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 evaluate the clinical significance of phural effusion and/or ascites and their prognostic role in patients with acute pancreatitis.Methods The clinical data of 312 patients with acute pancreatitis were collected and analyzed retrospectively.Results Pieural effusion was found in 47 patients and ascites in 18.of 47 cases with pleural effusion,there were 31 cases(65.9%)of severe pancreatitis(P＜0.01)and 27 cases (57.4%)complicated by pseudocyst(P＜0.01).Among 18 cases with ascites,there were 14 cases(77.7%)of severe pancreatitis(P＜0.01).6 cases with pleural effusion and/or ascites died of multiple organs failure.Conclusion Pleural effusion and/or aseites is closely associated with severe pancreatitis.

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.

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 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 analyze the clinical characteristics of gastric polyps in different histopathological types. Methods Based on histopathological difference, gastric polyps were categorized into fundic gland polyps, hyperplastic polyps, inflammatory polyps, adenomatous polyps, etc; Different types of polyps in the aspects of distribution, Helicobacter pylori (H. pylori) infection, the relationship between the proton pump inhibitors (PPI) and the occurrence of gastric polyps to provide guidance on treatment Results 365 cases of gastric polyps were diagnosed in 10 197 patients who underwent gastroscopy. The prevalence was 3. 6%. The histopathological type of the polyps were fundic gland polyps (61. 1%), hyperplastic polyps (23. 3%) , inflammatory polyps (12. 3%) , adenomatous polyps (2. 2%). 289 cases showed single polyps, which was the majoriry across all types of gastric polyps. Majority of the gastric polyps were located in gastric body and fundus, followed by gastric antrum and cardia Most of the fundic gland polyps were located in gastric body and fundus; Majority of the hyperplastic polyps and adenomatous polyps were located in gastric antrum; The main locations of inflammatory polyps were cardia and gastric body and fundus. A higher percent (51. 6%) of fundic gland polyps patients used PPI. The difference was statistically significant compared with the hyperplastic polyps(8. 2%)and inflammatory polyps group(8.9%) (x2 = 48. 31,27. 63 ,P <0. 01). The H. pylori infection rate of hyperplastic polyps and inflammatory polyps were 72.4% and 74.4% ,respectively, both of which were higher than that of fundic gland polyps(20. 2%)(x2 =46. 50,35. 04, P < 0. 01) . One year after the H. pylori eradication, the recurrence cases of hyperplastic polyps and inflammatory polyps were 1/41 and 0/19,respectively. Conclusions The main histopathological type of gastric polyps is fundic gland polyps followed by hyperplastic polyps. The main location of the gastric polyps is gastric body and fundus, followed by gastric antrum and cardia. The distribution of different types of gastric polyps has some characteristics. Long-time usage of PPI may increase the risk of fundic gland polyps. The occurrence of hyperplastic polyps and inflammatory polyps may be related to H. pylori infection. The H. pylori eradication helps preventing the recurrence of hyperplastic and inflammatory gastric polyps.

Objective To summarize the clinical and pathological data of gastric polyps under gastroscope,and to investigate the clinical characteristics of gastric polyps in elderly patients.Methods The 692 cases of gastric polyps diagnosed by gastroscopy and pathology were retrospectively analyzed.The elder group was defined as aged 60 years and over.The young group was defined as aged less than 60 years.The data were analyzed by SPSS software.Results The detected ratios of gastric polyps were 3.9% in the elder group and 2.9% in the young group (χ2 =15.792,P<0.01).The rates of gastric polyps found in fundus,gastric body and gastric antrum were 32.0%,41.3% and 19.8% respectively in the elder group.And the corresponding rates in the young group were 37.5%,45.8% and 11.1% respectively (χ2 = 2.277,1.404,10.289,P = 0.131,0.236,0.001).The pathological types of the gastric polyps were in the order of fundic gland (60.0%),hyperplastic (26.2%),inflammatory (11.3%),adenomatous (1.7%) and others (0.8%).The diagnostic rates of hyperplastic polyps in the elder group and the young group were 31.7% and 21.9% respectively;the corresponding rates of adenomatous polyps were 3.0% and 0.8% respectively (χ2 = 8.525,4.834,P=0.004,0.028).Conclusions The detected ratio of gastric polyps is higher in the elder group than in the young group.In both groups,the polyps in the fundus and the body are more prevalent,followed by those in the antrum.The diagnostic rate of polyps in the antrum is significantly higher in the elder group than in the young group.Although the main pathological type of the gastric polyps is fundic gland in both groups,the diagnostic rates of hyperplastic polyps and adenomatous polyps are both higher in the elder group,the risk of cancer is higher as well.Therefore,in the elderly,the gastric polyps are recommended to be cut off as soon as possible and followed up closely.

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 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.

Objective To compare the effectiveness of lactulose oral solution combined with PEG-4000 electrolyte lavage solution with PEG-4000 electrolyte lavage solution only in colonoscopy preparation.Methods A total of 121 patients preparing for colonoscopy were randomly divided into two groups:61 patients in lactulose oral solution combined with PEG-4000 electrolyte lavage solution group (the experimental group =group A),and 60 patients in PEG-4000 electrolyte lavage solution group(the control group =group B).During the colonoscopy,the endoscopist blindly scored the cleanness of the bowel,and recorded any adverse event to assess the safety.Results According to the Boston bowel preparation scale,the experimental group scored 7.07 ±0.79,and the control group scored 6.18 ± 1.03,which showed significant significance(P =0.000).There was no significant difference in the time of accessing rectum between the two groups[(8.80 ± 1.74) min VS(9.22 ± 1.94) min,P =0.220].Polyp detection rate in group A was higher than that in group B,with no significant difference (22.95％ VS 15.00％,P ＞ 0.05).The small polyp (≤0.5 cm)detection rate in group A was higher than that in group B with significant significance(P =0.038).No adverse event was recorded in either group.Conclusion The bowel preparation with lactulose oral solution combined with PEG-4000 electrolyte lavage solution is more effective than that with PEG-4000 electrolyte lavage solution alone.It will enhance the detection rate of small polyps with no evident adverse reactions.