Objective To explore how to promote the early medical consultation of patients with advanced esophageal cancer to improve the curative rate and the survival rate. Methods With the phenomenological research method, 12 patients with advanced esophageal cancer were sampled for the research. The semi-structure interview method was conducted to collect the data for analyses. Result There were 6 factors influencing the early consultation from the patients with advanced esophageal cancer in their early medical treatment, which included 6 items: lack of knowledge of the disease, economic burden, ignorance of early symptoms, lower medical level, heavy psychological burden of the disease, ageing and delay in seeking medical care. Conclusions The promotion of early medical treatment to the patients with esophageal carcinoma is in critically emergency. The measures including reducing economic burden, corresponding nursing care and health education can improve the cure rate and life quality.

Objective To observe the effect of lidocaine gargle,gentamicin,dexamethasone mixture on degree and cure time of oral mucositis caused by paraquat poisoning.Methods 61 patients with paraquat poisoning were randomly divided into the experimental group (31 cases) and the control group (30 cases); the experimental group was given lidocaine,gentamicin,dexamethasone mixture gargle,the control group was given dexamethasone dilution as gargle.The degree of oral mucositis and healing time were compared between two groups.Results There was significant difference in degree of oral mucositis and healing time between the experimental group and the control group.Conclusions Lidocaine gargle,gentamicin,dexamethasone mixture gargle can reduce degree of oral mucositis and hasten healing in patients with paraquat poisoning.It can alleviate the suffering of patients,and is worthy of clinical application.

Objective To explore the application value of improved B-Lynch suture in the treatment of cesarean section refractory hemorrhage.Methods To analyze retrospectively the information of cesarean section refractory hemorrhage patients who have taken conventional treatment or improved B-Lynch suture treatment in our hospital,taken the conventional treatment.the uterus was remove when it's invalid.the improved B-Lynch suture treatment was taken.Results In the improved B-Lynch suture treatment group,the patients have apprently little blood loss,shorter time in the cesarean section operation(t =8.58,6.38,P ＜ 0.05).And none of the cases took the hysterectomy or occured DIC.In the conventional treatment group,the blood loss was more,the operation time was longer,and 6 cases took the hysterectomy,5 cases occured DIC.The two groups were significantly different(x2 =6.98,4.59,all P ＜0.05).Conclusion In the cesarean section,if refractory hemorrhage happen and the conventional measures does not work,the improved B-Lynch suture should be taken into consideration.It has good hemostatic effect.

Objective To investigate the status of uncertainty in illness and social support among patients with post-traumatic brain syndrome (PTBS) and analyze their correlation.Methods One hundred and fourteen patients with PTBS were selected by convenience sampling and assessment.They were evaluated by Chinese disease Mishel Uncertainty in Illness Scale (MUIS) and Social Support Assessment Scale (SSAS) and the correlation of two scales was analyzed.Results MUIS total score was(135.23±19.29) scores with a median of 128.74 scores and SSAS total score was (43.14±5.54) scores with a median of 42.00 scores in patients with PTBS.Among 114 patients with PTBS,regarding ambiguity score was negatively correlated with objective support,subjective support,utilization degree of support and SSAS total score,r=-0.301,-0.374,-0.521,-0.509,complexity score was negatively correlated with objective support,sub-jective support,SSAS total score and utilization degree of support,r=-0.367,-0.326,-0.355,-0.533,both lack of information and regarding unpredictability score were negatively correlated with utilization degree of support,r=-0.376,-0.330,MUIS total score was negatively correlated with objective support,utilization degree of support and SSAS total score,r=-0.284,-0.424,-0.305.Conclusion There is high uncertainty of PTBS patients;increase of patients' social support will be good for decreasing the ambiguity and com-plexity among patients' uncertainty;promotion of patients' utilization degree of support will help to reduce patients' lack of information and unpredictability.

Objective To investigate the status of mental health and related factors in cervical cancer patients received radiotherapy and chemotherapy,and to implement individualized nursing intervention.Methods 60 cervical cancer patients with radiation and chemotherapy were enrolled in this study.The depression self rating scale(SDS),anxiety self-assessment scale(SAS) were evaluated,and the influence factors of self-designed questionnaires were investigated.During the same period,60 healthy women of 4 regions in Shantou were selected as control group.The SDS and SAS were compared in two groups.And combined with the influencing factors of the investigation group after the implementation of nursing intervention 7 d psychological assessment again.Results Cervical cancer patients with radiotherapy and chemotherapy,the SDS and SAS scores were (56.1±7.7)points,(45.2±7.5)points,which were significantly higher than those of healthy women [(45.0±6.3)points,(39.2±6.5)points,t=8.142,4.588,all P<0.01].After 7 days of nursing intervention,the SDS and SAS scores in cervical cancer patients decreased significantly[SDS(49.5±6.8)points,SAS(42.7±6.2)points,P<0.05],and the influence factors of patients' mental health were worry about the hospitalization expenses,do not understand the disease related knowledge,fear,the influence of family and society,and worry about the side effects of treatment on the prognosis of disease(88%,80%,80%,75%,68.3%,65%).Conclusion Cervical cancer patients received radiotherapy and chemotherapy have poor mental health status,in the treatment of diseases at the same time,the nursing staff should give psychological counseling and support,improve the patients' anxiety and depression,promote rehabilitation.

Objective To investigate the clinical effect of application of dezocine combined with sufentanil in patients under‐going thoracic surgery ,and discuss its security .Methods Selected 60 cases of patients undergoing thoracic surgery treatedn in the hospital from January to June 2013 ,then divided into two groups with 30 cases in each group randomly .ASA grade Ⅰ - Ⅱ ,the ob‐servation group took dezocine combined with sufentanil after the surgery ,the control group took sufentanil for analgesia ,then ob‐served the analgesia and sedative effect and the occurrence rate of adverse reaction between two groups of patients .Results The observation group′VAS pain score on postoperative 6 ,12 ,24 ,48 h were (3 .21 ± 0 .76)% ,(3 .01 ± 0 .77)% ,(2 .79 ± 0 .69)% , (2 .67 ± 0 .66)% and significantly better than the control group(P<0 .05);The observation group′Ramsay sedation score on post‐operative 6 ,12 ,24 ,48 h were (2 .12 ± 0 .23)% ,(2 .07 ± 0 .22)% ,(2 .02 ± 0 .24)% ,(2 .01 ± 0 .21)% ,the sedative effect was better than the control group(P<0 .05);48 h after the surgery the pressing times and effective analgesia pump frequency and adverse re‐action of the patients in the observation group were lower than that of the control group(P<0 .05) .Conclusion The effect for se‐dation and analgesia of dezocine combined with sufentanil in patients undergoing thoracic surgery is better and safe .

Objective To evaluate diagnostic accuracy of image interpretation using viewboxes at different luminance with ALVIM statistical phantom (TRG).Methods A digital film of TRG image was obtained by exposing the phantom of TRG with Kodak DR 3000 using proper parameter.Viewboxes with three different luminance were selected from those used in daily work.The film of TRG was evaluated with these viewboxes of three different luminance by three different radiologists with experience of five,eight and sixteen years respectively.A grade scale of 5 was used to evaluate each row of signal and noise.According to the results and formula,the probabilities of true-positive [P (S/s)],false-positive [P (S/n)] and true answer(Pdet) were obtained. Results The three kinds of luminance used in viewboxes were: (3489 ± 256),(2231 ± 220),(816 ± 168) cd/m2.When the average luminance of viewbox was 3489 cd/m2,Pdet of 0.6,0.7,0.8 mm in bone substitute was 0.558±0.009,0.788±0.008,0.813±0.006,Pdet of0.9,1.0,1.2 mm in muscle substitute was 0.663 ± 0.010,0.750 ± 0.008,0.933 ± 0.005 ; When the average luminance of viewbox was 2231 cd/m2 ,Pdet of 0.6,0.7,0.8 mm in bone substitute was 0.525 ± 0.013,0.713 ± 0.013,0.775 ± 0.016,Pdet of 0.9,1.0,1.2 mm in muscle substitute was 0.613 ± 0.019,0.650 ± 0.013,0.850±0.019 ;When the average luminance of viewbox was 816 cd/m2 ,Pdet of 0.6,0.7,0.8 mm in bone substitute was 0.475 ± 0.022,0.550 ± 0.018,0.688±0.020,Pdet of 0.9,1.0,1.2 mm in muscle substitute was 0.550 ± 0.025,0.575 ± 0.021,0.725 ± 0.016. Viewboxes of different luminance were compared to one another by paired t-test.The results of comparison all had significant statistical differences (t = 5.057 and 4.681 ,P <0.05).Conclusions The image displayed by viewboxes at different luminance had significant influence on image interpretation. The higher the luminace of viewbox,the richer the information displayed,and the higher the accuracy of diagnosis.

Objective:To study effect of health education on blood pressure control in patients with hypertension through community survey and perform health education.Methods:Residents from Datang street community re-ceived systematic sampling and questionnaire.A total of 490 patients with hypertension detected during census were regarded as subjects,and they were randomly divided into routine treatment group (n=240)and health education group (n=250).Health education group received health education,and effects were compared between two groups. Results:Compared with routine treatment group after intervention,there were significant rise in awareness rate of preventive and therapeutic knowledge [diagnostic value of hypertension (49.17% vs.58.40%),risk factors of hy-pertension (30.41% vs.58.00%),antihypertensive medication (58.75% vs.79.60%)]and control rate of blood pressure (23.33% vs.60.80%),and significant reduction in blood pressure [(147.68±13.97)/(89.30±12.43)mm-Hg vs.(143.57±13.53)/(85.73±11.54)mmHg]in health education group,P<0.05 or<0.01. Conclusion:Carry-ing out targeted health education possesses active significance for prevention and treatment of hypertension.

Objective To explore the incidences of postpartum depression as well as the influencing factors in Guangzhou.Method Nine hundred and seventy women participated in the investigation with the Edinburgh postnatal depression scale(EPDS)to analyze the influenceing factors.Results The incidence rate was 38.87%(377/970). The influencing factors included age,feeding mode,delivery mode and education level.Conclusions The incidence of postpartum depression is at a higher level.The feeding mode,delivery mode and education level are the influencing factors.

Objective To study the serotype , biochemical characteristics , virulence gene and multilocus sequence typ-ing(MLST) of S.flexneri 4c in Beijing, Shanghai and Shenyang .Methods Seventy-six strains of S.flexneri 4c isolated from stool samples which had been collected from above-mentioned cities of China were identified with Denka Seiken serum and MASF monoclonal serum .Biochemical characteristics of each strain were identified by API 20E test strip and PCR technology was used for detecting 12 pair virulence genes of S.flexneri.MLST was used to analyze the characteristics . Results The serum agglutination antigen structure of S.flexneri 4c was(Ⅳ:7,8).MASF:B+,Ⅳ:Ⅰ+,7 (8) +.S.flexneri 4c developed different results in biochemical reactions and carried different rates of virulence genes , respectively .The IND test positive rate was 17.11%; MEL weakly positive rate was 3.9%, and ARA test weakly positive rate was 22.37%. Virulence genes were carried at a rate of 89.47% -100%, MLST typing was ST245.Conclusion S.flexneri 4c with serum agglutination antigen structure (Ⅳ:7,8) is a new serotype of S.flexneri.The main biochemical reactions are glucose fermentation and mannitol decomposition .A variety of Shigella related virulence genes are carried .MLST generation is consistent,suggesting that the bacteria might have evolved from ST 270 cloning.