Application of artificial intelligence intestinal sound monitoring in the decision of postoperative feeding time in Crohn's patients / 中华普通外科杂志

Objective:To evaluate the impact of artificial intelligence continuous bowel sound auscultation recorder on enhanced recovery after surgery for patients with Crohn's disease.Methods:60 patients with Crohn's disease who underwent surgery in Sir Run Run Shaw Hospital , Zhejiang University School of Medicine in 2021 were enrolled in this trial prospectively. They were rendered to oral nutritional supplements (ONS) after surgery according to the hint given by artificial intelligence continuous bowel sound auscultation recorder or doctor's experience. In order to investigate the clinical value of artificial intelligence continuous bowel sound auscultation recorder.Results:the first postoperative flatus was earlier in the intervention group compared with control group [(58.3±1.5) h vs. (63.5±1.2) h, t=3.025, P=0.036], and the first ONS time was (18.3±0.3) h vs. (22.1±0.7) h, t=3.521, P=0.026; the incidence of postoperative complications in the intervention group was lower than that in the control group (3% vs. 7%, t=1.954, P=0.048) and the postoperative hospital stay was shorter [(7.2±0.4) d vs. (8.5±0.4) d, t=2.954, P=0.030]. The incidence of postoperative abdominal pain, abdominal distension, nausea, vomiting and fatigue in the intervention group was slightly lower than that in the control group, without statistically significant difference. Conclusion:In patient with Crohn's disease, the artificial intelligence continuous bowel sound auscultation recorder picks up accurate postoperative exhaust time, indicates the time of fist ONS after surgery, and shorten the postoperative hospital stay, without increase postoperative complication such as abdominal pain distension, accelerates postoperative recovery.

Relationship between uncertainty stress and occupational well-being of medical staff / 中国实用护理杂志

Objective:To understand the status of uncertainty stress and occupational well-being of medical staff in Zhejiang Province, and to analysis the relationship between them, in the context of a pandemic of novel coronavirus pneumonia (corona virus disease 2019, COVID-19).Methods:From May to June 2021, 1 028 medical staff were selected from 8 Class Ⅲ hospitals in Zhejiang Province by convenience sampling. The cross-sectional survey was conducted with the General Information Questionnaire, the Uncertainty Stress Scale and the Occupational Well-being Scale. Pearson method was used to analyze the correlation between uncertain psychological stress and occupational well-being of medical staff, and multiple linear regression was used to analyze the influencing factors of occupational well-being of medical staff.Results:The total score of uncertainty stress of 1028 medical staff was (25.62±8.92), and the total score of occupational well-being was (75.03±14.68) at a moderate level, including 48 (4.7%) participants with a high level of occupational well-being. Uncertainty stress of medical staff was negatively correlated with occupational well-being ( r=-0.46, P<0.01). Multiple regression analysis showed that working years, hospital class, interests, leisure time, personality traits, status of self-reported health and levels of uncertainty stress had statistically significant influence on occupational well-being ( t=-2.30-10.28, all P<0.05). Conclusions:The occupational well-being of medical staff in Zhejiang Province needs to be improved. Health administrative departments should formulate targeted intervention measures to enhance the ability of medical staff to cope with uncertainty stress, so as to improve the occupational well-being of medical staff.

Effects of micro video combined with situational experience on frailty and self-care activities in elderly diabetic patients / 中国实用护理杂志

Objective:To investigate the effects of micro video combined with situational experience health education program in elderly diabetic patients.Methods:Totally, 100 elderly diabetic patients were enrolled from January to December in 2018 in Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine. They were assigned to experimental group ( n=50) and control group( n=50) by random number table. The control group received routine health education, while the experimental group received micro video combined with situational experience health education program. The intervention effects were assessed by Chinese version of Tilburg Frailty Indicator and Summary of Diabetes Self Care Action. Results:Finally, 45 cases were included in the experimental group and 47 cases in the control group. There was no significant difference between the two groups before intervention ( P>0.05). After intervention, the scores of physical frailty, psychological frailty, social frailty and total frailty were (2.60 ± 1.19) points, (1.24 ± 0.87) points, (1.11 ± 0.83) points and (4.96 ± 1.76) points in the experimental group, significantly lower than in the control group (3.45 ± 1.18) points, (1.96 ± 0.86) points, (2.06 ± 0.79) points and (7.47 ± 1.57) points. The difference was statistically significant ( t values were 3.32-7.23, P<0.01); the scores of diet, exercise, blood glucose monitoring, medication, foot care dimension and total self-care activities were (20.36 ± 2.22) points, (12.02 ± 2.33) points, (5.07 ± 0.81) points, (9.98 ± 1.99) points, (7.53 ± 1.10) points and (54.96 ± 4.49) points in the experimental group, significantly higher than in the control group (18.96 ± 2.12) points, (10.47 ± 2.24) points, (3.85 ± 0.83) points, (8.62 ± 1.69) points, (6.60 ± 1.12) points and (48.49 ± 4.07) points. the difference was statistically significant ( t values were 3.10-7.25, P<0.01). Conclusions:Micro video combined with situational experience can improve frailty status and self-care activities in elderly patients with diabetes.

Design and application of unplanned extubation quality index management system based on direct data acquisition / 中国实用护理杂志

Objective:To acquire more scientific, accurate and efficient unplanned extubation (UEX) quality management data by using information technology to directly take the quality index data of unplanned extubation from the nursing medical record system.Methods:From June 2019 to August 2019, a knowledge base of pipeline management including the name of pipeline, pipeline evaluation, pipeline care measures, and reasons for unplanned extubation of pipeline was established in Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine. Through the analysis of each node of pipeline management, pipeline management system was established. And the non-planned pipeline management data set was directly collected to the nursing quality management system for statistics and analysis, which was verified.Results:In clinical application from September 2019 to september 2020, the direct collection of unplanned extubation quality index data saved 496 hours of nursing labor costs per month, and the accuracy of direct data collection increased from 95.8% (161/168) in trial operation to 100.0% (494/494). The underreporting rate of adverse events decreased to 0. Satisfaction with the application of the quality index management system for unplanned extubation was (4.35 ± 0.73) points.Conclusions:The direct collection of quality index data for unplanned extubation improves the accuracy of the data. Nurses no longer need to report unplanned extubation incidents. The clinical nursing information system and the nursing management system are interconnected to improve the management efficiency of unplanned extubation. It is worthy of application and promotion in clinic.

Quality of life and bowel function after laparoscopic proctocolectomy and ileal pouch anal anastomosis in patients with ulcerative colitis / 中华普通外科杂志

Objectives:To assess bowel function and quality of life in patients with ulcerative colitis (UC)after ileal pouch anal anastomosis (IPAA).Methods:Clinical data of 37 UC patients after IPAA between 2014 and 2017 were retrospectively analyzed at Sir Run Run Shaw Hospital School of Medicine Zhejiang University. The IBDQ and Bowel Function questionnaire were used for analyzing correlation between clinical variables and quality of life or bowel function.Results:Laparoscopic operation was performed in 12 cases at stage 2 and 25 cases at stage 3. Postoperative defecation of stage 3 patients were better than that of stage 2 ( t=6.72, P<0.05). The number of daily defecation in age >45-year-old group was more than that in <45-year-old ( t=3.49, P<0.05), and the rate of evening stool seepage in the older group was higher than in the younger group( t=5.28, P<0.05). The total score of intestinal symptoms of IBDQ in patients of pouchitis was lower than that without pouchitis ( r=0.330, P<0.05). The total score in age >45 in terms of systemic symptoms ( r=0.349, P<0.05) and emotional function ( r=0.379, P<0.05) was higher than age <45. Conclusions:Outcomes of UC patients after IPAA are satisfactory, bowel function and quality of life is related with age, and stage of IPAA affect postoperative defecation.

Development and application of quality checklist for the prevention and control of COVID-19 in fever clinic and isolation ward of the general hospital / 浙江大学学报·医学版

To develop a quality control checklist for the prevention and control of coronavirus disease 2019 （COVID-19） in fever clinic and isolation ward of the general hospital and to assess its application. Based on the relevant prevention and control plans and technical guidelines for COVID-19，Delphi method was used to identity items for evaluation，and a quality control checklist for the prevention and control of COVID-19 in the fever clinic and isolation ward was developed in Sir Run Run Shaw Hospital. The checklists included 8 dimensions and 32 items for fever clinic，7 dimensions and 27 items for the isolation ward. The appointed inspectors conducted daily quality control for each shift with this checklist. The expert authority coefficient was 0.88，the mean of the importance of each index in the quality control table was not less than 4.8，and the coefficient of variation was not more than 0.07. During the entire February 2020，8 problems were found and rectified on-the-spot with the application of the checklist. Quality inspection rate was 100% in both isolation wards and fever clinic. The compliance rate and accuracy rate of hand hygiene were 100%; the correct rate of wearing and removing protective equipment increased from 96% to 100%. During the same period，a total of 1915 patients were admitted to the fever clinic，including 191 suspected patients （all were isolated in the hospital，3 were confirmed）. There were no medical staff infected with COVID-19，no cross infection of patients and their families in the hospital. A quality control checklist for the prevention and control of COVID-19 has been developed and applied in the isolation wards and fever clinic，which plays an important role in preventing nosocomial infection.

Effect of multidisciplinary cooperation model on perioperative nursing of chronic ulcer of diabetes mellitus patients following lower extremity trauma / 中华创伤杂志

Objective:To explore the effect of multidisciplinary collaboration（MDT）mode on perioperative nursing of chronic ulcer of diabetes mellitus patients following lower extremity trauma.Methods:A retrospective case-control study was conducted to analyze the clinical data of 122 diabetes mellitus patients combined with chronic ulcer following lower extremity trauma admitted to Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from January 2015 to December 2019. There were 58 males and 64 females at age of 40-76 years［（56.0 ± 4.7）years］. The wounds were located at the heel in 10 patients，at the lateral ankle in 12，at the toe in 22，at the calf in 59 and at the thigh in 19. Sixty patients received MDT care（collaborative care group），and 62 patients received traditional care（traditional care group）. Visual analogue scale（VAS）and level of fasting plasma glucose were measured at days 1 and 3 postoperatively and on the day of discharge. Mental status of the patients was evaluated using self-evaluation of anxiety scale（SAS）and self-rating depression scale（SDS）after nursing. Area and depth of wounds was detected at postoperative 2 weeks and 1 month，and level of fasting glucose was measured again within 1 month after operation. The rate of amputation，incidence of debridement and direct suture rate were documented while hospitalized again at postoperative 1 month.Results:All patients were followed up for 0.5-3 months［（1.2 ± 0.7）months］. VAS was 1.0（1.0，2.0）points，1.0（0.0，1.0）points and 1.0（0.0，1.0）points in collaborative care group at days 1 and 3 postoperatively and on the day of discharge，compared to 2.0（2.0，2.3）points，2.0（2.0，2.0）points and 1.0（1.0，2.0）points in traditional care group（ P < 0.05）. Level of fasting blood glucose was（7.2 ± 0.8）mmol/L，（6.9 ± 0.8）mmol/L and（6.9 ± 0.7）mmol/L in collaborative care group on days 1 and 3 postoperatively and on the day of discharge，compared to（7.8 ± 0.8）mmol/L，（7.8 ± 0.8）mmol/L and（7.7 ± 0.9）mmol/L in traditional care group（ P < 0.05）. Scores of SAS and SDS were（8.4 ± 0.8）points and（11.2 ± 1.0）points in collaborative care group after nursing，compared to（8.7 ± 0.7）points and（12.3 ± 1.0）points in traditional care group（ P < 0.05）. Area and depth of wounds were（29.4 ± 3.9）cm 2 and（1.4 ± 0.4）cm in collaborative care group at postoprative 2 weeks，compared to（33.3 ± 3.6）cm 2 and（1.5 ± 0.5）cm in traditional care group（ P < 0.05）. Area and depth of wounds were（24.5 ± 3.8）cm 2 and（0.9 ± 0.4）cm in collaborative care group at postoprative 1 month，compared to（30.6 ± 4.8）cm 2 and（1.2 ± 0.5）cm in traditional care group（ P < 0.05）. Level of fasting blood glucose in collaborative care group was significantly lower than that in traditional care group at postoprative 1 month（ P < 0.05）. During hospital re-admission 1 month after operation，rate of amputation and incidence of re-debridement were 5%（3/60）and 7%（4/60）in collaborative care group，significantly lower than those in traditional care group［18%（11/62），22%（13/62）］（ P < 0.05），and direct repair suture rate was 88%（53/60）in collaborative care group，significantly higher than that in traditional care group［61%（38/62）］（ P < 0.05）. Conclusion:For chronic ulcer of diabetes mellitus patients following lower extremity trauma，MDT model is superior over traditional nursing for alleviated pain，controlled blood glucose，improved psychological state，promoted wound healing and reduced rate of amputation and incidence of re-debridement.

Standardized sputum collection increases sputum sample collection rate for novel coronavirus nucleic acid detection / 浙江大学学报·医学版

OBJECTIVE@#To evaluate the effect of standardized health education on the sputum specimen collection rate for nucleic acid detection of coronavirus disease 2019 (COVID-19).@*METHODS@#Two hundred and twenty-seven patients in fever clinics and isolation wards of Sir Run Run Shaw Hospital of Zhejiang University and 307 migrant workers returning to 5 enterprises in Shanghai from February 3 to March 14, 2020 were enrolled in the study. Through clarifying the procedures of collecting sputum specimens, making graphic/video health education materials, standardizing the contents and methods of health education, we conducted education to the subjects. The subject expectorated spontaneously or with medical assistance. For patients, the number of sampling attempts and sputum acquisition times were documented before and after the implementation of the standardized expectoration method; for the returning migrant employees in the enterprises, only the number of collected samples after the implementation of the standardized expectoration method were recorded.@*RESULTS@#A total of 378 sputum samples were collected from 227 patients. The sputum sampling rates before and after the implementation of health education were 40.9%and 58.4%, respectively (@*CONCLUSIONS@#The education for standardized sputum sample collection method can effectively increase the sputum collection rate.

Risk factors of progression to hepatocellular carcinoma in patients with hepatitis B cirrhosis under nucleoside/nucleotide analogue therapy / 中华临床感染病杂志

Objective:To explore the risk factors of hepatocellular carcinoma (HCC) in patients with hepatitis B cirrhosis receiving nucleoside/nucleotide analogues (NAs) antiviral therapy.Methods:The clinical data of 253 patients receiving NAs antiviral therapy in Zhejiang Provincial People’s Hospital from November 2014 to October 2019 were retrospectively analyzed. During treatment, HCC occurred in 116 patients. Multivariate logistic regression was used to analyze the risk factors of progression to HCC in patients with hepatitis B cirrhosis.Results:Multivariate logistic regression analysis showed that age( OR=1.094, 95% CI 1.034-1.158, P<0.01), smoking history( OR=5.056, 95% CI 1.453-17.594, P<0.05), family history of hepatocellular carcinoma( OR=6.763, 95% CI 1.253-36.499, P<0.05), Lamivudin (LAM) resistance( OR=6.097, 95% CI 1.370-27.134, P<0.05), fasting blood glucose(FBG)level( OR=7.219, 95% CI 3.716-14.024, P<0.01) were independent risk factors for the progression of hepatitis B cirrhosis to HCC; while HBV DNA negative conversion( OR=0.028, 95% CI 0.006-0.137, P<0.01) was a protective factor. Conclusions:For hepatitis B cirrhosis patients receiving antiviral therapy, drug resistance, HBV DNA, FBG levels should be closely monitored, intervention measures such as quitting smoking should be taken and NAs with high drug resistance gene barrier should be selected to prevent the occurrence of HCC.

The research progress of mobile health application in self-management intervention for cancer patients / 中国实用护理杂志

In foreign countries,the mobile health applications (mHealth APP) were widely applied and studied in self-management intervention of cancer patients.This article reviewed the theoretical framework of mHealth application APP design, the research status of mHealth APP in symptom management, behavior management, self-care, emotion management and compliance management of cancer patients′ self-management, and the research enlightenment of mHealth APP on self-management intervention of cancer patients.

Investigation of relationships among nurse work environment, organizational commitment and intent to stay / 中华医院管理杂志

Objective To investigate the status of the nurse work environment, organizational commitment and intent to stay, and explore the relationships among them, ultimately provide some references for the managers. Methods 1 168 registered nurses were recruited from seven hospitals in Zhejiang province. They were investigated with Nursing Work Environment Scale, Organizational Commitment Scale and Intent to Stay Scale. Multiple regression analysis utilized the intent to stay of nurses as the dependent variable, and the demographic data, the dimensions of work environment and dimensions of organizational commitment as the independent variables. Results The mean scores of work environment, organizational commitment and intent to stay were 2.78 ± 0.39, 2.42 ± 0.43, 3.30 ± 0.67, respectively. Among nurse work environment, organizational commitment and intent to stay,there was a significant positive correlation between any two of them. Duty, affective commitment, position of work, sufficient manpower and resources, normative commitment, leadership and ability of manager, gender, shift, housing condition (rent house), employment nature and education are the main factors for the intent to stay, which can explain 40.3% of the variations of nurse retention. Conclusions The results of the study showed that the nurse work environment and intent to work of the 1168 registered nurses were at a medium level, and the organization′s commitment was at a lower-middle level. Managers can refer to the factors affecting the intent of nurses to stay, develop retention strategies, and increase their intent to stay.

Analysis of clinical and pathological features of chronic hepatitis B patients with hepatic steatosis / 中华临床感染病杂志

Objective To analyze the clinical and pathological features of chronic hepatitis B (CHB) patients with hepatic steatosis.Methods Clinical and pathological data of 841 patients with CHB who underwent liver biopsy in Zhejiang Provincial People’s Hospital during September 2015 to September 2018 were retrospectively reviewed.One hundred and thirty five gender and age-matched pairs of steatosis and non-steatosis patients entered the analysis.Multivariable Logistic regression and rank sum test were used to analyze the clinical features and risk factors of hepatic steatosis in CHB patients .Spearman correlation test was used to analyze the correlation between hepatic steatosis and HBV DNA , hepatic inflammation and fibrosis status.Results Logistic regression analysis showed that overweight ／obesity ( χ2 ＝3.947, OR ＝1.436, 95%CI 1.005-2.051, P＜0.05) and hyperlipidemia (χ2 ＝4.277,OR＝1.803,95%CI 1.031-3.151, P＜0.05) were the risk factors for hepatic steatosis in CHB patients.There was no correlation of hepatic steatosis with serum HBeAg and HBV DNA levels (Z＝-1.762,r＝-0.011, both P＞0.05). However, hepatic steatosis was negatively correlated with inflammatory grade and fibrosis grade of the liver (r＝-0.146 and -0.192, both P＜0.05).Conclusions Overweight／obesity and hyperlipidemia are associated with steatosis in CHB patients.Hepatic steatosis may not aggravate the degree of liver inflammation and fibrosis in CHB patients.

Development and application of closed-loop execution system of drainage-tube / 中国实用护理杂志

Objective Through the design and application of the closed-loop drainage system,the whole process data is extracted from the clinical nursing information system,and the data tracking and quality management of the whole process node are carried out.Methods From October 2015 to February 2017,during the clinical application,the total number of drainage tube closed-loop data was 117 625,the whole process from the drainage tube placement to extubation could be traced,unified the name of drainage tube,statistics days by artificial to information,saved the time of nursing staff,improved the accuracy of channel statistics.The WeChat questionnaire was designed to investigate the satisfaction of nurses on the closed-loop executive system of drainage tube by using the Likert five scale.Results After improvement,saved the time for nursing staff,nurses from the original manual statistics,per capita spent 10 minutes a day to now the computer automatically crawl.After the implementation,nurses thought that the drainage tube assessment more effective overall satisfaction for(4.32±0.99)points;unplanned extubation of patients reporting process more convenient overall satisfaction for(4.22±0.80)points;application of the system more simple and more effective management overall satisfaction respectively for(4.35±0.73),(4.35±0.74)points.The transfer time was(7.85±5.10)minutes before the implementation and(4.53±3.98)min after the implementation,there was significant difference(t=5.68,P＜0.05).The color of drainage tube number was 309.3±204.8,the number of characters was 3020±1 097.Conclusions The establishment and development of drainage tube closed-loop execution system provide a reliable factual basis for clinical medical diagnosis decision;at the same time,the clinical term in classified,the description of the color and character of the drainage-tube has tended to be centralized and unified;improve the work efficiency and patient safety;the quality management system based on process management is generally effective.

The research status of the influencing factors of emergency mortality in foreign trauma patients and its implications for our country / 中国实用护理杂志

The purpose of this article is to review the trauma emergency system in foreign countries,102 references were searched through in PubMed,Wanfang Data,CNKI,and 8 related thesis searched though manual, then exclusion is not in conformity with the articles, finally into 35 references. Through the analysis of the related factors of extraction, the advantages of foreign trauma emergency system, to explore suitable for China's national conditions and trauma model of medical environment, improve the trauma team rescue ability,reduce the mortality of the patients after trauma.

Lab order administration algorithm in ICU:optimization and outcome analysis / 中华医院管理杂志

The hospital optimized the lab order administration algorithm in ICU along with full-range IT-based monitoring.The new algorithm can effectively prevent preanalytical errors and improve nurse 's satisfaction in carrying out such orders.Nurse managers should closely monitor the compliance of personal digital assistant usage and analyze the causes of error for higher compliance.With such measures, we can maximize the function to intercept potential errors of the information system, and avoid preanalytical errors ultimately.

Correlation of serum thrombin-activatable fibrinolysis inhibitor levels with liver fibrosis in patients with chronic hepatitis B / 中华临床感染病杂志

Objective To analyze the levels of serum thrombin-activatable fibrinolysis inhibitor ( TAFI) in patients with chronic hepatitis B ( CHB ) with different degrees of hepatic fibrosis , and to evaluate the value of TAFI in the evaluation of liver fibrosis .Methods Forty six patients with CHB who underwent liver biopsy from June 2016 to March 2017 in Zhejiang Provincial People' s Hospital were enrolled.According to liver fibrosis stage (S0-4), they were divided into mild liver fibrosis group (S0-1, n=16), significant liver fibrosis group (S2, n=15) and severe liver fibrosis group (S3-4, n=15).At the same time, 16 healthy subjects were randomly selected as health controls in the physical examination center of the hospital .Serum TAFI levels were analyzed in each group , and the receiver operating curve ( ROC) was used to evaluate the diagnostic value of TAFI in CHB patients with significant liver fibrosis and severe liver fibrosis (S≥2).The SPSS 23.0 software was used to analyze the data .Results Serum TAFI levels in the mild liver fibrosis group , significant liver fibrosis group , severe liver fibrosis group and health controls were (63.4 ±18.2), (43.8 ±20.4), (27.5 ±19.2) and (71.3 ±25.6) ng/mL, the difference between the four groups was statistically significant (F=13.512, P<0.01).The level of TAFI in the significant liver fibrosis group was lower than that in the healthy control group and the mild liver fibrosis group (t=3.283 and 2.822, P<0.01).The level of TAFI in the severe fibrosis group was lower than that in the significant liver fibrosis group (t=2.260, P<0.05).Serum TAFI levels were negatively correlated with liver fibrosis stage (r=-0.562, P<0.01).The area under the ROC curve of TAFI for predicting liver fibrosis (S≥2) was 0.832, and the sensitivity and specificity were 81.3％and 78.3％, respectively. Compared with the APRI score and the FIB4 index, the difference was not statistically significant ( P >0.05).Conclusion The serum TAFI level is negatively correlated with the degree of liver fibrosis in CHB patients, which has a good diagnostic value for liver fibrosis (S≥2) in patients with CHB.

The establishment and practice of the role of nurse navigator in multidisciplinary team for enhanced recovery after surgery / 中华护理杂志

In order to improve the clinical outcomes and promote the development of enhanced recovery after surgery(ERAS),a full-time specialized role of nurse navigator(NN) was established in Department of Surgery in February,2016. Clinical pathway for ERAS was designed,and role functions,core competencies and responsibilities of NN were formulated. According to the functions and the working frame,NN connected and coordinated teamwork activities,monitored the implementation of ERAS during the overall process. After implementation,the NN had dealt with 10 unusual incidents,the execution efficiency of the 14(82.4%) measurements were 100%,1 measurement was 97%,2 measurements were 94.1%,and 33 patients and 42 medical staff thought highly of the NN. This practice effectively promoted the development of ERAS team and specialist nurse role in our hospital.

The position-setting and clinical practice of informatics nurse / 中华护理杂志

In order to improve nursing informationization,and to promote the development of nursing informatics, our nursing department set up a new position called informatics nurse and a series of working systems and man-agement methods were developed. After implementation,the informatics nurse had achieved various goals,including:playing a role in developing 60 nursing information system programs,improving 11 medical and nursing process modification,collecting 399 items of nursing information system problems with 338 items solved,completing 22 nurs-ing information system using instructions,and organizing training meetings and lectures in the hospital for 12 times. The informatics nurse has been appreciated by medical staff and IT engineers who was believed to have promoted the development of nursing informatics in our hospital.

Efficacy and safety of long-term nucleos(t)ide analogue initial treatment in patients with chronic hepatitis B / 中华临床感染病杂志

Objective To evaluate the efficacy and safety of long-term nucleos (t) ide analogue treatment in patients with chronic hepatitis B (CHB).Methods Two hundred and two initially treated patients with CHB admitted in Zhejiang Provincial People's Hospital during March 2013 and August 2016 were enrolled in the study.Patients were divided into six groups according to the different antiviral therapy:adefovir group (ADV,n =43),entecavir group (ETV,n =44),lamivudine group (LAM,n =25),telbivudine group (LDT,n =23),LDT + ADV group (n =22),and LAM + ADV group (n =45).HBV DNA negative conversion rate,HBeAg serological conversion rate and estimated glomerular filtration rate (eGFR) at baseline and at 48th,96th,144th wk of treatment were measured.Chi-square test and repeated measure of ANOVA were used to analyze the data.Multivariate Logistic regression analysis was applied to detect the relevant risk factors of renal dysfunction in CHB patients.Results After treatment for 144 wks,the HBV DNA negative conversion rates in ETV and LDT group were higher than that in ADV group (both P ＜ 0.01),the levels of eGFR in ADV,ETV,LAM and LAM + ADV group were declined with time,while the eGFR levels in LDT and LDT + ADV group were increased with time (Ftime =3.939,Fgroup =3.983,P ＜0.01 or ＜0.05).After treatment for 96 wks and 144 wks,the levels of eGFR were higher in LDT and LDT + ADV group than those in other groups,respectively (all P ＜ 0.05).Multivariate Logistic regression analysis showed that age ≥40 (x2 =16.145,OR =4.452,95 ％ CI 2.149-9.223,P ＜ 0.05),mild abnormality of eGFR at baseline (x2 =16.449,OR =4.336,95％ CI 2.144-8.891,P ＜ 0.05),and ADV treatment (x2 =5.837,OR =5.280,95％ CI 1.369-20.365,P ＜ 0.05) were independent risk factors of renal dysfunction in CHB patients.Conclusion LDT long-term monotherapy or combination with ADV may improve renal function for patients with CHB,which provides a reference for long-term treatment of CHB patients with nucleos(t) ide analogues.

Application status of International Classification of Functioning, Disability and Health and domestic nursing application prospect / 中国实用护理杂志

WHO released the International Classification of Functioning, Disability and Health (ICF) in 2001. ICF is a kind of classification of multi-purpose used for different disciplines and fields, it belongs to by WHO for different applications in the field of health and to establish the international classification of family, it is a tool for internationally accepted, its overall goal is to provide a unified, standard language and framework to describe the condition of health and health-related. This article will review the application status of ICF at home and abroad, to explore the nursing of ICF application value, in order to explore the application of ICF in nursing standardized terminology space.