Objective To understand the actual situation of community‐based diabetes management and analyze common prob‐lems in diabetes management and find the solutions to diabetes management though the objective investigation .Methods The pa‐tient′s data including gender ,age ,education ,medication ,lifestyle information were collected by household face‐to‐face survey and were performed a single factor χ2 analysis of relevant indicators .Results Relative to the patients with middle school education only and is less than 3 000 a month ,the diabetic patients who ere above the junior middle school and family income equal to or greater than 3 000 had good diabetes management on medication ,diet ,exercise ,blood glucose monitoring ,diabetes related knowledge .Con‐clusion Patient′s education and economic level could effect attitudes toward diabetes ,medication ,diet ,exercise ,blood glucose moni‐toring ,diabetes‐related knowledge .

Objective To investigate the effects of exercise on learning and memory after cerebral ischemia. Methods Ninety Sprague-Dawley rats were randomly divided into a sham-operated group, a model group and a treadmill training group ( n=30 for each) , which were further subdivided into groups to receive 7 days, 14 days or 28 days of training with 10 rats in each. The training was treadmill running at 10 m/min for 30 min a day. Cerebral ische-mia was induced in the model and training groups using permanent, bilateral common carotid artery occlusion. The training began three days after the operation. Morris water maze tests were used to measure the rats′ learning and memory ability, and Nissl staining was employed to detect the survival rates of pyramidal neurons in the CA1 area of the hippocampus. Results The average escape latency in the treadmill trained group had shortened significantly by day 7, then further by days 14 and 28. It was significantly shorter than the model group′s average at each time point. The average platform crossing time increased significantly compared with the model group′s average. Few dead neu-rons were observed in the sham-operated group. On days 14 and 28 the average survival rate of pyramidal neurons in the model group was significantly lower than in the treadmill training group or the sham-operated group, though there was no significant difference on day 7. Conclusion Treadmill training can improve learning and memory after cere-bral ischemia, at least in rats. Better effects can be observed after longer training.

OBJECTIVE To investigate risk factors of bloodstream infection in ICU.METHODS From May 2007 to Aug 2007,the operation of central venous catheter and the medical attendance of 24 cases with bloodstream infection were retrospectively analyzed.RESULTS Fifteen cases with infection(62.5%) were found in 7 days;ESBLs-producing Klebsiella pneumoniae,Enterobacter,and Acinetobacter baumannii were the major pathogens.The major risk factors included severe underlying diseases,endovascular catheter operation and incorrect asepsis barrier.CONCLUSIONS The patients are severe in ICU.In order to control and prevent infection in ICU,effective measures should be taken,including taking strict aseptic treatment in central venous catheter and the medical attendance of catheters,and strengthen hygiene administration.

This paper aimed to review the recent literature on the TCM treatment for stroke sequelae. The content summarized and discussed the definition of stroke sequelae, herbalmedicine, TCM patents, acupuncture and so on. Sequelae of stroke’s pathogenesis was mainly caused by deficiency generating stasis, so the treatment principles were to tonifying Qi and blood and promote circulation and remove stasis with the common prescriptions, such asBuyang-Huanwudecoction,Xuefu-Zhuyu decoction andDihuang-Yinzi. Meanwhile, Chinese medicine patents and acupuncture treatment canimprove the brain function and ADL.

Objective To assess the occurrence of CNV in patients presenting with flat irregular pigment epithelial detachments (FIPED).Methods Forty-five patients (49 eyes) with FIPED on OCT were enrolled in this retrospective study.There were 25 males (28 eyes) and 20 females (21 eyes).The mean age was 61.022±9.292 years.FFA,ICGA,spectral domain OCT and OCT angiography (OCTA) were performed in all patients during the same period.The FIPED was defined as an irregular elevation of the RPE allowing distinct visualization of Bruch's membrane on OCT B-scan.The abnormal vascular signals from the deep retinal layer to the choroid layer on OCTA was defined as CNV.The CNV was classified into a type 1 CNV and a type 2 CNV according to the OCT characteristics.The CNV was classified into a typical and occult CNV according to the characteristics of the FFA image.Of all 49 eyes,fundus angiography revealed 18 eyes (36.7％) with CNV,and 31 eyes (63.3％) with no characteristic signs of CNV.FFA examination found that CNV in 8 eyes (classic CNV in 1 eyes,occult CNV in 7 eyes),which confirmed by OCT were type 1 CNV;transmitted fluorescence in 41 eyes.ICGA examination showed that CNV-like hyperfluorescence spots in 18 eyes,suspicious hyperfluorescence spots in late stage in 20 eyes,and choroidal high permeability in 11 eyes,respectively;and 18 CNV eyes were confirmed to be type 1 CNV by OCT.To compare the detection of CNV by OCTA and fundus angiography.Results Of the 49 eyes with FIPED,OCTA detected 36 eyes (73.5％) of type 1 CNV,and full or partial strong reflex signals were seen in FIPED;13 eyes (26.5％) were not associated with CNV,and some strong reflection signals were found in FIPED in 9 eyes,4 eyes with weak reflection signal.The FFA was examined for 1,7 eyes of the classic and occult CNV,which confirmed to be type 1 CNV by OCTA.Among the 18 eyes with CNV which detected by ICGA,OCTA also found type 1 CNV.Among the 20 eyes with ICGA's late suspicious strong fluorescent spots,OCTA showed 17 eyes of type 1 CNV;in 11 eyes with high choroidal permeability,OCTA showed type 1 CNV in 1 eye.Among the 36 eyes with CNV which detected by OCT,there were SRD in 32 eyes,no SRD in 2 eyes and retinal interlamellar cavities in 2 eyes.Conclusion OCTA can detect 73.5％ of FIPED eyes with CNV.Compared with traditional fundus angiography,OCTA has a higher detection rate of CNV under FIPED.The FIPED of the internal strong reflection signal has a certain diagnostic value for the type 1 CNV.

Objective To explore application effects of the tracking management mode in outpatient rescue vehicles. Methods From June 2015 to July 2016 Ningbo First Hospital of Zhejiang Province applied the tracking method to track the whole process of drugs in rescue vehicles in the outpatient care unit and the quality of the equipment section. According to the tracking results, improvement measures were made and implemented in time. The first-aid medicine in rescue vehicles, the quality of item management, the time of checking rescue vehicles and the nurses′ satisfaction degree with the use of rescue vehicles were compared between before and after the implementation of the tracking management mode. Results After the implementation of the tracking management mode, the average score of the first-aid medicine in rescue vehicles and the quality of item management was( 99.12±0.88) points. The time of checking rescue vehicles was (11.24 ±1.42) min. The nurses′ satisfaction degree of using rescue vehicles was ( 98. 37 ± 1. 63 ) points. Before the implementation, they were (95.56±1.51)points,(18.00±2.51) min and(93.37±2.24) points, respectively. The differences of scores were all significant before and after the implementation of the tracking management mode (t=7.344,8.751,6.508;P<0.01). Conclusions The application of the tracking management model improves the first-aid medicine in outpatient rescue vehicles and the quality of item management, reduces the nurses′time of checking rescue vehicles and improves the nurses′ satisfaction degree with the use of rescue vehicles.

ObjectiveTo explore the application of the management by wandering around (MB-WA) model in the management of outpatient service,listen to the nurses and patients in the outpatient service,induct nurses to pay attention to the nursing quality,enhance the collaboration awareness of nurses,improve the quality of nursing and the satisfaction of patients.Methods The MB-WA model was implemented from January 2016. According to the clinical nursing quality control score table,nursing managers went to the clinical line,handed out the outpatient satisfaction questionnaire,found out the problems in the clinical nursing,promptly formulated and implemented measures to consolidate the quality of improvement.Results After the implementation of the MB-WA model in 2016,the scores of triage nursing quality (96.27±0.69),nursing etiquette (98.33±1.31), nursing operation (96.97±1.26),management of emergency medicine instrument (99.36±0.44),and patient satisfaction (91.11±2.56) increased when compared to the scores before the implementation in 2015 [(95.10±1.08),(95.31±1.24),(95.47±1.15),(95.56±1.51) and (81.15±4.68)]. The differences were statistically significant (P<0.05).Conclusions The ME-WA model help the managers to directly access the clinical problems,provide timely and targeted interventions,achieve the goal of the cooperation of nurses, participate the outpatient management,increase the outpatient management quality and management level of managers,and improve the service quality.

Objective To explore the effects of patient-participating nursing mode in improving the nursing quality for chemotherapy patients in day-care ward. Methods A total of 80 cases of chemotherapy patients in the Day-care Ward of Ningbo First Hospital from April to September 2017 were selected and randomly divided into control group and observation group, with 40 patients in each group. Routine nursing care was applied in the control group. On the basis of routine nursing, patient-participating nursing mode was applied in the experimental group. The safety of intravenous chemotherapy (venous exudation and phlebitis), patient satisfaction and quality of life of the two groups were observed and compared. Results The incidences of phlebitis, venous exudation and patient satisfaction of the control group were 22.5%, 5.0% and 80.0% respectively. Those of the observation group were 15.0%, 0% and 97.5% respectively, and the differences were statistically significant (P< 0.05). After the application of patient-participating nursing mode, the patients in the observation group were superior to the control group in their overall condition, body, role, cognition, emotion and social support. The scores of fatigue, insomnia, loss of appetite, diarrhea and constipation were lower than those of the control group, and the differences were statistically significant (P<0.05). There were no statistical differences in the incidences of nausea and vomiting, pain and shortness of breath (P> 0.05). Conclusions Patient-participating nursing mode is conducive to improve the safety and effectiveness of intravenous chemotherapy, reduce the adverse reactions of chemotherapy, and improve patient satisfaction and quality of life to some extent.

BACKGROUND:The light curing and fluoride light curing enamel adhesives have a certain sealing effect on the etched enamel surface.The fluoride light curing enamel adhesives can also achieve the anti-caries function by releasing fluoride ions.However,the existing researches lack the long-term tracing of fluoride release effect,especially the amount of local pathogenic bacteria after 1-3 months of local fluoride application. OBJECTIVE:To analyze the changes in the expression of Porphyromonas gingivalis and Streptococcus mutans in subgingival plaque of the upper anterior teeth adhered by different components of enamel adhesives in adolescent patients with fixed appliance. METHODS:Ninety adolescent patients who received orthodontic treatment in Shanghai Stomatological Hospital from January to December 2016 were enrolled,including 43 males and 47 females,with a mean age of(13.27±1.12)years.These patients were randomly divided into three groups(n=30 per group).In the chemical curing group,Unite? bonding resin was used to bond fixed appliances.In the light curing group,Transbond XT light curing resin was used to bond the fixed appliance.In the fluoride light curing group,GC light curing orthodontic adhesive was used to bond the fixed appliance with cement.The subgingival plaque was collected on the day of bonding,1st,2nd,and 3rd month follow-up reviews.The expressions of Porphyromonas gingivalis and Streptococcus mutans in subgingival plaque were detected by PCR. RESULTS AND CONCLUSION:(1)Intragroup comparison:With the increase of bonding time,Porphyromonas gingivalis expression increased significantly in the 3rd month in the chemical curing group(P<0.05).In the light curing group,Porphyromonas gingivalis showed a significant decrease in the 1st month(P<0.05).Porphyromonas gingivalis expression decreased significantly in the 1st and 2nd months compared with initial data in the fluoride light curing group(P<0.05).The expression of Streptococcus mutans was higher in the chemical curing group in the 1st,2nd,and 3rd months compared with the initial data(P<0.05).In the fluoride light curing group,the expression of Streptococcus mutans was lower in the 1st,2nd,and 3rd months compared with the initial data(P<0.05).There was no significant difference in the proliferation and expression of Streptococcus mutans during follow-up in the light curing group compared to the initial adhesion(P>0.05).(2)Intergroup comparison:In the 1st month,the expression of Porphyromonas gingivalis was lower in the light curing group and fluoride light curing group than that in the chemical curing group(P<0.05).In the 2nd and 3rd months,the expression of Porphyromonas gingivalis was lower in the fluoride light curing group than that in the light curing group and chemical curing group(P<0.05).In the 1st,2nd,and 3rd months,the expression of Streptococcus mutans was lower in the light curing group and fluoride light curing group than that in the chemical curing group(P<0.05).The expression of Streptococcus mutans was lower in the fluoride light curing group than that in the light curing group(P<0.05).(3)The results show that in the fixed orthodontic process,the use of different components of enamel adhesives has different effects on the proliferation and expression of oral Porphyromonas gingivalis and Streptococcus mutans in the short term.Fluoride light curing enamel adhesives at the initial stage can reduce the occurrence of enamel demineralization,caries,and periodontal inflammation.

Objective? To explore the effects of symposium involving patients and their family members on health education in patients with acute myocardial infarction after percutaneous transluminal coronary intervention (PCI). Methods? Totally 86 patients with acute myocardial infarction receiving PCI in Ningbo First Hospital from January 2017 to June 2018 were selected continuously and divided into the control group (n=43) and the observation group (n=43). Patients in the control group received conventional health education which combined oral education and education manuals, while patients in the observation group symposium-based health education which involved both patients and their family members on the basis of conventional education after PCI. Both groups received health education for 4 weeks. Health knowledge about acute myocardial infarction, rehabilitation initiative, postoperative complication and satisfaction with overall nursing were compared between the two groups before and after intervention. Results? The health-related knowledge of the patients with acute myocardial infarction in the observation group 4 weeks after intervention scored (94.3±4.0), higher than that of the control group, which was (78.4±5.1), and there was statistically significant difference (t=8.285, P＜ 0.05). The scores of five dimensions of rehabilitation initiative (coordination with therapy, compliance, needs for rehabilitation, emotions post frustration and encouragement from family members and nurses) of the observation group were higher than those of the control group (t=4.726, 5.114, 3.975, 7.116, 5.893; P＜0.05). The incidence rate of postoperative complication in the observation group was 9.30%, lower than that of the control group, which was 30.23%, and there was statistically significant difference (χ2=5.939, P＜0.05). The nursing satisfaction of the observation group was 96.73%, higher than that of the control group, which was 83.78%, and there was statistically significant difference (χ2=4.904, P＜0.05). Conclusions? The symposium involving patients and their family members for patients with acute myocardial infarction after PCI can improve the patients' disease-related knowledge, satisfaction with overall nursing and rehabilitation initiative, and reduce the postoperative complications effectively.