Objective:To investigate the effect of self-help cognitive behavioral intervention on the recovery of patients with generalized anxiety disorder.Methods:A total of 123 patients with generalized anxiety disorder were recruited from a comprehensive hospital in Hunan province. The patients were randomly assigned into control group( n=62) and intervention group( n=61) according to random number table. The patients in the control group were received routine treatment alone, while the patients in the intervention group were received routine treatment and WeChat-based self-help cognitive behavioral therapy. The generalized anxiety disorder(GAD-7), self-rating depression scale(SDS), WHO quality of life scale(WHOQOL-BREF), Pittsburgh sleep quality index(PSQI) and medication adherence scale(MARS) were used to measure the anxiety, depression, quality of life, sleep quality and medication compliance at three time points: before intervention (T1), after intervention (T2) and during follow-up (T3). The SPSS 21.0 was used to analyze the data.Mean±standard deviation, frequency and constituent ratio were used to describe the data based on the type of data. Repeated measure ANOVA was used to compare the between-group variation, time effect and interaction effect of two groups at 3 time points. Results:The anxiety score of intervention group at T1, T2, T3 were (12.74± 2.02), (7.13± 1.48), (6.57±1.73) respectively, and the anxiety score of the control group were (12.08±2.11), (11.11±3.27), (10.11±3.33) respectively. Compared with the control group, the score of anxiety in the intervention group was significantly decreased at T2 and T3 ( P<0.05). Compared with control group, the sleep quality and quality of life of intervention group were significantly improved at T2, T3 ( P<0.05), and the medication compliance of the intervention group was significantly improved at T3 ( P<0.05). Conclusion:Self-help cognitive behavioral intervention can decrease anxiety significantly and improve the quality of life, sleep quality, and medication compliance in patients with generalized anxiety disorder.

Objective:To explore the effects of micro-class combined with closed-loop modularized teaching in practical course of emergency nursing.Methods:From March to July 2018, this study selected nursing students of four classes in Grade 2016 of Xianyang Vocational Technical College as subjects by convenience sampling. All of nursing students were randomly divided into observation group ( n=160) and control group ( n=162) with the method of tossing a coin by classes. Control group carried out the routine teaching, while observation group applied the micro-class combined with closed-loop modularized teaching in practical course of emergency nursing. This study compared the nursing students' examination scores and recognition on teaching model between two groups. Results:At the end of practical course of emergency nursing, the theoretical and operation achievements of observation group were (85.59±7.24) and (88.34±5.62) respectively higher than those of control group with statistical differences ( t=-6.308, -7.008; P<0.05) . Recognition of observation group on teaching model was higher than that of control group also with a statistical difference ( P<0.05) . Conclusions:Micro-class combined with closed-loop modularized teaching can improve the learning effects of nursing students in practical course of emergency nursing and is recognized highly by nursing students which is worthy of generalization and application.

Objective To investigate the antimicrobial resistance and distribution of klebsiella pneu‐moniae in Shandong Provincial Hospital and to provide a reference for clinical treatment. Methods The specimens collected in our hospital from January 1,2015 to December 31,2017 were cultured. The drug sensi‐tivity test was carried out according to the unified scheme by paper diffusion method or automated instrument method. The results were interpreted according to the CLSI 2014 M100‐S24,and the data were analyzed by using WHONET5. 6 software. Results From 2015 to 2017,a total of 79 615 specimens were sent to the hos‐pital for bacterial culture,and 2 159 strains of klebsiella pneumoniae (non‐repeat bacteria) were isolated,with a separation rate of 9. 87%, 9. 23% and 9. 98%, respectively. The detection rates of extended spectrum β‐lactamase(ESBLs)‐producing klebsiella pneumoniae strains were 37. 97%,43. 57% and 40. 87% respec‐tively. The specimens were mainly separated from sputum,blood,urine,skin soft tissue,ascites and cerebro‐spinal fluid. Except for the slight decrease in ESBLs‐producing rate of klebsiella pneumoniae in sputum cul‐ture specimens in 2017,other specimens showed an increasing trend year by year,especially in blood culture specimens. The ESBLs production rate of klebsiella pneumoniae increased from 24. 53% in 2015 to 55. 00%in 2017. The drug resistance rate of ESBLs‐producing strains to various antibacterial drugs was significantly higher than that of non‐ESBLs producing strains. ESBLs‐producing klebsiella pneumoniae had a high drug re‐sistance rate to most antibiotics,and it was most sensitive to carbapenems,with drug resistance rates lower than 17%. However,the rate of carbapenem‐resistant showed a rapid rise. Conclusion Klebsiella pneumoni‐ae is a common pathogenic bacteria in clinical practice, and the drug resistance rate of ESBLs producing strains is high. Strengthening the monitoring of bacterial resistance and infection control measures are very important for the effective treatment of bacterial infection.

With the continuous development of health care, people's awareness of health care is gradually enhanced. Pain has become an important part of disease rehabilitation and nursing. The research and evidence of pain assessment and management are increasing year by year. As the most direct assessor and manager of patients' pain, it is particularly important for nurses to identify and effectively manage different types of pain as soon as possible. In this background, the Registered Nurses' Association of Ontario (RNAO) released Clinical Best Practice Guidelines:Assessment and Management of Pain(Third Edition)in 2013. This article mainly introduces the development, application scope, methodology, main content, quality evaluation and subsidiary information of the guide.

Objective: To study the antiemetic effect of the ethyl acetate extract with ethanol extraction of Galangal (hereinafter referred to as galangal extract) in allotriophagic Kaolin model rats.Methods: The rats were administered respectively with chemical drug cisplatin and apomorphine, and received the rotation stimulation as well.Three types of allotriophagic Kaolin models were established, and apomorphine, ondansetron and metoclopramide were used as the control drugs.The experimental rats were divided into 3 groups at low, medium and high dose of Galangal extract with prophylactic effect.The antiemetic effect was observed after the treatment.Results: Chemical drug cisplatin (3.0 mg·kg-1, intraperitoneal injection) and apomorphine (3.2 mg·kg-1,subcutaneous injection) and the rotation stimulation (centrifugal force of 3.4×g,60min) could induce allotriophagic vomiting in rats.The galangal extract at low (1 500 mg·kg-1), medium (4 500 mg·kg-1) and high (9 000 mg·kg-1) dose all fail to effectively inhibit the allotriophagic Kaolin behavior of rats caused by cisplatin, apomorphine and rotation(P>0.05).Conclusion: Galangal extract can not effectively inhibit the vomiting of allotriophagic Kaolin model rats.Probably, there is no correlation between the pharmacological effects of galangal extract and substance P, 5-hydroxytryptamine, dopamine as well as receptive zone of chemical vomiting inhibition.

The aim of this review is to realize the significance of physical activity for colorectal cancer survivors, collect the common tools to assess colorectal cancer patients' physical activity, understand the current status and its influencing factors of colorectal cancer patients' physical activity as a reference to Chinese relevant research and provide a basis for carrying out medical or nursing intervention.

Objective To analyze and provide reference for developing clinical practice guidelines of ostomy care suitable for the domestic health care settings. Methods Content analysis method was used to analyze clinical practice guidelines searched from the Internet. Results A total of 13 clinical practice guidelines were included. All the guidelines were published between 2005 to 2016 without update. Four of them were evidence-based guidelines, the rest were not. A total of 21 items were identified as being related to ostomy care. Conclusions Although the existing clinical practical guidelines are instrumental to guiding clinical ostomy care practice, most of them were not evidence-based guidelines without high methodological quality. Meanwhile, some guidelines lack specific and updating recommendations for ostomy care, which may cause problems in ostomy care practice. What′s more, some recommendations may not suit for China because they were made in the foreign circumstance. Researchers and clinical nurses should develop local practice guidelines of ostomy care with consideration of the actual medical conditions in China and the best evidence.

To analyze colostomy patients′bowel function assessment tools and application status by describing the bowel function characteristics of colostomy patients and making a summary of colostomy patients ′bowel function through the literature research .The purpose of this article is to provide the reference for measurement of colostomy patients by thinking the application problems of bowel function assessment tools .

This study aims to develop a liquid chromatography with tandem mass spectrometry (LC-MS/MS) method for the simultaneous determination of ivabradine and N-demethylivabradine in human plasma, and investigate effects of stable isotope labeled (SIL) internal standard (IS) on ivabradine. The analytes and IS were extracted from plasma by protein precipitation with acetonitrile, and chromatographied on a Capcell PAK C18 (100 mm x 4.6 mm, 5 μm) column using a mobile phase of methanol and 5 mmol x L(-1) ammonium acetate. Multiple reaction monitoring with electrospray ionization (ESI) was used in the positive mode for mass spectrometric detection. The effect of ivabradine isotope peak [M+H+3] + on IS and the effect of SIL IS purity on ivabradine were evaluated. An appropriate concentration of SIL IS was chosen to permit method selectivity and linearity of the assay over the required range. The standard curves were demonstrated to be linear in the range of 0.100 to 60.0 ng x mL(-1) for ivabradine, and 0.050 0 to 20.0 ng x mL(-1) for N-demethylivabradine. The intra and inter day precision and accuracy were within the acceptable limits for all concentrations. Besides, the interaction between IS and ivabradine did not impact the determination of analytes. This method was successfully applied to a pharmacokinetic study of hydrogen sulfate ivabradine sustained release tablets on Chinese healthy volunteers.

AAV-ITR single strand DNA mini vector (AAV-ITR ssDNA mini vector) is a novel gene expression vector based on AAV-ITR. We have shown efficient gene expression of AAV-ITR ssDNA mini vector in HEK 293T. Here, we studied the efficacy of gene expression of AAV-ITR ssDNA mini vector in vivo. We injected the skeletal muscle of ICR mice separately with equal molars of AAV-ITR ssDNA mini vector, ITR mutated AAV-ITR single strand DNA mini vector (AAV-ITRmm ssDNA mutant vector), AAV-ITR dsDNA and pUC57-minivector-GFP, combined with TurboFect. Florescence microscope analysis of skeletal muscle section shows that AAV-ITR ssDNA mini vector had higher expression efficiency and longer expression period. We extracted DNA from the muscle three months after injection and quantified three vectors by Real-time PCR. RT-PCR analysis shows that there were highest copy numbers of AAV-ITR ssDNA mini vector existing in muscle. Stable existing of AAV- TR ssDNA mini vector in muscle could be the molecular basis of long term gene expression of the vector. The results suggest that AAV-ITR ssDNA mini vector might be a promising vector for gene therapy.
Animals ; DNA, Single-Stranded ; genetics ; Dependovirus ; genetics ; Gene Expression ; Genetic Therapy ; Genetic Vectors ; Mice ; Mice, Inbred ICR ; Muscle, Skeletal ; metabolism ; Real-Time Polymerase Chain Reaction