Objective:To explore the effects of nutrition management based on Patient-Generated Subjective Global Assessment (PG-SGA) on nutritional idicators,quality of life and other indicators in patients with pancreatic cancer undergoing chemotherapy, to provide guidance for the implementation of the intervention plan for pancreatic cancer patients undergoing chemotherapy.Methods:This was a randomized controlled study. From January 2021 to December 2022, 96 patients with pancreatic cancer who received chemotherapy in Shanghai Changzheng Hospital and Affiliated Cancer Hospital of Fudan University were selected using convenience sampling method and divided into the observation group and the control group according to the random number table, with 48 cases in each group. The control group was given routine nursing intervention, and the observation group was given PG-SGA-based nutrition management intervention. Patients in both groups continued the intervention until discharge. Nutritional indexes, quality of life, the score of cancer-related fatigue, sleep quality and mental state before and after intervention, intervention compliance and satisfaction after intervention, and complications during intervention of both groups were compared.Results:There were 48 patients in each group ultimately. In the control group, there were 28 males, 20 females, aged (63.33 ± 4.31) years old; in the observation group, there were 27 males, 21 females, aged (63.15 ± 4.25) years old. After intervention, the PG-SGA score, serum triacylglycerol level, and scores of Revised Piper ′s Fatigue Scale and Arsens Insomnia Scale, Self-rating Anxiety Scale and Self-rating Depression Scale in the observation group were (3.87 ± 1.16) points, (1.35 ± 0.52) mmol/L, (3.79 ± 0.67) points, and (5.31 ± 2.05), (44.55 ± 5.14), (45.15 ± 5.08) points respectively, lower than the control group ′s (5.77 ± 1.58) points, (2.04 ± 0.35) mmol/L, (4.82 ± 0.88) points, and (7.29 ± 2.14), (51.74 ± 5.18), (52.26 ± 5.11) points, the differences were statistically significant ( t values were 4.63-7.63, all P<0.05); the serum levels of retinol binding protein and transferrin were (18.13 ± 2.41) mg/L and (61.25 ± 5.34) ng/L, respectively, higher than the control group ′s (15.29 ± 2.33) mg/L and (48.31 ± 5.28) ng/L, with statistical significance ( t=5.87, 11.94, both P<0.05). The symptom domain score in the observation group after intervention was (56.17 ± 5.25) points, lower than (66.22 ± 5.57) points in the control group, while the cognitive, social, emotional, role, and physical scores were (76.35 ± 5.71 ), (77.55 ± 6.51 ), (75.87 ± 6.45), (77.38 ± 6.61), (75.75 ± 6.37) points, higher than (66.29 ± 5.39), (65.74 ± 6.34 ), (64.22 ± 6.18), (66.56 ± 6.26), (65.74 ± 6.11) points in the control group ( t values were 7.86 to 9.10, all P<0.05). Conclusions:Nutritional management based on PG-SGA could reduce the degree of cancer-induced fatigue, relieve negative emotions, improve the overall nutritional status, improve intervention compliance, reduce the occurrence of complications; improve sleep quality, quality of life, and patient ′s satisfaction.

In view of the problems existing in the traditional class of Advanced Nursing Practice for nursing masters and the learning characteristics of students, under the guidance of process orientated guided inquiry learning (POGIL) theory, with the medium of information technology, centered on the cultivation of students' clinical practice with different specialties of nursing practice as the carrier, the autonomous online teaching mode of teaching and learning is fully integrated into the teaching process. That has been adopted in the teaching of Advanced Nursing Practice for nursing students in grade 2019 of Nanjing Medical University. As a result, autonomous teaching and learning guided by POGIL theory can improve students' clinical nursing practice ability, critical thinking ability, problem-solving ability, communication and cooperation ability, thus achieving the teaching goal of this course.

Objective:To explore the current situation and influencing factors of most prominent character strength among disabled elders.Methods:The study selected 228 disabled elders of Department of Geriatrics and Cardiovascular Department at a ClassⅡ Grade A general hospital in Shanghai as subjects by convenience sampling. The cross-sectional survey was carried out with the self-designed General Information Scale, Chinese Virtues Questionnaire-96 (CVQ-96) and Barthel Index (BI) and influencing factors were analyzed.Results:Among 228 disabled elders, there were 90 cases with character strength in affinity, 137 cases with character strength in vitality and one case with character strength in willpower. The most prominent character strength of disabled elders was vitality. Single factor analysis showed that there were statistical differences in the scores of vitality among disabled elders with different ages, education levels, use smart products or not, religious belief, relationships with spouse, social communications, overall life satisfaction, monthly income and with or without speech disorders ( t=5.562, 5.025, 10.551, -2.098, 4.047, 96.006, 11.094, 20.952, -2.196; P<0.05) . The independent influencing factors of vitality strength of character among disabled elders included the age> 85, education levels with high school or above, being able to use smart products, high frequencies of social communication as well as high level of overall life satisfaction with statistical differences ( P<0.05) . Conclusions:Those protective factors under the direction of character strength theory can provide a theoretical basis for related departments to perfect health policies of disable elders and build health assessment system of the aged.

Objective To compare the systemic pathologic physiology parameter changes in sheep drowning in freshwater and seawater. Methods The experimental animals were healthy crossbred sheep. According to the envelope method, 24 sheep were randomly divided into two groups, with 12 animals in each group. The animals in both groups were subjected to mechanical ventilation and analgesia and sedation, the drowning models were reproduced by injecting 10-25 mL/kg of seawater or freshwater into the endotracheal tube of animals. The changes in hemodynamics before drowning, immediately after drowning (immediately after water injection) and 30, 60, and 120 minutes after drowning in both groups were recorded. The urine color changes after drowning and occurrence time were recorded. The animals were sacrificed at 120 minutes after drowning, and heart, kidney, liver, spleen and intestine were harvested for pathological observation under light microscope using hematoxylin and eosin (HE) staining. Results ① The changes in systemic hemodynamic: there was no significant difference in hemodynamics before drowning between the two groups.Compared with before drowning, heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), left ventricular maximum systolic force index (dPmax), and pulmonary wedge pressure (PAWP) immediately after drowning in both seawater and freshwater groups were significantly increased, which showed a decrease tendency with drowning time prolongation. Compared with drowning immediately, dPmax at 30 minutes after freshwater drowning was significantly decreased (mmHg/s: 919.83±14.51 vs. 2 628.42±59.75, P < 0.01), which was below the level before drowning till 120 minutes. CO at 30 minutes after freshwater drowning was retreated as compared with drowning immediately, but it was still higher than that before drowning (L/min: 8.25±0.66 vs. 5.75±0.73, P < 0.01). Global end-diastolic volume (GEDV) and PAWP at 120 minutes after freshwater drowning were decreased to the level before drowning [GEDV (mL): 642.92±7.29 vs. 638.25±7.00, PAWP (mmHg, 1 mmHg = 0.133 kPa): 5.83±1.19 vs. 5.42±1.08, both P > 0.05]. Compared with immediately after drowning, MAP, CO and PAWP at 30 minutes after seawater drowning were significantly lowered [MAP (mmHg): 90.50±3.58 vs. 159.42±3.18, CO (L/min): 2.37±0.45 vs. 10.33±0.73, PAWP (mmHg): 4.17±0.72 vs. 11.75±1.82, all P < 0.01], which were lower than those before drowning till 120 minutes. After drowning for 30 minutes, MAP, CO and PAWP in seawater group were significantly lower than those in freshwater group [MAP (mmHg): 90.50±3.58 vs. 117.42±1.78, CO (L/min): 2.37±0.45 vs. 8.25±0.66, PAWP (mmHg): 4.17±0.72 vs. 24.83±1.27], dPmax was significantly increased (mmHg/s: 1 251.42±62.50 vs. 919.83±14.51, all P < 0.01), and the tendency continued till 120 minutes. There was no significant difference in HR at all the time points between the two groups. ② The changes in urine: after freshwater drowning, the animals had hemoglobinuria and lasted until the end of the experiment, and the time of hemoglobinuria occurrence was at 20-35 minutes after drowning with an average of (25.30±5.15) minutes. After seawater drowning, the change in urine was not found until the end of the experiment.③ The variations of each organ tissue in pathology and hematology at 120 minutes after drowning: after freshwater drowning, the systemic tissue edema was found in organs such as heart, kidney, liver, spleen, and small intestine. After seawater drowning, there were different degrees of edema in the systemic organs, and some of them shrank. Conclusions After freshwater drowning, the animals showed decreased dPmax, increased CO and blood volume, edema and hemolysis of the tissue cells. After seawater drowning, CO and blood volume decreased, and some tissue cells were in atrophy.

Objective To discuss the nursing measures for patients who are receiving percutaneous antegrade ureteral stent implantation for ureteral stricture.Methods A total of 35 patients with ureteral stricture,who were treated with percutaneous antegrade ureteral stent implantation,were included in this study.The nursing care for these patients included the following measures:comprehensive preoperative ward nursing and nutritional support therapy;active preparation,cooperation and monitoring of vital signs during operation;strict postoperative dietary guidance,body position guidance,observation and nursing of complications,and discharge guidance.Results Successful implantation of ureteral stent with single procedure was accomplished in all 35 patients.Mter the procedure,the renal function was markedly improved,when compared with the preoperative data the difference was statistically significant (P＜0.05).The complications,including soreness of waist,lumbago,bladder irritation,hematuria,urinary tract infection,etc.were effectively relieved by positive nursing intervention measures.Conclusion Comprehensive,thoughtful and meticulous nursing care is an important guarantee to ensure a successful percutaneous antegrade ureteral stent implantation for ureteral stricture as well as to reduce the postoperative complications.(J Intervent Radiol,2017,26:277-280)

Objective To analyze the research hotspots of transitional care in China. Methods To retrieve the transitional care research literature in China national knowledge internet(CNKI),Chinese science and technology journal database(VIP),and Wanfang database. We counted up the key word frequency by Bibliographic Item Co-occurrence Matrix Builder(Bicomb)and constructed the co-word matrix. The cluster analysis was carried out by using SPSS 19.0 software,and the hot spots were analyzed according to the tree diagram. Results Totals of 2814 valid papers and 2921 effective keyword were selected. Totals of 34 high-frequency key words were intercepted. The clustering dendrogram showed that research hotspots were divided into five major categories. The transitional care research was focused on the following aspects:high quality nursing service and patient's satisfaction;transitional care research of breast cancer chemotherapy,PICC complications and rehabilitation of coronary heart disease;study on transitional care outside hospital by modern communication methods;community transitional care for the elderly and chronic diseases;and study on transitional care effect evaluation of patients' quality of life. Conclusions Co-word clustering analysis can reveal the research focus of transitional care in China and provide reference for researchers in this field.

Objective To investigate the influence of combined kinetotherapy with non-drug sleep on delirium in patients with mechanical ventilation. Methods 107 cases with acute exacerbation of chronic obstructive pulmonary diseases (COPD) respiratory failure and mechanical ventilation were randomly divided into the treatment group of 54 cases, and the control group of 53 cases. Two groups of patients were given conventional treatment, the treatment group while giving to kinetotherapy and non-drug sleep:an eye mask earplugs at night. Observe the difference of the incidence of delirium, duration of delirium, number of days of mechanical ventilation, case fatality rate. Results The incidence of delirium in the treatment group was 59.3%(32/54), while that was 77.4%(41/53) in the control group, the difference was significant, χ2=4.042,P=0.044. The duration of delirium in treatment group was (1.75 ± 1.05) d, while that was (2.56 ± 1.25) d in the control group, the difference was significant, t=-2.955, P=0.004. The number of days of mechanical ventilation in treatment group was (6.41 ± 2.84) d, while in the control group was (8.68 ± 3.85) d, the difference between the two groups was significant, t=-3.478,P=0.001. The case fatality rate in treatment group was 5.6%(3/54), while in the control group was,11.3%(6/53) , the difference between the two groups was no significant, P=0.283. Conclusions Kinetotherapy cooperate with non-drug sleep can reduce the incidence of delirium, duration of delirium and number of days of mechanical ventilation in patients with mechanical ventilation. This method are simple and it is worth spreading.

ObjectiveTo investigate the influence of the number of T-junctions between central venous catheter and pressure transducer on measurement of central venous pressure (CVP) in patients.Methods A prospective controlled study was conducted. The patients with CVP monitoring in Department of Critical Care Medicine of the Fifth Center Hospital in Tianjin from February to October in 2014 were enrolled. The patients were divided into three groups according to the number of T-junction between central venous catheter and pressure transducer: without T-junction control group and 1, 2, 3 T-junctions groups. In each patient, corresponding CVP values with different number of T-junctions placed between the central venous catheter and pressure sensors were determined within a certain period, and a square-wave graphic was obtained and preserved on the monitor. The own frequency (fn) and the attenuation coefficient (D) of the system of pressure measurement were calculated after measurement of the shock wave following a square-wave to obtain the distance between two vibrations and the amplitude of the shock wave. The difference in CVP, fn and D were compared among the groups.Results A total of 20 cases were enrolled, and 150 groups of data were collected.① With the increase in the number of T-junction, CVP showed a tendency of gradual reduction. The CVP of the groups of control and 1, 2, 3 T-junctions was (7.00±1.60), (7.00±3.00), (5.00±2.00), and (4.00±1.00) mmHg (1 mmHg = 0.133 kPa), respectively. The CVP of 3 T-junctions group was significantly lower than that of the control group (F = 9.333,P = 0.015).② With an increase in the number of T-junction, fn showed a tendency of gradual increase. The fn of groups control and 1, 2, 3 T-junctions was (12.30±0.79), (16.00±0.91),(18.10±1.75), (20.90±2.69) Hz, respectively. The fn of 1, 2, 3 T-junctions group was significantly higher than that of the control group (F1 = 45.962,F2 = 45.414,F3 = 46.830, allP = 0.000); the fn of groups 2 and 3 T-junctions was significantly higher than that of 1 T-junction group (F1 = 5.827,P1 = 0.042;F2 = 15.038,P2 = 0.004), but there was no significant difference between the groups of 2 T-junctions and 3 T-junctions (F = 3.800,P = 0.087).③ With an increase of the number of T-junction, D also showed a tendency of gradual increase. The D of 1, 2, 3 T-junction group was 1.62±0.27, 1.60±0.22, 1.82±0.25, and 2.15±0.58, respectively. There were no differences among four groups.ConclusionAfter the application of T-junctions between central venous catheter and pressure transducer, CVP values will be underestimated, the reason of which is considered to be the increase in length and thinner lumen of the T-junctions.

Objective To explore the constitution characteristics of patients with uterine fibroids.MethodsA total of 413 patients with uterine fibroids (patient group) and 413 healthy women (control group) were enrolled in this case-control study. All the participants were required to fill in a questionnaire on Chinese Medicine constitution.The frequency and percentage of indicators were calculated,and analysis of variance and Chi-square test were used to find difference between the two groups.Results The incidence of Qi-stagnation constitution in the patient group was higher than that in the control group (x2 =8.209,P ＜ 0.05 ). The incidence of menstrual abnormalities was increased in patients with constitution of Phlegm-dampness and Dampness-heat,Qi-stagnation and Blood-stasis.The detection rate of hypertension of the patient group was also significantly increased.ConclusionThe most common constitution of patients with uterine fibroid is Oi-stagnation.

ucting the students to correct their attitudes to-ward learning, consolidate the professional thinking, intensify their critical thinking awareness, then further improve the masters' ability of critical thinking.