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As a new type of medical service project, "Internet + nursing service" has become a new trend in the development of nursing. Ningbo area started the exploration of "Internet + nursing service" as early as the end of 2015, and gradually formed the Ningbo model of "government-led, regionalized layout, and online and offline collaborative services, medical professional support, market-based operation". And made the innovative practice of "medical insurance pay at home". By the end of December 2021, there were 6 200 registered nurses on the platform, and a total of 20 993 door-to-door services were provided. 197 medical institutions settled on the platform and carried out 49 home service projects. This paper introduced the exploration experience and practical results of "Internet + nursing service" in Ningbo, and provided reference and reference for the advancement of this work.
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Cutaneous T-cell lymphomas are a relatively rare group of mature T-cell lymphomas mainly manifesting in the skin, and its common subtype is mycosis fungoides. Total skin electron irradiation is one of the important conventional treatment methods, but there are many disadvantages, such as uneven dose distribution, poor position repetition, and long treatment time, which affect the clinical efficacy and patient prognosis. With the emergence and gradual popularization of helical tomotherapy in recent years, more and more medical institutions are gradually expanding their applications in total skin irradiation due to their ability to treat ultra-long targets and achieve dose-sculpted distribution, aiming to further explore its good or bad, and confirm whether it can replace the traditional total skin electron irradiation. In this article, research progress on total skin irradiation using helical tomotherapy was reviewed, the development of treatment technology, clinical efficacy and current concerns and controversies were illustrated.
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Objective To explore the effect of collaborative teaching mode oncritical thinking ability, specialized knowledge score and core competence of intern nurses. Methods 130 intern nurses who worked in the department of Obstetrics and Gynecology in our hospital from January 2015 to October 2017 were selected and randomly divided into control group and observation group by random number, and each group had 65 cases. Traditional nurse intern teaching mode was adopted in control group, while the observation group received collaborative teaching mode. After two months, the critical thinking ability, specialized knowledge score and core competence of intern nurses in each group we compared. Results l)Critical thinking ability:Seven dimensions of critical thinking ability including confidence, open mind, truth seeking, systematic ability, analytical ability, knowledge desire, cognitive maturityof intern nurses in observation group were significantly better than the control group(P＜0. 05). 2)Specialized knowledge score: The specialized knowledgescore in observation group was significantly higher than the control group (P＜0. 05). 3)Core competence: Core competence in four dimensions includingpersonal characteristics, clinical nursing ability, interpersonal communication ability, professional construction ability and development ability in observation group was significantly higher than the control group(P＜0. 05). Conclusion Compared with traditional teaching mode, collaborative teaching mode can significantly improve the critical thinking ability, specialized knowledge score and core competence of intern nurses.
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A new approach based on online coupled liquid chromatography-gas chromatography-mass spectrometry ( LC-GC / MS ) was developed for the rapid determination of 4-( methylnitrosamino )-1-( 3-pyridyl)-1-butanone (NNK) in mainstream cigarette smoke, in which a switching valve was employed to online switching between two-dimensional chromatography. The online LC-GC / MS system used in this study was built by using online gel permeation chromatography-gas chromatography-mass spectrometry except that the micro gel column was replaced by micro alkaline alumina column which was prepared by ourselves before. The NNK in mainstream cigarette smoke was collected by a Cambridge filter pad, then the pad was extracted with dichloromethane, and the extract was quantitatively analyzed by online LC-GC / MS with D4-NNK as an internal standard. Online LC-GC / MS allowed online pretreatment purification, and the sample was subjected to online LC-GC / MS without any prior purification, which reduced human error in analysis process. The injection volume of the present online LC-GC / MS could reach 40 μL, which was 20 times of that of the conventional GC / MS (2. 0 μL of injection volume), and thus significantly improved the sensitivity. Under the optimum conditions, good linearity ( r = 0. 9998) was obtained over the range of 1. 2 - 120 ng / mL. The recoveries at three spiked levels ranged from 93. 9% to 96. 0% , and the limits of detection for qualitative and quantitative detection were 0. 25 ng / mL and 0. 9 ng / mL, respectively. All the results obtained by the present method are comparable to those of standard method recommend by China National Tobacco Company.