Objective To investigate the pressure sources of caregivers in need of hematopoietic stem cell transplantation (HSCT) and to provide evidence for targeted intervention. Methods According to Hill′s ABC-X family pressure model, 12 main family caregivers were received semi-structured in depth interviews with phenomenological methods. Results Pressure sources of caregivers for HSCT patients were summed up to 7 aspects: search of donor, isolation with patient during transplantation, lack of knowledge in patient care, family resource difficulties, family economic overburden, social role transformation and uncertainty of disease prognosis. Conclusions The pressure sources of caregivers for HSCT patients is a persistent process, which is over layed as the patient′s condition worsens. The analysis on the pressure sources of primary family caregivers is becoming a new topic in HSCT nursing area.

Objective To evaluate the effect of integrated service platform of extensional care based on the combined internet and extensional care model in the orthopedics nurse care. Methods Two hundred and eighty six hospitalized patients in the orthopedic department were randomly divided into two groups including experimental group (144 cases) and control group (142 cases) according to the random number table method. Patients in the control group received extensional care by traditional telephone follow-up, patients in the experimental group received extensional care by using the integrated service platform combing internet and extensional care. All the patients were evaluated using the self-made extensional care satisfaction questionnaire and Short Form 36 Questionnaire. Results The extensional care satisfaction scores of experimental group using internet plus extended care mode were respectively ( 74.4 ± 5.3) points and (76.2 ± 8.1) points at the time points of 3 months and 6 months after discharge from hospital;The extensional care satisfaction scores of control group were respectively (69.4±9.9) points and (70.1±12.2) points at the time points of 3 months and 6 months after discharge from hospital;The two groups had statistically comparative difference (t=7.40, 6.37, P<0.01). There was a statistically significant improvement of extensional care satisfaction and physical function score and role-physical score and social function score in the experimental group compared with the control group both at the time points of 3 months and 6 months after discharge from hospital. There was a statistically significant improvement of vitality score and role-emotion score in the experimental group compared with the control group both at the time points of 1 month and 3 months after discharge from hospital (t=2.366-8.211, P<0.05). Conclusions The effect of integrated service platform of extensional care based on the combined internet and extensional care model is better than traditional telephone follow-up, patients′satisfaction is higher. This new mode of service platform could greatly deepen the connotation of quality nursing, intensify the effect of extensional care, and reduce the working strength of nurse who did extensional care as while.

In the early 20th century,the term Nursing was introduced into China.In 1884,with the arrival of the first batch of missionary nurse,modern nursing initiated by Nightingale was introduced into China and greatly changed the way of care.The missionary nurses were full of enthusiasm for the spreading Gospel of Christ,the love for nursing care and the empathy for Chinese people;and encountered the lack of staff and material,the mis-understanding and resistance from the local people and other multiple tests.With the untiring effort of them and the trained local nurses,China had led the international care in nursing education and practice standard.Based on this,nursing in Shandong gradually rose and had an unprecedented development as a new medical subject.By clearing up and consulting Chinese and English historical materials,this paper reviewed the 60 years of the mission-ary nurses in China,saw the early development of nursing in our country from the budding and development of Shandong nursing and provided more insights for understanding and solving the complex problems contemporary Chinese nursing faces.

Objective:To evaluate the best preventive measures for hypothermia in patients undergoing hip and knee replacement.Methods:Cochrane Library, PubMed, CINAHL, Embase, Web of Science, CNKI, Wanfang, VIP and Chinese biomedical literature database were searched by computer. Randomized controlled trials on hypothermia prevention measures in hip and knee arthroplasty were searched, and back into the literature references, the retrieval time is from database establishment to December 2019; the two researchers independently conducted literature screening, quality evaluation, and data extraction according to the inclusion exclusion criteria, and used Revman5.3 software for meta-analysis of the included literature.Results:A total of 608 patients were included in 11 literatures. The results of Meta-analysis showed that: in terms of core temperature, the main outcome index, the Forced-air Warming System was superior to the non-Forced-air Warming measure such as electric blanket, electric heating pad and circulating water mattress ( SMD=0.59, 95% CI 0.27-0.92, P=0.0004); in terms of secondary outcome indexes, the Forced-air Warming System was better than the non-Forced-air Warming measure such as electric blanket, electric heating pad and circulating water mattress ( OR=0.28, 95% CI 0.14-0.58, P=0.0006); in terms of thermal comfort, the Forced-air Warming System had no significant effect ( SMD = 0.21, 95% CI-0.56-0.98, P=0.59). Conclusion:Compared with the Forced-air Warming System, the non-Forced-air Warming measure can effectively maintain the core temperature of patients undergoing hip and knee arthroplasty, reduce the occurrence of postoperative chills, but in the aspect of improve thermal comfort of patients is not obvious. However, due to the number of studies and their statistical heterogeneity, large sample and high-quality studies are needed to verify the results of this study.

ABSTRACT:Objective To investigate the distributional characteristics of anaphylactogens in prurigo nodularis (PN)patients so as to provide clinical basis for selecting the method of allergy test.Methods We divided 262 PN patients into four groups and then used skin-prick (5 4 patients ),skin-patch (5 0 patients ),serum IgE allergen detection (56 patients)and serum IgG allergen detection (102 patients)to analyze anaphylactogen positive rate and their distribution differences in PN.Results For skin-prick test in 54 PN patients,the detection rates of platanus orientalis,artemisia argyi,poplar,dust mite,dirt mite,cod,peanut and tomato were higher than those in the control group (P<0.05 ).For skin-patch test in 50 PN patients,the detection rates of nickel sulfate,flavor compounds,black rubber,and carba mix were higher than those in the control group (P<0.05).For serum IgE test in 5 6 PN patients,the detection rates of house dust,scandent hop,cat/dog hair,bug,penicillium/neurospora and mutton were higher than those in the control group (P<0.05).For serum IgG test in 102 PN ones,the detection rates of crab,shrimp,beef and cod were higher than those in the control group (P<0.05).Conclusion Skin-prick test and serum IgE detection have high application values in PN patients.Serum IgG detection is of certain importance in adjusting PN patients’diet structure while skin-patch test applied in PN needs further exploration.

Objective To study T lymphocyte subsets and expression of costimulatory molecule CD154 on T-cells in peripheral blood from patients with ankylosing spondylitis and their changes after treated with Enbrel. Methods Sixty-six patients with AS(39 active and 27 inactive, 35 axial and peripheral joint involvement and 31 axial involvement only), 30 patients with rheumatoid arthritis(RA), 30 healthy volunteers were analyzed. The expression of CD154 on CD3+ T cell as well as T-cells subsets were evaluated using flow cytometry respectively. The changes of the expression of costimulatory molecule CD154 in 39 active AS patients(Enbrel treatment or placebo treatment) were observed in a randomized, double-blind, placebothan that of healthy volunteers, and CD154 expression on CD3+ T cells in peripheral blood in AS patients was on CD3+ T cells in the peripheral blood of active AS or AS patients with peripheral joint involvement were significantly higher than those in inactive or axial involvement only AS patients(P＜0.05), and CD154 on CD3+ placebo, in AS patients group, there was significant reduction in CD154 expression on CD3+ T cells in Enbrel group at week 6(P＜0.05), there was no significant difference between Enbrel group and healthy volunteers at week 6(P＞0.05). Conclusion T lymphocyte subsets are significantly abnormal and CD154 is overexpressed on T-cells in peripheral blood of patients with AS. A six-week course of treatment with Enbrel in active AS can induce a down-regulation of the expression of CD154 on T cells.

Objective To understand the cognition and experience of fall prevention amongthe geriatric ward staff. Methods The methods of qualitativeresearch conducted focus groups interviews of the geriatric ward staff. The interview data of focus groups were collated and analyzed using Colaizzi's seven-step analysis method. Results A total of 5 themes had been raised: the recognition of the uniqueness of elderly patients; the overestimation of self-competence; the lack of family support; the significance of environment facilities;the problem of cooperation and communication. Conclusions In the prevention of falls in elderly patients, We should identify related promote and hinder factors. And the special needs of elderly patients should be taken into consideration. The prevention strategy of falls prevention is formulated to reduce the incidence of falls.

Objective: To explore the night sleep quality of shift nurses and the current situation of their daytime tiredness, sleepiness, and to provide evidence for nursing administrators and managers to allocate human resources reasonably and prevent adverse events. Methods: The cross-sectional method was utilized to conduct a questionnaire survey among shift nurses in a tertiary teaching hospital in Shandong Province from March to May inclusive, 2017. Results: There was a total of 233 valid questionnaires returned. The prevalence of sleep disorder, daytime tiredness and sleepiness was 45.92%, 16.31% and 13.30%, respectively. The differences of the nurses' sleep quality at night between different ages, marriages, educational backgrounds and professional titles were statistically significant (P<0.05) , while the differences of daytime burnout and sleep state between different shift systems were statistically significant (P<0.01) . Night sleep quality was positively correlated with daytime tiredness and sleepiness (P<0.05) . The results of multiple linear regression analysis showed that age, marriage, educational background and professional title had an impact on nurses' sleep quality at night (P<0.05) . Shift system had an impact on nurses' daytime burnout and sleep apnea (P<0.01) . Conclusion There was a high prevalence of night sleep disorder, daytime tiredness and sleepiness among the shift nurses. Nursing administrators and managers should pay more attention to the night sleep quality of nurses who aged over 30 years old, married, without a bachelor degree and those with a lower professional rank. Furthermore, the current situation of daytime tiredness and sleepiness among two-shift only nurses was worrisome.

Comprehensive unit-based safety program(CUSP)is a project aimed at improving the patient safety culture and promoting the safety of patients. As a mature patient safety practice tool, it has carried out various successful research practices in the United States. This article summarizes the contents of the CUSP toolkit and reviews the domestic and international application status of CUSP, then discusses the application value and application space of CUSP in China, in order to provide new ideas for the development of the localized patient safety practice.

Objective:To investigate the expressions of micro RNA-26a (miR-26a) and toll-like receptor (TLR) in peripheral blood mononuclear cells (PBMCs) of patients with psoriasis vulgaris (PV), and to analyze their relationships with disease activity.Methods:Total 200 PV patients treated in our hospital from June 2016 to June 2018 were selected as the study group. According to Psoriasis Area and Severity Index (PASI) score, the PV patients were divided into 71 cases in mild group, 84 cases in moderate group, 45 cases in severe group, at the same time, 100 healthy people in the physical examination center were selected as the control group. The mRNA levels of TLR2 and TLR4 in PBMCs were detected by fluorescence quantitative polymerase chain reaction (PCR); serum C-reactive protein (CRP) level was detected by immunoturbidimetry; Pearson correlation was used to analyze the relationships between the expressions of miR-26a, TLR2 and TLR4 with the activity of PV (PASI score and CRP level).Results:There was no significant difference in sex, age, body mass index (BMI) and course of disease among PV patients of different grades in the study group ( P>0.05); the mRNA expression levels of miR-26a, TLR2 and TLR4 in PBMCs of the study group were significantly higher than those of the control group ( P<0.05); the PASI score, serum CRP level, miR-26a, TLR2 and TLR4 mRNA expression levels in severe PV group were significantly higher than those in mild group and moderate group ( P<0.05), and the above indexe in the moderate group were significantly higher than those in mild group ( P<0.05); the PASI score and serum CRP level of PV patients were positively correlated with miR-26a, TLR2 and TLR4 mRNA expression levels ( P<0.01). Conclusions:The mRNA expression levels of miR-26a, TLR2 and TLR4 in PBMCs of PV patients are increased and positively correlated with PASI score and CRP level, which can reflect the activity of PV disease.