Objective To explore the relationship between the cognitive function and plasma somatostatin(SS) level in the patients with leukoaraiosis(LA).Methods According to the clinical findings and CT imaging,the subjects were divided into three groups:26 patients with LA and dementia, 47 patients with LA but without dementia, and the normal controls for 38 cases. The three groups were determined by means of Hasegawa's Dementia Scale(HDS)and SS levels in plasma.Results As compared with the control group,HDS score and plasma SS level in patients with LA (including dementia group and non dementia group) decreased remarkable(P0.05).Conclusion LA might be the cause of cognitive impairment,the concentrations of plasma SS had declined before dementia did not occur,the cognitive impairment in patients with LA might relate to the decrease of SS levels in the body.

Platelet glycoprotein ⅡbⅢa receptor antagonists is a class of novel antiplatelet agents. This article explores the application and prospect of platelet glycoprotein ⅡbⅢa receptor antagonists in ischemic stroke from the aspects of its combination with thrombolytic agents, the application of carotid artery angioplasty and stenting (CAS), and be used alone.

Objective To study the change of the level of serum cytokines in patients with epilepsy after cerebral infarction.Methods The levels of serum interleukin(IL)-2,IL-6 and tumor necrosis factor-?(TNF-?) in 87 patients with epilepsy after cerebral infarction(epilepsy group) and 75 normal controls(NC group) were measured by radioimmunoassay.Results The levels of TNF-?[(2.5 ?0.57)ng/L],IL-2[(9.0?0.83)ng/L] and IL-6 [(97.5?13.1)ng/L] in epilepsy group were significantly higher than those in the NC group[TNF-?(0.89?0.36)ng/L,IL-2(4.3?1.5)ng/L,IL-6(13.3?11.1)ng/L](all P

Objective To explore the perioperative nursing method and effect of doing minimal invasive occlusion to children with congenital heart disease via subaxillary incision.Methods The data of 86 children patients with congenital heart disease underwent minimally invasive occlusion via right subaxillary incision were retrospectively analyzed and summarized nursing points including preoperative and postoperative mental nursing,postoperative postural care and sedative care,observing whether the occluder moved or detached and mechanical hemolysis,monitoring ECG and blood pressure,and preventing hemorrhage and thrombogenesis.Results One case of infracristal ventricular septal defect with frequent premature ventricular beat after occlusion was converted to thoracotomy surgery;one case of mixed atrial septal defect with heart rate increasing and dyspnea after 12 hours of occlusion was found occluder detached and immediately converted to remove the occluder and fix the atrial septal defect;The other children were successfully recovered and been discharged.Conclusions Full understanding and strengthened perioperative nursing care of complications of children with congenital heart disease after surgical minimally-invasive surgical closure is the key point to avoid the occurrence of fatal complications and ensure the children recover safely and smoothly.

Objective To assess the risk assessment of stroke associated pneumonia (SAP ) in patients with ischemic stroke using A2DS2 score.Methods A total of 1279 patients with ischemic stroke who were admitted and treated in our department from 2009 to 201 1 were retrospectively analyzed and applicated A2DS2 score.A2DS2 score was calculated as follows:Age ≥75 years=1,atrial fibrillation=1, dysphagia=2,male sex=1;stroke severity:NIHSS score 0-4=0,5-15 =3,≥16=5.The patients were divided into three groups according to A2DS2 score:620 in score 0 group,383 in score 1-9 group,276 in score ≥10 group.The three groups were comparatively analyzed.The diagnostic criteria for SAP were as follows:newly emerging lesions or progressively infiltrating lesions in post-stroke chest images combined with more than two of the following clinical symptoms of infection:(1 )fever ≥38 ℃;(2 )newly occurred cough,productive cough or exacerbation of preexisting respiratory tract symptoms with or without chest pain;(3)signs of pulmonary consolidation and/or moist rales;(4)peripheral white blood cell count≥10 ×109 L -1 or≤4 ×109 L-1 with or without nuclear shift to left,while excluding some diseases with similar clinical manifestations to pneumonia, such as tuberculosis, pulmonary tumors, non-infectious interstitial lung disease,pulmonary edema,pulmonary embolism and atelectasis.Analysis of the incidence and mortality of SAP as well as the correlation with ischemic stroke site were performed in the three groups,respectively. Mean ± standard deviation (x ±s)was used to represent measurement data with normal distribution and t test was used.Percentage was used to represent enumeration data and χ2 test was used.Results The incidence of SAP was significantly higher in A2DS2 score ≥10 group compared with those in score 1-9 and score 0 groups (7 1.7%vs..22.7%,7 1.7%vs..3.7%,respectively),whereas the mortality in score ≥10 group was significantly higher than those in score 1-9 and score 0 groups (16.7%vs.4.96%,16.7%vs.0.3%,respectively).The incidences of cerebral infarction in posterior circulation and cross-MCA, ACA distribution areas were significantly higher in SAP group compared with those in non-SAP group (35.1%vs.10.1%,11.4%vs.7.5%,respectively).The incidence of non-fermentative bacteria infection was significantly increased in score ≥10 group.Conclusions A2DS2 score provides a basis for risk stratification of SAP.The prevention of SAP needs to be strengthened in acute ischemic stroke patients having a A2DS2 score ≥10.

Objective To analyse both micro level and macro level factors influencing maternal mortality in order to set the priority to lowering maternal mortality. Method The results of an analysis of maternal mortality were reported, based on a conceptual model that combines micro level and macro level variables taken from demographic, sociological and epidemiological research. Multi level analysis techniques were used to analyse the 1997 linked county level maternal death data and related county level social demographic and health resources data in 114 counties of 5 remote and poverty stricken provinces. Results The maternal mortality rate in research areas was as high as 159.3/100 000. The main factors influencing maternal mortality were institutional delivery rate, population density, percentage of minority population, and percentage of village without village doctor. Conclusion To advocate institutional delivery rate, to pay greater attention to minority and low population density area, and to standardised village doctors' responsibility are recommended strategies to lowering maternal mortality in remote and poverty stricken areas of China.

Objective To investigate the clinical value of color doppler ultrasonography(CDU) to extracranial vertebral artery stenosis before and after percutaneous transluminal angioplasty and stent(PTAS) treatment.Methods 61 patients with extracranial vertebral artery stenosis confirmed by digital subtraction angiography(DSA) were detected by CDU on both sides of extracranial vertebral artery before and 3 d,30 d after PTAS.The flow volume(FV),peak systolic velocity(PSV) and resistance index(RI) at the site of C5-C6 segment and stenosis were as analysis targets.Results Before PTAS,80 stenotic extracranial vertebral arteries were found by CDU(mild degree 17 cases,moderate degree 38 cases,severe degree 25 cases).Compared with DSA,coincidence was 86.9%(77.3%,95.0%,83.3%).Among them,the coincidence of moderate extracranial vertebral artery stenosis detected by CDU was excellent(P0.05).Conclusion CDU has the important value in diagnosing extracranial vertebral artery stenosis,and can be used to follow up the blood hemodynamics in the extracranial vertebral artery of patients treated by PTAS.It provided a method for observing the efficacy of PTAS treatment.

As the development of fast-tracking, the patient perception of readiness for hospital discharge is becoming more and more popular in discharge decision making. A lot of research indicates that the patient readiness of discharge can predict the satisfaction, the safety, readmission, death and compliance of the patients. This study is about to review the conception, research significances, measurements, and determinants of the discharge readiness. The primary objective was to analyze the determinants of hospital discharge, according to three aspects of patient factors, hospital factors and social support. This study is expected to offer theoretical support for the improvement of discharge readiness.

Objective To discuss the effects of simulation -based team training on early adaptation and stress in patients with permanent intestinal stoma.Methods 164 patients with permanent intestinal stoma were divided into control group(82 cases)and intervention group(82 cases).In control group,routine peri -operational health education was adopted,while in intervention group,health education based simulation -based team training was adopted. Then,the intervention effects of ostomy adjustment inventory and stress distress were evaluated.Results After the intervention,there was significant difference between two groups at the level of ostomy adjustment inventory and stress distress(all P <0.05).Conclusion The simulation -based team training could increase the level of ostomy adjust-ment inventory,but reduce the level of stress distress.

Objective To discuss the effects of 6Emodel on stress distress in patients with colorectal cancer after permanent intestinal stoma and to provide reference for the implementation of psychological intervention. Methods A total of 168 patients with permanent intestinal stoma were divided into control group(85 cases)and intervention group(83 cases).In the control group,routine nursing was adopted,while in intervention group,nursing based 6Emodel (including experience,environment,event,engaging,effect,expand)was adopted.The time of intervention was 1 year,and the psychological distress scale for cancer patients was tested.Results After interven-tion,the psychological distress of the intervention group was (39.62 ±14.62)points,which was lower than (46.21 ± 13.68)points of the control group,the difference was statistically significant between the two groups(t =3.057,P =0.002).Conclusion The 6Emodel can reduce the level of psychological distress of colorectal cancer after per-manent intestinal stoma,and has positive effects on the early distress following stoma.The intervention can be one of the effective ways to implement psychological intervention for patients with stoma.