Objective To investigate the patients with postoperative skin damage around the stoma after Miles operation,take measures according to the influencing factors,and explore an effective way to reduce the incidence of skin damage around the stoma patients.Methods There were 62 cases of skin damage around the stoma in 110 cases of patients with permanent colostomy in out-patient follow-up.Each patient with skin damage occurring around the stoma were retrospectively analyzed the reasons,and the related factors that might affect Miles postoperative stoma skin damage were analyzed.Results The incidence rate of Miles postoperative skin damage around the stoma was 56.36％,through the multi-factor Logistic regression analysis,there were six related factors with the Miles postoperative skin damage around the stoma,patients' excrement stimulation,ostomy bag allergies,improper operation of the replacement of the ostomy bag,the potential skin disease,excessive scrub / rub the skin,unfamiliar with ostomy care knowledge were the influencing factors of patients with skin damage around the stoma.Conclusions Appropriate stoma care products and paste methods,detailed guiding of patients and their families about ostomy care knowledge and skills can significantly reduce the incidence rate of Miles postoperative skin damage around the stoma.

Objective To understand the situation of off-label use of sildenafil, so as to provide reference for developing off-label drug use policy. Methods A stratified random sampling method was used to collect prescription data of sildenafil in Guangdong Women and Children Hospital in 2015. The off-label drug use situation was analyzed according to drug labels. The situations of drug use in all departments were summarized, and off-label drug use occurrences were analyzed.Results A total of 1044 prescriptions with sildenafil were collected and analyzed to discover the occurrence of off-label use was up to 69. 54%. The top 3 departments of off-label use of sildenafil were assisted reproductive center, heart center and neonatal intensive care unit (NICU). The top 3 types of off-label use were non-indication(50. 35%), over drug population(31. 76%) and over drug administration(17. 89%). The top 3 diseases for non-indications were infertility, pulmonary hypertension and congenital heart disease. Conclusion Sildenafil off-label use was common in Guangdong Women and Children Hospital in 2015, especially in assisted reproductive center, heart center, and NICU. The result suggests that more clinical studies about sildenafil on cardiovascular system are expected to provide more evidence for drug use, so as to ensure the safety of drug use in special populations and avoid potential medical risk.

OBJECTIVE:To establish the quality standards for Qiqilian capsule. METHODS:TLC was used to identify the As-tragali Radix,Phellodendri chinensis,Coptidis rhizom. HPLC was used to determine the contents of ginsenosides Rg1,ginsenosides Rb1 and notoginsenosides R1. The column was Shim-pack VP-ODS C18 with mobile phase of acetonitrile-water(gradient elution) at flow rate of 1.0 ml/min,detection wavelength was 203 nm,column temperature was 20 ℃. RESULTS:TLC of Astragali Radix,P. chinensis,C. rhizom showed cleer sports and good separation. The linear range was 0.9-9.0 μg for ginsenosides Rg1,0.94-9.4 μg for ginsenosides Rb1 and 0.3-3.0 μg for notoginsenosides R1(r≥0.999 5);RSDs of precision,reproducibility and stability test were lower than 3.0%;recoveries were 96.08%-99.75%(RSD=1.52,n=6),97.03%-99.75%(RSD=1.10,n=6)and 96.38%-98.55%(RSD=0.90,n=6),respectively. CONCLUSIONS:The method is simple,good reproducibility,and can be used for the quality control of Qiqilian capsule.

Objective To explore the effect of transitional care model (TCM) on the prevention of complications in patients with severe cerebral infarction. Methods Sixty patients with severe cerebral infarction were randomly divided into the experiment group and the control group, 30 cases in each group. The control group was given conventional nursing and the observation group received TCM. The two groups were compared in terms of the incidence of complications and re-admission rate. Result The incidence of complications and the rate of re-admissions in the experiment group were significantly lower than those of the control group (P<0.05). Conclusion TCM can reduce the incidence of complications in patients with severe cerebral infarction, lower the incidence of hospital admission, relieve the pain of patients and improve the quality of life of patients.

Objective To evaluate the analytical performance of Mindray BS‐820 automatic biochemical analysis system used in primary hospitals in Guangzhou area for verifying whether its performance meeting the clinical requirements .Methods Accord‐ing to the EP5‐A2 ,EP6‐A ,EP7‐A2 and EP‐17A files recommended by CLSI and the Pharmaceutical Industry Standard of the Peo‐ple′s Republic of China YY/T0654‐2008 ,the precision ,linear rang ,anti‐interference capability ,sensitivity and carry‐over rate of the Mindray BS‐820 automatic biochemical analysis system were evaluated by adopting 16 routine biochemical items .Results The pre‐cision results of all 16 analyzing items conducted by the Mindray BS‐820 automatic chemical analysis system conformed to the re‐quirements .The results of 15 items showed good linear relation during the testing range (r≥0 .997 9) .In 16 biochemical items ,the anti‐interference capability of TBIL ,TP ,TC ,TG ,LDL ,HDL ,UREA and Ca to bilirubin ,triglyceride and hemoglobin conformed to or were higher than the anti‐interference capability declared by manufacturer ,but among other 8 items ,the anti‐interference capabil‐ity of 3 items was lower than that declared by manufacturer .The limit of blank(LOB) of all 16 analyzing items was less than LOB in the kit instruction .The carry‐over rate of Glu was 0 .02% ,less than 0 .50% .Conclusion This instrument has good precision , sensitivity and low carry‐over rate(0 .02% ) ,the linear range is ideal ,r≥0 .997 9 ,the anti‐interference capability basically satisfies the clinical needs .Therefore this instrument is suitable for the use in the middle‐small scale laboratory department .

Objective To investigate the state of Th1/Th2 cytokine imbalance in patients with lupus nephritis (LN) and its role in the pathogenesis. Methods Plasma level of interleukin-18 and interleukin-13 in 18 patients with active LN and 16 normal controls were measured by enzyme-linked immunoadsordent assay (ELISA). IL-18 and IL-13 expression in the renal tissues from 18 patients and 6 normal renal tissues were also detected by immunohistochemical assay. The ratio of plasma and renal IL-18/IL-13 was then calculated. Results Plasma levels and renal expression of IL-13 and IL-18 in patients with LN were increased significantly compared to those of normal controls (P0.05). The ratio of renal IL-18/IL-13 was not significantly different among all types of LN and normal controls. The ratio of plasma IL-18/IL-13 was positively correlated with LN renal tissue activity index (AI), but no correlationship could be found in renal IL-18/IL-13 ratio. Conclusion It seems that the immune disturbance in systemic lupus erythematosus (SLE) can not be simply divided into Th1 predominant and Th2 predominant. It seems far complicated than this Th1/Th2 paradigm. It may be affected by the state of disease activity, the lesion location and the type of pathology.

Objective:To approach the curriculum basis,current situation and possibility for constructing teaching system of Experiment Nuclear Medicine in regular college course.Methods:On the basis of discussing the Nuclear Medicine discipline and current situation of Nuclear Medicine teaching in our country,this article expounded the urgent demand to basic knowledge of Nuclear Medicine for Molecular Imaging development and the teaching basis of Experiment Nuclear medicine.Conclusion:This paper proposed a new view point for requirement to construct Experiment Nuclear Medicine teaching system in regular college course in our country.

Objective To investigate the effect of nursing clinical ladder program on the training of nurses in ICU.Methods Seventy seven nurses in ICU were trained with nursing clinical ladder program including defining the ladder system of nurse’s ability, regulating the standard of each level,conditions for promotion,range for practice,establishing courses.Regular assessment,classification and retraining were performed.Result After training,the qualification rate in special theory and skills was increased.The incidences of major complications were significantly lower than that before training(P<0.05).Conclusions Nursing clinical ladder program is good for the development of personal career and specialization.It may promote the improvement of positivity and the quality of nursing.