Objective To evaluate the effect of FOCUS- PDCA model in hypoglycemia management during hemodialysis in patients with diabetic nephropathy. Methods Totally 107 patients with diabetic nephropathy were divided into two groups. Patients in the control group received traditional hypoglycemia management, while FOCUS- PDCA model was implemented in the experimental group in hypoglycemia management, including reducing insulin dosage before hemodialysis,injecting 50%glucose and taking hyperglycemia food during hemodialysis,enhancing the monitoring of blood glucose and health education. Compared the incidence of blood glucose levels and hypoglycemia in two groups of patients at different time of dialysis. Results The frequency of hypoglycemia in the experimental group at the beginning of dialysis [ (9.04±2.08) mmol/L ], 2 hours after dialysis[ (5.78±1.82) mmol/L ]and at the end of dialysis[ (6.94±2.04) mmol/L ] were significantly lower than that in the control group[ (8.60±2.02) mmol/L, (5.20±1.62) mmol/L, (4.97±1.05) mmol/L ], (P <0.05), and the total incidence rate of hypoglycemia was 1.6%(61/3 889), which significantly lower than that 4.8%(185/3 816) in the control group, the difference was statistically significant (χ2=5.288, P < 0.05). Conclusions The application of FOCUS- PDCA model in the hypog1ycemia management of patients with diabetic nephropathy can reduced the incidence of hypoglycemia during hemodialysis. It deserves to be widely used in clinical practice to improve the patients′quality of life.

Objective: To investigate the effective methods of nutritional support, to improve the endurance for the operation and to promote postoperative recovery in patients undergoing liver transplantation. Methods: The perioperative nutritional condition and nutritional-support methods were reviewed in 33 patients with liver transplantation. In the first 3 postoperative days, parenteral nutrition (PN) was used in combination with infusion of human albumin and plasma. From the 4th to 5th day, enteral nutrition (EN) was used in combination with PN. Finally, the complete oral intake of food was applied. Results: Of 33 patients, there were 30 patients whose serum levels of total protein (TP) and albumin (ALB) were elevated, and glutamic-pyruvic transminase (GPT), total-bilirubin (T-BIL) and combined-bilirubin (D-BIL) were descended after nutrition support. Conclusion: The operative endurance and postoperative recovery were improved effectively by proper nutritional support in liver transplantation patients.

AIM: To compare the main saponins extracted respectively from the fruits and the whole plant of Tribulus terrestris L. and study its marked component. METHODS: Using C 18 ODS column and Refractive Index Detector, we compared the main saponins extracted respectively from the fruits and the whole plant of Tribulus terrestris L. in quantity by RP-HPLC. RESULTS: Tigogeniin contents from herb and its fruit had distinct difference between them (P

Objective To analyze the anticoagulation in patients with atrial fibrillation.Methods A retrospective analysis of anticoagulant therapy situation in 926 patients with atrial fibrillation was conducted,in order to sum up experience and improve the understanding of atrial fibrillation.Results In 926 patients with atrial fibrillation,there were no anticoagulant therapy in 675 patients,accounting for 72.89%,while only 251 cases received the treatment of anticoagulation,accounting for 27.11%.Only 66 patients aged>75 years were treated with anticoagulant therapy,accounting for 33.17%.The patients with coronary heart disease,in 17.60% and with anticoagulation treatment,the patients with diabetes in 28.37% and received anticoagulation therapy,28.32% patients with anticoagulation therapy in patients with hypertension,30.77% patients with cardiac insufficiency with anticoagulant therapy.Choice of treatment of aged>75,hypertension,coronary heart disease,clinical treatment strategies and patients were the main factors that affected the use of warfarin,but only>75 years of age,coronary heart disease,choice of treatment factors with statistical significance of three factors(OR=7.02,12.73,4.79,all P<0.05).675 cases without anticoagulant therapy in 101 patients with non warfarin treatment indications without the use of warfarin anticoagulation treatment,accounted for 14.96%.In addition,there were 574 AF patients with warfarin treatment indications and treatment with warfarin,analysis of its causes:63 cases had anticoagulant contraindications,172 cases for the doctor too much about bleeding complications,440 patients were not in accordance with the requirements of the detection of INR.Conclusion The positive effect of warfarin in prevention of ischemic stroke,but in basic hospital application of warfarin anticoagulation in patients with severe AF deficiency,should raise the awareness of risk of grassroots medical staff and patients of atrial fibrillation complicating embolism,do a good job of educating patients,to reduce the incidence of embolic events in patients with atrial fibrillation.

Objective To evaluate the effect cooperation by using iPAD for preoperative intervention undergoing phimosiectomy. Methods Totally 60 children,undergoing phimosiectomy,were divided into the experimental group and the control group with 30 cases each by random digits table method. A conventional preoperative interview was performed in the control group. In the experimental group, the parents and the children would be given education about the environment of operation room and materials of educational propaganda by watching video in a preoperative interview,furthermore,the children got the entitlement to chose their favorite cartoons, which would be played in operation room. The age, weight, time for surgery and the number for general anesthesia were recorded. The anxiety level of the parents, assessed by Hamilton Anxiety Scale, were carried out before and after operation. The satisfaction score, coming from the parents for operation room work and the surgeon for the operation process were also carried out. Results The anxiety level of the parents assessed by Hamilton Anxiety Scale, after the operation,the number for general anesthesia and the time for surgery were(44.2 ± 7.4)points,11 cases, (11.9 ± 3.2)points in the experimental group,and (51.2 ± 6.0)points,28 cases,(17.7 ± 5.8)points in the control group, and there were significant differences(t =4.005, 4.704, χ2=10.978, all P<0.01). The satisfaction score, coming from the parents for operation room work and the surgeon for the operation process were higher than that in the control group (χ2=10.162, 14.836, P<0.01). Conclusions The cooperation of the children,undergoing phimosiectomy,could be improved significantly by the application of iPAD in preoperative interview.