Objective:To investigate the effect of applying narrative therapy theory into game on improving the quality of bowel preparation in children, and to provide a basis for selecting nursing intervention methods before bowel preparation.Methods:This study was a quasi experimental study. Totally 62 children who took polyethylene glycol electrolyte dispersion for bowel preparation in Gansu Maternal and Child Health Hospital from January to December 2021 were included in this retrospective study. They were divided into control group with 28 cases and experimental group with 34 cases according to random number table method. The control group was given conventional bowel preparation and medication guidance, and the experimental group was given the intervention during bowel preparation by applying narrative therapy theory implanted games. The bowel preparation adequacy rate, complete medication taking rate and parental satisfaction of the two groups were observed and compared.Results:The bowel preparation adequacy rate and complete medication taking rate in the experimental group were 94.12% (32/34) and 52.94% (18/34), respectively, which were higher than 46.43% (13/28) and 10.71% (3/28) in the control group, and the differences were statistically significant ( χ2 = 15.23, 10.41, both P<0.01). According to the average BBPS score, the experimental group had better intestinal cleanliness compared to the control group (7.65 ± 1.07 vs 6.07 ± 1.41, t = -4.87, P<0.01), the difference was statistically significant. 97.06% (33/34) of the parents in the experimental group expressed satisfaction, which was higher than 64.29% (18/28) in the control group, and the difference was statistically significant ( χ2 = 12.74, P<0.05). Conclusions:By applying the narrative therapy theory implanted games, the complete taking of high-dose bowel cleasing agent can be promoted and the quality of bowel preparation can be improved, which is worth suggesting as a nursing intervention method for bowel preparation.

Objective To survey on training for general practice backbone mentors in tertiary hospitals of Hebei province.Methods A questionnaire survey on training status was conducted among general practice backbone mentors in tertiary hospitals of Hebei Province.The survey items included the basic information,knowledge of general practice and its training,suggestions for mentors training and general practice discipline construction in tertiary hospitals.Results Total 208 questionnaires were distributed and 208 were retrieved with a recovery rate of 100％.Among 208 participants,all of them were over the age of 30;202 (97.1％) had bachelor degree or above;202 (97.1％) were attending doctors or above;165 (79.3％) had worked for more than 10 years;169 (81.3％) had no or little knowledge of general practice;159 (76.4％)had not received general practice training before;124 (59.6％) thought that general practitioners were not qualified as "gatekeeper" at present;and 192 (92.3％) worked in the hospitals providing standardized residency training.The training contents in general section were prioritized as clinical skills,community health service development and policy,rules for general practice standardized training,theoretical training,the present situation and countermeasure of general teaching,the doctor-patient relationship and medical ethics.The contents in training method section were prioritized as lecture series of clinical medicine,case discussion,seminar,distance education with classroom teaching.The suggestions for mentors training included:the exploration of standardized training model,perfecting continuing education system for general practice mentors,more attention to the training at community health service centers and the consummation of general practice system.The suggestions for general practice discipline construction were that more attentions should be paid by the government and the hospitals leaders,the general practice departments in tertiary hospitals should closely cooperate with community health service centers in training ofqualified general practitioners.Conclusions The specialists in tertiary hospitals of Hebei province do not have enough knowledge about general practice and do not quite understand the necessity of establishment of general practice department,so the training for general practice mentors should be strengthened and improved.Properly policy and more social resources from the government and the hospitals leaders will be helpful for construction of general practice discipline in general hospital.

Objective To investigate the influence of WeChat + family centered health intervention on the self-efficacy of elderly hypertensive patients in General clinic. Methods A total of 102 elderly hypertensive patients aged≥60 years in General clinic from February 2017 to July 2017 were enrolled.They were divided into experimental group and control group with the table of random number, with 51 cases in each group. The experimental group used the WeChat+ family centered health intervention model,while the control group adopted the traditional health education model.The changes of blood pressure and self-efficacy were evaluated before intervention, 3 months and 6 months after intervention respectively. Results There were no statistic significant difference in blood pressure and self-efficacy total score between the two groups before intervention(P>0.05). At 3 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(144.20±4.60), (80.00±5.00)mmHg(1 mmHg=0.133 kPa)in the experimental group,those of which were(154.20±7.16), (87.00±3.81)mmHg in the control group,the differences were statistically significant (t=-2.628,-2.490,P<0.05).At 6 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(141.60±6.43),(76.00±4.85)mmHg in the experimental group,those of which were(151.60± 5.94),(85.40±4.56)mmHg in the control group,the differences were statistically significant (t=-2.555,-3.158,P<0.05).There were differences in systolic and diastolic pressure in patients with different groups at different time,and the differences were statistically significant(F=18.668,18.174,P<0.01).The total score of self-efficacy at 3 months and 6 months after intervention was(30.14±0.43),(32.56±0.23)points in the experimental group and (28.14 ± 0.15), (29.40 ± 0.19) points in the control group, the difference was statistically significant(t=9.736, 23.819, P<0.05). The differences in the total score of patients′self-efficacy in different groups at different time had statistically significance (F=2 631.551, P<0.01). Conclusions The WeChat+family centered health intervention model can significantly improve the self-efficacy of the elderly patients with high blood pressure in the General clinic.

Objective To analyze the angiographic characteristics of Kasabach-Merritt syndrome (KMS) and study the value of transcatheter arterial embolization (TAE) in KMS therapy. Methods The clinical data of 36 infants with KMS treated between June 2010 and June 2016 in our hospital were reviewed retrospectively. All infants performed angiography and TAE therapy. These angiographic characteristics were analyzed by comparing with infantile hemangioma(IH).The times of TAE and the level of platelet after TAE therapy were observed. Results The angiographic characteristics of KMS were as follows: The capillary blush of KMS were ill defined with no-uniform distribution. There were a lot of very fine feeding arteries. The diameter of feeding artery was disproportionate to the volume of tumor blush because the feeding arteries were too small or fine. Normal artery was usually embedded in tumor blush. However, the angiographic characteristics of IH were different as follows:the capillary blush of IH were well defined with uniform distribution.There were about 1-4 feeding arteries.The diameter of feeding artery was proportional to the volume of tumor blush. Normal artery was not embedded in tumor blush. Tumor blush was usually located beside the normal artery. In 36 patients, 107 embolization treatments were performed. The platelet declined for 11 times and increased for 96 times after TAE therapy. The platelet count for these 96 cases increased to ≥100×109/L at(7.1 ± 2.4)days following therapy. However, the platelet level fluctuated thereafter and the average relapse time was(45.9 ± 21.8)days. All cases were followed-up ranging from 6 months to 2 years and finally received other therapies.Eight cases were cured and the other 28 cases were improved. Conclusions The angiographic characteristics of KMS are different from common infantile hemangioma. It is difficult to embolize the feeding arteries of KMS because there are a lot of very fine feeding arteries.TAE may rapidly improve the level of platelets while the long term effect was poor.It might be better to combine TAE with other medical therapies to treat KMS.

Objective To evaluate the safety and efficacy of percutaneous ethanol embolization (PEE) in treating arteriovenous malformation (AVM) of foot in children.Methods The clinical data of 11 sick children with arteriovenous malformation of foot,who were treated with PEE in authors' department during the period from January 2007 to January 2016,were retrospectively analyzed.The clinical symptoms,the type of tumor nidus,the therapeutic effect and the postoperative complications were analyzed.Results The 11 sick children included 6 boys and 5 girls,with a mean age of 9 years.Foot mass was seen in 8 children,pain in 8 children,claudication in 3 children and ischemic skin ulcer in one child.Cho Ⅲ b type was observed in 10 children and Cho Ⅱ type in one child;Yakes Ⅳ type was found in 10 children and Ⅱa type in one child.A total of 30 PEE procedures were performed,with an average of 2.7 times per case.The children were followed up for 6-48 months,with a mean of 24 months.Evaluation of curative effect showed that complete cure was achieved in 7 children and partial remission in 3 children,the effective rate was 90.9％.Treatment failure (showing no remission) was seen in one child,and no deterioration of disease was observed.Complications included transient blood oxygen decrease in operation (n=1),toe ischemia (n=1),postoperativeblister (n=1) and local skin ulcer (n=l),no severe complications were observed.Conclusion PEE is a safe and effective treatment for arteriovenous malformation of foot in children.

Objective To assess the characteristics and satisfaction of outpatients in walk-in clinic of a grade A tertiary hospital.Methods A total of 1 100 outpatients visiting walk-in clinic of the Second Hospital of Hebei Medical University during March 2016 and June 2016 were randomly selected for the questionnaire survey.The self-designed questionnaire included the general information of patients,the satisfaction degree to the walk-in clinic,to special clinics of the hospital or to community clinics and related reasons,and suggestions for further improvement.Results Total 947 valid questionnaires were received with a retrieval rate of 86.09％.Most of participants had one chronic disease (594,62.72％).The satisfaction degree of walk-in clinic (1.78) was higher than that of hospital special clinics (1.93) (P =0.010),in turn the latter(2.33)was higher than that of conmmnity clinics (P ＜ 0.001).The reasons for patient to choose the walk-in clinic were wide range of medications (389,41.08％),reliable quality (285,27.98％),short waiting time (249,26.29％) and so on.Suggestions for improvement of the walk-in clinic were further reducing the waiting time (428,45.20％),need specialists for chronic disease management (210,22.18％),raising reimbursement rate (172,18.16％) and so on.The reasons for patients to choose special clinic were need readjusting prescription (587,61.99％),special disease or drug (427,45.09％).The reasons of dissatisfaction with special clinic were long waiting time (476,50.26％),frequent transfer to multiple departments (221,23.34％),high registration fee (221,23.34％).The reasons for patients to choose community clinic were short distance (350,36.96％),better environment (350,36.96％),short waiting time (184,19.43％).The reason of dissatisfaction with community clinic were low qualification of medical staff (405,42.77％),insufficient medications (392,42.39％);distrusting the quality of drugs (263,27.77％).Suggestions for improvement of the community clinics were upgrading the qualification of medical staff (317,33.47％),enlarging drug variety (298,31.47％),improving medical environment (94,9.93％) and so on.Conclusion Most outpatients visiting walk-in clinic of grade A tertiary hospital are highly satisfied the clinic.To meet the patients' needs the primary medical unit should further improve their overall service.

Objective To summarize the nursing effect of transcatheter ophthalmic artery chemotherapy ( TOAC) in treatment of children with retinoblastoma during perioperative period. Methods From March 2009 to December 2015, 421 children hospitalized in invasive technology department of our hospital with retinoblastoma were treated by TOAC with holistic nursing method. Results All 421 children were performed TOAC successfully and discharged within 1 week. After interventional treatment, no serious complications such as leukemia, liver and kidney function and hearing impairment, etc. chemotherapy toxicity reaction appeared, and no catheter-related complications were found. Postoperative follow-up of 4-36 months, the overall eye-keeping rate was: IIRC B stage 100%, IIRC C stage 100%, IIRC D stage 78. 6%, IIRC E stage 62%. Conclusions The optimization process of postoperative nursing with the service concept of holistic nursing method can reduce the incidence of complications, draw more attention to life care, strengthen diet guidance and pain nursing, which is conducive to the rehabilitation of patients and improvement of the quality of children′life.

Objective To detect radiation-induced changes of temporal lobe normal-appearing white matter on conventional MRI following radiation therapy (RT) for nasopharyngeal carcinoma (NPC).Methods The clinical and imaging features of 75 patients with nasopharyngeal carcinoma were retrospectively analyzed,all patients were confirmed by biopsy.All patients performed conventional MRI and Diffusion-tensor imaging (DTI) examinations,and there was no abnormal finding on conventional MRI.Eighteen patients without radiotherapy were selected as the control group and fifty-seven patients with radiotherapy were as the experimental group.We divided the experimental group into five subgroups based on completion time of RT:group 1 (less than 3 months,n =16),group 2 (3 to 6 months,n =12),group 3 (6 to 9 months; n =10),group 4 (9 to12 months,n =8),and group 5 ( more than 12 months,n =11 ).The mean diffusivity ( MD),apparent diffusion coefficient ( ADC ),fractional anisotropy ( FA),radial diffusivity ( λ⊥ ) and axial diffusivity ( k ‖ ) were calculated in bilateral temporal lobe.One-way analysis of variance (one-way ANOVA) test was used for comparison among groups.Results The mean λ⊥ values of the control group and experimental groups ( group1-5 ) after radiotherapy were ( 6.075 ± 0.341 ) × 10 -4 (6.700±0.379) × 10-4,(6.976 ±0.527) ×10-4,(6.621 ±0.388) ×10-4,(6.751 ±0.460) ×10-4,(6.222 ±0.256) × 10-4 mm2/s,respectively.The mean λ ‖ values of the control group and experimental groups were (12.524±0.713) ×10-4,(11.764 ±0.574) ×l0-4,(11.842±0.471) ×10-4,(11.569 ± 0.552) × 10-4,( 12.050 ±0.614) × 10-4,( 12.100 ±0.529) × 10-4 mm2/s,respectively.The mean FA values of the control group and experimental groups were 0.452 ± 0.030,0.379 ± 0.028,0.382 ± 0.028,0.389 ± 0.032,0.388 ± 0.022,0.423 ± 0.232,respectively.The three indicators were significantly different among groups ( F =10.485,4.625,16.539,respectively,P ＜ 0.05 ). Multiple comparisons showed that λ⊥ increased significantly in group 1-4 compared with that in the control group.In group 5,λ ⊥ was not significantly different from that in the control group,λ ‖ decreased in group 1-3 compared with that in the control group,but was not significantly different in the control group and group 4-5. In all experimental groups,FA decreased significantly. MD and ADC values in experimental groups were not significantly different from those in the control group. Conclusion Diffusion tensor imaging is a noninvasive and quantitative method to detect the structural changes in WM after RT and can provide scientific evidence for the early diagnosis and intervention treatment of radiation-induced changes.

Objective To investigate the serum levels of CD147 and MMP-2 and the relationship between these proteins and colorectal tumor differentiation, Dukes stage. Methods Serum levels of CD147 and MMP-2 in 44 patients with colorectal carcinoma,28 polyp intestinal patients and 36 normal subjects were measured by ELISA. Results Serum levels of CD147(103.59±40.74pg/ml)and MMP-2(14.92±2.02ng/ml)in the cancer patients were significantly higher than those of the polyp intestinal(66.27±16.91;10:96±1.71)and normal control(63.84±18.71;10.49±1.61)(P＜0.05).The levels were associated with tumor differentiation and Dukes stage. Patients with poor differentiation had significantly higher levels of MMP-2 than those of patients with well differentiation. And Dukes C and D stage tumors had significantly higher levels of CD147 than Dukes A and B stage tumors(P＜0.05).The levels of CD147 and MMP-2 declined remarkably after one month of radical operation. Conversely, it decreased illegibly after palliative operation. The serum levels of CD147were positively correlated with MMP-2 in patients with colorectal cancer. Conclusion Elevated CD147 and MMP-2 serum levels are associated with tumor differentiation, invasion, metastasis. Dynamic alterations of serum CD147 and MMP-2 may be used as the indicators of diagnosis, the choice of operative method and the judgment of prognosis in patients with colorectal cancer.

Objective To investigate the clinical efficacy,indications and complications of transcatheter arterial embolization for the treatment of traumatic hemorrhage of liver.Methods Retrospectively analyzed 33 cases of traumatic hemorrhage of liver admitted to West China Hospital from May 1996 to May 2006.Twenty-four cases underwent hepatic arterial angiography and were diagnosed as hepatic arterial pseudoaneurysms and followed by superselective embolization of the feeding vessel with gelatin sponge and/or spring coils.Results Embolization was succeeded technically in 28 pseudoaneurysms of 24 cases.Rebleeding occurred in 2 cases and a second embolization was performed with one recovered uneventfully.The other died of rebleeding and severe abdominal infection one week after the second embolization.Fever unrelated to embolization occurred in 9 cases.Conclusion Transcatheter arterial embolization is safe,prompt and effective for the treatment of hemorrhage due to hepatic injury.(J Intervent Radiol,2007,16:226-228)