Objective To investigate the mechanism,clinical features of severe skin infection developed in the rehabilitation of the elderly diabetic patients and the commonly seen bacterium.Methods The causes of skin injury,the places of infection and bacterium were analyzed retrospectively.Meanwhile,chemical indicators on admission were analyzed.Results Skin injury was caused by the improper family care and the lake of self protection knowledge.The common places for infection were feet and then back and hip skin.Almost all the infections were caused by opportunists,among which staphylococcus was the most common one.The major separated risk factors were hypoalbuminemia,hyperglycemia,and high level fibrinogen and anemia.Conclusion The elderly diabetic patients are subject to skin infection.Diabetic education and careful nursing are the key to the prevention of severe skin infection.

Objective To explore the effects of the bio-psycho-social-spiritual health model intervention on the bio-psycho-social-spiritual health model of the patients with cervical cancer.Methods 118 patients with cervical cancer were randomly assigned to the control group (60 cases) and the intervention group (58 cases).All patients received the routing nursing of cervical cancer.In addition the intervention group received the bio-psycho-social-spiritual health model intervention.Functional Assessment of Cancer Therapy-General (FACT-G) was used to investigate their quality of life before being intervened,being intervened for 3 and 6 months.Results The range of FACT-G total score was 44-96 (68.29±11.60).The total scores of FACT-G before the intervention,3 and 6 months after the intervention were 66.82 ±12.21,79.31±5.15 and 89.67±5.21,compared with those of the control group,which were 69.81 ±10.84,74.48±7.97,79.74±7.17,the time effect,Inter group effect and interaction effect were 137.723,10.944 and 14.639,P＜0.01.Conclusions The bio-psycho-social-spiritual health model intervention can improve the quality of life of patients with cervical cancer.

AIM:To investigate the expression of GAP-43 mRNA and protein of the motor neurons in spinal cord following the brachial plexus avulsion injury.METHODS: In the present study,three kinds of models of brachial plexus avulsion injury were made: right C7 anterior root avulsion(group A),C7 anterior root avulsion with right C5-T1 posterior roots breaking(group B),right C7 anterior root avulsion with hemi-transect between C5 and C6 segment of spinal cord(group C).The expression of GAP-43 mRNA in anterior horn of spinal cord was detected at 14 days after operation by SYBR green quantification RT-PCR technique.The amounts of GAP-43 positive neurons in spinal cord were detected at 1,3,7 and 14 days after operation by immunohistochemistry technique.RESULTS: In control group,the expression of GAP-43 mRNA was very low in anterior horn.By 14 days after operation,the expression of GAP-43 mRNA was evidently up-regulated compared with control group.GAP-43 positive neuron was observed in control group at 1st day and 3rd day after operation.GAP-43 positive neurons appeared at 7th day and peaked at 14th day after operation.The expression of GAP-43 mRNA and protein were maximum in group C,group B was the lowest.CONCLUSION: The expression of GAP-43 mRNA and GAP-43 protein were up-regulated following brachial plexus injury.The expression of GAP-43 protein results from the recombination of proteins.GAP-43 is closely related to the axon regeneration and functional reconstruction.

Objective To investigate the effect of standardized usage of antibiotics and hand hygiene on carbapenem-re-sistant Enterobacteriaceae (CRE) infection in neonates. Methods According to the situation of standardized management of an-tibiotics in our hospital, the study period, from January 2011 to December 2013, was divided into pre-intervention, transition and post-intervention. Retrospective study was employed to analyze the antibiotics use density (AUD), the hand hygiene compliance rate among the medical staff, the positive rate of CRE and the nosocomial infection percentage of the neonatology department. Results From pre-intervention to post-intervention period, the AUD was decreased from 12.93 DDDs to 8.10 DDDs;hand hy-giene compliance rate of medical staff was increased from 53.49%to 83.33%;the detection rate of CRE was decreased from 3.71%to 2.27%. The differences were all signiifcant among different periods (P<0.01). The nosocomial infection percentage decreased from 0.22%to 0.17%and there was no signiifcant difference (P=0.441). Conclusions Standardized usage of antibiotics and hand hygiene can be served as economical yet effective approaches to controlling CRE infection in neonates.

Objective To analyze data of fails among oncology inpatients from 2014 to 2015,and to explore the effects of the continuous quality improvement on management of falls among oncology inpatients.Methods According to data of falls among oncology inpatients in 2014,continuous quality improvement was carried out in prevention of falls,including health education,risk assessment process of falls and inter-department cooperation.Results One year after applying the continuous quality improvement for management of falls,the number and the rate of falls among oncology inpatients in the year of 2015 (Number=25,Rate=0.027‰) were significantly lower than those in 2014(Number=55,Rate=0.065‰,x2=15.195,P＜0.001).Conclusion Improvement of management protocol for falls can effectively reduce the rate of falls among oncology inpatients and ensure patient safety.

This paper introduced the definition of case management, the application of case management model in China and abroad, analyzed the necessity of the implementation of colostomy case management in the field of patients with colostomy, and then discussed the challenges and solving strategies in the delivery of colostomy case management in China in order to provide a theoretical basis for the establishment and promotion of colostomy case management model.

Objective To compose a scientific, systematic and operative nursing quality evaluation system for neonatal blood exchange transfusion, and to provide a reference for quality control of clinical nursing practice. Methods Semi-structured interviews were conducted, the related literature was reviewed, and a preliminary Delphi enquiry questionnaire with the frame of structure quality, process quality and outcome quality was ultimately formed. Through Delphi enquiry questionnaires and analytic hierarchy processing method, all the indictors and the weights were affirmed. Results Totally 19 experts participated in the inquiry, the authority coefficients in the 2 rounds were 0.91 and 0.93 respectively, theχ2 test of Kendall′s W coefficients was significance with P<0.01. The nursing quality evaluation system for neonatal blood exchange transfusion was finalized with 3 level-1 indicators, 9 level-2 indicators and 39 level-3 indicators. Conclusions The nursing quality evaluation system developed through this study can provide practical reference to clinical nursing practice.

A simple colorimetric method for detection of isocarbophos was developed based on the enhanced peroxidase-like activity of hemin. Hemin could catalyze the oxidation of peroxidase substrate 3,3′,5,5′-tetramethylbenzidine (TMB) by H2O2, which made TMB to lose one electron and caused reaction solution color changing from initial transparent to blue-green. Adding isocarbophos improved hemin affinity to substrates, which further enhanced peroxidase-like activity of hemin and made TMB to lose two electrons. The color of TMB solution was further changed from blue-green to yellow, and the degree of color change was proportional to the concentration of isocarbophos. Under the optimal conditions, the present analytical method for isocarbophos detection had a dynamic range from 2 μg/L to 100 μg/L with a detection limit of 1.2 μg/L (3σ). The selectivity assay demonstrated that other organophosphorus pesticides exhibited negligible interferences for isocarbophos detection. The application of the proposed method in the practical samples showed that the mean recovery of isocarbophos was in the range of 94.4％-113.0％, thus it could be widely applied to rapidly and sensitively detect isocarbophos in the agricultural products.

OBJECTIVE:The effects of Astragulus injection on cardiac function in myocardial infarction convalescents were observed.METHODS:42 cases were randomly divided into two groups(therapeutic group and control group).21 cases in therapeutic group were treated with routine treatment and 21 cases in control group were treated with Astragulus injection on the basis of routine treatment for three weeks.The ejection fraction(EF),early diastolic peak velocity of blood flow(E),late diastolic peak velocity of blood flow(A) and A/E of all patients were measured with pulse ultrasonic Doppler cardiography before and after the treatment.RESULTS:After the treatment,the EF,E and A/E were improved (P

Objective To explore laboratory diagnosis tests for lupus anticoagulant associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency.Methods We investigated the coagulation factors'activity,coagulation factors'antibodies,anticardiolipin antibodies,lupus anticoagulant and thrombin generation in thirteen patients of lupus anticoagulant associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency,ten hemophilia A patients, forty-eight healthy people. In these thirteen patients,there were five patients with schizophrenia and had been taking chlorderazin for a long time,two patients with antiphospholipid syndrome, one patient with pemphigus, five patients in which causes of disease were unknown.Among these patients,two patients has haemorrhage,eleven patients don't have reduced.The antibodies of these coagulation factors and LA were positive.Six patients in this group were ACA poslhve,and seven patients were ACA negative.The lag time of eleven non-haemorrage patients with LA positive associated by F Ⅷ,F Ⅸ and F Ⅺ deficiency was(5.60±1.18)min,higher than that of control group which was(1.88±0.25)min.This differenee had statistically significant(t=10.05,P＜0.01).The time to peak was(8.11±1.91)min,significantly higher than that of control group which was (4.10±0.36)min(t=8.83,P＜0.01).The endogenous thrombin potential(ETP)was(1 640.87±higher than that of hemophilia A patients which was(38.50±6.20)%(t=9.77,P＜0.01).The time to peak of hemophilia A patients was(8.01±1.81)min,significantly higher than that of control group which Was(4.10±0.36)min(t=8.20,P＜0.01).The lag time of control group and hemophilia A patients was (1.88±0.25)min and(2.01±0.84)min,respectively.There was no significant difierence of the lag time between these two groups(t=1.26,P＞0.05).Conclusions Diseases like lupus anticoagulant associated bv coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency and inherited hemophilia should use APTT,PT,should be used as confirmation tests. LA and ACA may serve as indication test for identifying the causes of these diseases. ETP and ETP percentage are quite good parametem for predicting the bleeding risk of patients with LA positive associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency.