Objective: To summarize the nursing experience of a case of pseudomonas aeruginosa septic shock with massive gangrene in infants, and to explore the nursing method of pseudomonas aeruginosa septic shock with massive gangrene in infants. Methods: Shock was treated by close observation, establishment of effective venous channels and effective dilatation; daily infusion of virus inactivated plasma supplemental immunoglobulin; planned detoxification and dressing change, as well as effective management of stool, urine and body position enable gangrene to be effectively controlled;At the same time, necessary nutrition and psychological support were given to the children. Results: After 15 days of careful nursing, the wound surface recovered well and the vital signs were stable. Pediculated skin grafting may be performed at a scheduled time. Conclusions The practice of this case proved that the above nursing measures were effective for pseudomonas aeruginosa septic shock with massive gangrene.

Objective To investigate the suitable mode of cognitive-behavioral therapy for lung transplant recipients during waiting for lung and evaluate the effect to improve patients' physical and mental state.Methods 50 cases were randomly divided into the experimental group and the control group,each group with 25 cases.The control group received conventional treatment.The experimental group received cognitive-behavioral therapy in addition to conventional treatment.SAS and vital signs were measured in the two groups on admission,2 weeks and 4 weeks after admission.Results The SAS score of the experimental group was lower than the control group 2 weeks and 4 weeks after admission and SAS score decreased as the intervention extended.The SBp of the experimental group was lower than the control group 4 weeks after admission.There was no significant difference of DBp between two groups.The heart rate of the experimental group was lower than the control group 4 weeks after admission.The heart rate of the experimental group was lower on 2 weeks and 4 weeks after admission than on admission.4weeks after admission,the respiratory rate of the experimental group was lower than the control group and on admission.Conclusions Cognitive-behavioral therapy can reduce the level of anxiety and keep vital signs stable with good feasibility and effectiveness.

This article summarized the technique research and application status of near-infrared spectroscopy (NIRS), in order to explore hypoxia,qi-deficiency and their connections with typical symptoms. It also discussed NIRS acquired oxygen saturation (SaO2) and its relevant means and methods for information quantification ofqi-deficiency. The accurate obtained SaO2 value was applied in the association with the strength of chest distress in the subjective sensation due toqi-deficiency. According to current data, the normal value,qi-deficiency degree and uncomfortable degree of subjective sensation among patients of different altitudes and ages were summarized. It can be applied to assist TCM physicians in the quick quantification of qi-deficiency.

This paper summarized nursing care in intra-hospital transfer of 13 critically ill patients with extracorporeal membrane oxygenation. The key points to guarantee safety of critically ill patients were establishing a well-trained professional team and developing standardized procedures,and applying checklist for ECMO Transfer. The key points in nursing were assessment and pretreatment,homogenized nursing during transfer and effective handover after transfer. As a result,six cases of avian influenza patients successfully completed CT ex-amination,five cases of lung re-transplant patients and two cases of lung transplant patients were successfully trans-ferred to the operating room.

Objective To explore the results of non-compliance of fluid intake in maintence hemodialysis patients.Methods The qualitative phenomenological research method was adopted in this study.Self-structured in-depth interviews were conducted with 13 maintenance hemodialysis patients.Data were analyzed by content analysis.Result Four themes were extracted including allotrigeusia,have a smattering of fluid intake knowledge,self-condemned and guilty,muddling along.Conclusions Fuild restriction is the most difficuilt prescribed treatment schedule among maintence hemodialysis patients.Nurses should pay attention to those people and provide multilevel,continual,individual and comprehensive measures.

Objective:To compare the incidence of complications associated with arm and chest ports by Meta-analysis.Methods:To Janurary 2019, studies published in PubMed, Embase, CINAHL, Cochrane, CBM and Wanfang regarding complication comparison between arm ports and chest ports were searched. Newcastle-Ottawa Scale was applied to evaluate the quality of studies. Review Manager 5.3 software was applied to conduct this meta-analysis.Results:A total of 19 articles covering 4 203 patients were included. The results showed that the incidence of pneumothorax ( OR value was 0.22, 95% CI0.05-0.88, P value was 0.03) and artery injury ( OR value was 0.24, 95% CI0.07-0.77, P value was 0.02) between arm ports group and chest ports group were statistically significant. No significant difference was observed in infection ( OR value was 0.81, 95% CI0.58-1.12, P value was 0.20), thrombosis ( OR value was 1.25, 95% CI0.64-2.45, P value was 0.52), extravasation ( OR value was 1.13, 95% CI0.54-2.35, P value was 0.75), catheter misplacement ( OR value was 1.58, 95% CI0.95-2.61, P value was 0.08), skin incision ( OR value was 0.64, 95% CI0.23-1.74, P value was 0.38), sepsis ( OR value was 0.68, 95% CI0.27-1.70, P value was 0.41) and exudate ( OR value was 0.88, 95% CI0.32-2.42, P value was 0.80). Conclusion:The incidence of pneumothorax and artery injury in arm ports is significantly lower than in chest ports, there was no difference in other complications. More studies are needed to further confirm the advantages of arm ports.

Objective To summarize the successful application experience of intra-hospital transport of 13 H7N9 avian influenza patients from the general wards to the avian influenza ward. Methods Form the expert group, to determine the design target and principle of the standardized workflow and point out the operation points of standard workflow in intra-hospital transport of each link. Results The standardized workflow included the disposal of the transfer notice, condition assessment, department contact,patient preparation,object preparation,custody transfer personnel preparation,transit guardianship and transfer to the avian influenza ward,a total of eight procedures.Between January 2013 and March 2017,13 cases were successfully transfered.All patients safely arrived avian influenza ward. The process was quick and smooth.Nobody was died or rescued within 1 h after transport. Conclusions The main differences of intra-hospital transport between H7N9 avian influenza patients and general critically ill patients are the transit time control, the particularity of terminal disposal, transshipment arrangement and hospital infection management personnel involved in the whole process.

Objective:To explore the early warning of blood growth differentiation factor-15 (GDF15) as a new stress indicator.Methods:A total of 53 armed police soldiers selected to participate in high-intensity training, measuring the soldiers' serum GDF15, high-sensitivity C-reactive protein (S-CRP), and C-reactive protein (CRP) before and after the high-intensity training , Interleukin-6 (IL-6), Procalcitonin (PCT) levels, compare the coefficient of variation of each index; use SPSS 24 software for statistical analysis, measurement data are expressed as mean ± standard deviation (Mean±SD), The comparison of measurement data adopts group t test. Results:The GDF15 level of fighters after high-intensity training was (176.28±97.45) pg/mL, which was higher than (120.35±69.87) pg/mL before high-intensity training. The difference was very significant ( P <0.001). After high-intensity training, IL-6 and CRP levels were lower than before high-intensity training, the difference was statistically significant ( P<0.05); there was no statistically significant difference in S-CRP and PCT before and after high-intensity training ( P>0.05). The coefficient of variation of GDF15 index is smaller than S-CRP, CRP, IL-6, PCT. Conclusion:Blood growth differentiation factor-15 (GDF15) is of great significance in warning the stress state after high-intensity training. It has higher sensitivity than other conventional stress indicators like S-CRP, CRP, IL-6 and PCT.

Objective:To explore the value of growth differentiation factor 15 (GDF15) in the early diagnosis of acute chest pain.Methods:A total of 96 patients with acute chest pain admitted to the Emergency Department of Hainan Hospital of PLA General Hospital from January to November 2020 were retrospectively collected. The sex, age, troponin T, creatine kinase, creatine kinase isoenzyme, GDF15 and B-type natriuretic peptide of patients within 30 min after admission were recorded, and the differences of each index in different groups were compared. ROC curve was drawn to evaluate the diagnostic value of GDF15 and TNT/BNP in acute coronary syndrome (ACS). The Gensini score, left ventricular ejection fraction, length of stay in hospital and the number of stents were calculated, and the correlation between these indexes and GDF15 concentration was evaluated.Results:The general trend of acute chest pain was more male than female (72.92% vs. 27.08%) , the oldest group was the UA group (64.67 ± 13.87) years old , the youngest group was cardiac arrest group (47.29 ± 9.99) years old . There were higher rates of hypertension in the STEMI group, NSTEMI group and UA group, and none of the groups showed significant advantage in diabetes. The GDF15 concentration was higher in ACS related chest pain group [(2.360 ± 1.710) ng/mL vs. (1.380 ± 1.040) ng/mL, P<0.01]. The area under the Receiver Operating Characteristic Curve (AUC) of GDF15 combined with TNT was up to 0.863. GDF15 concentration was negatively correlated with ejection fraction, positively correlated with Gensini score, positively correlated with the number of stents implanted, and positively correlated with the length of hospital stay. Conclusions:GDF15 is valuable in the diagnosis and prognosis of acute chest pain. The combination of GDF15 and TNT can improve the diagnostic rate of ACS.

Objective:To investigate the current situation of the implementation of breastfeeding in the state of mother infant separation in 75 hospitals in China, based on the evidence-based guidelines for breastfeeding of hospitalized newborns (hereinafter referred to as the guidelines).Methods:Totally 75 hospitals in China were selected using the convenience sampling method to distribute questionnaires to compare the implementation of breastfeeding after separation of mother and infant.Results:All the hospitals selected in this survey were not satisfied with the overall implementation of the guide, but the general hospital's interpretation and learning of the guide was better than that of the specialized hospital, with a statistically significant difference ( χ2 value was 5.616, P <0.05); the breastfeeding rate was lower after the separation of mother and infant, and only 18.7% (14/75) of the units with the feeding rate ≥ 75%; they provided support related to breast milk collection, kangaroo nursing and professional professionals in the aspect of quality management, specialized hospital was better than general hospital, the difference was statistically significant ( χ2 values were 9.450, 10.516, 6.436, P<0.05); 62.1% (18/29) of the specialized hospitals have multi-disciplinary cooperation teams to promote the separation of mother and infant breastfeeding, while only 34.8% (16/46) of the comprehensive hospitals have multi-disciplinary cooperation teams , the difference was statistically significant ( χ2 value was 7.254, P<0.05). Conclusion:The evidence-based guidelines for breastfeeding of hospitalized newborns in China mostly refer to the relevant international standards. There are some difficulties in the implementation of the guidelines due to the large differences in the economy and policies of various regions in China. In order to improve the success rate of breastfeeding separation between mother and infant, China should establish a national standard that is in line with the national conditions, so as to facilitate the reference implementation of hospitals at all levels.