Our hospital adopted a series of measures in its nursing reform so as to meet the needs of its pa- tients and improve its nursing quality. The steps include: appointing head nurses via competition; rewarding the best performing nurse and firing the worst one; adopting a ranking list with regard to nursing quality; implementing the mode of holistic nursing; carrying out flexible shifts and shift according to the needs of both patients and the hospital; changing the flow of nursing work; and improving the model of nursing management. Nursing reform in our hospital inspired the enthusiasm of the nursing personnel, enhanced the efficacy of nursing management and ensured nursing quality. [

Objective To investigate and analyze the economic burden and family burden among patients with depression.Methods 180 patients who diagnosed with depression according to Diagnostic and Statistical Manual of Mental Disorders-version Ⅳ (DSM-Ⅳ) had been enrolled randomly.The self-made economic costs questionnaire and the Family Burden Scale of Diseases (FBS) were utilized for investigation.168 participants finished this study.Results The per capita total economic cost of patients was 21 650 Yuan,direct economic costs was 6 806 Yuan,indirect costs was 14 844 yuan.The total economic costs,direct economic costs and direct medical costs of hospitalized patients were significantly higher than outpatients.The total economic cost per capita,indirect economic costs,costs decreased by work delays and work ability impairment of urban patients were significantly higher than rural patients.Four factors of FBS such as subjective feeling,family life,home entertainment and mental health had higher positive answer rate,which was above 60％.The positive answer rate of family relationship and physical health was lower than 40％.Conclusions Patients with depression suffered high economic burden and family burden.

Objective: To study the effect of seed oil of Hippophae rhamnoides L.(SOHR) on experimental hepatocirrhosis in mice. Methods: CCl_(4) was used in the experiment to form the model of experimental hepatocirrhosis in mice.In order to measure the possible changes of GPT and SOD in serum and SOD and MDA in tissues,we fed these mice with different concentration of SOHR for 45 days.The Does-Effect Curve was set up based on the data of this experiment. Results: SOHR could control the increase of GPT in serum and the decrease of SOD evidently,as well as the increase of MDA in tissues.The relationship of that the Hippophae rhamnoides dose with the decrease of GPT is significant. Conclusion: SOHR protects the experimental hepatacirrhosis in mice.

Objective To observe the effect of Chinese herbal compound Yitangkang on the expressions of advanced glyclation end-products (AGEs) and the receptor of advanced glyclation end-products mRNA(RAGE-mRNA) in rats with diabetic nephropathy(DN),and to discuss the mechanism of the formulas in the treatment of DN. Methods The rat model of DN were established by intraperitoneal injection of strepotozotocin(STZ). After 8 weeks intervention with medications, the expression of renal RAGEs mRNA was detected by Real-time PCR, renal RAGE by immunohistochemistry, and renal content of AGEs by spectrophotometry. Results Compared with normal control group, the expression of renal RAGEs mRNA and RAGEs in diabetic nephropathy rats were increased significantly(P<0.01). Compared with DN group, the expression of renal RAGEs mRNA and RAGEs in three doses Yitangkang groups and western medicine group were decreased significantly(P<0.01). Conclusion Chinese herbal compound Yitangkang could protect kidney of diabetic nephropathy rats,and the mechanism is related to its loweirng renal expression of RAGEs mRNA, RAGEs and AGEs content.

Objective To investigate the pulmonary morphologic changes and pulmonary surfactant protein A (SP-A) mRNA expression in fetal rats with maternal intrahepatic cholestasis of pregnancy (ICP).Methods Animal models of intrahepatic cholestasis of pregnancy were induced by 17-α-ethinylestradiol and progesterone.Histopathologic examination of the fetal lungs was performed under light and electronic microscopes.The expression of SP-A mRNA in the fetal lungs was measured by reverse transcription-polymerase chain reaction technique.Results (1) Compared with the control group,histopathologic examination showed that fetal pulmonary tissues had dilated and congested interstitial lung capillaries,thickened alveolar septum,mild focal inflammatory exudation and focal hemorrhage in alveolus.Furthermore,reduced microvilli,mitochondrion vacuolization,cytoplasm disintegration and increased lamellar body evacuation were observed in alveolar epithelial cell II in ICP group under light and electronic microscopes.(2) Expression of SP-A mRNA in fetal lungs of ICP group (0.71 + 0.10) was significantly lower than that in control group (1.00±0.27),t=3.093,P＜0.05.Conclusions Hyperbileacidemia in ICP maternal rat might lead to pathological changes in fetal pulmonary tissues.Low expression of SP-A mRNA might contribute to lesions of fetal lung with ICP.

Objective To investigate the influence of intrahepatic cholestasis of pregnancy (ICP) on the pulmonary morphologic changes of fetal rats.Methods Twenty pregnant SD rats at 15 days of gestations were randomly divided into ICP and control group.Rats in the ICP group were subcutaneously injected with 17-α-ethinylestradiol and progesterone for 5 consecutive days to establish the rat ICP model, and those of the control group received subcutaneous injection of sirasimeyu also for 5 days.The levels of serum alanine aminotransferases (ALT), aspartate transamlnase (AST), and total bile salt (TBA) were measured before and after the treatment, respectively.Maternal rats were sacrificed on 21 days of gestations and hysterotomies were performed immediately.Histopathologic changes of mammal rats' livers and fetal lungs were observed under light and electron microscopes.Results (1) The maternal serum levels of ALT, AST, and TBA showed no significant difference between the ICP and control group [ALT: (55 ± 15) vs (49 ±12) U/L; AST:(146±16)vs (145±20) U/L; TBA: (13±4) vs (14 ±4) μmol/L, P>0.05, respectively]before the ICP models were established, but higher levels were shown in the ICP group after [ALT: (94±12) vs (59±17) U/L; AST: (245±26) vs (163±27) U/L; TBA: (44±16) vs (17± 3) μmol/L, P <0.05, respectively].(2) The livers of maternal rats' in the ICP group were gloomy with blurred margins, however those of the control group were normal.Microscopic observed swollen and degenerated hepatocytes with narrowed hepatic sinusoid, dilated bile duct and necrosis of hepatocytes occasionally in the ICP group, while the morphology of hepatocytes and structures of lobuli hepatis in the control group were normal.(3) The fetal pulmonary tissues in the ICP group were dark, and normal in the control group.Histopathologic examination showed matured fetal pulmonary tissues with dilated and congested interstitial lung capillaries, thickened alveolar septum, mild focal inflammatory exudation and focal hemorrhage in alveolus.Furthermore, reduced microvilli, mitochondrion vacuolization, cytoplasm disintegration and increased lamellar body evacuation were observed in type Ⅱ pneumonocytes in ICP group under light and electron microscopes.While fetal pulmonary tissues of the control group did not show any significant lesions.Conclusions Rat model of ICP can be established with the combination of estrogen and progestin.Hyperbileacidemia in ICP rat may lead to pathological changes in fetal pulmonary tissues.

Autoimmune polyendocrinopathy syndrome type Ⅰ( APS-Ⅰ) is a rare autosomal recessive disorder caused by mutations in autoimmune regulator gene( AIRE) . A number of mutations have been described in the AIRE gene of patients with APS-Ⅰ, including nonsense mutation, missense mutation, silent mutation, splice site mutation, insertions and deletions mutation, et al. The mutation characteristics of the APS-Ⅰ pathogenic gene have been reviewed in the article.

The paper analyzes the challenge of big data environment to the traditional medical information services,presents the practical significance and basis of constructing the medical information service platform,introduces the construction objectives,architecture,function feature of the platform,describes the medical information service mode based on the digital platform,including medical information resource services,intelligence study services and health decision-making support services,etc.

Objective To investigate the clinical characteristics of juvenile rectal carcinoma in order to improve the diagnostic level and therapeutic efficacy at the early stage. Methods Clinical data, including clinical manifestations, misdiagnosis, clinical pathology, treatment, and prognosis, from 89 cases of juvenile rectal carcinoma were analyzed retrospectively and compared with those from 440 cases of senile rectal carcinoma. Results ① The main manifestations of juvenile rectal carcinoma included anal and rectal pains, abdominalgia, abdominal distention, and sacrococcygeal pain. ② In juvenile group, carcinomas with distance less than 9 cm and less than 7 cm away from the anal verge amounted to 92.13% and 69.66%, respectively (average distance: 5.43 cm). ③ The average period of misdiagnosis in juvenile group was 5.7 months with a misdiagnosis rate of 97.75%, significantly higher than that in senile group ( P

The extract content and in vitro releasing content from different processed products of Squama Manitis were determined using protein as index.The result indicates that the releasing rate of both pro- eessed products are obviously higher than that of the crude.The in vitro study on releasing rate of the same processed product shows that the dissolving rate in vitro has tight relation to its particle size.