 feet, R2 7 feet.Conclusions:Preoperative 3D-CTA examination can confirm the anatomy of the superficial branch of the medial toe base artery in the donor site and guide the design of the medial saphenous nerve nutrient vessel flap for retrograde repair of skin and soft tissue defects of the distal foot. The blood supply is reliable, the wound is small and the effect is satisfactory.