Objective:To investigate the changes of thyroid hormones and the flow velocity of superior thyroid artery in patients with Graves' disease and Hashimoto's thyrotoxicosis before and after treatment with methimazole.Methods:A case-control study was conducted to select 45 cases of Graves' disease and 45 cases of Hashimoto's thyroiditis from October 2021 to December 2022 in the Department of Endocrinology, North China University of Science and Technology Affiliated Hospital. The changes of thyroid hormone and blood flow velocity of superior thyroid artery in patients with Graves' disease and Hashimoto's thyroiditis before and after treatment with methimazole were analyzed. Measurement data satisfying normal distribution were expressed by xˉ±s, and the mean between two groups was compared by t test. Measurement data not satisfying normal distribution were expressed by M( Q1, Q3), and the median between two groups was compared by Wilcoxon rank sum test. χ 2 test was used to compare the constituent ratio of enumeration data among groups. Results:There was no significant difference in thyroid stimulating hormone (TSH) between the two groups before treatment, and there was no significant difference in TSH between the two groups after 1 month and 3 months of treatment (all P>0.05). The levels of free triiodothyronine (FT3) were (24.09±9.29) pmol/L and (17.41±9.36) pmol/L in Graves' disease group and Hashimoto's thyroiditis group respectively before treatment. FT4 were (60.23±20.82) and (43.47±21.71) pmol/L, respectively, and the peak stolie vloiy (PSV) were (69.53±5.70) and (52.65±4.64) cm/s, respectively in Graves' disease group and Hashimoto's thyroiditis group respectively before treatment. There were significant differences between the two groups ( t values wrere 3.39 and 3.74, Z=13.83, all P<0.001). The difference of FT3 between one month after treatment and before treatment was (-6.36±5.32) and (-12.64±9.08) pmol/L ( t=4.02, P<0.001) and the difference in FT3 between 3 months of treatment and before treatment was (-10.14±9.50) and (-17.80±11.17) pmol/L, respectively ( t=3.51, P<0.001) between the Graves disease group and the Hashimoto's thyroiditis group. The difference in FT4 between the Graves disease group and the Hashimoto's thyroiditis group after 1 month of treatment and before treatment was (-28.47±10.09) and (-20.57±14.48) pmol/L ( t=7.01, P<0.001), and the difference of FT4 was (-47.06±20.57) and (-30.17±20.54) pmol/L ( t=3.91, P<0.001) between the Graves disease group and the Hashimoto toxin group. The difference between one month after treatment and before treatment was (-13.10(-34.10,-2.60)) and (-10.50(-27.5,-0.20)) cm/s ( Z=2.63, P=0.009), respectively. The difference between 3 months and before treatment was (-31.40(-53.20,-12.70)) and (-19.90(-46.00,-4.70)cm/s ( Z=4.40, P<0.001)) between the Graves disease group and the Hashimoto's thyroiditis group, and the difference was statistically significant. Conclusion:Thyroid hormone levels were decreased after treatment with methimazole in patients with diffuse toxic goiter and Hashimoto toxemia, but the difference was not statistically significant. The PSV level of superior thyroid artery in patients with diffuse toxic goiter was significantly lower than that in patients with Hashimoto's thyrotoxicosis.

Objective To explore the current situation and influencing factors of caregiver readiness of elderly patients with chronic heart failure.Methods From March 2021 to April 2022,the convenient sampling method was used to select 335 caregivers of elderly patients with chronic heart failure who were hospitalized in 6 hospitals in Hangzhou as the survey subjects.The general information questionnaire,Caregiver Readiness Scale and Caregiver Burden Scale were used to investigate the caregivers of elderly patients with chronic heart failure.Results A total of 326 valid questionnaires were collected.The score of Caregiver Readiness Scale for elderly patients with chronic heart failure was(18.88±6.36),and 61.04%of the caregivers had mild to moderate burden.The results of multiple linear regression analysis showed that the caregiver's age,education level and cumulative care time were the positive influencing factors of the caregiver readiness,and the caregiver burden was the negative influencing factor of the caregiver readiness(P＜0.001).Conclusion The caregiver readiness of elderly patients with chronic heart failure is at a medium level.Caregivers who are older,more educated,have a longer cumulative caregiving time,and have a lighter caregiving burden are more prepared.Medical staff should pay attention to the motivation of caregivers,provide professional support from multiple aspects,and reduce the burden of care,increase readiness level.

Objective:To retrieve and obtain the relevant evidence for in-hospital exercise rehabilitation in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) and to summarize the best evidence.Methods:By applying evidence-based nursing method, the relevant evidence of in-hospital exercise rehabilitation in AMI patients after PCI in domestic and foreign databases was retrieved by combining computer and manual methods, including guidelines, evidence summary, clinical practice guidelines, systematic reviews, randomized controls test and so on. The retrieval time was from the establishment of the database to December 1, 2019. A total of 4 evidence-based groups independently conducted literature quality evaluation, and the controversial content was ruled by the hospital evidence-based group, and the evidence was extracted. Appraisal of guidelines research and evaluation (AGREEⅡ) and literature evaluation criteria and evidence grading system of Australia Joanna Briggs Institute (JBI) Evidence-based Health Care Center were respectively used to evaluate quality of literature and grade the various studies.Results:A total of 15 articles were included, including 4 guidelines, 1 evidence summary, 1 systematic evaluation and 9 randomized controlled trials. Finally, 20 pieces of best evidence of in-hospital exercise rehabilitation in AMI patients after PCI were summarized.Conclusions:This study summarizes best evidence for in-hospital exercise rehabilitation of AMI patients after PCI, which can provide an evidence-based basis for clinical practice. However, in the actual implementation process, it should be carried out step by step on the premise of ensuring the safety of patients by combining the cultural background of patients and the level of medical institutions.

Objective:To apply the best evidence of exercise rehabilitation during hospitalization for patients with acute myocardial infarction after percutaneous coronary intervention (PCI) in clinical practice, in order to standardize the management of exercise rehabilitation of patients by medical staff and promote the practice of cardiac rehabilitation.Methods:By using the clinical evidence practice application system of Joanna Briggs Institute (JBI) Evidence-Based Health Care Center, the literatures related to the subject were systematically retrieved and quality evaluation was conducted. A total of 20 best evidences were collected, and 16 evidence-based quality review standards were developed in combination with the clinical context. The implementation of nurses' review indicators, the score of Cardiac Rehabilitation Knowledge Test and the score of Exercise Fear Scale before and after the application of evidence were compared respectively on the nurses and patients with acute myocardial infarction after PCI from February 1 to March 30, 2020 and from May 1 to July 3, 2020.Results:Except for index 1 and index 2, the implementation rates of all review indexes before and after the application of evidence were all increased, and the differences were statistically significant ( P<0.01) . The score of Cardiac Rehabilitation Knowledge Test was (91.14±14.05) after the application of evidence, which was higher than (80.00±10.41) before the application of evidence, and the difference was statistically significant ( t=-2.682, P<0.05) . After the application of evidence, the score of Exercise Fear Scale for Patients with Heart Disease was (43.43±10.93) , which was not statistically significantly different from the score (44.19±8.58) before the application of the evidence ( t=0.280, P>0.05) . Conclusions:The application of the best evidence of exercise rehabilitation during hospitalization in patients with acute myocardial infarction after PCI can improve the management and cognition of medical staff on exercise rehabilitation of patients and reduce the influence of exercise fear avoidance of patients.

This article summarizes the application of cardiac rehabilitation from the aspects of the generation, demand and feasibility, application status and effects of cardiac rehabilitation, so as to provide a basis for the development of cardiac rehabilitation in our country.

Objective:To establish an intelligent management system and explore its application in the management of high-value consumables in Interventional Operating Room.Methods:Supply and processing and distribution (SPD) combined with the intelligent management system was applied in the Intervention Center at Ningbo First Hospital of Zhejiang Province in October 2019. High-value consumables managed with traditional information management between October 2018 and September 2019 were included into the control group, while those managed with SPD combined with the intelligent management system from October 2019 to September 2020 were included into the observation group. The high-value consumable system and inventory compliance rate, average daily inspection time, average daily claim time, timely supply of consumables, return rate of unused consumables, and nurse satisfaction under the two different management modes were compared.Results:The coincidence rates of the high-value consumable system inventory and actual inventory in the observation group and the control group were 98.26% (226/230) and 85.21% (196/230) , respectively; the average daily inspection time, (67.44±1.42) min in the observation group was less than (108.00±2.51) min in the control group, and the average daily claim time, (53.41±5.24) min was less than (118.22±4.68) min in the control group; the total rate of untimely supply of consumables and unreturned unused consumables in the observation and control groups were 3.46% (138/3 986) and 20.86% (881/4 224) , respectively; and the satisfaction of nurses in the two groups were 93.75% (135/144) and 63.89% (92/144) . The differences between the two groups were all statistically significant ( P<0.05) . Conclusions:The construction and application of the intelligent consumable management system can effectively improve the standardization and refinement of the management of high-value consumables in the Interventional Operating Room, and reduce the operating cost of the department.

Objective:To analyze the nursing management information system in China based on bibliometric analysis so as to provide a reference for further research.Methods:This study retrieved literatures on nursing management information system in Chinese National Knowledge Infrastructure (CNKI) , WanFang Data and VIP from 2000 to 2018 and carried out the bibliometric analysis.Results:A total of 421 literatures were included. The number of literatures showed a trend of rising. There were 1 461 authors from 30 province-level regions and 287 research institutions focused on hospitals. Province-level regions with literature number in the top 10 mainly were distributed in east of China. Journals with literature number in the top 10 were statistical source or core journals publishing 192 (47.29%) literatures. The average time cited per paper was 5.04. There were 29.69% of literatures with the program fund. The study focused on nursing quality involving the nursing human resource, nursing teaching, nursing administration and nursing research.Conclusions:Nursing management information system is one of the research hotspots in China. We should increase the research depth, literature recognition and fund support, and concentrated on nursing quality improvement, and accelerate to build the nursing standardized language of China so as to promote the development of nursing information construction in China.

Objective:To construct the continuous nursing health empowerment program for chronic heart failure (CHF) patients based on health empowerment theory so as to improve the participation and self-management of CHF patients in continuous nursing.Methods:From January to June 2019, we initially established the continuous nursing health empowerment program for CHF patients based on literature search combined with qualitative interview results. From July to August 2019, we selected 15 experts in cardiovascular medical nursing, geriatric nursing, community nursing and nursing management for two rounds of Delphi expert consultations by purposive sampling to construct the continuous nursing health empowerment program for CHF patients.Results:The recovery rate of two rounds of expert consultation questionnaires was 100% (15/15) , and the expert authority coefficient was 0.90. The results of the first round showed that the modification rate of experts was 66.67% (10/15) , adding 22 items, modifying 10 items, merging 13 items and deleting 7 items. The results of the second round showed that the modification rate of experts was 20.00% (3/15) , adding 1 item and modifying 2 items. After two rounds of Delphi expert consultations, we determined 5 first-level items, 18 second-level items and 75 third-level items.Conclusions:Construction of continuous nursing health empowerment program for CHF patients based on Delphi expert consultation help improve the participation and self-management of patients with CHF and improve the effectiveness of continuous nursing.

ObjectiveTo investigate the acceptance and influencing factors of manual hyperinflation (MIH) in patients with open sputum suction after tracheotomy, so as to provide reference for improving the acceptance of MIH for patients. MethodsBy convenience sampling, 140 patients with tracheotomy on open suction in Affiliated Hangzhou First People＇s Hospital, Zhejiang University School of Medicine from October 2016 to September 2018 were selected as participants in the study and the Self-Designed Questionnaire was used to study the acceptance towards MIH of the patients. Univariate analysis and Logistics regression analysis were conducted to analyze the influencing factors of the acceptance of patients on MIH. A total of 140 questionnaires were distributed, and 134 valid ones were collected. ResultsUnivariate analysis showed that there were statistical difference in age, gender, family support, duration of tracheotomy, whether the medical staff had explained the relevant knowledge of MIH, and whether the patients had experienced MIH on patients＇acceptance of MIH (P＜ 0.05). The above 6 statistically significant factors were analyzed by multivariate Logistic regression and the results showed that age, gender, duration of tracheotomy, whether the patients had experienced MIH before were the influencing factors of the patients＇ acceptance on MIH(P＜ 0.05). ConclusionsAge, gender, duration of tracheotomy, whether or not the patents have experienced MIH are independent impact factors for the patients＇ acceptance of MIH and the above factors can be the cut-in points of explanation and education in the process of MIH,so as to improve the patients＇ acceptance of MIH and promote recovery.

Objective To observe the changes of serum ferritin and 25-(OH) vitamin D3 in patients with diabetic cranial neuropathy.Methods There were 50 patients without diabetic Cranial neuropathy,46 patients with diabetic cranial neuropathy,and 40 cases of normal control group.The changes of serum ferritin and 25-hydroxy vitamin D3 were observed in each group.The correlation between two indexes and the correlation with diabetic cranial neuropathy were analzyzed.Results The serum ferritin levels in diabetic group and diabetic neuropathy group were significantly higher than those in normal control group (P ＜ 0.01),and its level in patients with diabetic cranial neuropathy [(687.54 ± 65.38)ng/ml] was significantly higher than that of patients without diabetic cranial neuropathy [(497.28 ± 46.39) ng/ml,P ＜0.01].The serum 25-(OH) vitamin D3 levels in the diabetic group and diabetic neuropathy group were lower than those in the control group (P ＜ 0.01),and its level in patients with diabetic cranial neuropathy [(26.45 ± 8.93)nmol/l] was significantly less than that of patients without diabetic cranial neuropathy [(37.19-± 9.74)nmol/L,P ＜ 0.01].Serum ferritin levels were positively correlated with 25-(OH) vitamin D3 (r =-0.59,P ＜ 0.01).Multivariate unconditional Logistic regression analysis showed that diabetic neuropathy was negatively correlated with 25-(OH) vitamin D3 (P ＜ 0.05).Conclusions The increases of serum ferritin and 25-(OH) vitamin D3 are closely related to the occurrence and development of diabetic cranial neuropathy,which provides the theoretical basis for clinical intervention therapy.