Objective To hy out a course of nursing intervention programmes for patients undergoing coronary intenrentional therapy on the basis of the health belief model(HBM),and estimate its clinical effectbv measuring the change ofquality of life(QOL).Methods 64 patients were randomly selected and divided into 2 groups,the experimental group was treated with the nursing intervetnion on the basis of the HBM,and the control group was treated with routine nursing measures.The quality of life wes compared between the two groups after intervention.Results The total score of QOL,the restricted ability of activity,the therapy satis-faction and the subiective feelings of patients to disease of the two groups had significant difference after inter- vention,P<0.01,but no difference in angina stabilization and occurrence was seen,P>0.05. Conclusions Nursing programmes on the basis of the HBM make the QOL of patients to improve evidently.

Objective To retrospectively explore the incidence and causes of apnea after operation for retinopathy of prematurity(ROP). Methods The clinical data of 17 premature infants with operation for ROP(ROP group)and the other 23 premature infants without ROP(control group)were collected.The occurrence of apnea(time of onset and remission and original diseases) was recorded after operation in ROP group and at adjusted 37 weeks of gestational age in control group.Follow-up was conducted for 4 weeks,and the prevalences of apnea were compared between these two groups.Results There was significant difference in prevalenees of apnea between ROP group and control group ( 52.9%vs 21.7%,P<0.05).In ROP group,time of occurrence of apnea was (38±40)h after operation,and time of remission was (126±145)h after onset.Among the infants with apnea,there were 3 cases of pneumonia(33.3%),1 case of hypoglycemia(11.1%)and 5 cases with unexplained causes(55.5%). Conclusion Infants after operation for ROP are more prone to apnea,and pediatricians and ophthalmologists are required to collaborate in the perioperative care.

ObjectiveTo explore the metabolite status on prefrontal lobe and thalamus by proton magnetic resonance spectroscopy (1H-MRS) and affecting factors in patients of schizophrenia.Methods 159 schizophrenics met with CCMD-3 and 45 normal controls were examined at prefrontal lobe and thalamus by multi-voxel 1H-MRS.The N-acetylaspartate ( NAA),Choline-congtaining compounds ( Cho),and Creatine compounds (Cr)were measured and the ratios of NAA/Cr,Cho/Cr were determined. Positive and Negative Syndrome Scale (PANSS),Social Disability Screening Schedule (SDSS),and Wisconsin Card Sorting Test (WCST) were also assessed.ResultsOn left prefrontal lobe of patients,the NAA/Cr ratio demonstrated lower than that in normal controls (1.42 ±0.34 vs.1.64 ±0.39,t =3.70,P＜0.01 ).The same phenomenon were appeared on left thalamus (1.46±0.35 vs.1.66±0.38,t=3.32,P＜0.01) and on right thalamus (1.49±0.34 vs.1.62±0.37,t=2.04,P ＜ 0.05 ).Contributing to the NAA/Cr ratio,main influencing factors on left prefrontal lobe were age of onset,duration of illness,score of negative symptoms,antipsychotic treatment,total score of PANSS,Categories completed of WCST,total score of SDSS,year of education.Main influencing factors on left thalamus were age of onset,duration of illness,antipsychotic treatment.Main influencing factors on right thalamus were duration of illness,age of onset,score of negative symptoms,antipsychotic treatment,and family history.ConclusionsAbnormalities in neuronal function and/or integrity presented on prefrontal lobe and thalamus in schizophrenics are related to many respects,especially age of onset,duration of illness and antipsychotic treatment.

Objective To compare with the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) between the left and the right prefrontal on refractory negative symptoms and serum brain-derived neurotrophic factor (BDNF). Methods 80 hospitalized schizophrenics with refractory negative symptoms were divided into study group (n=40) and control group (n=40) randomly. Both groups were received 4-week treatment of 10 Hz rTMS. The stimulus lo?cation of the study group was the left prefrontal, and the control group was the right prefrontal. The type and dose of anti?psychotics remained unchanged during the treatment. The evaluation of positive and negative symptom scale (PANSS) and the measurement of BDNF concentration before treatment and after 4 weeks treatment was analyzed. Results Com?pared with before treatment, the total score of PANSS after treatment significantly decreased (P<0.05) both in the study group [(71.2±13.8) vs. (63.3±11.4)] and the control group [(70.3±13.4) vs. (63.7±12.2)]. The score of negative symptoms in the study group decreased [(22.8±6.6) vs. (18.4±5.9), P<0.01]. The BDNF concentration increased in the study group ](6.78±2.16) vs. (8.74±2.76)] and the control group [(6.83±2.32) vs. (8.66±2.70)]. Conclusion 10Hz rTMS on the left pre?frontal combined with drugs are helpful to improve the refractory negative symptom of the patients with schizophrenia. Stimulation on both left and right prefrontal lobe could increase serum BDNF concentration.

ObjectivesTo explore the characteristic of different subtypes of depression on prefrontal lobe and hippocampus by proton magnetic resonance spectroscopy (1H-MRS),and its relationship.Methods 46 patients of depression,which were met with the third edition of the Chinese Classification of Mental Disorders (CC-MD-Ⅲ ) since December 2010 to March 2012 from Mental Diseases Prevention and Treatment Institute,were examined at prefrontal lobe and hippocampus by multi-voxel 1 H-MRS.They were divided into male ( n =25) and female ( n =21 ),early-onset subtype ( n =26) and late-onset subtype ( n =20 ),short-duration of illness ( n =23 )and long-duration of illness ( n =23 ) by different criteria.The N-acetylaspartate ( NAA),Choline-congtaining compounds (Cho),and Creatine compounds (Cr) were measured and the ratios of NAA/Cr,Cho/Cr were determined.ResultsOn left prefrontal lobe,the NAA/Cr ratios in patients of male ( 1.83 ± 0.19),late-onset subtype (1.86 ±0.16),and short-duration of illness ( 1.83 ±0.17) showed higher than those in female ( 1.70 ±0.12,t=2.711,P ＜ 0.01 ),early-onset subtype ( 1.70 ± 0.19,t =3.028,P ＜ 0.01 ),and long-duration of illness ( 1.71±0.20,t =2.192,P＜0.05).Both on left prefrontal and on left thalamus,the ratios of NAA/Cr were positively correlated with the age of onset ( r=0.493 and 0.478,P＜0.01 ),and were negatively correlated with the duration of illness ( r =- 0.482 and - 0.470,P ＜ 0.01 ).ConclusionsDifferent subtypes of depression maybe have different characteristics of 1H-MRS due to the age of onset and the duration of illness.

Objective To investigate the current situation of undergraduate nursing students ’ ability of communication with standardized patients (SP), and explore the effect of SP and student as SP (SSP) on the undergraduate nursing students ’ ability of communication.Methods Ten SP, ten SSP and sixty undergraduate nursing students were chosen , the undergraduate nursing students ’ ability of the communication was evaluated by the communication skills assessment scale .Results The undergraduate nursing students ’ ability of the communication with SP and SSP was at medium level , and the score was (2.89 ±0.52).The total score of evaluating the undergraduate nursing students ’ ability of the communication by SP was (2.36 ±0.35), and the score by SSP was (2.36 ±0.35), and the difference was statistically significant (t=-0.43,P<0.05). Conclusions The undergraduate nursing students ’ ability of the communication with SP should be evaluated from various angles in order to reduce the error evaluation .

Objective To develop a nurse medication unsafe behavior scale, so as to provide an effective tool for evaluating nurses' unsafe behaviors and provide scientific basis for the safe medication management of clinical nurses. Methods From July to August 2016, a semi-structured interview was conducted among 5 nursing managers and 5 clinical nurses from an affiliated hospital of a medical university in Harbin city selected by purposive sampling method. The initial scale was formed by analyzing semi-structured interview data, combining with relevant literature. From November to December 2016, a pre-test was conducted among 380 nurses from an affiliated hospital of a medical university in Harbin city, who met the inclusion criteria, selected by convenience sampling method, by pre-test version of the scale. A large sample test scale was formed by expert review and pre-test. From January to February 2017, a total of 1 243 clinical nurses from 2 medical university affiliated hospitals, 2 provincial class Ⅲ grade A hospitals and 1 municipal class Ⅲ grade A hospital were selected by convenience sampling method for a large sample test, and the reliability and validity of the scale were tested to form the final scale. Results The nurse medication unsafe behavior scale consisted of 4 factors (treatment of medical orders, medication preservation and dispensing, medication administration and medication monitoring) and 25 items. The cumulative variance contribution rate was 60.897%. Confirmatory factor analysis showed that the fit indexes χ2/df, GFI, CFI, IFI and RMSEA were 2.872, 0.922, 0.951, 0.951 and 0.050 respectively. The content validity index was 0.96. The Cronbach's α coefficient and split half were 0.935 and 0.841 respectively. Conclusions The nurse medication unsafe behavior scale has good reliability and validity. It can be used as a valid tool to measure nurse medication unsafe behavior.

Objective To investigate the influence of peer education on improving postoperative self-management behavior and medication compliance in percutaneous coronary intervention (PCI) patients. Methods A total of 120 patients undergoing PCI in the Second Hospital Affiliated to Harbin Medical University from July 1st, 2016 to December 31st, 2016 were selected as the study subjects. The patients were numbered according to the sequence of PCI. The odd number was the observation group and the even number was the control group. There were 60 patients in each group. The patients in the control group were given routine health education, while the observation group adopted peer education. The score of medication compliance and self-management behavior were compared. Results After the intervention, the medication compliance score of the observation group was (6.97±0.89), which was higher than that of the control group (6.12±1.22), and the difference was statistically significant (t=2.667, P=0.009). After the intervention, The scores of the self-management behavior scale of the observation group were higher than those of the control group, and the differences were statistically significant (P＜0.05). Conclusions Peer education can improve self-management behavior and medication compliance of postoperative patients with PCI, which is worth popularizing and applying.

Objective:To explore the potential mediating effects of cognitive appraisal and coping style between perceived stress and major adverse cardiac events (MACE) in patients after percutaneous coronary intervention (PCI) .Methods:Using the convenient sampling method, a total of 383 patients with coronary heart disease who underwent PCI for the first time in the Department of Cardiology in the Second Affiliated Hospital of Harbin Medical University were selected as the research objects from July 2018 to September 2018. They were investigated with Chinese Perceived Stress Scale (CPSS) , Cognitive Appraisal of Health Scale (CAHS) and Medical Coping Modes Questionnaire (MCMQ) . The occurrence of MACE was followed up 1 year after operation. Mplus 7.0 was used for path analysis and to examine the mediating effects of cognitive appraisal and coping style.Results:A total of 364 patients completed the questionnaire survey and 1-year telephone follow-up. The CPSS score of 364 patients after PCI was (29.09±11.07) , and the incidence of MACE was 13.7% in 1 year after PCI. There were 4 significant paths between perceived stress and MACE. The first path was from perceived stress to MACE [ OR=1.023, 95% CI= (1.010-1.347) , P=0.031], and path effect accounted for 29.6% of the total effect. The second path was from perceived stress to threat appraisal to MACE [ OR=1.039, 95% CI= (1.026-1.379) , P=0.010], and acceptance-resignation coping effect accounted for 48.9% of the total effect. The third path was from perceived stress to threat appraisal to yielding response to MACE [ OR=1.010, 95% CI= (1.004-1.096) , P=0.019], and the path effect accounted for 12.1% of the total effect. The fourth path was from perceived stress to challenge appraisal to acceptance-resignation coping to MACE [ OR=1.026, 95% CI= (1.003-1.042) , P<0.050], and the path effect accounted for 4% of the total effect. Conclusions:Perceived stress can act on MACE directly or indirectly through intermediary variables. Challenge appraisal, threat appraisal and acceptance-resignation coping are the intermediary factors of perceived stress and MACE of patients undergoing PCI.

Objective To study the clinical features and risk factors of acute pulmonary reperfusion injury after operation in neonates with severe pulmonary stenosis or pulmonary atresia.Method From February 2014 to February 2018,a retrospective analysis was performed in patients with critical pulmonary stenosis or pulmonary atresia who received percutaneous balloon pulmonary valvuloplasty (PBPV) in the neonatal intensive care unit of our hospital.Clinical characteristics,perioperative cardiac structure,hemodynamic data and biochemical results were collected.The neonates were assigned into injury group if they had acute lung reperfusion injury,and non-injury group if not.The risk factors of acute lung reperfusion injury were analyzed using multi-variate Logistic regression model.Result A total of 32 patients (24 prenatal diagnosis and 8 postnatal diagnosis) with severe pulmonary stenosis or pulmonary atresia with intact ventricular septum were enrolled.The main manifestations were dyspnea and cyanosis.Intravenous prostaglandin E was administered to keep the ductus arteriosus open.The age of operation ranged from 1 to 52 days and the median age was 7.5 days.Postoperative acute lung reperfusion injury occurred in 7 cases (21.9％).Preoperative and intraoperative pulmonary valve annulus diameter,balloon diameter,preoperative hemoglobin,hematocrit and blood albumin were significantly lower in the injury group.The operation duration,total length of hospital stay and postoperative duration were longer than in the non-injury group,the differences were statistically significant (P ＜ 0.05).Multi-variate Logistic regression analysis showed that the diameter of pulmonary valve annulus (OR =5.814,95％CI 1.106 ～30.568),preoperative blood albumin (OR =1.361,95％ CI 1.063 ～ 1.742),and hematocrit (OR =1.173,95％ CI 1.010 ～ 1.363) were risk factors of acute lung reperfusion injury,with statistically significant differences (P ＜ 0.05).Conclusion Acute lung reperfusion injury is one of the common complications after the operation of severe pulmonary stenosis or pulmonary atresia.The severity of pulmonary valve annulus stenosis,preoperative hematocrit and blood albumin level may be the risk factors of postoperative acute lung reperfusion injury.