Objective To investigate the benefits and challenges of the reform in evidence-based obstetric nursing practice in clinical nursing,therefore to provide a reference for initiating and keeping the reform in evidence-based nursing practices.Methods A method of descriptive phenomenological research was conducted between January and February 2024 in our hospital on 10 selected clinical nurses by purposive sampling.An outline for interviews was developed based on literature review and expert interviews,followed by semi-structured interviews with the nurses.Core themes were extracted with Colaizzi's seven-step analysis.Results Three themes and 12 sub-themes were summarised in this study.The 3 core themes that were identified among the nurses included:acceptance of evidence-based nursing practice reform(with 3 domains regarding knowledge,decision-making and action),perception of the benefits of the reform in evidence-based nursing practice(with 5 domains regarding the professionalism and scientific nature of clinical nursing,improvement of patient experience and nursing outcomes,enhancement of nursing quality and safety,promotion of innovation in on-the-job training and education,and facilitation of collaboration within the nursing team),and perception in the challenges of reform in evidence-based nursing practice(with 4 domains regarding the stress and challenges,doubts and resistance,poor cooperation between doctors and nurses,and risks in clinical decision-making).Conclusion The acceptance regarding reform in evidence-based nursing practice varies among the nurses.It is necessary to promote the acceptance,provide the targeted guidance and intervene in the factors of benefits and challenges among the nurses,hence to facilitate a smooth implementation of the reform in evidence-based nursing practice.

Objective To investigate the benefits and challenges of the reform in evidence-based obstetric nursing practice in clinical nursing,therefore to provide a reference for initiating and keeping the reform in evidence-based nursing practices.Methods A method of descriptive phenomenological research was conducted between January and February 2024 in our hospital on 10 selected clinical nurses by purposive sampling.An outline for interviews was developed based on literature review and expert interviews,followed by semi-structured interviews with the nurses.Core themes were extracted with Colaizzi's seven-step analysis.Results Three themes and 12 sub-themes were summarised in this study.The 3 core themes that were identified among the nurses included:acceptance of evidence-based nursing practice reform(with 3 domains regarding knowledge,decision-making and action),perception of the benefits of the reform in evidence-based nursing practice(with 5 domains regarding the professionalism and scientific nature of clinical nursing,improvement of patient experience and nursing outcomes,enhancement of nursing quality and safety,promotion of innovation in on-the-job training and education,and facilitation of collaboration within the nursing team),and perception in the challenges of reform in evidence-based nursing practice(with 4 domains regarding the stress and challenges,doubts and resistance,poor cooperation between doctors and nurses,and risks in clinical decision-making).Conclusion The acceptance regarding reform in evidence-based nursing practice varies among the nurses.It is necessary to promote the acceptance,provide the targeted guidance and intervene in the factors of benefits and challenges among the nurses,hence to facilitate a smooth implementation of the reform in evidence-based nursing practice.

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

OBJECTIVE: To evaluate the effects of special prescription comment model intervention on prophylactic application of antibiotics during perioperative period of clean operation in our hospital. METHODS: By founding specialist group and prescription comment group, formulating unified form for evaluating prophylactic application of antibiotics during perioperative period of clean operation, establishing comment criteria referring to Guidelines for Clinical Antibiotics Use (2015 edition), Notice on Further Strengthening the Management of Clinical Antibiotics Use, drug package inserts and so on; havivg the aid of administrative intervention and quality assessment, The special prescription comment model was established. Based on stratified sampling (according to the clinical departments, kind of procedure), Each 180 medical records were collected from our hospital during Jan. -Jun. 2015 (before intervention) and Jan. -Jun. 2016 (after intervention). The unified form for perioperative period of clean operation was formulated to comment each medical record in respects of prophylactic utilization rate of antibiotics, medication indication, medication timing, drug selection, usage and dosage, medication course, drug combination, etc. RESULTS: After the following intervention measures were adopted, such as The prophylactic utilization rate of antibiotics of our hospital during perioperative period of clean operation decreased from 96. 7％ before intervention to 25. 0％ after intervention (P< 0. 05). The rates of drug use without indication, irrational medication timing before surgery, irrational drug selection, irrational usage and dosage, irrational medication course and irrational drug combination were decreased from 71. 3％, 72. 4％, 65. 5％, 23. 0％, 97. 1％, 17. 8％ before intervention to 4. 4％, 0, 8. 9％, 11. 1％, 22. 2％, 0 after intervention (P<0. 05) respectively. Before intervention, 8 categories 20 kinds of antibiotics were used prophylactically in our hospital during perioperative period of clean operation; 86 patients used 2 kinds of or more antibiotics, among which there were 31 cases of drug combination and 55 cases of drug replacement. After intervention, 3 categories 4 kinds of antibiotics were used prophylactically in our hospital during perioperative period of clean operation; there was no drug combination and drug replacement. CONCLUSIONS: Special prescription comment model can obviously improve rational use of antibiotics during perioperative period of clean operation.

OBJECTIVE:To prepare paeonol-HP-β-cyclodextrin (PAE-HP-β-CD) inclusion compound and to optimize its pre-scription technology. METHODS:PAE-HP-β-CD was prepared by freeze drying method and validated. Using inclusion rate as in-dex,main drug-accessory ratio,inclusion time,inclusion temperature and stirring speed as factors,the preparation technology was optimized by central composite design-response surface methodology. RESULTS:Prepared PAE-HP-β-CD underwent phase transfor-mation. The optimal inclusion technology was as follows as main drug-accessory ratio of 3.39∶1,inclusion temperature of 50 ℃, inclusion time of 3.2 h, stirring speed of 350 r/min. Relative error between measured value (87.46%) and predicted value (89.12%) of inclusion rate was 1.86%(n=6). CONCLUSIONS:PAE-HP-β-CD inclusion compound is prepared successfully, and its prescription technology is stable and feasible.

Objective To construct a rat fixation device for local infra-red irradiation in rats, observe the binding effect of this fixation device, and assess its practical application.Methods Twelve SD rats were held by this home-made simple device.The holding time was recorded at room temperature (24℃ to 26℃), 38℃ to 39℃ and 42℃ to 43℃ by infrared irradiation, respectively, and the maximum observation point was 60 min.Results Most rats (10/12) were held for more than 30 minutes at room temperature, 38℃ to 39℃ and 42℃ to 43℃ infrared irradiation.While 8 rats reached 60 min.There was no statistically significant difference among the holding times at various temperatures (P > 0.05).Conclusion This self-made device is simple, easy to operate and can be used to hold rats for a long time, and is a convenient and reliable holding device in animal experiments.

Objective To study the prevalence situation of chronic diseases among teachers from some middle and primary schools in Chongqing City.Methods The physical examination data of 6969 teachers in 52 middle and primary schools in a district of Chongqing major city were collected.The survey data of overweight,obesity,hyperlipidemia,osteoporosis,fatty liver and hyperuricemia were statistically analyzed.Results The total morbidity rates of overweight,obesity,hyperlipidemia,osteoporosis,fatty liver and hyperuricemia were 31.3 ％,7.5 ％,35.1％,34.7 ％,22.4 ％ and 22.2 ％ respectively.The incidence rates of above diseases had difference among the age periods of ≤44 year old,＞44 ＜60 years old and ≥60 year old (P＜0.05).The incidence rate was significantly increased with age increase (P＜0.05).The incidence rate of osteoporosis in females was higher than that in males(P＜ 0.01);while the incidence rate of fatty liver and hyperuricemia in males were higher that in females (P＜0.01).Conclusion The incidence of chronic diseases among teachers in middle and primary schools is worth attention.Therefore it is necessary to carry out the health education aiming at the teacher population characteristics,strengthen their heath management and behavior intervention for increasing their health level.

OBJECTIVE:To investigate the role of clinical pharmacists on drug therapy for acute exacerbations of chronic ob-structive pulmonary disease(AECOPD)patients with benign prostatic hyperplasia(BPH). METHODS:Clinical pharmacists partici-pated in drug therapy for a AECOPD patient with BPH. According to clinical guideline and relevant literatures,based on the history of disease,the characteristics of bronchodilators and the symptoms of acute urinary retention,it was suggested to stop taking Ip-ratropium bromide solution for inhalation but receive Finasteride capsules 5 mg,po,qd,to reduce prostate volume and improve ob-struction+Terazosin hydrochloride tablets 2 mg,po,qd,to relax urethral smooth muscle;the occurrence of ADR was monitored closely. Salmeterol xinafoate and fluticasone propionate powder for inhalation was suggested and medication guidance for patients af-ter discharge was given by clinical pharmacists. RESULTS:Physicians adopted some suggestions of clinical pharmacists. The pa-tient was stable and had no dysuria. The patient was allowed to leave the hospital with drugs. CONCLUSIONS:Rational use of bronchodilators is directly related to the remission of clinical symptoms and prognosis in AECOPD patients. In view of patient's dis-ease history,drug characteristics and clinical symptoms,clinical pharmacists point to possible risks of anticholinergics use,and as-sist physicians to formulate and adjust therapy plan so as to guarantee the safety and effectiveness of drug use.

Objective To explore the feasibility and clinical effects of rotary cutter in laparoscopic splenectomy in treatment of traumatic spleen rupture.Methods The study retrospectively identified 10 cases with traumatic spleen rupture treated with laparoscopic splenectomy from June 2014 to June 2016.Results Total laparoscopic splenectomy combined with rotary cutter was completed successfully in 9 cases and 1 case was converted to open laparotomy due to intraoperative uncontrollable hemorrhage. The former operative time was 95 ~ 170 min, the estimated intraoperative amount of blood loss was 300 ~ 800 ml and autologous blood transfusion of 400 ~ 1 200 ml was conducted. The postoperative hospital stay was 8 ~ 14 d. No serious complications were found in the cases followed-up for 3 ~ 24 months after operation.Conclusion Laparoscopic splenectomy combined with rotary cutter is not only feasible and safe but also has the merits of minimally invasive surgery. It can be applied in treating those with abdominal trauma and with benign lesions in spleen. So it deserved promotion and application in clinical work.

To understand the adverse reactions of Kan,glaite injection and its incidenceand explore the factors affecting the safety of Kan,glaite Injection in clinical use.Methods A noninterventional and prospective hospital based monitoring study and nested case-control study were conducted.All hospitalized cancer patients receiving Kan.glaite injections from 28 hospitals in northeast, north, central,east, south, southwest, northwest regions of China from September 2013 to September 2014 were enrolled in this study. The main monitoring contents included the general status of patients, the drug administration (including indications and combined use), medication safety, and so on. Patients developing adverse reactions related to Kan,glaite injection distributed in the case group and patients who did not develop adverse reactions were randomly selected and distributed into the control group with a ratio of l : 3 , and the factors that affect the safe use of Kan,glaite injection were analyzed.Results A total of 5 022 cancer patients were entered into the study, including 2 926 males and 2 096 females with age from 9 t0 95 years and their average age was (60 + 12) years. The top five tumors were lung cancer (1 456 patients,28.99%) ,intestinal cancer (867 patients,17.26% ) , marmuary cancer ( 372 patients, 7.41% ) , gastric cancer ( 346 patients, 6.89%) , and liver cancer (335 cases,6.67%). There were 3 863 patients (76.92% ) with tumor stage III and IV, 348 patients with allergic history (6.93%) ; 2 524 patients were complicated with other diseases (50.26% ) ; 4 687 patients (93.33%) had combined drug therapy.During the monitoring period,751(14.95%) of 5 022 patients developed adverse events and of them, 18 cases met the criteria of causality of adverse reactions, including 7 cases of phlebitis, 3 cases of nausea and vomiting, 3 cases of chills, 2 cases of rash, 1 case of palpitation, 1 case of transammase increase, and l case of fever. The incidence of adverse reactions was 0.36%. Univariate analysis showed that the incidence of adverse reactions in patients with combined diseases was higher than that in patients without combined diseases (X2=5.4723,P=0.019),the incidence of adverse reactions in patients with combined western medication was higher than that in patients with combined westem and Chinese medication (P=0.002).Logistic regression analysis showed that the influencing factors of adverse reactions were coexisting diseases (OR=1. 636, 95%C/:1.100-2.433,P= 0.013)and combined medication (OR=1.475,95%C/:1.108-1.965,P=0.027).Nested case-control study showed that the influencing factors of adverse reactions induced by Kan.glaite injection were radiotherapy (OR= 1.864,95% C/:0.930-3.736,P<0.01)and corubined medication (OR=1.622,95% C/:1.102-2.389,P<0.01) .Conclusions The incidence of adverse reactions of Kan,glaite injection in clinical application is lower and the safety is good. Coexisting diseases, combined medication and radiotherapy are main factors affecting its clinical safety.