Pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries is a rare kind of congenital heart disease. Nowadays, staged surgical treatment has been recognized by more and more surgeons with the surgical treatment of the disease continuing to progress and a deeper understanding of surgical treatment.

Objective To investigate the diagnostic value of multiparametric MRI in early prostate cancer(PCa) based on PI-RADS version 2.Methods 27 surgically-proved early PCa patients were collected in this retrospective study.T2WI,DWI and DCE were evaluated by two blinded radiologists.By 12 sub-region classification method the possibility of the presence of cancer at each sub-region was scored according to the PI-RADS V2.The receiver operating characteristic (ROC) curve was used to analyze the diagnosic efficacy of the following 4 protocols:T2WI alone(protocol 1),T2WI+DWI(protocol 2),T2WI+DCE(protocol 3),T2WI+DWI+DCE(protocol 4).The sensitivity,specificity and accuracy for each protocol were calculated.The average scores of cancerous sub-regions and non-cancerous sub-regions were calculated and the independent sample t test was used to compare the four protocols.Results 324 sub-regions were analyzed in 27 early PCa patients and then divided into 119 cancerous sub-regions and 205 non-cancerous sub-regions,including 64 peripheral zone cancerous sub-regions and transition zone cancerous sub-regions.In protocol 1-4, the average scores of cancerous sub-regions in orderwere 3.13±1.19,3.27±1.15,3.28±1.23, 3.33±1.16,respectively.Non-cancerous sub-regions's scores in order were 1.98±0.90,1.91±0.91, 2.03±0.99,1.94±0.96 respectively and there were significant differences among each protocol (P<0.05).The area under the ROC curve of the 4 protocols for region-based analysis were displayed in descending order: protocol 4 (0.819), protocol 2 (0.810), protocol 3 (0.772), protocol 1 (0.765) and there were no significant differences between any two protocols (P>0.05).In four protocols, the sensitivity in order were 45.40%, 56.30%, 59.70%, 61.34%, while the specificity in order were 95.10%, 96.10%, 89.80%, 96.60%, and the accuracy in order were 76.85%, 81.48%, 78.70%, 83.65%.Conclusion Multiparametric MRI can improve the diagnostic accuracy for the detection of early PCa, and T2WI+DWI+DCE is with the highest value.The PI-RADS V2 system is a better semi quantitative method for evaluation of early PCa.

Objective To investigate the effects of self-efficacy-oriented nursing intervention on postoperative quality of life of lung tumor patients. Methods Ninety patients with lung tumors undergoing chest surgery in our hospital from March 2010 to March 2012 , involved in the study. The nursing data were retrospectively analyzed for investigation of the nursing strategies. The patients were randomized into two group with random digits table in equal number: The control group received routine nursing and the intervention group with self-efficacy-oriented nursing intervention beside routine nursing care. 3 months after nursing intervention , the two groups were compared by Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) in terms of quality of life and psychological state. Results The scores of the intervention group by SDS and SAS were both significantly higher than those of the control group (P < 0.05). The scores of the intervention group on self efficacy and quality of life were significantly higher than those of the control (P < 0.05). Conclusion The self-efficacy-oriented nursing intervention applied in the postoperative nursing care to lung cancer patients can significantly improve the postoperative symptoms and psychological status. It can also improve their self efficacy and then enhance their quality of life.

Objective:To conduct reliability and validity test of Chinese versions of TeamSTEPPS medical teamwork perceptions questionnaire and TeamSTEPPS medical teamwork attitudes questionnaire so as to evaluate whether they are applicable to the current situation of medical teamwork in China.Methods:From January to April 2019, the Chinese versions of TeamSTEPPS teamwork perceptions questionnaire and TeamSTEPPS teamwork attitudes questionnaire were used to evaluate 900 emergency department workers in 9 ClassⅢGrade A hospitals in Shanghai by cluster sampling, and reliability and validity of the questionnaires were analyzed and evaluated. In this study, a total of 900 questionnaires were issued, 870 were recovered and 861 were valid, with an effective recovery rate of 96%.Results:The exploratory factor analysis of the Chinese versions of Chinese versions of TeamSTEPPS medical teamwork perceptions questionnaire and TeamSTEPPS medical teamwork attitudes questionnaire was carried out to extract the five dimensions of team structure, leadership, situation monitoring, mutual assistance and communication. The cumulative variance contribution rates were respectively 71.248% and 71.010%. In addition, a confirmatory factor analysis was performed on the questionnaires. The Chi-square degrees of freedom ratio (χ 2/ df) values were 2.870 and 2.214, normed fitting index ( NFI) values were 0.861 and 0.906, Tucker-Lewis index values were 0.896 and 0.940, incremental fit index ( IFI) values were 0.905 and 0.946, comparative fit index (CFI) values were 0.904 and 0.946, and root mean square error of approximation ( RMSEA) values were 0.066 and 0.053. The fitting values all reached the judgment standard, and the structural validity of the two questionnaires was good. The content validity indexes were good and they were respectively 0.94 and 0.95. The overall Cronbach's α coefficients of TeamSTEPPS medical teamwork perceptions questionnaire and TeamSTEPPS medical teamwork attitudes questionnaire were respectively 0.949 and 0.938, the split-half reliability was respectively 0.848 and 0.959, and the test retest reliability were respectively 0.959 and 0.964. Conclusions:The Chinese versions of TeamSTEPPS medical teamwork perceptions questionnaire and TeamSTEPPS medical teamwork attitudes questionnaire have good reliability and validity and high applicability, which can be used to measure the attitude and perceptions of medical teamwork in China.

Objective To investigate the social support of clinical nurses in second-level hospitals in remote areas of Tibet, and to explore the influencing factors, so as to provide the basis for nursing managers to develop targeted interventions. Methods A total of 212 nurses were selected by convenient holistic sampling method and investigated by self-designed questionnaire and social support rating scale. Results The total score of social support of clinical nurses was (30.72 ± 6.78) points. The main influencing factors of social support were educational background(F=4.602),ages(F=2.694),working years (F=2.387), budgeted posts(t=2.391), income(F=3.112) and marital status (F=2.636). Difference was statistically significant(P<0.05). Conclusions The social support of clinical nurses in second-level hospitals in remote areas of Tibet is low. It is important to establish a relatively perfect social support system according to the difference of nurses working conditions and geographical to improve their work enthusiasm and satisfaction rate.

Objective To explore the application effect of the fast rehabilitation nursing pathway in the elderly patients with tension-free hernioplasty during the perioperation period .Methods One hundred and thirty-eight patients with tension-free hernioplasty were chosen and divided into the observation group and the control group according to the random number table , each with 69 cases.The observation group received the nursing on the basis of fast rehabilitation nursing pathway , and the control group received the routine nursing . The occurrence of complications during and after the operation , the days and costs of hospitalization were compared between the two groups .Results The cases of urinary retention , abdominal distension and pulmonary infection were respectively 2, 3 and 4 cases in the observation group , and were lower than 10, 18 and 16 cases in the control group, and the differences were statistically significant (χ2 =5.841, 12.637, 8.420, respectively; P <0.05).The days and costs of hospitalization in the observation group were respectively (6.6 ±0.8)d, (2 313.6 ±139.7) yuan, and were lower than (9.3 ±1.0) d, (3 637.8 ±226.1) yuan in the control group, and the differences were statistically significant (t =4.67, 5.01, respectively; P <0.05). Conclusions The fast rehabilitation nursing pathway which was carried out in the nursing of the elderly patients with tension-free hernioplasty can accelerate the progress of rehabilitation in patients .

Objective To research the status of awareness to the risk informed system and compare the differences between nurses and patients .Thus, we can provide an identifiable ground to improve the system and the implementation capacity among nurses .Methods Self-designed questionnaire about informed nursing risks were distributed to 245 nurses and 200 patients.Results A total of 445 questionnaires were distributed , and 445 questionnaires were returned , with an effective rate of 100%.All the nurses took a supportive attitude on the risk informed system.65.00%nurses believed that the system had a positive impact on the nurse-patients relationship.97.14%nurses thought that the risk should be informed by the charge nurse .As for the patients, 98.0% patients thought that there were risks during nursing process , so the healthcare professionals should inform the risks.41.5% patients read the notification before sign it .There were significant differences in the informed place, method, object, subject and whether they can read the notification and take the initiative to ask questions and cooperate (P<0.05).Conclusions There was significant difference in the awareness of risk informed system between nurses and patients .Hospital administrators should fully consider the importance of training the nurses’ knowledge and ability, and they should develop standardized nurses ’ risk informed system. The nurses should pay attention to the patients ’ requirements in order to develop the form of inform method . Finally, we can establish an effective nursing risk prevention barrier .

Objective To explore the effect of self-efficacy theory on nursing of patients with lung cancer.Methods Totals of 80 patients with lung cancer were randomly divided into study group and control group,control group received routine treatment and nursing,while study group received self-efficacy intervention measures.Between the two groups,patients' self-efficacy and quality of life (WHOQOL-100) score were compared.Results The score of self-efficacy in study group and control group respectively was (37.05 ± 4.23) and (31.12 ±5.21).And the quality of life (WHOQOL-100) score in study group and control group was (77.14 ±4.25) and (62.03 ± 4.52),respectively.Patients' self-efficacy and quality of life scores of two groups were significantly increased (t =5.607,15.403,respectively; P ＜ 0.01).Conclusions Self-efficacy theory has a guiding meaning for pain care of cancer patients,which can improve the quality of life of patients.

Objective To explore structured psychological intervention in improving lung cancer patients’ preoperative self-efficacy.Methods Totals of 60 patients with lung cancer were randomly divided into the study group and the control group .The control group was given conventional nursing care .The study group was given structured psychological nursing intervention , including psychological support , health education , stress treatment and coping technique .Before and after 5 days of the intervention , patients ’ self-efficacy was compared.Results The General Self Efficacy Scale ( GSES) scores before and 5 days after intervention were (26.25 ±4.05) and (36.23 ±4.54) in the study group, and (26.18 ±6.21) and (30.05 ±5.05) in the control group .And the structured psychological intervention can significantly improve the preoperative self -efficacy level of patients with lung cancer (t=4.98,P<0.05).Conclusions The structured psychological intervention can enhance preoperative patients ’ self-efficacy, and can effectively help patients cope with disease and surgery.

Objective To discuss the surgical treatment of anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA) and the risk factors of postoperative recovery in infants and children.Methods A retrospective review of all patients who underwent surgical treatment of ALCAPA in Shanghai Children Medical Center(2003.1-2018.1) was conducted.Patients were divided into early surgery group (2003.1-2012.12) and late surgery group (2013.1-2018.1) according to the operation time,a preoperative left ventricular ejection fraction(LVEF) ＜0.35 was defined as severe group and LVEF≥0.35 as the control group in both surgery group.Meantime,and the clinical data among the groups were analyzed and compared.Results 102 patients were included in our study.According to the operation time and preoperative LVEF grouping:10 cases in the early severe group,early death in 4 cases(40％);28 cases in the early control group,and 3 cases died(10.7％)in hospital.Preoperative LVEF(0.29 ± 0.06 vs.0.53 ± 0.12),surgical age [(8.0 ± 7.9) months vs.(23.3 ± 27.7)months],and cardiopulmonary bypass time [(131.1 ± 39.6) min vs.(103.8 ± 29.8) min] were statistically different between the early two groups.The results of the late surgery had been improved:24 cases in the late severe group,4 cases died in hospital(16.7％);40 cases in the late control group,and early death in 2 cases (5％).In the late surgery groups,there was a statistically significant difference in preoperative LVEF(0.28 ±0.05 vs.0.59 ±0.12),left ventricular end-diastolic diameter(LVDD) Z-score(3.09 ±1.16 vs.2.11 ±0.95),and surgical age [(5.3 ±3.0) months vs.(24.8 ±30.5)months],clamping time [(67.1 ± 15.5) min vs.(82.7 ± 28.4) min].In the severe group,there was no significant difference in preoperative clinical data between early and late patients,and the early mortality decreased from 40％ in the early period to 16.7％ in the late period.In this study,13 cases(38.2％) of children with severe ALCAPA underwent mechanical circulation support(MCS).One patient died during MCS support and 2 died after weaning.Conclusion The early mortality severe ALCAPA remains high,which may be related to severe cardiac ischemia,left ventricular enlargement and age at surgical time.The modify of surgery technology and the use of MCS in the early clinical stage can improve the early survival rate.