Objective:To investigate the effect of flexible visiting policies in ICUs by comparing with restrictive visiting policies.Methods:English database (Pubmed, embase, Cochrane library, scopus, OvidSP, Wiley Online library, Google scholar and web of science) and Chinese database (CNKI, VIP, CBM and Wanfang) are retrieved, the search time is up to February 2020. The included literatures were evaluated quantitatively and qualitatively.Results:The flexible visiting policies can reduce the risk of delirium in ICU patients [RR=0.59, 95%CI=(0.36,0.96)], shorten the length of stay [MD=-0.21, 95%CI=(-0.35,-0.06)], improve patients' anxiety symptoms [MD=-2.2, 95%CI=(-3.8,-0.61)], reduce the incidence of anxiety and depression and improve the nursing satisfaction of patients and their families, without increasing the risk of ICU acquired infection [RR= 0.77, 95% CI= (0.51, 1.16)] and patient mortality (RR= 0.82, 95% CI= (0.53, 1.26)]. Sensitivity analysis suggested that the results were stable.Conclusions:Compared with the current restrictive visitation policies, the flexible visitation system can reduce the risk of delirium, improve anxiety symptoms and depression, and obtain more satisfaction from family members and patients, and It can be tried further.

Objective To explore the relationship between meta-mood and learning adaptability of undergraduate nursing students in order to promote the students' academic achievement.Method 225 nursing students participated in the survey using the trait Meta-Mood Scale and the college students' learning adaptability scale.Results The average total scores on meta-mood and learning adaptability were(3.42±0.53)and(3.60±0.52),respectively.They were positively correlated and the 3 dimensions of meta-mood predicted the variance of learning adaptability by 12.7%.Conclusions The meta-mood of undergraduate nursing students is at moderate level,and learning adaptability is at a better level.The nursing administrations or educators should guide students to manage their moods so as to improve the students' learning adaptability.

Objective:To investigate the relationship of the mRNA expression of BRCA1 andβ-tubulinⅢwith docetaxel-resistance in esophageal cancer. Methods:The genes BRCA1 andβ-tubulinⅢwere determined at the mRNA level using RT-qPCR in 36 esophageal carcinoma specimens. Results:The mRNA expression of BRCA1 andβ-tubulinⅢwas determined in the 36 tumor samples using RT-qPCR. The median BRCA1 mRNA expression level in relation to that ofβ-actin was 6.27. The medianβ-tubulinⅢmRNA expression level in relation to that ofβ-actin was 4.44. The patients were divided into two groups using these cutoff values. The BRCA1 mRNA expression level was not correlated with the sensitivity of esophageal cancer patients to docetaxel (P=0.733). The response rate of the tumors with highβ-tubulinⅢexpression was (38.9%), which is significantly lower than in patients with lowβ-tubulinⅢexpression (83.3%) (P=0.015). Conclusion:Theβ-tubulinⅢexpression levels in the tumor tissues were probably an important biomarker for the efficacy of docetaxel chemotherapy in esophageal cancer patients. Our study may provide new insights into taxane chemotherapy for advanced esophageal cancer patients.

ObjectiveTo evaluate the clinical value of magnifying endoscopy in diagnosis and treatment of colorectal benign neoplastic lesions.Methods78 colorectal lesions in 61 patients were examined with magnifying colonoscopy after indigo carmine dye, and a pit pattern diagnosis was made for every lesion according to Kudo's classification.All the lesions were totally resected, and the specimen were sent for pathologic examinations.ResultsThe diagnostic sensitivity of neoplastic lesions was 98.4% and specificity was 85.7% when types Ⅰ and Ⅱ represented the pit pattern of nonneoplastic lesions, whereas types Ⅲ, Ⅳ, and Ⅴ represented adenoma and early colorectal cancer. The overall accuracy in differentiating adenoma and early colorectal cancer from nonneoplastic lesions was 96.2%.94.5% of adenomarous lesions were treated by colonoscopy.ConclusionThe magnifying colonoscopy can provide an instantenous accurate diagnosis of tumorous lesions in colon and rectum. Synchronize, minimally invasive and curative treatment is possible to be completed by using it for a large number of lesions.

Mammal metallothionein(MT) folds into two separate domains that exhibit different structure and metal binding propertity independently, the study of the strategy of metal ions binding with MT would give better understanding of their exact biological functional mechanisms. In this study, a method using eletrospray ionization mass spectrometry (ESI-MS) phase liquid chromatography and identified by ESI-MS. Different amounts of Cd or Cu were then added in MT-2a samples and ESI-MS was employed to determine the mass difference of MT in different samples. The results Cd2+4S11; while Cd is attached in separate binding sites for the formation of Cd2+3S9 cluster, which intermediately formed with five and six Cd ions were detected. For the Cuprous ions, it prefers to cooperatively bind in β-domain with the form of Cu4-MTβ. The binding form in β-domain would convert from Cu4 into more Cu binding form with the addition of Cu. When high concentration of Cu was added in samples, the result suggested that

Objective To improve the nursing skills of low age and service seniority nurses and meet the needs of clinical nurses,in order to serve patients better and improve the quality of cave.Methods According to knowledge tests 50 points for nurse job-related skill issued by Chinese Ministry of Health,our hospital selected 12 commonly used basic operation skills and designed comprehensive cases through integration and reformation.We trained and examined nurses with undergraduate degree came to our hospistal in 2008.Results After training,the score of clinical nursing skill reached 91.81,86 nurses reached the standard and the effective compliance rate was 95%.Conclusions It proved to be an effective method to improve the nursing skills of low-age and service seniority nurses by carrying out the comprehensive casestyle training methods.

Objective To determine serum vascular endothelial growth factor (s-VEGF) and serum endostatin (s-endostatin) levels in patients with colorectal cancer after preoperative regional intraarterial chemotherapy (PRAC). Methods Peripheral venous blood was sampled preoperatively and postoperatively, and was assayed for VEGF and endostatin by ELISA. Results Patients' preoperative level of s-VEGF and s-endostatin elevated significantly, which was in close correlation with Dukes' stage. The level of s-VEGF and s-endostatin before chemotherapy elevated significantly compared with that on day 7 after chemotherapy and on postoperational day 1 and 14 after operation. In patients undergoing palliative resection, only the level of s-endostatin before chemotherapy was significantly higher than that on day 1 after operation. Conclusions PRAC, inhibiting angiogenesis, is of antitumor effect, the decrease of s-endostatin after chemotherapy may suggest the combination of chemotherapy and antiangiogenesis for a better antitumor effect.

Objective To analyze the background and connotation of the maker education 2.0 and the innovativeness of the nursing maker education 2.0, and put forward the blended teaching of the nursing maker education 2.0. Methods The present situations of the maker education 2.0 and the connections between the maker education 2.0 and the nursing education were analyzed through documents and descriptive research, and the blended teaching program of the nursing maker education 2.0 was designed through exploratory research. Results Maker education 2.0 has gradually became an important way to cultivate students' innovation ability, and all kinds of schools tried to implement the maker education 2.0, but there has not been relevant research reports in nursing. Conclusions The blended teaching of the nursing maker education 2.0 can triggerthe reform of the nursing education. We should research the developmental mechanism and supporting theory, etc. of the nursing maker education 2.0 to explore much further for more knowledge about its application results.

Objective To analyze the efficacy of endoscopic ultrasonography-guided biliary drainage ( EUS-BD) for malignant obstructive jaundice and the management of adverse events. Methods Clinical data of 12 patients with malignant obstructive jaundice, who underwent EUS-BD between April 2016 and January 2017, were retrospectively analyzed. All patients received EUS-BD after unsuccessful ERCP, including EUS-guided hepaticogastrostomy ( EUS-HGS ) , EUS-guided antegrade stenting ( EUS-AS ) , and EUS-guided choledochoduodenostomy(EUS-CDS). Procedure outcomes, serum bilirubin and liver enzyme levels before the procedure and 1 week after, complications, treatment results, hospitalization time and follow-up were recorded. Results Two patients underwent EUS-HGS, 3 underwent EUS-AS, and 7 underwent EUS-CDS. Total bilirubin ( t=3. 462, P=0. 005 ) , direct bilirubin ( t=3. 351, P=0. 006 ) , alanine transaminase (t=2. 399, P=0. 037), γ-glutamate transpeptidase (t=3. 256, P=0. 031) reduced significantly after the procedure. Two patients ( 16. 67％) developed complications. A patient undergoing EUS-HGS developed bile leakage, biliary peritonitis, and pneumoperitoneum. A patient undergoing EUS-CDS developed upper gastrointestinal bleeding. Both patients were successfully treated. There were no other adverse events, such as acute pancreatitis, subcutaneous emphysema, pneumothorax and emphysema. No procedure-related death occurred. The mean hospital stay was 13. 75 ± 6. 92 days ( range 5-26 days ) . Conclusion EUS-BD is a safe substitute after unsuccessful ERCP when performed by experienced biliary endoscopists. However, intensive care is necessary after the procedure for early detection and management of complications.

Objective:To investigate the risk factors of non-obstructive gastric retention before endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliopancreatic disease.Methods:The matched case-control study included 109 patients with non-obstructive gastric retention before ERCP as the case group, and 218 patients without gastric retention as the control group. The patients′ medical records including comorbidities, preoperative medication and laboratory indicators were compared between the two groups. Multivariate conditional logistic regression models were subsequently used to determine the risk factors for non-obstructive gastric retention before ERCP.Results:Logistic regression revealed that the jaundice ( OR=12.359, P<0.001), opiates use ( OR=3.009, P=0.001), somatostatin use ( OR=2.445, P=0.033), fasting hyperglycemia ( OR=1.513, P=0.045), hypokalemia ( OR=4.634, P=0.001) and hyponatremia ( OR=1.805, P=0.023) were independent risk factors for non-obstructive gastric retention before ERCP in patients with biliopancreatic disease. Conclusion:Except for gastrointestinal obstruction, jaundice, opiates use, somatostatin use, fasting hyperglycemia, hypokalemia and hyponatremia are all risk factors for gastric retention in patients with biliopancreatic disease. Comprehensive evaluation and early intervention for patients showing these risk factors are needed.