Objective:To explore the application value of acoustic radiation force impulse (ARFI) imaging technology in the dif-ferential diagnosis of benign gallbladder wall thickening or gallbladder carcinoma. Methods:Siemens ultrasound ARFI, involving virtu-al touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ), was used to examine the gallbladder wall in 327 cases. To compare transverse shear wave velocity (VTQ) of gallbladder waland VTI image characteristics. Results:Significant differences exist-ed in the gallbladder wall elastic parameters of normal and benign gallbladder wall thickening, as well as thick-walled gallbladder carci-noma. The ROC curve displayed that a velocity of 2.65 m/s can be used to diagnose gallbladder carcinoma, with sensitivity and specific-ity of 94.0%and 93.7%, respectively. Conclusion:The VTQ parameters were significantly different in benign and malignant gallblad-der wall thickening, thereby exhibiting clinical application value.

Objective To investigate the mental health and the general well-being among Hangzhou scientific and technical workers,and the mediating effect of coping strategies in perceived level of stress and mental health status.Methods A stratified cluster sampling method were developed among engineering technicians,agrotechnicians,researchers,health works and teaching staff.510 participants were evaluated with perceived stress of different types,Trait Coping Style Questionnaire (TCSQ),General Well-Being Schedule (GWB),and Self-Reporting Questionnaire 20 (SRQ-20).Results There was significant difference among sub-groups with different educational backgrounds,different occupation,and different age group for total scores of perceived stress (F=5.026,5.637,6.421,P＜0.01).Female had significantly higher scores than male on total scores of negative coping factor of TCSQ,total scores SRQ-20 (26.33±6.29,4.36±3.84 vs 24.93±5.68,3.32±3.53) (all P＜0.05).Total scores of negative coping factor of TCSQ,total scores of positive coping factor of TCSQ,and total scores of perceived stress were the significant predictors of both total scores SRQ-20 and total scores of GWB (all P＜0.001).Both total scores of positive coping factor of TCSQ and total scores of negative coping factor of TCSQ mediated the effects of perceived stress on total scores of SRQ-20 (23.87％,29.33％,respectively) and total scores of GWB (24.29％,23.24％,respectively).Conclusion There do exist the mediating effects between coping strategies in perceived stress and mental health status,the improvement of coping modes of scientific and technical workers can be regarded as a useful intervention strategy to improve their mental health status.

Objective To investigate the effect of selectiveα1 adrenergic receptor blocking agent in the treatment of bladder neck contracture caused by refractory urinary tract infection in elder.Methods 70 cases of bladder neck contracture were selected and randomly divided into two groups, 35 cases each.Two groups received Ceftriaxone sodium 1 g qd at acute episode,Levofloxacin Hydrochloride 0.5 g tid at non acute phase,control group received the treatment of urethral dilatation, Terazosin hydrochloride 10 mg qd, the experiment group received more with Tamsulosin Hydrochloride Sustained 0.2 mg qd.Two groups were both treated for four weeks.Urinary dynamics index, international prostate symptom score,quality of life score, clinical symptom disappearance time, the number of daily spasm and adverse reactions were compared.Results After treatment, the total effective rate in the experiment group(94.29%) was higher than the control group(65.71%)(P<0.05).Maximum and the average urinary flow rates in two groups increased after treatment(P<0.05), residual urine volume, maximum urethral closure pressure decreased(P<0.05), international prostate symptoms and quality of life score decreased(P<0.05); and compared with the control group, maximum and the average urinary flow rates in the experiment group were higher(P<0.05), residual urine volume, maximum urethral closure pressure were lower(P<0.05), international prostate symptoms and quality of life score were lower(P<0.05), and the average duration of symptoms of bladder neck spasm and the number of daily spasm in the experiment group were significantly shorter than the control group ( P <0.05 ).There was no significant difference in adverse reactions between the two groups. Conclusion Selectiveα1 adrenergic receptor blocking agent in the treatment of bladder neck contracture caused by refractory urinary tract infection in elder was effective, and it can improve the patient's urine flow rate, reduce the residual urine level, increase the quality of life.

Objective To summarize the experience of nursing cooperation in endoscopic sinus surgery for low temperature plasma radiofrequency ablation of skull base tumor, and to explore the safety and feasibility of this technique. Methods A total of 69 patients with skull base tumor were treated with low temperature plasma radio frequency technology to remove skull base tumor. Results Totally 62 cases of skull base tumors completed total resection in low temperature plasma radiofrequency ablation, 7 cases gained subtotal resection. The operation demonstrated superior advantage of less bleeding, short operation time, less postoperative pain and no adverse events. Conclusions The skull base tumor resection for patients with skull base tumors with low-temperature plasma radiofrequency possesses the advantages of short operation time, less bleeding and thermal damage to the surrounding tissues, besides it can reduce the postoperative discomfort, shorten hospitalization time and reduce the occurrence of nursing adverse events.

Objective To build new management model for diabetic foot disease,and to observe the therapeutic effect of diabetic foot ulcers under the new model.Methods 52 patients with newly diagnosed diabetic foot disease were recruited and randomly divided into the experimental group (n=26) and the control group (n=26).While the experimental group adopted the interdisciplinary collaboration model (nurse-doctor jointed diabetes care management model),the control group were treated by the single department pattern.The foot ulcer healing rate,average length of stay (ALOS),fasting plasma glucose (FPG),2 h postprandial blood glucose (2 h PBG),glycosylated hemoglobin (HbA1c),and the patient awareness of the knowledge about diabetes self-management were respectively compared at 3 and 6 months.Results After receiving a multidisciplinary joint diagnosis and treatment,FPG and 2 h PBG of the patients from the experimental group [(6.44±2.93)mmol/L,(8.52± 2.09)mmol/L] were significantly decreased than those of the patients from the control group [(8.17±3.19)mmol/L,(10.77±3.27)mmol/L].HbA1c at 3 and 6 months (7.2％,7.7％) and ulcer recurrence rate (3.8％) after 6 months of patients of the experimental group were significantly reduced than those of the control group(8.9％,9.1％ and 15.4％).When compared with patients of the control group,patients of varying severity in the experimental group showed significantly shortened ulcer healing time and hospital stay.Moreover,patients from the experimental group showed statistically higher knowledge level and self management ability (P＜0.05).Conclusion Through interdisciplinary collaboration,podiatric medical joint management model can significantly improve cure rate,shorten ALOS,improve blood sugar control and patient satisfaction.

Objective: To investigate the chemical constituents of Chaenomeles speciosa. Methods: The chemical constituents of Chaenomeles speciosa was analyzed by various chromatographic methods. The structures of the compounds were identified based on physicochemical properties and spectral data. Results: Nine compounds were obtained from the ethyl acetate fraction of C. speciosa and were identified as methyl chlorogenate (I), 5-O-cafeoyl quinic acid butyl ester (II), quinic acid butyl ester (III), 5-hydroxymethyl-furan-2-carbaldehyde (IV), triacontanoic acid (V), (-)-epicatichin (VI), 7,8-dihydroxy-coumanrin (VII), protocatechuic acid ethyl ester (VIII), and protocatechuic acid (IX). Conclusion: Compounds III-VIII have been obtained from this genus for the first time.

Objective To conduct targeted surveillance of nosocomial infections in intensive care units(ICU)to provide reference for comprehensive infection control . Methods All the 374 patients treated in ICU in 2013 were investigated by targeted surveillance methods .Results A total of 82 episodes of nosocomial infections were identified in 62 (16 .6% )of the 374 patients . The cumulative hospital stay was 2 724 days .The infection incidence per patient‐day was 22 .8‰ .The infection in ICU was primarily pneumonia (75 .6% ,including 39 ventilator‐associated pneumonia) ,bloodstream infections (including 6 central line‐associated bloodstream infections ) and catheter‐associated urinary tract infections . The incidence of ventilator‐associated pneumonia ,central line‐associated bloodstream infection and catheter‐associated urinary tract infection was 33 .3‰ ,2 .8‰ , 2 .3‰ patient‐day ,respectively .Overall ,74 strains of pathogens were isolated ,of which 93 .2% ,5 .4% and 1 .4% were gram‐negative bacilli ,gram‐positive cocci and fungi ,respectively .The top three gram‐negative bacilli were Pseudomonas aeruginosa(25 .7% ),Klebsiellapneumoniae(14 .9% ),and Acinetobacterbaumannii(10 .8% ).Conclusions Theincidenceof nosocomial infection was 16 .6 % in ICU patients ,of which device‐related infection accounted for 62 .2 % .Control of equipment‐related infections is critical for curbing the nosocomial infections in ICU . The antimicrobial regimens for ICU patients should cover gram‐negative bacilli .

ObjectiveTo investigate the nursing key points to 8 end-stage ovarian cancer patients with totally implantable venous access ports.Method The totally implantable venous access ports were used in the 8 patients and nursing was carried out to them.Result There were no occurrences of infection,leakage,seepage,pipe obstruction and the needlepoint shift.Conclusions The ovarian cancer patients in the end-stage had very low resistance and high risk of infection.Individualized nursing care to them may ensure the use of the ports in a safe way.

Objective To explore the diagnosis and treatment rule of eczema by Zhuang Guokang. Methods Data of 58 eczema patients treated by Zhuang Guokang were collected as research objects to set up the database. Support vector machine (SVM) method was adopted to take data mining research of the key points of syndrome differentiation and the rule of medication. Results The nourishing Yin method was extracted as the category property to get 3 classification models of the syndrome differentiation key points, the related treatment methods and medication rule and 63 relevant quantitative data. The accuracy rate of model classification of the main differentiation points of nourishing Yin method corresponding to Yin reached 77.586%, and Kappa value was 0.536. Among these points, the weight of chapping(1.558), papules(1.456), thready pulse(1.036)and desquamation(0.858) got higher significance. The accuracy rate of model classification of medication feature reached 86.2069%, and Kappa value was 0.719. Among these medicines, Pseudostellaria heterophylla(0.776), Semen plantaginis (0.550), Asparagus root(0.525) and Solomonseal (0.388) got higher significance. Conclusion The research revealed the syndrome differentiation key points and the medication rule of Zhuang Guokang’snourishing Yin methodin the treatment of eczema, and explored the path of experience transforming to knowledge of the famous old TCM doctors.