Objective We aimed to assess systematically the effect of evidence-based nursing in the prevention of postpartum hemorrhage in puerpera of our country.Methods Relative literature was searched by computer at home according to the inclusion and the exclusion criteria,which was analyzed by RevManS.2 software,and literature selection and repetition was used according to the Note Express software.Results A total of 22 studies were brought into the study,the statistical result was analyzed by fixed effect model and the result was OR=0.29,95％CI (0.22,0.39),P ＜ 0.01.The sensitive analysis was carried out by replacement of statistical models,the result was OR=0.31,95％CI (0.24,0.42),P ＜ 0.01,which indicated that the result was stable and reliable.Conclusions The results of this study show that the application of evidence-based nursing can significantly reduce the postpartum hemorrhage rate in China,which is worthy of application in clinic.

Objective To compare the long-term effects and later period toxic reactions between preop-erative simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and 3-dimensional conformal radiotherapy RT (3D-CRT) for locally advanced rectal cancer.Methods A total of 130 patients with clinical stage cT3-4/N+M0 rectal adenocarcinoma receiving neoadjuvant chemoradiotherapy in this hos-pital from May 2010 to May 2015 were selected as the study subjects.The patients were divided into the SIB-IMRT group (66 cases) and 3D-CRT group (64 cases) according to the random number table method.The SIB-IMRT group took the irradiation 55 Gy/25 frequencies,irradiation 45 Gy/25 frequencies in the high risk recurrent region and regional lymphatic drainage area.The 3-DCRT group took the irradiation 45 Gy/25 fre-quencies in the high risk recurrent region and regional lymphatic drainage area.All patients orally took capecitabine (825 mg/m2) on 1-14 d and 22-35 d of radiotherapy (twice daily) in synchronized radiothera-py.The total mesorectal excision was performed in 6-8 weeks after radiotherapy end.The overall survival (OS) rate,disease free survival (DFS) rate,locoregional recurrence free survival (LRFS) rate,distant metas-tasis rate (DMR) and occurrence situation of advanced stage toxic reactions were observed and compared be-tween the two groups.Results The median follow-up time of all study subjects was 105(2,136) months.The 10-year OS rate,DFS rate,LRFS rate and DMR in the SIB-IMRT group was 67.8％,64.5％,91.8％ and 29.9％ respectively,which in the 3D-CRT group was 62.6％,61.2％,88.7％ and 34.5％ respectively,but the differences were not statistically significant (P>0.05).The grade 2 and 3 adverse reactions in the SIB-IMRT group were higher than those in the 3D-CRT group (34.48％ vs. 28.07％),but the difference was not statistically significant (P>0.05).Conclusion SIB-IMRT provides the acceptable long term effect and toxic results than 3D-CRT.

Objective To analyze long-term prognosis and influencing factors of thymoma after complete resection.Methods Clinical data of recurrence free survival(RFS)and disease specific survival(DSS)of 106 patients with thymoma after complete resection in Jinhua Central Hospital from August 2007 to January 2018 were retrospectively analyzed.Relevant prognostic and treatment failure factors of patients were analyzed.Results RFS for 5-year and 10-year of 106 cases were 86.9%and 77.9%respectively;DSS for 5-year and 10-year of 106 cases were 95.0%and 85.8%respectively.There was statistically significant difference in Masaok-Koga staging between recurrent and non-recurrent patients(P<0.05).There were statistically significant differences in gender,World Health Organization(WHO)histological classification,Masaok-Koga staging and tumor size between deceased and non-deceased patients(P<0.05).Univariate analysis showed that Masaokak-Koga stage,WHO histological classification and tumor size were risk factors affecting recrudescence in patients with thymoma after complete resection.Masaoka-Koga stage was risk factor affecting specific survival in thymoma.Multivariate analysis showed that Masaoka-Koga stage,tumor size and age were independent risk factors affecting RFS in patients with thymoma after complete resection.Masaoka-Koga stage was independent risk factor affecting DSS in patients with thymoma after complete resection.Conclusion Long-term prognosis of patients with thymoma after complete resection is good,and DSS can reach 85.8%in 10 years.Masaoka-Koga stage is independent prognostic factor for DSS.Advanced Masaoka-Koga stage,larger tumor size and younger age are risk factors for thymoma recurrence.

Objective To investigate the status of health promoting lifestyles in nursing students , and to analyze its influencing factors .Methods Three hundred and seventeen nursing students were chosen according to cluster sampling method , and the cross-sectional study was carried out through the health promoting lifestyle profileⅡ( HPLPⅡ) and self-esteem scale .Results The average score of all items of health promoting lifestyle was (2.33 ±0.32), and the highest score was (2.63 ±0.29) (self-realization), and the lowest score was (2.04 ±0.33) (exercise).The difference was found in the health promoting lifestyles in different nursing students including different age , grade, living conditions and school satisfaction (P<0.05).The average score of self-esteem was (22.91 ±4.20), and the correlation analysis showed that the score of health promoting lifestyle was positively correlated with self-esteem (r =0.517, P<0.05).The major influencing factors of health promoting lifestyle were respectively self-esteem, school satisfaction and age , which can explain 19.7%of the variance in health promoting lifestyles .Conclusions Self-esteem may be an important factor of health promoting lifestyles in nursing students , and the improvement of self-esteem can help them to take positive health promoting lifestyle .