Objective To discuss the perioperative nursing measures and their effectiveness for patients with malignant airway stenosis who are receiving airway stent implantation once more due to airway re-stenosis.Methods The clinical data of 7 patients,who received airway stent implantation once more due to airway re-stenosis during the period from May 2014 to July 2016,were retrospectively analyzed.The effectiveness of nursing intervention for stent implantation was assessed.Results The symptoms of dyspnea were relieved immediately after the stent re-placement procedure in all the 7 patients,and no severe complications,such as massive hemorrhage,respiratory failure or asphyxia occurred.Conclusion The key points to ensure a successful second airway stent implantation include following measures and preparations:cooperation mode of medical care integration,preoperative individualized psychological intervention,guiding the patients to cooperate with the treatment,ready for in-operation emergency rescue,rapid and effective assistant cooperation for stent placement,and postoperative close observation for the occurrence of respiratory tract infection,bleeding and other complications.

Objective To determine the influencing factors of post-stroke depression by machine learning.Methods Stroke patients' medical records (688 cases eligible) were extracted from record system,including age,gender,pulse manifestation,complexion,tongue quality,fur,Chinese medicine intervention,body mass index (BMI),blood pressure,blood glucose,blood triglyceride,blood total cholesterol,smoking history,drinking history,depression family history,stroke lesion site in imaging,as well as the final depression judgment.Single rule algorithm (1R) was adopted to learn.The risk factors influencing post-stroke patients' depression in extracted information were determined.Then the cases collected were divided into the training dataset (500 cases) and the test dataset (188cases).Optimal discriminant results were obtained by random forest model.Results Single rule algorithm showed that the most important influencing factor of post-stroke depression was stroke lesion site.By computer speculation,stroke lesions in the frontal and temporal lobes were most prone to post-stroke depression.Basal ganglia,brain stem,cerebellum,medulla oblongata and occipital lobe lesions were less likely to cause depression.The accurate classification rate could amount to 88.95％ (612/688 cases).Random forest model determination was made in the former 500cases in the training dataset.The total correct rate of determining depression was 98.2％.The total correct rate of determination in 188 cases of the test dataset was 99.47％.Six hundred and eighty-eight patients' data were learnt by random forest model.The total correct rate was 98.84％.The importance measure results showed that top 3 important indexes of post-stroke depression were lesion site,Chinese medicine intervention and depression family history.Conclusion Patients with lesions in the frontal & temporal lobes and depression family history were most prone to post-stroke depression.

Objective To study the usefulness of oral contrast-enhanced helical CT cholangiography in the diagnosis and treatment for bile duct diseases.Methods 18 cases of suspected bile duct diseases were studied. The dose of iopanoic acid was 6.0 gram (n=5), 3.0 gram (n=10) and 1.0 gram (n=3). CT scan was performed 12~14 h after administration. Reformatted 2D and 3D MIP images were got from axial source images. The opacified degree of bile duct was described as no opacification, light opacification, well opacification or overopacification . The findings of CT chonlangiography were compared with pathological and/or clinical results . Results (1) The dose ofiopanoic acid could effect the opacified degree of bile duct. It should be more than 6.0 gram to investigate intrahepatic bile duct, and 3.0gram should be enough to investigate extrahepatic bile duct; (2) Intra- and extrahepatic bile duct anatomy could be display clearly,especially the extrahepatic duct. Function of bile duct system, relations between lesion and bile duct, and the obstructed degree of bile duct could be revealed too. Sensitivity was 80% in diagnosis of negative gallstone and gallpolypus . Sensitivity was 88.9% and specificity was 100% in diagnosis of negative gall-stone in general bile duct ; (3) 2D and 3D MIP reconstructions displayed the spatiality of bile duct better.Conclusion Oral contrast-enhanced helical CT cholangiography is feasible and noninvasive. It is a well method in revealling the bile duct anatomy and diagnosing the bile duct lesions, and is useful for bile duct operations.

OBJECTIVE: To explore the expression of interleukin-25 (IL-25) in chronic rhinosinusitis with nasal polyps (CRSwNP) and its potential significance in pathogenesis. METHOD: IL-25 expression in blood was detected by enzyme-linked immunosorbent assay (ELISA). IL-25 expression in tissue was detected by immunohistochemistry (LSAB method) from polyps (68 CRSwNP patients) and 55 inferior turbinate mucosa from patients with deviation of nasal septum served as control. Complete blood count and HE staining of blood and tissue eosinophil infiltration degree. RESULT: IL-25 expression in CRSwNP group were significantly higher than the control group, the difference was statistically significant (P < 0.01). IL-25 expression in local organizations was positively correlated with the number of eosinophil infiltration in CRSwNP group (r = 0.679, P < 0.01). CONCLUSION The expression of IL-25 in CRSwNP patients mutually reinforcing and might increase eosinophil infiltration and play an important role in the development of CRSwNP.
Chronic Disease ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-17 ; blood ; Nasal Polyps ; blood ; Nasal Septum ; Rhinitis ; blood ; Sinusitis ; blood ; Turbinates

Objective To compare the clinical effect of different doses of methylprednisolone in the treatment of children with severe hand foot mouth disease research and analysis. Methods 100 patients in our hospital from January 2014 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group were treated with small doses of methylprednisolone, 2 mg/ (kg?d), intravenous injection. The experimental group was treated with large dose of methylprednisolone, 10～15 mg/(kg?d) intravenous infusion. The therapeutic effects of the experimental group and the control group were compared and analyzed. Results after the corresponding treatment, the number of adverse reactions in the experimental group was 31, the adverse reaction rate was 62.0％, and the adverse reaction rate in the control group was 60.0％. There was no significant difference in the incidence of adverse reactions between the two groups. The upper respiratory rate and critical illness in the experimental group were 26.0％ and 32.0％, significantly lower than that of the control group (P<0.05). The average remission time of the patients in the experimental group was (2.19±1.01) days. The symptomatic remission time in the control group was (4.19±1.89) days. The remission time of the control group was significantly longer than that of the experimental group, with statistical difference (P<0.05). Conclusion The short term large dose of methylprednisolone in treatment of children with severe HFMD clinical effect is ideal, can be reduced to critical illness rate, less symptom remission time, with the further promotion of the clinical significance.

Objective To discuss the clinical application value of Omaha system-based targeting nursing care for patients with hepatocellular carcinoma (HCC) who were treated with transcatheter arterial chemoembolization (TACE).Methods A total of 60 advanced HCC patients,who were planned to receive TACE,were prospectively and randomly divided into the control group (n=30) and the observation group (n=30).Routine nursing mode was adopted for the patients in the control group,while Omaha system nursing model was employed for the patients in the observation group.The patients of the observation group were evaluated with Omaha system at the time of admission,the key common problems were screened out and targeted nursing measures were employed.Meanwhile,on the days of admission and discharge all the patients of both groups were asked to fill in the forms of Hamilton depression scale (HAMD-17),Hamilton anxiety scale (HAMA),social support rating scale (SSQ) and numerical pain rating scale (NRS);and the degrees of depression,anxiety,social support and pain were respectively assessed.Results Both nursing modes could improve the degrees of depression and anxiety as well as the social support system of HCC patients,but the curative effect of these two aspects in the observation group were obviously better than those in the control group (P＜0.05).No statistically significant difference in the improvement of pain degree existed between the two nursing models,but Omaha system-based targeting nursing mode could alleviate the patient's pain to a certain extent.Conclusion For patients with advanced HCC,Omaha system-based targeting nursing care can alleviate the patient's negative emotion and promote the patients to establish effective social support system,this nursing mode is superior to conventional nursing mode.Therefore,Omaha system-based targeting nursing has great application potential in clinical practice.

Objective To analyze the specimen types,ward distribution and risk factors for infections caused by extended-spectrum β-lactamase(ESBLs)-producing-Escherichia coli(ECO) in recent two years,so as to provide bacteriological basis for both hospital infection control and clinical anti-infection treatment.Methods Non-repetitive 443 ECO strains isolated from the hospitalized patients in the Third People′s Hospital of Shenzhen were collcted,and the phoenix100 system was employed for bacterial identification and antimicrobial susceptibility tests.ESBLs-ECO was further confirmed by the double-disk synergy test,and the risk factors caused ESBLs-ECO were statistically analyzed.Results A total of 115 strains of ESBLs-ECO were identified among the 443 strains of ECO,which accounted for 26.0%.The ESBLs-ECO strains were mainly isolated from the sputum,urine,and blood specimens.Among the isolated ESBLs-ECO strains,20.9% were isolated from the department of Tuberculosis,13.9% from the department of pediatric,12.2% from the department of live disease,and 8.7% from the department of infection.The male sex,surgery and use of the third generation cephalosporins were independent risk factors of ESBLs-ECO infection.Conclusion The isolation rate of ESBLs-ECO in this hospital is high.It is necessary for the hospital to strengthen the control of nosocomial infections according to the risk factors.More attention should be payed on male patients,the standardization of surgical operation and disinfection,and the restriction of using the third generation cephalosporins,so as to reduce the incidene of ESBLs-ECO infections.

The levels of total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, apolipoprotein (APO) A1 and APO B were lower in Bai Ku Yao than those in Han nationalities (all P<0.01). There was no significant difference in serum triglyceride levels and the ratio of Apo A1 to Apo B between two nationalities. Dyslipidemia was positively correlated with body mass index, waist circumference, total energy and total fat intakes, and inversely correlated with degree of physical activity and total dietary fiber intake in both ethnic groups. In addition, dyslipidemia was also positively correlated with age and alcohol consumption in Han, but not in Bai Ku Yao.

Objective To evaluate the efficacy and safety of Houpu Paiqi mixture in treatment of functional dyspepsia (FD)with abdominal distension symptom.Methods From July 2014 to June 2015 , in nine centers,a total of 162 FD patients with abdominal distension symptom and met Rome Ⅲpostprandial distress syndrome (PDS)diagnostic criteria were enrolled.All patients were randomly divided into trial group and control group,81 patients in either group.The patients of trial group and control group took Houpu Paiqi mixture or placebo,respectively,25 mL per time,twice daily,and both the courses of treatment were two weeks.Before and after the treatment,the improvement of main symptoms,total clinical efficacy rate and efficacy of traditional medicine between two groups were compared.Chi square test,Fisher exact probability method and Wilcoxon test were performed for statistical analysis.Results According to the results of per-protocol (PP)analysis,the total efficacy rate of trial group and control group was 69.4% (50/72)and 59.2% (42/71),respectively,and there was no statistically significant difference in total efficacy rate between the two groups (χ2 =1 .650,P =0.199 ). And there was no statistically significant difference in the improvement of PDS main symptoms(postprandial fullnessand early satiety)between the two groups (56.3% ±27.9% vs 54.4% ±32.1%,t =0.606,P =0.727 ).For those with baseline symptom score over 14,median early satiety score of trial group after the treatment was 0,which was lower than that of control group,and the difference was statistically significant (Z =-2.370,P =0.018).The total efficacy rate of traditional medicine of trial group was 80.8% (59/73 )and that of control group was 72.0% (54/75 ),and the difference was not statistically significant (χ2 = 0.676,P =0.411 ).Conclusion Houpu Paiqi mixture has certain efficacy in FD with abdominal distension,and could be used for the treatment of PDS-predominant FD.

Objective To analyze the characteristics and treatment of aortic intramural hematoma ( IMH) in non-traumat-ic elderly patients, and to provide clinical reference for the diagnosis and treatment of this disease .Methods A retrospective analysis of clinical data of 36 elderly patients without trauma during the period from March 2013 to May 2017 in our hospital , to clarify the characteristics of pathogenesis and imaging feature , and to evaluate treatment options.Results 36 patients were followed up and the outcomes of them were satisfactory .Of which 17 asymptomatic patients were given conservative treatment . 19 cases of emergency patients, 7 patients received the emergency operation, 9 patients were given interventional treatment after initial conservative medical treatment, 3 patients received drug treatment, of which 1 patient was conservatively successful, and 2 patients progressed.During follow-up, the imaging data of most of the patients were obtained.The aortic enhanced CT indi-cated that the hematoma disappeared or decreased markedly, and the asymptomatic patients were in stable condition, and the dilatation of aorta was not obvious in patients who have access to imaging examination .Conclusion Elderly patients with IMH are more common in men, especially Stanford B type.IMH in asymptomatic elderly patients with multiple penetrating aortic ul-cer(PAU), but the range of hematoma is limited, no significant progress.And this type of patients can be considered only for conservative treatment.On the contrary, IMH of symptomatic elderly patients usually involve a wide range of aorta , and most of them were caused by single small ulcer.Although the patients have been treated with conservative medicine , the disease is still progress and endovascular treatment repair of aorta can be considered .