Objective To explore the effect of token on the pain and compliance of wound care of postoperative children with hypospadias, and provide evidence for the pain management and psycho-behavior intervention of children. Methods Selected 80 cases of hypospadias and they were assigned to the experience group and the control group. The control group was guided by conventional nursing intervention method while the experience group was guided by token intervention. Compare the pain score and compliance of two groups. Results The pain score of the experience group were (2.65±1.89), (2.40± 1.73), (2.10±1.43) points, the control group were (4.10±2.52), (3.35±2.09), (2.90±1.75) points. There were significant differences between the two groups (t=2.912, 2.399,- 2.239, all P<0.05). There were significant differences between the two groups for the compliance (χ2=5.415, 7.587, 9.372, all P<0.05). Conclusion Token can relief the pain of wound care of postoperative children with hypospadias, increase the compliance of wound care of the children.

AIM:To discuss the main clinical characteristics of current drug eruption for reference of prevention and treatment of drug eruption.　METHODS: Two hundred and thirty-three with drug eruption in 1999 were collected, and their clinical characteristics, such as age, main causative drugs and eruption types, etc. were analysed.　RESULTS: The age of current drug eruption increased. Antibiotics was the most common causative drug, while antiinflammatory analgestics, serum and vaccine, traditional Chinese medicine were next to it. Scarlet fever-like or measles-like type was the most common eruption type, while urticaria type, erythema multiforme type and fixed type were next to it.　CONCLUSION: Clinical physicians shoud inquire alergic history of patients thoroughly and avoid unnecessary drugs, so as to decrease the occurrence of drug eruption.

Objective To investigate the influencing factors on re-examination compliance of patients with breast cancer Who were in the stage of recovery.Methods By clinic services and telephones,we investigated the reexamination compliance of 189 cases of breast cancer.Results 66.1% of the cases took periodic re-examinations and on the opposite,33.9% of the patients didn't do so.Statistical meaning could be found from the difference of ages,living sites and survival time limits(P＜0.05).Conclusions The main factors to influence the re-examination compliance of patients with breast cancer are age,living site and survival time limit.And it is possible to improve the re-examination compliance of patients by enhancing health education,raising medicsl levels and service qualities,and creating comfortable environment for patients.

Objective To understand the effect of astragalus on serum levels of advanced glycation end products (AGEs),soluble receptor for advanced glycation end products (sRAGE) in newly diagnosed patients with type 2 diabetes.Methods 60 patients of newly diagnosed type 2 diabetes were randomly divided into control group (28 patients) and treatment group (28 patients),the control group was given control of blood glucose,blood pressure,lipids and other necessary treatment,and the treatment group was additionally treated with astmgalus granule based on the control group.The course for both treatments is 12 weeks.Various clinical and biochemical parameters were tested before and after treatment in both groups with enzyme-linked immunosorbent assay for the detection of serum AGEs,sRAGE levels.Results ① Glycosylated hemoglobin (HbA1c) in the control group after treatment (7.28± 0.83)％ was significantly decreased than before treatment (9.57±1.14) ％,the difference was statistically significant (t＝5.75,P＜0.05); glycerin three greases (TG) in the control group after the treatment (1.45± 0.39)mmol/L decreased significantly compared with those before treatment (1.92± 1.01)mmol/L,the difference was statistically significant(t＝2.79,P＜0.05); ② HbA1c (7.16± 0.88) ％ in the treatment group after treatment was significantly decreased than before treatment (9.29± 1.62)％,the difference was statistically significant (t＝6.08,P＜0.05) ; TG (1.53 ± 0.41) mmol/L in the treatment group after treatment was significantly decreased compared with those before treatment (2.11 ± 0.79)mmol/L,the difference was statistically significant (t ＝ 2.40,P ＜ 0.05) ; the levels of serum sRAGE (20.38 ± 8.01) ng/ml in the treatment group after treatment increased obviously compared with those before treatment (15.10 ± 9.22)ng/ml,the difference was statistically significant (t＝-2.29,P＜0.05); ③ The level of serum sRAGE (20.38 ± 8.01) ng/ml in the treatment group after treatment increased obviously than the levels of serum sRAGE (15.13 ± 9.27)ng/ml in the control group after treatment,the difference was statistically significant (t＝-1.17,P＜0.05).Conclusion Astragali can increase serum sRAGE expression in newly diagnosed type 2 diabetic patients.

Objective To understand the serum levels of advanced glycation end products (AGEs),soluble receptor for advanced glycation end products (sRAGE) in newly diagnosed patients with type 2 diabetes.Methods 60 patients of newly diagnosed type 2 diabetes were chosen from 2010 September to 2011 December in Department of Endocrinology Changshou Chinese medicine hospital in Jiangsu Province,and 30 healthy people were screened as control group.Various clinical and biochemical parameters were detected,using enzyme-linked immunosorbent assay for the detection of serum AGEs and sRAGE levels.Results The levels of serum AGEs in newly diagnosed type 2 diabetic patients and control group were (1379.2 ± 431.8) and (1154.5 ±326.4) pg/ml,and there were significant differences between two groups (P＜0.05).The levels of serum sRAGE in newly diagnosed type 2 diabetic patients and control group were (14.6± 9.3)and (19.5 ± 8.9)ng/ml,and there were also significant differences between two groups (P＜0.05).The level of serum AGEs in newly diagnosed type 2 diabetic patients was positive correlation with glycosylated hemoglobin (HbA1c),and the level of serum sRAGE was associated with low density lipoprotein cholesterol (LDL-C) negative correlation.Conclusion The level of serum AGEs increase in newly diagnosed type 2 diabetic patients,and the level of serum sRAGE decrease in newly diagnosed type 2 diabetic patients.

Objective To understand the effect of astragalus on insulin resistance and plasma amylin levels in newly diagnosed type 2 diabetic patients.Methods 88 patients of newly diagnosed type 2 diabetes were randomly divided into three groups:Group A (lifestyle intervention group) contained 30 patients,Group B (metformin treatment group) also contained 30 Patients,and Group C (astragalus and metformin treatment group) contained 28 Patients.Patients in group A were intervened with the control of diet,blood pressure and lipids level; patients in group B were additionally treated with metformin on the basis of group A; patients in group C were additionally treated with metformin and astragalus on the basis of group A.The course for both treatments were 8 weeks.Various clinical and biochemical parameters were detected before and after the treatment in all three groups and enzyme-linked immunosorbent assay was adopted for the detection of plasma amylin.Results Fasting blood glucose levels were significantly decreased after treataent in the three groups (t=-2.696、-4.029、-3.995,P＜0.05) ; insulin resistance index reduced in group B and group C (t=-2.599、-3.813,P＜0.05),the difference between group C and group B was statistically significant (t=-2.334,P＜0.05) ;treatments of group B and group C could improve the beta cell function index (t=2.303、2.384,P＜0.05),and they also could increase the plasma amylin level (t=2.341、3.045,P＜0.05).Conclusion Astragalus and metformin can improve insulin resistance index and increase plasma amylin levels in newly diagnosed type 2 diabetic patients.

ObjectiveTo examine the expressions of amplified in breast cancer 1(AIB1) and epithelial cadherin (E-cadherin) in ovarian carcinoma (OC) tissues,and determine the correlation between the expression and clinical pathological features.MethodsThe expression of AIB 1,E-cadherin,estrogen receptor (ER),progesterone receptor (PR) and Ki-67 in tissues of 50OCs and 13 normal ovarians tissues were detected by immunohistochemistry(IHC) EnVision two step process analysis.ResultsPositive expression of AIB1 in OC tissues[68％(34/50) ] was obviously higher than that in normal ovarian tissues [8％ (1/13)] (P ＜0.01).Down-regulation of E-cadherin expression was 60％ (30/50).The positive expression of AIB1 was significantly higher in stage Ⅲ and Ⅳ than in stage Ⅰand Ⅱ according to International Federation of Gynecology and Obstetrics (FIGO) stage (P =0.036),in lymph node metastasis group than in none lymph node metastasis group ( P =0.027 ),in stage G3 than in stage G1 and G2 according to Silverberg stage (P =0.003),and in serous adenocarcinoma group than in non-serous adenocarcinoma group (P=0.049);positive rates of ER and Ki-67 were higher than negative rates of ER(P=0.000) and Ki-67 (P =0.009) respectively.Down-regulation of E-cadherin expression was higher in FIGO stage Ⅲ and Ⅳ than in stage Ⅰ and Ⅱ (P =0.044),in serous adenocarcinoma group than in non- serous adenocarcinoma group ( P =0.022) ; positive rates of ER and Ki-67 were higher than negative rates of ER ( P =0.02 1 ) and Ki-67 (P=0.035) respectively.The expression of AIB1 was negatively correlated with E-cadherin expressioh (P =0.026).ConclusionsThe expressions of AIB1 and E-cadherin in OC tissues is closely related to clinical stage.Therefore,AIB1 and E-cadherin may be important moleculars involved in the progression of OC.

Objective To improve the non?surgical N staging system for esophageal carcinoma ( EC) . Methods A retrospective analysis was performed in 501 patients newly diagnosed with esophageal squamous cell carcinoma who received radiotherapy in our hospital from 2009 to 2013. The impacts of the supraclavicular lymph nodes and mediastinal lymph nodes on the overall survival ( OS) rate were analyzed. The original non?surgical N staging system was improved and the proposed N staging system was evaluated. The OS rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The univariate and multivariate analyses were performed using the log?rank test and Cox regression model, respectively. Results The 3?and 5?year sample sizes were 404 and 205, respectively. In all patients, the 1?, 3?, and 5?year OS rates were 64?9%, 26?5%, and 18?3%, respectively;the 1?, 3?, and 5?year distant metastasis?free ( DMF) rates were 86?2%, 68?9%, and 67?3%, respectively;the 1?, 3?, and 5?year local control rates were 72?7%, 53?1%, and 43?6%, respectively. The univariate analysis showed that the incidence, 3?year OS rate, and 3?year DMF rate of supraclavicular lymph node metastases in patients with cervical and upper?thoracic EC were significantly higher than those in patients with middle?thoracic and lower?thoracic EC ( 25?7% vs. 14?2%, P=0?034;24?2% vs. 11?5%, P=0?016;84?8% vs. 69?2%, P=0?007) . The multivariate analysis also showed that the number of metastatic lymph nodes was an independent prognostic factor for the OS and DMF rates in patients ( P= 0?000;P= 0?007 ) . Conclusions It is reasonable to classify upper?thoracic EC with supraclavicular lymph node metastasis into stage N1 diseases. The proposed N staging system with the factor of the number of metastatic lymph nodes is more scientific and objective than the original N staging system.

Objective We summarized the nursing care experience of spinal muscular atrophy complicated with pneumonia.Methods The measures of nursing care to the 9 children patients were comprised of preventing sputum blockage; preventing suffocating due to milk choking; paying special attention to the time being when the sputum blockage and milk choking occurred; early detection of paralysis of respiratory muscle; and training nursing skills to the families,and so on.Results All 9 children patients were cured and discharged from hospital.Conclusions The measure of targeting nursing intervention to the children with infantile spinal muscular atrophy and pneumonia could improve therapeutic effect and reduce mortality rate.

Objective To compare of clinical effect between radiotherapy and chemoradiotherapy and investigate the prognostic factors in elderly patients with esophageal squamous cell cancer.Methods 229 elderly patients with esophageal squamous cell cancer who received radiotherapy and chemoradiotherapy from January 2009 to December 2013 were retrospective analyzed.The Local control rate and survival rate were calculated by Kaplan-Meier method,and the short effect and long term effect between radiotherapy and chemoradiotherapy were compared.Cox regression model was used for invariant analysis and multivariate analysis.Results The follow up time was 15.3months.The short effect of radiotherapy group was not better than that of chemoradiotherapy group,with CR 35.6％ vs 45.8％,RR 61.0％ vs 53.0％,SD 2.7％ vs 0 and PD 0.7％ vs 1.2％ (P=0.211).The 1-,2-,3-year local control rates of radiotherapy group were significantly poorer than that of chemoradiotherapy group,with 82.8 ％,60.5 ％ and 52.7％ vs 89.5％,85.4％ vs 80.9％,respectively (P=0.009).However,there were no significance difference between the 1-,2-,3-year survival rates of radiotherapy group and chemoradiotherapy group,with 66.4％,29.5％,17.1％ vs.65.9％,40.3 ％,30.8 ％,respectively (P =0.071).In invariant analysis,T stage,N stage,clinical stage and radiotherapy dose (＜ 60 Gy,60 ～66 Gy,＞66 Gy) were related with the prognosis of esophageal carcinoma.The COX regression model showed that T stage,N stage and radiotherapy dose were independent prognostic factors that effected survival rate.Conclusion In elderly patients with esophageal squamous cell cancer,chemoradiotherapy can improve the local control rates,but not benefit the survival rate.T stage,N stage and radiotherapy dose were independent prognostic factors that effected survival rate,which could provided evidence for prognosis judgement and clinical practice.