Objective?To construct the training evaluation system for nurses specialized in cardiovascular disease based on the Kirkpatrick model. Methods?From January to October 2017, a total of 30 domestic experts of clinical medicine and nursing specialized in cardiovascular disease from several ClassⅢ Grade A hospitals, in accordance with Kirkpatrick model, were consulted by Delphi method. According to the expert opinion, the weight of the indexes at all levels was determined by the analytic hierarchy process. Results?The study conducted a total of 2 rounds of correspondence. The positive coefficient of the first round of consultation was 90.00%, and the positive coefficient of second rounds of consultation was 92.59%; The authority coefficient (Cr) of the experts was 0.76, and the Kendall coefficient of concordance (W) was 0.6～0.8, which was statistically significant by χ2test (P＜0.05). The evaluation index system included 4 first level indicators, 14 second level indexes and 45 third level indexes. Conclusions?The training effect evaluation model of nurses specialized in cardiovascular can reflect the standard of training quality, make the training management scientific and fair, and have wide application value, which is beneficial to promote the construction of specialized nursing team for cardiovascular diseases.

OBJECTIVETo investigate the outcomes, survival status, and the prognostic factors of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) patients.

METHODSA retrospective study was carried out to analyze the clinical data of 61 EBV-HLH cases, from January 2008 to July 2014. Prognostic factors were analyzed through COX model (single factor and multiple factors).

RESULTSA total of 246 patients with HLH were diagnosed, among which 102 cases were with EBV infection (including 61 EBV-HLH, 36 lymphoma associated HLH, 5 primary HLH. Among the 61 cases, 40 were male and 21 were female, with a ration of 1.9:1. The median age was 28 years (range, 12-78). 1, 3, 6 and 12-month overall survival rates of 61 EBV-HLH were 65.6%, 47.5%, 32.4%, and 25.0%, respectively. The median follow-up time was 3 (0.5-28) months. 12 patients didn't use etoposide within 4 weeks after diagnosis, while HLH-94 protocol was used in 33 patients and HLH-2004 protocol was used in 16 patients. Response rates of theses three groups were 33.3%, 51.5%, and 43.8%, respectively (P=0.401). There was statistically difference between the group without etoposide and the HLH-94/ HLH-2004 group in the overall survival rate (P=0.033). Serum albumin level (P=0.033) and whether EBV could became negative (P=0.010) were independent predictors for EBV-HLH.

CONCLUSIONEBV-HLH patients have severe clinical feature and poor prognosis. Early application of immune chemotherapy based on etoposide can improve survival. Serum albumin level and whether EBV can become negative are independent prognostic factors for survival.

Adolescent ; Adult ; Aged ; Child ; Epstein-Barr Virus Infections ; Etoposide ; Female ; Herpesvirus 4, Human ; Humans ; Lymphohistiocytosis, Hemophagocytic ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Young Adult