Objective In this paper,we aimed at discussing the impacts of follow-up nursing on treatment compliance and lung function of patients with chronic obstructive pulmonary disease(COPD)during the rehabilitation period after discharge.Methods COPD patients(68 cases)were divided randomly into the intervention group and the control group with 34 cases in each group.We gave the intervention group follow-up nursins during the ensuing 6 months after discharge to give them guidance on health problems in order to promote the treatment compliance of patients.On the contrary,the control group did not take any follow-up nursing.Six months later,we conducted an evaluation of the tmalment compliance and amelioration of lung function in the t wo groups.Results As a result,six months after discharge,the patients'treatment compliance status and lung-function indicators in the intervention group were significantly better than those of the control group(P＜0.01).Conclusions The follow-up nursingcan promote the COPD patients'treatment compliance status and amelioration of lung function during the rehabilitation period.

A 36-year-old female presented with multiple dark brown papules on the chest and abdomen for more than 10 years,which had gradually increased in number.Physical examination revealed dozens of dark brown,flat papules measuring 1-3 mm in diameter in the chest and abdomen.Most of the lesions had a smooth surface,and some lesions gave a papilloma-like appearance,with no confluent trend.Biopsy of abdominal lesions showed mild hyperkeratosis of epidermis,acanthosis,extension of epidermal protrusions forming a reticulated appearance,horn pseudocysts in prickle cell layer,enhanced pigmentation of basal layer,and a sparse lymphocytic perivascular infiltrate in superficial dermis.A diagnosis of dermatosis papulosa nigra (DPN) was made.

Objective To summarize the experience on diagnosis and treatment of splenic neoplasm. Methods Clinical data of 40 patients with primary splenic space occupying lesion treated in our hospital were retrospectively analyzed. Results Thirty four out of the 40 cases were diagnosed as primary splenic neoplasm preoperatively. The detectable rate of B-US was 94%, and that of CT was 96%. The discrimination rate of benignancy and malignancy by CT was 84%. Serum AKP and ?-GT were significanfiy increased in most of the malignancies. Seventeen among 22 cases with benignancy were treated by splenectomy, and the others underwent partial splenectomy or tumor resection. Sixteen of 18 patients with malignancy underwent splenectomy, and two did biopsy. Pathology revealed cysts in 13, angiocavernoma in 4, inflammatory pseudotumor in 3, caverous lymphangioma in 1, and cystic degeneration of liomyoma in 1; malignant lymphoma and lymphsarcoma in 9, hemangiosarcoma in 3, and fibrosarcoma, liomyosarcoma, malignant fibrous histiocytoma in 1 each. Three cases with malignancy have survived more than 5 years. Conclusions Splenic neoplasm is diagnosed mainly according to clinical manifestation and image examination. The discrimination of benignancy and malignancy depends on CT, angiography, and serous AKP and ?-GT level. Radical operation and complex treatment could improve the prognosis of splenic malignant tumor.

Objective To evaluate effectiveness of peripheral Mohs micrographic surgery for the treatment of extramammary Paget′s disease (EMPD). Methods A total of 28 patients with EMPD were treated with peripheral Mohs micrographic surgery. The depth and extent of tumor infiltration were evaluated before the surgery. One day before the surgery, 20% aminolevulinic acid hydrochloride was topically applied to determine and label surgical margins under a Wood′s lamp. After fluorescence-based localization, peritumoral skin tissues were resected and underwent frozen-section examination according to the protocol for Mohs micrographic surgery. Meanwhile, the tumor was resected. After surgery, patients were followed up every 3 - 6 months to detect local recurrence and metastasis. Results Of the 28 patients, 25 were male and 3 were female. Six patients each underwent 3 sessions of frozen-section examination, and 12 patients each received 2 sessions, with an average of 1.86 sessions for each patient. During the follow-up for 5 - 72 months, local recurrence occurred in 3 cases, and 1 patient died of tumor metastasis and uremia after 2 years of follow-up. Conclusion Peripheral Mohs micrographic surgery is a time-saving and effective treatment for EMPD.

Objective To explore the effects of application of the new model of evidence-based land humanized nursing in patients with universal pustular psoriasis.Methods Divided 84 patients with universal pustular psoriasis into the experimental group (42 cases) and the control group (42 cases) randomly.Evidence-based questions were raised according to the requests about humanized nursing of patients in the experimental group,and then retrieved and screened literature,sought high-level evidence,combined with previous nursing experience,developed new evidence-based and humanized nursing programs and implemented in the experimental group.The control group used conventional care program.Two weeks after admission,pain,anxiety,depression degree and the complications of two groups were compared.Results Two weeks after admission,the patients with 0 to 5 levels of pain in the experimental group was 0,5,26,7,4 and 0 cases respectively,which in the control group was0,0,0,12,20 and 10 cases respectively,the difference was significant between the two groups (U=6.957,P＜0.01).Anxiety and depression scores in the experimental group was (41.35±4.30) and (42.55±7.71) respectively,which in the control group was (51.31±4.56) and(50.36±6.89) respectively,the difference were significant between the two groups (t=10.540 and 4.893,P＜0.01).Conclusions The new model of evidence-based and humanized nursing can effectively improve the effects of humanized nursing in patients with universal pustular psoriasis.

Objective To compare the applicability of the Beijing Version of the Montreal Cognitive Assessment (MoCA) and the Mini Mental State Examination (MMSE) in screening for cognitive impairment in patients with acute ischemic stroke for 2-3 weeks.Methods MoCA and MMSE were conducted in 201 patients with acute ischemic stroke within 2 to 3 weeks after the onset of stroke.With MoCA＜23 and MMSE ＜26 as the cut off value,we assessed the clinic effect of the MoCA and MMSE and explored the correlation between two instruments.Results The average scores of MoCA and MMSE scale were (20.5±4.3) and (25.4±3.5) points.The prevalence of cognitive impairment evaluated with MoCA and MMSE were 57.2％and 43.3％,respectively.MoCA showed significant correlation with MMSE score (Pearson's correlation coefficient=0.833,P＜0.001),and an agreement with Kappa values of 0.532 (P＜0.01) in screening for cognitive impairment.Conclusions The prevalence of cognitive impairment assessed with MoCA is higher than that of with MMSE when using MoCA＜23 and MMSE＜26 as the cut off values.Both instruments show a good agreement for screening cognitive impairment in acute ischemic stroke within 2 to 3 weeks following the disease onset.

A 48-year-old man presented with a 4-day history of fever and 10-year history of papulovesicles on the face, neck, trunk and limbs which had been aggravated 10 days prior to the presentation.Skin biopsy showed a dermal infiltration of numerous small- to medium-sized atypical lymphocytes, which was mainly located around blood vessels or appendages, with the involvement of subcutaneous fat tissue and destruction of blood vessels. The infiltrating atypical cells stained positive for CD45RO, CD8, CD56, T-cell intracellular antigen-1, granzyme B, Epstein-Barr virus-encoded small nuclear RNAs (EBER), but negative for CD20, CD79a, CD3, CD4 or CD30. Cytoplasmic CD3ε was also observed in these cells. Laboratory examinations on admission revealed a progressive decrease in peripheral erythrocytes, white cells and platelets, persistent increase in serum aminotransferase and bilirubin, and decline in serum fibrinogen and hypertriglyceridemia. The B-mode ultrasound of the abdomen showed hepatosplenomegaly. Based on the above findings,the diagnosis was made as extranodal nasal type NK/T-cell lymphoma of skin complicated by hemophagocytic syndrome.

A 38-year-old woman presented with a 20-year history of yellow papules and band-like atrophy on the right neck. The lesions developed slowly and were asymptomatic. There was no history of long-term sun exposure or family history of similar diseases. Skin examination revealed multiple irregularly sized yellow papules and plaques on the right anterior neck following cleavage lines, multiple pin cap-sized perifollicular papules on the posterior right neck. Well-defined band-like atrophic patches with fine wrinkling were observed in the whole right neck, giving an aged appearance. The skin of the left neck was nearly normal. Pathological examination of biopsy specimens from the yellow papules showed a normal epidermis, scant lymphohistiocytic and melanophage infiltrates around the vessels in the superficial dermis without solar degradation. The collagen bundles in the mid dermis were slightly thickened and arranged tightly in parallel to the skin surface with the absence of inflammatory infiltrate. Verhoeff-van Giesen's staining confirmed a nearly complete absence of elastic fibers in the mid dermis as well as obvious swelling and breakage of resident scant elastic fibers. Von Kossa's staining was negative. Based on the above findings, the diagnosis was made as unilateral mid-dermal elastolysis.

To study the effect of chinese herbal medicine preventing gallstone formation, morphology of livers and gallbladders as well as conjugated bile acids of the bile. 58 female guinea pigs were randomly divided into three groups. The control group was fed on normal diet; the lithogenous groups was high cholesterol diet (HCD) and the antilithic group was high cholesterol and the chinese herbal medicine capsule (13.5 g/kg). 8 weeks later the guinea pigs were killed. Liver and gallbladder were removed for light and electroscope observation. Gallbladder bile were withdrawn and gallbladder were collected. The minute construction of gallstones were observed by scanning electron microscope and gallstone components were quantified by Fourier Transform Infrand Spectros Copy (FT-IR). The morphology of liver and gallbladder were observed by light microscope and transmission electron microscope. Conjugated bile acid of biles were determined by Thin-layer Chromatograph. The effect of chinese herbal medicine preventing gallstone formation, morphololgy of livers and gallbladders as well as conjugated bile acids of the bile were also observed. We measured conjugated bile acids in all groups and found that decreased in lithogenic group and increased notably in antilithic group (P＜0.01). The gallstone formation rate was 100% when the animals were fed on HCD in lithogenic group. The rate decreased to 5.3% when the animals were fed on HCD and Chinese herbal medicine capsule inantilithic group. It indicates that changes in diet is an important factor in the process of gallstone formation and the chinese herbal medicine can prevent gallstone formation effectively.

Objective To investigate the extracellular polysaccharide distribution and components of Ureaplasma urealyticum (Uu) after biofilm having been developed in.Methods The standard serotype 3 and serotype 14 belong to biovar Parvo,and the standard serotype 4 and serotype 8 belong to biovar T960 were employed to form biofilrns in vitro.Scanning electron microscope and confocal laser scanning microscope were used to analysis the biofilms and extracellular polysaccharide.We used combination of two different labeled lectins,Canavalia ensiformis(FITC-ConA) and Erythrina cristagalli(ECA) which bind to specific polysaccharide residues to visualize extracellular polysaccharide in biofilms,and average uorescence intensity was evaluated Results All the strains can form the biofilmsin vitro.The biofilm was honeycomb-Like structures mainly,and extracellular polymeric substances accounts for majority of proportions.All the extracellular polysaccharide could be combined with FITC-ConA and ECA,and the total average fluorescence intensity of FITC-ConA was higher than ECA( P＜0.001 ).Conclusion Ureaplasma urealyticum biofilm is honeycomb-like structures mainly.The extracellular polysaccharide contains,galactose,and N-acetyl glucan residual,and the glucose,mannose residual are the main components.