Objective To understand patients' experience of intensive care with mechanical ventilation at intensive care units to provide a more holistic approach to patient care. Methods In-depth interviews were applied to 11 participants who survived from mechanical ventilation. The pa-tients were asked to describe their experience by responding to the research question "what is it like to experience mechanical ventilation treatment at an ICU?"The data were analyzed by Giorgi's ph e-nomenological procedures. Results Five mutually exclusive themes emerged, which were titled "be-ing in an unconventional environment", "suffering from physical discomfort", "encountering psycho-logical crisis", "self-encouragement", and"self-reflection". Conclusions Patients' experiences while receiving mechanical ventilation at an intensive unit were poignant and afeard, but "self-encour-age-ment" and "self-reflection" will enhance patients' self-confidence which will be beneficial for their re-covery of critical illness.

Objective To analyze rotaviral enteritis outbreak situation parenteral clinical manifestations and understanding of characteristics of multiple organ damage caused by rotaviral enteritis .Methods The clinical data of 68 cases diagnosed as the infection of rotaviral enteritis were retrospectively analyzed .The proportion of observed ap-pearance of multi-organ damage and fever ,acidosis were used as grouping criteria to analyze the relationship with CK-MB abnormalities.Results In 68 cases,including 46 cases of the elevation of CKMB ,9 cases of ECG T wave abnor-malities,symptoms of respiratory tract infection occurred in 37 patients,10 cases of liver function damage symptoms and increase of ALT,37 cases of acidosis,6 cases with symptoms of kidney damage ,skin rashes in 3 cases,2 cases of non febrile convulsions;fever,acidosis and CKMB anomaly had obvious correlation (χ2 =4.390,4.271,all P <0.05 ) .Conclusion Rotaviral enteritis with apparent clinical injury of multiple organ is relatively common .The regu-lar treatments after symptoms are very effective and the prognosis is good .The activity of creatine kinase isoenzyme al-ways is abnormal when the patients have fever ,acidosis ,which suggests that the active control of temperature and cor-rection of acidosis may reduce myocardial injury .

Objective To evaluate the pregnancy outcome of women with pulmonary arterial hypertension (PAH).Methods The medical records of 103 pregnant women with PAH admitted to Beijing Anzhen Hospital from January 2007 to March 2011 were studied retrospectively.Results (1) Degree of PAH and cardiac function.Among the 103 PAH,92 cases were patients with congenital heart disease and 13 cases were with rheumatic heart disease.They were divided by color doppler ultrasound into mild PAH group (34 cases),moderate PAH group (22 cases) and severe PAH group (47 cases).Per heart function classification,21 cases (20.4％,21/103) were class Ⅰ,44 cases (42.7％,44/103) were class Ⅱ,27 cases (26.2％,27/103) were class Ⅲ and 11 cases (10.7％,11/103) were class Ⅳ.More patients were class Ⅲ and Ⅳcardiac function in the severe PAH group than in the mild and moderate PAH groups,with statistically significant difference (P ＜ 0.05).(2) Delivery mode.There were 44 term delivery and 23 preterm birth in the 103 PAH patients.Sixty-three cases (94％,63/67) received cesarean section and 4 cases had vaginal delivery.There were 36 iatrogenic abortion (35.0％,36/103).The iatrogenic abortion rate in the severe PAH group was significantly higher than those in the mild and moderate PAH groups (P ＜ 0.05).(3) Perinatal outcomes.The full-term delivery rates in the mild and moderate PAH groups [80％ (20/25) and 14/17] were significantly higher than the severe PAH group (40％,10/25),respectively (P ＜ 0.05).And the premature birth rate of the severe PAH group(60％,15/25) was significantly higher than the mild and moderate PAH group [20％ (5/25)and 3/17,P ＜ 0.05].There were 4 neonatal asphyxia.The birth weight of mild,moderate and severe PAH groups were (3071 ± 443),(2910 ± 619) and (2381 ±589) g,respectively.The birth weight in the severe PAH group was significantly lower than the mild and moderate PAH groups (P ＜ 0.05).(4) Mortality.Nine cases naternal death happened,with a mortality of 8.7％ (9/103).All of them were severe pulmonary hypertension patients.Conclusions PAH is a serious complication during pregnancy.Women with mild PAH and normal cardiac function could continue pregnancy to full-term.Women with moderate PAH might continue pregnancy to 32 weeks under intensive care,cesarean delivery is preferable.Pregnant women with severe PAH should terminate pregnancy because of the high mortality.

Objective To investigate the effect of puerarin on proliferation of human embro fibroblast and extracelluar matrix. Method Human embro fibroblasts were incubated with 0～400 ?g/mL puerarin for 24～96 h. The MTT method was used to assay the biological activities and extracelluar matrix formation in different time and different dose of pueratin. The cell cycle distribution was detected by flow cytometric analysis. Result Incubation cells in presence of puerarin of 40～400 ?g/mL for 24～72 h could significant inhibit cell proliferation and restrain the collagen synthesis in a dose- and time-dependent manner (P

Objective To estimate help-seeking behavior among individual with overactive bladder (OAB) in type 2 diabetes mellitus and its influencing factors.Methods This was a cross-sectional survey with a representative sample of 133 patients with OAB in type 2 diabetes mellitus responded the questionnaires,including a self-designed Demographic Data Questionnaire,12-item Short-Form health survey questionnaire,Overactive Bladder Symptom Score,Patient Perception of Bladder Condition,Help-seeking Behavior Questionnaire.Results Among cases,21.8％(29/133) had seen a doctor for voiding problems.In the Logistic model,educational status,Charlson comorbidity index,glycosylated hemoglobin,and OAB symptom bother were found to be associated with help-seeking behavior,OR value(95％ confidence interval) were 3.158(1.511-6.599),2.537(1.327-4.849),0.631(0.430-0.926),1.655(1.126-2.434),P ＜0.01 or 0.05.Conclusions The help-seeking rate of OAB individuals in type 2 diabetes mellitus patients is low.Health care providers should understand the predictors of help-seeking behavior and take actions to improve patient's health care utilization and quality of life.

Objective To explored the effect of sildenafil in treatment of pregnant women with pulmonary arterial hypertension.Methods From January 2012 to November 2013,64 pregnant women with pulmonary arterial hypertension (PAH) were randomly divided into group and control group.Control group:16 cases with mild and 16 cases with moderate PAH.To treatment with low-flow oxygen,low-salt diet therapy,cardiac,etc.sildenafil group:15 cases were mild pulmonary hypertension,and 17 cases moderate PAH.Treatment sildenafil 25 mg,rid in this study.Then the variation of the blood oxygen saturation,pulmonary artery systolic pressure,hemodynamic parameters and pregnancy outcome,including delivery modes,neonatal weight,morbidity of mother and fetus were compared.Results (1) Cardiac function and pulmonary hypertension:control group:the proportion of cardiac functional class Ⅰ-Ⅱ reduced from 81％ (26/32) to 56％ (18/32) significantly after treatment (P ＜ 0.05).Sildenafil group:the proportion of cardiac functional class Ⅰ-Ⅱ increased from 75％ (24/32) to 84％ (27/32) significantly after treatment (P ＜ 0.05).Between two groups,the proportion of mild and moderate turning to server PAH patients were significant differentce (P ＜ 0.05).(2) The pregnancy outcome of two group:the premature birth rate,low birth weight rate and cesarean section rate of 9％ (3/32),9％ (3/32)and 69％ (22/32)in sildenafil group were significantly lower than 16％ (5/32),19％ (6/32) and 81％ (26/32) in control group (P ＜0.05).The rate of vaginal delivery,term pregnancy and neonatal weight of 31％ (10/32),91％ (29/32) and (3 214 ±306) g in sildenafil group were different with 19％ (6/32),84％ (27/32) and (3 004 ±458) g in control group (P ＜ 0.05).(3) Hemodynamic parameters:in control group,arterial partial pressure of oxygen,oxygen saturation and left ventricular ejection fraction,pulmonary systolic pression were (80 ± 5) ％ to (72 ±8)％,(87 ±8) to(83±9) mmHg(1 mmHg=0.133 kPa),0.77 ±0.24 to 0.70 ±0.38 and (63 ±9) to (69 ± 12) mmHg before and after treatment,which showed remarkable decreased trends(P ＜ 0.05).The other parameter were not significantly different (P ＞ 0.05).In sildenafil group,arterial partial pressure of oxygen,oxygen saturation and left ventricular ejection fraction,pulmonary systolic pression showed increased trend before and after treatment,which were (80 ± 9) ％ to (88 ± 9) ％,(84 ± 3) to (89 ± 7) mmHg,0.70 ± 0.32 to 0.79 ± 0.27 (P ＜ 0.05),in the mean time,pulmonary systolic pression showed decreased trend from (65 ± 18) to (60 ± 13) mmHg (P ＜0.05).The other parameter did not show significant different (P ＞ 0.05).Conclusions Sildenafil treatment can significantly improve the clinical symptoms,cardiac function and hemodynamic parameters.It also could significantly improve pregnancy outcomes,reduce premature delivery,the incidence of low birth weight children,and cesarean section rate.

Objective To explore the status of toileting behavior and its relationship to lower urinary tract symptoms (LUTS) in female nurses. Methods A total of 636 nurses were selected from three top three hospitals in Jinan by multi-stage sampling. The nurses′toileting behavior and LUTS were assessed by Women′s Toileting Behavior Scale and The International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms. Univariate analysis and hierarchical regression analysis were conducted to examine the factors associated with LUTS. Results The nurse groups were widespread adverse toileting behavior. Delayed voiding was the most severe problem in nurses. Among LUTS storage symptoms were the most severe,voiding symptoms followed and incontinence symptoms were mild. Hierarchical regression analysis exhibited that factors associated significantly with LUTS included age, body mass index, menstrual status, working experience, history of urinary tract infection and poor toileting behavior (mainly hard urination, delayed voiding, and anuria urination),which explained 9.1%,12.9% and 12.6% of the variance of storage symptoms, voiding symptoms and incontinence symptoms, respectively. Conclusions Poor toileting behaviors are highly prevalent in nurses and they are closely related to LUTS, leading to concerns about possible effects of working environment and poor bladder habits on LUTS. Cognitive-behavioral intervention for this group is essential for delivering information about correct toileting behavior and its association with LUTS. Hospital administrators are suggested to pay more attention to nurses′working environment and its impact on nurses′health in order to improve their quality of life and job satisfaction.

Objective To study the effect of authorization theory on patients with new-diagnosed type 2 diabetes with impaired glucose regulation.Methods Authorization education on diabetes were carried out in 54 new-dhgnosed type 2 diabetes patients with impaired glucose regulation for 1 year.The blood glucose,body weight,BML,systolic and diastolic blood pressure,waist circumference,waist-hip ratio and adiponectin were examined before and after authorization education.Courses of education were divided into five steps:identify the problem;express feelings;Set goals;make a plan;evaluate the result.Results All the above factors alleviated after authorization education,P＜0.05.Conclusions Authorization education for patients can make them change their living style actively and achieve the goal of behavior change.

Objective To understand the experience of stroke patients during the period of com-munity rehabilitation by analysis of the in-depth feeling of them in order to supply reference for communi ty rehabilitation nursing. Methods According to the possible problems of stroke patients including in-nermost feelings, difficulties during community rehabilitation, and the expectation of getting solution, by the instruction of Van Manen's hermeneutic phenomenological methods and adoption of in- depth inter-view, the data of 11 participants were collected and analyzed deeply. Results By using the principle of reflection, comparison and induction six mutually exclusive themes emerged, which were tided: sadness and dread, frustration and useless, fate, unfair and punishment, infeh disguise, self-balance and aspiration of the professional guidance. Conclusions The professional instruction for stroke patients and their families is impending during the period of community rehabilitation.

Objective This study aimed to construct an index system for nurse performance appraisal based on the quantity,quality,efficiency and technology in holistic nursing mode.Methods Expert interviews and Delphi expert enquiry were used to complete the construction of index system,and SPSS17.0 was used to do data statistics and reliability analysis.Results The nurse performance appraisal index system was constructed which contained 4 level-Ⅰ indicators such as level coefficient,nursing workload scores,nursing quality scoring rate and reward amount and 12 level-Ⅱ indicators.The calculation method of each part was also established.The expert positive coefficients were 94.3％ and 100.0％ respectively,the authority coefficients were 0.83 and 0.84,the importance and feasibility mean scores of every index were 4.27-5.00 and 4.26-4.94,and coefficients of variation were 0.00-0.26 and 0.05-0.26 in 2 rounds of enquiry.The importance of level-Ⅰ or level-Ⅱ indicators and operability coordination coefficients were 0.13-0.43,the significance test showed P ＜ 0.05.Conclusions The design of each dimension of the index system gives full consideration to nurse post management,hierarchical using,the nurse in charge of the patient,grading nursing care and many other factors.Representative of key indicators is strong,and it can reflect the distribution concept that more payment for more contributions,best's best reward and rewarding the good and punishing the bad.