Objective To evaluate the effect of antimicrobial management guideline on the daily antimicrobial use rate in a general hospital.Methods An one-day point-prevalence survey on antimicrobial use in hospitalized patients was conducted in 2010,2011,and 2012 by means of cross-sectional investigation method.Results The daily utiliza-tion rate of antimicrobial agents in 2010,2011,and 2012 was 65.40% ,42.09% and 26.74% respectively,the rate of the submission of specimens for bacterial culture was 22.53% ,35.74% and 41.74% respectively(χ2 trend= 266.42, 29.02,respectively,bothP<0.01). The utilization rate of single drug was 83.72% ,80.27% and 93.41% respec-tively. the utilization rate of both two-drug and more than three-drug combination kept a downward tendency. The utilization rate of antimicrobial agents in several departments(digestive internal medicine,cardiovascular,hematolog-ical tumor,neurology,general surgery,orthopedics,obstetrics,pediatrics,and ophthalmology)showed a decreasing tendency(all P<0 .0 1 ).Conclusion The implementation of antimicrobial management guideline has remarkably re-duced the daily antimicrobial use rate,and increased etiological detection rate for therapeutic antimicrobial use.

Objective To investigate the efficiency of chitosan hemostatic dressing combined radial artery hemostasis device in patients after transradial coronary intervention.Method Six hundred consecutive patients after transradial coronary intervention were selected and randomly divided into the experimental group and the control group according to the hospital number,there were 300 cases in each group.Single pneumatic tourniquet was used in the control group,while the chitosan hemostatic dressing combined with pneumatic tourniquet was used in the experimental group.Hemostasis consumption time,incidence of bleeding,ecchymosis and radial arterial occlusion were compared between two groups.Results There was no significant difference in the incidence of skin ecchymosis between two groups,P ＞ 0.05.The hemostasis consumption time and the incidence of bleeding,early radial arterial occlusion and chronic radial arterial occlusion were (127.6± 33.0) min,7.0％(21/300),5.7％(17/300),4.0％(12/300) in the experimental group and (181.6± 32.2) min,20.0％(60/300),11.7％(35/300),9.0％(27/300) in the control group,t or x2 values were 20.258,21.708,6.822,6.170 respectively,and there were significant differences,P＜0.01 or ＜0.05.Conclusion In patients after transradial coronary intervention,the application of chitosan hemostatic dressing combined with pneumatic tourniquet is safer and more effective than using pneumatic tourniquet alone.

Objective To report the nursing care for a patient with resistant hypertension underwent bilateral renal denervation therapy by cryofocus cryoablation system.Methods We summarized the nursing care work, which included the operation preparation, observation points, service during the operation, and the essential instruction for inpatient care and future follow-up, for one case of patient with resistant hypertension underwent bilateral renal denervation through the femoral pathway in February 2016. Results The whole operation spent 60 minutes, and after operation, the patient′s blood pressure decreased from 200/110 mmHg to (152.38±24.53)/ (83.65±12.71) mmHg. The operation was successful and the patient was discharged 3 days after operation. In the 3-month follow-up, the 24-hour mean blood pressure was 128/70 mmHg, without the presence of operation-related or nursing-related complications. Conclusions The perioperative nursing care includes the good preoperative preparation, precise nursing during the operation, and further intensive observation, which would facilitate the operation process, avoid the risk, and guarantee the operation quality.

This paper introduced the management process of acceptance of acute myocardial infarction patients with suspected COVID-19 by Cardiac Catheterization Laboratory which carried out general management in many aspects, such as system and process optimization, whole quality prevention and control management as well as special disinfection and isolation. This paper aimed at providing reference for medical staff to ensure the rapid and highly efficient treatment for patient and zero infection in medical staff, and providing basis for clinical nursing, prevention and control work.

Objective? To explore the clinical effects of traditional Chinese medicine at the acupoint on gastrointestinal function recovery after abdominal surgery. Methods? Totally 84 patients receiving laparoscopy were divided into the observation group (n=42) and the control group (n=42) using randomized, double-blinded and placebo controls. Patients in the observation group received traditional Chinese medicine at the acupoint, while patients in the control group received placebo. Both groups were observed continuously for 3 days. Time of postoperative borborygmus recovery, time of first exhaust, and time of first defecation were compared between the two groups postoperatively, and safety evaluation was performed. Results? The time of borborygmus recovery of the observation group was 15.5 (13-22) h, and the time of first defecation was 45.5 (29-62) h, both lower than those of the control group (Z=2.40, 2.05; P＜ 0.05). The time of first exhaust of the control group was 18 (15-27) h, and there was no statistically significant difference as compared with the observation group (Z=1.96,P=0.05). Neither group showed adverse effects on local skin after the use of traditional Chinese medicine. Conclusions? Traditional Chinese medicine at the acupoint can promote gastrointestinal function recovery after abdominal surgery, which is simple, easy, cheap and effective and is worth promoting in clinical practice.

With reference to the teaching reform of standardized training cases based on organ systems, a teaching case writing team has been established, integrating the teaching experts in basic medicine, clinical medicine, humanities medicine, and other fields. Through collective lesson preparation and discussion, non-fictional comprehensive scenario writing techniques have been used based on organ systems and oriented by competency development, and the teaching cases for postgraduate students were written on the basis of real cases, which lays a solid foundation for the hierarchical and progressive cultivation and improvement of the quality of competency cultivation for postgraduate students through case teaching based on organ systems.

By identifying and analyzing the problems and difficulties in the implementation process of student stratification, goal stratification, practice stratification, and assessment stratification in standardized residency training, this article proposes to fully leverage the main role of professional bases in hierarchical and progressive teaching for standardized residency training and strengthen the specific responsibilities of professional base teaching groups in discussing hierarchical and progressive teaching plans, evaluation standards, and assessments. It is also necessary to scientifically implement student stratification, achieve consistent stratification goals, strengthen the training of hierarchical and progressive teaching concepts and teaching abilities for teachers, enhance the ability for homogeneous and hierarchical evaluation, and develop countermeasures that combine stage training goal process evaluation with dynamic personalized teaching by mentors, so as to provide a useful reference for further promoting the reform of standardized residency training using a hierarchical and progressive teaching model.

Objective:To explore the status and influencing factors of participation in cardiac rehabilitation of cardiovascular nurses.Methods:This is a cross-sectional study. From January to February 2022, a total of 3 047 cardiovascular nurses in members of China Cardiovascular Health Alliance were selected as research objects by convenience sampling method. General data questionnaire and Cardiovascular Nurses Participated in the Cardiac Rehabilitation Questionnaire (CNPCRQ) were used to investigate cardiovascular nurses. Multiple linear regression analysis was used to investigate the influencing factors of participation in cardiac rehabilitation of cardiovascular nurses. A total of 3 047 questionnaires were distributed in this study, and 2 704 valid questionnaires were effectively received, with an effective recovery rate of 88.74%.Results:The total score of CNPCRQ of cardiovascular nurses was (93.23±31.58), which was at a moderate level. Multiple linear regression analysis results showed that age, education, professional title, hospital location, hospital level, position type and hospital type were the influencing factors of participation in cardiac rehabilitation of cardiovascular nurses.Conclusions:The status of participation in cardiac rehabilitation of cardiovascular nurses in China needs to be improved. Role and job content of cardiovascular nurses should be further clarified, and cardiac rehabilitation knowledge and skills training should be strengthened in the future, so as to promote the profession development of cardiac rehabilitation and improve patients' health outcomes.