Objective To observe the effects of central exudative chorioretinopathy(central exudative chorioretinopathy,CEC)treated with blood-activating and stasis-removing Chinese medicines.Methods All 339 cases of central exudative chorioretinopathy with 346 infected eyes were randomly recruited into a treatment group(176 cases with 181 infected eyes)and a control group(163 cases with 165 infected eyes).The treatment group was treated with traditional Chinese medicine by dialectical combination of syndrome and disease,while the control group was treated with conventional treatment.Results The corrected visual acuity was 0.01～1.2 in the treatment group.Of all 181 eyes in 176 patients,76 eyes were cured(41.98%),85 eyes were improved(46.96%),and 20 eyes were ineffective(11.6%),with a total effective rate being 88.94%.BY contrast,in the control group,of all 165 eyes in 163 patients,62 eyes were cured(37.57%),67 eyes were improved(40.60%),and 36 eyes were ineffective(21.83%),with a total effective rate being 78.17%.There was significant difference in the total effective difference between the two groups(U=2.05693,P＜0.05).FFA and OCT were reexamined for the patients in the treatment group three menths after the treatment.The results showed that fluorescein leakage and choroidal neovascularization(choroid al neovascularisation,CNV)lesions disappeared in 76 eyes;fluorescein leakage and CNV lesions relieved in 85 Eyes;fluorescein leakage still existed in 12 eyes;and sear formed in 8 eyes.Conclusion Blood-circulating and stasis-removing Chinese medicines have good effects in promoting subhyaloid hemorrhage and exudation,eliminating retinal oedema,and improving eyesight.

Objective To study the changes of gonadotropin releasing hormone agonist (GnRH-a) in pinopodes during luteal phase and to explore the possible mechanism of GnRH-a in luteal phase support of assisted reproductive technology (ART).Methods Totally 40 primary infertility women who were treated with ART due to male factors were enrolled,according to the order of the group they were randomly divided into experimental group and control group.On the 7th day after ovulation,the experimental group received a subcutaneous injection of 0.1 mg of GnRH-a,while the control group received a subcutaneous injection of placebo only (0.9％ salinc 2 ml),3 days later they came to the clinic again.Serum estradiol and progesterone levels were measured before and after treatment in each group.Pinopodes were collected for electron microscopic examination.Levels of ER and PR were detected by western blot.Results (1) There was no significant difference between the experimental group and the control group in the estrogen level before and after the treatment (all P＞0.05).The level of progesterone in the experimental group after treatment [(66.8± 14.9) nmol/L] was significantly higher than that before treatment(P＜0.05);also significantly higher than the same period of the control group (P＜0.05).(2) There was no significant difference in the expression of ER protein in the experimental group before and after treatment (P＞0.05).The expression of PR in the experimental group after treatment was significantly lower than that before treatment (P＜0.05);also lower than the same period of the control group (P＜0.05).(3) Expression amount of pinopodes in the experimental group after treatment was significantly higher than that before treatment [65％ (13/20) versus 25％ (5/20),P＜ 0.05],and the development trend was more mature [the percentage of maturation:75％ (15/20) versus 35％ (7/ 20),P＜0.05].Expression amount of pinopodes after treatment and the percentage of maturation in the experimental group were significantly higher than those in the same period of control group (P＜0.05).Conclusion GnRH-a in luteal phase support may play a role through the corpus luteum,which may promote the secretion of progesterone,downregulation of PR expression,promote the growth of pinopodes,and improve the endometrial receptivity.

Objective To explore the value of microRNA in differential diagnosis of tuberculous ascites and cancerous ascites.Methods From January 2011 to October 2013,31 patients with ascites were enrolled in this study,19 cases of whom had cancerous ascites (two cases of ovarian cancer,three cases of liver cancer,one case of bile duct carcinoma,five cases of gastric cancer,three cases of pancreatic cancer,four cases of colon cancer and one case of peritoneal mesothelioma) and 12 cases had tuberculous ascites.Ascites was collected for microRNA microarray detection,and the possible differential expressed microRNA was screened.The results of microarray were confirmed by TaqMan stem-loop real-time polymerase chain reaction (PCR) method.The t test,receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were performed for statistical analysis.Results The results of microRNA expression profiles indicated that there were differences between tuberculous ascites and cancerous ascites.The findings of TaqMan real-time PCR showed the expression of microRNA-21 in cancerous ascites was 39.3±11.6,which was much higher than that of tuberculous ascites (12.6 ±4.1),and the difference was statistically significant (t=4.921,P＜0.05).The expression of microRNA-134 in cancerous ascites was 68.2±20.4,which was lower than that of tuberculous ascites (210.2±37.2),and the difference was statistically significant (t =3.430,P ＜ 0.05).The AUC of microRNA-21 and microRNA-134 in differential diagnosis of tuberculous ascites and cancerous ascites was 0.882 (95 ％ CI 0.816-0.917) and 0.877 (95％ CI 0.782-0.901).The AUC of combined microRNA-21 and microRNA-134 in differential diagnosis of tuberculous ascites and cancerous ascites was 0.915 (95％ CI 0.863-0.967).Conclusions There are differences in microRNA expression profiles between tuberculous ascites and cancerous ascites.The detection of microRNA-21 and microRNA-134 expression in ascites is of great importance in differential diagnosis.

Objective To explore the influences of the network medical health management on the coping styles , hope level and quality of life in patients with primary kidney cancer surgery .Methods The patients of control group received normal health management and the participants included 77 kidney cancer patients who were laboratory diagnosed during March 2011 and September 2012 .The patients of intervention group received the network medical health management based on the normal health management and the participants included 79 kidney cancer patients who were laboratory diagnosed during March 2013 and September 2014 .The coping styles , hope level and quality of life before and after the intervention were compared between the two groups .Results Before the intervention , the coping styles and the hope level had no statistical differences between the two groups (P>0.05).After the intervention for the coping styles , the intervention group had higher scores of the positive coping style (25.44 ±2.61) and lower scores of the negative coping style (9.76 ±1.89) and presented statistical differences compared with that of the control group ( t=-10.468, 7.572;P <0.01).For the hope level, there was no statistical significance between two groups before intervention (P >0.05); however, after intervention, the intervention group had higher scores of positive attitudes (14.5 ±2.6), positive behaviors (15.1 ±2.4) and close contact with people (15.6 ±2.1), and presented statistical differences with that of the control group (t=4.965, 5.569, 4.965; P<0.05).For the quality of life, there were no statistical differences for the dimensions of PF , RF and DY (P>0.05) but the intervention group performed better on other 12 dimensions′scores ( P <0.05 ); the quality of life in the intervention group was better than that of control group .Conclusions The network medical health management should be further applied to the clinical practice , because it can significantly improve the coping styles , hope level and quality of life among the patient with primary kidney cancer surgery .

Objective To investigate the effects of application of problem-based learning (PBL) education in primary renal cell carcinoma surgical patients.Methods A total of 1 00 renal cell carcinoma patients who received surgical treatments from July 201 3 to January 201 5 in Cancer Hospital Affiliated to Zhengzhou University were randomly divided into control group (50 cases)and observation group (50 cases). The patients in control group received routine health education and the patients in observation group received PBL health education.The psychological status,satisfaction with nursing and occurrence of postoperative complications were compared in two groups when admitted and discharged from hospital.Results The difference of psychological status in two groups was not significant when admitted hospital (P >0.05),while it is better in observation group when discharged from hospital (P <0.05).In addition,the degree of satisfaction was higher in observation group (P <0.05).Furthermore,the occurrence of complications was lower in observation group (P <0.05).Conclusions Health education based on PBL can arouse patients′enthusiasm in actively learning disease-related knowledge, improve their psychological status, decrease the occurrence of postoperative complications and increase patients′satisfaction.

Objective To explore the effects of swallow-feeding management in patients with dysphagia after traumatic brain injury (TBI). Methods By convenient sampling, 53 TBI patients from the Forth Department of Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) from January 2016 to December received a conventional rehabilitation program as the control group. 52 TBI patients from January 2017 to December were recruited into the observation group, while they received the swallow-feeding training and rehabilitation nursing intervention in comparison with the conventional rehabilitation program received in the above control group. The therapeutic effects were evaluated in the two groups through comparing swallowing function pre and post the 30-days interventions, respectively. Results Before intervention the swallowing function of the observation group was graded as grade I (0 example), grade Ⅱ (16 examples), grade Ⅲ (14 examples), grade Ⅳ (14 examples) and grade Ⅴ (8 examples) respectively, while the swallowing function of the control group was graded as gradeⅠ(0 example), gradeⅡ(11 examples), grade Ⅲ(13 examples), gradeⅣ (18 examples) and grade Ⅴ (11 examples) respectively before intervention. The difference in the degrees of the swallowing function had no statistical significance between the control group and the observation group before interventions (Z=-1.268, P=0.205). After intervention the swallowing function of the observation group was graded as grade Ⅰ (20 example), grade Ⅱ (19 examples), grade Ⅲ (10 examples), grade Ⅳ (2 examples) and grade Ⅴ (8 examples) respectively. Meanwhile the swallowing function of the control group was graded as grade Ⅰ (8 example), grade Ⅱ (19 examples), grade Ⅲ (13 examples), grade Ⅳ(10 examples) and grade Ⅴ(3 examples) respectively after intervention. Hence, The difference in the degrees of the swallowing function had statistical significance between the observation group (Z=-6.222, P＜0.01) and control group (Z=-5.892, P＜0.01) pre and post interventions. Moreover, the improvement of swallowing function in the observation group was larger than that of the control group and the difference in the degree of the swallowing function have statistics significance between the two groups (Z=-3.265, P＜0.01). The food intake of the two groups were observed for 30 days, and the results revealed that there were 1 502 cases and 808 cases in respiratory aspiration in the control group and observation group respectively. It can be seen that the incident rate of respiratory aspiration was significantly lower in the observation group than that of the control group (χ2=52.567, P=0.047). Conclusion The Swallow-feeding management can improve the swallowing function, effectively reduce the incidence of respiratory aspiration and also enhance the quality of life in TBI patients.

Objective:To explore the application effects of the Doctor-nurse-therapist integrated Model on the patients with brain injury in the rehabilitation period.Methods:A total of 60 patients with brain injury from January 2016 to October 2017 were selected as the control group underwent interventions based on traditional treatment model involving medical treatment, nursing and rehabilitation, and then 56 patients with brain injury from January 2018 to October 2019 were aselected as the experimental group followed Doctor-Nurse-Therapist integrated model for rehabilitation treatment. All subjects were recruited from inpatients hospitalized in the Forth Department of Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center). The differences of motor function, activities of daily life (ADLs), anxiety and depression scores between the two groups were compared.Results:After 6 weeks of interventions, the scores of motor function were 80.27±18.20 and 67.32±19.71, and ADLs scores were 73.14±19.18 and 64.59±20.33 for the experimental group and the control group, respectively. The differences of the motor function and ADLs scores showed statistical significance between the experimental group and the control group ( t values were 3.491, 2.105, P<0.05). The anxiety and depression scores were 44.68±12.29 and 42.61±17.95 in the experimental group, while 52.25±12.95 and 50.84±18.14 in the control group, respectively. Statistical significance was found according to differences of anxiety and depression scores between the experimental group and the control group ( t values were 2.965,-2.236, P<0.05). Conclusions:Under the integrated model, doctors, nurses and therapists can evaluate, discuss, formulate and implement the flow scheme of the model, which can significantly improve the motor function and daily life ability of patients with brain injury in the rehabilitation period as well as anxiety, depression and the quality of medical services, and reduce the burden of family and society.

Objective:To explore the effect of hospital-community-family trinity linkage home visiting on quality of life of convalescent patients with traumatic brain injury.Methods:A total of 100 convalescence patients with traumatic brain injury admitted to Shanghai Yangzhi Rehabilitation Hospital from January 2019 to January 2020 were selected as the research objects, and randomly divided into the intervention group ( n=51) and the control group ( n=49) by random number table method. The control group received routine rehabilitation nursing guidance. Patients in the intervention group were treated with hospital-community-family triple linkage family visit for nursing intervention for 10 months. The Medical Outcomes Study 36-Item Short-Form (SF-36), General Self-Efficacy Scale (GSES) and Exercise of Self Care Agency Scale (ESCA) were used to compare the quality of life of 2 groups before intervention, 1, 4, 6, 8 and 10 months after intervention. Results:After 6 months of the intervention, eight dimensions of SF-36 such as physiological function, role-physical, body pain, general health, vitality, social function, role-emotional, and mental health scored 29.61 ± 9.21, 38.73 ± 14.42, 41.96 ± 8.25, 38.63 ± 8.43, 50.10 ± 8.03, 42.40 ± 18.28, 43.14 ± 15.34, 38.31 ± 8.88 in the intervention group, and 35.92 ± 8.02, 52.04 ± 14.29, 50.00 ± 11.90, 47.76 ± 9.08, 56.12 ± 7.66, 56.99 ± 19.40, 55.10 ± 16.03, 44.96 ± 7.73 in the control group. The difference between two groups showed significant difference ( t values were -5.21--3.81, all P<0.05). The GSES scores and ESCA scores after 1,4,6,8,10 months of the intervention showed an distinct advantage in the intervention group than the control group ( t values were -20.99-11.55, all P<0.05). Conclusions:The hospital-community-family trinity linkage home visiting could improve the quality of life, self-efficacy, and self-care ability of patients with traumatic brain injury, and promote their rehabilitation effect when they returned to family and society.

Objective:To investigate the effect of hospital-community-family transitional rehabilitation care model on patients with brain trauma and explore an economic, effective, all-sided rehabilitation approach.Methods:A total of 82 in-patients with brain trauma were recruited from January 2018 to June 2019 in Shanghai Yang Zhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center). The participants were allocated into 2 groups based on randomized digital tables. Forty patients in the observation group received the hospital-community-family transitional rehabilitation care, and forty-two patients in the control group received routine rehabilitation care. All the participants completed assessments with the Fugl-Meyer Assessment Scale (FMA), the Barthel Index for the Activities of Daily Living (BI) and the Hamilton Anxiety Scale (HAMA) before the intervention, at discharge, 1 month, 4 months, 6 months and 10 months after discharge, respectively.Results:Before the intervention, no statistical significance was identified in the total scores of FMA, BI and HAMA between the two groups ( P>0.05). Compared to the control group, the total scores of FMA, BI and HAMA in the observation group were significantly improved at the discharge, 1 month, 4 months, 6 months and 10 months after discharge, respectively ( t values were -13.82 - 10.28, all P<0.05). Significant differences were observed in the level of FMA, BI and HAMA between the two groups across 6 time points ( Ftime×group=20.34, 18.34, 19.55, Ftime=183.24, 184.30, 179.09, Fgroup=28.86, 32.19, 26.63, all P<0.05). Conclusions:The hospital-community-family transitional rehabilitation care model which is based on medical consortium effectively improved traumatic brain-injured patients′motor function, the level of activities of daily living, and patients′anxiety. In addition, the model also improved the quality of medical services.

Objective To know the patients′ and their families′ satisfaction to the nursing service and nursing quality in general intensive care unit ( ICU) . Methods A self-designed questionnaire was used in this study which contains two parts: the basic information of patients, and the satisfaction to 20 items during ICU. 374 patients and their families in general ICU of our hospital from April to December 2015 received follow-up investigation. The SPSS17.0 software was used for statistical analysis.Results Among the satisfaction survey of 20 entries in patients and their families: 5 entries were in low scores: sleep environment (4.72±0.63), life nursing (4.78±0.57), visitation arrangements (4.79±0.52), transfer process (4.79±0.48), and privacy protection (4. 80±0.52). The overall satisfaction score of nursing service quality in different surveyed object group:patients group (97.12±6.63) was higher than that of the family group (95.46±885) with significant difference ( P<0.05) . The differences in satisfaction score of privacy protection, convenience of bedside items and other 6 items were statistically significant in different groups ( P<0. 05 ) . Conclusions In order to comprehensively improve the overall satisfaction of ICU patients and their family members we should improve the working environment of ICU, optimize workflow, strengthen health guidance, refine nursing service, pay attention to privacy protection.