The paper first sums up the types of clinical nursing ward rounds and points out that at present two types play a dominant role in China, viz. the problem-based nursing ward round and the nursing procedure-oriented nursing ward round. Then it expounds the goal of clinical nursing ward rounds, introduces the forms, participants, and schedules of nursing ward rounds, and analyzes the major problems that currently exist in this aspect. The paper argues that it is imperative for the hospital to reinforce the management of nursing ward rounds and ensure that they are well planned and prepared and highly standardized and focused so as to improve their quality.

Objective To study the role of calcitonin gene-related peptide(CGRP)and vasoactive intestinal peptide(VIP)in the pathogenesis of alopecia areata(AA).Methods Radioimmunoassay(RIA)was used to measure the levels of CGRP and VIP in plasma from30patients with AA and20normal controls.Immunohistochemistry was employed to detect the expression of CGRP and VIP in lesions of21patients with AA and16normal scalps.Results①The plasma levels of CGRP in progressing stage of AA(142.63?67.95pg/mL)were significantly lower than those in stable stage of AA(197.33?67.15pg/mL)and in normal controls(188.40?72.95pg/mL).②The plasma levels of VIP in progressing stage of AA(105.94?55.42pg/mL)were significantly lower than those in stable stage of AA(156.86?47.37pg/mL)and in normal controls(176.44?84.70pg/mL).③The expression of CGRP and VIP was significanly decreased in lesions of AA than that in normal scalps.Conclusion These findings indicate that CGRP and VIP may play a role in the pathogenesis of alopecia areata.

To translate the Kolcaba brief general comfort questionnaire (GCQ) to Chinese and measure the applicability under the Chinese culture background. Methods This study was composed by two phases, the first phase was to measure the content validity of brief GCQ by 5 nursing specialist after GCQ was translated into Chinese. The second phase was to testing the reliability of the brief GCQ by investigating patients when they had undergone chest surgery operation before 48 hours. Results The overall CVI of brief GCQ was 0.86, the Cronbach's a was 0.92, the subscale ? was from 0.53 to 0.85. The total GCQ score about patients with chest surgery was 91.27?8.63. The lowest mean score was physical subscale: 2. 50?0. 47, the highest mean score was psychological sub-scale: 3.26?0.35. Conclusion The Kolcaba brief GCQ fit to use in China, but its content validity and the internal consistency should be tested in future study.

Objective To observe the effects of trimetazidine (TMZ) on the cardiac function and neurohormonal of heart failure model in rats.Methods Partially banding abdominal aortic artery to achieve congestive heart failure rats model.Interventricular septum thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter (LVESD),left ventricular ejection fraction(LVEF) and shortening fraction(FS) were measured by echocardiogram,Pathological changes of myocardial cells was observed,B-type natriuretic peptide (BNP)、C-type natriuretic peptide receptor (NPRC),atrial natriuretic peptide (ANP),myosin heavy chain (β-MHC) and angiotensinl (AT1) were measured by Real-Time PCR,superoxide dismutase (SOD) was measured by immunohistochemistry method.Results Trimetazidine treatment of the high-dose group and the model group compare IVST LVPWT,LVESD,LVEDD were (0.63 ± 0.05) mn,(0.73 ± 0.06) mm,(0.73 ±0.05)mm,(0.87 ±0.06)mm and (1.07 ±0.06)mm,(1.13 ±0.06) mm,(0.93 ±0.06)mm,(1.33 ±0.06) mm,was significantly reduced (P ＜ 0.05),LVEF,FS increased to (27.75 ± 1.83) ％,(11.44 ± 0.76) ％ and (11.78 ±0.56)％,(4.27 ± 0.22)％ (P ＜ 0.01),Myocardial cell structure were remarkably improved.The expression of BNP,ANP,NPRC,ATI,β-MHC were remarkably decreased.The expression of SOD was elevated.Conclusion TMZ treatment group can improve the secretion of neurohormonal of heart failure model in rats,and also obviously improve the cardiac contractility.

ObjectiveTo investigate the prevalence of preoperative malnutrition and nutrition support among gastrointestinal cancer patients.MethodsA retrospective study was conducted based on the nutritional status and nutrition support of 336 gastrointestinal cancer patients who received elective radical surgery in Peking Union Medical College Hospital from April to December 2009.ResultsMalnutrition was found in 34.6％ gastric cancer patients,23.8 ％ colorectal cancer patients,and 23 ％ esophageal and cardiac cancer patients.The patients with worse nutritional status were given longer duration of nutrition support and higher energy intake.Conclusion Malnutrition occurs in gastrointestinal cancer patients,yet sometimes treated with inappropriate nutrition support.

Objective To investigate clinical service delivered at the Polyclinic of Beijing 2008 Olympic and Paralympic Village and outcomes of the medical patients visited there.to provide experiences in medical care service for other mass-gatherings in the future.Methads Clinical data of all the medical patients evaluated at the Polyclinic during July 27 to August 27 and during August 29 to September 19,2008 were reviewed retrospectively.with univariate and multivariate analyses.Results In total.1537 and 1206 medical patients visited the Polyclinic at the Olympic and Paralympic Village,respectively.Proportion of athletes visited was hisher during the Paralympic Games than that during the Olympic Games(14.2% vs.9.8%,P<0.01).We reeeived 775 patients(50.4%)with acute respiratory tract disorders,including 16 cases(1.0%)with asthma,during the Olympic Games,and 686(56.9%),including eight cases (0.7%)with asthma,during the Paralympic Games,and antibiotics were prescribed for 149(9.7%)and162(13.4%)of them,respectively.Twelve(0.8%)patients were hospitalized during the Olympic Games and four(0.3%)during the Paralyrnpie Games,and age equal to or nlore than 55 years and digestive disease were independent risk factors for hospitalization,with odds ratios(ORs) of 5.3 and 9.5 and their 95% confidence intervals(Cls)of 1.4-19.6 and 2.5-36.4,respectively.Conclusions Acute respiratory disorder was the most connnon cause for medical visits in the Polyclinic.Asthma did not play a significant role to iniluence athletes'performance in the Beijing 2008 Olympic and Paralympic Games.Antibiotic prescription in the Polyclinic had been controled to an acceptable level.Conditions in elder patients and those with digestive disorder tended to be severe.deserving more attention infuture's mass gathering.

Objective To investigate clinical characteristics of smear- or culture-positive pulmonary tuberculosis (TB) in patients hospitalized at a general hospital to improve its diagnosis. Methods Clinical data of smear- or culture-positive pulmonary TB diagnosed in 50 patients hospitalized at Peking Union Medical College Hospital, Beijing during 2006 to 2009 were analyzed retrospectively. Results Seventeen (34%) of 50 cases of smear- or culture-positive pulmonary TB aged more than 60 years, with 30 males (32%), 16 retirees and nine farmers (18%). Their main symptoms included fever (80%), cough (94%) and sputum expectoration (92%), with elevated erythrocyte sedimentation rate (ESR) in 38 of 45 patients (84%). Chest X-ray examinations showed that lesions located mostly in the upper lobes or in both of the lungs diffusedly, with patchy infiltrations, nodular opacities and cavities. Acid-fast bacilli were demonstrated on sputum smear in 41 ( 82% ) and in specimens of six ( 12% ) cases obtained through bronchoscopy with brush or bronchoalveolar lavage fluid ( BALF), and M. Tuberculosis was cultured from sputum specimens in three (6%). Mean time interval between admission and diagnoses averaged 14 days.Conclusions Basic knowledge about prevention and control of pulmonary tuberculosis should be publicized comprehensively in general hospital keeping alert in its diagnosis with acid-fast staining for sputum smear as a routine test for patients with respiratory symptoms, and in some cases, bronchoscopy procedures ( brush or BALF) are reasonable options to improve its detection.

Objective To investigate the relationships among free triiodothyronine( FT3 ), free thyroxine (FT4 ), and thyroid-stimulating hormone( TSH) in both plasma and breast milk of patients with thyroid diseases. Methods A total of 102 female subjects with hyperthyroidism(GD), normal thyroid function(NC), and Hashimoto′s hypothyroidism(HT or hypothyroidism)were enrolled. Their plasma and breast milk were collected for measurement of FT3 and FT4 , and TSH. Meanwhile, 11 infants of patients with hyperthyroidism and another 11 infants of patients with hypothyroidism were selected, blood FT3 , FT4 , and TSH content were determined during lactating period and 2 months after lactation. Results (1) FT3 and FT4 contents in breast milk among 3 groups were different[(1. 48 ± 0. 81), (7. 79 ± 3. 56), and (0. 77 ± 0. 42)pg/ ml; (2. 94 ± 1. 43), (14. 78 ± 7. 40), and (1. 51 ± 0. 40)pg/ ml, P<0. 05], TSH in breast milk was similar between hyperthyroidism and normal groups(P>0. 05). (2) FT3 ratio of breast milk to plasma of the hyperthyroidism group was different to other 2 groups(0. 42 ± 0. 04 vs 0. 35 ± 0. 03, 0. 36 ± 0. 03, P<0. 05), but no difference existed in FT4 and TSH among 3 groups(both P>0. 05). (3)Blood FT3 , FT4 , and TSH contents from infants of patients with hyperthyroidism and hypothyroidism were different, both during lactating period and 2 months after lactation[(5. 06 ± 1. 76)vs (6. 51 ± 2. 23)pg/ ml, (17. 39 ± 2. 78)vs (19. 87 ± 3. 26)pg/ ml, (1. 34 ± 1. 33)vs (0. 74 ± 0. 78)mIU/ L; (1. 43 ± 0. 74)vs (1. 83 ± 0. 91)pg/ ml, (4. 28 ± 1. 55)vs (5. 00 ± 1. 75)pg/ ml, (6. 48 ± 2. 70) vs (5. 49 ± 2. 39) mIU/ L; all P<0. 05]. (4) FT3 and FT4 contents were positively correlated in plasma and breast milk(all P<0. 05), while TSH contents were positively correlated only in hypothyroidism group(P<0. 05). Conclusion FT3 , FT4 , and TSH in blood and breast milk are correlated.

Objective To explore what are the proficient nurses view on and attitudes toward their position during nursing position management reform, in order to promote development of nursing stratified management and position management. Methods The semi-structure review was utilized for 50 proficient nurses work in different specialist area in a three-level general hospital. Data was analyzed based on Colaizzi analysis method. Results 4 themes were refined: (1) clearly view on position, stratified management is meaningful (2) feeling of acceptance and pressure (3) unclear of job content, unsatisfied between effort and reward (4) desire for communication and official support. Conclusions Proficient nurses have clear view on and positive attitudes towards their position. Nursing management should formulate more detailed job content and job responsibility, provide more opportunity of communication, which could promote these proficient nurses′career developments.

Objective:To explore the feasibility of CT angiography (CTA) in investigating vascular dilatation of anterior choroidal artery (AChA) and posterior communicating artery (PComA) in patients with Moyamoya syndrome (MMS).Methods:From July 2017 to July 2018, the clinical and imaging data of MMS patients with brain CTA and DSA performed were analyzed retrospectively. According to DSA results, 71 MMS patients were divided into unilateral MMS group (20 cases, 20 hemispheres) and bilateral MMS group (51 cases, 102 hemispheres). There were 20 cases in unilateral MMS group, 10 males and 10 females, with an average age of (45±9) years; 51 cases in bilateral MMS group, 24 males and 27 females, with an average age of (44±12) years. The hemispheres were divided into dilated group and non-dilated group according to the dilatation of AChA or PComA. Kappa analysis was used to evaluate the consistency of two inspection methods to judge the expansion of AChA. The lumen diameters of PComA, P1 and P2 segments of posterior cerebral artery were measured on CTA images, and the ratio of PComA/P1 and PComA/P2 were calculated. The repeatability of CTA measures was evaluated by intra-group correlation coefficient. Independent sample t-test was used to compare CTA measurement results between PComA dilated group and non-dilated group, and ROC curve was drawn to calculate the best threshold for diagnosis of PComA expansion. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA measures were calculated. Results:The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA diagnosis of AChA expansion inunilateral MMS were all 100.00%. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA diagnosis of AChA expansionin bilateral MMS were 90.00%, 93.90%, 93.14%, 78.26% and 97.47%. Compared with DSA, there was no significant difference in the diagnostic performance of AChA expansion between single and bilateral MMS diagnosed by CTA ( P>0.05). The two methods had strong consistency (Kappa value was 1.00 and 0.79 respectively, P<0.01). A total of 46 patients (69 cerebral hemispheres) were included in the evaluation of PComA. PComA/P1 (1.09±0.41) and PComA/P2 (0.86±0.13) in the dilated group were significantly higher than those in the non-dilated group (0.71±0.21 for PComA/P1 and 0.75±0.23 for PComA/P2). The differences were statistically significant ( t=-4.59, -2.50, P<0.05). The best threshold in diagnosing PComA expansion was 0.87 (PComA/P1) and 0.76 (PComA/P2), and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 84.62%, 83.33%, 84.06%, 86.84%, 80.65% and 79.49%, 60.00%, 71.01%, 72.09% and 69.23%, respectively. Compared with DSA, the Kappa value of CTA measures in diagnosis of PComA expansion was 0.68 (PComA/P1) and 0.40 (PComA/P2), respectively, and the difference was statistically significant ( P<0.05). Conclusions:CTA has a strong consistency with DSA in evaluating the AChA expansion in MMS. When the PComA/P1 ratio on CTA is greater than 0.87, it can be used as the diagnosis criterion for PComA expansion.