Objective To investigate the clinicopathological features and key points of diagnosis and treatment of malignant perivascular epithelioid cell tumor(PEComa)to increase awareness of the disease.Methods The clinicopathological data of 2 patients with malignant PEComa treated in our hospital were retrospectively analyzed,and relevant literatures were reviewed.Results Both patients were male,aged 53 and 16 years,respectively.The sites of occurrence were in the retroperitoneum and pelvis,respectively.Both tumors were resected surgically,and the diagnosis was confirmed with postoperative pathology.Under the microscope,the tumor tissue of one patient was mainly composed of smooth muscle-like cells,and that of the other patient was composed of epithelioid cells,both showing pathological mitotic images and expressing HMB45,Melan-A,SMA and CD34,no tumor recurrence or metastasis was observed during the follow-up.The literatures collected involved 15 patients with retroperitoneal or pelvic PEComa,including 3 males and 12 females,of which 9 were malignant.The clinical manifestations were abdominal pain,bloating,or lower back pain.Some cases were detected during physical examinations.Conclusion Malignant PEComa is difficult to be diagnosed before surgery and easy to be misdiagnosed.The confirmed diagnosis depends on the postoperative pathological results.The preferred treatment is complete resection of tumor.Long-term follow-up is needed.

OBJECTIVE:To construct integrated medication decision-making system,and to provide reference for safe,effec-tive,economical and reasonable drug use in clinic. METHODS:The construction of integrated medication decision-making system was introduced in our hospital. RESULTS&CONCLUSIONS:The integrated medication decision-making system included three as-pects as real-time intervention in advance,interactive review in the matter,afterward comment and analysis,as 3 steps before and after the implementation of inpatient medical order and outpatient prescription. The real-time intervention in advance was mainly to control the rationality of medical orders or prescriptions from their source,thus requiring the timely treatment. The interactive re-view in the matter required that pharmacists judged the medical order or prescription and made a decision of refusing prescribing within the fixed time. To make a decision accurately,the clinical information should be highly structured and correlated with drug signs. Afterward comment and analysis required that pharmacists evaluated the medical order or prescription regularly after the im-plementation. The three were not only different,but also coordinated,and they were an organic unity,especially interactive review in the matter needed to be coordinated with the other two processes. After the implementation of integrated medication decision-mak-ing system,the proportion of irrational medical orders or prescriptions in our hospital decreased from 6.07％ in the first half of 2016 to 2.56％ at corresponding period of 2017. Drug dose errors and incompatibility were greatly reduced,and medication against contraindications was more likely to be found in the review and analysis. The system can improve the efficiency of prescription re-view,improve rational drug use,and effectively ensure the safety,effectiveness,economy and rationality of clinical drug use.

Objective To investigate effect of specific psychological guidance in improving mental elasticity of intern undergraduates.Methods A total of 80 nursing interns were randomly divided into control group with regular courses and skills training,and experimental group with psychological guidance.Working pressure score,social support score,psychological symptoms score and mental elasticity score before and after intervention were compared.Results After nursing intervention,nursing and work,workload and time allocation,the working environment and resources,patient care,management and interpersonal skills,stress score,somatization,interpersonal sensitivity,depression,anxiety,hostility between terror,paranoia and psychosis scores in the experimental group were significantly lower than the control group,the objective and subjective support,support utilization,social support,firm,self-reliance,optimism and total scores of mental elasticity were significantly higher than the control group (P ＜ 0.01).Conclusion The effect of psychological counseling for nursing undergraduates is remarkable,and it is worthy of clinical application.

Objective To investigate effect of specific psychological guidance in improving mental elasticity of intern undergraduates.Methods A total of 80 nursing interns were randomly divided into control group with regular courses and skills training,and experimental group with psychological guidance.Working pressure score,social support score,psychological symptoms score and mental elasticity score before and after intervention were compared.Results After nursing intervention,nursing and work,workload and time allocation,the working environment and resources,patient care,management and interpersonal skills,stress score,somatization,interpersonal sensitivity,depression,anxiety,hostility between terror,paranoia and psychosis scores in the experimental group were significantly lower than the control group,the objective and subjective support,support utilization,social support,firm,self-reliance,optimism and total scores of mental elasticity were significantly higher than the control group (P ＜ 0.01).Conclusion The effect of psychological counseling for nursing undergraduates is remarkable,and it is worthy of clinical application.

Objective:To investigate the influence of social support to nursing students occupation maturity, provide a new perspective and reasonable suggestions for the cultivation of nursing students occupation planning. Methods:A total of 759 nursing students of different education levels were selected. The Social Support Rating Scale and the Career Maturity Inventory Attitude Scale were used to investigate the influence of social support to nursing students occupation maturity. Results:Different levels of nursing students in subjective support and utiliza-tion of support,the total score difference was statistically significant(P <0. 05),college students social support score lower than the college students. Overall maturity of undergraduate and college nursing students occupation de-gree higher than secondary school students,students occupation maturity in the condition assessment,personal ad-justment,value conception,occupation cognition,self-cognition of these dimensions also exist a significant differ-ence(P<0. 05). Social support and occupation maturity of each factor is correlated in most dimensions. Conclu-sion:The social support of nursing students′ occupation maturity degree has important influence,requirements of professional teachers should integrate education occupation maturity while imparting professional knowledge,lay a solid foundation for nursing students′occupation career planning.

Double-blind randomized controlled trial design is the most recognized scheme of therapeutic experimental design.On the assessment of the efficacy of traditional medicine, randomized controlled clinical trial design also has the same value.Only when using the research method towards epidemiology to perform the rigorous design on the clinical trial of traditional medicine and make the objective evaluation of its effect, can it get the real understanding and approval from modern medicine.When making the therapeutic clinical trial under the traditional medicine, due to the characteristics of the subject, therapeutic measures usually need to be changed so they cannot be standardized, and the modification may result in the share of multiple intervention components, which leads to the inaccurateness of results under the effect of confounding bias.According to the characteristics of traditional medicine, a new method was proposed for therapeutic clinical trial.Firstly do the randomization with the inclusion criteria made by the same symptom arise in a certain stage of disease, secondly adopt the standardized intervention measures for processing.Eventually confirm whether there is significant statistical difference.The symptom directing standardized interventions have provided the experimental design of the traditional medical clinical therapy with a feasible scheme, which can solve several problems existing in this design.

Objective To estimate the acceptability of nurses for division of labor pattern in China.Methods A total of 1 609 nurses in 3 provinces were investigated by self-made questionnaires.The contents of questionnaires included assignment distribution,the acceptability of current division pattern,and whether current division pattern can arouse working enthusiasm of nurses.Results The proportion of those engaged in not only life nursing but also technical nursing was more than 40％,and those only engaged in life nursing was lower than 5％ in nurses with junior college,college or bachelor education degree.The nurses' acceptability of current division pattern of nursing work was poor,most fairly reasonable and very general.The improvement of working enthusiasm for division of labor pattern at present was also poor.The higher educational background except master,the lower improvement of working enthusiasm.Conclusions The poor nurses' acceptability of division of labor pattern was low and impacted working enthusiasm.It suggested to establish a scientific and reasonable division of labor pattern for improvement of nurse working enthusiasm,and promote the overall development of clinical nursing,nursing management,nursing education and nursing scientific research.

Objective To clarify great benefit to prevention of wound infection as well as reduction of economic expenditures by a new method of connecting latex gloves and cigarettes in peritoneal drainage. Methods We randomly selected 121 cases of patients with peritoneal pyogenic infection, divided them into the latex gloves group (64 eases)and the common dressing group (57 cases). The incision infection rate and eco-nomic cost in two groups were comparately studied. Results The latex gloves group's incision infection rate was 10.94% (7 / 64), the common dressing was 31.58% (18/57). Each patient of the latex gloves group spent less cost about 15.70 yuan,changed dressing 5.3 times less than the common dressing group. Conclusions Connecting latex gloves and cigarettes in peritoneal drainage is a new method of reducing economic expandi-tures and the chances of incision infection. Clinical application of this method should be fully prospected.

Adult ; Capsules ; Dinoprost ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Dysmenorrhea ; drug therapy ; Female ; Hemorheology ; drug effects ; Humans ; Phytotherapy

Objective To analyze and evaluate the impact of adolescents' sexual and reproductive health education on students' sexual knowledge,attitude and behavior.Methods A short-term intervention was conducted among high school students in two schools in Xixiang county,Shaanxi Province.The intervention was carried out in the forms of manual,video,discussion,consultation,and so on .The contents of intervention consisted of the knowledge about adolescent physiology,care,conception,STD/HIV, and so on. Results The results showed that students' knowledge increased significantly(11.92±4.61 before intervention vs 19.81±4.8 after intervention,P=0.000).The sexual attitude and behavior changed insignificantly,especially the change of behavior.Conclusion The intervention is significantly effective in increasing knowledge,but less effective in the change of attitude and almost ineffective in the behavior change.