Objective To research the effects of progressive time phase selective light (PTPSL)therapy on shift work disorder patients.Methods 24 shift work disorder patients were randomlv divided into PTPSL group and control group.Both groups received treatment for 12 days including 6 days during the night shift time and 6 days during the day shift time continuously.The clinical effects were evaluated by Karolinska Sleepiness Scale (KSS),Leeds sleep evaluation questionnaire (LSEQ) and core body temperature rhythm.Results (1) During the night shift time,PTPSL group patients were better in score LSEQ and KSS(discerned for 39.80 ± 2.89,6.59 ±0.48) than control group' s(discerned for 36.86 ± 3.88,6.98 ± 2.03) ; temperature curve peak phase in PTPSL group moved backward greater than that of control group((8.35 ± 0.82) h vs (7.45 ± 1.05) h) ; and the difference was statistical significance(P ＜ 0.05).During the day shift time,PTPSL group patients were better in score LSEQ and KSS(discerned for 45.57 ± 2.77,6.33 ± 0.48) than control group' s (discerned for 40.35 ± 4.19,6.82 ± 1.03),temperature curve peak phase in PTPSL group moved forward greater than that of control group((7.37 ± 0.94)h vs (6.31 ±1.37)h),and the difference was statistical significance(P＜0.05).Conclusion PTPSL can adjust shift sleep disorder patients' mussily sleep rhythm system in order,and make the inner rhythm svstem and external schedules tend to be consistent,and provides a new treatment choice for shift sleep disorders.

Objective To evaluate the effectiveness of internet-based cognitive behavior therapy (CBT-I) on blood pressure in patients with hypertension comorbid with insomnia.Methods One hundred and six patients met the JNC-8 diagnostic criteria for hypertension and DSM-5 diagnostic criteria for insomnia were selected,and randomly assigned to CBT-I group (n=53) and regular treatment group (n=53).All the patients accepted relevant treatment for 8 consecutive weeks.Changes of systolic blood pressure (SBP),diastolic blood pressure (DBP),the sleep parameters and the anxiety and depression levels were observed between baseline and 8 weeks of follow-up.Results Compared with pre-treatment,SBP and DBP decreased significantly in both CBT-I group and regular treatment group (P＜0.01),the decrease was more significant in CBT-I group than in regular treatment group (P＜0.01).The sleep latency,sleep efficiency,bed time and rating anxiety scale were improved more significantly in CBT-I group than in regular treatment group (44.49 ± 22.75min vs.55.50 ± 34.96min;72.31％ ± 9.15％ vs.57.70％ ± 11.53％;302.65 ± 43.76min vs.262.70 ± 50.64min and 17.14 ± 6.45 vs.21.02 ± 6.64,respectively),the differences were of statistical significance (P＜0.05).In addition,no significant difference was found in the level of depression between CBT-I group and regular treatment group.Conclusion CBT-I can effectively shorten sleep latency,improve sleep efficiency,extend bed time and improve anxiety,meanwhile effectively lower the blood pressure of patients with hypertension comorbid with insomnia by optimizing sleep quality.

Objective To explore the correlation between oxygen reduction index(ODI) with blood lipid and renal function in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) .Methods Selected 208 patients by polysomnography (PSG) and diagnosed as OSAHS ,divided into four groups according to ODI(ODI ≤ 7 ,7 < ODI ≤ 18 ,18 < ODI ≤ 38 and ODI > 38) .Four groups were compared in total cholesterol (TC) ,triglyceride (TG) ,high‐density lipoprotein cholesterol (HDL‐C) ,low density lipo‐protein cholesterol (LDL‐C) ,apolipoprotein A1 (ApoA1) ,apolipoprotein B (ApoB) ,urea ,creatinine ,uric acid and other differ‐ences ,analysis the correlation between ODI with blood lipid and renal function .Results There were significant different in TC ,TG , HDL‐C ,LDL‐C ,ApoB ,urea ,creatinine ,uric acid in four groups with different degree of ODI (P< 0 .05) ;ODI were positively relat‐ed to TC ,TG ,LDL‐C ,ApoB ,urea ,creatinine ,uric acid levels ,and negatively related to the level of HDL‐C .Conclusion Abnormity of blood lipid metabolic and changes in renal function are associated with the increase of ODI in patients with OSAHS .

Objective To assess the effect of remote-interactive cognitive behavioral therapy in pa-tients with chronic insomnia.Methods A total of 62 patients with chronic insomnia were randomly divided into combined treatment group,cognitive behavioral therapy for insomnia ( CBTI) group and drug treatment group.The study lasted for 6-8 weeks.The curative effects were assessed using sleep diary and scales.Results The sleep onset latency (SOL) ((39.9±23.7)min) and wake time after sleep onset(WASO) ((79.1± 39.4) min) in the drug treatment group were higher than that in the combined treatment group ( ( 25.5 ± 11.2)min and (54.4±38.5)min,respectively) and CBTI group ((27.8±11.6)min and (51.8±29.0)min,re-spectively) at the end of treatment,the difference was statistical significance( P=0.018 and P=0.046 respec-tively).The sleep efficiency(SE) in drug treatment ((76.5±11.9)%) was lower than that in the other two groups((83.8±8.7)%and (82.8±7.0)%respectively),(P=0.042).And no similar difference were seen in TST after treatment(P>0.05).The Brief Version of Dysfunctional Beliefs and Attitudes about Sleep(DBAS-16) score in the drug treatment group (97.6±16.4) was higher than the other two groups((67.5±20.1) and ( 75.0±26.9) respectively) after treatment(P=0.000) .No significant difference was seen in scores of the oth-er scales among the three groups(P>0.05) .After treatment,a greater proportion of patients in the combined treatment group had withdrawn from hypnotics use completely (29%(6/20) vs 5%(1/18);odds ratio( OR ) was 7.286);and the combined treatment group produced significant reduction in frequency of hypnotics use ((3.35±3.05) nights/week) when compared with drug treatment group((5.56±2.33) nights/week, P=0.016) .Conclusions Remote-interactive cognitive behavioral therapy was effective and acceptable for treating pa-tients with chronic insomnia,combining drug treatment in the early period could quickly relieve the symptoms of in-somnia,and can avoid the adverse effect from the hypnotics.And the treatment method can reduce the dropout rate.

Objective To screen the incidence of transient hypertension in conventional hypertensive management population of hypertension and analysis it's related etiology and constituent ratio.Methods People who met the diagnosis of hypertension were selected from inpatient and outpatient of this department.All patients were followed up for 2 months of home blood pressure monitoring,if the patients who were normal when monitoring home blood pressure were included in the trial and symptomatic hypertension was excluded.Results Three hundred of patients met the diagnostic criteria for hypertension,46 cases (15.3％) met the standard of transient hypertension,the etiology and constituent ratio of transient hypertension in the observed cases were as follows:25 cases (54.3％) of anxiety and depression,8 cases (17.4％) of acute cerebrovascular disease,7 cases (15.2％) of sleep disorders,4 cases(8.7％) of a variety of head and face pain,1 (2.2％)case of epilepsy tonic clonus,1 (2.2％)case of vertigo.Conclusion The application of interactive management of home blood pressure measurement is particularly helpful for screening patients with transient hypertension,and it can timely avoid excessive anti-hypertensive treatment.

Objective:To construct evaluation index system of traditional Chinese medicine (TCM) nursing quality of tuberculosis bases on "structure-process-result" three-dimensional quality structure model as a framework so as to provide evaluation standards and basis for tuberculosis TCM nursing quality management.Methods:By the convenient sampling method, 12 doctors and nurses in tuberculosis department from 2 third-class grade-A hospitals of Traditional Chinese medicine or integrated traditional Chinese and western medicine hospital in Zhejiang province were selected from March 2019 to April 2019 in order to conduct semi-structured interviews. 26 nursing experts were selected for expert consultation. Through literature research, semi-structured interview, Delphi method and superiority chart, the evaluation index system of TCM nursing quality of tuberculosis and the weight of each index were established.Results:The effective recovery rates of the letter questionnaires were 84.62% (22/26) and 77.27% (17/22) , the expert authority coefficients were respectively 0.831 and 0.843 and the Kendall's W were respectively 0.236 and 0.335. The eventually established evaluation index system of TCM nursing quality of tuberculosis included 3 first-level indicators, 16 second-level indicators and 56 third-level indicators. Conclusions:In this study, the evaluation index system of TCM nursing quality of tuberculosis constructed by various methods is more scientific, complete and reliable, which can provide references for the evaluation of TCM nursing quality of tuberculosis and the formulation of standard.

Objective:To explore the status and influencing factors of discharge readiness of patients with pulmonary tuberculosis.Methods:A total of 200 patients with tuberculosis in Zhejiang Tuberculosis Diagnosis and Treatment Center from August to December 2020 were selected as the objects by convenience sampling method. The patients were investigated on the day of discharge by general information questionnaire, Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS) . Multiple linear multivariate regression analysis was used. 200 questionnaires were distributed and 200 valid questionnaires were recovered in this study. The effective recovery rate was 100%.Results:The total RHDS score of 200 patients with pulmonary tuberculosis was (94.04±14.31) , and the item average score was (7.83±1.19) . There were statistically significant differences in RHDS scores among patients with different educational backgrounds, hospitalization days, hospitalization times and other chronic diseases ( P<0.05) . The total RHDS score of patients with pulmonary tuberculosis was negatively correlated with age ( r=-0.246, P<0.05) , and positively correlated with the total QDTS score ( r=0.641, P<0.01) . Multiple linear regression analysis showed that education background and quality of discharge teaching were the influencing factors of discharge readiness of patients with pulmonary tuberculosis, explaining 42.8% of the total variation ( P<0.05) . Conclusions:The level of discharge readiness of patients with pulmonary tuberculosis needs to be further improved. Medical staff should focus on patients with different educational backgrounds and carry out multi-form and multi-channel health education, in order to improve the quality of discharge teaching for patients with pulmonary tuberculosis, and then improve the discharge readiness of patients.