Objective To investigate the rebleeding rate after endoscopic selective variceal devascularization (ESVD) and the predictive factors for rebleeding in patients with hepatitis B cirrhosis and esophageal variceal bleeding (EVB). Methods The patients with hepatitis B cirrhosis and EVB who attended Beijing Ditan Hospital, Capital Medical University, from October 2010 to December 2019 and underwent ESVD for the first time were enrolled, and a total of 442 patients were screened out based on inclusion and exclusion criteria. Routine clinical indices, laboratory markers, imaging findings, and endoscopic findings were compared between patients, and the patients were followed up to observe rebleeding. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to describe rebleeding and survival status, and a Cox regression analysis was used to determine the independent risk factors for variceal rebleeding. Results The 1-, 2-, 3-, 4-, and 5-year cumulative rebleeding rates after first ESVD treatment were 25.11%, 33.94%, 39.82%, 42.08%, and 45.02%, respectively. The univariate analysis showed that age, systolic pressure, duration of antiviral therapy ≥1 year, ascites, white blood cell count, neutrophil, and direct bilirubin were associated with rebleeding (all P < 0.05), and the multivariate analysis showed that duration of antiviral therapy ≥1 year (hazard ratio [ HR ]=0.504, 95% confidence interval [ CI ]: 0.357-0.711, P < 0.001) and ascites ( HR =1.424, 95% CI : 1.184-1.714, P < 0.001) were independent influencing factors for variceal rebleeding. Conclusion ESVD has a low rebleeding rate in the treatment of hepatitis B cirrhosis with EVB, and presence of ascites and a short duration of antiviral therapy are independent risk factors for rebleeding after treatment.

Objective To investigate the effects of two different oxygen therapies (oxygen time<4 h/d, oxygen flow>6 L/minversus oxygen time>4 h/d, oxygen flow<6 L/min) on conservative treatment of spontaneous pneumothorax by meta-analysis. Methods The following electronic databases as PubMed, The Cochrane Library, Web of Science, Chinese Biomedical Literature Database, WanFang Database and China National Knowledge Database were retrieved on computer for randomized controlled trials (RCTs) of comparing two different oxygen therapies (oxygen time<4 h/d, oxygen flow>6 L/minversus oxygen time>4 h/d, oxygen flow<6 L/min) on conservative treatment of spontaneous pneumothorax. The retrieval time was from inception of each database to December 2017. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then data were analyzed by RevMan 5.3 software. Results A total of 4 RCTs involving 226 patients were included. The meta-analysis showed that compared with lower oxygen flow (oxygen time>4 h/d, oxygen flow<6 L/min), the higher oxygen flow (oxygen time<4 h/d, oxygen flow>6 L/min) could obviously decrease the degree of pulmonary compression after oxygen therapy for 5 days (MD=–2.81, 95%CI –4.18 to –1.44, P<0.05), shorten duration of hospital stay (MD=–3.26, 95%CI –6.05 to –0.47, P<0.05) and duration of recruitment maneuvers (MD=–2.78, 95%CI –5.27 to –0.28, P<0.05), but there was no significant difference in oxygen partial pressure after oxygen therapy for 5 days (MD=10.68, 95%CI –7.03 to 28.39, P=0.24). Conclusion The higher oxygen flow (oxygen time<4 h/d, oxygen flow>6 L/min) can obviously decrease the degree of pulmonary compression after oxygen therapy for 5 days, shorten duration of hospital stay and duration of recruitment maneuvers, but the results are influenced by the number and quality of RCT.

Objective To explore the status and related influencing factors of disaster preparedness for ICU nurses and provide reference for carrying out learning and training of the knowledge of specialized disaster rescue. Methods With convenience sampling of network questionnaire, ICU nurses in two Fujian province hospitals attended the investigation. Results A total of 347 valid questionnaires were recovered. The score of ICU nurses disaster preparedness score was 146.32 ± 38.71. located in the middle level. Sex, working years, educational background, disaster relief experience, disaster knowledge and skill training were the main factors influencing the disaster preparedness of ICU nurses (t=-4.190-2.682, P＜0.01). Conclusions The level of disaster preparedness degree for ICU nurses was not optimistic. It was necessary to actively formulate and improve targeted training of disaster nursing theory knowledge and disaster nursing skills drills, so as to effectively promote the disaster preparedness of ICU nurses.

From the view-point of a front-line research team in clinical laboratory medicine , the advantages of microfluidic technology and its prospect in the field of in vitro diagnosis ( IVD) were reviewed in this paper. This paper introduces the application of microfluidics in molecular diagnosis , immune detection and microbial pathogen testing , showing the value of this technology in meeting challenges posed by clinical laboratory medicine .Opportunities and challenges of microfluidic IVD technology under the new situation were also discussed.The authors believe this technology will play a great role in promoting the improvement of clinical laboratory technology .

Objective To investigate the clinical value of homemade uniform drainage system and application results in continuous lumbar drainage of cerebrospinal fluid. Methods A total of 75 patients underwent continuous lumbar cistern drainage of cerebrospinal fluid in patients with mechanical sampling were randomly divided into two groups, the control group (35 cases) using the traditional methods of continuous lumbar cistern drainage, the test group (40 cases) with self-designed uniform drainage device, compared with two groups of 24 hours from fluid volume flow control and the incidence of adverse reactions and the workload of nurses. Results The drainage rate equilibrium, the frequency of inspections and time respectively and the incidence of adverse reaction were (1.07 ± 0.35)/h, (23.67 ± 7.23) min/d and 5.00%(2/40) in the test group, less than that in the control group (2.14 ± 0.83)/h, (48.54 ± 11.69) min/d and 25.71%(9/35), there were significant differences (t=8.547, 7.641, χ2=16.347, all P <0.05). Conclusions In order to control the workload of nurses and reduce the incidence rate of adverse reactions, it is worth to promote the application of the continuous lumbar cistern drainage.

Objectives To detect the cord blood vitamin D level in neonates and to determine the association between the cord blood vitamin D level and neonatal outcomes. Methods A total of 223 eligible mother-and-singleton-offspring pairs were recruited. The information of mothers' pregnancy was collected by questionnaires. The weight, length, and head circumference of neonates were measured. The levels of 25(OH)D in cord blood of neonates and in blood of late pregnancy mothers were determined by chemiluminescence immunoassay. Results The median concentration of 25(OH)D in cord blood was 20.7 nmol/L, and 82.1% of neonate had vitamin D deficiency, and 12.1% had severe vitamin D deficiency (<10 nmol/L). The concentration of 25(OH)D in cord blood was consistent with that in blood of late pregnancy mother. The distribution of concentration of 25(OH)D in cord blood was significantly different in neonates in different seasons of birth (P<0.05). There were more cases <10 nmol/L in winter and spring. The concentration of 25(OH)D in cord blood had no significant associations with the incidences of low birth weight (LBW) and small for gestational age (SGA) (P>0.05). After the variables of sex, gestational age and birth season are controlled, the birth weight and head circumference were significantly different in neonates with different concentrations of 25(OH)D in cord blood (P<0.05). Conclusions The concentration of 25(OH)D in cord blood in term neonates was generally lower. The vitamin D status in neonates was consistet with that in their late pregnancy mothers. Cord blood 25(OH) D levels were associated with neonates' birth weight and head circumference, but it should be confirmed by larger sample size in the future.

Objective To explore the effect of motor imagery therapy and its combination with counterbalance exercise on the fall efficacy of elderly people.Methods Totals of 156 eligible elderly people with fear of falling ( FOF) were selected as objects and randomly divided into three groups. The first group was the control group, treated with routine rehabilitation nursing. People in the second group were treated with routine rehabilitation nursing plus motor imagery therapy. People in the third group were treated with routine nursing plus motor imagery therapy, combined with counterbalance exercise. The intervention lasted for 2 weeks. People in the three groups were assessed by fall efficacy and depression scales before and after the intervention. Results Regarding fall efficacy before and after the intervention, there were not significant differences in the control group [(3.79±1.46) points vs. (4.01±1.35)points, t=0.798, P>0.05)], or in the second group [(3.88±1.86) vs. (4.38±1.14), t=1.653, P>0.05)], but there was significant difference in the third group [(3.91±1.54) vs. (5.75±1.43), t=6.314, P<0.01)]. As for depression scores before and after the intervention, there was not significant difference in the control group [(56.68±8.64) vs. (54.21±8.28), t=1.489, P>0.05)], but there were significant differences in the second group [(55.58±7.42) vs. (47.45± 6.89), t=5.790, P<0.01)], and in the third group [(56.23±6.54) vs. (46.23±7.21), t=7.408, P<0.01)].Conclusions The motor imagine therapy alone can not significantly improve fall efficacy of the elderly with FOF, but can significantly reduce their depression. Combined use of motor imagery therapy and counterbalance exercise can significantly increase their fall efficacy and reduce their depression.

Objective To explore the path relationship of working stress , self-esteem and the sense of achievement for acute critical care nurses .Methods Using the method of convenient sampling , a questionnaire survey was conducted on 265 emergency nurses and ICU nurses . The questionnaire included general information , nurse burnout scale , self-esteem scale and nurse stress scale .Results Totals of 265 questionnaires were distributed, and 255 questionnaires were returned , with an effective rate of 96.2%.The scores of stress scale for nurses who worked for one year , two-five years and over five years were (3.03 ±0.40), (3.12 ± 0.54) and (3.06 ±0.39), respectively.There was a significant difference among groups (F=23.534,P=0.00).The scores of self-esteem for nurses who worked for one year , two-five years and over five years were (19.87 ±2.17), (20.19 ±1.98) and (18.93 ±2.87), with a statistically significant difference (F=21.391, P=0.00) .The scores of working achievement for nurses who worked for one year , two-five years and over five years were (4.18 ±1.64), (4.25 ±1.43) and (4.20 ±1.63), and the difference was significant (F =18.733, P=0.00).There was a negative correlation between the critical nurses'working achievement and working stress (r=-0.317, -0.271, -0.211, -0.231, -0.356, respectively;P <0.05), and the working achievement and the self -esteem was positively related (r=0.357,P<0.01).The self-esteem was not completely intermediary between working stress and working achievement , and the indexes of model fitting were χ2/df=1.244,P=0.305, RMSEA=0.019, NFI=0.977, RFI=0.984, IFI=0.987, TLI=0.960, CFI=0.937.Conclusions Self-esteem plays a significant intermediary role between working stress and working achievement for acute and critical care nurses .

Objective To explore the relationship between functioning mechanisms of self-efficacy and perceived social support in stress and maladjustment among intensive nurses .Methods A total of 446 intensive nurses were assessed by general information questionnaire , General Self-efficacy Scale(GSES), Perceived Social Support Scale ( PSSS ) , General Maladjustment Scale ( Gm ) , and Chinese Nurse Stressor Scale ( CNSS ) . Results The scores of Gm were positively correlated with the scores of CNSS (r =0.466,P <0.05), and negatively correlated with the scores of GSES and PSSS ( r=-0.205,-0.333,respectively;P<0.05).Self-efficacy had an obvious effect on mediating between stress and maladjustment ( P <0.05).Perceived social support had an obvious effect on mediating and moderating between stress and maladjustment ( P <0.05). Conclusions Self-efficacy among intensive nurses can mediate the effects of stress on maladjustment .Perceived social support can mediate and adjust the effects of stress on maladjustment .

The paper described the practice of contingency nursing management for ICU wards in case of power breakdown in the hospital The SICU wards have developed their power failure contingency plan in which the nurses on duty are divided into Group A,B and C according to their positions and qualifications.Respectively,they take charge of patient safety,coordination and command,and medical aid.We also established the procedure of emergency response for these duties.Training and examination familiarize the medical personnel with the procedure and their duties.Four practices proved that the implementation of the plan reduces risks exposure and improves the satisfaction.With the contingency plan,the nurses in ICU can now take care of critical incidents and avoid nursing risks in ICU efficiently.