Objective:To explore the association between sleep duration, sleep quality and the prevalence of hypertension in the elderly aged 65 years and above.Methods:This study was conducted among the elderly in communities in Yiwu, China from April to July, 2019, and participants were recruited through physical examination in the hospital. Face-to-face interview was performed to obtain basic information. Sleep duration and sleep quality were evaluated by Pittsburgh Sleep Quality Index (PSQI). Associations between sleep duration, sleep quality and hypertension were evaluated by multivariate logistic regression analysis.Results:A total of 3 169 elderly persons, aged ≥65 years old, were included in the study. The overall prevalence of hypertension was 50.8%. The elderly with very poor sleep quality and short sleep duration accounted for 22.4% and 28.5%, respectively. After adjusting for demographic characteristics, socioeconomic status, lifestyle and health status, the OR of hypertension for the elderly with very poor sleep quality was 1.42 (95% CI: 1.12-1.80) compared with those with very good sleep quality. Compared with the elderly with sleep duration of 6-7 h a night, the OR of hypertension for those with sleep duration <6 h was 1.37 (95% CI: 1.15-1.65). As the sleep quality decreased, the risk for hypertension increased. An U-shaped association was found between sleep duration and risk of hypertension. Subgroup analyses showed that this association existed in both men and women, but only significant in the elderly aged <75 years. Conclusion:Poor sleep quality and short sleep duration were associated with risk for hypertension in the elderly.

Objective: To explore the difference of personality characteristics of physicians, nurses, medical skills and administrative personnel in a general hospital and its influence on job burnout. Methods: Employee entered the hospital before 2018 were enrolled in the current study and the position was classified as physicians, nurses, medical technician and administrative staff. Minnesota Multiphasic Personality Inventory (MMPI) was completed by the employee at the time of entering the hospital. Status of job burnout was assessed in 2018 using the Maslach Burnout Inventory-General Survey (MBI-GS) . Results: Physicians have a higher rate of paranoia than others (P<0.05) , and administrative staff and medical technician have a slightly higher score than the other two categories of people (P<0.05) , and administrators lie at a higher rate than others (P<0.05) . Further analysis found that personality traits did not have a significant association with job burnout at the time of entry. Conclusion The administrative and medical staff is slightly more irritable, the administrative staff lying slightly higher score, the staff after the entry of job burnout is not affected by the personality characteristics of the onboarding.

Objective? To explore the influence of emotional intelligence training on the clinical communication ability and job burnout of nurses in Cardiology, and to guide the administrative direction of nursing managers and provide effective management methods. Methods? Using the convenient sampling method, a total of 89 nurses from the department of Cardiology of Wuxi Second People's Hospital from September to November 2018 were selected as the subjects. According to the random number table method, they were divided into the experimental group (44 nurses) and the control group (45 nurses). The experimental group were given 8 emotional intelligence training sessions, and the control group received regular training. The Emotional Intelligence Scale (EIS), the Maslach Burnout Inventory (MBI) , and the Clinical Communication Ability Scale were used to evaluate the difference before and after the training. Results? After the training, the experimental group nurses' EIS total scores and scores in all dimensions were higher than those in the control group (P＜0.05);the MBI scores of emotional exhaustion, and cynicism dimensions of experimental group were significantly lower in the control group, the scores of personal accomplishment were significantly higher in the control group, and the difference was statistically significant (P＜0.05); the scores of Clinical Communication Ability Scale in the experimental group were higher than those in the control group, and the difference was statistically significant (P＜0.05). Conclusions? Emotional intelligence training for clinical Cardiology nurses can effectively improve their emotional intelligence, clinical communication ability,and reduce their level of job burnout and it is worth promotion.

Objective To explore the effect of drug injection under bronchoscopy on the retreatment of smear positive cavitary pulmonary tuberculosis. Methods From June 2016 to December 2017,164 cases of pul-monary tuberculosis with smear Yang cavity type were selected,which were divided into 2 groups according to the random digital table method,each groups has 82 cases.The control group received routine treatment,the observa-tion group underwent bronchoscopy with Kangfuxin Liquid combined with drug injection therapy.The clinical effect of the two groups,the changes of lung function before and after treatment and the improvement of clinical symp-toms were compared.Results The clinical curative effect of the treatment group was better than the control group, which difference was statistically significant(P < 0.05). FEV1,FEV1/FVC,PEF index in the observation group were better than the control group,which difference was statistically significant(P<0.05).The complication rate of observation group was lower than the control group,which difference was statistically significant(P < 0.05). Conclusion Drug injection under bronchoscopy can significantly improve the clinical efficacy and lung function and promote clinical symptoms in patients with retreated smear positive pulmonary tuberculosis.It is worthy of popu-larization and application.

Objective:To establish a method of ion chromatography for the determination of sodium, potassium and citric acid in potassium sodium hydrogen citrate granule. Methods:The chromatographic conditions for potassium and sodium were as follows:a Di-onex IonPac CS12A column (250 mm × 4. 6 mm, 5μm), 0. 02 mol·L-1 methane sulfonic acid solution as the mobile phase, the flow rate of 1. 0 ml·min-1 , the suppressor of CSRS 300, the inhibition current of 59 mA, the inhibition type conductivity detector, and the injection volume of 25 μl. The chromatographic conditions for citrate were as follows: a Dionex HPICE-AS1 colunm ( 250 mm × 9. 0 mm,7. 5 μm), 0. 015 mol·L-1sulfuric acid solution as the mobile phase, the flow rate of 0. 6 ml·min-1, the detection wave-length of 220 nm and the injection volume of 10 μl. Results: The linear range of sodium was 0.82-82.49 μg·ml-1(r=0.9999), and the average recovery was 98.9%(RSD =0.55%, n =9). The linear range of potassium was 1.38-137.89 μg·ml-1 (r =1. 0000), and the average recovery was 100. 5% (RSD=0. 53%, n=9). The linear range of citric acid was 0. 021-10. 600 μg· ml-1(r=1. 0000), and the average recovery was 99. 1% (RSD=0. 54%, n=9). Conclusion:The method is simple, rapid and ac-curate, and can be used for the quality control of potassium sodium hydrogen citrate granule.

Objective To compare the effects of fluid therapy by "measurement" water dispenser and routine fluid therapy on standard fluid therapy among patients with percutaneous coronary intervention (PCI) in coronary care unit (CCU). Methods A total of 204 patients with PCI were divided into observation group (n=102) and control group (n=102) by random number table. Patients in the observation group received drinking water plan according to regulatory requirements using the self-designed "measurement" water dispenser. Patients in the control group accepted nursing plan of routine drinking fluid therapy. This study compared the qualified rate of standardized drinking water, patient satisfaction, renal function and the incidence of contrast-induced nephropathy (CIN) three days after intervention between two groups. Results There were 102 (100.00%) qualified patients drinking water according to stipulations in the observation group, while there were 68 (66.67%) in the control group. The qualified rate of drinking water in the observation group was higher than that in the control group with a significant difference (χ2=38.4, P<0.01). There were two patients with contrast induced nephropathy in the observation group, and eight patients with contrast induced nephropathy in the control group (χ2=4.2,P=0.04). Conclusions The effect of fluid therapy by "measurement" water dispenser supplemented with diversified education is satisfactory among patients with PCI in CCU.

Objective:To analyze the implementation and effectiveness of primary health care reform in Feixi county, Anhui province. Methods: This paper uses data analysis of interviews with key insiders, policy documents and archives, as well as institutional questionnaire survey and other methods to collect information, and then it com-bines qualitative and quantitative research to arrive at research findings through cross-analysis and interpretation. Re-sults:From 2010 to 2014, the reform enhanced the capacity of primary health care in four main aspects, including capacity building of primary health care personnel, network construction of primary health care system, improvement of working conditions, and system construction of institutional management. Accordingly, the human capacity of pri-mary health care personnel was improved, their enthusiasm for work increased, their income was raised, the working conditions were improved, the cooperation mechanism for vertical and horizontal health care services was established, and the consultation rate and primary health care utilization in Feixi county increased. Conclusion:Both the“bottom-up” exploration approach and “from point to area” implementation strategy adopted by Feixi county have not only been the core content of primary health care system’s comprehensive reform, but also effectively leveraged the other aspects of the reform. They have played an important role in deepening medical reform and establishing institutional mechanism of health care system.

Objective:The paper aims to explore the structure and effectiveness of three health service systems in Anhui province and provide policy recommendations to promote the integration of health care systems. Methods:By using typical sampling method, this paper conducts case study analysis of health service system in Ma’anshan, Feidong and Feixi county of Anhui province. The data mainly come from questionnaires for the institutions, doctors and patients, as well as from interviews with key informants. By integrating quantitative and qualitative data analysis, this paper uses social network analysis method to analyze the system structure and its degree of integration. Results:The degree of integration of health service structure in Ma’anshan is the highest, followed by Feixi, and Feidong is the lowest. The system effectiveness is same as the degree of integration. All three health service systems have advantages and disadvantages regarding to system integration. Conclusion:The effectiveness of health service system integration and its implementation is the product of combined effects of internal and external environment of each health service system. The reforms in Ma’anshan and Feixi health service systems have not only integrated health care structures, but also had a positive impact on the effectiveness of the health service systems.

Objective:To analyze reverse effects induced in the implementation process of“primary health care strengthening” policies, and the innovative initiatives and countermeasures raised in primary health care system’s comprehensive reform of Feixi county. Method:Based on the principles of Critical Discourse Analysis ( CDA) , this paper designs its analytical framework for policy analysis. Results:Many reverse effects appeared in the implementa-tion process of “primary health care strengthening” policies. However, through improvements in terms of manpower upgrading, network building, working conditions and management mechanisms, Feixi county has successfully strengthened the capacity building for primary health care institutions. Conclusions:The expected and unexpected re-sults should be evaluated systematically when the policies are being implemented, and local governments need to pro-ceed according to local conditions in order to prevent unintended reverse effects from happening.

The fragmentation of health care system within a county and serious capacity constraints of health-care services in township health centers are generally the most significant problems facing underdeveloped counties in western China. Under constraints of limited public financial resources, how to increase service capability of township health centers and improve service quality, continuity and convenience of health care system has become one of the most severe challenges in implementing China’s county health care system reform. This paper takes Huangzhong coun-ty, Qinghai province as a case study. It investigates how the locals use health care alliance to vertically integrate county health care resources during reform implementation, analyzes various aspects of reform measures and the corre-sponding structural characteristics such as the integration of administrative management, integration of human re-sources, dual diagnosis referral, interoperability of information systems, sharing of resources and test results, etc. , and provides similar China’s counties with a case study to be used for reference.