Objective To investigate the effect of nursing intervention for dysphagia in elderly patients with stroke.Methods 17 patients accepted swallow training individually.Their swallowing functions were assessed before and after training.Results Their swallowing functions improved after 4-week-training(P<0.01).Conclusion Rehabilitation nursing is effective on dysphagia in elderly patients with stroke.

Constipation has become a common clinical symptom in the elderly. Many factors can result in constipation, including diet,physiological aging, lack of exercise, inappropriate medication, psychological factors, perianal disease, and so on. If the individualized, targetedand comprehensive care interventions that consist of health education, psychological intervention, dietary intervention, medicationguide, functional exercise, passive attention to bowel training and abdominal massage etc. are done well, it can decrease the incidence ofconstipation, reduce a variety of complications and adverse effects caused by the constipation and improve the quality of life in the elderly.So it has important clinical significance.

Objective To explore the related factors of hepatitis B virus(HBV) drug resistance and their clinical significance . Methods The retrospective analysis was performed on the dinical data in 153 cases of CHB in our hospital during 2011-2013 .The 8 viral drug resistance loci of 4 known nucleosides analogues lamivudine ,adefovir ester ,entecavir and telbivudine were performed the direct sequencing by using the double DNA end termination method(Sanger method);the related clinical factors of drug‐resist‐ant virus genotypes were statistically analyzed and the correlation between prognosis and drug resistance was analyzed .Results A‐mong 153 patients with CHB ,47 cases(29 .8% ) appeared virus genotype drug‐resistant ,the common sites were 204M‐I(18 cases) , 204M‐V(8 cases) ,followed by 181A‐T(10 cases) ,181A‐V(5 cases) ,then 180L‐M (14 cases) .The proportion of viral drug resist‐ance in the patients with family history ,HBeAg positive ,using the nucleotide analogues in the past and the baseline ALT≥5 times was significantly increased ,the incidence rates were 38 .8% ,34 .8% ,34 .6% and 50 .0% respectively .The multivariable COX re‐gression found that HBV‐DNA genetic drug resistance increased the risk of progression to cirrhosis of the liver ,the OR value was 4 .704(95% CI:1 .199 -18 .454) .Conclusion the Sanger method for direct sequencing is reliable and accurate method of HBV‐DNA genotype drug resistance .The proportion of viral drug resistance in the patients with a family history of hepatitis B ,HBeAg positive ,using nucleotide analogues and baseline ALT≥5 times is significantly increased;HBV‐DNA genotype drug resistance also increases the risk of progression to cirrhosis of the liver .

Objective To explore the effect of hospital-community-based collaborative management on elderly out-patients with chronic heart failure (CHF).Methods A total of 228 out-patients with CHF were randomly assigned to the community-based health management group (n =106 ) and the hospitalcommunity-based collaborative health management group (n =122).In community-based health management group,the patients only received community-based health management,while in hospital-community-based collaborative health management group the patients accepted comprehensive health management.One year later,medication compliance,readmission rate,mortality,average length of hospitalization,medical costs and Minnesota living with heart failure questionnaire (LiHFe) were compared between the two groups.Results No statistically significant differences in clinical data were found between the two groups at baseline.After one year,medication compliance was significantly improved in hospital-community-based collaborative health management group when compared to community-based health management group ( x2 =8.97,P ＜ 0.05 ).Readmission rate,averagelengthof hospitalizationandmedicalcostsof hospital-community-based collaborative health management group were lower than community-based health management group (x2 =9.91 ; t =3.78,3.61 ; all P ＜ 0.05 ).One year ago,the items of LiHFe including physical dimension,emotion,symptom and social dimension and total score showed no significant between the two group (t =0.42,0.81,0.66,0.44,0.41 ; all P ＞ 0.05 ).While one year later,all the scores of hospital-communitybased collaborative health management group were significantly declined( t =6.37,11.81,6.16,9.64,9.13;P ＜ 0.05 ).Mortality showed no significant difference between the two groups ( x2 =0.247,P ＞ 0.05 ).Conclusion Hospital-community-based collaborative management for health care may be a practical and valuable strategy for decreasing readmission rate and medical burden and improving quality of life of elderly patients with CHF.

Objective To investigate the trends in incidence and mortality of esophageal cancer from 1981 to 2002 in Tianjin,China and to predict future trends and facilitate future prevention.Methods All new cancer cases registered in the Tianjin Cancer Registry between 1981 and 2002 were reviewed.Yearly age-specific,crude and age-adjusted incidence rates were calculated for males and females.Secular trends of incidence and mortality were indicated by the estimated annual percentage change(EAPC).Results A total of 8206 cases of esophageal cancer were reported in Tianjin form 1981 to 2002,with 5533 males and before 45 years,but increased rapidly after 45 years.The median age of esophageal cancer cases was 69 years,with quartile range from 62 to 75 years.The peak for age specific incidence in females was 75-80 years,which was earlier than that in males(aged 80-85).But recent data indicated that the peak age in females had increased and became similar to that of the males.The crude and age-standardized incidence rates(ASIR)of esophageal cancer decreased in last 22 years.For male and female,crude incidence decreased by 2.22% and 3.56% per year and ASIR decreased by 5.18% and 6.56% per year.The mortality of esophageal cancer decreased in the last 22 years.Conclusion The incidence of esophageal cancer decreased in the last 22 years in Tianjin,but there is little overall improvement in survival.

Objective To establish and evaluate the review criteria of blood routine detection by the Sysmex XE‐5000 hematolo‐gy analyzer in our hospital for improving the effectiveness of the measurement results .Methods 606 blood samples were collected from the outpatients and inpatients during 2014 and performed the microscopic examination by 2 technologists‐in‐charge with the double‐blind method .The average value of these results was used as the judging criteria .According to the 41 items of rule formula‐ted by the international expert group and combining with the patients characteristics of infectious disease hospital and instrument features in this hospital ,20 items of review criteria for blood routine test of our hospital was formulated .Results With the micro‐scopic examination results as the criteria ,among 606 detected samples ,116 samples were in line with the rules and the review rate was 19 .14(116/606) ,in which the true positive rate was 6 .93% (42/606) ,the false positive rate was 12 .21% (74/606) ,the false negative rate was 2 .64% (16/606) ,the true negative rate was 78 .22% (474/606) ,the sensitivity was 72 .41% and the specificity was 86 .5% .The expected values of positive and negative results were 36 .21% and 96 .73% respectively .The total effective rate was 85 .15% .Conclusion The review criteria formulated by this laboratory are reasonable and effective ,which has an important significance in the clinical application for increasing the detection speed of blood routine ,improving the laboratory reports quality , without missed true blood patients and accurately providing the valuable information for clinicians .

Objective To investigate the life quality changes and influencing factors of acute coronary syn -drome after stent implantation .Methods 100 cases with acute coronary syndrome received stent implantation were selected .SF-36 life quality questionnaire was used to survey the patients′life quality before operation and 6 months af-ter operation,and the life quality changes and influence factors were analyzed .Results 6 months after operation,the physical activity ,mental health ,social activities ,physical pain ,physical function ,physical role ,energy and health score of the patients were higher than before operation (P<0.05).According to Logistic regression analysis ,female,type 2 diabetes,underwent percutaneous coronary intervention ,ST-T segment elevation myocardial infarction were the im-portant factors affecting patients′recovery(P<0.05).Conclusion 6 months after stent implantation,the life quality of the patients with acute coronary syndrome were improved obviously;the female and underwent percutaneous coro-nary intervention have positive influence on patients′recovery,while type 2 diabetes,ST-T segment elevation myocar-dial infarction affect patients′recovery in negative way .

Objective To investigate the effect of β-elemene on SGC7901 gastric cancer cell line and the potential proteins involved. Methods Human SGC7901 gastric cancer cells were treated with different concentrations ofβ-elemene.Cell viability was assessed.A proteomic method,isobaric tags for relative and absolute quantitation (iTRAQ),was employed to detect the proteins altered by β-elemene.Protein expression was validated by Western blot.Results β-elemene inhibited the viability of SGC7901 gastric cancer cells in a dose-dependent manner.Altogether,147 upregulated proteins and 86 downregulated proteins were identified in response to β-elemene treatment in SGC7901 gastric cancer cell line.Among them,the expressions of p21-activated protein kinase-interacting protein 1 (PAK1IP1 ),Bcl-2-associated transcription factor 1 (BTF)and topoisomerase 2-alpha (TOPIIα)were validated by Western blot and the trends were consistent with iTRAQ results.Top pathways involved inβ-elemene treatment in SGC7901 gastric cancer cell line included ribosome signaling,peroxisome proliferator-activated receptors (PPARs)signaling pathway,regulation of actin cytoskeleton,phagosome,biosynthesis and metabolism of some amino acids.Conclusion Our results suggest a promising therapeutic role of β-elemene for gastric cancer.The differentially expressed proteins give us better insights into the potential mechanisms involved in gastric cancer treatment using β-elemene.

Objective To analyze the safety of laparoscopic splenectomy for traumatic splenic rupture.Methods The clinical data of 62 patients with traumatic splenic rupture treated by laparoscopic splenectomy in our hospital from Jan 2013 to Jan 2018 were retrospectively analyzed.Results All 62 patients successfully underwent laparoscopic surgery except for 1 case who was converted to open surgery.One case suffered from postoperative bleeding.There was no infection,serious pancreatic leakage and other major complications.The total amount of intraoperative bleeding was 1 600 ml on average,the average operation time was 135 min,the average splenectomy time was 55 min,and the average hospital stay was 12.5 d.Conclusion Laparoscopic splenectomy is a safe and reliable minimally invasive operation for traumatic splenic rupture.

OBJECTIVE:To reduce the incidence of irrational medical orders for parenteral nutrition,and promote the rational use of parenteral nutrition. METHODS:The medical orders for parenteral nutrition of the first quarter of 2016 in general surgery de-partment of our hospital were collected,and the number and types of its irrational medical orders were summed up. Then FO-CUS-PDCA(Find-organize-clarify-understand-select-plan-do-check-act)cycle management was adopted to analyze and improve the existing problems in issuing medical orders for parenteral nutrition. The improved(the third quarter of 2016)medical orders for par-enteral nutrition were collected,the number and types of its irrational medical orders were summed up,and management effect was evaluated. RESULTS:Establishing nutrition support group,strengthening the training and communication of medical staff,adding prescription evaluation module for parenteral nutrition in hospital information system and a number of measures had made the inci-dence of irrational medical orders for parenteral nutrition in general surgery department declined from 48.25%(1433/2970)before improvement to 5.67%(120/2118)after improvement. The incidences of cation excess,inappropriate selection of drugs and inap-propriate compatibility in irrational types were 0. CONCLUSIONS:FOCUS-PDCA cycle management can reduce the irrational rate of medical orders for parenteral nutrition and promote the rational use of parenteral nutrition in hospital.