Objective To investigate the nursing intervention on the effect of diagnosis and treatment of emergency patients with urolithiasis. Methods 98 patients with urolithiasis in emergency department of our hospital from January 2009 to January 2011 were randomly assigned into the observation group and the control group with 49 cases in each group. The control group received routine care, on this basis the observation group was given systemic nursing intervention. The tolerance, SAS score and satisfaction degree was compared. Results 40 patients in the observation group was well tolerated, accounting for 81.6%, significantly higher than 63.3% of the control group. SAS score and satisfaction degree of the observation group were significantly better than the control group. Conclusions Nursing intervention for emergency patients with urolithiasis can significantly reduce pain, improve the mental state and increase their satisfaction degree, which is worthy of clinical application.

Objective To investigate the nursing points of the mechanical ventilated patients after percutaneous endoscopic gatrostomy (PEG). Methods The nursing approaches of 28 mechanical ventilated patients after percutaneous endoscopic gatrostomy in our department was analyzed retrospectively. Results The nutritional status of the 28 patients was improved to different degree after enteral nutrition (EN) support by PEG. Thereby, the nutritional requirement of the mechanical ventilated patients was ensured effectively. Among these patients, 4 patients could take food by mouth after taking off ventilator and extubation and stoma tube was pulled out, 15 patients were discharged carrying with stoma tube and convalescent care was continued, 3 patients died of primary diseases. Conclusions The PEG is a simple,safe and cost-effective approach of nutritional support for EN of mechanical ventilated patients. The key point of insuring EN of severe patients is intensive nursing and to prevent and reduce the complication of PEG.

Objective To explore the application of linear programming and assignment model on nursing shift mode, in order to reduce the nursing manpower allocation and reach nurse hierarchical use. Methods In 2014, linear programming was applied to calculate the number of the minimum number of daily work, and then we assigned job optimally according to the average operation time of each nurses. We analyzed comparisons retrospectively in the workload of nursing work in 2013, the number of personnel, skills assessment scores, self-assessment of the work load of nurses, and nursing quality control results. Results There were statistically significant in the differences of Emergency Room ( ER ) visits and times of “120” ambulance utilization in each month′s comparison (P<0. 05); but the total number of staff members had no statistical significance comparing in several years (P>0. 05);the comparisons in working hours, overtime hours, training time, nursing skills assessment had statistical significance (P<0. 05), as well as the nurse′s skill assessment (P<0. 05);all 9 nursing quality control indicators reached the requirements of the Nursing Department of our hospital. Conclusions It can optimize emergency nursing human resource allocation by using linear programming and assignment model.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.