This article reports the significance of the application of intraluminal electrocardiogram (EKG) positioning technology in peripherally inserted central catheterization (PICC) in children. It reviews the the application of EKG in the placement of PICC in children at home and abroad, the selection of EKG positioning tools, the guidance method, and how to decide the position of the tip of catheter by the P wave. It also analyzes the relevant factors affecting the stability of EKG in children. This study looks forward to the application prospects of EKG positioning technology in children's PICC catheterization, and puts forward suggestions to facilitate clinical guidance. Key words: Children; Intracavitary electrocardiogram; Peripherally inserted central catheter; Application

In recent decades, the research on clinical nursing pathways for breast cancer in China mainly explores their nursing benefits when applied in breast cancer patients who undergo surgery, chemotherapy and radiation therapy. However, there is no official clinical nursing pathway for breast cancer yet in China and the pathway formulation methods and norms are uneven in the existing research. Since the research on the formulation of clinical nursing pathways are relatively lacking in China, this article reviews the domestic and foreign literatures from the formulation and clinical application of clinical nursing pathways for breast cancer, with a view to providing reference for the subsequent research on clinical nursing pathways for breast cancer. Key words: Review; Breast neoplasms; Clinical nursing pathway; Clinical application

This paper summarizes the current status, obstacles and support programs of informed consent in patients with intravenous thrombolysis for acute cerebral infarction, and provides a reference for the research on the model of obtaining informed consent for medical and nursing collaboration in China, in order to shorten the decision-making time of thrombolysis, and improve the quality of decision-making and promote the smooth implementation of thrombolytic therapy in the clinic practice. Key words: Review; Cerebral infarction; Intravenous thrombolysis; Informed consent; Decision-making assistance

Objective To develop a matching service with supply and demand questionnaire for the disabled elderly in medical-nursing combined institutions. Methods From April to May 2019, the first draft of questionnaire was designed based on literature review, semi-structured interview and expert consultation. Two rounds of expert consultation by 14 experts were carried out with the Delphi method. The questionnaire was revised and perfected according to results of expert consultation to form the final version of questionnaire. We calculated the expert active coefficient, expert authority coefficient, concentration and coordination coefficient of expert opinion. Results Around two rounds of expert consultation, the valid recovery rates of questionnaire were 93.3% and 100.0% with 0.92 for the expert authority coefficient. In the second expert consultation, coordination coefficients of expert opinion of dimension and item were 0.638 and 0.407 respectively with statistical differences (P<0.001) and with <20% for all the coefficients of variation. The final version of the matching service with supply and demand questionnaire for the disabled elder in medical-nursing combined institutions included 5 dimensions and 30 items. Conclusions The matching service with supply and demand questionnaire for the disabled elderly in medical-nursing combined institutions has the high level of scientific nature, reliability and all-round content. The questionnaire can be used to researches on matching service with supply and demand questionnaire for the disabled elder as a beneficial investigation tool and can provide a reference for formulating a supply and demand plan of medical and nursing combined care service. Key words: Aged; The disabled elderly; Combination of medical-nursing; Service demand; Service supply and demand; Delphi technique

Health is an essential element to promote social progress and economic development. It is also a symbol of citizen's peaceful work and life with happy and long life, as well as an emblem of national prosperity and national rejuvenation. Public health develops vigorously in our country. Policy Outlines has been successively issued in China, such as Healthy China 2030 and The Thirteenth Five-year Plan Outline of National Economic and Social Development. Under the Healthy China background, as an important guarantee for public health, nursing higher education in China has experienced a long process of development an reform. It meets the change of the era from education scale, teaching philosophy, establishment of specialized direction and teaching model. Key words: Education, nursing; Reform; University

Objective To explore the effects of Barthel index assessment exercise in postoperative grading nursing among total laryngectomy patients. Methods From January 2018 to June 2019, we selected 51 laryngeal carcinoma patients undergoing total laryngectomy in Otolaryngology Head and Neck Surgery at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, as subjects by convenience sampling. All of patients were divided into control group (n=24) and observation group (n=27) with the method of random number table. We compared the differences in the levels of grading nursing, compliance of early ambulation after surgery and self-care ability of patients between two groups. Results There were no statistical difference in the levels of grading nursing of patients between two groups after surgery (P>0.05) . The compliance of early ambulation of patients after surgery in observation group was better than that in control group with a statistical difference (P<0.05) . The total score and dimension scores of self-care ability of patients in observation group were higher than those in control group one day before discharge with statistical differences (P<0.05) . Conclusions Barthel index assessment exercise can objectively assess the activities of daily living of total laryngectomy postoperative patients, improve the compliance of early ambulation after surgery and self-care ability of patients. Key words: Grading nursing; Total laryngectomy; Barthel index; Barthel index assessment exercise

Objective To define the traditional Chinese medicine (TCM) nursing core knowledge and practical ability which nurses should be equipped with when carrying out TCM service so as to provide a reference for the training of nursing talents of TCM at home and abroad. Methods On the basis of establishing a research group, a questionnaire was formed based on literature research, university research, brain storm and expert interviews. A total of 76 TCM nursing experts from universities and hospitals at home and abroad of TCM were investigated with the questionnaire to form an expert consensus. Results A total of 76 questionnaires were issued in this survey, of which 64 were valid.This study formed the core knowledge and practical ability training standard including three course modules of basic courses of TCM, basic courses of TCM nursing and specialized courses of TCM nursing, and 9 courses of basic theory of TCM, diagnosis of TCM, science of Chinese materia medica, pharmacology of TCM, fundamental of TCM nursing, TCM diet therapy, acupuncture and moxibustion and nursing, TCM nursing skill operation, TCM nursing clinical practice. Conclusions The standard could provide a basis for the standardized teaching of TCM nursing, establishment of training module, formulation of training plan and evaluation of talent training quality. Key words: Traditional Chinese medicine nursing; Core knowledge; Practical ability; Training standard; Expert consensus

Objective To explore the work content of nurses in menopause multidisciplinary outpatient team so as to summarize the nursing work well and improve the quality of nursing work. Methods This study used case study of qualitative research. From June 2018 to August 2019, we selected 10 relevant personnel in Menopause Multidisciplinary Teamwork (MDT) Outpatient Department at Beijing Shijitan Hospital of Capital Medical University to interview MDT outpatient nurses about the work content. Data were collected with the method of personalized depth interview and observation, and data were analyzed with the method of content analysis. Results A total of 5 themes were extracted by analyzing data including the MDT outpatient work flow management, comprehensive evaluation and diagnosis by interdisciplinary, menopause knowledge education for patients, formulating and implementing the plan of individualized continuous nursing as well as participating in MDT publicity, promotion and team development. Conclusions Nurses take part in effective flow management, comprehensive health evaluation, enriching menopause knowledge education, formulating and implementing the plan of individualized continuous nursing as well as MDT publicity, teaching and research in MDT outpatient work to make MDT outpatient flow simple and efficient, improve patients' health knowledge, medical compliance and satisfaction. Key words: Nurses; Menopause; Multidisciplinary teamwork; Outpatient Department; Work content; Qualitative research

Objective To investigate the relationship between blood glucose variability and major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) . Methods From July to Decebmer 2017, The fasting blood glucose (FBG) of 125 ACS patients was dynamically monitoredfor 1 year after discharge. The coefficient of variance (CV) of blood glucose was calculated and the morbidity of MACE was recorded. Logistic regression analysis was used to analyze the relationship between the CV of blood glucose and MACE. The receiver operating characteristic (ROC) curves were used to evaluate the predictive power of the CV of blood glucose for MACE. Results The morbidity of MACE was 15.2%, which was positively correlated with the CV of blood glucose (OR=1.461; 95%CI: 1.202-1.775; P<0.001) and negatively correlated with high density lipoprotein (HDL) levels (OR=0.008; 95%CI: 0.000-0.684; P=0.033) .The CVof blood glucose showed a predictive power for the morbidity of MACE, whose cutoff value was 18.4%. Conclusions Long-term variability is a risk factor for the morbidity of MACE after discharge in ACS patients. Continuous care should be strengthened for patients after discharge, controlling their blood glucose while reducing the volatility of blood glucose. Key words: Blood glucose variability; Coefficient of variance (CV); Acute coronary syndrome (ACS); Major adverse cardiovascular events (MACE)

Objective To explore the effects of family supervisors on prognosis and compliance among the aged with type 2 diabetes. Methods From June 2017 to June 2018, we selected 170 elderly patients with type 2 diabetes at Xindu People's Hospital of Chengdu City by convenient sampling. All of patients were divided into experimental group and control group with the method of the random number table, 85 cases in each group. Control group carried out routine health education. On the basis of that, experimental group recommended a family supervisor manage and control patient. One year after intervention, we compared the fasting plasma glucose (FPG) , glycosylated hemoglobin (HbA1c) , 2-hour postprandial glucose (2 h PG) , nursing compliance with the questionnaire and quality of life with the MOS item short from health survey (SF-36) of patients between two groups. Results There was no patient loss to follow-up between two groups within a year after intervention. After intervention, the FPG, 2 h PG and HbA1c of experimental group were (5.0±0.8) mmol, (11.2±1.3) mmol and (6.1±0.6) % respectively lower than those of control group with statistical differences (P<0.05) . After intervention, the compliance cases of experimental group were higher than control group , the differences were statistical significant (P<0.05) . The scores of overall health of patients of experimental group and control group were (85.3±12.1) and (80.4±9.4) with a statistical difference (P<0.05) . Conclusions Family supervisor can improve glucose levels of elderly patients with type 2 diabetes , treatment compliance and patients' quality of life which is worthy of being practiced. Key words: Diabetes mellitus, type 2; Aged; Family supervisor; Prognosis; Compliance