ObjectiveTo explore the proper service mode during perinatal period in obstetric de-partment through application of clinical nursing pathway theory. Methods2597 outpatient and inpatient pregnant women were randomly chosen. The experimental group (1332 cases): the clinical nursing pathway in different stages of perinatal period was designed, nurses completed their tasks according to the standard process. The control group (1265 cases): accepted the routine healthcare education and ordinary delivery method. The delivery outcome and the delivery time of the two groups were observed and recorded, satisfac-tion degree with the nursing service and nurses' mental condition before and after the application of clinical nursing pathway were also investigated. ResultsThe rate of cesarean operation of the experimental group was lower than that of the control group. The difference of total delivery time in the two groups was signifi-cant. The satisfaction degree to the nursing service improved obviously in the experimental group. The dif-ference of nurses' self- confidence, self- determination, working satisfaction, sense of competence before and after the application of clinical nursing pathway was significant. ConclusionsApplication of clinical nursing pathway in pregnant and lying-in women during perinatal period can improve the confidence of natural delivery, shorten the delivery time, reduce the cesarean operation rate, improve satisfaction degree to nurses' work, mental condition, and their general diathesis.

OBJECTIVE To search for the correlative factors among nurses with leukcopenia who occupationally contacted with chemotherapeutic agents,so as to increase their occupational protecting level.METHODS Totally 1232 nurses who occupationally contacted with chemotherapeutic agents from 24 hospitals were investigated by a stratified sampling method.The factors leading to leukopenia were surveyed and analyzed.RESULTS The leukopeuia was prominently correlated with five factors,namely nurses' protective knowledge,protective manipulation scoring,protective condition,exposure index and kinds of agents.CONCLUSIONS Low occupational protecting level can lead to leukopenia.A supporting system based on the occupational health and safety management must be established to insure the clinical nurses' health level.

Objective To investigate the relationship of the killer cell immunoglobulin-like receptor (KIR) gene polymorphism with Hashimoto′s thyroiditis(HT). Methods One hundred HT patients and 260 randomly matched healthy controls were enrolled to detect the KIR genotype. The genomic DNA were extracted, and 15 selected KIR genes, KIR2DL1-5, KIR3DL1-3, KIR2DS1-5, KIR3DS1 and pseudogene KIR2DP1, were determined by a polymerase chain reaction using sequence-specific primers (PCR-SSP). Results The frequency of KIR2DL5 gene was significantly lower of the patient group than that of the control group (0.200 vs 0.312, RR=0.64, P<0.01). Conclusion There may be an association between pathogenesis of HT and KIR2DL5 gene.

Objective To explore the effect of low molecular weight heparin calcium on coagulation function and platelet(PLT)in patients before and after anterolateral thigh flap transplantation.Methods Fifty patients with skin and soft tissue defects of hands and feet treated in Wuxi Ninth Hospital and Jiujiang No.1 People's Hospital from January to December 2022 were selected as the study objects.They were divided into observation group(26 cases)and control group(24 cases)according to random number table method.Patients in observation group received low molecular weight heparin calcium 12h before surgery,and continued to receive routine treatment once a day after surgery.Patients in control group began to use low molecular weight heparin calcium routinely 4h after surgery,once a day.The coagulation function and PLT before and after surgery were compared between two groups.Results There were no significant differences in incidences of vascular crisis and skin flap necrosis between two groups(P>0.05).Five patients in observation group received intraoperative or postoperative blood transfusion,which was excluded in further analysis.On first day and third day after surgery,fibrinogen(FIB)and PLT in two groups were significantly higher than those before surgery,and thrombin time(TT)was significantly shorter than that before surgery(P<0.05).On third day after surgery,activated partial thromboplastin time(APTT)and prothrombin time(PT)in observation group were significantly longer than those before surgery(P<0.05).Before surgery,first day and third day after surgery,there were no significant differences in FIB,APTT,PT and TT between two groups(P>0.05).On third day after surgery,PLT of observation group was significantly higher than that of control group(P<0.05).Conclusion Both FIB and PLT were higher after surgery regardless of the use of low molecular weight heparin calcium before and after surgery,and FIB and PLT were more significantly higher in patients treated 12h before surgery.