Objective To explore the effect of psychological nursing on the treadmill exercise tests(TET)in patients with cardiacneurosis.Methods 86 patients with cardiacneurosis were randomly divided into the treatment group(n=44)and the control group(n=42): both were treated with medication for two weeks and the former with extra treatment of psychological nursing intervention.Then the anxiety and depression among all the participants were assessed using the Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS).The two groups were compared in terms of anxiety and depression as well as TET.Results The scores on anxiety and depression in the treatment group were significantly lower than those in the control group and the negative rate of TET was significantly higher than that in the control group(all P<0.05).Conclusion The psychological nursing intervention may reduce the anxiety and depression of the patients with cardiacneurosis and improve the accuracy of TET.

Objective To observe and analyze the changes of C-reactive protein and inflam-matory factors in patients with obstructive sleep apnea syndrome.Methods 205 patients with ob-structive sleep apnea syndrome were divided into observation group Ⅰ (n =72),group Ⅱ (n =68) and observation group Ⅲ (n =65)according to apnea-hypopnea index (AHI),and the other 50 pa-tients were designed as control group.Levels of C-reactive protein,interleukin-6 and interleukin-18 were detected.Results The sicker,apnea-hypopnea index gradually increased (AHI),oxygen sat-uration decreased,C-reactive protein,interleukin-6 and interleukin-18 levels increased gradually. Logistic regression analysis showed that C-reactive protein,interleukin-6 and interleukin-18 and AHI,oxygen saturation were positively correlated with AHI and negatively correlated with oxygen saturation.Conclusion C-reactive protein level,interleukin-6 and interleukin-18 and other related inflammatory factors are the important indicators for prognosis judgment of patients with obstructive sleep apnea syndrome,so it is worthy of clinical application.

Objective To observe and analyze the changes of C-reactive protein and inflam-matory factors in patients with obstructive sleep apnea syndrome.Methods 205 patients with ob-structive sleep apnea syndrome were divided into observation group Ⅰ (n =72),group Ⅱ (n =68) and observation group Ⅲ (n =65)according to apnea-hypopnea index (AHI),and the other 50 pa-tients were designed as control group.Levels of C-reactive protein,interleukin-6 and interleukin-18 were detected.Results The sicker,apnea-hypopnea index gradually increased (AHI),oxygen sat-uration decreased,C-reactive protein,interleukin-6 and interleukin-18 levels increased gradually. Logistic regression analysis showed that C-reactive protein,interleukin-6 and interleukin-18 and AHI,oxygen saturation were positively correlated with AHI and negatively correlated with oxygen saturation.Conclusion C-reactive protein level,interleukin-6 and interleukin-18 and other related inflammatory factors are the important indicators for prognosis judgment of patients with obstructive sleep apnea syndrome,so it is worthy of clinical application.

Objective This study aims to assess the hazard vulnerability risks in emergency wards to enhance their flexibility and resilience in response to unexpected events.Methods A cross-sectional survey of 73 emergency specialist nurses from 39 hospitals in Zhejiang province was conducted to identify potential threats,assess their probability,and estimate their impact on specific organizations or regions using hazard vulnerability analysis(HVA)based on Kaiser model.The risk values associated with such events were calculated.Results Among the four categories of risk indicators,the highest risk value was attributed to the"system"(37.68％),followed by"staff'(36.53％),"stuff'(29.45％),and"space"(29.25％).The top 10 ranked risk events included exceeding emergency room capacity with patient numbers(52.03％),insufficient staff(47.23％),workplace violence(46.86％),medical litigation(43.64％),accidental removal of high-risk tubes(41.63％),lack of rescue experience or skills(41.51％),specimen errors(40.72％),inadequate experience in observing and handling circulatory support abnormalities(39.22％),information system failures(38.95％),and patient elopement(38.28％).Conclusion Improvements should be made in areas such as leadership planning,system enhancement,communication and collaboration,and adaptability.Emergency ward preparedness and service quality can be further enhanced through measures such as strengthening nurse training and staffing,continuously monitoring item and space-related risks,and implementing bed management and new nurse training programs.

Objective:To investigate the current status of anticoagulant therapy and the incidence of ischemic and bleeding events in hospitalized patients aged 90 years and over with non-valvular atrial fibrillation(NVAF).Methods:We retrospectively collected clinical data, antithrombotic treatment strategies, in-hospital ischemic stroke and bleeding events from NVAF patients(≥90 years)who were admitted to our hospital from June 2014 to August 2018.Based on the CHA 2DS 2-VASc score(2, 3, and ≥4 respectively), patients were divided into three ischemic risk groups, and antithrombotic treatment strategies and in-hospital ischemic stroke events were compared between the three groups.Alternatively, patients were divided into the high bleeding risk group(HAS-BLED score ≥3, )and the non-high bleeding risk group(HAS-BLED score ≤2), and antithrombic treatment strategies and the major bleeding events were compared between the two groups. Results:Among the 223 hospitalized NVAF patients aged 90 years and over, 42.6% of them received anticoagulant treatment, 25.6% received antiplatelet drugs, and 31.8% received non-antithrombotic treatment.With the increase of the CHA 2DS 2-VASc score, there was a trend of declined rates of non-antithrombotic treatment among the three ischemic risk groups(47.4%, 42.9%, 26.4%, P=0.06), and the rates of in-hospital ischemic stroke were similar among groups(10.5%, 12.2%, 15.5%, P=0.75). Moreover, compared with the non-high bleeding risk group, patients in the high bleeding risk group more frequently received anticoagulant treatment(47.2% vs.38.3%)and less frequently received non-antithrombotic therapy(28.7% vs.34.7%). There was no significant difference in antithrombotic treatment strategies( P=0.39)or rate of in-hospital major bleeding events(13.0% vs.10.2%, P=0.51). However, the rate of in-hospital major bleeding events was significantly higher in those with concurrent infections(16.8% vs.6.4%, P=0.02)or respiratory failure(21.3% vs.8.0%, P=0.01). Conclusions:The rate of anticoagulant use in NVAF patients aged 90 years and over is too low during hospitalization, and anticoagulant therapy should be standardized.In addition to the HAS-BLED score, we should consider the complications that increase the bleeding risk, such as infections and respiratory failure, when evaluating the bleeding risk.