An empirical study on the evaluation system of clinical nurse training in hospitals of traditional Chinese and Western medicine based on post competency / 中华医学教育探索杂志

Objective:To evaluate the discrimination, reliability and validity of the evaluation system of clinical nurse training based on post competency in hospitals of traditional Chinese and Western medicine.Methods:From August 2018 to January 2019, 271 clinical nurses from a three-A hospital were selected by convenient sampling method. The competency of clinical nurses was assessed on the spot by case tracking method. The discrimination, reliability and validity of the evaluation system were tested by item analysis, Cronbach's α coefficient and confirmatory factor analysis.Results:The evaluation system had good discrimination, reliability and validity. Among the four scales of the evaluation system, there were significant differences in the high score and the low score of all items ( P < 0.05). The Cronbach's α coefficient of each dimension of the four scales was 0.769-0.898. Four structural equation model diagrams were established, the AVE (average variance extracted) of each dimension was 0.51-0.74, factor load was 0.53-0.93, C.R. (composite reliability) was 0.79-0.91, and the discrimination validity was up to the standard. Conclusion:This system provides a reference for the establishment of scientific, objective, measurable and homogeneous clinical nurse training evaluation tools.

Efficacy and safety evaluation of magnesium aluminate, lansoprazole, amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer / 中国综合临床

Objective:To investigate the efficacy and safety of magnesium aluminium carbonate, lansoprazole, amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer.Methods:From March 2016 to December 2017, 120 patients with HP related gastric ulcer who met the inclusion criteria were enrolled in the digestive department of Linxi Hospital of Kailuan general hospital.They were divided into observation group and control group with random number table method, 60 cases in each group.The control group was given lansoprazole+ amoxicillin+ furazolidone triple therapy.On this basis, the observation group was added with magnesium aluminum carbonate.The clinical efficacy, clearance rate of Helicobacter pylori, the level of VEGF and EGF in gastric juice were compared between the two groups.Results:The total clinical effective rate of the observation group was 95.0% (57/60), which was significantly higher than that of the control group (83.3%) (50/60). The difference between the two groups was statistically significant (χ 2=4.23, P<0.05). The comprehensive symptom scores of the two groups decreased significantly with the treatment time (observation group: before treatment(9.6±2.2), treatment 2 weeks (5.5±1.5), treatment 4 weeks (4.3±1.2), treatment 6 weeks (3.1±0.8), control group (9.4±2.5), treatment 2 weeks (7.2±1.3), treatment 4 weeks (6.6±1.4), treatment 6 weeks (4.5±1.0)), and observation group syndrome scores There was significant difference between the two groups ( Finter-group=23.54, Pinter-group<0.05; Fintra-group=87.62, Pintra-group<0.05; Finteraction=8.47, Pinteraction<0.05). After treatment, VEGF level in gastric juice of the two groups increased significantly after treatment.In the observation group( (429.4±128.5) pg/ml )was significantly higher than that in the control group( (380.3±137.2) pg/ml, t=2.02, P<0.05). The EGF level in gastric juice of the two groups increased significantly after treatment.In the observation group( (658.1±164.0) pg/ml )was significantly higher than that in the control group ((583.5±135.1) pg/ml, t=2.72, P<0.05). The incidence of adverse reactions was 6.7% (4/60) in the observation group and 8.3% (5/60) in the control group.There was no significant difference (χ 2=0.12, P>0.05). Conclusion:The treatment of Helicobacter pylori related gastric ulcer with the combination of aluminum carbonate, lansoprazole, amoxicillin and furazolidone can obviously improve the clinical symptoms and promote the regeneration of ulcer mucosa.

Efficacy and safety evaluation of magnesium aluminate, lansoprazole, amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer / 中国综合临床

Objective@#To investigate the efficacy and safety of magnesium aluminium carbonate, lansoprazole, amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer.@*Methods@#From March 2016 to December 2017, 120 patients with HP related gastric ulcer who met the inclusion criteria were enrolled in the digestive department of Linxi Hospital of Kailuan general hospital.They were divided into observation group and control group with random number table method, 60 cases in each group.The control group was given lansoprazole+ amoxicillin+ furazolidone triple therapy.On this basis, the observation group was added with magnesium aluminum carbonate.The clinical efficacy, clearance rate of Helicobacter pylori, the level of VEGF and EGF in gastric juice were compared between the two groups.@*Results@#The total clinical effective rate of the observation group was 95.0% (57/60), which was significantly higher than that of the control group (83.3%) (50/60). The difference between the two groups was statistically significant (χ2=4.23, P<0.05). The comprehensive symptom scores of the two groups decreased significantly with the treatment time (observation group: before treatment(9.6±2.2), treatment 2 weeks (5.5±1.5), treatment 4 weeks (4.3±1.2), treatment 6 weeks (3.1±0.8), control group (9.4±2.5), treatment 2 weeks (7.2±1.3), treatment 4 weeks (6.6±1.4), treatment 6 weeks (4.5±1.0)), and observation group syndrome scores There was significant difference between the two groups (Finter-group=23.54, Pinter-group<0.05; Fintra-group=87.62, Pintra-group<0.05; Finteraction=8.47, Pinteraction<0.05). After treatment, VEGF level in gastric juice of the two groups increased significantly after treatment.In the observation group( (429.4±128.5) pg/ml )was significantly higher than that in the control group( (380.3±137.2) pg/ml, t=2.02, P<0.05). The EGF level in gastric juice of the two groups increased significantly after treatment.In the observation group( (658.1±164.0) pg/ml )was significantly higher than that in the control group ((583.5±135.1) pg/ml, t=2.72, P<0.05). The incidence of adverse reactions was 6.7% (4/60) in the observation group and 8.3% (5/60) in the control group.There was no significant difference (χ2=0.12, P>0.05).@*Conclusion@#The treatment of Helicobacter pylori related gastric ulcer with the combination of aluminum carbonate, lansoprazole, amoxicillin and furazolidone can obviously improve the clinical symptoms and promote the regeneration of ulcer mucosa.

Construction of competency model for evaluating clinical nurses in hospital of Integrated Traditional Chinese and Western Medicine / 中华医学教育探索杂志

Objective@#To construct the objective and quantifiable model for evaluating clinical nurses' competency in hospital of Integrated Traditional Chinese and Western Medicine.@*Methods@#From December 2016 to August 2017, preliminary formulation of evaluation indicators was constructed through semi-structured interviews, combined with literature analysis. 21 experts from five hospitals of Traditional Chinese Medicine and medical universities were selected using Delphi method for performing two rounds of consultations and weight assignment of indexes. Data was logged and processed using SPSS 16.0.@*Results@#The preliminary system of the competency model included four items of Level one and 20 items of Level two. The weight coefficients of the first level indicators were 0.260 9, 0.259 8, 0.257 0 and 0.222 4. The positive coefficients from consulations of experts were 100.00% and 95.24%, respectively. Authority coefficient was 0.88. The coefficients of variation were 0.092 3 to 0.162 8 and 0.043 0 to 0.182 7, respectively.@*Conclusions@#This model can provide guidance for the training objective of nurses' competency and serve as an instrument for hospital managers to evaluate nurses in hospital of Integrated Traditional Chinese and Western Medicine.

Construction of competency model for evaluating clinical nurses in hospital of Integrated Traditional Chinese and Western Medicine / 中华医学教育探索杂志

Objective To construct the objective and quantifiable model for evaluating clinical nurses' competency in hospital of Integrated Traditional Chinese and Western Medicine. Methods From December 2016 to August 2017, preliminary formulation of evaluation indicators was constructed through semi-structured interviews, combined with literature analysis. 21 experts from five hospitals of Traditional Chinese Medicine and medical universities were selected using Delphi method for performing two rounds of consultations and weight assignment of indexes. Data was logged and processed using SPSS 16.0. Results The preliminary system of the competency model included four items of Level one and 20 items of Level two. The weight coefficients of the first level indicators were 0.2609, 0.2598, 0.2570 and 0.2224. The positive coefficients from consulations of experts were 100 . 00％ and 95 . 24％, respectively . Authority coefficient was 0.88. The coefficients of variation were 0.0923 to 0.1628 and 0.0430 to 0.1827, respectively. Conclusions This model can provide guidance for the training objective of nurses' competency and serve as an instrument for hospital managers to evaluate nurses in hospital of Integrated Traditional Chinese and Western Medicine.

Prevalence of isolated diastolic hypertension and associated cardiovascular risk: four years follow up results / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the prevalence of isolated diastolic hypertension and associated cardiovascular risk and blood pressure changes during follow up.</p><p><b>METHODS</b>This cohort study screened 101 510 participants who were employees of the Kailuan Group, a state-run coal mining company in 2006 and 2007. Among them, 6 778 subjects were diagnosed with isolated diastolic hypertension (IDH). IDH subjects without history of cardiovascular disease and not treated with antihypertensive drugs were included in this analysis. Participants without health examination between 2008 to 2009 or 2010 to 2011 were excluded. A total of 4 600 participants were included in the final analysis. At the end of the third health examination, the conversion rate of different blood pressure turnover was calculated after standardizing age and gender according to demographic data of China in 2006. Multivariate logistic regression analysis was applied to analyze the risk factors of blood pressure turnover in IDH population.</p><p><b>RESULTS</b>(1) Participants were followed up for (4.03 ± 0.26) years and the rates of turnover from IDH to normotension, isolated systolic hypertension (ISH) and systolic diastolic hypertension (SDH) were 51.4%, 3.5%, 18.3%, respectively (45.6%, 3.6%, 22.0% in male, 57.4%, 3.3%, 14.7% in female). (2) Multivariate logistic regression analysis showed that low baseline age, low diastolic pressure, low body mass index, low uric acid, physical exercise and low alcohol intake were associated with turnover from IDH to normotension; the risk factors of turnover from IDH to ISH were older age at baseline, higher systolic pressure and higher sensitivity C-reactive protein; the risk factors of turnover from IDH to SDH were older baseline age, high systolic pressure and excessive salt intake.</p><p><b>CONCLUSIONS</b>Untreated subjects with IDH can transform from IDH to normotension,ISH, SDH, and the rate of turnover from IDH to normotension is higher than others during follow up. Aging, higher systolic pressure, higher sensitivity C-reactive protein and excessive salt intake are risk factors for IDH subjects to suffer from ISH and SDH.</p>

Association between the concentration of the serum high-sensitivity C-reactive protein and acute myocardial infaraction / 中国综合临床

Objective To explore the association between the concentration of the high-sensitivity C-reac-tive protein(hs-CRP) and acute myocardial infarction(AMI).Methods The concentration of hs-CRP and serum cholesterol were determined by latex-enhanced immunoturbidimetry in 356 patients with AMI and 356 healthy con-trols.Results The concentration hs-CRP was significantly higher in patients with AMI[(18.6±6.9)mg/L ]than in healthy controls[(2.5±1.7)mg/L,P<0.01].and so the concentration of triglyceride(TG)and low-density lip-oprotein(LDL-C)(P<0.05).Conclusion The concentration of serum hs-CRP can predict the risk of AMl with higher prediction value than TG and LDL-C.

Effect of long-term combination of Hydrochlorothiazide with Captopril or Spironolactone on serum high-sensitivity C-reactive protein in hypertension patients / 中国综合临床

Objective To study the effect of combination of Hydrochlorothiaside (HCTZ) with Captopril or spironolactone on serum high-sensitivity C-reactive protein (hsCRP) in hypertension patients. Methods A multi-centre, random and parallel control study was applied in this study. Slight and moderate hypertension patiens were se-lected. The patients were treated with placebo for two weeks and HCTZ 12.5 mga day for 6 weeks,wbo were then randomly divided into HCTZ group(12.5 mg once a day), spironolactone group(HCTZ 12.5 mg once a day + Spi-ronolactone 20 rag once a day) and captopril group(HCTZ 12.5 mg once a day + Captopril 25 rag twice a day) . By the end of one-year follow up, HCTZ group was randomly added to Spironolactone group and Captopril group because combination therapy was superior to single medication,which was recognized. During the treatment, the patients were followed up once a month ,for monitoring blood pressure, and serum hsCRP level was measured every year. Follow-up last for 4 years. By the end of 4 years, the patients were divided into treatment group and control group in order to compare the changes of serum hsCRP levels. Results At the end of 4 years, the blood pressure and serum hsCRP level were significantly decreased as compared with baseline, and were statistically different from that of control group (P <0.05 or 0.01). Multi-factor analysis showed that pre-treatment systolic blood pressue and serum hsCRP level, post-treatment decrease value of systolic blood pressue and age were the major influencing factors for the de-crease of serum hsCRP level(P < 0.05 for each). Conclusion The long-term combinaion of HCTZ with Spironolactone or Captopril not only effectivley decreases blood pressure but also decreases serum hsCRP level. The decrease value of systolic blood pressure is the major factor for influencing serum hsCRP level.

Effect of Fat Emulsion on Blood Lipid and Liver Function in Criticaly Ⅲ Premature Infants / 中华围产医学杂志

Objective To observe the effect of different doses of fat emulsion on blood lipid and liver function in critically ill premature infants. Methods 40 babies were randomly divided into 4 groups,receiving fat emulsion 0,1,2,3 g?kg~(-1)?d~(-1) for 5 days respectively. The blood levels of cholesterol and triglyceride and the serum biochemical indexes relative to liver functions were measured before and after the period of 5 days. Results Blood lipid and serum ?-GT levels did not change remarkably in 1 or 2 g?kg~(-1)?d~(-1) group, but increased significantly in 3 g?kg~(-1)?d~(-1) group. Serum bilirubin levels decreased in all groups, but it was significantly higher in the group of 3 g?kg~(-1) ?d~(-1) than the others. Conclusion It is suggested that the blood lipid level would increase with 3g?kg~(-1)?d~(-1) of fat emulsion used in critically ill premature infants and that the use of fat emulsion would retard the falling of serum bilirubin level when used in newborn infants with byperbilirubinemia.