Objective:To explore the influence of health behavior intervention strategies based on health action process approach model on medication compliance of asthma patients.Methods:Selected in July 2018 to March 2019 in the respiratory medicine clinics, 405 cases of patients with asthma as the research object, 205 cases were randomly divided into observation group and control group 200 cases, control group to implement regular medication guidance and health education, group implementing general guidelines and based on the health action process approach model building model of health education. The compliance of asthma patients before and after intervention was compared between the observation group and the control group .Results:After 3 months intervention, the behavior change stage of the observation group was significantly advanced ( Z value was -5.999, P<0.01), among which the proportion of patients in the action stage was the highest 58.7% (98/167). After intervention 1 month and 3 months, the compliance scores of patients of the observation group were 40.34±4.20 and 44.05±3.49, and those in the control group were 33.25±5.05 and 34.89±4.19. The differences between the two groups were statistically significant ( t values were 13.895, 21.646, P<0.01). Conclusion:The model of health education for asthma patients based on health action process approach model is helpful to improve the medication compliance of patients, and has a positive guiding significance for the construction of healthy lifestyle of asthma patients.

Objective: To study the best time of early feeding in patients with acute oral organophosphorus pesticide poisoning. Methods: A prospective study was conducted on 123 patients with acute oral organophosphorus poisoning admitted from January 2018 to May 2019 in Department of Emergency, the Affiliated Hospital of Binzhou Medical University. The patients were divided into four groups, A(<6 h), B(≥6 h-<12 h), C(≥12 h-<24 h) and D(≥24 h), according to the time of poisoning at the time of admission. All the patients in the four groups were fed immediately upon admission with the same method. The cholinesterase activity at 24, 48, 72, 120 h after poisoning, the incidence of rebound after poisoning, the disappearance time of clinical poisoning symptoms were compared among the four groups. Results: Compared with the other three groups, group A had a statistically significant difference in the cholinesterase activity at 24, 48, 72, 120 h after poisoning (H value was 9.466-24.933, P<0.05 or 0.01). There was no significant difference between the two groups in B, C, D group (P>0.05). The incidence of rebound after poisoning in A, B, C, D group was 3.448%(1/30), 7.407%(2/29), 6.452%(2/33), 6.897%(2/31), respectively, with no statistically significant difference (χ² value was 0.431, P>0.05). Compared with the four groups, the disappearance time of clinical poisoning symptoms in group A was shorter than that in the other three groups, and the difference was statistically significant (H value was18.199, P<0.05). Conclusions The earlier the patients ate, the faster the recovery of cholinesterase activity, the earlier the improvement of poisoning symptoms, and the incidence of gastrointestinal reaction and rebound after poisoning is not increased.The best time for early feeding is less than 6 h after poisoning.

Objective To compare and analyze the etiology,clinical manifestations and imaging differences of bilateral pontine infarction (BPI) and unilateral pontine infarction (UPI),and investigate the possible independent risk factors for BPI.Methods Consecutive patients with pontine infarction admitted to the Department of Neurology,the First People's Hospital of Kunshan from January 2015 to December 2017 were enrolled retrospectively.They were divided into BPI group and UPI group.The risk factors,laboratory findings,National Institutes of Health Stroke Scale (NIHSS) scores,clinical manifestations,and basilar artery lesions were compared between the two groups.Multivariate logistic regression analysis was used to determine the independent risk factors for BPI relative to UPI.Results A total of 131 patients with pontine infarction were enrolled,aged 66.22 ± 12.29 years,97 patients (72.52％) were male;14 (10.69％) were BPI,and 117 (89.31％) were UPI.In terms of clinical symptoms,consciousness disorder (35.71％ vs.6.83％;x2 =8.657,P =0.003),quadriplegia (50.00％ vs.5.12％;x2 =30.202,P ＜ 0.001),and dysphagia (71.42％ vs.29.91％;x2 =7.804,P =0.005) in the BPI group were more common than those in the UPI group.In terms of etiological classification,vertebrobasilar large artery disease (VLAD) was more common in the BPI group (85.71％ vs.27.35％;x2 =16.567,P ＜ 0.001),while small artery disease (SAD) was more common in the UPI group (49.57％ vs.7.14％;x2 =7.460,P =0.006).In addition,the baseline NIHSS scores (12.43 ±11.1 vs.3.78 ±3.98;t=2.873,P=0.013),white blood cell count ([9.21±2.81] ×109/L vs.[6.92± 2.40] ×109/L;t=3.191,P=0.002),baseline systolic blood pressure (170.57 ±31.21 mmHg vs.156.75 ±23.50 mmHg,1 mmHg =0.133 kPa;t =2.004,P =0.047),as well as the proportion of patients with severe stenosis or occlusion in basilar artery (78.57％ vs.8.55％;x2 =40.49,P ＜ 0.001) and with other site infarction (78.57 ％ vs.11.11％;x2 =33.652,P ＜ 0.001) in the BPI group were significantly higher than those in the UPI group.Multivariate logistic regression analysis showed that severe basilar artery stenosis or occlusion (odds ratio [OR] 20.195,95％ confidence interval [CI]2.308-176.703;P =0.007),baseline NIHSS score (OR 1.147,95％ CI 1.019-1.292;P =0.023),and infarction at other sites (OR 19.483,95％ CI 2.969-127.868;P =0.002) were independently associated with BPI.Conclusion Compared with UPI,patients with BPI had more severe clinical symptoms and most of them with other site infarction.Severe stenosis or occlusion of the basilar artery was an independent risk factor for BPI.

Objective To explore the cognitive level of patients with breast cancer who were undergoing adjuvant endocrine therapy and their needs for related knowledge, so as to provide powerful references for making effectively compliance interventions. Methods An in-depth interview was conducted on 12 breast cancer patients who were undergoing adjuvant endocrine therapy. Data were analyzed by Colaizzi analysis procedure. Results The views on adjuvant endocrine therapy were very disagree and the main needs were: the related knowledge of adjuvant endocrine therapy, side effects of adjuvant endocrine therapy and its cope measures, the needs about healthy lifestyle during taking medicine, the needs of communicating with doctors and nurses, the regulation methods on alleviating psychological stress and releasing worries of the drug costs. Conclusion More efforts should made to strengthen the health education on adjuvant endocrine therapy and create effectively follow-up system, strengthen multi-discipline cooperation and doctor-patient communication, also we need deeply recognize the cognitive level about endocrine therapy of the patients and meet their psychological needs, aim directly interventions to relieve or eliminate their concerns, thus reinforce their believes of drug administration and promote the adherence of adjuvant endocrine therapy.

Objective To assess the cerebrovascular reserve (CVR)and the relationship of CVR with the short-term prognosis in patients with acute atherosclerotic cerebral infarction.Methods A total of 106 patients with unilateral acute (within 72 h) atherosclerotic cerebral infarction (trial group) were selected from December 2016 to December 2017 in the Department of Neurology of the First People's Hospital of Hefei,which were divided into two groups including the lesion group (106 cases) and the nonlesion group (106 cases).The median score of NIHSS in patients was 4(2,5).The control group included 40 healthy controls.The cerebral blood flow reserve and pulsatility index were measured by transcranial Doppler combined with CO2 inhalation test in both the trial group and the control group.According to the rate of change of cerebral blood flow velocity (CBFV),all subjects were divided into two groups including the normal group and the impaired cerebral blood flow reserve group.The changes of CBFV were compared in the control group and the trial group,which was divided into two groups including the group with lesion side and the group with non-lesion side.To evaluate the brain structure reserve the circle of Willis in the trial group was assessed by MRA.According to the integrity of the circle of Willis anterior and posterior circulation all subjects were divided into four groups (type Ⅰ,type Ⅱ,type Ⅲ and type Ⅳ).The effect of the factors,such as diabetes,hypertension,low density lipoprotein (LDL),high density lipoprotein (HDL),smoking,and drinking history,on cerebral blood flow reserve was measured by single-factor analysis.The correlation of NIHSS scores,infarct size and volume with CVR was also measured.All patients in the trial group were treated with drugs and were followed-up for three months.The modified Rankin Scale (Mrs) was used to evaluate the prognosis of the patients.It means poor prognosis if the value of Mrs was more than three.The effects of factors,such as sex,HDL,LDL,diabetes,hypertension,smoking history,drinking history,cerebral blood flow reserve,NIHSS scores,brain structure reserve,infarct location,age,on the prognosis were measured by multivariate Logistic regression.Results The increase rate of CBFV in the lesion-side of patients with atherosclerotic cerebral infarction was 5.94％ (2.18％,10.49％),and the increase rate of pulsatility index was 10.77％ (2.21％,22.62％),which were both lower than the control group (CBFV:11.54％ (5.01％,17.96％),Z =2.547,P＜0.05);pulsatility index:48.36％ (33.93％,64.51％),Z =6.604,P ＜ 0.01).There was significant difference (x2 =4.328,P ＜ 0.05) in the distribution of diabetes,which was 2/14 in the normal group and 43.48％ (40/92) in the impaired cerebral blood flow reserve group.And in the trial group the brain structural reserve was positively correlated to the infarct volume and the NIHSS score,and the rank correlation coefficient was 0.219 and 0.238 respectively (P ＜ 0.05).The prognosis of cerebral blood flow reserve in the normal group was better than the impaired group (x2 =4.155,P ＜ 0.05),for example,the proportion of patients with good prognosis and normal CBFV was 18.84％ (13/69),the proportion of patients with good prognosis but decreased CBFV was 81.16％ (56/69),the proportion of patients with poor prognosis but normal CBFV was 2.70％ (1/37),the proportion of patients with poor prognosis and decreased CBFV was 97.30％ (36/37).The proportion of patients with type Ⅰ and type Ⅲ of the brain structure reserve was 37.68％ (26/69) and 5.80％ (4/69) respectively,whose prognosis was better (x2 =8.456,P ＜ 0.05) than patients with type Ⅱ and type Ⅳ,whose proportion was 43.48％ (30/69) and 13.04％ (9/69).Multivariate Logistic regression analysis showed that NIHSS score,age,and brain structural reserve were risk factors for poor prognosis in the trial group.Normal cerebral blood flow reserve was a protective factor for good prognosis.Conclusions CVR in patients with acute atherosclerotic cerebral infarction is significantly reduced.CVR can be used as an index to evaluate the prognosis of patients who were followed-up for three months.

ObjectiveTo investigate clinical features and outcomes in acute ischemic stroke patients with remote symptomatic intracranial hemorrhage (sICHr) after intravenous thrombolysis.MethodsThe acute ischemic stroke patients with sICHr after intravenous thrombolysis therapy were enrolled retrospectively.The clinical data were collected and the related literature was analyzed and summarized.ResultsA total of 6 acute ischemic stroke patients with sICHr were enrolled, including 4 males.Three patients had a history of using antiplatelet agents, 2 with atrial fibrillation, 4 with hypertension, 3 with previous stroke history, 4 with smoking history, and 4 had sICHr at 2 h after intravenous thrombolysis.Of the 14 hemorrhagic foci (except in the infarct areas), 10 were in the cerebral cortex.Three patients died within 1 week, and 1 was in a persistent vegetative state.Conclusions SICHr after intravenous thrombolysis in patients with acute ischemic stroke is mainly located in the cerebral cortex.The outcomes in acute ischemic stroke patients with SICHr after intravenous thrombolysis are poor, and the mortality is high.

Objective To evaluate the nursing outcomes of patients with chronic diseases discharged from various fields,and to analyze the related factors,and provide the basis for the nursing of patients with chronic diseases.Methods A total of 640 patients with chronic diseases discharged from hospital were investigated by the general information questionnaire and the Chronic Disease Patients Nursing Outcomes Classification Evaluation Form.Results In nursing outcome classification evaluation of patients with different diseases,the score of patients with cardiovascular disease was (250.27 ± 38.82) points,the score of patients with chronic obstructive pulmonary disease was (267.27± 32.46) points,the score of patients with cerebral apoplexy was (238.69 ± 38.80) points,and the score of patients with diabetes was (287.71 ± 21.86) points,the differences were statistically significant (F=40.062,P＜ 0.01).Evaluation in each dimension,physiological,functional outcome scores higher,cognitive,behavioral health outcome scores lower;,in addition,education,place of residence,average annual family income,types of illness,mentality,the whether hospitalized for the first time become discharged patient care of the main factors.Conclusions Nursing care should be guided by the classification of nursing outcome,and individual nursing intervention for the differences between the types of illness and individual factors.

Objective:To analyze the situation and problems of prescription medication for pregnant patients in outpatient depart-ment of our hospital in order to improve and ensure the safe and rational drug use. Methods: The prescriptions concerning pregnancy except normal pregnancy monitoring in our outpatient department in 2014 were selected and analyzed and reviewed according to classifi-cation, related regulation and medicine instruction issued by FDA. Results:Totally 882 prescriptions were selected with average varie-ties of (1. 3 ± 0. 1) and sum of (77. 7 ± 0. 2) yuan. Among them, 31 ones were irrational prescriptions accounting for 3. 5%. Con-clusion:In order to promote the rational and safe drug use in pregnant patients, it is necessary to strengthen relevant knowledge educa-tion and prescription review of clinical pharmacist.

Sleep-disorderedbreathingarecloselyassociatedwithischemicstroke.Sleep-disordered breathing includes obstructive sleep apnea and central sleep apnea. Studies have show n that obstructive sleep apnea is an independent risk factor for stroke, w hile stroke can also increase the incidence of sleep-disordered breathing. This article review s the latest research progress of sleep-disordered breathing and stroke.

Objective To explore the relationship between social support and professional identification among nursing students,and to examine the mediating role of resilience.Methods A total of 650 nursing students were evaluated with Social Support Rating Scale,Professional Identity Questionnaires for Nursing Students and Chinese revision of Connor-Davidson Resilience Scale.Results The scores of nursing students' social support,resilience and professional identification were (38.93±5.30),(66.79±11.93),(57.45±9.95).Professional identification could positively influence their professional identification(r=0.233-0.422,P＜0.01).Resilience mediated the relationship between social support and professional identification,the effect sizes were 52.27％.Conclusions Resilience plays a mediating role between social support and professional identity.It is important to pay attention to social support and resilience and take proper interventions to promote nursing students professional identification.