Concurrent chemoradiation therapy is currently a recommended treatment approach for locally advanced inoperable stage ⅢA and stage ⅢB non-small cell lung cancer (NSCLC).There is no consensus on the optimal treatment regimen.It is one of these options for the consolidation chemotherapy following concurrent chemoradiation therapy.To date,there is no sufficient evidence indicating that consolidation chemotherapy following concurrent chemoradiation therapy further improves survival rates.The benefit remains to be confirmed by more clinical test.

Objective: To investigate the knowledge, attitude and practice of hepatitis B prevention and control among junior high school students in Linping District, Hangzhou City, so as to provide insights into management of hepatitis B among adolescents. Methods: Two classes were sampled using a cluster sampling method from grades 2 in 12 public junior high schools in Linping District, and all students in these two classes were enrolled. Students' knowledge, attitude and practice of hepatitis B prevention and control were collected using questionnaire surveys, and factors affecting knowledge, attitude and practice of hepatitis B prevention and control were identified using a multivariable logistic regression model. Results: A total of 1 102 questionnaires were allocated and 1 094 valid questionnaires were recovered, with an effective recovery rate of 99.27%. The respondents included 540 males (49.36%) and 554 females (50.64%), and 542 rural students (49.54%) and 552 urban students (50.46%). The awareness of hepatitis B prevention and control knowledge was 43.60%, and a low awareness rate was seen for the item “use of condom may prevent hepatitis B” (21.12%). The percentage of correct attitudes towards hepatitis B prevention and control was 57.77%, and a low percentage was found for the item “individuals living with hepatitis B will tell others” (38.67%). The percentage of positive practices towards hepatitis B prevention and control was 80.07%, and a low percentage was seen for the item “hepatitis B vaccines have been inoculated in recent five years” (16.54%). Multivariable logistic regression analysis identified gender (females, OR=1.483, 95%CI: 1.159-1.898), household registration (urban, OR=1.300, 95%CI: 1.011-1.670), and parental highest educational level (high school or technical secondary school, OR=0.703, 95%CI: 0.532-0.929) as factors affecting the awareness of hepatitis B prevention and control knowledge among junior high students, and parental highest educational level (high school or technical secondary school, OR=0.705, 95%CI: 0.533-0.934) and serving as class cadres (OR=1.449, 95%CI: 1.128-1.860) were factors affecting the attitudes hepatitis B prevention and control, while household registration (urban, OR=1.566, 95%CI: 1.144-2.143) and route of acquiring hepatitis B control knowledge (internet or magazine, OR=0.473, 95%CI: 0.288-0.776) were factors affecting the formation of practices towards hepatitis B prevention and control. Conclusions The overall awareness of and percentage of attitudes towards hepatitis B prevention and control, and the percentage of hepatitis B vaccination are low among junior high school students in Linping District. Targeted health education pertaining to hepatitis B prevention and control is required to be reinforced and promotion of hepatitis B vaccination is recommended.

Objective To investigate the status quo of new allocated nurses to master relevant knowledge of blood specimen collection.Methods 197 new allocated nurses and young nurses within 5 working-years were included and the new allocated nurses accepted knowledge training of blood specimen collection.Differences in training effect between nurses with different work experience and education background were analyzed.Results Average score of new allocated nurses before training was lower than young nurses,while after training,there was no difference between them.The training score of new allocated nurses did not correlate with their background before and after training.Conclusions In order to improve the quality of testing and prompt development of new nurses,the department of clinical nursing should strengthen the relevant training about knowledge of blood specimen collection in new allocated nurses.

Objective To investigate the development status of tumor radiotherapy in Guangxi Zhuang autonomous region in order to provide reference for the decision-making of the competent administrative departments for public health.Methods A questionnaire survey was conducted by the aid of on-site inspection and telephone or Email investigation among the medical institutions in Guangxi to know the current status of radiotherapy units and settings,human resources,allocation of radiotherapy facilities,and standardization of medical practices.Results Up to the end of August 2014,radiotherapy was carried out in 39 hospitals,with other 5 hospitals under preparation for construction.Among these 40 hospitals were three-dimensional conformal radiotherapy in 38,intensity modulated radiation therapy (IMRT) in 23,and image guided radiation therapy (IGRT) in 5.There were 48 linear accelerators,15 afterloading therapy apparatus,and 4 γ-knife or X-knife in Guangxi.There were 647 professional personnel (except nurses),including 322 radiation oncologists,100 radiotherapy physicists,213 radiotherapy technologists and 12 professional engineers.There were 2 000 to 2 500 hospital beds and 20 000 cancer patients had received radiotherapy in 2013.1 600 to 2 000 people received treatment on average every day.Conclusions The present radiotherapy resources in Guangxi are insufficient and the input to radiotherapy equipment is deficient,with low proportion of cancer patients treated with radiotherapy.Because of the uneven radiotherapy quality among different hospitals,the reasonable planned development and unified diagnostic and treatment practices are required to improve radiotherapy level in Guangxi.For shortage of medical staff and high-quality physical and technical personnel,the improvements are needed by fostering and introduction of personnel.Compared with developed regions in China,the introduction of new technology is largely needed.

Astract: Objective To explore the efifcacy and safety of endoscopic tissue adhesive injection in treatment of gastric variceal bleeding from liver cirrhosis.Methods Object of study are 92 cirrhotic patients (72 male/20 female) in hospital, who had been diagnosed with gastric varices bleeding from June 2014 to May 2016. Child-Pugh score at presentation for cirrhotic patients was A-28; B-36; C-28. According to endoscopic classiifcation of gastric varices, GEV1 were detected in 80 patients, GEV2 in 12. All patients were treated with endoscopic hypertonic glucose tissue adhesive ‘sandwich’ injection.Result Successful injection rate was 100.0% in 92 patients, among which 40 patients had accepted emergency endoscopic treatment and the immediate hemostasis rate was 100.0%. 65 patients were Having gastroscope review after the injection six months, 22 patients were significantly effective, accounting for 33.8%; 38 patients were effective, accounting for 58.4%; 5 patients were invalid, accounting for 7.7%. All the patients were followed up in 1 to 24 months. The late-rebleeding rate was 2.2%. None of them were having early-rebleeding or dead; Complications the incidence of rebleeding rate which caused by removing the needles which trapped in the varices was 2.2%. The incidence of chest pain rate was 4.3%, the bloating rate was 6.5% and the ulceration rate was 15.2%. There was no complications like fever, infection, stomachache, embolism and so on.Conclusion With low rebleeding rate and light side-effect, endoscopic tissue adhesive injection in the treatment of gastric variceal bleeding caused by cirrhosis portal hypertension has really good effect.

Objective To understand the nutrition status in elderly patients with hip fracture, and clarify its effects on postoperative functional recovery,complications and mortality based on literature analysis of the past 10 years. Methods PubMed,Medline,Embase Database,Wanfang Database,Chinese National Knowledge Infrastructure(CNKI)and China Biology Medicine disc(CBMdisc)were searched,and relevant researches published from 1st January,2010 to 31th May,2019 were collected. Single rate Meta-analysis was used to integrate the prevalence and mortality of malnutrition. A qualitative systematic review was used to analyze the relationship between nutritional status and prognosis after surgery. Results A total of 11 articles was included,including 21791 patients. Meta-analysis showed that the mean prevalence of malnutrition during hospitalization in elderly patients with hip fracture was 46％(95％CI:45％-47％)using serum albumin(ALB),and was 17％(95％CI:12％-22％)assessing by the Mini Nutritional Assessment (MNA),and the risk of malnutrition prevalence was 42％(95％CI:45％-47％). The results of qualitative evaluation showed that compared with the well-nutrition group(Short-form MNA 12-14 points),the malnutrition risk group(Short-form MNA 8-11 points)had lower activity ability 4 months after the operation (OR=2.03,95％CI:1.24-3.31),and the MNA score decreased by 1 point,the risk of death increased by 15％(HR=0.869,95％CI:0.757-0.998). The malnutrition group(ALB<3.5 g/dl)had a higher incidence of sepsis (P< 0.001)and pulmonary infection(P=0.019),with every 1 g/dl reduction in ALB and 0.59-fold increased risk of death(RR=0.59,95％CI:0.53-0.65). Conclusions The incidence of hip fracture malnutrition or malnutrition risk is very high in the elderly patients with hip fracture. Both malnutrition and malnutrition risk have negative effects on postoperative functional recovery,complications and death rates,and the worse the nutritional status,the worse the prognosis. So,both ALB and MNA are recommended to be included in the care plan of elderly patients with hip fracture. When ALB is failed to diagnose malnutrition,the MNA evaluation method should be adopted to find the problems of nutrition and offer nutritional intervention in advance.

Objective To compare the clinical efficacy of refined mirabilite vs.Chaishao Chengqi Decoc-tion in treating sever acute pancreatitis(SAP) complicated with abdominal compartment syndrome(ACS). Methods 60 cases of SAP complicated with ACS were divided into treatment group(n = 32) and control group (n=28) with random number table.The treatment group was given the nasal feeding and enema with refined mira-bilite base on routine western medicine treatment. The control group was given the nasal feeding and enema with Chaishao Chengqi Decoction. The 2 groups were compared with respect to the changes of the APACHEⅡ scores, intra-abdominal pressure,endotoxin,calcitonin(PCT),tumor necrosis factor alpha(TNF-α),recovery time of bowel sound,self-defecation recovery time,length of stay and hospitalization expenses. Results After 7 days of treatment,the intestinal permeability index(endotoxin) and the related indicators(PCT,TNF-α) were significantly lower than before treatment in both groups(P<0.05).The abdominal pressure of both groups at days 1,3 and 7 days after treatment was significantly lower than before treatment(P < 0.05) but the difference between the two groups had no statistical significance(P > 0.05). In the 3rd and 7th days of the treatment,APACHEⅡ scores were significantly lower than before treatment(P<0.05),but the difference between the two groups was not statis-tically significant in the score(P>0.05).The two groups showed no significant difference in the recovery time of bowel sound,self-defecation recovery time,length of stay and hospitalization expenses(P > 0.05). Conclusions Refined mirabilite as adjuvant therapy in SAP with ACS,can effectively reduce the internal pressure,promote the intestinal function recovery,protect the intestinal mucosal barrier function,reduce intestinal bacteria and endotox-in translocation and the complications of infection.It has a similar clinical effect as Chaishao Chengqi Decoction to the recovery of the disease.

Training and improving the clinical skills of specialist nurses is an important part of nursing education in Operating Room. The objective structured clinical examination is currently recognized as an objective assessment method to evaluate the clinical practice skills of medical students. Its assessment model is still in its infancy in the field of clinical nursing education in China. This article reviews the connotation of clinical skills,the design of objective structured clinical examination and the application status of clinical skills training of specialist nurses in Operating Room.

Objective:To construct nursing quality evaluation indicator system for comprehensive stroke center, so as to provide reference for standardized nursing quality evaluation of comprehensive stroke center.Methods:From September 2018 to December 2019, based on the theory of Donabedian′s structure-process-outcome quality model, literature review, semi-structured interview, Delphi method and analytic hierarchy process were used to determine nursing quality evaluation index system and index weight for comprehensive stroke center.Results:A total of 16 experts from comprehensive stroke center were consulted for two rounds. The clinical working time was 24.63±10.08 years, and the effective recovery rates of two rounds were 100%. The authority coefficient of experts was 0.888, and the coordination coefficients W of two rounds were 0.229 and 0.283 respectively.Finally, a nursing quality evaluation indicator system for comprehensive stroke center was constructed, including 3 first-level indicators, 13 second-level indicators and 46 third-level indicators. Conclusions:The established nursing quality evaluation indicator system for comprehensive stroke center covers the whole process of stroke emergency, stroke unit, and follow-up, which is scientific and reliable, and provides an evaluation tool for daily nursing quality monitoring and continuous quality improvement in comprehensive stroke centers.

Background: Intestinal mucosal barrier function is closely related to the prognosis of patients with severe acute pancreatitis (SAP). Protecting intestinal mucosal barrier function has become the key of treatment of SAP. Aims: To explore the relationship between autophagy and intestinal mucosal barrier function in SAP and the effect of autophagy inhibitor 3-MA. Methods: SD rats were randomly divided into sham operation (SO) group, acute necrotizing pancreatitis (ANP) group and 3-MA group. Each group was further divided into 3 subgroups: 3, 6 and 12 hours after surgery. HE staining was used to observe the pathological changes of pancreatic and intestinal tissue. Blood amylase was detected; serum endotoxin and intestinal fatty acid-binding protein (I-FABP) were determined by ELISA; protein expression of Beclin-1 was examined by Western blotting. Results: Compared with SO group, pathological score of pancreatic and intestinal tissue, blood amylase, endotoxin and I-FABP were significantly increased at each time points in ANP group (P<0.05), while protein expression of Beclin-1 was significantly decreased (P<0.05), and all above-mentioned indices were time-dependent (P<0.05). After treatment with 3-MA, above-mentioned indices were significantly ameliorated (P<0.05). Conclusions: In SAP, intestinal autophagy gradually increases with the progress of disease. After intervention with 3-MA, intestinal autophagy decreases and damage of intestinal mucosal barrier function is alleviated, suggesting that intestinal autophagy is related to the damage of intestinal mucosal barrier function of SAP, and 3-MA has an inhibitory effect.