Objective:The effect of Xuan Bi Decoction on inhibition of cyclooxygenase-2(COX-2)pathway on inflammation in rats with acute gouty arthritis(GA).Methods:Sixty SD rats randomly allocated into control group,model group,celecoxib group(20 mg/kg),Xuan Bi Decoction low-dose group(5 g/kg),Xuan Bi Decoction medium-dose group(10 g/kg),Xuan Bi Decoction high-dose group(20 g/kg),with 10 rats in each group.The classic method of Coderre was used to establish a rat gout model and observe the general condition of each group of rats;analysis of rat gait scores and joint swelling of rats;the histopathological growth of rat ankle Sy-novial membrane were observed by HE staining;the levels of inflammatory factors IL-1β,TNF-α,PGE2 and LTB4 in rats joint fluid were detected by ELISA;Western blot detection of PGE2 receptor 2(EP2)and LTB receptor 1(BLT1)expressions in rats ankle syno-vial tissue;qRT-PCR to detect the effect of mRNA expression of COX-2 and 5-lipoxygenase(5-LOX).Results:Rats in the model group had swollen joints,lameness,lusterless fur and mental lethargy;the rats in the celecoxib group and Xuan Bi Decoction low,medium and high dose groups showed effective improvement in related symptoms;compared with control group,the gait score,degree of joint swelling,degree of histopathology,IL-1β,TNF-α,PGE2,LTB4,COX-2,5-LOX,EP2 and BLT1 levels of the rats in the model group were significantly higher(P<0.05);compared with the COX-2 inhibitor celecoxib,Xuan Bi Decoction(20 g/kg)showed better anti-arthritic properties in rats treated with MSU crystals,accompanied by reduced expression of IL-1β,TNF-α,PGE2,LTB4,COX-2,5-LOX,EP2 and BLT1.Conclusion:Dual inhibition of COX-2 and 5-LOX by Xuan Bi Decoction in GA rats to improve MSU crystal-induced inflammation and may serve as a novel therapeutic strategy.

Objective:To investigate the effect of biological maternal sounds on blood gas analysis index, mechanical ventilation time, oxygen therapy time and hospital stay in mechanically ventilated children with severe pneumonia.Methods:This study was a randomized controlled trial. From June 2020 to November 2020, 128 mechanically ventilated children with severe pneumonia in Hunan Children′s Hospital were selected by convenient sampling method and divided into four groups with 32 cases in each group by random number table method. Group A was given routine nursing care, group B was given mother sounds, group C was given mother cardiotone, group D was given biological maternal sounds. Data of blood gas analysis index, mechanical ventilation duration, oxygen therapy duration, hospital stays were collected for comparative analysis.Results:Finally, group A, B, C, and D included 28, 30, 28 and 28 cases, respectively. There was no statistically significant difference in PaO 2 among the four groups on the 1st to 2nd day after intervention ( P>0.05), but PaO 2 on the 3rd to 7th day after intervention were (75.57 ± 12.88), (77.71 ± 15.81), (78.21 ± 14.51), (78.64 ± 17.71), (79.04 ± 11.57) mmHg (1 mmHg=0.133 kPa), (81.71 ± 17.89), (82.93 ± 18.36), (82.68 ± 15.47), (83.25 ± 14.24), (83.77 ± 13.90) mmHg, (80.89 ± 18.78) (82.11 ± 13.34), (82.96 ± 14.20), (83.43 ± 14.37), (83.68 ± 12.64) mmHg, (84.54 ± 18.77), (86.29 ± 10.94), (86.96 ± 10.53), (87.46 ± 12.64), (89.08 ± 12.21) mmHg, with statistically significant differences ( F values were 41.17 - 332.68, all P<0.01). Further pairwise comparison revealed that PaO 2 in group B and group C were higher than those in group A on the 3rd to 7th day after intervention, while those in group D were higher on the 3rd to 7th day after intervention than those in group A, B, and C, with statistically significant differences( t values were 3.35- 4.75, all P<0.01). There was no statistically significant difference in PaCO 2 among the four groups on the 1st to 4th day after intervention ( P>0.05), but PaCO 2 on the 5th to 7th day after intervention was (47.31 ± 2.89), (46.18 ± 2.06), (41.94 ± 2.09) mmHg, (44.73 ± 1.76), (41.38 ± 1.30), (38.33 ± 1.16) mmHg, (44.81 ± 1.24), (41.23 ± 1.89), (38.73 ± 2.55) mmHg, (40.83 ± 1.78), (37.87 ± 1.43), (34.78 ± 2.05) mmHg, with statistically significant differences ( F=29.48, 36.12, 34.52, all P<0.05). Further pairwise comparison revealed that PaCO 2 in group B and group C were lower than those in group A on the 5th to 7th day after intervention, while PaCO 2 in group D were lower than those in groups A, B, and C, with statistically significant differences ( t values were 3.37-4.85, all P<0.01). During the analysis of PaO 2 and PaCO 2 in the four groups at different time points, the interaction effects were not statistically significant ( P>0.05). There was no significant difference in invasive mechanical ventilation duration, non-invasive mechanical ventilation duration and hospital stay among the four groups after intervention ( P>0.05). The oxygen therapy time of the four groups were (8.61 ± 6.40), (6.17 ± 4.80), (6.23 ± 2.75), and (3.75 ± 2.10) days, with statistically significant differences ( F=17.27, P<0.01). Further pairwise comparison revealed that the oxygen therapy time in group B and group C was shorter than that in group A, while group D was significantly shorter than that in groups A, B, and C, with statistically significant differences ( t values were 4.02-4.74, all P<0.01). Conclusions:Biological maternal sounds is superior to maternal sound and mother cardiotone in improve the blood gas analysis index, shorten the oxygen treatment time, which is worthy of clinical promotion in neonatal unaccompanied ward.

Objective:To explore the effect of knowledge-clinical-sharing (KCS) model in humanistic care training of pediatric nurses.Methods:A total of 182 specialist nurses who were trained in Hunan Children's Hospital from June 2019 to December 2019 were selected as the research objects. Among them, 102 specialist nurses from June 2019 to August 2019 were selected as the control group, and 80 specialist nurses from September 2019 to December 2019 were selected as the intervention group. The Jefferson empathy scale was used to compare the effect of humanistic training before and after the implementation. SPSS 22.0 statistical software was used, measurement data were test by F-test and t-test, and the counting data were analyzed by Chi-square test. Results:After the implementation of humanistic care training based on KCS model, the empathy ability score of the intervention group was higher than that of the control group [(80.23±5.33) vs. (78.14±4.37)], and the difference was statistically significant ( P < 0.01). There was no significant difference between neonatal and pediatric specialist nurses before and after the training. Conclusion:The phased humanistic training based on KCS model can improve the empathy ability of pediatric nurses and enhance their confidence in the clinical implementation of humanistic care. However, the humanistic training mode of pediatric nurses should be improved according to the hospital's own situation, so as to adapt to the development of nursing industry.

Objective:To deeply understand the real emotional experience and needs of the parents of dying newborns, so as to provide a reference for future neonatal palliative care.Methods:From February to October 2021, purposeful sampling was used to select 15 parents of dying newborns in the Department of Neonatology of Hunan Children's Hospital as the research object. A qualitative research design was conducted, and the semi-structured interview method was used to conduct in-depth interviews with the research subjects, and NVivo 10.0 software was used for data analysis.Results:A total of 3 themes were extracted, namely, the ambivalence when giving up treatment, negative life effects after giving up, needs and expectations.Conclusions:Parents of dying newborns generally have ambivalence when they give up treatment. After giving up, they will show emotions such as sadness and helplessness, self-blame and regret, and depression. Understanding the real emotions and inner needs of the parents of dying newborns helps medical and nursing staff to pay attention to parents' negative psychology and understand their needs, and provide parents with targeted psychological support and other care, so as to help the parents of dying newborns and their families through a special period.

Objective:To analyze the effect of comprehensive nursing education on anxiety, depression, quality of life and survival of patients with hepatocellular carcinoma (HCC) after surgery.Methods:A total of 136 HCC patients were randomly divided into two groups: general nursing education group and comprehensive nursing education group. The comprehensive nursing education group carried out 12 months of health belief education, psychological care, care activities and telephone condolence. The routine nursing group received basic education for 12 months. The changes of anxiety and depression were assessed by hospital anxiety and depression scale (HADS). The quality of life (QOL) of participants within 12 months was assessed using the European research and treatment cancer quality of life questionnaire (QLQ-C30). The 3-year survival of the two groups was compared.Results:There was no significant difference between the two groups in baseline data. At the 9th and 12th month, the HADS-A score of the comprehensive nursing education group was significantly lower than that of the general nursing group ( P< 0.05). In the 12th month, the overall health of QLQ-C30 in the comprehensive nursing education group was better than that in the general nursing group ( P<0.05). The QLQ-C30 function score of the comprehensive nursing education group at the 12th month was better than that of the general nursing group ( P<0.05). There was no significant difference in QLQ-C30 symptom scores between the two groups at all time points ( P>0.05). The overall survival of the patients in the comprehensive nursing education group was better than that in the general nursing group ( P=0.026). Conclusion:the comprehensive nursing education can reduce the anxiety and depression of HCC patients after surgery, and can improve their quality of life and survival.

Objective:To perform principal component analysis on the status quo of nurses' research ability, and explore the status quo of their relevant research needs.Methods:In this cross-sectional study, totally 588 clinical nurses working in a children's hospital in Hunan Province from July to December 2019 were selected by stratified random sampling and investigated with the self-designed questionnaire. The survey content included three parts: the first part was general information; the second part was the survey of the status quo of nurses' research ability; the third part was the survey of the status quo of nurses' research needs. A total of 588 questionnaires were distributed, and 577 questionnaires were collected, accounting for an effective recovery rate of 98.13%.Results:The three items with the higher scores in the survey of research ability status were frequently search for professional materials through the Internet (3.255±0.491) scores, able to perform statistical description (2.931±0.572) scores and able to use Chinese database (2.894±0.429) scores. The three items with the higher need for research ability were project application 80.94% (467/577) , paper writing 76.95% (444/577) and special lecture 71.92% (415/577) , whereas the three items with the lower need for research ability were continuing learning 46.10% (266/577) , retrieving documents 40.90% (236/577) and group symposium 38.30% (211/577) .Conclusions:Nursing staff has relatively good ability in information retrieval and basic statistics, but relatively poor ability in paper writing. The research ability of nurses can be summarized as statistical analysis ability, information retrieval/document reading ability, research topic selection ability and paper writing ability. Attention should be paid to whether there are high research needs in the weak links of research ability, and nursing research guidance and education should be provided purposively.

Objective To explore effective methods to improve specialized nurses' professional ability and standardize the post management. Methods Since 2015, Hu'nan Children's Hospital has adopted the the three-level (including the national, provincial and hospital level) specialized nurses training and management program to cultivate the hospital-level specialized nurses in neonatology, intensive care, infection and other departments. The training program was carried out in three-level, including the whole hospital, big departments and their own department (small departments). The assessment of the program also covered three parts, including the specialized theoretical knowledge, technical and academic competence. From 2015 to 2016, the professional academic ability and the development of professional technique were censused. The development speed with link relative method and the comparative growth on moving base of specialized nurses' academic and technical competence were calculated. At the same time transfer rate of specialized nurses was censused. Results The qualification rate of 202 hospital-level nurses reached 95.5% in 2015, and that of 244 nurses reached 96.7% in 2016. Over the past two years, the specialized nurses have been responsible for the hospital-level nursing rounds and consultation for 11 times and the department-level nursing ward rounds for 209 times. A total of 19 new technique projects have been approved by the hospital, and 7 hospital-level and above-hospital-level projects have been set up. The number of the overview published have reached 153 and that of published scientific articles beyond the hospital was 231. Conclusions The three-level (including the national, provincial and hospital level) training and post management program of specialized nurses can effectively improve the ability of specialized nurses from the children's hospitals, promote the stability of specialized nursing team, and guarantee the improvement of the quality and influence of specialized nursing.

Objective Baseline investigation was conducted on the current situation of intravenous infusion treatment in a Class Ⅲ Grade A children's hospital in Hu'nan Province, and the quality improvement was carried out according to the investigation results, and explored the quality improvement effect. Methods The baseline investigation on intravenous infusion treatment was conducted in a Class Ⅲ Grade A children's hospital in Hu'nan Province in September 2016. A total of 558 children from 18 clinical departments were selected as research subjects by random number table method. Quality improvement was carried out according to the survey results. A total of 1 088 cases of children undergoing intravenous treatment were investigated for the second round in September 2017. The infusion site, puncture tool, catheter fixation, catheter related complications, catheter maintenance and connection mode were compared before and after quality improvement. Results The selection of infusion sites before and after quality improvement meets the requirements. The usage rate of indwelling needle increased from 88.5% to 94.4%, and the usage rate of spiral joint increased from 56.6% to 73.8%. Both the differences were statistically significant (χ2=78.38, 50.0;P＜0.05). After quality improvement, the incidence of catheter missing was decreased from 92.5% to 82.5% when nurses performed catheter maintenance, with statistical significance (χ2=30.1,P＜0.05). Conclusions By practicing standards for clinical venous treatment, strengthening training, and carrying out process quality control, the quality of work for nursing staff in the selection of infusion tools and the control of complications of indwelling catheters has been significantly improved.

Objective To study the effectiveness of family-integrated-care (FICare) for preterm infants with moderate to severe bronchopuhnonary dysplasia (BPD) in neonatal intensive care unit (NICU).Method Preterm infants with moderate to severe BPD in Hunan Children's Hospital from January 2015 to March 2016 were selected as the objects.These infants were assigned into two groups (FICare group and control group) in the base of whether the parents agreed to implement FICare.If the infant was enrolled into FICare group,the parents need to spend 3 hours in ward every day,and participate in nursing services under the guidance of nurses.The nursing services included bathing,cuddling,skin care,breast-feeding,and so on.If the infant was enrolled into control group,these nursing services were implemented by nurses.Oxygen exposure time,breast-feeding rate,time of begin oral feeding,time of total oral feeding,weight growth rate during hospitalization,weight of discharge,length of stay,readmission rate within 30 days,the rate of parents that mastered basic care knowledge and skills when discharge from hospital,the rate of satisfaction,and the rate of follow-up within 30 days of the two groups were compared.Result There were 106 cases in our study,54 in the FICare group and 52 in the control group.Compare the FICare group and the control group,there were statistical differences between two groups in the follow aspects (all P ＜ 0.05):oxygen exposure time [(57.1 ±20.9) d vs.(71.4 ±32.6) d],breast-feeding rate (77.8％ vs.44.2％),time of total oral feeding [(46.1 4 19.6) d vs.(59.4 ± 30.2) d,length of stay [(65.8 ± 18.4) d vs.(84.3 ±35.0) d],the rate of parents that mastered basic care knowledge and skills when discharge from hospital (96.3％ vs.82.7％),the rate of satisfaction (94.4％ vs.84.6％),the rate of follow-up within 30 days (92.6％ vs.73.1％).Conclusion FICare could significantly reduce oxygen exposure time of preterm infants with moderate to severe BPD,could improve the level of parents mastered basic care knowledge and skills of preterm infants,especially in critically ill preterm children,and could shorten length of stay of them.FICare is beneficial to the healthy growth of premature infants with BPD.