OBJECTIVE To search for the reasons of unqualified level of bacteria in exit-entrance fluid of hemodialyzer and draft the measures of adjustment to meet the evaluation criteria for exit-entrance fluid of hemodialyzer.METHODS According to MOH′s Hospital Infection Management Standards to detect level and species of bacteria.RESULTS The average numbers of bacteria in exit-entrance fluid of hemodialyzer decreased from 2152.95?826.45 CFU/ml before adjustment to 579?541.04 CFU/ml after adjustment,checking with chi square test,the entrance fluid of hemodialyzer was ?2 =15.92,P

Objective To evaluate the effect of an Internet support program on uncertainty in illness in breast cancer patients after operation. Method One hundred and nineteen breast cancer patients after surgery who were discharged from Shanghai Cancer Hospital were assigned into the control group (63 cases) and the intervention group (56 cases). A 12-week Internet support program was offered to the patients in the intervention group, while the patients in the control group received the routine follow-up. Measurement of uncertainty in illness was taken at the sixth week and the twelfth week after the baseline survey. Results The total score of the uncertainty in illness as well as the factor scores of ambiguity and lack of information showed downward trend in both the intervention group and the control group, and the three indexes in the intervention group declined more rapidly than those in the control group. The scores of the three indexes in the intervention group were significantly lower than those in the control group at the twelfth week. Conclusion The Internet support program which offers abundant information, multi-disciplinary cooperation and real-time interaction intervention is an effective approach in reducing uncertainty in illness for breast cancer survivors.

Objective To evaluate the effect of a nurse-led case management intervention on arm function and uncertainty for women with breast cancer.Methods 90 women with breast cancer were divided into the intervention group and the control group according to their nurses,with 45 patients in each group.All participants were followed six months after surgery.The intervention group attended a 6-month nurse-led case management program,while the control group received the routine care and follow-up only.Questionnaires on arm function and uncertainty were administered 1 month,3 months and 6months after the surgery respectively.Score changes were compared by repeated-measure ANOVA and MANOVA.Results The arm function of the intervention group was better than the control group,except for the 10th day after the operation,there were significant differences at other three time points.The disease uncertainty level of the intervention group was better than that of the control group,except for the dimension of unpredictability,there were evident differences in other dimensions at other three time points.Conclusions The nurse-led case management intervention could improve arm function recovery and decrease the uncertainty to disease of breast cancer survivors.

OBJECTIVE:To observe clinical efficacy and safety of Xuebijing injection combined with imipenem and cilasta-tion in the treatment of severe abdominal infection,and its effects on plasma endotoxin and inflammatory factors. METHODS:Dur-ing Apr. 2013-Apr. 2016,100 patients with severe abdominal infection in our hospital were divided into observation group and control group according to random number table,with 50 cases in each group. Both groups were given Imipenem and cilastation sodium for injection 0.5 g added into 0.9% Sodium chloride injection 500 mL,ivgtt(≥40 min),q12 h. Eight hours later,ob-servation group was additionally given Xuebijing injection 100 mL added into 0.9% Sodium chloride injection 500 mL,ivgtt, bid;Both groups were treated for 5-7 d. The levels of plasma endotoxin and inflammatory factors(TNF-α,IL-6,IL-6/IL-10) were compared in 2 groups before after treatment,and clinical efficacies and the occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in plasma endotoxin or inflammatory factor levels between 2 groups(P>0.05). After treatment,plasma endotoxin and inflammatory factor levels of 2 groups were decreased significantly,and the obser-vation group was significantly lower than the control group,with statistical significance(P<0.05). The excellent and good rate of observation group was 98.00%,which was significantly higher than 78.00%,with statistical significance(P<0.05). No obvi-ous ADR was found in 2 groups. CONCLUSIONS:Xuebijing injection combined with imipenem and cilastation show significant therapeutic efficacy for severe abdominal infection,can effectively control the release of endotoxin and inflammatory factors with good safety.

Objective To evaluate the diagnostic value of three tumor markers ,including alpha‐fetoprotein(AFP) ,golgi glyco‐protein 73(GP73)and tumor specific growth factor(TSGF) ,and significance of combined detection in diagnosis of primary liver cancer(PHC) .Methods Serum levels of AFP ,GP73 and TSGF were detected in 90 cases of patients with PHC(PHC group) ,52 cases of patients with liver metastasis(liver metastasis group) ,41 cases of patients with benign liver disease(benign liver disease group) ,and 55 cases of healthy individuals(healthy control group) .And clinical value of combined detection of AFP ,GP73 and TS‐GF for diagnosing PHC was analysed .Results The serum levels of AFP ,GP73 and TSGF were significantly higher than those in benign liver disease group and healthy control group ,the differences were statistically significant(P< 0 .05) .The specificity of AFP ,GP73 and TSGF in diagnosis of PHC was 79 .7% ,71 .6% and 83 .1% ,respectively .The sensitivity of AFP ,GP73 and TSGF in the diagnosis of PHC was 57 .8% ,74 .4% and 65 .6% ,respectively .The combined detection of AFP ,GP73 and TSGF improved the sensitivity for diagnosing PHC(96 .6% ) ,while the specificity of combined detection was decreased(68 .9% ) .And the diagnosis rates of PHC patients with negative AFP or low levels of AFP were increased when combined the three tumor markers . Conclusion Combined detection of AFP ,GP73 and TSGF as a significant indicator for diagnosing PHC could improve the diagnosis rate of PHC .

Objective To discuss the clinical value of susceptibility weighted imaging (SWI) in the brain vascular malformations. Methods Imaging data of 34 patients with brain vascular malformations proved by digital subtraction angiography (DSA) or pathology obtained on Siemens Sonata 1.5T MR system were studied prospectively, and compared with those of conventional MRI (cMRI) and SWI. Results All 41 lesions of 34 patients with brain vascular malformations showed clearly by SWI. These patients were diagnosed by surgical findings or DSA. These nidus comprised 19 cavernous angiomas, 9 arteriovenous malformations and 6 cerebral venous malformations. Conclusion SWI should be used for clinical diagnosis of brain vascular malformations, and providing more complete and detailed information combining with other sequence.

Objective To evaluate the effects of different doses of ephedrine combined with hydroxyethyl starch as a volume preload for preventing hypotension in caesarean section before combined spinal and epidural anesthesia.Methods 250 pregnant wemen undergoing cesarean section were randomly allocated into the control group (n =50) and the observation group(n =200)(group was divided into A,B,C,D group,each group 50 cases).Control group preloaded Lactated Ringer's solution 250ml before CSEA.A group preloaded hydroxyethyl starch combined with 5mg ephedrine; B group preloaded hydroxyethyl starch combined with 10mg ephedrine.C group preloaded hydroxyethyl starch combined with 15mg ephedrine; D group preloaded hydroxyethyl starch combined with 15mg ephedrine.The parturient SBP,HR and untoward reaction were monitored in five experimental groups.Results Compared with T0 A group parturient SBP was lower at T1,T2,T5 [(111.8 ± 17.18)mm Hg,(114.58 ± 19.80)mm Hg,(115.06 ± 10.39) mum Hg vs (120.88 ± 13.24) mm Hg,all P ＜ 0.05)].Compared with B,C,D group,statistical differences were found at T1,T4,T6[(111.8 ± 17.18)mm Hg vs (120.78 ± 14.47)mm Hg,(118.56 ± 14.25)mm Hg,(118.42 ± 18.71)mm Hg.(125.58 ± 14.45) mm Hg vs (120.02 ±21.15)mm Hg,(115.92 ± 17.56)mm Hg,(119.00 ±12.49)mm Hg.(118.08 ±9.09)mm Hg vs (121.52 ± 10.92) mm Hg,(116.04 ± 11.61)mm Hg,(124.98 ± 9.16) mm Hg,all P ＜ 0.05].Compared with T0 parturient HR was undulation at T1,T5 (P ＜ 0.05).Compared with C,D group,statistical differences were found at T1,T3,T4,T6 [(82.92 ± 19.55) times/min vs (98.86 ±17.82)times/min,(96.72 ± 17.91) times/min.(89.04 ± 16.68) times/min vs (92.10 ± 16.55) times/min,(98.46 ± 19.49) times/min.(87.56 ± 17.13) times/min vs (98.86 ± 16.76) times/min,(88.58 ± 19.22) times/min.(93.20 ± 14.07) times/min vs (98.80 ± 11.69) times/min,(90.98 ± 10.93) times/min.all P ＜ 0.05].In B and C group,parturient SBP and HR were steady and the untoward reaction was very few.Although parturient SBP of D group was steady,but HR obviously fast during operation (P ＜ 0.05).Compared with B,C group,statistical differences were found at T4,T6 (P ＜ 0.01).Conclusion The optimum dose is 10 ～ 15 mg of ephedrine.It combined with hydroxyethyl starch as a volume preload can keep the stable of blood circulation.

Objective To explore the prognosis of mild hypothermia treatment in cases of severe traumatic brain injuries(sTBI),improve the knowledge of mild hypothermia treatment on brain injuries.Methods Cases were divided into 2 groups:mild hypothermia treatment group and control group.Mild hypothermia was applied to the cases of sTBI in mild hypothermia group.The prognosis was divided into five grades such as good recovery(GR),moderate disability(MD),severe disability(SD),persisted vegetative state(PVS)and death(D).Results In mild hypothermia group,there were 20 GR cases,5 MD,2 SD and 3 D cases,while in control group,there were 14 GR cases,9 MD,4 SD and 3 D cases.Conclusion Mild hypothermia treatment can improve the prognosis of sTBI.

Objective To evaluate the effect of nurse-led follow-up on medication adherence and quality of life for breast cancer patients receiving adjuvant hormonal therapy.Methods A randomized controlled trial was conducted with 157 patients in the intervention group and 154 in the control group.A self-design web-database medication monitoring platform was designed for managing patients such as texting,reminding and mailing.Participants were randomized to follow-up care as usual(yearly outpatient clinic visits) or nurse-led telephone follow-up(monthly consultation with structured intervention).Telephone follow-up was performed by four trained breast care nurses (BCN) and consisted of a semi-structured interview including managing the side-effects of endocrine therapy,compliance with hormonal therapy and an open discussion of these issues.Patients' medication adherence and quality of life were evaluated by Morisky Medication Adherence Questionnaire(MAQ) and FACT-B at baseline and 3,6 18 and 24 months,respectively.Results The Nurse-led telephone follow-up did not significantly improve the quality of life(P＞0.05).MAQ score in the intervention group was significantly greater than that in the control group(P＜0.05) at 3,6,18 and 24 months.Conclusion Nurse-led follow-up using computer-based monitoring system can improve patients' medication adherence,but there is no obvious increase in quality of life.