Objective To analyze the clinical effects of low molecular heparin calcium on early onset severe pre-eclampsia.Methods Sixty patients with early onset severe pre-eclampsia at 26-34 weeks of gestational age were divided into treatment group(28 cases)and control group(32 cases).The conventional treatment was delivered in control group and low molecalar heparin calcium(LMWHC)was used in treatment group additionally.The time of prolonged gestational age,umbilical arterial S/D ratio,amniotic fluid index,placenta weight,neonatal weight and Apgar score were measured in two groups.Results The time of prolonged gestational age was 10.19 ±4.57days in treatment group and 6.14 ±3.56 days in control group,which were significantly different(P ＜ 0.01).Umbilical arterial S/D ratio,amniotic fluid index,placenta weight and neonatal weight were all significantly different between the two groups(P ＜ 0.05).Neonatal Apgar score in treatment group was remarkably improved(P ＜ 0.01).Conclusion LMWHC treatment in the patients with early onset severe pre-eclampsia could extend gestational age,increase neonatal weight and improve perinatal outcomes.

Objective:To summarize the best evidence for the evaluation and management strategies of adolescent non-suicidal self-injury, and provide a basis for medical staff to carry out standardized evaluation and management of adolescent non suicidal self injury.Methods:According to evidence-based nursing methods and the "6S"evidence pyramid model, the evidences of non-suicidal self-injury in adolescents, including guidelines, standards, case report, evidence summary, randomized controlled trial (RCT) , systematic review, clinical practice and other evidences were searched in BMJ Best Practice, UpToDate, World Health Organization, National Institute for Health and Care Excellence, National Guidelines Clearinghouse, Registered Nurses ' Association of Ontario, Scottish Intercollegiate Guidelines Network, American College of Physicians Club, Australian Joanna Briggs Institute (JBI) Evidence-based Health Care Center Library, Cochrane Library, PubMed, Embase, PsycINFO, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, Medlive and other databases. The retrieval period was from the establishment of the databases to June 30, 2022. The quality evaluation of the articles was evaluated by two researchers trained in the evidence-based curriculum. Included studies were pre-graded using the Australian JBI Evidence-based Health Centre Evidence pre-grading system and the Evidence Recommendation Level System (2014 edition) . Results:Finally, a total of 18 articles were included, including 5 guidelines, 2 standards, 1 case report, 1 evidence summary, 3 systematic reviews, 1 Meta-analysis, 2 clinical practices and 3 RCT studies. A total of 22 pieces of best evidence were summarized from 6 dimensions, such as screening and assessment, multi-professional and multi-form intervention strategies, training and education, self-management strategies, disposal after self-injury treatment and follow-up.Conclusions:The best evidence based on evidence-based assessment and management strategies of adolescent non-suicidal self-injury is scientific and practical, which can provide reference for the clinical practice of adolescent non-suicidal self-injury.

Objective:To explore the mediating effect of nurses' presenteeism behavior between job alienation and job burnout.Methods:From May 2019 to October 2021, a total of 506 nurses working in the Nursing Department of Jiaozuo People's Hospital were selected as the research objects by the convenient sampling method. General information questionnaire, Presenteeism Behavior Scale, Job Alienation Scale and Job Burnout Scale were used to investigate the nurses. Pearson correlation was used to analyze the correlation between presenteeism behavior and job burnout and job alienation, and Bootstrap test was used to explore the mediating effect. A total of 506 questionnaires were distributed and 506 were valid, with an effective recovery rate of 100.00%.Results:The total scores of job burnout, job alienation and presenteeism among 506 nurses were (63.43±8.03) , (34.16±5.55) and (6.32±1.56) , respectively. Pearson analysis showed that presenteeism was positively correlated with job alienation and job burnout ( P<0.01) . Using the Bootstrap sampling test method to conduct a mediating effect study, 95% confidence interval for the path analysis from burnout to presenteeism to job alienation did not include the number 0, and nurses' presenteeism behavior played a mediating role between job alienation and job burnout. Conclusions:Nurses have high presenteeism behavior, which plays a mediating role between job burnout and job alienation. Therefore, it is necessary to reduce the frequency of nurse presenteeism behavior and promote physical and mental health.

OBJECTIVE: To explore the effect of occupational aluminum exposure on the blood of male workers. METHODS: A total of 249 male workers were selected as the research subjects by cluster sampling method in the electrolytic workshop of an aluminum plant. Blood samples were collected for determination of the blood aluminum concentration and blood routine. The subjects were divided into low-, medium-, and high-aluminuml groups based on the tertile of blood aluminum level(P_(33) is 13.9 μg/L, P_(67) is 37.7 μg/L). RESULTS: The red blood cell(RBC) count and hemoglobin level in patients of the high-aluminum group were lower than that of the low-aluminum group(P<0.05). There was no significant difference of the RBC count and hemoglobin level of patients in middle-aluminum group compared with that of the low-and high-aluminum groups(P>0.05). There was no statistical significant difference in white blood cell count and platelet count among the three groups(P>0.05). The results of the generalized linear regression model showed that the higher the blood aluminum level, the lower the RBC count and hemoglobin level of workers(P<0.05) after eliminating confounding factors such as age, length of service, education level, smoking, and drinking. CONCLUSION: Occupational aluminum exposure can cause a decrease of RBC count and hemoglobin level with a dose-effect relationship in workers.