Hospital-acquired pneumonia (HAP) is a very common complication in patients with neurological diseases.Its incidence and mortality are very high and result in a prolonged hospital stay and an increase in hospitalization costs.Therefore,how to effectively prevent HAP has become the focus of attention by neurologists.There are many risk factors for HAP,such as advanced age,conscious disorders,dysphagia,body position,oropharyngeal colonization,mechanical ventilation,enteral nutrition,and stress ulcer prevention drugs,etc.Clearing the risk factors for HAP and taking appropriate measures to strengthen protection may reduce the occurrence of HAP and improve the prognosis of patients.

Objective To investigate the characteristics and clinical application value of anti-double stranded DNA antibody de-tected by Crithidia indirect immunofluorescence assay method and enzyme linked immunosorbent assay method.Methods Eighty-five patients with systemic lupus erythematosus,20 disease controls and 75 healthy controls were selected.The serum anti-double stranded DNA antibody was detected simultaneously by the methods of Crithidia indirect immunofluorescence assay and enzyme linked immunosorbent assay and their diagnostic efficacies for detection were compared.Results For each method the positive rate in the systemic lupus erythematosus group was significantly higher than that in the disease control group and healthy control group. The difference had statistical significance (P <0.05).The positive rates of Crithidia indirect immunofluorescence assay and enzyme linked immunosorbent assay in the systemic lupus erythematosus group were 72.94% and 88.24% respectively,and the positive predictive value of enzyme linked immunosorbent assay is lower(P <0.05).Meanwhile the anti-double stranded DNA antibody con-centrations detected by enzyme linked immunosorbent assay method showed statistically significant difference among the active sys-temic lupus erythematosus group,the stable systemic lupus erythematosus group and the control group (P <0.05 )and presented linear trend.Conclusion Using Crithidia indirect immunofluorescence assay method to detect anti-double stranded DNA antibody for the systemic lupus erythematosus group has high specificity and is helpful for the diagnosis of systemic lupus erythematosus. Enzyme linked immunosorbent assay can be used to detect anti-double stranded DNA antibody concentration quantitatively,which is linearly related with systemic lupus erythematosus activity and the method is of high sensitivity,which can effectively screen the pa-tients with systemic lupus erythematosus.

Objective To share for the nursing adverse events resources in the region, which would provide scientific data for nursing security management. Methods The form of nursing adverse events reporting was first designed by researchers. Then with the help of computer engineers the module on regional collaborative information platform was constructed. Preliminary running was used to modify and improve. Through continuous improvement the module function of adverse events reporting, query and statistics was finally made out. Results The module on regional collaborative information platform for nursing adverse events reporting and analysis was constructed, and it worked well. Conclusions The module realizes the sharing of nursing adverse events resources in the region. It can improve the level of nursing safety management in each hospital, which helps to reduce the incidence of nursing adverse events.

Objective To build the dynamic management system of nursing staff allocation in general pediatric wards based on working hours measurement.Methods 30 general pediatric wards of 25 general or children hospitals of upper first class were selected to measure working hours.Depending on the average nursing hours required for pediatric patients in different care levels by each positions,we achieved the nursing staffing formulas.Results 7 nursing posts under double-shift turn and three-shift turn were collected.The average hour that nursing posts provide for one different nursing grade patient was made out.Taking a ward which had 20 patients as nursing grade one and 20 patients as nursing grade two for example,it would need 8-9 responsible nurses,2-3 long night shift nurses,1-2 general affairs nurses,2 night assistance nurse,1 day assistance nurse by double-shift turn,meanwhile,it would need 8 responsible nurses,4 early night shift nurses,3 late night shift nurses,1-2 general affairs nurses by three-shift turn.Conclusions Using the formulas based on measurement of working hours to calculate the number of nursing staff could provide a way to help the managers.

Objective We tried to investigate the current status of pediatric nursing post setting and analyze the practical application effect in the clinical working practice for the foundation of readjusting and setting up the pediatric nursing positions.Methods By convenient sampling method,the general condition and current post setting situation in the pediatric wards of 7 hospitals with self-designed questionnaires were investigated.The results underwent analysis Results The nursing post setting in pediatric wards of 7 hospitals were not all the same,nursing posts in the pediatric ward included three categories:management positions,teaching positions and clinical positions.Management positions included the head nurse,deputy head nurse and head nurse assistant; teaching positions included the teaching secretary and clinical total teaching nurse; the seven kinds of clinical nursing positions were office job,day shift,night shift,evening shift,midnight shift,late-morning shift,auxiliary job.Though some nursing jobs differed in the position names and working hours,their job contents were nearly identical.Conclusions Pediatric nursing post setting management in our country is still in the exploratory stage at present,it has not form a unified perfect job management system.Pediatric nursing positions should be set from the perspective of evidencebased theory,satisfying the demands of patients as the guidance,coming from clinical needs as the first principle,in the full implementation of the accountability for nursing and based on comprehensive consideration of various factors,so that the post setting can be scientific and reasonable.

Objective To investigate the effects of preoperative iv different doses of pantoprazole on acidity of gastric fluid in patients undergoing elective surgery. Methods Sixty ASA Ⅰ -Ⅲ patients aged 38-80 yr,weighing 44-72 kg undergoing elective surgery were randomly allocated into 3 groups (n = 20 each): group Ⅰ control (group C); group Ⅱ pantoprazole 40 mg(group P1) and group Ⅲ pantoprazole 80 mg(group P2). The patients received intravenous normal saline (NS) 100 ml, pantoprazole 40 and 80 mg in NS 100 ml respectively in group C, P1 and P2 at 30 min before surgery. Gastric content was aspirated using a gastric tube on the patients'arrival in the operating room and at 1,2 h and the end of surgery. The pH of the gastric fluid was measured. The adverse effects including dizziness, diarrhea, PONV and incidence of stress ulcer were recorded. Results The pH was significantly increased in group P1 and P2 as compared with control group but there was no significant difference in pH between group P1 and P2 . There were no significant difference in the incidence of stress ulcer and pH of the gastric fluid≤2.5 among the 3 groups. Conclusion Preoperative intravenous pantoprazole 40 mg can effectively increase pH of gastric juice and is helpful in reducing the incidence of stress ulcer and the risk of acid aspiration.

Objective We sought to evaluate the effect of structured health education on quality of life and the end point of patients with coronary disease with evidence-based method.Methods The Cochrane Library,Cochrane Database of Systematic Reviews (CDSR),Medline (OVID),Pubmed and Web of Science were searched to collect the randomized controlled trials (RCT) which mentioned the structured health education to CHD patients,the quality of the RCTs was evaluated by Jadad Score,then effective data were extracted and analyzed by Meta-analysis with RevMan 5.2 software.Results A total of 12 eligible studies of RCT were included in the study with Jadad Score evaluations at B level or above.There were 20 476 cases in the intervention group,14 522 cases in the control group.Meta-analysis showed that the quality of life scores of the intervention group were significantly higher than those of the control group,weighted mean difference was 3.29,95％ CI (0.49-6.09).No significant difference was found in cardiac morbidity outcomes,re-hospitalization and the mortality rate,relative risk,95％ confidence interval were respectively 0.72(0.50-1.04),0.98(0.86-1.11),0.77(0.58-1.03).Conclusions The structured health education can improve the quality of life of patients with coronary disease,but has no obvious effect on the cardiac morbidity outcomes,re-hospitalization and mortality rate.We suggest transitional care to be carried out in future research to decrease the incidence rates of them.

Objective Using the evidence-based medicine to investigate the effect of cognitive behavior intervention on physical and mental health in patients with type 2 diabetes mellitus.Methods Controlled studies related to psychological intervention on depression and glyeosylated hemoglobin in patients with type 2 diabetes were retrieved from electronic databases such as CNKI,VIP,Wanfang database and Pubmed,etc.The quality of included studies was evaluated and then data were analyzed by using RevMan5 software.Results A total of 273 articles were retrieved and finally 6 were enrolled.Results of Meta analysis were listed as follows:Cognitive behavior intervention could reduce score of Self-rated Depression Scale (SDS) in patients with diabetes mellitus.Cognitive behavior intervention could effectively reduce glycosylated hemoglobin values in patients with diabetes mellitus.Conclusions Cognitive behavior intervention can improve physical and mental health,decrease glycosylated hemoglobin and improve depression status in patients with type 2 diabetes mellitus.However,all the trials included in this review are of low quality; larger scale RCTs of higher quality are needed to confirm this conclusion.

Objective To study the application of photodynamic therapy (PDT) for dental caries prevention using whole body luminescence fiber,and to investigate the effects of PDT on the content of Ca and P in rat molar enamel.Method The rat dental caries model was established by inoculating with S.mutans.Eighty male rats were randomly divided into five groups,including three experimental groups:17 mW (8 mW/cm2) PDT (group A),34 mW (15 mW/cm2) PDT (group B),68 mW (30 mW/cm2) PDT (group C),a positive control group:20 g/L NaF solution (group D),and a negative control group:0.9％ physiological saline (group E).The experimental groups were treated by 40 μg/mL hematoporphyrin monomethyl ether (HMME) and 650 nm diode laser irradiation.The experiments were conducted for 4 weeks.The contents of Ca and P in the molars of each group were measured by inductively coupled plasma emission spectrometry.Results The contents of Ca and P in group B,C and D after PDT were significantly higher than those in group A and E (all P＜0.05).The contents of Ca and P in group A showed no significant difference before and after PDT,while those in groups B and C showed significant increase after PDT (all P＜O.05).The increment of Ca in group A after PDT was lower than that in group D (P＜0.05),while those in group B and C were significantly higher than those in group D (all P＜0.05).There was no significant difference in the increment of Ca and P between group B and C after PDT.Conclusions In the range of the experimental parameters,the PDT promoted effect of tooth remineralization is better than 20 g/L NaF.The levels of Ca and P in the tooth enamel can be promoted by PDT treatment,and the contents of Ca and P are related to the pewer of PDT.The effect of low power PDT on the remineralization of enamel is not obvious.The contents of Ca and P in the tooth enamel are increased with laser power of PDT.When the laser power increased to a certain value,the change in contents of the two elements is not obvious.PDT can maintain the tooth remineralization microenvironment.

Objective To investigate the apoptosis induction effects and the possible mechanism of YM155 on triple negative breast cancer MDA-MB-231cells.Methods MDA-MB-231 cells were treated with dif-ferent concentrations of YM 155, and the survival rate of the cells was determined by CCK-8 assay and the half maximal inhibitory concentration ( IC50 ) value of YM155 was calculated .The apoptosis rate was examined by An-nexin V-FITC/PI double staining.mRNA expression of survivin and bcl-2 in MDA-MB-231cells was detected by RT-PCR.The protein expression of survivin , bcl-2, caspase-3, and PARP were detected by Western blot .Re-sults YM155 significantly inhibited the growth of MDA-MB-231 cells in a dose-and-time-dependenct way .IC50 was(1.749 ±0.265) ng/ml and(0.823 ±0.125) ng/ml respectively at 24 and 48 hours.The apoptosis rate of cells treated with 0.5 ng/ml, 1.0 ng/ml, and 1.5 ng/ml YM155 was (10.93 ±0.94)%,(31.10 ±1.51)%, and(46.83 ±2.92)%respectively, which had significant difference compared to that of the control group (6.4 ± 1.2)%(P<0.01).YM155 could significantly decrease mRNA and protein expression of surviving , besides, it reduced bcl-2 expression and increased caspase-3 and PARP protein expression .Conclusions YM155 can ef-fectively induce the apoptosis of MDA-MB-231 cells by downregulating survivin and activating caspase pathway . Bcl-2 might play a role in the apoptosis .