Objective To evaluate diagnostic value of Sonoclot in the diagnosis of heat stroke complicated with disseminated intravascular coagulation (DIC). Methods 43 patients with heat stroke and coagulation dysfunction were retrospectively included and divided into 2 groups according to scores by International Society of Thrombosis and Hemostasis (ISTH): DIC dominant group (22 case) and DIC non-dominant group (21case). Regular coagulation tests , routine blood test , D-dimer and Sonoclot tests were performed at admission and their clinical data were compared. Logistic regression analysis was applied to evaluate the relationships between DIC occurrence and Sonoclot parameters. ROC curves were used to evaluate diagnostic value of Sonoclot for the patients with DIC and heat stroke. Results There were no differences in age, sex, central temperature and total hospital stay between the 2 groups except ICU stay, DIC symptoms, outcome, ISTH scores and APACHEⅡscores (P <0.05). ACT and CR correlated with the occurrence of DIC (P < 0.05). The AUC of ACT and ACT combined with CR were 0.854 and 0.877 respectively. The specificity of ACT in predicting DIC was 69.2%with the sensitivity of 90.3%. When combined with CR, both the specificity and the sensitivity were increased to 80.2% and 93.5%, respectively. Conclusions Sonoclot can predict DIC quickly and is effective in the diagnosis of heat stroke patients with DIC.

Objective To investigate the status of self-management of elderly patients with chronic heart failure (CHF) in Xinjiang Region,and to explore the effects of different demographic factors on self-management.Methods A total of 704 patients with chronic heart failure were randomly selected from Urumqi,Kashgar,Khotan,Changji,Shihezi,Yili Hazakh in Xinjiang Uygur Autonomous Region via convenience sampling method and were investigated using heart failure self-management scale.Results The total score of self-management of chronic heart failure elderly patients was(47.6±11.1) and scoring rate was 59.5％.There were statistically significant differences(P＜0.01) in self-management score among patients with different ethnicity,religion,self-care ability,per capita income.The influencing factors of self-management were self-care ability,NYHA class and per capita monthly income(P＜0.05).Conclusion The overall level of self-management of elderly patients with chronic heart failure in Xinjiang Region is low,and self-management is affected by self-care ability,NYHA class and per capita monthly income.Tailored culture-based education should be provided to improve patients' self-management.

Objective To investigate the status of self-management in community-dwelling elderly patients with chronic heart failure in Pudong district and analyze demographic influence factors.Methods A total of 328 patients with chronic heart failure were randomly selected from 4 Shanghai Pudong community centers based on cluster sampling method and were investigated via heart failure self management scale.Results The total score of self-management of chronic heart failure patients was (51 .3 ±8.3),within which the scores of medication management,dietary management,psychological and social management and symptom management were (1 4.5 ±2.7),(9.1 ±2.0),(1 2.2 ±3.1 )and (1 5.5 ±3.9).Gender,religion and self-care ability were the main influencing factors of self-management,which accounted for 9% of variation.Conclusions The self-management of community-dwelling elderly patients with chronic heart failure is medium level.The self-management ability of chronic heart failure patients are affected by many factors.Targeted nursing should be performed to improve patients′self-management.

This paper presents a review of the research status and application progress of the transcultural nursing concept in self-management of elderly patients with chronic heart failure both at home and abroad, and puts forward suggestions and prospects for the development of self-management mode in patients with chronic heart failure in our country. According to the diversified needs of elderly patients with chronic heart failure in our country and the current situation of self-management, this paper proposes that the concept of transcultural nursing should be combined with self-management. It is suggested that the content of transcultural nursing education should be combined with the goal of nurse training. Referring to the application content and mode of transcultural nursing concept in self-management of chronic heart failure patients in foreign countries, it is advised to pay attention to assess the diversified needs of self-management of patients with chronic heart failure, and pay attention to the belief of patients' behavior change. The cultural background of the patients with chronic heart failure should be followed, and the motivation of strengthening the self-management of patients should be emphasized. Meanwhile, we should build a transcultural incentive self-management model for patients with chronic heart failure based on systems theory to improve their quality of life.

Objective To development a self-management intervention model for elderly patients with chronic heart failure in China based on the methodology of systematic science, so as to provide theoretical guidance for the formation of scientific, standardized and operable clinical intervention programs. Methods Through literature review and theoretical research, the paper analyzed the necessity of self-management intervention model for elderly patients with chronic heart failure, clarified the interrelationship and interaction between patients and their families and the nurse-centered multidisciplinary team. Results The self-management intervention model of elderly chronic heart failure established in this study was based on the principle of system theory, that was, integrity principle, orderliness principle, dynamic principle, purpose principle, optimization principle and openness principle. Conclusions The self-management target intervention model of elderly patients with chronic heart failure based on system theory enriches the theoretical research of self-management and opens up a new path for the formation of scientific, standardized and operable clinical intervention programs.

This paper summarizes the application of health coaching in self-management of patients with cardiovascular diseases. Health coaching can help patients with cardiovascular diseases gain the knowledge, skills, tools, and confidence that they need to become active participants in their self-health and enhance their self-management. The form of health coaching includes motivational interview, self-management support and remote home monitoring. Health coaching can enhance the medication adherence among patients with cardiovascular diseases, promote healthy lifestyles and maintain good psychology in patients, and finally strengthen their self-management. Finally, this paper proposes that China should pay more attention to the health coaching, such as establishing the relevant departments of health coaching, strengthening the training and certification of health coaches through the examination of theory and skills, and exploring the establishment of a technical program for health coaching and intervention that is suitable for China, so that patients with cardiovascular diseases can be benefited.

Objective To evaluate the effects of Phentolamine combined with Lincomycin Hydrochloride and Lidocaine Hydrochloride Gel for phlebitis caused by amiodarone extravasation in an animal study.Methods A total of 15 adult rabbits were selected in March 2017. We built a model according to amiodarone damage. All of the rabbits were numbered by weight from light to heavy and divided into five groups with the random number table including group A (model group), group B (group with 50％ magnesium sulfate for external application), group C (with Phentolamine for external application), group D (with Lincomycin Hydrochloride and Lidocaine Hydrochloride Gel for external application) and group E (Phentolamine combined with Lincomycin Hydrochloride and Lidocaine Hydrochloride Gel for external application). We compared the differences in naked eye observation, pathological observation and immunohistochemistry among five groups and compared the differences of group A with other four groups.Results There were no significant differences in effects of symptom observation among five groups on the first day after different treatments for amiodarone extravasation (P>0.05). The differences in treatment effects were significant among five groups on the second and third day after treatments (P<0.01). There were significant differences between group D and group A, group E and group A on the second and third day after treatments for extravasation (P<0.05). The differences in ear vein and surrounding tissues pathological injury of rabbits were significant among five groups on the third day after different treatments for amiodarone extravasation (P<0.05). There were significant differences in average positive rates of vascular endothelial growth factor (VEGF) among five groups (P<0.001), the average positive rate of VEGF in group A was higher than that in other four groups (P<0.05); the average positive rate of VEGF in group E was lower than that in other four groups with significant differences (P<0.05); there was no significant differences among group B, group C and group D (P>0.05).Conclusions The Phentolamine combined with Lincomycin Hydrochloride and Lidocaine Hydrochloride Gel for phlebitis caused by amiodarone extravasation has obvious effects in an animal study.

Objective? To evaluate the effects of competency-based training model in training for new nurses. Methods? Randomized controlled trials and quasi experiments on application of competency-based training model in training for new nurses were retrieved in PubMed, EMBASE, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), China Scientific Journal Database, Wanfang Data and VIP by computer. Meta-analysis was carried out with the RevMan 5.3 after literature screening, data extraction and quality assessment of literature. Results? A total of 6 literatures were included. Meta-analysis showed that competency-based training model could improve the knowledge comprehensive capacity [MD=4.91, 95%CI(3.84, 5.99), P＜ 0.001], good personal qualities [MD=0.28,95%CI(0.22,0.35),P＜0.001], interpersonal communication skills [MD=2.31, 95%CI(0.84, 3.78), P=0.002], clinical nursing ability [MD=0.33, 95%CI(0.08, 0.58), P=0.040], construction and development ability of specialty [MD=0.23, 95%CI(0.19, 0.27), P＜ 0.001], critical thinking and innovation ability [MD=1.37, 95%CI(0.17, 2.57), P=0.020]. Conclusions? Competency-based training model in training can effectively improve new nurses' knowledge comprehensive capacity, good personal qualities, interpersonal communication skills, clinical nursing ability, construction and development ability of specialty, critical thinking and innovation ability, and improve their competency. The multicenter, high quality and large-sample study on effects of competency-based training model in training for nurses should be carried out since number of the included literatures involving evaluation indexes of this study was few and heterogeneity occurred in some evaluation indexes.

This paper reviewed the content and assessment tools of self-management needs in elderly patients with chronic heart failure according to diversified demand, current status of self-management and existing problems of them so as to provide a reference for developing the practice in self-management needs among elderly patients with chronic heart failure in China.

Objective:To investigate the self-management of elderly chronic heart failure (CHF) patients and to explore the structural equation modeling (SEM) on the influencing factors of self-management behavior among CHF patients so as to provide a basis for constructing the self-management education plan for elderly CHF patients suitable for the characteristics of our country.Methods:From January 2015 to June 2017, The study selected 6 124 elderly patients in 102 hospitals of 16 provinces, cities and autonomous region from 5 areas, east China, west China, south China, north China and central China by random cluster sampling as subjects. All of patients were investigated with the self-management scale of heart failure patients, heart failure knowledge questionnaire, chronic disease self-efficacy scale, self-concept scale and the medica coping modes questionnaire. AMOS 22.0 was used to construct the model on the influencing factors of self-management behavior among CHF patients.Results:The total score self-management of 6 124 elderly CHF patients was [49.00 (43.00, 54.00) ] with 61.25% for the scoring rate. The SEM on the direct or indirect influencing factors of self-management among elderly CHF patients fitted well. The influencing factors of self-management included the per-capita incomes, works, self-care, nations, religious belief, education levels, heart failure knowledge, self-concept, self-efficacy, coping styles.Conclusions:Self-management of elderly CHF patients are in the below average level influenced by different demographers, cultural background and heart failure knowledge. Medical staff should formulate a systematic and individual self-management education plan for elderly CHF patients based on patients' demographic characteristics, cultural background, heart failure knowledge, self-concept and self-efficacy to improve their self-management.