Objective To compare the clinical effect of montelukast sodium and ketotifen in the treatment of children with cough variant asthma,thus to provide theoretical basis for clinical treatment.Methods 61 children with cough variant asthma were randomly divided into control group and observation group according to the digital table method,31 cases in each group.Patients of two groups were all given antispasmodic and antitussive.The control group was given ketotifen tablets drug therapy,1mg/time,2 times/d,and the observation group was treated with montelukast chewable tablets,5mg/time,1 time /d.After 8 weeks of treatment,the clinical effects were compared between the two groups.Results The total effective rate of the observation group (96.77%)was higher than that of the control group (77.42%),and the difference was statistically significant (χ2 =16.65,P <0.05).The clinical symptoms improved time of the observation group was (5.78 ±1.36)d,which was shorter than (8.45 ±2.24)d of the control group,the difference was statistically significant (t =2.71,P <0.05).The recurrence rate of the observation group (6.45%) was lower than the control group (16.13%),the difference was statistically significant (χ2 =4.67,P <0.05 ). Recurrence time of the observation group was better than that of the control group,the difference was statistically significant (t =7.98,P <0.05 ).Conclusion The curative effect of montelukast special chewing tablets in the treatment of children with bronchial asthma is obviously superior to ketotifen,has less adverse reactions.It was worthy of clinical application.

Objective To observe the changes of the multifocal electroretinograph (mf-ERG) in commotio retinae. Methods The affected eyes (traumatic group) and the fellow eyes (control group) of 31 patients with unilateral commotio retinae were examined by RETI scan 3.15 system. The responses of 61 retinal regions were recorded, and the average amplitude densities of the N 1 (the first negative) wave and P 1 (the first positive) wave in different regions of retinal were analyzed. Results The average amplitude densities of 1-4 rings in N 1 wave and 1-5 rings in P 1 wave were much lower in traumatic group than those in the control. Conclusions The average amplitude densities of N 1 wave and P 1 wave of mf-ERG in retinal affected regions decreases markedly in eyes with commotio retina; mf-ERG may provide the quantificational and orientational detection for the visual ability of the eyes with commotio retinae.

Covered in the paper is the development of the hospital's surgical information acquisition system during the healthcare reform and upgrading of its performance assessment scheme.Such a system is designed to precisely collect surgery scheduling, daytime surgery, and outpatient surgery workload, conducive to developing a performance assessment scheme based on surgery workload, motivating medical workers, and improving quality of care.

Objective To investigate the risk factors of gallbladder neoplastic polyps,to determine the proper surgical indications,and to understand more about the clinical characteristics of gallbladder adenoma.Methods The clinical data of 748 patients diagnosed to have polypoid lesion of gallbladder (PLG) and underwent cholecystectomy from January 1998 to December 2012 in the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively reviewed.Results Among 748 patients,340 had abdominal symptoms.Postoperative histopathology showed non-neoplastic polyps (n =659),gallbladder adenoma (n =68),gallbladder cancer (n =15) and no polyps (n =6).The mean diameters of the nonneoplastic lesions and the neoplastic polyps were (9.38 ± 3.44) mm and (14.55 ± 5.71) mm,respectively (P ＜ 0.01).The average age of the patients with non-neoplastic lesions was (44.14 ± 11.42) years and (47.39 ± 12.82) years in those with neoplastic polyps (P ＜ 0.05).The proportion of solitary PLG was 41.4％ (253/611) and 59.59％ (47/79) for the non-neoplastic lesions and the neoplastic polyps respec tively (P ＜ 0.01).The size of PLG (13.34 ± 4.18 mm vs.20.07 ± 8.19 mm,P ＜ 0.05) and the age of the patient (45.78 ± 11.66 years vs.54.13 ± 15.82 years,P ＜0.05) between the gallbladder adenoma and gallbladder cancer groups were significantly different.Gallbladder adenoma or dysplasia was identified in 66.7％ (10/15) of gal1bladder cancer specimens.Conclusions Patients with PLG and with abdominal symptoms,large size (≥ 10 mm),old age (≥50 y) and solitary polyp are indications for cholecystectomy.Gallbladder adenoma may develop to gallbladder cancer within 10 years.

Objective To investigate the clinical value of multi-slice spiral CT (MSCT)in diagnosis of internal abdominal hernia (IAH).Methods The MSCT findings in 1 5 patients with IAH confirmed by surgery were retrospectively analyzed.Results MSCT showed intestinal obstruction in 14 patients with strangulating intestinal obstruction in 8.The typical features of MSCT were as follows:translocated position of intestines (occupying effect),closed loop intestinal obstruction (gathered intestinal loops with different forms),assembled,expanded and translocated blood vessels of mesenteries,and thickened intestinal walls with ischemic edema and abnormal density.Surgical results showed paraduodenal hernia in 2,transomental hernia in 2,transmesenteric hernia in 5,ankylenteron strap hernias in 4,pericecal hernia in 1 and hernia through the Douglas fossa in 1,Intestinal obstruction in 14 and strangulating intestinal obstruction in 8 were also confirmed by surgery.The CT findings of IAH were correlated with the surgical results,and the accurate rate of grading of intestinal obstruction with CT was also consistent with the surgical results (Kappa=0.758,t=3.462,P=0.001).Conclusion IAH can be diagnosed accurately by MSCT in most patients,MSCT is helpful for guiding the surgical programs.

Objective To explore the design and application of the multifunctional treatment beds on patients′ position compliance and comfort after intraocular retinal reattachment surgery. Methods Eighty-six patients needing special position nursing after intraocular retinal reattachment surgery were randomly divided into experiment and control groups. The former received the special multifunction treatment beds while normal ward beds were used for the control patients . The position compliance , comfort and the complications were observed one month after surgery. Result The position compliance and the degree of comfort in the experiment group were significantly better than those in the control group and the complication rate was significantly lower than that of the control group (all P<0.05). Conclusion The special multifunction treatment beds can be effective in increasing the patients compliance in positions and compliance as well as reducing postoperative complications and increasing the operation success rate.

Objective To evaluate the impact of epidural anesthesia with levobupivacaine combined with general anesthesia on colon surgery. Methods Sixty patients undergoing elective radical procedure for colon carcinoma were randomLy divided into four groups: saline group (group S), 0.125% levobupivacaine group (group L1), 0.25% levobupivacaine group (group L2), and 0.5% levobupivacaine group (group L3). Group S received normal saline of 10 mL epidurally and then infusion of 5 mL·h-1 until the procedure was finished; groups L1, L2, and L3 received levobupivacaine instead. Anesthetic induction was performed after epidural puncture. Mean blood pressure and heart rate were recorded at 8 time points including 5 min after entering into the operation room, 1 min after intubation, skin incision, abdominal exploration, 1 h after skin incision, completion of operation, extubation, and leaving PACU; meanwhile blood glucose and cortisol were detected, anesthesia time, time to PACU stay, bleeding, transfusion volume, adverse reaction, and doses of propofol, remifentanil, ephedrine, and fentanyl were noted. Results Time to PACU stay was longer in S group than in other 3 groups. Doses of remifentanil and fentanyl were larger in L1 group than in L2 group and L3 group. Ephedrine dose in L3 group was larger than in other 3 groups. Blood sugar in L1 group was higher than L2 group and L3 group. Cortisol in S group was higher than in other 3 group. Cortisol in L1 group was higher than in L3 group. The number of patients with hypotension was greater in L3 group than other 3 groups. Conclusions Continue epidural infusion of 0.25%levobupivacaine can reduce stress response and opioid uses, shorten PACU stay, whereas it does not increase use of ephedrine.

Objective At present , there is only a small amount of survey scale of caregivers′cognitive level on continuous nursing care for premature infants , which had not been subject to stringent testing of reliability and validity .This paper aims at developing a suitable survey scale of caregivers′cognitive level oncontinuous nursing care for 0-1 year premature infants , and testing its reliability and validity. Methods Convenience sampling method was used and totally 495 caregivers of premature infants of Army General Hospi-tal affiliated BaYi Children hospital from April to August 2016 has been investigated .After we had preliminary content of the question-naire, two-round Delphi consultations were used to identify the draft of the scale , and the reliability and validity were tested . Results Totally 419 valid questionnaires from 495.Questionnaires effective recovery was 84.65%.Critical ratio for each entry was 9.355-23.179 ( P<0.05) , which suggested that entries had good distinction .Coeffi-cient of correlation between scale items and total score was 0.500-0.775(P<0.05), whichindicated highly homogeneity between entries and table.By exploratory factor analysis , 5 entries were removed and 77 entries remained .The final scale of caregivers′cognitive level on continuous nursing care for premature infants included 4 indicators in level one , 15 indicators in level two and 77 indicators in level three .The Cronbach′s alpha was 0.985 for overall questionnaire and 0.848-0.939 for each dimension .The split-half reliability was 0.895 for overall questionnaire and 0.814-0.939 for each dimension .The content validity index was 0.963.The cumulative contribution rate of each dimension was 64.645%-83.236%. Conclusion The scale content was scientific and comprehensive .It can be used to investigate the caregivers′cognitive level on continuous nursing care for 0-1 year pre-mature infants, direct nurses to provide continuous care for premature infants , and evaluate the continuous nursing effect .

Objective To explore and build a real, objective, comprehensive clinical nursing individual performance indicators architecture model,and check the rationality and validity for prize distribution by clinical application. Methods The methods included that discuss new ideas of nursing performance management by multi- disciplinary experts,developed clinical personal nursing staff performance evaluation program,worded out indicators and methods for the clinical assessment of individual nurses and nurse managers respectively,then applied research in the pilot departments and hospital step by step. Results A personal performance evaluation framework model was constructed, which include clinical nurses and nursing managers. Experimental results show that the nursing staff in this regard performance program have a high degree of recognition, 98.82% (1 741/1 762) nursing staff understanding of the purpose and significance, 97.15%(1 712/1 762) nurses think the performance model structure is reasonable. After the implementation of the performance program, the outstanding rate of personal performance appraisal of nurses was 93% (1 639/1 762). Conclusions The application of scientific performance appraisal programs can play a positive role in helping improve the quality of clinical care, and promote the stable development of the care team.

Objective To evaluate the long-term efficacy and safety of donepezil in treating patients with Alzheimer's disease(AD).Methods Totally 86 patients with AD were randomly divided into control group(n =43)and treatment group(n =43).The control grou,p received conventional therapy with aniracetam,nimoldipine and ginkgo tablet,while the study group was administrated with donepezil(10 mg/d)on the basis of conventional therapy.The improvements of recognitive ability,mental state,activities of daily life were graded by mini-mental state examination (MMSE),Alzheimer's disease assessment scale-cog(ADAS-cog),activity of daily living(ADL)and global deterioration scale(GDS).The scores were compared between the groups before the treatment and 3,6,12,18,24,30,36,42,48,54,60,66 and 72 months after the treatment,respectively.Results The scores of MMSE,ADAS-cog and GDS after 3 months and ADL score after 6 months (t=2.361,-2.198,-1.790,-2.420,P＜0.05 or P＜0.01)were improved in treatment group than in control group with the best effects at 12 months(all P＜0.01)and the scores continued to decrease after 36 months.At 72 months,the score improvements in treatment group were 7.5 for MMSE,20.3 for ADAS-cog,19.5 for ADL,and 1.4 for GDS as compared with control group(all P ＜0.01).In contrast to pretreatment,there were statistically significant differences in the scores of MMSE,ADAS-cog and GDS at 3,6,12,18 and 24 months,and in the score of ADL at 6,12,18,24 and 30 months after treatment(P＜0.05 or P＜0.01).The differences in the scores of ADAS-cog and GDS after 24 months as well as MMSE and ADL after 30 months were not found(P＞0.05)between pre-treatment and post-treatment.Conclusions Donepezil might be long term effective and safe in slowing down the recognitive and overall function deterioration of AD.