Objective:To investigate the perceptions of ICU patients on nurse caring behaviors and related factors,then raise nursing straties. Methods:101 ICU patient samples were selected from two tertiary general hospital(sGrdae A)in Fuzhou.The mod- ified caring behavior assessmen(tCBA)scale was used to interview the subjects. Results:The most important caring behaviors were to help patients satisfy their basical requiments. There were statistically significant differences in the perceptions of importance of nurse caring behaviors among the patients’demographic data such as marriage and length stayed in ICU.Conclusion:ICU patients need nurse caring behaviors. Nurses should provide patients with individual caring behaviors to satisfy their requi-ments. So nursing quality and patient satisfaction would be improved.

Objective To investigate the clinical characteristics of upper gastrointestinal diseases in very old people (aged ≥ 90 years),and to explore the necessity and safety of the gastroscopy for the super elderly people.Methods Clinical data of 50 very old people were retrospectively analyzed.Results The total detection rate of upper gastrointestinal disease was 76.0％ (38/50),in which the reflux esophagitis (RE) was the most common (26.0％),followed by erosive gastritis (20.0％),atrophic gastritis (18.0 ％),peptic ulcer (12.0 ％),gastrointestinal cancer (10.0％),duodenitis (8.0％) and fundic gland polyps (6.0％) respectively.RE lesions detected by gastroscopy were mainly mild and were divided into endoscopic grade LA-A (46.1％),LA-B (30.8％),LA C (7.7％),and LA-D (15.4％) according to the Los Angeles classification.The most common symptoms were abdominal distension and anorexia,and the both incidences were 12.0％.There was no significant difference in the prevalence of clinical symptoms between the elderly people with upper gastrointestinal disease and without abnormal gastroscopic findings [44.7％ (17/38) vs.41.7％ (5/12),x2 =0.035,P＞0.05].22 patients (44.0％) underwent gastroscopy under intravenous anesthesia.Conclusions The incidence of upper gastrointestinal disease is high in very old people,and mild reflux esophagitis is the most common.Clinical symptoms are little or asymptomatic in most very old people.Gastroscopy under intravenous anesthesia is safe and feasible for the very old people.

Objective To investigate the clinical manifestations,pathological features hy endoscopy and possible risk factors of ischemic colitis (IC).Methods A retrospective analysis was made upon 89 hospitalized patients diagnosed as IC.Logistic regression analysis was performed to determine morbidity risk factors.Results The majority of patients with IC in our study group had histories of hypertension,heart disease,hyperlipidemia,diabetes,etc.The common features included abdominal pain (80.9％,72/89),hematochezia (76.4％,68/89),etc.Colonic mucosal lesions presented regional distribution under colonoscope (80％,72/89),with manifestations of petechial hemorrhages,edema,segmental erosion,pleomorphism ulcerations,visible lesion edge and sharply defined segment of involvement,even be characterized by lumens stricture (13.5％,12/89).Histopathological examination revealed mucosa edema,necrosis,hemorrhage and formation of ulceration,inflammatory cell infiltration,and submucous hemorrhage,etc.Laboratory examination showed that white blood cells,neutrophils,serum fibrin,D-Dimer,serum TC,TG and serum apolipoprotein B were higher than normal.Colonic mueosal roughness,thumbmark symptoms,etc,and even bowel limited spasm,stricture or curtailment were visible in 47 patients underwent barium enema.Colonic wall thickening was visible in 29 patients underwent mesentericography,however,strictured or closed blood vessels were not found logistic regression analysis showed that hypertension,diabetes,higher TG,atrial fibrillation were strongly associated with onset of IC (all P values ＜ 0.05).Conclusions Since IC symptoms are not typical,it requires early colonoscopy to clarify diagnosis.Hypertension,diabetes,hyperlipidemia,and atrial fibrillation are risk factors for IC.

Objective To observe the effects of enteral nutrition on the glucose and fat metabolism in elderly patients with metabolic symdrome (MS) and nonalcoholic fatty liver disease (NAFLD).Methods The 109 patients with MS and NAFLD were randomized into enteral nutrition(EN)(n=55)and total parenteral nutrition(TPN) (n=54) group.The EN patients received aggressive enteral nutrition therapy,the TPN patinets got the treatment of total parenteral nutrition.The body mass index (BMI),liver function,blood glucose,blood liquid and hepatic ultrasonography were observed in two groups.Results After treatment of 2 monthes,the values of BMI,TG and LDL-C were decreased,2 hBG,HbA1c,ALT,AST and BIL were significant improved in enteral nutrition group in comparison with pretherapy (P＜0.05),while not significantly different in total parenteral nutrition group(P＞0.05).There were 55.6 ％ (10/18) patients changing from middle fatty liver mild fatty liver in enteral nutrition group,while only 46.2％ (6/13) in TPN group (P＞0.05).Conclusions EN support is superior to TPN in improving the glucose and fat metabolism in elderly patients with MS and NAFLD.

Objective To investigate the effect of Helicobacter pylori (Hp) plantation in Barrett's esophagus (BE) columnar epithelium on esophageal adenocarcinoma (EA) in the elderly.Methods 109 patients with reflux esophagitis (RE),51 patients with Barrett's esophagus and 16 patients with esophagus adenocarcinoma were diagnosed by endoscopy and pathological biopsy.The 4-quadrant biopsies in esophagus lesions were respectively taken from each patients.1 were tested by silver staining and urease test for rapid detection of Hp,and the other were stained by HE staining for pathological analysis,AB /PSA staining and immunohistochemistry for gene expressions of cyclooxygenase-2 (COX-2) and B cell lymphoma / leukemia-2 (Bcl-2).Results Hp colonization in RE group,BE group and EA group were 0％,44.4％ and 42.1％ respectively.The expression levels of COX-2 in abnormal squamous epithelium in RE group,BE group and EA group were 46.7％,100％ and 100％ respectively.The expression of COX-2 was higher in BE and EA groups than in RE group (x2=126.21,both P＜0.05).Moreover,a gradually increase in COX-2 expression was observed in abnormal esophageal squamous epithelium from RE to BE to EA.COX-2 expression was significantly increased in mucosa in BE and EA patients with Hp plantation and in lower esophageal carcinoma in EA patients with Hp plantation and without Hp plantation.Bcl-2 expression in esophageal squamous epithelium was 40.2％,85％ and 100％ in RE,BE and EA groups respectively.The expression of Bcl-2 was higher in BE and EA groups than in RE group (x2 =125.25,P＜0.05).Bcl-2 expression was increased in mucosa BE patients with Hp plantation.Conclusions Hp plantation in BE esophageal columnar epithelium can increase the expression of COX-2,and induce its downstream Bcl-2 expression,inhibit cell apoptosis,and might lead to EA.

Objective To evaluate the clinical efficacy of endoscopic esophageal variceal ligation (EVL) for esophageal variceal bleeding (EVB) in elderly patients with hepatic cirrhosis.Methods From July 2007 to July 2013,clinical data of 198 patients who had been diagnosed with liver cirrhosis presenting with EVB were retrospectively analyzed.Among them,167 patients who had received EVL were divided into the elderly EVL group (n=97,age≥60 years) and the non-elderly EVL group (n=70,aged ＜ 60 years).The other 31 cases (aged ≥ 60 years) had received propranolol therapy.Treatment effectiveness,adverse effects,complications and the one-year survival rate of each group were analyzed.Results The efficacy rates and variceal recurrences were 77.3％ (75/97) and 78.6％ (55/70) in the elderly EVL group and 19.6％ (19/97) and 18.6％ (13/70) in the non-elderly EVL group,respectively,with no significant difference between the two groups (each P＞0.05).The re-bleeding rate was higher in the propranolol treatment group than in the elderly and non-elderly EVL groups [58.1％ (18/31) vs.24.7％ (24/97) vs,22.9％ (16/70),x2 =14.76,P =0.00].One-year survival rates in the elderly group,the non-elderly EVL group and the propranolol treatment group were 86.6 (84/97),88.6％ (62/70),64.5％ (20/31),respectively,with statistically significant differences between the three groups (x2 =10.24,P=0.01).Conclusions EVL is effective for the treatment of hepatic cirrhosis with EVB and can be used as a secondary prophylaxis measure for EVB in elderly patients with hepatic cirrhosis.

BACKGROUND:Proteoglycan, chondroitin sulfate and keratan sulfate, and hyaluronic acid are important substances in the maintenance of intervertebral discs of normal structure. They impact the physiological function of intervertebral disc.
OBJECTIVE:To observe the influence of Liuwei Dihuang Wan on proteoglycan in rabbit models of intervertebral disc degeneration, and to study the efficacy of Liuwei Dihuang Wan on prevention and treatment of intervertebral disc degeneration.
METHODS:80 New Zealand rabbits were randomly divided into Liuwei Dihuang Wan group, model group, sham surgery group and blank control group (n=20 per group). Animal models of intervertebral disc degeneration were established in the model and Liuwei Dihuang Wan groups. In the sham surgery group, surgery via the same approach to expose the lumbar spine was conducted fol owed by layer-by-layer suturing. In the Liuwei Dihuang Wan group, rabbits were given 10 mg/kg Liuwei Dihuang Wan by lavage, once a day. In the model group, sham surgery group and blank control group, rabbits were given an equal volume of physiological saline, once a day, by natural feeding. At 2, 4, 6 and 8 weeks, five rabbits from each group were sacrificed, and intervertebral disc specimens were taken to measure proteoglycan components in the intervertebral disc.
RESULTS AND CONCLUSION:With the extension of feeding time, Liuwei Dihuang Wan could increase sugar amino polysaccharide content, chondroitin sulfate/acid ratio of keratin, and hyaluronic acid content in the intervertebral disc degeneration model, and stabilized the proteoglycan content. Thus, it delayed the degeneration of the intervertebral disc to a certain extent.

Objective To compare the differences in the efficacy of Bifidobacterium tetravaccine tablets.Bifidobacterium triple viable capsules and live Bacillus licheniformis capsule in the treatment of persistent and chronic diarrhea.Methods From September 2015 to June 2016,a total of 484 outpatients with persistent and chronic diarrhea were enrolled and divided into observation group (treated with Bifidobacterium tetravaccine tablets) and control group (treated with the combination of Bifidobacterium triple viable capsules and live Bacillus licheniformis capsule).Before and after treatment,the frequency of defecation and the characters of stool were observed and the differences in the treatment efficacy in persistent and chronic diarrhea between two groups were compared.Paired t test and Chi square test were used to compare the difference before and after treatment in each group,and independent sample t test was used for comparison between groups.Results There were a total of 256 patients in the observation group (four cases lost and 256 cases were completed).Meanwhile there were 228 patients in the control group (30 cases lost and 228 cases completed).In the observation group,after treatment the frequency of defecation was (2.13±1.06) times,which was less than that before treatment ((3.83±0.95) times),and the difference was statistically significant (t=29.149,P＜0.01).In the control group,after treatment the frequency of defecation was (2.19 ± 1.06) times,which was less than that before treatment ((3.87 ±0.98) times),and the difference was statistically significant(t =27.800,P＜0.01).There was no statistically significant difference in the frequency of defecation before and after treatment between two groups (t=-0.460 and-0.662,both P＞0.05).Furthermore there was also no statistically significant difference in the rate of normal bowel movements between observation group and treatment group after treatment (50.8％(130/256) vs 57.9％(132/228;x2=2.458,P=0.117).There was no significant difference in effective rate (64.8％(166/256) vs 69.7％ (159/228) and excellence rate (47.7％ (122/256) vs 51.3％ (117/228)) between two groups (P=0.253 and 0.422);besides,no severe adverse events were reported.Conclusion In the aspect of improving of times of defecation and characters of stool in patients with persistent and chronic diarrhea,single medication of multi bacteria strains Bifidobacterium tetravaccine tablets has the same satisfied efficacy and good safety as the combination of Bifidobacterium triple viable capsules and live Bacillus licheniformis capsule.

The needles were inserted in the center of inferior margin and on the left and right sides of patella. Then moxibustion with warming needle and electroacupuncture were used respectively to treat 25 cases of patellar ligament strain. The effective rates were 96.0% and 69.6% respectively.

Objective To evaluate the efficacy of endoscopic variceal ligation(EVL)in esophageal variceal bleeding (EVB)in elderly patients with hepatic cirrhosis,and the safety of endoscopic operation under anesthesia.Methods From July 2007 to July 2013,170 patients diagnosed as liver cirrhosis complicated with EVB were retrospectively analyzed.Among them,139 patients who received EVL were divided into elderly anesthesia group (n=52,age≥60 years),elderly non-anesthesia group (n=45 ,age≥60 years)and non-elderly anesthesia group (n=42,age<60 years);the other 31 cases (age≥60 years) received propranolol therapy.The degree of satisfaction of visual fields and esophageal peristalsis under the gastroscope,the effect,adverse effects and complications of EVL,the recurrence of EVB and mortality of each group were analyzed.Two-way analysis of variance and crosstabs chi square test were performed for statistical analysis.Results The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope were 82.5 % (104/126)and 89.7% (113/126)in elderly anesthesia group;82.6% (71/86) and 89.5 % (77/86)in non-elderly anesthesia group;40.3% (29/72)and 44.4% (32/72)in elderly non-anesthesia group.The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope in anesthesia group were better than those in non-anesthesia group (χ2 =47.46,64.28;both P <0.01 ). The efficacy rates of EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group were 84.6%(44/52 ),68.9%(31/45 )and 81 .0%(34/42 ),respectively.The variceal recurrence rates were 19.2% (10/52 ),20.0% (9/45 )and 19.0% (8/42 ),respectively.There was no significant difference among them (all P > 0.05). Rebleeding rate of medication treatment group was 58.1%(18/31),which was obviously higher than that of elderly anesthesia group (19.2%,10/52 ), elderly non-anesthesia group (31 .1 %,14/45 )and non-elderly anesthesia group (23.8%,10/42 ),and the difference was statistically significant (χ2 =15 .10,P <0.01 ).No case of hepatic encephalopathy was found in elderly anesthesia group or non-elderly anesthesia group after EVL.The incidence of pneumonia in elderly non-anesthesia group was 4.2%(3/72),which was higher than that of elderly anesthesia group and non-elderly anesthesia group,and the difference was statistically significant (χ2 =8.93,P =0.01). The mortality within a month after EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group was 0,8.9% (4/45 )and 0,and the difference was statistically significant (χ2 =9.27,P =0.01).Conclusion The efficacy of EVL under anesthesia in EVB in elderly patients with liver cirrhosis was good,with no induction or aggravation of hepatic encephalopathy or irreversible complications were found.