Objective To construct an evidence-based discharge preparation service plan for patients after receiving percutaneous transhepatic biliary drainage(PTBD)so as to provide a theoretical reference basis for improving the quality of discharge nursing service.Methods A computerized retrieval of academic papers concerning the discharge preparation service plan for patients after receiving PTBD was conducted.The quality of the included literature was evaluated and the evidences were summarized.According to the clinical actual requirements,the first draft of discharge preparation service for patients after receiving PTBD was formed.Using Delphi method,two rounds of letter inquiries were conducted in 17 experts to determine the final version.Results In the first round of expert consultation,17 questionnaires were distributed and 15 questionnaires were recovered;and in the second round of expert consultation,15 questionnaires were distributed and 15 questionnaires were recovered.In the first round of expert correspondence,11 experts made suggestions for modification,and in the second round of expert correspondence,4 experts made suggestions,indicating that the experts were more motivated to participate in the research.The coefficient of expert consultation judgment(Ca)was 0.90,the degree of familiarity(Cs)was 0.91,the coefficient of authority(Cr)was 0.91,and the Kendall's w for round 1 and round 2 were 0.363 and 0.368 respectively.The final discharge preparation service scheme consisted of 13 items at six different time points from patient admission to after discharge.Conclusion The established discharge preparation service plan for patients after receiving PTBD is scientific and reliable,which can provide theoretical basis for patients'discharge service.

Objective Based on the best evidences to establish the practice plan of discharge preparation service for patients after receiving percutaneous transhepatic biliary drainage(PTBD),and to assess its clinical application value.Methods According to the PIPOST principle the clinical questions were proposed,the best evidences of discharge preparation service for patients after receiving PTBD were retrieved and summarized.The review indicators and review methods were formulated.The baseline review was carried out,the facilitators and barrier factors were analyzed,the change strategies were developed,the clinical transforms were implemented,and the patient outcomes were evaluated.Results After application of the evidences,the implementation of the review indicators of discharge preparation services after PTBD was improved.After discharge,the incidence of catheter complications(including catheter falling-off and puncture site skin infection)was decreased,and the difference was statistically significant(P＜0.05).There were no statistically significant differences in the incidences of tube obstruction and fluid extravasation.Conclusion The evidence-based practice of discharge preparation service for patients after receiving PTBD is helpful for improving the self-care ability of patients after discharge,reducing the incidence of tubular complications and improving the clinical outcome of patients.

The ethical review work in hospitals has played an increasingly important role in protecting the rights and safety of subjects.However,in its practical process,there are inevitably a series of problems and difficulties,such as the need for a sound and perfect organizational structure of the ethical team,the need for detailed manage-ment system operation,and the need for standardized and innovative internal control supervision and assessment.It analyzes the practical issues of hospital ethical review and the optimisation strategies of ethical review are ex-plored based on institutional ethical perspectives to provide reference for improving the quality of ethical review in hospitals.

The ethical review work in hospitals has played an increasingly important role in protecting the rights and safety of subjects.However,in its practical process,there are inevitably a series of problems and difficulties,such as the need for a sound and perfect organizational structure of the ethical team,the need for detailed manage-ment system operation,and the need for standardized and innovative internal control supervision and assessment.It analyzes the practical issues of hospital ethical review and the optimisation strategies of ethical review are ex-plored based on institutional ethical perspectives to provide reference for improving the quality of ethical review in hospitals.

The ethical review work in hospitals has played an increasingly important role in protecting the rights and safety of subjects.However,in its practical process,there are inevitably a series of problems and difficulties,such as the need for a sound and perfect organizational structure of the ethical team,the need for detailed manage-ment system operation,and the need for standardized and innovative internal control supervision and assessment.It analyzes the practical issues of hospital ethical review and the optimisation strategies of ethical review are ex-plored based on institutional ethical perspectives to provide reference for improving the quality of ethical review in hospitals.

The ethical review work in hospitals has played an increasingly important role in protecting the rights and safety of subjects.However,in its practical process,there are inevitably a series of problems and difficulties,such as the need for a sound and perfect organizational structure of the ethical team,the need for detailed manage-ment system operation,and the need for standardized and innovative internal control supervision and assessment.It analyzes the practical issues of hospital ethical review and the optimisation strategies of ethical review are ex-plored based on institutional ethical perspectives to provide reference for improving the quality of ethical review in hospitals.

Objective　To understand the impact of early and timely treatment and initial antiviral treatment regimen on mortality and attrition of antiretroviral therapy. Methods A retrospective cohort study was conducted using download data on antiretroviral therapy for HIV-infected patients in Liuzhou City, Guangxi Province, from the database of the Basic Information System for AIDS Control and Prevention (BISAC) from 2010 to 2020. The Cox proportional risk regression model was used to analyze the influencing factors of mortality and attrition. Results A total of 15 713 infected patients were included, including 53.4% aged 18-<50 years, 69.4% male, 61.0% farmer, 75.1% CD4 count <350 cells /μL before initial antiviral treatment, the overall mortality rate was 4.30/100 person-years, and the overall attrition was 2.42/100 person-years. The results of Cox regression analysis showed that the influencing factors of mortality were pretreatment CD4 counts of 350-<500 cells/μL(AHR=0.72, 95%CI: 0.63-0.81) and ≥500 cells/μL (AHR= 0.64, 95%CI: 0.55-0.76); duration from diagnosis to initial antiviral treatment 91-180 days (AHR=1.25, 95%CI: 1.08-1.45), 181-365 days (AHR=1.26, 95%CI: 1.08-1.47), and ≥365 days (AHR=1.26, 95%CI: 1.11-1.44); initial antiviral treatment regimens of D4T+3TC+EFV/NVP (AHR=1.47, 95%CI: 1.32-1.63) and AZT/D4T/TDF+3TC+LPV/r (AHR=1.73, 95%CI: 1.50-1.99). Factors affecting attrition were pretreatment CD4 counts of 350-499 cells/μL (AHR=1.32, 95%CI: 1.16-1.50) and ≥500 cells/μL (AHR=1.28, 95%CI: 1.10-1.50); interval from HIV positivity confirmation to initial dosing ≥365 days (AHR=1.21, 95%CI: 1.04-1.40), initial antiviral treatment regimens of TDF+3TC+NVP (AHR=1.32, 95%CI: 1.13-1.55), AZT+3TC+EFV/NVP (AHR=1.43, 95%CI: 1.26-1.62) and AZT/D4T/TDF+3TC+LPV/r (AHR=1.33, 95CI%: 1.06-1.67). Conclusions　Early and timely treatment and the initial antiviral treatment regimen of TDF+3TC+EFV have good efficacy, but attention should be paid to the high risk of attrition of HIV-infected people with high CD4 count before treatment.

The ethical review work in hospitals has played an increasingly important role in protecting the rights and safety of subjects.However,in its practical process,there are inevitably a series of problems and difficulties,such as the need for a sound and perfect organizational structure of the ethical team,the need for detailed manage-ment system operation,and the need for standardized and innovative internal control supervision and assessment.It analyzes the practical issues of hospital ethical review and the optimisation strategies of ethical review are ex-plored based on institutional ethical perspectives to provide reference for improving the quality of ethical review in hospitals.

The ethical review work in hospitals has played an increasingly important role in protecting the rights and safety of subjects.However,in its practical process,there are inevitably a series of problems and difficulties,such as the need for a sound and perfect organizational structure of the ethical team,the need for detailed manage-ment system operation,and the need for standardized and innovative internal control supervision and assessment.It analyzes the practical issues of hospital ethical review and the optimisation strategies of ethical review are ex-plored based on institutional ethical perspectives to provide reference for improving the quality of ethical review in hospitals.

The ethical review work in hospitals has played an increasingly important role in protecting the rights and safety of subjects.However,in its practical process,there are inevitably a series of problems and difficulties,such as the need for a sound and perfect organizational structure of the ethical team,the need for detailed manage-ment system operation,and the need for standardized and innovative internal control supervision and assessment.It analyzes the practical issues of hospital ethical review and the optimisation strategies of ethical review are ex-plored based on institutional ethical perspectives to provide reference for improving the quality of ethical review in hospitals.