OBJECTIVE:To provide reference for avoiding the recurrence of medical safety(adverse)events or inducing more severe medical accident. METHODS:The medical safety(adverse)events reported by a class A grade 3 hospital from July 2013 to March 2016 were studied retrospectively,and excluded purely adverse drug reactions and transfusion reactions to analyze the rea-son and characteristics. RESULTS:Of 747 events,there were 578 medical,nursing and drug-related medical safety (adverse) events,accounting for 77.38%;among 175 medical related medical safety(adverse)events,top 3 reasons were basic skills defi-ciencies,defects in the system processes,inadequate communication and education, accounting for 32.00%,24.00%,19.43%. The occurrence of medical safety (adverse) events were closely related to working life and qualifications;among 578 medical, nursing and drug-related medical safety (adverse) events,the incidence of adverse events was 71.11% in 5-year working life group,and that was 73.18% in junior titles group. CONCLUSIONS:Various professionals should strictly implement procedure and regulations,strengthen communication and education in daily work,and improve professional knowledge and skills so as to prevent the occurrence of adverse event completely.

ObjectiveTo compare the effectiveness of ω-3 fatty acids and middle/light fatty acids in the intervention of rats model of bleomycin-induced pulmonary fibrosis.MethodsTotally 120 rats were randomly divided into 4 groups: normal saline (NS) group,bleomycin-induced pulmonary fibrosis without treatment group ( BLM group),middle/light fatty acids group,ω-3 fatty acids group.Lung tissues were obtained on the 7th,14th,and 21st day after modeling.The left lung were measured by using immunohistochemical methods for transforming growth factor β1 (TGF-β1) and interferon garmma ( IFN-γ).The lower lobe of the right lung underwent HE staining.Serum TGF-β1,IFN-γ,and interleukin-4 (IL-4) were measured using double-antibody sandwich ELISA.ResultsThe pulmonary alveolitis and fibrosis in the ω-3 fatty acids group was significantly milder than in middle/light fatty acids group and BLM group.On the 7th,14th,and 21st day after modeling,stronger TGF-β1 protein expression was detected in the bronehiolar epithelia of middle/light fatty acids group and BLM group and poorer IFN-γexpression in both groups.However,the opposite results were found in the ω-3 fatty acids group: on the 7th,14th,and 21st day after modeling,TGF-β1 protein expression ( 13.60 ± 5.90,10.53 ± 4.21,and 7.23 ± 2.21 )was lower ( P =0.047) and IFN-γ ( 13.85 ± 7.48,15.32 ± 2.12,and 18.74 ± 2.65 ) was stronger in ω-3 fatty acids group (P =0.041).On the 7 ,14,and 21st day after modeling,the serum IL-4 levels in the middle/light fatty acids group and BLM group became significantly higher,while the IFN-γ level in both groups was significantly lower than in ω-3 fatty acids group ( P =0.008 ) ; meanwhile,in the ω-3 fatty acids group,the serum IL-4 levels [ (8.73 ± 1.20),(5.73 ±2.03),and (4.98 ± 1.89) pg/ml] were significantly lower (P =0.044) and serum IFN-γlevels [ (5.67 ± 0.13 ),( 6.58 ± 0.64 ),and ( 7.05 ± 0.52 ) pg/ml ] were significantly higher ( P =0.048 ) on the 72,14th,and 21st day after modeling.Conclusionsω-3 fatty acids can lower TGF-β1 protein expression in rat lung tissue and reduce the surum TGF-β1 and IL-4 levels.Compared with the middle/light fatty acids,it can more effectively upregulate the expression of IFN-γ in lung tissue and increase its serum level,and thus alleviate pulmonary fibrosis in rats.

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Objective To explore the application effect of action-oriented teaching method in senior midwifery practice teaching.Methods Selecting 30 students from class 1,grade 2011 of the midwifery professional for the experimental group,another 30 students from class 2 for the control group.We selected four core contents for the experimental teaching refbrm such as obstetric abdominal examination,external pelvimetry measurement,prenatal vulva washing disinfection and sterile towel covering before the delivery.The experimental group was taught by action-oriented teaching,in accordance with the procedures:putting forward the projects or work task,set goals and grouping,making work plans,implementing and evaluating.The control group was taught by traditional teaching.We used questionnaire smvey and skills examination to evaluate the teaching effects and conducted teaching satisfaction scores and scores for t test to two groups of students.Results (1)Questionnaires:The resuhs of the 18 issues on the teaching effect evaluation,professional technology level and nursing soft skills,etc.showed that the experimental group's evaluation of the action-oriented teaching is higher than the control group's evaluation of the traditional teaching(P＜0.05),action-oriented teaching is more helptul to improving the professional skill and nursing soft skills(P＜0.05).@The scores of skill examination:The skills scores of the experimental group(80.01 ± 9.36) were significantly higher than those of the control group(71.32 ± 8.85)(t=3.70,P=0.000).The difference was statistically significant (t=3.70,P=0.00).Conclusions Action-oriented teaching helps to raise practice teaching effecr,train students' clinical work ability and nursing soft skills.It is suitable for practice teaching of senior midwifery.

Objectives To understand the effects of different doses of vitamin D supplementation on serum calcium,phosphorus,alkaline phosphatase and 25-hydroxyvitamin D levels in very low birth weight infants (VLBWI) and to provide guidance for early prevention of metabolic bone disease in VLBWI.Methods A total of 90 VLBWI hospitalized in the Department of Neonatology,Huzhou Maternal and Child Healthcare Hospital between January 2014 and January 2016 were enrolled and randomly divided into two groups:highdose group and low dose group.High-dose group was given vitamin D 900 U/d orally and low-dose group was given 400 U/d since the eighth day after birth.Serum calcium,phosphorus and alkaline phosphatase levels were detected at 1,7,21 and 42 days of age and serum 25-hydroxyvitamin D levels were detected at 7,21and 42 days of age.Two-sample t-test,Chi-square test,one-way analysis of variance and LSD or Dunnett's T3 test were used for statistical analysis.Results No significant differences in serum calcium,phosphorus and alkaline phosphatase levels were found between the two groups at 1 and 7 days of age,nor were found in serum 25-hydroxyvitamin D level at 7 days of age (all P＞0.05).At 21 days of age,high dose group had higher serum calcium,phosphorus and 25-hydroxyvitamin D levels than low-dose group [(2.38 ± 0.09) vs (2.04 ± 0.15) mmol/L,t=2.421;(1.80±0.50) vs (1.71 ±0.60) mmol/L,t-0.637;(45.58± 18.43) vs (42.53± 16.33) nmol/L,t=0.421],but lower alkaline phosphatase level [(505.12± 185.61) vs (588.32± 168.72) U/L,t=5.314] (all P＜0.05).The same trends were found at 42 days of age.In high-dose group,serum calcium level increased at 7,21 and 42 days of age as compared with that at 1 day of age [(2.43±0.13),(2.38±0.09),(2.39±0.08) vs (2.06±0.57) mmol/L];serum phosphorus level at 7 days of age was lower than that at 1,21 and 42 days of age [(1.31 ±0.26) vs (1.89±0.39),(1.80±0.50),(1.98±0.30) mmol/L];serum alkaline phosphatase level at 7,21 and 42 days of age was higher than that at 1 day of age [(475.18± 133.73),(505.12± 185.61),(538.43 ± 168.16) vs (296.15 ± 99.41) U/L] and a significant increase was observed at 42 days of age as compared with that at 7 days of age;serum 25 hydroxyvitamin D level at 21 days of age was higher than that at 7 days of age,and that at 42 days of age was higher than that at 7 and 21 days of age [(73.55±23.65) vs (30.63± 12.66) and (45.58 ± 18.43) nmol/L];the differences were all statistically significant (LSD or Dunnett's T3 test,all P＜0.05).Conclusions Vitamin D supplementation from the eighth day after birth can improve calcium and phosphorus metabolism in VLBWI and the dose of 900 U/d is more effective than 400 U/d.

Objective To explore the relationship between job stressors,montal health and intention to quit of pediatric nurses by comparing with nurses in internal medicine department. Methods Job stressors, mental health,intention to quit of pediatric nurses and their relationship were investigated among nurses in above mentioned wards from three third-level and first-class hospitals by using questionnaires. Results The scores of some factors of job stressors and nine factors of SCL- 90 of pediatric nurses were much higher than those of internal medicine nurses. There was a significantly positive correlation between some factors of job stressors, mental health and intention to quit of pediatric nurses. Conclusions Working pressure is a factor of low mental health level and intention to quit of pediatric nurses. Effective management strategies should be imple-mented to protect the mental health of pediatric nurses and decrease the loss of nurses.

[ABSTRACT]OBJECTIVETo study of the relationship of age and climate with the nasal mucosa lesions.METHODSAll the patients met with the inclusive criteria were registered and followed-up once a month and their nasal mucosal lesions were observed through nasal speculum and/or nasal endoscope. The recording data was analyzed by SPSS17.0 software.RESULTSA total of 259 patients, 555 person-times and 957 lesion spots were observed. The nasal mucosa was injured by airflow with the highest incidence rate from October to next year April. Patients numbers gradually increased after August, and significantly increased at November, December (P<0.05). Children aged from 2 to 12 years old and the adults aged from 40 to 80 years old were susceptible population (P<0.05), the incidence rate had a negative relation with humidity (P<0.05). The susceptible spots of the lesion were ranked as follows: Little area, inferior turbinate, mucosa of the both side of the deviated nasal septum, inferior meatus, middle meatus, middle turbinate and olfactory area. CONCLUSIONNasal mucosal injury relates to age and seasons. The nasal cavity airflow may be a factor of these lesions.

Objective:To investigate the status of disaster preparedness of pediatric nurses and its influencing factors, as well as the impact path of psychological capital and perceived organizational support on disaster preparedness.Methods:This was a cross-sectional study. A total of 361 pediatric nurses from Henan Provincial People ′s Hospital, the Third Affiliated Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital were sampled from August to October 2021. They were investigated by the general information questionnaire, psychological capital questionnaire, perceived organizational support questionnaire and disaster preparedness questionnaire. SPSS25.0 was used to analyze the questionnaire and scale data, and AMOS23.0 was used to construct a structural equation model about the disaster preparedness of pediatric nurses. Results:The scores of disaster preparedness from pediatric nurses was 4.65 ± 0.92. The level of disaster preparedness was significantly positively correlated with psychological capital and perceived organizational support ( r=0.690, 0.525, both P<0.05). Disaster training and emergency drill 2 dimensions of psychological capital questionnaire (hope, resilience), perceived organizational support were independent contributing factors ( P<0.05). Psychological capital had direct effect on disaster preparedness. And the direct effect was 0.77, the indirect effect was 0.11, the total effect was 0.88, and the direct effect of perceived organizational support on disaster preparedness was 0.21. Conclusions:The score of disaster preparedness of pediatric nurses was in the middle level. Hospital managers should strengthen the training of pediatric nurses in disaster knowledge, operational and simulation exercise, pay attention to the level of nurses' psychological capital and perceived organizational support, so as to provide reference for the follow-up clinical pediatric disaster nursing education and management.

Objective:To investigate and summarize the chest CT imaging features of patients with novel coronavirus pneumonia (COVID-19), bacterial pneumonia and other viral pneumonia.Methods:Chest CT data of 102 patients with pulmonary infection due to different etiologies were retrospectively analyzed, including 36 patients with COVID-19 admitted to Hainan Provincial People's Hospital and the Second Affiliated Hospital of Hainan Medical University from December 2019 to March 2020, 16 patients with other viral pneumonia admitted to Hainan Provincial People's Hospital from January 2018 to February 2020, and 50 patients with bacterial pneumonia admitted to Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from April 2018 to May 2020. Two senior radiologists and two senior intensive care physicians were participated to evaluated the extent of lesions involvement and imaging features of the first chest CT after the onset of the disease.Results:Bilateral pulmonary lesions were more common in patients with COVID-19 and other viral pneumonia, and the incidence was significantly higher than that of bacterial pneumonia (91.6%, 75.0% vs. 26.0%, P < 0.05). Compared with other viral pneumonia and COVID-19, bacterial pneumonia was mainly characterized by single-lung and multi-lobed lesion (62.0% vs. 18.8%, 5.6%, P < 0.05), accompanied by pleural effusion and lymph node enlargement. The proportion of ground-glass opacity in the lung tissues of patients with COVID-19 was 97.2%, that of patients with other viral pneumonia was 56.2%, and that of patients with bacterial pneumonia was only 2.0% ( P < 0.05). The incidence rate of lung tissue consolidation (25.0%, 12.5%), air bronchial sign (13.9%, 6.2%) and pleural effusion (16.7%, 37.5%) in patients with COVID-19 and other viral pneumonia were significantly lower than those in patients with bacterial pneumonia (62.0%, 32.0%, 60.0%, all P < 0.05), paving stone sign (22.2%, 37.5%), fine mesh sign (38.9%, 31.2%), halo sign(11.1%, 25.0%), ground-glass opacity with interlobular septal thickening (30.6%, 37.5%), bilateral patchy pattern/rope shadow (80.6%, 50.0%) etc. were significantly higher than those of bacterial pneumonia (2.0%, 4.0%, 2.0%, 0%, 22.0%, all P < 0.05). The incidence of local patchy shadow in patients with COVID-19 was only 8.3%, significantly lower than that in patients with other viral pneumonia and bacterial pneumonia (8.3% vs. 68.8%, 50.0%, P < 0.05). There was no significant difference in the incidence of peripheral vascular shadow thickening in patients with COVID-19, other viral pneumonia and bacterial pneumonia (27.8%, 12.5%, 30.0%, P > 0.05). Conclusions:The probability of ground-glass opacity, paving stone and grid shadow in chest CT of patients with COVID-19 was significantly higher than those of bacterial pneumonia, and it was more common in the lower lungs and lateral dorsal segment. In other patients with viral pneumonia, ground-glass opacity was distributed in both upper and lower lungs. Bacterial pneumonia is usually characterized by single lung consolidation, distributed in lobules or large lobes and accompanied by pleural effusion.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.