Objective To discuss the clinical significance of the changes of endothelin-1 and troponin-1 levels in kawasaki disease after acute stage. Methods 60 patients of kawasaki disease in which 12 cases of patient were complicated with coronary artery disease and 48 cases of patient who were not complicated with coronary artery disease were enrolled this study. Blood plasma endothelin-1 and serum cardiac troponin I were determined in kawasaki disease acute phase and recovery phase and 30 healthy children. Results Acute phase ET-1 and cTnI [(90.19±3.43)ng/L, (1.35±0.14)μg/L] and recovery phase ET-1 and cTnI [(89.09±2.44)ng/L, (1.12±0.11)μg/L ] in coronary artery lesions of (CAL) group had no significant difference（P＞0.05）. The concentration values of ET-1, cTnI in no coronary artery lesions (NCAL) group of acute phase (64.49±4.78)ng/L,(0.62±0.02)μg/L were different with convalescent phase (50.47±4.49)ng/L,(0.07±0.05)μg/L. There were significant difference between the the two phases (P＜0.01). Plasma endothelin-1 and serum troponin I concentrations were positively correlated in acute phase of Kawasaki disease in children (r＝0.93,0.96,P＜0.01). Conclusions Plasma endothelin-1 and serum cardiac troponin I test for the diagnosis of Kawasaki disease with coronary artery disease may be early indicators of risk monitoring, they are valuable indexes in diagnosis and treatment of Kawasaki disease.

Objective To explore the effectiveness and safety of fiberbronchoscope combined with cryotherapeatic equipment in treatment of bronchial foreign body in children.Methods 72 children with bronchial foreign body received fiberbronchoscope combined with cryotherapeatic equipment, then the complications were observed during and after the operation.Results Bronchial foreign bodies were successfully removed in all the patients. Among the 72 cases, transient hypoxia was the most common complication during the operation which happened in 37 cases and most occurred in the small age group, and decreased with the age increasing; cough or worsening of cough was the most common complication after the operation which happened in 20 cases; No serious complications were found during the follow-up.Conclusion Although it has some complications when bronchial foreign body received the fiberbronchoscope combined with cryotherapeatic equipment, but the operation time is short, and the complication is mild. It has great application value and security.

Objective To investigate risk factors of the adverse event during the fiberoptic bronchoscopy in children and to give some related nursing strategies. Methods Eighty cases were enrolled from pediatric department of the first people's hospital of hangzhou, who were performed by bronchoscope from July 2012 to July 2015, and were divided into the observation group and the control group according to whether appeared the adverse event, with 40 patients each, then univariate and multivariate Logistic regression analysis were adopted. Results Univariate logistic regression analy-sis showed that age, basic disease and operation time were the risk factors of the adverse event during the fiberoptic bronchoscopy in children. Multivariate logistic regression analysis showed that age(OR:16.628,95%CI:1.688-163.764), basic disease (OR:9.369,95%CI:1.429-61.412), operation time (OR:15.252,95%CI:1.767-131.676), were independent risk factors of the adverse event during the fiberoptic bronchoscopy in children. Conclusion More attention should be paid to the younger patients with underlying diseases and long operation time, and corresponding nursing measures should be applied to reduce the adverse event when performed by bronchoscope.

Objective To observe the effect of Bifico particles combined with Qiuxieling granule in the treatment of infantile rotavirus enteritis. Methods Children with infantile rotavirus enteritis in our hospital, with 74 patients in the control group and the observation group each. Patients in control group were taken montmorillonite and patients in observation group were taken Bifico particles combined with Qiuxieling granule, the course of treatment was 3 successive days,then the therapeutic effects in the two groups were evaluated after 5 days. Results Clinical symptoms,the fecal bifidobacterium and stool fecal lactose before therapy were compared, there were no significant difference between the two groups (P>0.05). After therapy, the vomiting times and the frequency of diarrhea in the observation group were significantly less than the control group (P<0.01). The fecal bifidobacterium in the observation group was significantly more than the control group (u=8.49,P<0.01). The stool fecal lactose in the observation group was significantly more than the control group (χ2=15.39,P<0.01). Conclusion It has a definite therapeutic effect of Bifico particles combined with Qiuxieling granule in treatment of infant with rotavirus enteritis,and it deserves popularization and application.

Objective To investigate the effect of comprehensive nursing intervention in transcervical fracture after operation. Methods A total of 64 cases of transcervical fracture were retrospectively analyzed from the ward of depart-ment of orthopedics in our hospital, from February 2010 to February 2014, with thirty-two patients in each group. The control group adopted routine postoperative nursing in department of orthopedics and the intervention group adopted comprehensive nursing intervention. Then the postoperative mental state, joint function, complications and quality of life were compared between the two groups. Results Four weeks after operation, 12 patients happened pressure sores, 13 patients happened constipation, 11 patients happened infection in control group, and 3 patients happened pressure sores, 4 patients happened constipation, 3 patients happened infection in intervention group, there were significantly differences between the two groups (χ2=5.12~6.40, P<0.05). The psychological state of anxiety and depression was compared between the two groups after 4 weeks, in control group, anxiety and depression was (43.69±5.47) and (42.34± 5.24), while in intervention group, anxiety and depression was (37.26 ±6.18) and (36.36 ±4.87), there were significantly difference between two groups (t=4.40, 4.72, P<0.01). The joint function was compared between the two groups after 4 weeks, Harris score in intervention group and control group was (64.35±9.27) and (56.26±8.35) respectively, there was significantly difference between the two groups (t=3.67, P<0.01), and HSS score in intervention group and control group was (88.67±12.26) and (81.33±13.31) respectively, there was significantly difference between the two groups (t=3.67, P<0.01). 4 weeks after operation, activities, sleep, pain, self-care was compared between the two groups, the score was (37.42±4.62), (39.62±3.13), (29.25±3.15), (29.32±3.14) respectively in the control group, while the score was(41.13±6.73), (43.34±4.28), (31.61±3.57), (32.57±4.32) in the intervention group, there were significantly differences between the two groups (t=2.80~3.96, P<0.01). Conclusion Comprehensive nursing intervention can effectively reduce the postoperative complications of femoral neck fracture, improve the psychological state and joint function, and it can also improve the quality of life.

Objective To explore the changes and clinical significance of joint fluid TNF-α and TNF-β1 levels in patients with knee osteoarthritis (KOA). Methods A total of 90 patients with KOA hospitalized in our hospital were selected. They were assigned to group A with 30 patients at early stage, group B with 30 patients at medium stage,and group C with 30 patients at advanced stage according to the stage of X ray; 30 healthy volunteers were in the con-trol group. Levels of joint fluid TNF-αand TNF-β1 were tested in four groups of patients. Results Levels of joint fluid TNF-β1 at medium and advanced stages of KOA were significantly lower than those in the control group, and the dif-ferences were significant (P<0.01); Levels of joint fluid TNF-α at medium and advanced stages of KOA were signifi-cantly higher than those in the control group, and the differences were significant(P<0.01); the difference of levels of joint fluid TNF-α and TNF-β1 at early stage of KOA was not significant compared with those in the control group(P>0.05);levels of TNF-α/TNF-β1 at early,medium and advanced stage of KOA were significantly higher than those in the control group(P<0.01);TNF-αwas positively correlated with KOA stage(r=0.930,P<0.01);TNF-β1 was nega-tively correlated with KOA stage(r=-0.849,P<0.01);TNF-α/TNF-β1 was positively correlated with KOA stage(r=0.828,P<0.01). Conclusion TNF-α and TNF-β1 are involved in the formation and progression of OA, and levels of joint fluid TNF-α and TNF-β1 are able to reflect the severity of KOA lesions; joint fluid TNF-α/TNF-β1 is able to detect KOA early.

Objective To study the effect of psychological intervention in the rectal cancer after operation. Methods Thirty-seven patients each in control group and intervention group with rectal cancer after operation from February 2012 to February 2015 in our department were retrospectively analyzed. The complications, quality of life and psycho-logical status were compared between the two groups. Results The intervention group was significantly lower than that of the control group in urinary tract infection (χ2=4.44, P<0.05), intestinal obstruction (χ2=3.85, P<0.05), pulmonary infection(χ2=6.51, P<0.05). The intervention group were significantly higher than that in the control group after 4 weeks of the operation in physical function(t=5.75, P<0.01), role function(t=5.50, P<0.01), emotional function(t=6.08, P<0.01), cognitive function(t=6.60, P<0.01), social function(t=2.92, P<0.01). The intervention group was significantly lower than that of the control group in SAS(t=4.05, P<0.01) and SDS (t=3.11, P<0.01). Conclusion Psychological inter-vention can decrease the rate of postoperative complications and improve the psychological state in the rectal cancer after operation, it can also enhance the quality of life.