Objective:To construct a structured education course for patients with neurogenic bladder during the rehabilitation period.Methods:This study consisted three stages of current situation survey, literature search, and expert consultation. From February 2022 to February 2023, a current survey was conducted on the self-management needs of 62 patients with neurogenic bladder. In April 2023, a literature search was conducted to summarize the best evidence on nursing and management of neurogenic bladder, and form the initial version of course indicators and content. From April to May 2023, 14 experts were selected for consultation, and the Delphi method was used to demonstrate the course indicators and content, and to construct the final draft of the course.Results:A total of 62 patients with neurogenic bladder were included, they have requirements for water management, bladder function training, and dietary requirements, etc. A total of 2 053 articles were retrieved, and 14 articles were ultimately included, including eight guidelines, four evidence summaries, one expert consensus, and one systematic review. The expert authority coefficients for the two rounds of expert consultation were 0.93 and 0.92, respectively. The Kendall coordination coefficient of various indicators in the second round of expert consultation was 0.227 to 0.288 ( P<0.01). After two rounds of expert consultation, a structured education course for patients with neurogenic bladder during the rehabilitation period was finally developed, including six primary indicators, 21 secondary indicators, and 30 tertiary indicators. Conclusions:The structured education course for patients with neurogenic bladder during the rehabilitation period, based on current situation survey, high-quality evidence, and expert consultation, is comprehensive in content and reasonably designed, which can provide supportive assistance for future nursing health education and management for patients with neurogenic bladder.

Objective:To analyze the application effect of standardized exercise program based on motivation and volitional model in home-based cardiac rehabilitation of patients with acute myocardial infarction.Methods:The method of non-simultaneous control trial was used. Using convenient sampling method, 60 patients with acute myocardial infarction treated in the Department of Cardiovascular Medicine of Huaibei People's Hospital Affiliated to Bengbu Medical College from December 2021 to April 2023 were selected as subjects. The patients were divided into two groups according to the order of admission: 30 patients admitted from December 2021 to June 2022 as the control group, and 30 patients from July 2022 to April 2023 as the observation group. The control group received routine nursing methods,on the basis of routine nursing, the observation group was intervened with the standardized exercise program based on the theoretical model of motivation and will. The differences of 6-minute walking distance, Duke Activity Status Index Score, Exercise Self-efficacy Score, compliance level of cardiac rehabilitation exercise prescription between the two groups were compared.Results:There were 23 males and 7 females in the control group with age of (58.27 ± 10.86) years old, and 24 males and 6 females in the observation group with age of (57.07 ± 10.91) years old. After 3 months of intervention, 6-minute walking distance, Duke Activity Status Index Score and Exercise Self-efficacy Score in the observation group were (565.53 ± 66.90) m, (29.80 ± 9.76) and (41.87 ± 11.76) points respectively, significantly higher than those in the control group (488.00 ± 91.94) m, (21.63 ± 7.21) and (29.80 ± 8.48) points, the differences were statistically significant ( t=3.73, 3.69, 4.56, all P<0.01). The rates of good, average, and poor compliance with cardiac rehabilitation exercise in the observation group were 56.7% (17/30), 36.7% (11/30), and 6.7% (2/30), respectively, while in the control group were 23.3% (7/30), 46.7% (14/30), and 30.0% (9/30), respectively. The difference between the two groups was statistically significant ( χ2=8.98, P<0.05). Conclusions:The application of standardized exercise program in home-based cardiac rehabilitation of patients with acute myocardial infarction can improve patients ′ exercise endurance, improve exercise self-efficacy, enhance the effect of home-based cardiac rehabilitation, and further reduce cardiovascular risk factors.

Objective:To investigate the features of chest computed tomography (CT) imaging and dynamic changes of severe corona virus disease 2019 (COVID-19).Methods:The clinical and CT data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed.Results:The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and two cases presented with three lobes involved, one case with four lobes involved and 14 cases with five lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, three cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, three cases with lymphadenopathy with the short diameter of 1.0-1.2 cm.Among 16 patients who underwent repeated CT examination, the lesions of eight patients showed continuous improvement, and those of the other eight patients showed fluctuating changes.Conclusions:The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with five-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Pynamic monitoring chest CT is useful for the evaluation for the therapeutic effects.

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) occurs when fetal platelets are sensitized and then phagocytized by macrophages in the reticuloendothelial system after antibodies specific for allogeneic platelets in the pregnant women cross the placenta and enter the fetus. In severe cases, intracranial hemorrhage and even fetal death may occur. This article reviews the recent progress in the following aspects: the mechanisms of pregnancy-related platelet alloimmunity, platelet destruction mechanisms in FNAIT, correlation of anti-angiogenic effects and intracranial hemorrhage, correlation between anti-GPIbα antibodies and miscarriage, and the diagnosis, treatment and prevention of FNAIT.

Objective In view of the trend of networking development in modern high education and the characteristics of students' strong self-learning ability, Peking Union Medical College established a multimedia morphological teaching website from 2013 including human anatomy, neuroanatomy, histology and embryology.Methods According to the teaching demand, the use of the ASP script, combined with Mysql database completed the website development, from the interface design to the curriculum, the syllabus, presentations and laboratory videos uploading.Results Through the questionnaire survey, 45% of the students use website more than 3 times a week, and course content column has the highest use frequency (79%).An independent learning platform effect has been achieved.Conclusions After nearly 4 years exploration and practice, multimedia website has become an important part of morphological courses, as a kind of new teaching mode, not only popular for college teachers and students, but also widely used in clinical teaching.

Objective To analyze the serum level of 25-hydroxy vitamin D [25-(OH) D] in pregnant women in Nanjing and its relationship with age,gestational week,pre-pregnancy body mass index (BMI) and season,so as to provide some guidance on clinical application of vitamin D measurement and supplementation.Methods 880 pregnant women (in 21-36 gestational weeks) regularly visiting antenatal clinic in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University were selected from January to December 2015.Their serum 25-(OH)D concentrations were measured by enzyme-linked immunosorbent assay (ELISA).Results The mean serum 25-(OH) D concentration in these pregnant women was (42.03 ± 19.22) nmol/L and sufficient in only 42 (4.77％).Vitamin D levels showed seasonal variation (P =0.0164),with the levels in summer [(44.61 ±23.57) nmol/L] and autumn [(43.43 ± 19.31) nmol/L] being higher than spring [(39.68 ± 16.91) nmol/L] and winter [(39.65 ± 13.36) nmol/L].There was no statistically significant difference in serum vitamin D level among different gestational weeks (P =0.929 4).There was statistically significant difference in serum vitamin D level among different age groups (P =0.038 3).Vitamin D level was not associated with pre-pregnancy BMI.Conclusions Vitamin D deficiency is highly prevalent among pregnant women in Nanjing.We suggest vitamin D testing be carried out more actively.

Objective To explore the effects of stress and self-efficacy on the quality of life in patients with gallstones and the effect relationship of self-efficacy in the quality of life and stress, and provide guidance for the health intervention of patients with gallstones. Methods Totally 362 patients with gallstones after operative that already returned to the community for 12 months were investigated, and their stress condition, self-efficacy and quality status of life were measured by the life events scale ( LES ) , self-efficacy scale and gastrointestinal quality of life index (GIQLI). The effect relationship of self-efficacy in the quality of life and stress was analyzed.Results The self-efficacy played partial mediating effect between stress and quality of life. When the intermediary variables-self-efficacy sense was participated in, the regression coefficient between stress and quality of life was significantly reduced (β was reduced from -0. 695 to -0. 548 ) . Self efficacy played regulating effect between stress and quality of life, which means that self efficacy sense × stress partial regression coefficient in the regression which regard the quality of life as the dependent variable can reach to a significant level (β=-0.086, P<0.05) , and introduced interaction terms after new interpretation (△R2 ) also can reach to a significant level (△R2 = 0. 017, P<0. 05 ) . Conclusions Self efficacy played the mediating effect and regulating effect in the relationship between stress and quality of life. Nursing staff can reduce the negative effects of stress events in patients′quality of life through the interventions in patients′self-efficacy.

Objective To inverstigate the effects of follow-up management based on social goals model on social relation quality in hepatocellular carcinoma patients after transcatheter arterial chemoebolization (TACE).Methods By convenience sampling method, a total of 113 patients after TACE were divided into the control group ( n=56) and the intervention group ( n=57) according to the treatment time. In the control group, routine follow-up based on case-management was adopted, while in the intervention group, the follow-up based on social goals model was adopted. The intervention effect in two groups were tested by social relation quality scale.Results After intervention, the total score of social relation quality, score of family adaptability and score of family commitment were (53.60±8.86),(20.34±3.28) and (18.07±2.96), and they were all significantly higher than the scores in the control group [(49.25±9.75),(18.52±3.55),(16.22±3.21)](P<0.05). Conclusions The follow-up management based on social goals model can effectively improve the level of family adaptability and family commitment. The intervention could be one of the effective ways to implement social relational quality fin patients after TACE.

Objective To investigate the error monitoring function damages on the patients with schizo?phrenia ( SCH) . Methods A total of 32 patients with schizophrenia were compared with matched 34 health con?trols ( HC) on the error monitoring tasks which were compiled by E?Prime. Results The comparison between SCH group ((713.22±174.52)ms,( 491.14±170.29) ms,( 1060.31±130.84) ms,(8.28±12.55)time,( 8.00± 7.53)time respectively) and HC group ((560.73±156.94) ms,(395.62±188.03) ms,(989.85±104.33) ms, (2.97±4.13) times,(3.12±6.50) times) on the reaction time of choice,assessment,incongruent condition,the numbers of uncertain and the numbers of dropout were significant ( t=-3.737, P=0.000;t=-2.159, P=0.035;t=-2.426, P=0.018;t=-2.282, P=0.022;t=-2.824, P=0.006) . The SCH group and HC group did not signifi?cantly difference in Full Correct((124.72±23.74)/(131.74±21.96)times),Full Error((15.69±17.64)/(13.35± 18.63)times),Part Correct((6.83±10.40)/(4.21±7.03)times),Part Error((2.91±10.91)/(0.62±1.10)times) and Accuracy((0.831±0.161)/(0.874±0.159))(P>0.05).There was no significantly correlation among the course of disease,HAMA,HAMD and the error monitoring. Conclusion These results demonstrate that the error monitoring function damages on the patient with SCH may be involved in the dysfunction of anterior cingulate cortex.

There is a significance of pregnancy thyroid hormone reference ranges establishment,because the consequences of thyroid dysfunction during pregnancy are terrible.This review will focus on meaning of pregnancy thyroid hormone reference range,importance of TPO antibody testing and current advances of methodology.