Objective To explore the best time interval to extubate catheter for the postoperative gastric cancer patients,and provide the basis for early extubation after operation.Methods To collect 108 cases with gastric cancer in Department of Forensic Surgery of Yuncheng Central Hospital from March 2013 to February 2014 with indwelling catheter preoperatively.According to the admission sequence,they were divided into the observation group and the control group with 54 cases in each group,the observation group began clipping catheter in 10-15 hours after operation,extubating catheter within 24 hours after operation;the control group began clipping catheter on the second day after operation,and extubating catheter during 48-72 hours after operation.The time of extubation,urinary tract irritation symptoms,resetting catheters and the incidence of early postoperative ambulation in patients of two groups were observed.Results The incidence of urinary tract irritation was lower in the observation group than that of the control group [3.7％ (2/54) vs 16.7％(9/54)],the difference was statistically significant (x2=4.960,P＜0.05).Early ambulation compliance of the observation group was higher than that of the control group (complete compliance 52 vs.40,partial compliance 2 vs.8,no compliance 0 vs.6),the difference was statistically significant (x2 =10.565,P ＜0.05).Conclusions The method of extubation catheter within 24 hours after gastric canter operation can reduce the incidence of urinary tract irritation and improve early ambulation compliance.

Objective To establish a RP- HPLC method for the determinatio n of protocatechualdehyde in Danqi tablet. Methods LiChrospher RP- 18 column w as used, the mobile phase was MeOH- 1.5 % Hac(1∶ 9) with a flow rate of 1.0 mL/ min, and the detection wavelength was at 280nm. Results There was a goo d linearity within the range of 0.030～ 0.150 ? g of protocatechualdehyde. The average recovery was 103.08 % and RSD was 0.796 % (n=5). Conclusion This method can be used for the quality control of Danqi tablet .

Objecfive To observe the effects of combined acupuncture and point injection in the treatment of diabetic ophthalmoplegia patients.Methods 40 patients with diabetic ophthalmoplegia were randomly recruited into a control group and a treatment group,with 20 patients in each group.The control group was treated with acupuncture,and the treatment group was additionally treated with point injection.Therapeutic effects were observed after the treatment.Results Effective rate was 85% and 55%in the treatment group and the control group respectively,showing significant difference(P=0.0384<0.05).Conclusion Acupuncture combined with point injection is effective in treating patients with diabetic ophthalmoplegia.

Objective To observe the changes of serum ferritin and 25-(OH) vitamin D3 in patients with diabetic cranial neuropathy.Methods There were 50 patients without diabetic Cranial neuropathy,46 patients with diabetic cranial neuropathy,and 40 cases of normal control group.The changes of serum ferritin and 25-hydroxy vitamin D3 were observed in each group.The correlation between two indexes and the correlation with diabetic cranial neuropathy were analzyzed.Results The serum ferritin levels in diabetic group and diabetic neuropathy group were significantly higher than those in normal control group (P ＜ 0.01),and its level in patients with diabetic cranial neuropathy [(687.54 ± 65.38)ng/ml] was significantly higher than that of patients without diabetic cranial neuropathy [(497.28 ± 46.39) ng/ml,P ＜0.01].The serum 25-(OH) vitamin D3 levels in the diabetic group and diabetic neuropathy group were lower than those in the control group (P ＜ 0.01),and its level in patients with diabetic cranial neuropathy [(26.45 ± 8.93)nmol/l] was significantly less than that of patients without diabetic cranial neuropathy [(37.19-± 9.74)nmol/L,P ＜ 0.01].Serum ferritin levels were positively correlated with 25-(OH) vitamin D3 (r =-0.59,P ＜ 0.01).Multivariate unconditional Logistic regression analysis showed that diabetic neuropathy was negatively correlated with 25-(OH) vitamin D3 (P ＜ 0.05).Conclusions The increases of serum ferritin and 25-(OH) vitamin D3 are closely related to the occurrence and development of diabetic cranial neuropathy,which provides the theoretical basis for clinical intervention therapy.

Early postoperative ambulation is one of the three key techniques of fast track surgery,which can not only promote the recovery of gastrointestinal function but also can reduce pulmonary complications and improve patients′ self healing ability. The concept of early postoperative ambulation was summarized in this review and the main factors that can affect the early postoperative ambulation were analyzed from the view of medical staff and patients,which provide basis for further implementation of early postoperative ambulation.

Objective To understand the cognitive level of chronic obstructive pulmonary disease (COPD) disease management and pulmonary rehabilitation among medical staff in the respiratory departments and community of public health institutions in Panyu of Guangzhou, in order to assess the status of prevention and treatment of COPD in this area. Methods From March to October 2017, a questionnaire survey was conducted among 339 medical staff in Panyu, including respiratory doctors, nurses and therapists of four tertiary hospitals, five secondary hospitals, and three first-level hospitals, GPs, nurses and therapists at 16 community health service centres, among them, there are 147 respiratory and general practitioners (hereinafter referred to as doctors), 171 respiratory and general nurses (hereinafter collectively referred to as nurses), and 22 rehabilitation therapists (hereinafter collectively referred to as therapists). Using Epidata software to create questionnaire database entry data. Results The awareness rate of COPD airflow limitation severity of nurses was only 19.9％, which was lower than that of doctors (39.7％) and therapists (22.7％). Doctors, nurses, and therapists are familiar with the low percentage of the GOLD guidelines, which are respectively only 12.3％, 7.6％, and 4.5％. Nurses were diagnosed with pulmonary function as a basis for COPD, and the awareness rate was only 60.2％ lower than that of doctors (82.9％) and therapists (81.8％). In alleviating COPD patients′shortness of breath, only 31.8％therapists chose short-acting beta-agonists, lower than doctors (61％) and nurses (45％). There is disagreement about the long-term use of inhaled corticosteroids in COPD. Medical staff have the highest awareness of lip-reducing and abdominal breathing, followed by Taiji and Ba Duan Jin exercises, and low awareness of modern rehabilitation programs such as elastic bands, upper and lower limb exercises. The effective pulmonary rehabilitation program should last at least 8 weeks, and the awareness rate of this therapy practice was 40.9％, higher than doctors (13.7％) and nurses (18.1％). Medical staff believe that the main factors affecting patient compliance are the cost of the drug and the patient′s lack of understanding of the benefits of the treatment. Additionally, 40.4％ of doctors, 51.5％ of nurses, and 54.5％of therapists believe that community health services cannot manage COPD. The reasons that affect community management of COPD, doctors believe that patient compliance and lack of man power, nurses believe that the main shortage of manpower and equipment, the therapist believes that the lack of medical awareness and poor patient compliance. Conclusion Doctors, nurses, and therapists have inconsistent understandings of COPD disease management and pulmonary rehabilitation, and each has its own focus. It is necessary to strengthen learning exchanges for each weak knowledge point. The awareness rate of modern rehabilitation exercise for pulmonary rehabilitation is not as high as that of traditional Chinese medicine. It is necessary to pay attention to the promotion of the benefits and significance of COPD pulmonary rehabilitation treatment and improve compliance.

Objective: To provide the mechanism-based pharmacotherapy of the Huatan Qushi formula (HTQS formula), for the health management and treatment of non-alcoholic fatty liver disease (NAFLD). Methods: A rat model of NAFLD was employed to examine the efficacy and safety of the HTQS formula. In vivo active components and potential mechanisms of the HTQS formula were identified using UPLC‒MS/MS combined with network pharmacology. The influence of the HTQS formula on the dominating proteins in PI3K/Akt pathway was validated in vivo using western blot. Finally, 16S rRNA sequencing of the gut microbiome was conducted followed by targeted metabolomics detecting fecal short-chain fatty acids (SCFAs) and bile acids to determine the impact of the HTQS formula on gut microbiota. Results: The HTQS formula reduced weight gain and hepatic steatosis in NAFLD rats and decreased serum total cholesterol (TC), triglycerides, blood glucose, and insulin resistance (IR) without causing liver or kidney injury. We detected 28 components using UPLC‒MS/MS and identified 439 shared targets between NAFLD and the HTQS formula. Primarily, we focused on the PI3K/Akt signaling pathway based on protein‒protein interaction network analysis. We validated that the HTQS formula inhibited liver steatosis and inflammation by increasing the phosphorylation levels of PI3K, AKT, P27, GSK3β in the PI3K/Akt signaling pathway. 16S rRNA sequencing revealed that the HTQS formula reduced the abundance of the genus Family_XIII_AD3011_group, which was positively correlated with IR and taurodeoxycholic acid. In addition, Lachnospiraceae_UCG_010 inversely correlated with TC and five bile acids, which could be essential to the therapeutic effect of the HTQS formula against NAFLD. Conclusions The HTQS formula proved to be an effective pharmacotherapy for NAFLD without causing liver or kidney injury. Multiple potent components of the HTQS formula could alleviate liver steatosis and lipid metabolism disorder by modulating the PI3K/Akt signaling pathway and restoring gut microbiota composition.

Objective To evaluate the status and influencing factors of early ambulation in patients following postoperative gastric cancer, and provide evidence for making reasonable evaluated standard to patients.Methods Self-designed questionnaires were used to investigate the early ambulation of 108 patients following postoperative gastric cancer from June 2013 to August 2014. Results The mean time of first ambulation was(30.82±13.83)h in 108 patients, and the average distance was(13.14±14.68)meters. 51 cases completed the early ambulation and accounted for 47.2%. The results of logistic regression analysis showed that postoperative pain and postoperative fatigue could greatly affect early ambulation of patients following postoperative gastric cancer(P<0.05).Conclusions Postoperative pain intervention and postoperative fatigue management benefits to the early ambulation for patients following postoperative gastric cancer.

Objective To explore the effect of assessment criteria in early ambulation of gastric cancer patients after surgery. Methods Totally 327 gastric cancer patients from January 2013 to March 2016 in our hospital were selected as the research object by convenience sampling method. All patients were randomly divided into the control group ( n=160) and the observation group ( n=167) by throwing a coin. Patients in the control group received routine nursing before surgery, while patients in the observation group were assessed by postoperative assessment criteria of early safety ambulation. The status of postoperative early ambulation and satisfaction degree were compared between two groups. Results In the observation group, the proportion of ambulation within 24 hours after surgery was 80.2%, and it was 46.9% in the control group (χ2=39.439,P<0.05). The satisfaction degree towards nursing work in the observation group was 95. 8%, and was significantly higher than that in the control group ( 81. 2%) . The situation of observation group with early ambulation is better than that of control group (χ2=9.115,P<0.05).Conclusions Assessment criteria of early ambulation for patients with postoperative gastric cancer is benefit for developing early postoperative ambulation and improving the satisfaction degree towards nursing.

Objective To explore the link management of medical device related pressure ulcers in neonatal intensive care unit ( NICU) , and reduce the incidence of NICU medical device related pressure ulcers through various link management. Methods From June 2012 to May 2014, 726 cases of patients in our department were selected as the control group and received commonly used preventive measures and conventional pressure ulcer grading nursing care. From June 2014 to May 2016, another 869 patients in our department was selected as the observation group, and they received link intervention based on the routine nursing method which includes the establishment of pressure ulcer steering group, developing nursing measures of common medical device related pressure ulcers, establishing management principles of prevention and management of medical devices related pressure ulcers and strengthening personnel training and development of all levels of responsibility.The incidence rate of NICU medical device related pressure ulcers was observed. Results There were 28 cases of medical device related pressure ulcers in the control group, and the incidence rate was 3. 9%( 28/726);while there were 7 cases of medical instrument pressure ulcers in the observation group, and the incidence rate was 0.8% (7/869). The severity of pressure ulcer in the control group was significantly higher than that in the observation group; the cure rate of the wound was significantly lower than that of the observation group (U=-2.001,P<0.05). The score of nursing staff on the knowledge of medical device related pressure ulcers was (26. 2±1.7) after training, which was higher than that before training (17.6± 0. 8) (t=-6.04,P<0.01).Conclusions Through the link management of medical device related pressure ulcers, incidence rate of pressure ulcers is reduced;the quality of nursing is improved; the use of medical equipment is standardized;and the new concept of medical device related pressure ulcers is updated.