Objective To know the influence of health education on anxiety and respiratory function of patients with cardiothoracic surgery. Methods Divided 123 patients with cardiothoracic surgery into the observation group (60 cases)and the control group (63 cases)randomly, routine nursing cares was used in the control group, related health education was used in the observation group in addition. Compared the condition about anxiety, respiratory function, pains and master degree about cardiothoracic surgery related knowledge. Results After the nursing intervention, the anxiety condition in the observation group was significant better than control group and itself before the intervention, related knowledge master degree and the pains condition in the observation "group were also better than those of in the control group. Conclu-sions Health education can effective release the postoperative pains and anxiety for patients with cardio-thoracic surgery, and then promote the rehabilitation.

Objective To probe into the related factors and nursing of nosocomial infection for infectious diseases ward. Methods 2198 cases of patients in infectious diseases ward of our hospital were selected from February 2008 to December 2009, prospective monitoring and retrospective analysis were simultaneously adopted. Results In cases of nosocomial infection, mainly respiratory tract was the infection site, where the upper respiratory tract infection rate was 30.52%, lower respiratory tract infection rate was 28.57%, higher than other parts, there were significant differences. At the same time, nosocomial infection due to indwelling catheter and the irrational use of antibiotics led to higher rates of infection, 19.23%and 17.69%, there were significant differences. In addition, we could see from the age of nosocomial infection, ≤ 3-year-old children and elderly patients ≥ 60 years old had higher infection rate, 9.43% and 9.71%, there were significant differences. Conclusions According to elements features of infectious disease outbreak in hospital ward, to take effective care and prevention measures to reduce the infectious diseases room of the hospital infection will be of great clinical significance.

Forty rats were selected for the experiment, which were divided into three groups including experimental ulcer group, normal saline and normal control groups. The pancreatic tissue were prepared for immunohistochemical staining at 6th, 10th, 14th, and 21st day after operation. Sternberger's PAP method was used to show the glucagon cell (A cell) and insulin cell (B cell) in order to observe their changes during the experimental peptic ulcer. In normal control group, the percentage of A cells is 23.31?1.91 (X?SD) and that of B cells is 73.1?4.01. But in experimental ulcer group, the A cell percentage is raised up to 42.6?5.59 and the B cell percentage is lowered down to 57.5?4.55 on the 10th day after operation. Comparing with normal saline group and normal group their differences show statistical outstanding differences. The result may point out that both A and B cells of pancreatic islet take part in the body's natural resistance against the disease, especially A cells.

Purpose To investigate the expression of Wnt-1 and β-catenin protein in cervical squamous cell carcinomas ( CSCC) and their relationship with invasion and lymph node metastasis. Methods Expression of Wnt-1 and β-catenin protein were examined on immunohistochemistry containing 78 specimens of CSCC and 30 specimens of normal cervical tissues. Results The positive rates of Wnt-1 and β-catenin protein in normal cervical tissues were 20.0% and 10.0% respectively. The positive rates of Wnt-1 andβ-cate-nin protein in CSCC were 56.4%, and 74.4% respectively. There was a significant difference between the two groups (P<0.001). The positive rates of Wnt-1 andβ-catenin protein in 33 cases with lymph node metastasis of CSCC were 72.7% and 90.9% respective-ly. The positive rates of Wnt-1 andβ-catenin protein in 45 cases with no lymph node metastasis of CSCC were 44.4% and 62.2% re-spectively. The expression of Wnt-1 andβ-catenin protein was significantly related with grades of tumors and depth of invasion and FI-GO stages (P<0.05), and there was no significantly difference between the expression of Wnt-1 andβ-catenin protein and CSCC pa-tients age (P>0.05). Spearman analysis showed that the expression of Wnt-1 protein was positive related to the expression ofβ-cate-nin protein (rs =0.490, P<0.001). Conclusion The abnormal expression of Wnt-1 and β-catenin may be involved in initiation, development, invasion, and metastasis of CSCC, and it is suggested that Wnt-1 and β-catenin be considered as potential markers for invasion, metastasis, and prognosis.

BACKGROUND:Articular cartilage injury is often complicated by subchondral bone damage to form osteochondral defects, and its treatment remains a pressing problem in orthopedics. Osteochondral composite grafts fabricated by tissue engineering technology provide a new way to repair osteochondral defects. OBJECTIVE:To explore the feasibility of fabricating osteochondral composite grafts in an independently designed double-chamber stirring bioreactor. METHODS: Goat bone marrow mesenchymal stem cels were seeded into β-tricalcium phosphate scaffolds. The cel/scaffold constructs were subjected to chondrogenic and osteogenic induction simultaneously in the double-chamber stirring bioreactor. According to the applied shear stress, they were divided into dynamic and static culture groups. The proliferation of bone marrow mesenchymal stem cels was detected by MTT test and scanning electron microscope examination. Osteogenesis and chondrogenesis related genes were detected by RT-PCR for the evaluation of chondrogenic and osteogenic differentiation. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem cels in both dynamic and static culturegroups demonstrated satisfactory proliferation and differentiation. Better proliferation and differentiation ability were found in the dynamic culture group. Fabrication of osteochondral composite grafts in the independently.designed double-chamber stirring bioreactor is feasible, which is better under the mechanical stimulus environment than the static environment.

Objective To understand the clinical features of infant pulmonary hemorrhage of enterovirus 71 infection without skin rash, and to improve the diagnosis and treatment of this disease.Methods Six infants infected with enterovirus 71 and presented pulmonary hemorrhage but no skin rash between November 2007 and October 2008 were retrospectively reviewed. The clinical manifestations, clinical outcomes, treatments, laboratory data and chest imaging changes of the cases were analyzed. Results The 6 cases were all younger than 2 years old. The cases distributed throughout the whole year without peak season. Enterovirus 71 gene was detected by reverse transcription-polymerase chain reaction (RT-PCR) and real time polymerase chain reaction from throat swabs and secretions of the respiratory tract. All the cases began with fever, and 4 of which were accompanied with vomit, and 2 accompanied with cough. After 1 to 3 days, they all got sudden deterioration, manifested with pale and cyanosis, and 1 had hyperspasmia. After intubation, they all had pink frothy fluid from the endotracheal tube. They all had obvious hyperglycaemia, 4 had tachycardia, and 2 had hypertension. All the 6 cases died, and 4 died within 6 h after deterioration. Conclusions Pulmonary hemorrhage of enterovirus 71 infection without skin rash is seen in infants. It is sporadic throughout the whole year. The disease is fulminant and the case often dies in short period of time.

The pathogen of COVID-19 is 2019-nCoV, which belongs to the beta coronavirus. Angiotensin-converting enzyme 2 (ACE2) is the receptor of 2019-nCoV as the same of SARS-CoV. Most of the severe patients were the elderly with underlying diseases, which may be related to the decrease in the number of naive T cells. In addition to pulmonary symptoms, COVID-19 can also cause multiple organ dysfunction and even multiple organ failure (liver, nervous system, heart, kidney, etc.). Pathogenic mechanisms such as direct virus invasion, cytokine storm, endothelial cells damage, and down-regulation of ACE2 may play important roles in the severity of the disease.

Objective With methods of literature review, item test, reliability and validity test, etc., to develop a fall risk assessment scale specific to the obstetrical department, which, after reliability and validity test, can be used for women health care before, at and after delivery.Methods Items in the fall risk assessment scale for pregnant and maternal women were determined and weights were assigned by reviewing relative risk factors in literature, referring to items in other fall risk assessment tools from home and aboard. After a preliminary scale was formed, 154 pregnant and maternal women hospitalized from May to December 2016 were assessed, so that reliability and validity of the scale were tested.Results In this fall risk assessment scale for the obstetrical department, test-retest reliability was 0.822, interrater reliability was 0.926, content validity of expertise was 0.927, and area under the curve (ROC) was 0.750 (P<0.05). When the dividing value was 3.5, sum of sensitivity (0.714) and specificity (0.714) reached the max.Conclusions The new fall risk scale, with favorable reliability and validity, can filter patients with high risk of fall, yet, it is still to be testified and perfected in future application.

Objective To explore the effects of two kinds preoperative fasting and liquid-fasting time before caesarean section on blood glucose of puerperae with GDM before and after the operation,intra-operative complications and on blood glucose of neonates.Methods With prospective study method,162 puerperae with GDM admitted to obstetrical department of Peking University First Hospital and received cesarean section under combined spinal-epidural anesthesia between April 1st and Sep. 30th in 2015,were selected as the research object,and were divided into the control group (admitted on odd-numbered days) and the observation group (admitted on even-numbered days). Puerperae in the control group were forbidden to eat solid food for 8 h and drink transparent liquid for 6 h before the operation,while those in the observation group were forbidden to eat solid food for 6 h and drink transparent liquid for 2 h before the operation. Puererae in two groups were compared about their preoperative blood glucose,incidence of intraoperative nausea and vomiting or aspiration,intra-operative quality of bleeding,postoperative exsufflation time and blood glucose half an hour after the operation, meanwhile,neonates in two groups were compared about their Apgar scores 1 min and 5 min after birth,and their blood glucose half an hour after birth. Statistical analysis was done by independent-samplest test,Mann-WhitneyU test and χ2 test.Results Difference of preoperative blood glucose of puererae in two groups was statistically significant (P<0.01). Differences of intraoperative bleeding of puererae in two groups and blood glucose of neonates half an hour after birth in two groups were statistically significant (P<0.05). There was no statistic difference in the incidence of intraoperative nausea and vomiting or aspiration,postoperative exsufflation time of puererae,or Apgar scores 1 min and 5 min after birth of neonates in two groups(P>0.05).Conclusions The scheme of forbidding puererae from eating solid food for 6 h and drinking transparent liquid for 2 h before cesarean section can reduce the incidence of preoperative hypoglycemia,maintain a smooth post-operative blood glucose, reduce intraoperative bleeding without increasing the incidence of intraoperative complications like nausea,vomiting or aspiration,or hypoglycemia of the neonates. The new fasting and liquid-fasting scheme is safe and feasible,which makes it worth promoting in clinic.

Objective:To retrieve and analyze the relevant guidelines for the second and third stages of normal delivery, and summarize the evidence of high-quality guidelines so as to provide references for the formulation of clinical practice programs.Methods:We took Johns Hopkins evidence-based nursing practice model as theoretical guidance and set up an evidence-based team.We systematically searched major guideline publication websites, electronic resource databases, related academic groups and guideline networks at home and abroad, evaluated guidelines and summarized the best evidence, and the search time limit was up to June 1, 2019. The literature quality evaluation and evidence extraction were carried out independently by four researchers with evidence-based training.Results:This study included two guidelines, summarizing the 20 best evidences in 9 aspects of humanistic support, delivery companion, delivery position, fetal monitoring, delayed exertion, perineal protection, fundus compression, prevention of postpartum hemorrhage, and delayed umbilical cord clamping.Conclusions:Based on the existing evidence, it integrates the best evidence of nursing measures for the second and third stages of normal delivery. It is recommended that maternal and child institutions promote the transformation of the best evidence based on their actual conditions.