Objective To study the effect of lidocaine combined with local anesthesia and psychological intervention in induced abortion.Methods200 cases of artificial abortion in our hospital from March 2015 to August 2016 were selected as the research object and randomly divided into control group and experimental group,with 100 cases in each group.The control group was treated with lidocaine for local anesthesia,direct abortion,and the experimental group was given lidocaine local anesthesia and psychological intervention.The pain and satisfaction index of the two groups were compared.ResultsAfter the treatment, the satisfaction rate of cervical dilatation in the experimental group was 93 cases was 93% higher than that in the control group, and the difference was statistically significant (P<0.05).The number of patients with grade Ⅱ pain in the experimental group was 12, and the number of patients with grade I pain was 87.In the control group, the number of patients with grade Ⅱ pain was 25, and the number of patients with grade Ⅱ pain was 57.But the control group was significantly lower than the experimental group, with statistical difference (P<0.05).In the control group, patients with grade Ⅱ pain were significantly higher than those in the experimental group, the number of patients with grade I pain was significantly less than that in the experimental group, and the difference was statistically significant (P<0.05).There was no significant difference in the operation time and blood loss between the control experimental and the control group.ConclusionThe application of lidocaine local anesthesia combined with psychological intervention can effectively relieve the pain of patients and improve the therapeutic effect.It has the value of clinical popularization and Application.

Objective To investigate the clinical effect of periodontal fiber retention periodontal splint and Periocline combined treatment for severe tooth. Methods the control group was given routine retention of fiber periodontal splint treatment, study group in retention of fiber periodontal splint treatment combined with periocline. The changes of PLI, BI, PD and AL before and after treatment in two groups of patients with severe periodontal disease were recorded. The data were input into SPSS software and given statistical analysis. Results The detection of two groups of PLI, BI, PD, AL and other indicators of no significant difference between before treatment; after treatment of different options of group AL, PD decreased than the control group (P<0.05); PLI of the study group after treatment, BI decreased significantly than before (P<0.05), the control group on the index no obvious change than before. Conclusion The application of retention of fiber periodontal splint combined with Periocline treatment of severe periodontal disease can significantly improve the curative effect, is conducive to the protection of the quality of life.

Objective To introduce the methods and experiences of establishing health education management system in a certain tumor hospital and to evaluate the application effect.Methods By building president led,nursing department guided nursing education committee management system,establishing and enhancing the following aspects:health education inspection and assessment criteria,health education clinical pathway,patient satisfaction questionnaire,evaluation system of telephone follow-up of discharge patients; Implementing the following matters:training for nurses on delivering health education,health education clinical pathway,patient and family health education lecture tour,homes for tumor patients and care givers,etc,forming the management network with the core of health education management committee-head nurse-leader of the ward health education group,which was quality control downward,full participation.Results The differences of tumor knowledge awareness,satisfaction of the patient and the ability of delivering health education and giving lecture of the nurses after education were statistically significant compared with those before the education.Conclusions The health education management system can ensure the efficient operation of the care,improve the level of nursing health education for patients and their families,provide certain health guidance,and improve patient satisfaction degree.

Objective To summarize the meticulous nursing experience of indwelling urinary catheter between the children with hypospadias during perioperative. Methods 317 cases of indwelling urethral only in the silicone Foley tube, and without other urinary diversion with hypospadias were retrospectively analyzed, summarized the fine points of nursing, including preoperative children with comprehensive risk assessment, standardized preoperative skin preparation and postoperative protective constraint, effective properly fixed catheter keep the urine drainage unobstructed, close observation of urine drainage characteristics, maintain urine collection system tightness, maintain perineal skin clean and improved extubation nursing method, and do a good job after extubation nursing. Results 266 cases were cured with a cure rate of 83.9%(266/317);the incidence of urine leakage in 42 cases, the incidence rate was 13.2%(42/317); 7 cases of urethral stenosis, the incidence rate was 2.2%(7/317); 2 cases of urethral closing, the incidence was 0.6% (2/317), none of the patients had accidental extubation. Conclusions The meticulous nursing has a better effect in hypospadias patients during the perioperative period and it can reduce the incidence of postoperative complications;shorten the time of hospitalization and alleviate the suffering of children;improve the quality of nursing service, which is worthy of clinical application.

Rat hepatic oval cell model was induced by hyperglycemia and streptozotocin in vivo. Expression of insulin and mRNA expression of pancreatic transcription factors(Nkx6.1, PDX-1) were carried out. It showed that under high glucose, liver tissues were positive for insulin staining, the expression of Nkx6.1 and Pdx-1mRNA was significantly enhanced, and insulin-1mRNA was found to be expressed. The result suggests that under high glucose, hepatic oval cells can differentiate into insulin-producing cells.

Objective To investigate the association between nonalcoholic fatty liver disease (NAFLD) and metabolism or carotid intima-media thickness (CIMT) in Type 2 diabetic(T2DM). Methods According to the liver B-ultrasonography, a total of 321 T2DM patients were divided into two groups, with or without NAFLD. Metabolic indexes such as BMI, BP, blood glucose, blood lipid, uric acid ( UA ), insulin, C-peptipe,insulin resistance index(HOMA-IR) between the two groups were compared, and the relationships between alanine aminotransferase (ALT) and the above indexes were analyzed. Furthermore,the CIMT of the two groups were compared, and the relationships between NAFLD, ALT and CIMT were investigated by correlation and regression analysis. Results Compared with the group without NAFLD, the patients with NAFLD had higher level of BMI, triglyceride ( TG ), UA, fasting blood glucose ( FBG ), fasting insulin ( FIns ), fasting C peptide (FCP) ,HOMA-IR,and lower level of high density lipoprotein ( HDL-C ) significantly; BMI ( OR = 1.25, P ＜0. 001 ), TG ( OR = 1.74, P = 0. 008 ) and HOMA-IR ( OR = 2. 33, P = 0.010) were independent risk factors of NAFLD while H DL-C was independent protective factor; ALT was positively correlated with BMI (r = 0. 255, P ＜0. 001 ) ,TG(r =0. 156,P ＜0. 018) ,UA(r =0. 239,P ＜0. 001 ) ,FIns(r =0. 213,P =0. 001) ,FCP(r =0. 199,P ＜0. 003), HOMA-IR ( r = 0. 247, P ＜ 0. 001 ) and negatively correlated with HDL-C ( r = - 0. 199, P =0. 002) ,and BMI (β =0. 456,P =0. 048) ,UA (β =0. 021 ,P =0. 025) and HOMA-IR(β =3.634 ,P =0. 004)were independent associated facrors. The difference of CIMT between the two groups didn't reach statistical significance, while mutiple regression analysis revealed that ALT was independently associated with CIMT(β =0. 002,P = 0. 013). Conclusion T2DM patients with NAFLD show more serious disorder of metabolism and insulin resistance. ALT is an independent risk factor of CIMT in T2DM patients.

Objective To explore the real experiences of young nurses who accepted training of concept maps,to evaluate its effectiveness and feasibility,and provide guidance for clinical training and usage.Methods 50 young nurses who worked in a 3A hospital in Ningxia for 1～3 years were trained using concept maps teaching method for a period of 12 weeks.Using phenomenological method of qualitative research,12 nurses among them were invited to face to face,semi-structured in-depth interviews after one month of attending the training of concept maps.The data were analyzed after using Colaizzi method collected.Results Respondents felt advantages of applying concept maps on learning,thinking,and clinical usage.However,there were certain problems and difficulties of applications.Conclusions Training young nurses using concept maps shows many advantages,which will help improve the quality of clinical care training.But there were some problems in its application which need to be solved.

Objective To investigate drug resistance and clinical efficacy of second-line anti-tuberculosis drugs in patients with multidrug-resistant pulmonary tuberculosis.Methods A total of 183 multi-drug resistant pulmonary tuberculosis (MDR-PTB) patients received standard anti-tuberculosis treatment in Zhejiang Provincial Center for Diagnosis and Treatment of Tuberculosis during March 2011 and March 2013.Patients were divided into four groups according to the results of first-line anti-tuberculosis drugs susceptibility test:group A (n =30) resistant to isoniazid (H) and rifamipicin (R) ; group B (n =28) resistant to HR and ethambutol (E) ; group C (n =53) resistant to HR and streptomycin (S) ; groups D (n =72) resistant to HRES.Drug susceptibility tests of second-line drugs kanamycin (Km),protionamide (Pto),paraaminosalicylic acid (PAS) and levofloxacin (Lfx) were performed.Negative conversion rates of mycobacterium tuberculosis in sputum culture were also observed and compared among different groups with x2 test.Results Among 183 MDR-PTB patients,49 cases (26.8％) were resistant to Lfx,which was significantly higher than that of Km (8.7％,n =16),Pto (13.1％,n =24) and PAS (6.6％,n=12) (x2 =37.983,P＜0.05).The resistant rate to Lfx in group D was 45.8％ (33/72),which was higher than that in group A (2/30,6.7％),group B (6/28,21.4％) and group C (8/53,15.1％) (x2 =14.413,5.047 and 13.087,P ＜0.05).The occurrence of pre-extensively drug resistance (Pre-XDR) in group D was 34.7％ (25/72),which was higher than that in group A (3/30,10.0％) and group C (9/53,17.0％) (x2 =6.499 and 4.852,P ＜ 0.05).Among 157 MDR-PTB patients who received standard anti-tuberculosis treatment for one year,the negative conversion rate of mycobacterium tuberculosis in sputum culture was 87.3％ (137/157).The negative conversion rate in group D was lower than that in other groups,but the difference was not of statistical significance (x2 =1.899,P ＞ 0.05).Conclusions The efficacies of second-line anti-tuberculosis drugs vary among MDR-TB patients resistant to different firstline anti-tuberculosis drugs.The sensitivity tests results of the first-line drugs may serve as reference for MDR chemotherapy regimen in lack of test results of second-line drugs.

Objective To analyze implementation outcomes of the new health reform policy at a provincial hospital for the past six months.Methods Trend analysis,factor analysis and ratio analysis approaches were used in monthly surveillance,along with comparative study of the data before and after the reform,to probe into impacts of the new policy on hospital operations.Results Medical income increased by 22.09％,mainly contributed by volume growth (22.28％) of medical services; Medical income dropped by 0.16％ due to pricing policy factors; medicine proportion deceased by 4.84％; following the reform,the income per outpatient and inpatient increased by 12.32％ and 5.35％ respectively.Conclusion Following the drug zero profit policy and rise of the charging standards for medical treatment service at the hospital,the growth of total income mainly comes from growing volume of medical services instead of pricing policy factors.The new health reform is conducive to optimizing the hospital's income structure and raising value to doctors' technical service.

Objective To explore the MSCT manifestations of chromophobe renal cell carcinoma (CRCC)and to improve its accu-racy of preoperative diagnose.Methods Clinical and MSCT finding were retrospectively reviewed in 14 patients with CRCC,which were confirmed by surgical pathology or biopsy.Results (1)On plain scanning,most of the CRCC lesions showed round or oval (86.7%,13/1 5)and isodensity (73.3%,1 1/1 5)mass;and the border of 66.7% (10/1 5)lesions were clear.53.3% (8/1 5)of the lesions were heterogeneous with lamellar cystic low density (8 lesions)and coarse ringed and/or foliated calcifications (4 lesions). (2)On contrast-enhanced sacanning,the CRCC lesions showed mild to moderate (86.7%,13/1 5)and heterogeneous (60%,9/1 5) enhancement,and 73.3% (1 1/1 5)of the lesions were persistent enhanced.(3)According to the pathology,80% (12/1 5)of the le-sions was the typical type,20% (3/1 5)was the eosinophilic type,and 0 was the hybrid type.Conclusion CRCC demonstrates cer-tain characteristics signs at MSCT examination.Lesion mostly shows well-circumscribed round or oval mass in the renal parenchy-ma,mild to moderate,heterogeneous and continuous enhancement on the contrast scanning.The diagnosis of CRCC should be con-sidered especially when the lesion has cystic change and coarse ringed and/or foliated calcifications.