Objective To study the application effects of from-bottom-to-up objective management model in nursing quality control.Methods Eight surgical departments in our hospitals were selected as research objects.Traditional objective management model was applied in the control group (8 004 cases,9 453 visiting times) from June 2012 to June 2013.From-bottom-to-up objective management model was applied in the experimental group (8169 cases,9 603 visiting times) from July 2013 to July 2014.Nursing work quality and continuous improvement projects were compared between two groups by questionnaire survey,a return visit by telephone and statistical evaluation.Results The satisfaction of patients with nurses' service attitudes and professional technology level and the awareness of patients about major nurses in the experimental group were significantly higher than those in the control group [95.56％ (7 806/8 169),95.19％ (7 776/8 169),97.17％ (7 938/8 169) vs.93.22％ (7 461/8 004),92.62％ (7 413/8 004),84.60％ (6 771/8 004),allP＜0.01].Patient complaints and the incidence of nursing adverse events in the experimental group were significantly lower than those in the control group (46,16 cases vs.85,39 cases,x2=9.783,P＜0.01).Conclusions Applying from-bottom-to-up objective management model could cultivate self-control abilities and innovation awareness of nurses,which can improve nursing work quality.

Objective To assess the left ventricular(LV) regional myocardial systolic function after bone marrow mesenchymal stem cells (BMSCs) injection in rabbits with acute myocardial infarction(AMI) by 2-dimensional ultrasound speckle-tracking imaging.Methods Twenty-four healthy rabbits were randomly divided into three groups:group of sham-operated,group of masculine control (AMI was induced by ligation of left anterior descending coronary artery),and group of cell infusion(after two weeks of AMI,bone marrow mesenchymal stem cells were injected to the region of AMI).Four weeks after cell deliver two-dimensional strain images were acquired from LV short-axis view(at the levels of mitral annulus,muscle papillary and apex),radial strain rate (SrR),circumference strain rate (SrC),rotation rate (RotR) and rotation (Rot) of three levels in short-axis views were measured by speckle-tracking imaging.The conventional echocardiography indices included LV diameter of end diastole(LVEDd),LV ejection fraction(LVEF),LV fractional shortening(LVFS).The catheter indices included LV systolic pressure(LVSP),LV end diastolic pressure (LVEDP)and maximum rate of rise and descend of LV pressure(LVdp/dtmax).ResultsCompared with sham-operated group,rabbits had significantly larger LVEDd,lower LVEF and LVFS,lower LVSP and LVdp/dtmax,higher LVEDP in control group,SrR,SrC,RotR and Rot of LV anterior regional myocardial function and global myocardial function of three levels in short-axis views were lower.Compared with control group,the rabbits had significantly smaller LVEDd,larger LVEF and LVFS,larger LVSP and LVdp/dtmax,lower LVEDP,SrR,SrC,RotR and Rot of LV anterior regional myocardial function and global myocardial function of three levels in short-axis views were larger in group of cell infusion.There was no significant between group of cell infusion and group of sham-operated.Conclusions Speckle tracking imaging can evaluate the regional myocardial systolic function of the area of BMSCs transplantation accurately.

Objective To investigate the association between body mass index (BMI) and exercise capacity in patients with chronic systolic heart failure.Methods The elderly patients with chronic systolic heart failure were consecutively recruited from 2008 to 2011 in cardiovascular clinic of Zhejiang Hospital.All the participants underwent height and weight measurements and BMI was calculated with these two parameters.Cardiopulmonary exercise test were performed to achieve peak oxygen uptake (PVO2),oxygen uptake to body mass ratio (PKVO2),oxygen uptake to heart ratio (VO2/HR) and ventilation/carbon dioxide production (VO2/VCO2).Results A total of the 273 patients with chronic systolic heart failure included 6 underweight patients (BMI ＜ 18.5 kg/m2),113 normal weight patients (BMI 18.5-＜ 24.0 kg/m2),116 overweight patients (BMI 24.0-＜ 28.0 kg/m2),and 38 obese patients (BMI ≥ 28 kg/m2).In both NYHA Ⅱ and Ⅲ/Ⅳ patients,unadjusted correlation analyses showed that BMI was positively related to PVO2 and VO2/HR,and was inversely related to PKVO2 and VE/VCO2 (P ＜ 0.05),respectively.Multiple stepwise regression analyses showed age,sex,BMI (P ＜ 0.05) and left ventricular ejection fraction (LVEF) were independent determinants of PKVO2,and age and BMI (P ＜ 0.05) were independent determinants of VE/VCO2.Conclusions BMI is significantly associated with exercise capacity in patients with chronic systolic heart failure,and also independent determinant for the PKVO2 and VE/VCO2,respectively.

Objective To construct subsystem of picture archiving and communicating system (PACS) based on video database of ophthalmology and to evaluate on effectiveness of applying PACS system in postgraduate teaching.Methods PACS subsystem were constructed by collecting audiovisual materials of ophthalmology surgery videos,retinal photography,B-ultrasonography,OCT,UBM of patients.A total of 24 postgraduates were divided into control group (n =12) and experimental group (n=12) by random number table.Students in control group was taught by traditional cases,books and literature while those in experimental by network teaching from PACS subsystem.Two teaching methods were assessed subjectively and objectively.Objective indicators including ophthalmology examination results,operational skill ratings and paper reviewing results as well as subjective indicators including efficiency to accept the knowledge,satisfaction degree of teaching,influencing degree of papers were employed to assess the effectiveness of the two teaching methods.Independent samples t-test and twosample rank sum test were used for statistical analysis,P ＜ 0.05 was considered statistically significant.Results Students in experimental group done better in operation scores and in the assessment of the efficiency of knowledge accepting,satisfaction of teaching and papers effect than control group(P =0.000、0.000、0.000、0.003).The two groups had no significant difference in professional exam achievements and paper review scores (P =0.625、0.354).Conclusions PACS subsystem based on video database of ophthalmology are benefit for postgraduate teaching.

0.05).Genotype B with YMDD mutations in 10 samples were found,including 2 YIDD(M+I) mutations and 8 YVDD(M+V) mutations.Genotype C with YMDD mutations in 68 samples were found,including 44 mutations I(M+I) and 24 mutations V(M+V).There was significant difference in YMDD mutation types between genotypes B and C(?2=5.5,P

Objective To investigate the application of parametric quantification (PQ) with targeted microbubbles on angiogenesis after stem cell transplantation in rabbits with myocardial infarction.Methods A CD34-targeted microbubble was prepared.Acute myocardial infarction (AMI) model were established by ligating coronary artery in 80 New Zealand white rabbits.Rabbits in common microbubble group (T + C group) and CD34-targeted microbubble group (T + T group) were subjected to myocardial contrast echocardiography(MCE),then compare myocardial perfusion parameters (A,β and A × β values) pre- and 3d post- ligation and 4 weeks after stem cell transplantation.Microvessel density (MVD) were determine by CD34 antibody immunohistochemistry.Results Compared to before stem cell transplantation,the perfusion scores ( P ＜0.05) and A,β and A× β values( P ＜0.01) of T+ C group and T+ T group were increased than before transplantation and control group.MVDs after stem cell transplantation in experimental groups were higher than those of control group ( P ＜0.01),especially the T + T group.A × β value in the T + C group was correlated with MVD ( r =0.658,P ＜ 0.05) ; β and A × β value in the T + T group were correlated with MVD ( r =0.620,0.859,P ＜0.05).A × β value ( X ) and MVD ( Y ) were included to establish the following regression equation:Y =- 130.986 + 34.505 X ( R 2 =0.556,P ＜ 0.05).Conclusions PQ and CD34-targeted microbubble probably provides some value in invasive evaluation of angiogenesis after stem cell transplantation.

Background Fungal keratitis is a common ocular surface disease and the treatment is dissatisfactory because of short of high efficiency,low toxicity and broad-spectrum medication.Penetrating keratoplasty is an effective therapy,but its clinical applications is limited due to lack of corneal donor.To seek a low-cost and effective management is of an important significance.Objective This clinical trial was to compare the clinical effectiveness between corneal ulcer debridement combined with amniotic membrane cover+drugs therapy and corneal ulcer debridement of combined drugs therapy for fungal keratitis.Methods A prospective cases-controlled study was designed.A total 210 eyes of 210 patients with fungal keratitis were included from January 2001 to January 2013 in Affiliated Hospital of Qingdao University.The patients were randomly divided into observation group (109 eyes) and control group (101 eyes).The combination therapy of corneal ulcer debridement with amniotic membrane cover and drugs was administered in the observational group,and only lesion debridement and drugs therapy was performed on the control group.The curative effect,postoperative visual acuity and therapeutic course were compared between the two groups.Results The effective rates for fungal keratitis were 100.00％,90.41％,77.78％ in the mild,moderate and severe patients,respectively,and those of the control group were 52.38％,80.00％,25.00％ respectively,showing significant differences between them (U =2.211,2.214,2.356,all at P＜0.05).The total effective rate was significantly higher in the observational group than that in the control group (91.09％ versus 75.23％),with a significant difference between them (U=3.040,P=0.002).Postoperative visual acuity was better in the observational group than that in the control group (0.44 ± 0.04 versus 0.22 ± 0.03),with a significant difference between them (t =2.225,P ＜ 0.05).The mean therapeutic course was (22.4 ± 1.8) days in the observational group,which is shorter than (33.2±2.4) days in the control group,with a significant difference between them (t =2.097,P＜0.05).Conclusions Combination therapy of lesion debridement with amniotic membrane coverage and drugs can shorten treating duration and improve vision,and it is superior to only lesion debridement and drugs therapy.

Objective To observe the therapeutic effects of Liuwei Shunji Capsule on survival state, visceral hypersensitivity, the content of 5-HT of model rats with liver depression and spleen deficiency-type irritable bowel syndrome (IBS), and explore its mechanism.Methods SD rats were randomly divided into normal group, model group, pinaverium bromide group and Liuwei Shunji Capsule of high, medium and low dose groups. Senna with restraint stress was used in duplicating liver depression and spleen deficiency-type IBS model. From the second day after the model was established, each drug treatment group was administered with corresponding drugs once a day for two weeks. The effects of Liuwei Shunji Capsule on survival state, visceral hypersensitivity, the content of 5-HT in serum and hypothalamus were observed.Results Compared with model group, Liuwei Shunji Capsule could raise weight growth rate of model rats with liver depression and spleen deficiency-type IBS (P<0.05), improve their diarrhea, fatigue demeanor, fur quality, irritability and other symptoms, significantly decrease their visceral hypersensitivity, the content of 5-HT in serum and hypothalamus (P<0.01).Conclusion Liuwei Shunji Capsule can effectively improve survival state and intestinal disorders of rats with liver depression and spleen deficiency-type IBS, and the mechanism of treatment could be realized through regulating 5-HT level.

Objective To review and investigate the malaria control history of Wuzhou City,Guangxi Zhuang Autonomous Region from 1950 to 2015,so as to provide the evidence for future malaria control and surveillance. Methods The data of ma?laria control in Wuzhou City from 1950 to 2015 were collected and analyzed. Results In 1950 decade,the malaria incidence in Wuzhou City was 1 435.55/100 000,higher than the average level in Guangxi,and the mortality of malaria was 0.95/100 000. The malaria incidence of local residents was reduced to 3.61/100 000 in 1979 and no local malaria case was found since. The im?ported malaria cases were found in Wuzhou City since 1980,and were more than local cases since 1981. In recent five years, 87.50%(7/8)of imported malaria cases were from south?east Asia. Conclusions Wuzhou City has reached the national criteri?on of malaria elimination,but the imported malaria is the recent threat. The surveillance and control work of malaria should be strengthened.

Objective To explore the interaction of sleep quality and depression among patients with type 2 diabetes. Methods With multistage cluster sampling, all the participants were interviewed with self-designed questionnaire, diabetes-specific quality of life scale and self-rating depression scale, and Pittsburgh sleep quality index scale. Chi-square test was used for qualitative data. Risk factors were analyzed by means of multiple linear regression or logistic regression model. The indicator of interaction was calculated according to the delta method. Results There were 944 residents involved in the final analysis, including 365 males and 579 females. The average age was (64. 0 ± 10. 2) years. Compared with patients with type 2 diabetes mellitus( T2DM) who had good sleep quality and no depression symptoms, the risk of quality of life in those with good sleep quality but depression was 2. 75 (95% CI 1. 59-4. 77); and the risk of quality of life in those with poor sleep quality and no depression was 1. 55(95%CI 1. 03-2. 33). The risk of quality of life in those with poor sleep quality and depression was 4. 97(95% CI 2. 34-9. 63). Due to poor sleep quality and depression in patients with T2DM the combined interaction index was 2. 48 (95% CI 1. 44-4. 29), the relative excess risk was 3. 42(95% CI 2. 16-4. 67), and the attributable proportion was 0. 51(95% CI 0. 32-0. 70). Conclusion A combined interaction of poor sleep quality and depression in affecting the quality of life was found in type 2 diabetic patients. When both factors existed at the same time, the interaction effect of these 2 factors was greater than the single one.