Objective] To discuss the effect of timely infection evaluation and intervention on reducing infection to low-body mass incubator infants of primary hospitals. [Method] Select 98 cases of low-body mass incubator infants of 1210~2000g as control group(routine prevention used), and another 95 cases of 1200~2010g as observation group(taking timely infection evaluation, giving pointing intervention to infants with various infective risk factors). Compare their infection and in-hospital period. [Result]In control group 98 cases, 45 cases(45.92%) had infection; in observation group 95 cases, 11 (11.58%) had infection; the infective rate of observation group was lower than control group, the difference had statistical meaning( P<0.05). [Conclusion] To take timely infection evaluation and preventive intervention can definitely reduce infection.

Objective To discuss the perioperative nursing for patients with Laparoscopic resection of gastrointestinal stromal tumors. Methods A retrospective study was carried out in 18 patients with gastrointestinal stromal tumors on the effect of perioperative nursing and surgery. Results The gastrointestinal stromal tumors were resected under Laparoscopy with average operation time of 70 minutes. Blood loss volume during the operation was 20 to 50 ml. All patients recovered well with hospitalization days of 4 to 9 days. No relapse or metastasis was seen after 6 to 22 months of follow-up visit. Conclusions Laparoscopic resection of gastrointestinal stromal tumors was safe and effective. Perioperative nursing had significant effect on the recovery of patients.

OBJECTIVE:To investigate clinical efficacy and safety of recombinant human tissue type plasminogen activator (rt-PA) intravenous thrombolytic in the treatment of elderly patients (over 75 years old) with acute cerebral infarction (ACI). METHODS:78 elderly ACI patients,on the basis of routine treatment,were divided into thrombolysis group (40 cases) and non-thrombolysis group (38 cases) according to the will of patients or family members. Non-thrombolysis group received aspirin 200 mg,qd;thrombolysis group was given rt-PA 0.9 mg/kg(maximum dose of 90 mg)by intravenous push of 10% dose within 1 min,and intravenous dripping of residue dose within 60 min;receiving aspirin 200 mg,qd,24 h after thrombolytic therapy with-out contraindications. Both groups were treated for 14 days. The effective rate,NIHSS score before treatment and 24 h,7 d and 14 d after treatment,prognosis after 90 d were compared between 2 groups,and the occurrence of ADR was observed in 2 groups. RE-SULTS:The total effective rate was 67.50% in thrombolysis group and 52.63% in non-thrombolysis group,with statistical signifi-cance(P<0.05);there was significant difference in NIHSS score between 2 groups 24 h,7 d,14 d after treatment(P<0.05);90 d prognosis of thrombolysis group was superior to that of non-thrombolysis group,there was statistically significance (P<0.05);there was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:4.5 h time window rt-PA intravenous thrombolytic therapy is safe and effective for elderly patients with ACI,and can reduce disability and fatality,im-prove prognosis.

ObjectiveTo investigate the effect of tacrolimus (FK506) on macrophage accumulation,proliferation and activation in the kidney of early diabetic rats and to explore its possible mechanism of renal protection.Methods Rats were randomly divided into control,model and tacrolimus groups.Diabetic model rats were induced with intraperitoneal injection of streptozotocin.Tacrolimus(0.5 or 1.0 mg·kg-1 ·d-1) was orally administered once a day for 4 weeks.Kidney weight index(KWI),24-h urinary albumin excretion rate(UAER) and creatinine clearance rate(Ccr) were measured.Kidney pathology was observed by light microscopy.ED-1,PCNAandiNOSpositivemacrophagesweredetectedbysingleanddoublestainingof immunohistochemistry.Results KWI increased in model group and was significantly reduced by tacrolimus treatment with 1.0 mg·kg-1 ·d-1 (P＜0.05).UAER elevated in model group and was markedly attenuated by tacrolimus treatment with 0.5 and 1.0 mg·kg-1 ·d-1 (P＜0.05).Elevated glomerular volume of model rats was significantly decreased by tacrolimus treatment with 0.5 and 1.0 mg·kg-1·d-1 (P＜0.05),and increased indices of tubulointerstitial injury were only ameliorated by 1.0 mg·kg-1·d-1 tacrolimus(P＜0.01).Marked accumulation of ED-1+ cells in diabetic kidney was found,which was not inhibited by tacrolimus treatment with 0.5 and 1.0 mg·kg-1·d-1.ED-1PCNA+ cells and ED-1+ iNOS+ cells were significantly elevated in kidneys of model group,while they were significantly inhibited by tacrohmus treatment with 0.5 and 1.0 mg·kg-1·d-1 (P＜0.01).Conclusion Tacrolimus can ameliorate early renal injury of diabetic rats and its mechanism may be partly associated with the suppression of increased macrophages activation.

Objective To understand the experiences of patients prior to operation with recurrent glioma based on the Corbin and Strauss chronic illness trajectory framework. Methods Fourteen patients participated in the semi-structure interviews.Data were analyzed with Colaizzi′s phenomenologica l procedure. Results Based on the Corbin and Strauss chronic illness trajectory framework, experiences of patients prior to operation with recurrent glioma were extracted. (1) Illness-related work including severe symptoms of illness and lack of knowledge of illness. (2) Biographical work including loss of biography and identity of self. (3) Everyday life work including change of social roles, complicated mood combined negative experience and positive experience, heavy economic burden. Conclusions Nursing staff should attach importance to experiences of patients, and provide targeted interventions for successful operations and recovery of physical and spiritual healing.

Objective To systematically evaluate the relationship between stroke location and post-stroke depression (PSD) in first-ever stroke patients.Methods The studies on the relationship between stroke location and PSD published from January 1980 to March 2016 were retrieved from databases,including Chinese science and technology journal full-text database (VIP),China journal full-text database (CNKI),Wanfan database,PubMed,ISI Web of Science,Ovid database and Elsevier Science Direct.RevMan5.3 software was adopted for data consolidation and analysis.Results A total of 14 studies,including 1 952 cases of patients were included.The meta analysis indicated that no direct relationship was found between stroke location and PSD in first-ever stroke patients [random effects model,95 ％CI(0.89,1.43),P＜0.01].The results of subgroup analysis indicated that the PSD was associated with the right hemisphere lesion when the Hamilton Depression Scale (HAMD) was adopted for assessment [fixed effects model,95 ％ CI(1.21,1.76),P＜0.01],while the relationships were not found in the subgroup analysis of time course after stroke and the aphasia occurrence.Conclusion Stroke location may be not directly associated with PSD,further studies are needed to ascertain the relationship between stroke location and PSD.

Objective To observe the effect of liraglutide, an analogue of glucagon like peptide-1 (GLP-1), on the expression of PDX-1 gene in the islet beta cells of type 2 diabetes rats. Methods Sixty male SD rats were divided into 3 groups:normal control group, diabetic model group and GLP-1 group. Normal control group was given normal diet and diabetic model group and GLP-1 group were given high fat diet. After the eighth weekend, the high fat diet group was intraperitoneally injected with streptozotocin (STZ) 30 mg/(kg·bw), and the GLP-1 group was subcutaneously injected with liraglutide 200μg/kg with 2 times per day for 8 weeks. The other groups were treated with normal saline by subcutaneous injection. Real-time fluorescent quantitative reverse transcription polymerase chain reaction (Real-Time RT-PCR) was used to detect the expression of PDX-1 gene in rat pancreatic islet cells. Results The expressions of PDX-1 mRNA in the GLP-1 group and untreated group were significantly lower (P <0.001) than that in the normal control group, but significantly higher than that after GLP-1treatment (P < 0.001). Conclusion GLP-1 can upregulate the expression of PDX-1 gene in the islet beta cells of type 2 diabetes rats.

Objective To study the ocular manifestations in patients with Behcet's disease (BD).Methods Medical records at Peking Union Medical College Hospital from 2002 to 2012 were reviewed to identify the patients who were diagnosed as BD with ocular involvement.Results One hundred and eleven BD patients developed ocular involvement.Males were more frequently involved,and the male/female ratio was 2.08∶ 1.The age at the onset of BD and the time of ocular involvement were (27.6-± 10.8) and (31.5 ± 10.7) years,respectively.The median interval between the diagnosis of BD and ocular disease was 24 (0,372) months.Ocular involvement was bilateral in 85.6％ patients.About two thirds patients (66.7％) had impaired vision,for example,visual acuity of 0.1 or less was detected in 60.4％ patients.Uveitis (90.1％) was the most common findings in BD patients with ocular involvement and the most frequent type of uveitis in both sexes was panuveitis (62.16％).Vision loss,proliferative retinopathy and cataract were more common in men.There was a statistically significantly higher frequency of positive human leukocyte antigen(HLA)-B51 in the male BD with ocular involvement than in the female.All BD patients with uveitis were given systemic corticosteroid or combined immunosuppressive agents.The improvement of visual acuity was seen in 77％ BD patients,but the recurrent attacks occurred in 49％ patients,resulting in blindness in 25.5％ of them.TNFα blockers were given to 19 recurrent uveitis patients,12 patients improved while two had no response.Conclusions The most common ocular involvement in BD was uveitis.Males were more frequently involved with a more severe disease,higher complications and positive HLA-B51 than in females.Glucocorticoids and immunosuppressants were effective to uveitis,but high rate of recurrent inflammatory ocular attacks led to high risk of blindness.TNFα blockers may improve the outcome of recurrent BD uveitis.

Objective To build the access standard and role function of cancer case manager which is suitable for China.Methods The draft indicators of access standard and role function of cancer case manager were formulated based on literature review,group discussion and Delphi method.All the indicators were appraised by using two-round Delphi method.Results Round 1 consulting experts 43,and round 2 consulting experts 41.The experts showed high degree on the access standard and role function of cancer case manager during the two rounds of expert advice (two advisory Kendall coordination coefficients were 0.300,0.358 and 0.375,0.358,P ＜ 0.01).The access standard of cancer case manager included 4 first-level indicators and 34 secondary indicators,and the system of role functions included 7 first-level indicators,35 secondary indicators.Conclusions It indicates that the outcome is high reliability.The finding provide scientific basis for the selection of cancer case manager as well as clear identify of role functions which are significant for improving their work efficiency.

Objective To describe the quality of life and symptom distress in esophageal cancer patients undergoing postoperative adjuvant chemotherapy,and explore the influence of symptom distress on quality of life.Methods The Functional Assessment of Cancer Therapy-General (FACT-G),M.D.Anderson Symptom Inventory (MDASI) and demographic questionnaire were used to measure eighty-four patients undergoing postoperative adjuvant chemotherapy.Results The total average score of quality of life in patients undergoing chemotherapy after radical esophagectomy was (65.95±13.76) points.There was a significanfly negative relationship between the symptom distress and the severity of symptom and quality of life.Analysis of multiple factors showed that education level and symptom distress were the included variables in the multiple regression equation of quality of life,and the R2 was 0.253.Conclusions Quality of life in esophageal cancer patients undergoing postoperative adjuvant chemotherapy is influenced by many factors.The nurses should take measures to manage the symptom of patients and improve the quality of life of the patients.