Objective To systematically review the effect of cluster-based nursing for prevention of deep venous catheter-related bloodstream infection.Methods We searched the domestic literature,using RevMan5.2 software for statistical processing.Results A total of 13 qualified literature was included.Its combined OR=0.33,95％CI=(0.26,0.43),indicating that the cluster-based nursing could significantly reduce deep venous catheter-related bloodstream infection rate.Conclusions Cluster-based nursing is a practical nursing intervention,which should be promoted in clinical practice.

At present,reports at home and abroad suggest a low probability of successful preservation of ovarian endocrine function after ovarian shift radiotherapy.After radiotherapy for cervical carcinoma,the ovarian function is associated with various factors,such as radiotherapy dose and method,patient's age,shift position,and concurrent chemotherapy drugs.Therefore,as for each patient,the dose to the ovarian tissue should be controlled within the individual dose limit to effectively preserve the ovarian function.

Objective To evaluate the effect of Angio-Seal vascular closure device by the femoral artery hemostasis.Methods Relative literature was searched by computer,according to the inclusion and the exclusion criteria,which were analyzed by RevMan5.2 software.Results A total of four studies of randomized controlled trial were brought into this research,the total sample size was involved in 3 191 cases,the sample size of the intervention group and the control group respectively was 1 583 and 1 608.The analysis results showed,Angio-seal vascular closure device can significantly shorten the time of hemostasis after femoral artery interventional therapy in patients and the limb braking time.The sensitive analysis results showed that the results stability were high and the conclusions were reliable.Conclusions Application of Angio-seal vascular closure device can significantly shorten the interventional therapy in patients with bleeding time and braking time.

Objective To investigate the subthreshold depression for long-term survivors after breast cancer surgery and its effect on their quality of life (QOL). Methods The self-made general questionnaire, Centre for Epidemiological Studies Depression Scale (CES- D), Hamihon Rating Scale for Depression and Functional Assessment of Cancer Therapy- Breast were used to investigate the subthreshold depression and its effect on their QOL for 210 long-term survivors after breast cancer surgery. The difference in general conditions and score of QOL between the subthreshold depression and non-subthreshold depression groups was also compared. Results The subthreshold depression with incidence rate of 46.67%(98/210) was observed for the log-term survivors after breast cancer surgery in this study. The results indicated that the age (≤50) (OR=5.627, 2.662,P<0.01), marriage (unmarried, divorced or widowed) (OR=5.087, P<0.01), employment (unemployed, sick leave or retired) (OR=2.077,P<0.05) and low income (<3000 RMB/month) (OR=3.375,P<0.01) were the key factors that led to the occurrence of subthreshold depression. The score of QOL for the subthreshold depression group were lower than those of the non-subthreshold depression group (t=-6.653--2.926,P<0.01), and had a significantly negative correlation with score of depression and QOL (β=-0.362--0.132). Conclusions A high incidence rate of subthreshold depression for long-term survivors after breast cancer surgery was observed. The incidence rate of subthreshold depression increased for the patients with younger age, low income,unmarried or unemployment. Due to their low QOL, attentions should be paid to the early detection and early prevention for the long-term survivors with subthreshold depression after breast cancer surgery.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ) or high glucose on the toll-like receptor 4 (TLR4) expression,inflammatory cytokines and fibrotic factors in human tubular epithelial cells (HK-2),revealing the innate immune-related pathogenesis of diabetic nephropathy (DN) which may have clinical implications.Methods Three TLR4 siRNA sequences were designed and synthetized.After transfection,the most effective siRNA was selected to use for further expriments.The experiment consisted of 2 parts.Part 1:Cells were divided into three groups:normal-glucose group (NG,5.5mmol/L glucose),mannose group (M,5.5 mmol/L glucose + 19.5 mmol/L mannose),High-glucose group (HG,25 mmol/L glucose),preliminary validated the effects of high glucose and high osmotic pressure.Part 2:Cells were divided into seven groups:NG group,HG group,Ang Ⅱ group,Ang Ⅱ + negative group,HG+ negative group,Ang Ⅱ + siRNA group and HG+ siRNA group.Real time PCR was used to analyze the mRNA expression of TLR4,myeloid differentiation factor 88 (MyD88),heat shock protein 47 (HSP47).Western blotting was used to observe the protein expression of TLR4,MyD88,HSP47,NF-κB,type Ⅳ collagen (ColⅣ).ELISA was used to detect the expression of monocyte chemotactic protein-1 (MCP-1) and interleukin-6 (IL-6).Results Compared with NG group,TLR4,MyD88,HSP47 mRNA and TLR4,MyD88,NF-κB,ColⅣ,HSP47 protein were highly expressed under high glucose or Ang Ⅱconditions (P ＜ 0.01),and the expression levels of MCP-1 and IL-6 also increased significantly (P ＜ 0.01).Compared with HG or Ang Ⅱ group,the above indicators were obviously inhibited in the TLR4 siRNA groups (P＜0.01).Comparison between blank vector transfected groups and HG group as well as Ang Ⅱ group indicated no statistic significance (P ＞ 0.05).Conclusions Both Ang Ⅱ and high glucose stimulate TLR4 expression,which result in the up-regulation of inflammatory and fibrotic factors in HK-2.Specific target of TLR4 gene silencing can block the TLR4 pathway that is activated by high glucose and Ang Ⅱ,and thus reduce the inflammatory and fibtogenic factors' release.TLR4 signal is the common innate immune response pathway which induces the release of inflammatory and fibrotic factors in HK-2 under high glucose or high angiotension conditions.

Objective To evaluate the effect of early nursing interventions on the dysphagia of strok e patients.Methods The randomized controlled trials (RCT) on early nursing interventions were collected using the database such as Chinese Science and Technology Periodical Database (VIP),China national knowledge internet (CNKI) and Wanfang Database.The results were analyzed with RevMan5.2 Software.Resuits Six studies were included in the study.The dysphagia recovery rate was significandy increased in the intervention group.Conclusions Early nursing interventions can effectively promote the dysphagia function recovery of stroke patients.

Objective To explore the effects of clinical psychological intervention on anxiety and depression in hemodialysis patients .Methods Hemodialysis patients were randomly divided into two groups:psychological inter-vention group and control group ,25 patients in each group .In intervention group ,besides routine clinical treatment and nursing measures ,we analyzed the clinical information of the patients ,consulted the relevant documents ,combined the evidence and clinical experience ,and finally conducted the psychological intervention .Self-Rating Anxiety Scale and Self-Rating Depression Scale of these patients were analyzed .Results Before the intervention , the SAS and SDS scores of intervention group and control group were (57.3 ±1.5) versus (56.9 ±1.6) and (55.3 ±2.3) versus (56.1 ±3.5),respectively.The t values were 0.912(P>0.05) and 0.955(P>0.05),respectively.After interven-tion,the score before and after the trial between these two groups were significantly different (P<0.05).The SAS and SDS scores of intervention group and control group were (16.4 ±0.9) versus (10.1 ±1.3) and (14.3 ±2.1) ver-sus (9.7 ±1.5),respectively.Conclusion Clinical psychological intervention can effectively relieve anxiety and depression in hemodialysis patients .

Objective To investigate the protective effects of ambroxol on lung during perioperation in elderly patients with myasthenia gravis.Methods 58 elderly patients diagnosed as myasthenia gravis combined with thymic disease were divided into treatment group and control group randomly.During the perioperation,the treatment group was treated with ambroxol,while the control group was not.Comparative analysis of pulmonary complications,pulmonary ventilation indexes,blood gas indexes,and serum concentration of C-reactive protein (CRP),tumor necrosis factor-α (TNF-α),interleukin 1β (IL-1β) and IL-10 was performed.Results The incidence rate of postoperative pulmonary complications (pulmonary atelectasis,pneumonia and bronchitis) was significantly lower in the treatment group in the control group (9.4％ vs 15.6％,P＜0.05).Peak inspiratory pressure (PIP) and resistance of air way (RAW) were lower in treatment group than in control group [(22.32±3.43) cmH2O vs (26.54±4.81) cmH2O,(29.17±5.74) cmH2O· L-1s-1vs (34.47±7.94) cmH2O · L-1 · s-1 both P＜0.05],while compliance of lung (CL) washigher in treatment group than in control group [(106.04±-14.73)ml/cmH2O vs (95.11±9.50) ml/cmH2O,P＜0.05].Two days after operation,PaO2,SaO2 and PaO2/FiO2 were significantly higher in treatment group than in control group [(89.66 ±13.23) mmHg vs (70.94±12.75) mmHg,(96.95±2.65)％ vs (89.44±2.78)％,(219.47±54.05)mmHg vs (187.38±37.72) mmHg,respectively,all P＜0.05].Serum concentration of CRP,TNF-α,IL-1β were lower and serum level of IL-10 was higher in treatment group than in control group [(29.37 ± 14.87)mg/L vs (43.94 ±21.42) mg/L,(35.55±4.74)μg/L vs.(52.80±6.63) μg/L,(17.06±6.85)μg/L vs.(28.62±7.72) μg/L],[(132.84± 12.91)μg/L vs.(87.18± 16.37)μg/L,respectively,all P＜0.05].Conclusions Ambroxol hydrochloride can effectively reduce the incidence rate of postoperative pulmonary complications after thymectomy,improve the pulmonary ventilation function,and inhibit the inflammatory reaction in elderly patients with myasthenia gravis,which is worthy of wide application in the perioperation.

During the foreign aid mission against Ebola,the 302 Military Hospital of PLA strengthened emergency science research management according to the features of this task and the reality,and toke effective measures in research direction selection,human resources concordance,scientific potential transformation and other aspects,which contributed to the successful completion of this mission.They gathered experiences in emergency science research management and gave recommendations for similar tasks in the future.

Objective To explore the family adaptability and cohesion in cerebral palsy children.Methods A total of 225 children were selected in two hospitals of Anhui province from May to November in 2014.Their parents or family primary caregivers were interviewed using Family Adaptability and Cohesion Scale,Second Edition-Chinese version (FACESII-CV) and self-designed general information questionnaire.Results The actual family types of 225 cerebral palsy children families were:102 cases of intermediate type (45.3％),76 cases of extreme type (33.8％),47 cases of balance type (20.9％),while the ideal family types were:92 cases of intermediate type (40.9％),62 cases of extreme type (27.6％),71 cases of balance type (31.5％),it was significant between the actual and the ideal family types (x2=6.817,P＜0.05).The actual and ideal scores of family adaptability and cohesion scale were (64.09 ± 12.23) points,(43.28 ± 9.91) points and (73.91 ± 9.31) points,(52.73 ± 7.16) points,respectively,the difference was significant (t=-9.049,-10.976,P＜0.01).The scores in the family which the mother had a higher culture degree (F=7.075,8.499,P＜0.01),the cerebral palsy children did not live with grandparents (t=5.925,4.138,P＜0.05),the one-child family (t=5.370,4.652,P＜0.05) were higher.Conclusions The relationship between family members are estranged in most cerebral palsy children families,the ability of family coping with stuff is low and the family function is poor,in addition,the family adaptability and cohesion are mainly affected by the mother's culture degree,whether live with grandparents,the number of children.All above these are need to be intervented early to improve family function.