Through the research and analysis of patients' group ages, cultural level and profession structure. etc, combined with the requirement of new medical mode, the paper raises the cultural ethical accomplishment nurses should have, and gives examples to discuss the relationship between this accomplishment and nursing quality.

ObjectiveTo analyze the influential factor of anxiety and depression scores in patients with broken limb(finger),and find the effective nursing interventions.MethodsThe international general hospital anxiety and depression scale research studies on the 100 patients with broken limb(finger) were conducted.ResultsThe patients' age,education level,the nature and size of the company,pre-service training,the level of income and the patients' family economic conditions had a significant impact on scoring a high level of anxiety and depression in patients with broken limb (finger).The differences between the various influencing factors were statistically significant (F =2.926,2.722,t =5.701,4.117,3.311,2.837,3.021,2.947,4.106,3.199,5.286,4.310,5.129,4.152,all P ＜0.05 ).Then the patients' gender,marital status,work experience,the time of injury for overtime and the injured situations do not constitute the relevant factors affecting the patients' anxiety and depression scores.ConclusionPatients with broken limb(finger) have a high incidence of anxiety and depression.The patients' age,education level,the nature and size of the company,pre-service training,the level of income and the patients' family economic conditions have significant impact on scoring a high level of anxiety and depression in patients with broken limb (finger).Clinical care for such patients,should be thought their background,in order to take appropriate nursing intervention.

Objective To explore the role of CD4+CD25+CD127low/-regulatory T cells (Tregs) in the pathogenesis of psoriasis vulgaris(PV). Methods Flow cytometry analysis was used to detect the amount of Tregs in peripheral blood and ELISA to test the levels of IL-10 and TGF-β1 in blood serum; the suppressive function of Tregs on autologous CD4+CD25-T cells was determined by MTT method. Results No significant difference was found in the proportion of Tregs in PV patients and healthy controls(P>0.05). There was a diminished suppression of Tregs from patients on autologous CD4+CD25- responder T cell proliferation in PV patients when compared with that in controls (P < 0.01). The serum level of IL-10 in patients was lower than that in controls (P < 0.01) while that of TGF-β1 in PV patients was significantly higher than that in controls(P < 0.01). Conclusion Abnormal function of Tregs and low secretion of IL-10 in PV patients might be related to the pathogenesis of psoriasis.

Objective To investigate the application effect of pelvic rocking with balloon bionic midwifery in head dystocia. Methods Prospective research method was selected, and 400 pregnant women with head dystocia were divided into 2 groups by random digits table method with 200 cases each. The observation group was given pelvic rocking with balloon bionic midwifery delivery, and the control group was given gauge and comfortable posture with manual rotation fetal head delivery. The labor stage and delivery outcome were observed in two groups. Results The rate of successfully correct the fetal position was 91.00%(182/200) in observation group and 65.00%(130/200) in control group,and there was significant difference between 2 groups, χ2=39.394,P<0.01. The cesarean section rate was 7.00%(14/200) in observation group and 27.00%(54/200) in control group,and there was significant difference between 2 groups, χ2=113.119,P<0.01. The first, second and total labor stage were (8.86 ±2.20), (0.72 ±0.52), (9.78 ±2.82) h in observation group and (12.60±2.10), (1.02±0.82), (13.83±3.01) h in control group, and there were significant differences between 2 groups, t=15.684,4.058,12.609, P<0.01. The incidence of episiotomy, perineal laceration of Ⅱ degree, fetal distress, neonatal asphyxia and postpartum hemorrhage were 17.20%(32/186), 6.45%(12/186), 1.00%(2/200), 0, (150.80 ±43.54) ml in observation group, and 42.47%(62/146), 41.48%(61/146), 9.00%(18/200), 3.00%(6/200), (254.60±83.50) ml, and there were significant differences between 2 groups, P <0.01 or 0.05. Conclusions Pelvic rocking with balloon bionic midwifery can effectively correct the fetal position, reduce head dystocia and cesarean section rate, shorten the first labor stage, the second labor stage, reduce the occurrence of complication of mother and infant.

Facing the current situation of scientific literacy in vocational medical school, med-ical science literacy education has been penetrated into the teaching process of human functionology by measures of combining with research materials and clinical cases, increasing the proportion of ex-perimental teaching, stressing comprehensive practical projects and carrying out the ‘competitive learning’ to improve competency and occupation competitiveness of vocational medical students.

Objective To investigate the value of spleen stiffness measured by transient elastography (FibroScan,FS) for diagnosing esophageal-gastric varices in liver cirrhosis patients.Methods A total of 259 cirrhotic patients in Tianjin Third Central Hospital from Apr 2011 to Apr 2012,and 30 healthy controls were enrolled.All the patients and controls were evaluated for spleen and liver stiffness by FS and 201 cirrhotic patients also underwent gastroscopy for the diagnosis of esophageal-gastric varices.By using gastroscopy as the gold standard,the receiver operating characteristic (ROC) curves of three parameters including spleen stiffness,liver stiffness and platelet/thickness of spleen were delineated for different disease stage.The areas under curves (AUC) were used to evaluate the value of these parameters in the diagnosis of esophageal-gastric varices.Results The spleen and liver stiffness values in cirrhotic patients were (44.64 ± 22.27) kPa and (24.27 ±18.89) kPa,respectively,while those in healthy controls were (20.94± 14.78) kPa and (6.12±5.77) kPa,respectively,which were both lower than cirrhotic patients (P＜0.05).The stiffness values of liver and spleen both increased with higher Child-Pugh scores.And the liver stiffness values were different among groups (F=0.068,P =0.000),while the spleen stiffness values in patients with Child-Pugh A and B were different from that in patients with Child-Pugh C (P＜0.05).In patients with moderate or serious esophageal-gastric varices,the spleen and liver stiffness values were significantly higher.The ROC curve analysis showed that the AUC of spleen stiffness,liver stiffness and platelet/thickness of spleen in the patients with moderate to serious esophageal-gastric varices were 0.918,0.749 and 0.743,respectively.The corresponding optimal cut-off values were 50.7 kPa,20.1 kPa and 1.65.The AUC,sensitivity and specificity of spleen stiffness were all higher than liver stiffness and platelet/thickness of spleen.Conclusion Spleen stiffness measured by transient elastography is a valuable parameter for non-invasive diagnosis of esophageal-gastric varices in cirrhotic patients.

Objective To retrospectively analyze the diagnostic value of a noninvasive score system based on transient elastography (TE),serological test and imaging examination on esophageal variceal bleeding (EVB) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between April 2011 and December 2012,172 patients with HBV-related cirrhosis including 120 males and 52 females who visited clinic or hospitalized at the Department of Hepatology,Tianjin Third Central Hospital,were retrospectively enrolled.The mean age was (52.9 ± 10.6) years.Patients underwent upper gastrointestinal endoscopy to evaluate esophageal varices (EV) and were further categorized into three stages of mild,moderate and severe according to the morphology of EV and the risk of bleeding.Liver stiffness and spleen stiffness measurement were performed using Fibroscan.Portal vein width,splenic width and spleen thickness were measured using color Doppler ultrasound.All the patients were tested for white blood cell counts and platelet counts.With endoscopy as the gold standard,receiver operating characteristic (ROC) curves and the areas under curves (AUC) were used to assess the performance of the noninvasive score system in predicting EV by liver stiffness,spleen stiffness,portal vein width,spleen thickness and platelet counts.Student's t-test was performed to determine differences between continuous variables.Pearson's correlation was used to evaluate the association between EVB and these parameters.Results All these 172 patients underwent endoscopy.Among them,41 were EVB patients and 131 with no bleeding of EV.Among 172 EV patients,39 without EV,30 were mild EV,47 were moderate EV and 56 were severe EV.EVB was all positively correlated with liver and spleen stiffness,portal vein width,spleen thickness,splenic vein width (r=0.224,0.771,0.214,0.425 and 0.364,respectively; all P＜0.05).EVB was negatively correlated with platelet counts (r=-0.408,P=0.000).Liver stiffness,spleen stiffness,portal vein width,spleen thickness and splenic vein width in EVB patients were significantly higher than those in EV patients (P＜0.05).In contrast,platelet counts level was lower in EVB patients with difference of statistical significance (P＜0.05).AUC of non-invasive score system for EV and EVB were 0.953 and 0.882,respectively (P＜0.05).The optimal cut-off level of noninvasive score system for prediction of EV and EBV were 7 (sensitivity:96 ％,specificity:85 ％) in EV patients and 10 (sensitivity:78％,specificity:89 ％) in EVB patients.Conclusion Non-invasive score system based on liver stiffness,spleen stiffness,spleen thickness,width of splenic and portal vein and platelet counts is of clinical importance in assessing the presence of EV in patients with HBV-related cirrhosis,which is higher clinically valuable in the diagnosis for EV.

Objective To investigate the CT and MRI features of ovarian fibroma.Methods CT and MRI findings of 42 patients with ovarian fibroma confirmed by operation and pathology were analyzed retrospectively.Twenty-one patients were examined by CT,26 cases was examined by MRI,and 5 cases were examined by CT and MRI.Results In 42 cases of ovarian fibroma,there were simple type in 29 cases,degenerative type in 11 cases,and special type in 2 cases.All the cases had single lesion,morphology were round or elliptic or lobulated,clear boundary in 40 cases,partial fuzzy boundary in 2 cases,3 cases with calcification,hemorrhage in 1 case.The maximum tumor diameter were 1.4-26.7 cm,median value was 5.5 cm.Simple type of ovarian fibroma were equal density on CT,low signal on T1WI and T2WI.Degeneration type was patchy,fissure,low density areas on CT or high signal on T2WI,and the tumor parenchyma was almost no enhancement or only slight enhancement.A large number of hemorrhages had been found in 1 special type patient,and significantly enhanced in the other special type patient.Special type were misdiagnosed as malignant tumor.Conclusion CT and MRI performance of ovarian fibroma has some characteristics,but diagnosis still need to rely on pathology.

Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on cognitive function in patients with chronic schizophrenia.Methods:100 cases patients with chronic schizophrenia weree selected.They were divided into rTMS stimulation group and pseudo stimulation group according to the random number table method,and each group include 50 cases.The positive and Negative Syndrome Scale (PANSS) and the Treatment Emergent Symptom scale (TESS) were used to assess the clinical symptoms and side effects before and after the treatment;The Wisconsin Card Sorting Test (WCST) and Repeatable Neuropsychological State Measurement (RBANS) were used to assess the patients' cognitive function before and after treatment.Results:After treatment,the PANSS total score,the positive subscale score,the negative subscale score,the general psychopathological subscale score in the rTMS stimulation group were significantly reducing (P＜0.05),and significantly lower than those in the pseudo stimulation group (P＜0.05),but the TESS scores between the two groups did not differ significantly before and after treatment.The percentage of WCST in rTMS stimulation group was significantly higher than that in the pseudo stimulation group (P＜0.05),and the total time and wrong thinking time was shorter than that in the pseudo stimulation group (P＜0.05);The visual span and delayed memory performance of RBANS was significantly increased in the rTMS stimulation group (P＜0.05),and the visual span was significantly higher than that in the pseudo stimulus group (P＜0.05);There were 2 cases of patients with mild symptoms after the first treatment in RTMS stimulation group,all patients were without complaint followed up for 3 months.Conclusion:rTMS treatment on the part of the cognitive function of patients with chronic schizophrenia has a certain improvement effect,and higher security,it is worth further study.

Objective The survey is based on status of sexual health and sexual needs for male patients with acute myocardial infarction and Percutaneous Transluminal Coronary Angioplasty (PTCA) plus stent implantation.The survey data provides the basis for guiding patients' health education.Methods General questionnaire,sexual knowledge status questionnaire and sexual health knowledge demand questionnaire were used to carried out the investigation in 214 cases of patients with PTCA plus stent implantation.Collected data entered into a database for statistical analysis.Results The overall score of sexual health of 214 patients was (8.79±2.52) points.There was a statistically significant difference in different education levels,occupation and monthly income.There was no statistically significant difference in different ages.The overall score of knowledge of sexual health demand was (29.40 ± 6.47) points.There was a statistically significant difference in different ages,education levels and occupations.There was no statistically significant difference in different monthly income.Conclusions The sexual knowledge cognitive level of patients with PTCA plus stent implantation is low,but they have higher demand of sexual health knowledge,the medical personnel should strengthen the knowledge of sex education for patients to improve the quality of sex.