Objective The study is to investigate the effects of skin protectant carried out among the patients with incontinence,analyze the risk factors and protective factors of the occurrence of incontinence-associated dermatitis,and provide effective preventive measures for clinic.Methods From May 2013 to January 2014,174 cases of high-risk patients with incontinence from care units of intensive care unit,neurology intensive care unit,neurosurgery intensive care unit,and emergency intensive care unit of a top three hospital of Nantong were divided into three groups and provided with preventive interventions of skin protectant.Group A used ostomy skin care powder,group B used tannic acid ointment,and group C used Comfeel skin protective film.The incidence rate and time to onset of incontinence-associated dermatitis were compared,and then the relevant factors which might cause the occurrence of incontinence-associated dermatitis underwent Logistic regression analysis.Results 32 cases (18.4％) of patients after application of skin protectants occurred incontinence-associated dermatitis.The incidence rate of IAD in the three experiment groups (group A,group B and group C) were 30.4％,10.3％ and 15.0％.The incidence rate of IAD was the lowest in group B,followed by group C and group A.There was a significant difference among the three groups.In the comparison pair match,the differences of incidence rate between group A and group B,group A and group C were statistically significant,but the incidence rate of group B and group C was statistically insignificant.Mean time to onset of incontinence-associated dermatitis was (7.00± 3.91) days.The occurrence time of IAD among the three groups was not statistically significant.Conclusions In the process of incontinence care,it should be given as early as possible to clean the peri-anal skin and apply skin protectant with better preventive effects.

Objective To examine the reliability and validity of the Chinese version of the perineal assessment tool (PAT),and explore its applicability in domestic patients with incontinence.Methods A convenience sample of 100 patients were recruited for evaluation.The patients with incontinence were assessed for lAD risk using the Chinese version of PAT.The reliability tests were conducted on internal consistency,interrater,test-retest,and the validity tests were conducted on content validity index(CVI),exploratory factor analysis,receiver operator characteristic curve (ROC).Results The Chinese version of PAT comprised 4 items,Cronbach's α was 0.512,and items related to the total score was appropriate; inter-rater reliability was 0.889; test-retest reliability was 0.791.CVI was 0.95.Exploratory analysis showed that the most interpretable solution consisted of 2 factors.The accumulative variance contribution explained 67.397％ of variance of the total scale.Predictive validity was moderate,the best cut-off point was determined at 6.5 points.Conclusions Due to the special design,its internal consistency reliability was low; content validity was relatively sufficient,but it still needs further revision and test.Inter-rater reliability,test-retest reliability,construct validity,predictive validity was generally good,and it could be used as the screening tool of IAD risk.The results prompt PAT could be used as a benchmark,and we can adjust the entry of PAT to provide a more accurate IAD predicting tool by studying the IAD risk factors.

Objective:To Study the efficacy and satety of lamivudine in the treatment of CHB and HBV carrier.　Methods:All patients were divided into three groups. 21 patients with CHB were classified CHB test group(namely groupⅠ), 16 HBV carries were classified ASC test group(namely Group Ⅱ), 40 patients with CHB were CHB controlled group(namely controlled group). Both group Ⅰ and group Ⅱ received lamivudine, group Ⅰ was added protecting liver therapy. The controlled group only received protecting liver therapy. The treatment courses of three groups were one year. 　Results:The effective rates of group Ⅰ and group Ⅱ were higher than the controlled group in turning into negative HBeAg and HBV-DNA, both the negative-turning rate of liver functions and hepatic serology target declining fibrosis in group Ⅰ was more significant than the controlled group without severe side effect. 　Conclusion:Lamivudin is efficient and safe medicine in the treatment of CHB and HBV carrier.

Objective To study the relationship between the number of examined lymph nodes and the prognosis of colorectal cancer by TNM stage. Methods According to the number of examined lymph nodes, 567 patients of colorectal carcinoma who underwent resection were divided into three groups: ≤ 6,7-11 and ≥ 12, the 5-year overall survival rates of three groups were compared. For each TNM stage ( stage Ⅰ -Ⅳ ) , patients were substratified into two groups basing on the number of examined lymph nodes:<12 group and ≥12 group, the 5-year survival rates of two groups in each TNM stage were assessed, and prognostic factors of stage Ⅱ and Ⅲ stage were analyzed. 5-year survival curves were estimated with the Kaplan-Meier method and compared by the log-rank test. Cox proportional models were used to conduct multivariate analyses of prognostic factors. Results The average number of examined lymph nodes was 16. 75 ±9. 88. With the patients grouped by the number of lymph nodes ( ≤6,7 -11 and ≥12 nodes) , the 5-year survival rate was 32. 3% , 43. 8% , and 57. 7% , the univariable analysis indicated that the 5-year survival rate of ≥ 12 examined nodes were significantly higher than the other groups (P<0. 05). There was no difference between two groups in the 5-year survival rates of stage Ⅰ or Ⅳ colorectal cancer (89. 5% vs.89. 1% ,8. 0% vs. 18. 2% , P>0. 05 ) , however, the 5-year survival rates of stage Ⅱ and Ⅲ colorectal cancer in ≥12 group were significantly higher than<12 group(71. 1% vs. 32. 6% ,48. 8% vs. 30. 0% ,P<0. 05) , multivariable analysis revealed that the number of lymph nodes examined was an independent factor of prognosis of stage Ⅱ and Ⅲ colorectal cancer. Conclusions The number of examined lymph nodes significantly influenced the 5-year overall survival rate of TNM stage Ⅱ and Ⅲ colorectal cancer.

Objective To investigate the status of the anxiety and depression in the patients with paralysis after spinal cord injury, and the measures to cope with it. Methods Sixty cases of patients with paralysis after spinal cord injury were evaluated with Self-Rating Anxiety Scale (SAS) and SelfRating Depression Scale (SDS), the results were compared with those of the domestic norm of healthy individuals. Results The scores of patients with paralysis after spinal cord injury were higher than that of domestic norm of healthy individuals. 54 cases had anxious symptom (90.00%), and 37 had depression.The causes led to anxiety and depression mainly came from the suffering of the disease, the influence of the work as well as the study and the cost of the treatment. Conclusions The patients with paralysis after spinal cord injury had mental problems, they need to be interfered with by healthy education and mental nursing in order to promote rehabilitation.

The incidence, mortality and survivorship of female breast cancer in China, and the distribution of its several key characteristics were described brielfy in this article. The breast cancer incidence and mortality rates among Chinese women were increasing rapidly, especially in rural area during the recent 10 years, though they were still in low level worldwidely. The distribution of breast cancer incidence and mortality among Chinese women by age and district were showing signiifcant characters. The total survival rate was estimated to be closed to the average level of developing countries, while disparity between urban and rural area was recognized. Because of lacking population data, it is dififcult to describe the characteristics on histological subtypes, stages on diagnosis and molecular subtypes nationwide. The national strategies on breast cancer prevention and control should be focused on disease surveillance, etiological research and survival study. Moreover, measurement should be taken to improve the capacity on breast cancer prevention, screening and clinical services in rural area, in order to narrow the gap of survivorship between urban and rural area and control the rapid increase of mortality in rural area.

Objective To investigate the effect of acupuncture at the primary points of the three yin meridians of the foot on blood pressure in an animal model of high/low blood pressure and explore the specific effect of the meridian points-the primary points of the three yin meridians of the foot.Methods The study included the parts of hypertension and hypotenstion. Both parts were allocated to the primary points of the three yin meridians of the foot, non-acupoint, model and blank groups, six rats each. Except the model and blank groups, all the groups were given acupuncture treatment for seven consecutive days. Blood pressure was measured after the completion of treatment. Five consecutive measurements were made in each rat. Mean values of blood pressure were taken.Results For the part of hypertension, blood pressure at each time point was higher in the acupuncture groups than in the blank control group and lower than in the model group, and there were statistically significant differences (P<0.05), indicating that acupuncture at the primary points of the three yin meridians of the foot has a hypotensive effect. The hypotensive effects of Taichong and Taixi were better than those of Taibai and the non-acupoint (P<0.05). The hypotensive effects of Taichong and Taixi were equal (P>0.05). The hypotensive effect of Taibai was equal to that of the non-acupoint (P>0.05). For the part of hypotension, blood pressure at each time point was lower in the acupuncture groups than in the blank control group and higher than in the model group, and there were statistically significant differences (P<0.05), indicating that acupuncture at the primary points of the three yin meridians of the foot has a pressor effect. The pressor effect was worse in the the non-acupoint group than in the primary points of the three yin meridians of the foot group (P<0.05). The pressor effects of Taibai and Taixi were equal but worse than that of Taichong (P<0.05).Conclusions Acupuncture at the primary points of the three yin meridians of the foot has a specific bidirectional regulating effect on blood pressure. Of them, point Taichong produces a best bidirectional regulating effect on blood pressure.

Objective To investigate the effect of Mycobacterium vaccae vaccine combined with chemotherapy on immune function in treatment of children with pulmonary tuberculosis.Methods 89 cases with pulmonary tuberculosis from December 2010 to December 2013 treated in three hospitals in xinxiang city were randomly divided into control group and observation group.The control group was given regular chemotherapy,the observation group was given chemotherapy combined with Mycobacterium vaccae vaccine therapy.CD4 +,CD8 +,CD8 +/CD4 +and CD16 +CD56 +in peripheral blood were evaluated by FCM before and after treatment.Serum TNF- αand IL-10 levels were detected by the method of ELISA.Taking 3 sputum samples (night sputum,morning sputum and sputum at moment)of each patient to smear after treatment.Results Before treatment,there was no significant difference of each index between two groups.After treatment,CD4 +,CD4 +/CD8 +and CD16 +CD56 +in the observation group were significantly higher than that before treatment and the control group(P<0.05).The proportion of CD8 +in two groups was significantly lower than before treatment(P<0.05),the difference between groups was not statistically significant.Serum TNF- αand IL-10 levels decreased significantly in two groups than those before treatment and the control group(P<0.05).After treatment,the negative conversion rate in the control group was 90.9%(n=40),while 100%(n=45)in the observation group.The difference between two groups was statistically significant(P<0.05).Conclusion Mycobacterium vaccae vaccine combined with chemotherapy has a significant effect on children with pulmonary tuberculosis.It could significantly improve the immune function of children.

Objective To explore the effect of early phase rehabilitation training on the urination function recovery of the patients with paraplegia caused by spinal cord injury (SCI).Methods Sixty-six patients with paraplegia caused by SCI were selected and divided into the rehabilitation and the control group.The rehabilitation group of patients received early phase rehabilitation training on the urination function,the control group received routine training on the urination training and urinary catheter nursing care.The urination function recovery effect was compared between two groups.Results The urination function recovery effect of the rehabilitation group was significantly better than the control group.Conclusions The usage of early phases of urination training measures on the SCI paraplegia patients can help them cast off the catheter,build up regular urination,and reduce complications.

Objective To investigate the clinlic therapeutic result of detenial sigmoid neobladder after radical cystectomy.Methods 20 patients with bladder cancer(18 males and 2 females;age range from 33 to 76 years) were admitted and underwent radical cystectomy and detenial sigmoid neobladder.Results All the 20 patients were followed up for a mean of 18 months(range from 6 to 48 months).The blood Cr and BUN levels were both in the normal range without acidosis in all the cases.Only 1 had unilateral ureteral urine reflux during cystography.3 of the 20 cases were incontinent,but 2 of the 3 cases could control urination by being woken up at night.The capacity of the neobladder was 230 to 500ml with a mean of 330ml and the maximal pressure of the neobladder during filling was 16 to 50cmH_2O.Conclusion As a simple operation the detenial sigmoid neobladder can be performed easily with less complications and more reliable results.This operation may be generally applied in clinical practice.