Objective:To understand the degree of professional autonomy of nurses in Pediatric Nursing Alliance and the status of pediatric nursing practice environment, which providing guidance for the development of a series of specialized training in the alliance.Methods:Stratified random sampling method was used to conduct a questionnaire survey on nursing staff of different professional levels in Pediatric Nursing Alliance, which through the questionnaire star by using the questionnaire general information and training demand questionnaire, nurses practice professional autonomy scale, pediatric nursing staff structural empowerment questionnaire and nursing practice influencing factors questionnaire through the questionnaire star.Results:The total score for professional autonomy of nurses in the pediatric alliance was 192.66±18.63, the structural empowerment ( OR=1.137, 95% CI=1.084-1.194), lack of caring team ( OR=2.763, 95% CI=1.443-5.292) and performance evaluation ( OR=0.498, 95% CI= 0.274-0.908), specialized education and professional experience ( OR=0.548, 95% CI= 0.334-0.871) were affecting the clinical nursing practice. Conclusion:The degree of professional autonomy of nurses in the Pediatric Nursing Alliance is in the middle and high level. Key factors affecting nursing practice including insufficient structural empowerment, lack of opportunities to continue learning, lack of nursing teams, lack of effectiveness evaluation and the lack of specialized education and work experience, which guiding the pediatric nursing alliance to continuously deepen the connotation of pediatric nursing professional and innovative team collaboration new model, utilize the advantages of resources to actively cultivate specialized nursing research personnel, carry out multi-disciplinary and cross-disciplinary cooperation, improve the nursing quality evaluation index system, so as to enhance the professional nursing service capacity and value.

Objective To investigate the utilization rate of gold fiducial markers and reasons for abandonment of gold fiducial markers in the CyberKnife VSI System, and to provide reference data for implantation of gold fiducial markers and radiotherapy planning. Methods From March to August,2017,a total of 47 patients had gold fiducial markers implanted or pasted. In those patients, 42 patients had gold fiducial markers implanted,including 32 receiving computed tomography(CT)-guided 3D-printing coplanar template assisted implantation, 1 receiving CT-guided 3D-printing non-coplanar template assisted implantation,1 receiving CT-guided implantation,and 8 receiving ultrasound-guided implantation. A total of 44 patients received the CyberKnife treatment, including 2 patients who failed to use gold fiducial markers and were treated with spine tracking instead and 3 patients missing the treatment for other reasons. The numbers of utilized and abandoned gold fiducial markers were recorded for calculation of the utilization and abandonment rates. The reasons for abandonment of gold fiducial markers were analyzed and classified. Results A total of 134 gold fiducial markers were implanted into or pasted to the 44 patients.In all the gold fiducial markers, 111 were utilized and 23 abandoned, yielding a utilization rate of 82.8% and an abandonment rate of 17.2%.The reasons for abandonment of gold fiducial markers included large rigidity error(26.1%), unqualified implanted fold fiducial markers(17.4%), displacement of gold fiducial markers(26.1%), and others(30.4%). Conclusions Compared with the CT-guided or ultrasound-guided implantation of gold fiducial markers, the CT-guided 3D-printing coplanar or non-coplanar template assisted implantation of gold fiducial markers requires only two puncture needles for each implantation and implants two gold fiducial markers by a single needle,which reduces the number of puncture needles,risk of puncture-induced injury,and incidence of complications after implantation. Not all the gold fiducial markers implanted by a variety of ways will be utilized. Some gold fiducial markers will be abandoned for different reasons,which should be taken into account during implantation of gold fiducial markers.

Objective To evaluate the efficacy and safety of Qingpeng ointment for the treatment of localized eczema in children.Methods A multicenter,randomized,open-labeled,tacrolimus 0.03％ ointment-controlled clinical trial was conducted.A total of 442 children with localized eczema were enrolled into this study,and divided into 2 groups to topically apply Qingpeng ointment (Qingpeng group) and tacrolimus 0.03％ ointment (tacrolimus group) respectively twice a day for 2 weeks.The children were followed up before the treatment and 1,2 weeks after the treatment,and the efficacy and safety were evaluated at the same time.Results Clinical data from 426 children were included in the efficacy analysis.At 1,2 weeks after the treatment,there were no significant differences in the response rate between the Qingpeng group and tacrolimus group (1 week after the treatment:78.92％ vs.81.77％,x2 =0.545,P =0.460;2 weeks after the treatment:98.65％ vs.97.54％,x2 =0.721,P =0.396).However,the pruritus scores at 1,2 weeks after the treatment were both significantly lower in the Qingpeng group than in the tacrolimus group (1 week:F =14.001,P =0.000;2 weeks:F =11.252,P =0.001).At 1 week after the treatment,the incidence rate of adverse reactions was significantly lower in the Qingpeng group than in the tacrolimus group (P ＜ 0.05).Mild itching,burning sensation and other local irritant sensations were the most common adverse reactions.Conclusion Qingpeng ointment is safe and effective for the treatment of localized eczema in children with good tolerability.

OBJECTIVE:To investigate the effects of low molecular weight heparin calcium and rivaroxaban combined with atorvastatin on related indexes in patients with acute pulmonary embolism(APE). METHODS:The data of 72 APE patients were analyzed retrospectively. According to treatment plan,the patients were divided into group A(21 cases),group B(26 cases)and group C(25 cases). Group A was treated with intramuscular injection of Low molecular heparin calcium injection immediately after admission;2 days later,they were given Warfarin sodium tablets;7 days later,Low molecular heparin calcium injection was stopped while warfarin was still administrated,lasting for 3-6 months. Group B was given Low molecular heparin injection(same usage and dose as group A);2 days later,they were additionally treated with Rivaroxaban tablets;7 days later,Low molecular heparin calcium injection was stopped while rivaroxaban was still administrated,lasting for 3-6 months. Based on the treatment in group B,group C was treated with Atorvastatin calcium tablets 20 mg orally,once a day in the evening,lasting for 3-6 months. The time of dyspnea,chest pain and cyanosis disappearance were observed in 3 groups as well as the levels of HR,pa(O2),pa(CO2), CRP,D-dimer,TNF-α,IL-1,IL-6,ET-1 and NO before and after treatment. The occurrence of clinical outcome events and ADR were also observed. RESULTS:The time of dyspnea,chest pain and cyanosis disappearance in group A were longer than group B, and the group B was longer than the group A,with statistical significance(P<0.05). Before treatment,there was no statistical sig-nificance in the levels of HR,pa(O2),pa(CO2),CRP,IL-1,IL-6,TNF-α,D-D,ET-1 and NO among 3 groups(P>0.05). After treatment ,HR of 3 groups were all lower than before ,and they showed group Agroup B>group C,with statistical signif-icance(P<0.05). After treatment,CRP,IL-1,IL-6,TNF-α and D-D levels in 3 groups were significantly lower than before,and they showed group C>group A and group B,with statistical significance (P<0.05);but there was no statistical significance be-tween group A and B(P>0.05). ET-1 levels in 3 groups were significantly lower than before,and the levels showed group group group B>group A,with statistical significance (P<0.05). The incidence of clinical outcome events in group A was significantly higher than group C, the incidence of ADR in group B was significantly lower than that group A,with statistical significance(P<0.05). CONCLUSIONS:Low molecular weight heparin calcium and rivaroxaban combined with atorvastatin can significantly im-prove clinical symptoms and blood gas indexes,relieve vascular endothelial damage,reduce the levels of inflammatory cytokines and improve the prognosis of patients with APE,without increasing the incidence of ADR.

OBJECTIVE:To evaluate the effects of interventions on the use of human serum albumin in respiratory department of our hospital,and to promote rational clinical drug use.METHODS:According to package inserts,related guideline and literatures of human serum albumin,the evaluation standard of human serum albumin use in respiratory department of our hospital was established with evidence-based medicine method.The comprehensive intervention of human serum albumin use was carried out by means of medical order review,prescription comment,permission setting of information system and performance evaluation.The prescriptions of patients receiving human serum albumin were collected during Jan.-Jul.2015 (pre-intervention group,226 cases)and Jan.-Jul.2016 (post-intervention group,148 cases).Those prescriptions were analyzed statistically in respects of total amount of human serum albumin,per capita amount,average duration,indications,contraindications and rationality,etc.The utilization of human serum albumin was compared between 2 groups before and after intervention.RESULTS:The total amount of human serum albumin,per capita amount and average duration decreased from 18 350 g,(81.2±71.3)g,(7.8±7.2)d before intervention to 7 584 g,(51.2±48.3)g,(4.7±2.1)d after intervention,respectively.The proportion of not in line with the indication stated in Guidelines for Use of Human Serum Albumin,Non-protein Colloidal Solution and Srystalline Solution,the proportion of being contrary to contraindication decreased from 80.1％,50.0％ before intervention to 39.9％,16.9％ after intervention,respectively.The number of patients with serum albumin concentration ≥35 g/L,ranged ≥30-＜35 g/L or ranged ≥20～＜25 g/L before medication in pre-intervention group was more than post-intervention group;the number of patients with serum albumin concentration＜ 20 g/L or ranged 20-25g/L in post-intervention group was more than pre-intervention group.The proportion of patient who took human serum albumin rationally increased from 16.8％ before intervention to 52.7％ after intervention (P＜0.05),there were statistical significances in above-mentioned indexes between before and after intervention.CONCLUSIONS:The comprehensive intervention can effectively reduce the indication,medication course and proportion of unreasonable use of human serum albumin,and improves rational use of human serum albumin.

Objective To observe the effects of Zuogui Jiangtang Jieyu Formula (ZJJF) on the ability of learning and memory and the expressions of JNK, Bcl-2 and Bax in hippocampus in diabetic rats with depression; To explore the protective mechanism of hippocampal damage in diabetic rats with depression. Methods High-fat gavage combined with intravenous injection of STZ was used to establish the model of diabetic rats. 28 days of chronic stress was given continuously and diabetic rats complicated with depression were built successfully. Then rats were randomly divided into 6 groups, including normal, model, positive medicine, high-, medium-, and low-dose of ZJJF groups. After the last administration, Morris water maze was used to detect escape latency time;Western blot was used to disclose the protein expressions of JNK, Bcl-2 and Bax in rat hippocampaus;RT-PCR was used to test the gene expressions of JNK and Bcl-2 and Bax. Results Compared with the normal group, escape latency time in model rats was significant longer (P<0.01), the protein and gene expression of JNK and Bax in rat hippocampaus significantly increased, Bcl-2 was markedly decreased (P<0.05, P<0.01);Compared with the model group, escape latency time in positive medicine group and high-dose of ZJJF group was significant shorter (P<0.01), the protein and gene expressions of JNK and Bax significantly decreased, and Bcl-2 markedly increased (P<0.05, P<0.01). Conclusion ZJJF can significantly improve the ability of learning and memory in diabetic rats with depression, which might be associated with preventing neuronal apoptosis in hippocampus.

Objective To evaluate the relationship between vitamin D receptor(VDR) (rs731236)single nucleotide polymorphisms and genetic susceptibility to overweight/obesity in school-age children of Han and Kazakh in Xinjiang Uygur Autonomous Region.Methods The VDR gene rs731236 genotypes were detected by using polymerase chain reaction-restriction fragment length polymorphism method in 250 overweight/obesity school-age children(127Han,123 Kazakh) and 255 healthy controls(131 Han,124 Kazakh) as well.Results (1)There were statistically significant differences in the frequencies of rs731236 genotypes and alleles between the healthy controls of Han and Kazakh (x2 =9.904,P =0.005;x2 =9.312,P =0.002).(2)There were statistically significant differences in the frequencies of TT/Tt + tt genotype and the alleles between the overweight/obesity cases and healthy controls of Kazakh (x2 =3.891,P =0.049 ; x2 =5.871,P =0.015).But the difference in frequencies of rs731236 genotypes and alleles between the overweight/obesity cases and controls of Han were not statistically significant (x2 =0.064,P =0.800 ; x2 =0.190,P =0.663).(3)There were statistically significant differences in the frequencies of TT/Tt + tt genotype and alleles between the overweight/obesity cases and healthy controls of male school-age children of Kazakh (x2 =5.25,P =0.02;x2 =4.57,P =0.03),but the differences in frequencies of rs731236 genotypes and alleles between the overweight/obesity cases and controls were not statistically significant in female school-age children of Kazakh (x2 =0.06,P =0.80 ; x2 =1.40,P =0.24).There was no statistically significant difference in the frequencies of TT/Tt + tt genotype and alleles between the overweight/obesity cases and healthy controls of female school-age children of Han (x2 =0.04,P =0.84 ; x2 =0.04,P =0.84),and there was no statistically significant difference in male school-age children of Han(x2 =0.05,P=0.82;x2 =0.18,P=0.67).Conclusions VDR gene(rs731236)polymorphism bears ethnic diffe-rence.The polymorphisms of VDR gene polymorphism rs731236 are not associated with the susceptibility to overweight/obesity in school-age children of Han,while it is associated with the susceptibility to overweight/obesity school-age children in Kazakh,especially in male school-age children.

Objective To investigate the relationship between β3 - adrenergic receptor(β3 - AR)gene poly-morphism and the susceptibility of occurrence in children obesity. Methods The database of PubMed,Web of Science,Springer Link,Medlink,SinoMed,Wanfang,VIP and CNKI were systematically browsed online. The study re-ports regarding β3 - AR associated with children obesity from January 1995 to February 2014 were included in the re-search. The data were extracted,evaluated and heterogeneity tested by using software RevMan 5. 1. Results A total of 162 related literature were retrieved,and 9 of them were eligible with 1 494 obese children and 1 623 normal children were included. Allele T compared with C,the differences between the study group and the control group were statistical-ly significant(P < 0. 05),the findings from the same TC + CC compared to TT and TC compared with TT + CC were similar. Japanese research findings were similar to those of China,but the differences between the study group and the control group had no statistical significance(P ﹥ 0. 05)in Hungary. The sensitivity analysis in each study was stable and the funnel graphics were basically symmetric. The results of sensitivity analysis and publication bias diagnostics demonstrated the reliability and stability of the Meta analysis. Conclusions TC + CC/ TT,TC/ TT + CC genotype and allele T/ C are related to the occurrence of childhood obesity in China,Japan,but there is no significant correlation with childhood obesity in Hungary. There are regional difference between β3 - AR gene polymorphism and genetic susceptibility to children obesity.

Objective To investigate intestinal bacteria genera distribution between normal weight and overweight/obesity school-age children in Yili region of Xinjiang.Methods Selecting eligible 150 fecal samples from school-age children (aged from 7 to 13 years old),all samples were divided into normal weight group and overweight/obesity group according to the body mass index (BMI),and each group contained 75 samples.Fecal samples were collected and DNA was extracted,then 6 types of intestinal bacteria genera were detected by the quantitative real-time polymerase chain reaction.Results The distribution of age,gender,ethnicity and hip circumference between 2 groups had no statistically significance (all P ＞ 0.05),except that of BMI and waist circumference (t ＝ 20.740,8.533,all P ＜ 0.01).The concentration of Lactobacillus,Clostridium and Enterococcus were significantly higher in the obese/overweight children (t =9.735,9.681,26.070,all P ＜ 0.01),whereas no significant differences were found in the concentration of Escherichia,Bifidobacterium and Bacteroides between 2 groups.According to the stratified analysis of ethnicity,gender and age,there was no significant difference among Han,Kazakh and Uyghur children.While stratified by gender,Bifidobactcrium was significantly lower in girls than that of boys (t =4.931,P ＜ 0.05).The distribution of the 6 types of intestinal bacteria genera was no statistically significant among different ethnicity,gender and age groups.Conclusions The intestinal bacteria genera number distribution in different ethnicity,gender and age groups makes no sense.The 16SrRNA type number of the Lactobacillus,Clostridium and Enterococcus may be associated with childhood obesity.

To investigate the efficacy and safety of minimal y invasive endovascular techniques treatment of hydronephrosis in pregnancy complicated by infection.
65 cases of pregnancy hydronephrosis coinfected patients with minimal y invasive endovascular treatment. Patients were fol owed up for 3-12 months, compared with 48 patients with the same period of conservative treatment .
Ureteral perforation and other surgery-related complications occurred in 65 patients in the observation group has not occurred. The patient's duration of hospitalization、the recurrence rate of postoperative infection, antibiotic duration of treatment, fever days were significantly lower than the control group(P<0.05).
Compared with conservative treatment, minimal y invasive endovascular technical treatment of gestational hydronephrosis co-infection with faster recovery, shorter hospital stay, can significantly reduce the number of days of fever patients and reduce the number of days of antibiotic use, can be used as conventional means of treatment of gestational hydronephrosis infection combined conventional.