Objective To explore the continuous care needs of stroke patients when discharge,and analyze the related influenced factors.Methods One hundred and twenty cases with first stroke attack were selected,and their continuous care needs were investigated by methods of filling in questionnaires when discharged.The National Institutes of Health Stroke Scale and Barthel Index were applied to assess the severity of acute stroke and their ability of daily life when cases were admitted and discharged,respectively.We investigated the continuous care needs of stroke patients,and analyzed the relationship of that with the severity of acute stroke and their ability of daily life.Results The top five continuous care needs were knowledge of stroke,safety administration,methods of rehabilitation,self control and monitoring blood pressure,and diet direction.Those ratios of needs ranged from 87.25%to 94.12%.The score of continuous care needs had a positive relationship with that of NIHSS(r=0.271,<0.05),and had a negative relationship with that of BI both at the time of discharge(r=-0.226,<0.05).Conclusion The various continuous care needs are very common in patients with first stroke attack for varied reasons.More serious the neurological dysfunction and lower ability of daily life,higher the level of needs for continuous care.

Objective: To investigate the survival status and influencing factors of HIV/AIDS patients after receiving highly active antiretroviral therapy（HAART）in Shangluo,Shaanxi Province,so as to provide evidence for improving the effect of HAART. Methods: HIV/AIDS patients who received HAART for the first time in Shangluo from 2010 to 2018 were investigated. Life table method was used to analyze the survival rate,mortality rate and median survival time of the subjects. A proportional hazards model was used to analyze the influencing factors for the survival time of HIV/AIDS patients. Results: A total of 286 HIV/AIDS patients were collected,and 27 of them died of AIDS. After HAART,the 1-year,cumulative survival rates of less than 1 year,4 years and 8 years were 93.95%,89.71% and 88.39%,respectively. The results of multivariate proportional hazards regression analysis showed that the patients aged 30 years when first received HAART had higher risk of death than those aged 18-29 years（RR：4.208-24.095,95%CI：1.219-79.491）;patients with AIDS had higher risk of death than those with HIV（RR=38.590, 95%CI：15.451-96.382）;patients by homosexual transmission（RR=3.425,95%CI：1.385-8.470）and non-sexual transmission（RR=10.299,95%CI：3.602-29.446）had higher risk of death than those by heterosexual transmission;patients with baseline CD4+T lymphocytes number of 200/μL and more（RR：0.133-0.170,95%CI：0.048-0.604）had lower risk of death than those with less than 200/μL. Conclusions The survival rate of HIV/AIDS patients in Shangluo after receiving HAART is relatively high. Age at the start of treatment,course of disease,route of infection and the number of CD4+T lymphocytes at baseline are the influencing factors of survival time.

Objective To discuss the feasibility and safety of retroperitoneal laparoscopic nephrectomy for treatment of kidney tuberculosis. Methods From March 2005 to February 2009, 28 patients with kidney tuberculosis underwent retroperitoneal laparoscopic nephrectomy. The patients′ data were reviewed and analyzed. Results There were 18 men and tencwomen with an average age of 36 (26-51) in the cohort. Sixteen patients had lesions on the left kidney and 12 on right kidney. All patients had a normal renal function on the contra lateral side. The severely impaired renal function of the lesion side was confirmed before operation. Anti-tuberculosis chemotherapy was administered to patients for two weeks to six months in advance of the surgery. No active lesion of tuberculosis was found and ESR level was normal before operation. All the operations were successfully performed without switching to open surgery. The average operative time was 170 (121-258) minutes, blood loss was 110 (70-250) ml and average postoperative hospital stay was 5.7 (5-14) days. Peritoneum injury was seen in three patients and incision infection in two patients. No severe complications were observed. Anti-tuberculosis chemotherapy was continued for three months. Twenty-four patients were followed-up, and the average follow-up time was 12.5 (6-20) months. All patients recovered without any lesion remaining. Conclusions Retroperitoneal laparoscopic nephrectomy could be a safe and reliable method for the treatment of non-functioning kidney due to tuberculosis.

Objective To compare WHO 2004 and WHO 1973 pathological grading methods of non-muscle invasive urothelial neoplasms. Methods The clinical pathological features of 160 non-muscle invasive urothelial neoplasms patients, treated in our hospital from February, 1998 to Decem-ber, 2008, were re-graded according to WHO 2004 and WHO 1973 classification system. To evaluate recurrence and progression of all the patients during the follow up period, we used statistical method to analyses the differences between two classification system. Results There were 160 patients, ac-cording to WHO 1973 classification methods: 5 cases of papilloma, 52 cases of grade 1 tumors, 83 ca-ses of grade 2 and 20 cases of grade 3;By WHO 2004 classification method: 7 cases of papilloma, 31 cases of low-grade malignant potential of urothelial papilloma, 99 cases of low-grade papillary urotheli-al carcinoma and 23 cases of high-grade papillary urothelial carcinoma. There was no difference in re-currence among the grades of WHO 2004 and WHO 1973 pathological grading system (both P>0.05). Regarding the progress of non-muscle invasive papillary urothelial neoplasms, no significant difference was found among grades of WHO 1973 classification system(P>0.05)while difference exis-ted among grades of WHO 2004 pathological grading system (P<0.05), especially between papillary neoplasm of low malignant potential (PNLMP) and high grade papillary urothelial carcinomas(HG-PUC) (P<0.01). Moreover, HGPUC grade had more progression rate (30.4%) than G_3 grade (15.0%). Conclusions Compare to G_3 grade, HGPUC grade was more easily to make progress in pa-tients,due to this grade include more high malignant papillary urothelial carcinomas. Therefore, it is necessary for urologists to use a more rigorously follow up and therapy method in connection with HG-PUC grade of new classification system.