Objective To investigate the influence of antiplatelet drugs in patients with coronary heart dis-ease after intervention incidence of no -reflow.Methods 180 cases of coronary artery interventional treatment of coronary heart disease and patients with no -reflow phenomenon as research subjects were randomly divided into ob-servation group and the control group of 90 cases.Observation group after intervention produce given tirofiban hydro-chloride treatment of no -reflow or slow reflow, and the control group received verapamil therapy .Results The final group was injected with drugs Coronary angiography showed TIMI 3 cases number than the control group , and the difference was statistically significant ( p<0.05);After treatment of coronary angiography for the first time , the last observation group was significantly higher level TMPG3, and the difference was statistically significant (p<0.05). Conclusion Compared with verapamil hydrochloride tirofiban in patients with coronary heart disease , intervention can effectively reduce postoperative incidence of no -reflow, which should be spreaded in clinical practice .

At present, problems in nursing diagnoses include: omission of important diagnoses, inexact diagnoses, irregular writing of diagnoses, unclear differentiation of what is primary from what is secondary in the ordering of diagnoses, improper classification of relevant factors, neglect of psychological and social problems, confusion of problems involving cooperation and potential problems, and lack of conformity between diagnoses and admission evaluation. Measures for solving these problems include: change of concepts, improvement of the overall quality of the nursing personnel, enhancement of the awareness of quality, and reinforcement of assessment and guidance.

OBJECTIVE To discuss the management method of hospital medical waste in nursing activity,prevent from the pollutant proliferation,and avoid the second exposure.METHODS Reinforced the management of the medical waste,established the management network of medical waste,and made the training of all staffs,we drew up a series of effective measures according to the law and regulation.RESULTS Various plan and measure were done, nursing personnel were fully aware of the importance of the environmental protection.(medical) waste(management) was much better than before.The infection which related to the medical waste was not occurred.(CONCLUSIONS) Doing well management of the medical waste is depending on some conditions,which are as(follows:)(1)the leaders pay more attention to;(2)strengthen the training of all staffs;and(3)the management system is sound.

Objective To explore the current situation of knowledge,beliefs and behavior of elderly patients with COPD during their community-based rehabilitation.Methods Phenomenological research method of qualitative research was used,14 elderly patients with COPD during their community-based rehabilitation period received in-depth interviews.Results There were three themes and corresponding subthemes sublimated from the patients:self-management knowledge and skills,self-management beliefs and attitudes and self-management behavior.Conclusions It is necessary to pay close attention to spreading disease related health information,especially for patients with low health literacy.During the process of COPD self-management projects,we should focus on negative beliefs and negative attitudes on their selfmanagement behavior choice,which is as important as strengthening the patients' self-efficacy.

Objective To determine the median effective concentration(EC50) of remifentanil by TCI inhibiting the cardiovascular response to the placement of operating laryngoscope performed under propofol anesthesia administered by TCI.Methods Twenty ASA Ⅰ orⅡ patients,aged 20-51 yr,weighing 52-83 kg,undergoing extirpation of vocal cord polyps under general anesthesia with remifentanil-pmpofol administered by TCI.were enrolled in the study.The target plasma concentration (Cp) of propofol was set at 4μg/ml.Operating laryngoscope was placed at 3 min after tracheal intubation.HR and MAP were continuously monitored.When HR or MAP increased by 15%,the candiovascular response was defined as positive.The EC50 was determined by up-and-down technique.The initial Cp of remifentanil was set at 5 ng/ml and was increased/decreased by 20%in the next patient if the cardiovascular response was positive or negative.Results No chest wall stiffness and intraoperative awareness occurred in all the patients.The EC50 of remifentanil TCI inhibiting the cardiovascular response to the placement of operating laryngoscope was 3.50ng/ml with confidence interval(CI) between 3.47-3.60 ng/ml.Conclusion Thee EC50 of remifentanil TCI inhibiting cardiovascular response to the placement of operating laryngoscope is 3.50ng/ml with CI between 3.47-3.60ng/ml.

Objective This article aimed to investigate the treatment adherence of patients with hypertension and examine determinants of adherence.Methods A longitudinal design was adopted to test the treatment adherence and correlated factors of patients with hypertension twice from 2009 to 2012.The influencing factors of treatment adherence in patients with hypertension were analyzed.Results A total of 520 patients finished the first investigation,and 331 patients completed the second investigation.The comparison of demographic characteristics between patients who participated the second investigation or not showed no significant difference except for the education degree (x2=9.38).The incidences of symptoms and complications,systolic blood pressure and diastolic blood pressure of hypertensive patients and the laboratory indexes such as serum creatinine (SCr),total cholesterol (TC),low density lipoprotein (LDL),high density lipoprotein (HDL),fasting blood-glucose and postprandial blood sugar in the second investigation were lower than those of the first investigation,but the difference showed no statistical significance.The scores of treatment adherence,self-efficacy,social support,quality of life were higher in the second investigation than those of the first investigation.The multiple regression analysis found that treatment adherence,social support,education degree and duration of disease course were significant predictors in the first investigation entered the equation,accounting for 26％ of the total variance,among which treatment adherence explained 15％ of the variance,social support 7％,education degree 3％ and duration of disease course 1％.Conclusions The treatment adherence of hypertensive patients improved over one year follow-up.Healthcare providers should pay attention to adherence behavior at initial phase of disease development,and effective strategies targeted patients at risk are suggested to be necessary and should be designed according to the factors affecting adherence.

Objective To explore the lived study feeling and experience of nursing upgrade students during blended learning model so as to provide the evidence of reforming teaching model of nursing educators.Methods Phenomenological research of qualitative research was used.Four focus groups,25 upgrade nursing students were interviewed in-depth.Results Six themes were sublimated:relief the contradiction between work and study,promote communication in double interaction,improve self-learning ability,improve selfconfidence as learning controllability,online courses lack a sense of belonging,lack of skills support.Conclusions Blended learning model meets students,needs,provides students with personalized learning and improves comprehensive quality.However,the development of blended learning model in China is in the primary stage,we should combine conditions and reference foreign experience to develop it.

Objective To understand and explore the feelings and viewpoint of obstetrics and gynecology nursing professional degree postgraduates′core competency. Methods This study used semi-structured focus group to interview 3 obstetrics and gynecology department nurse specialists and 6 nursing postgraduates who work in the obstetrics and gynecology department. The data was transcribed based on the tape and were analyzed by software Nvivo 10.0. Results A comprehensive analysis of the five core competencies: clinical practice competency, research ability,clinic thinking ability, interpersonal communication and psychological counseling skills, self- planning ability. Conclusions Setting curriculum on basis of core competency. Quantify the clinical practice plan. Exploring the pattern of clinical education. Tamp the foundation, pay attention to practice, a positive attitude.

Objective To determine the serum levels of cross-linked telopoptide of type Ⅰ collagen (ICTP),alkaline phosphatase (ALP) in patients with primary malignant bone tumor,primary benign bone tumor and malignant tumor metastasized to the bone,and to explore the clinical value of ICTP and ALP in identification and diagnosis of bone tumor.Methods Sixteen primary malignant bone tumor patients,16 primary benign bone tumor patients and 18 malignant tumor metastasized to the bone patients in 2012 were studied.Serum ALP was assayed by SFBC rate method and ICTP by enzyme linked immunosorbent assay (EIA).Results The serum levels of ICTP was not significantly different between primary benign bone tumors and normal control group (P ＞ 0.05),but the other between-groups had statistically significant difference (P ＜ 0.05).The serum levels of ALP in malignant tumor metastasized to the bone was significantly higher than the rest of the group (P ＜0.01),but the difference between the remaining groups was not statistically significant (P ＞ 0.05).The area under roc curve (AUC) of ICTP for diagnosis of primary benign bone tumors,malignant tumor metastasized to the bone,primary malignant bone tumor (0.923,0.926,0.874) was higher than the ALP (0.354,0.702,0.865).Conclusions Serum ICTP and ALP were sensitive and convenient biochemical indices which reflected metabolism of patients with bone tumor.Serum ICTP was more specific and sensitive than ALP and they have clinical importance for differential diagnosis as an index of bone tumor.