Objective To explore the effect of earplugs on the reduction of noises in the wards with a few patients after gynecological surgery.Methods Two hundred and fifty-four patients hospitalized in our hospital after gynecological surgery from March 2012 to May 2013 were divided into control group(n=124)and observation group(n=130). The observation group was managed with earplugs and the control group patients received routine nursing. The two groups were compared in terms of breathing,heart rate,blood pressure,24 h scores on anxiety before and after operation.Results The postoperative respiration,heart rate,blood pressure of the observation group patients was significantly lower than those of control group(all P<0.05),anxiety score was significantly lower than that of the control group(P<0.01). Conclusions Earplugs can create a quiet environment in wards with a few patients after gynecological surgery and help to stabilize vital signs and reduce anxiety.

Objective To study the influence of the early ambulation on postoperative patients' comfort and complications with the femoral artery puncture interventional therapy.Methods After searching for related literatures with computer,we evaluated the quality of the literatures and screened them.12 random controlled trials met the inclusion criterion.Using RevMan 5.1.2 software,we respectively made Meta analysis for patients with sense of comfort and complications after operations.Results Compared with the control groups,the experimental groups were better in back pain,abdominal pain,limb numbness and acid bilges,sleep disorder,dysuria and urinary retention than those of the control groups.And the difference in the site of puncture bleeding and hematoma had no statistical significance between the two groups.Conclusions It can improve comfort for patients without increasing incidence rate of complications by lying in bed and rest for 12 hours after interventional therapy.It reflects the patient-centered nurs-ing service concept and can improve the patients' quality of life.

Objective To study the organ damage in patients with systemic lupus erythematosus (SLE) and its significance in prognosis. Methods The SLE damage index (SDI) was used to evaluate 121 female and 15 male patients. Results Among these patients, the lowest and the highest SDI was 0 or 9, separately (average: 1.79 ? 2.22). Most damaged organ was renal (39.0%), followed by muscle/skeletal system (19.9%) and cardiovascular system (18.4%). There was statistically significant difference of SDI in different groups of prognosis, life condition or disease duration ( 10 years). However, there was no significant difference of SDI in different sex groups. The correlation analysis revealed that the age at onset or diagnosis was not related to SDI. Conclusion SDI is effective in evaluating the organ damage in predicting prognosis of SLE patients.

Objective To study influences of intervention in pregnant women with positive thyroid autoantibodies on the thyroid function of babies. Methods A total of 55 pregnant women were enrolled with positive thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) during prenatal checkup. They were randomly divided into two groups: intervening group( n= 36, newborn group A) was treated with levothyroxine ( L-T4 ), and non-intervening group ( n= 19, newborn group B) was not treated. 30 cases of pregnant women with negative thyroid autoantibodies served as a normal population control group (newborn group N). Serum TSH, TPOAb, TgAb, TT3, TT4, FT3 and FT4 were measured by high-sensitive immunochemiluminescent assay ,and urinary iodine was also examined in the pregnant women. Fetal plasma TSH, TT3, TT4, FT3, and FT4 levels were measured after cutting the umbilical cord from placenta, and repeated measurements were made by 3-4 weeks and 8-10 weeks postpartum. Results At baseline, serum TSH levels of the pregnant women in intervening and nonintervening groups were significantly higher than that in control group ( P＜0.05 ). Non-intervening group had higher TSH and lower TT3, TT4, FT4 compared with the other two groups (P＜0. 05 or P＜0.01 ). The cord blood TSH levels of the neonates in both group B [(7.06 ± 1.31 ) mIU/L] and group A [(6.23 ± 1.26 ) mIU/L] were significantly higher than that of group N [(5.48±1. 17) mIU/L, P＜0.01 and 0. 05]. By 3-4 weeks postpartum,the serum TSH level [(3.21±0.70)mIU/L] in group B was significantly higher than those in group N [(2.72±0.51)mIU/L] and group A [(2.78±0.42) mIU/L, all P＜0.05]. The serum TSH level in group B [(2.99±0.57) mIU/L] was still higher than those in group N [(2.48±0.68) mIU/L] by 8 to 10 weeks postpartum (P＜0.05 ). Multiple stepwise regression analysis revealed that TSH, TPOAb, and urine iodine levels of mothers were independently related to TSH of their infants. Conclusion When differences in thyroid function exist in pregnant women, these differences also reside in their offspring. The thyroid function in neonates correlates with both the thyroid autoantibodies and thyroid function of their mothers.

Objective Invasive candidiasis is associated with a significant mortality clinically.The purpose of this study was to observe the T cells immune response to fructose bisphosphate aldolase (Fba), an immunodominant antigen of Candida albicans, and determine whether the antigen has the possibility of priming cellular immune protection in invasive candiasis.Methods Using ELISPOT assay, we determined the frequencies of positive spot-forming cells (SFCs) of Fba antigen-specific T cells secreting IFN-γ, IL-4 and IL-17A in the peripheral blood mononuclear cells (PBMCs) of 26 healthy individuals.Results After Fba stimulation, the frequencies of positive SFCs of IFN-γ, IL-4 and IL-17A in the 26 healthy subjects were 23 (9.75, 42.50), 0 (0, 0.25) and 1.5 (0.75, 8.25), respectively, with statistically significant differences among the three (P<0.01).The response rates of IFN-γ (100% [26/26]) and IL-17A (76.92% [20/26]) were significantly higher than that of IL-4 (15.38% [4/26]) (P<0.01).Fba-induced strong response (SCFs ≥20) for IFN-γ was observed in 57.69% (15/26) of the healthy individuals, that for IL-17A in only 1, while that for IL-4 in none.Responses of both Th1 and Th17 cells to Fba were found in 65.38% (17/26) of the subjects, that of Th1 cells in 19.23% (5/26), but that of Th2 cells in none.Conclusion Fba of Candida albicans can induce immunodominant responses of Th1 and Th17 cells and is a potential vaccine against invasive candiasis.

Objective To discuss on nursing of patients multiple- patient burn- blast combined injury, the cooperation of processes and quality control. Methods For 35 cases of burn- blast combined injury, emergency plan was initiated immediately, including staffing allocation, supplies allocation, nursing quality control and monitoring the inpatient areas, etc. Results 35 cases of burn- blast combined injury acquired immediate treatment of burn shock and nursing. Rescue rate of multiple- patient burn blast arrived 77.14%(27/35), with no case of nursing complication. Conclusions Timely allocation of nursing staff, rational quantity and structure, forceful organization and coordination, complete and timely supplies, correct quality control of emergence nursing and beneficial solutions are keys to ensure successive nursing of intensive patients of burn-blast combined injury, and also reflection of nursing quality guarantee.

Objective To systematically evaluate the optimal dose of early enteral nutrition support in critically ill patients.Methods Systematic search database including PubMed,Web of science,Scopus,CINAHL,CBM,CNKI.RCTs about early enteral nutrition dose selections in critically ill patients were chosen according to include and exclude criteria by two researchers independently.Cochrane system evaluation manual bias risk assessment was used to evaluate quality of literature.RevMan5.3 Meta analysis software was used to analyze the data.Results A total of 1 571 literatures were retrieved and 8 RCT studies were included,2 713 subjects in total.Meta analysis results showed that there were statistically significant differences in mechanical ventilation time,incidence of diarrhea,and utilization rate of gastro dynamic drugs between trophic feeding and full feeding (P＜0.05).There were no statistically significant differences in mortality,length of stay,incidence of nosocomial infections,reflux,vomiting,constipation,etc.(P＞0.05).Conclusions Trophic feeding has familiar effects on mortality,length of hospital stay compared to full feeding,but it can help to shorten ICU mechanical ventilation time,improve the gastrointestinal tolerability.

Objective To prospectively survey the well-known experts of critical care and endocrine secretion to summarize their experience in treating diabetes mellitus complicated by sepsis for the purpose of providing guidance of theory and practice in making treatment schemes of traditional Chinese medicine for such disease.Methods The questionnaires were designed and submitted to the experts.The statistic analysis was undertook to investigate the rules.Results A total of 30 questionnaires were released and 28 were retrieved.The experts generally believed that eight-principle syndrome differentiation was the most useful method in the syndrome differentiation and treatment of this disease.The heat,stasis and toxin were usually acted as the main pathogenic factors while damp and phlegm commonly act as secondary pathogenic factors.They thought that weak body resistance under the invading of evil was the key mechanisms in the deterioration of the disease and they chose clearing heat,activating blood and detoxication as 3 core treatment principles.Conclusions The summarized opinions from the experts should be act as important reference in treating this disease,but its effectiveness and possibility for further generalization need to be validated in the clinical practice.

Objective:To investigate the correlation between activities of daily living and hemoglobin level in patients with acute ischemic stroke (AIS).Methods:A retrospective analysis was performed in 190 patients with acute ischemic stroke from August 2015 to April 2017. The hemoglobin (Hb) levels at admission were analyzed . According to the Barthel index (BI) score, the patients were divided into good improvement group ( n=119) and poor improvement group ( n=71). Spearman correlation analysis was used to study the relationship between hemoglobin level and short-term activities of daily living in patients with acute ischemic stroke. Results:(1)The short-term activities of daily living was improved in 119 patients. Among them, 62 (52.1%) were under 65 years old and 57 (47.9%) were over 65 years old, 9 (7.56%) male patients with hemoglobin <120 g/L and 39 (32.77%) male patients with hemoglobin > 150 g/L. There were 71 patients with poor short-term activities of daily living. Among them, 23(32.39%)were under 65 years old and 48(67.61%)were over 65 years old, 1(1.41%)male patients with hemoglobin <120 g/L and 12(16.9%) male patients with hemoglobin > 150 g/L. There were significant differences in age (χ 2= 6.985, P=0.008) and male hemoglobin level (χ 2= 8.069, P=0.005) between patients with good activities of daily living and patients with poor activities of daily living.(2)Regression analysis showed that age > 65 years ( β =1.386, OR=4.000, 95% CI=1.189-3.461, P=0.025) and abnormal hemoglobin levels in men (Hb<120 g/L or > 150 g/L) ( β =1.089, OR=2.972, 95% CI=1.383-6.388, P=0.005) were the influencing factors of poor short-term quality of life in patients with acute ischemic stroke.(3)Spearman correlation analysis showed that abnormal hemoglobin levels in men (Hb<120 g/L or>150 g/L) were positively correlated with poor short-term activities of daily living in patients with acute ischemic stroke( r=0.244, P=0.004). Conclusion:Abnormal hemoglobin level is associated with poor short-term activities of daily living improvement in patients with acute ischemic stroke.

Objective:To investigate the correlation between serum 25-hydroxyvitamin D (serum 25(OH)D) and Meige syndrome.Methods:A retrospective analysis was performed on 47 patients with Meige syndrome (Meige syndrome group) treated in Yuquan Hospital of Tsinghua University admitted from August 2012 to July 2018 in our hospital.In the same period, 69 healthy people of the same age group were selected as the healthy control group.The difference of serum 25(OH)D concentration among different subtypes of Meige syndrome (type I, II, III) was compared.Logistic regression analysis was used to analyze the correlation between serum 25(OH)D level and Meige syndrome.Results:The serum 25(OH)D concentration in patients with Meige syndrome was (12.68±6.77) μg/L, which was significantly lower than that in the healthy control group ((17.93±6.93) μg/L). The difference was statistically significant ( t=4.044, P<0.001). The serum 25(OH)D concentrations of subtypes I, II and III in patients with Meige syndrome were (14.7±8.14), (11.4±5.02), (8.38±4.99) μg/L, respectively. There was no significant difference among the three types ( F=1.892, P=0.231). Logistic regression results showed that serum 25(OH)D levels were correlated with Meige syndrome ( OR=0.938, 95% CI: 0.885-0.995, P=0.034). Conclusion:The serum 25(OH)D expression level in patients with Meige syndrome is low, suggesting that vitamin D deficiency may be involved in the pathogenesis of Meige syndrome.