Objective To evaluate the value of the three dynamic contrast-enhanced scan with spiral CT in hepatic tu-bercular lesion. Methods Retrospectively 38 cases with hepatic tubercular lesions less than 5cm were studied , which were performed with the three dynamic contrast-enhanced scan with spiral CT in our hospital from Jun. 2010 to Mar. 2014. Results Ten cases of hepatocellular carcinoma were characterized by lower density in the venous and delay phase, and obviously enhanced in the arterial phase. 7 cases of liver metastases were characterized by less enhanced in the arterial phase, loop in the venous phase, lower density in the delay phase. 8 cases of hemangioma were charac-terized by tubercular in the arterial phase , concentric enhanced in the venous phase , equidensity in the delay phase. 3 cases of inflammatory pseudo tumors were characterized by less enhanced in the arterial phase , concentric en-hanced in the venous phase and delay phase. 1 case of tuberculoma were characterized by slightly loop especially in the venous and delay phase. Not enhanced in the all the phase for 9 cases of cysts. Conclusion The imaging of three dynamic contrast-enhanced scan with spiral CT are characteristic in mostly hepatic tubercular lesion , and could pro-vide reference to qualitative diagnosis.

Objective To observe the effects of flurbiprofen on tourniquet-induced lower extremity ischemia-reperfu-sion (I/R) injury. Methods Ninety ASA I or II patients, aged 30-59 years, scheduled for elective orthopedic operation on CSEA,were randomly assigned into 3 groups (n=30 each):control group (group C),low dose flurbiprofen (group D1) and flurbiprofen (group D2). A tourniquet was applied after affected limb blood droved and inflated (80kPa) and dura-tion of less than 90 min. Patients in group D1 were infused flurbiprofen 1mg/kg slowly on 10 min before the tourniquet inflated and patients in group D2 infused flurbiprofen 2mg/kg. Patients in group C received normal saline 5mL.Blood samples were taken before operation (T0) and taken 30min(T1),2h(T2) after tourniquet release to determine the plasma concentrations of MDA, SOD, TNF-α,IL-6,IL-8.Results The plasma concentrations of MDA, SOD, TNF-α,IL-6,IL-8 in these three group was lower at T1 and T2 than it at T0(P<0.05). The plasma concentrations of MDA, SOD, TNF-α, IL-6,IL-8 in group D1and D2 was lower at T1 and T2 than it at T0(P <0.05). The plasma concentrations of MDA was lower at T2 than it at T1(P<0.05). Conclusion Flurbiprofen can reduce inflammation on tourniquet-induced lower ex-tremity ischemia-reperfusion injury.

Objective To observe the clinical effect of ultrasound-guided technology in the operation of upper limb in patients with nerve block. Methods Two huandred patients had be performed upper limb operation in our hospital form Jan2012 to Dec 2013 were randomly divided into two groups, 100 cases of each group, group A who was guided by tra-ditional anatomical method;group B who was guided by ultrasound-guided positioning technolog, 1% Lignocaine +0.375%Ropivacaine+10 mg Dexamethasone were injected in two groups. Comparison of the effect of two groups nerve block: the onset time of anesthesia, success rate, the amount, complications. Results Anesthesia operation completion time, group B was shorter than group A (TA=7.7±1.9min, TB=4.6±1.4min);Nerve block work time, group B was longer than groupA(TA=19.4±3.4min, TB=10.7±2.3min);group B anesthesia effect was good, with excellence rate reached 97%and fine rate was 100.00%;group A anesthesia effect was general, excellence rate reached 47.00%,fine rate was 91.00%;group B adverse reactions incidence was 2.00%, group A was up to 9.00%;compared the above group A and B related datas of difference was statistically significant (P<0.05).The duration of anesthesia (TA=417.5±98.7min, TB=406.3±79.1min), the more similar between two groups had no statistical significance (P>0.05). Conclusion Ultrasound-guided technology was applied to the upper limb brachial plexus block, which could enhance the effect of nesthesia, re-duce the dosage of anesthetic drug ,complications and adverse reaction.

Objective To investigate the postoperative analgesic effect of dezocine and sufentanil in patients with col-orectal cancer. Methods Sixty-eight cases with colon cancer, rectal cancer undergoing radical operation in our hospital from January 2011 to June 2013, were randomLy divided into control group and observation group, 34 patients in each group, the patients in control group were given sufentanil analgesia after surgery, and patients in the observation group were given dezocine and sufentanil for analgesia. The VAS and Ramsay sedation score in 2h, 6h, 12h, 24h, 48h and the incidence ratio of adverse reaction during analgesia were compared in two groups. Results There was no statistical significance in the difference of the two groups of sex ratio, age distribution, body weight, ASA classification (P>0.05);there was no significnt difference in VAS scores between the two groups at different time points (P>0.05);There were statistically significant in differences of Ramsay scores among different time points of two groups (P<0.05);There were statistically significant in differences of the incidence ratio of adverse reaction of two groups during analgesia (drowsiness, nausea and vomiting, urinary retention) (P<0.05). Conclusion Analgesic effect of using dezocine and sufentanil with less adverse reaction, good safety is obvious better than sufentanil only in the patients with colorectal cancer after operation, and is worth the clinical promotion.

Objective To study the prevention of postoperative laryngeal cancer tracheotomy nursing method of lower respiratory tract infection. Methods The laryngeal cancer patients after tracheotomy in patients with 70 cases , were randomly divided into two groups, including 33 cases in the control group, the observation group of 37 cases. The con-trol group were given routine care, observation group were given evidence-based care patients, please two group of pa-tients to evaluate the nursing satisfaction. Results The observation group was significantly lower than the control group of patients with lower respiratory tract infection , the complication rate was significantly lower than the control group , swallowing function recovery time and hospital stay were significantly shorter than the control group; After treatment and intervention,two groups of patients with SF-36 scale were significantly improved than before treatment, and the patients in the observation group improved more obviously; the observation group of patients for nursing very satisfied andsatisficers were higher than the control group (P < 0.05). Conclusion The postoperative laryngeal cancer patients with tracheotomy implementation of evidence-based nursing can effectively prevent the occurrence of lower respiratory tract infection, promote the rehabilitation of patients, improve patient quality of life.

Objective To investigate the infection after abdominal hysterectomy factors to provide reference for clinical nursing. Methods The general data of 200 patients were retrospectively analyzed by abdominal hysterectomy ,the causes of postoperative infections were analyzed by using the Pearson univariate analysis and multivariate Logistic regression analysis method. Results All 17 strains of pathogens were detected ,Gram negative bacteria were 12 strains (70.59%),Gram positive bacteria were 4 strains(23.53%),there was one strains of fungi(5.88%).Single factor analysis showed that age, tumor, malignant, operation time, incision length, anemia, hospitalization time had significant difference in terms of the infection after operation (P<0.05).Multivariate Logistic regression analysis showed, 55 years of age or older (β=1.119,OR=3.052),malignant tumor (β=2.014,OR=7.478),anemia (β=1.585,OR=6.063),operation time (β=1.010,OR=5.755)were the risk factors for infection after operation (P<0.05). Conclusion The pathogenic bacteria is pseudomonas aeruginosa, escherichia coli and Staphylococcus aureus.The age,malignant tumor, anaemia, operation time are the important risk factors of postoperative infection.We should adopt according to the incidence of infection nursing measures to reduce postoperative.

Objective To investigate orthopedic wound infection using vacuum sealing drainage clinical results, summa-rized the clinical impact of the intervention on the patient in order to improve the level of clinical treatment. Methods Randomly selected from February 2010-October 2012 110 cases of orthopedic wound infection patients in this study were divided into two groups, control group received conventional dressing and clinical treatment observation, observa-tion group VSD technology and clinical interventions to be observed after treatment in the clinical effects, pain and de-pression scores and satisfaction differences. Results In the control group, the cure rate was 41.82%, total effective rate was 74.55%; observation group cure rate 72.73%, total effective rate was 94.55%, the difference was significantly (P<0.05); the other two groups in the average pain score and depression scores and pain score and depression score grad-ing, satisfaction and compliance was relatively significant difference(P<0.05), there were statistically significant. Con-clusion VSD can control orthopedic surgery wound infection and improve wound healing time , improve patient satis-faction and quality of life.

Objective To observe the effect of evidence-based nursing (EBN) care model and conventional anaerobic impact on pregnant women of reproductive tract infections in patients with pregnancy outcome, and evidence-based care to improve the quality of life of the reproductive tract of anaerobic infections in pregnant women, the impact of nursing satisfaction. Methods A total of 145 cases with genital tract anaerobic infection during pregnancy were selected as the objects and were divided into two groups randomly, A group (n=76 cases) and B group (n=69 cases). A group re-ceived conventional prenatal guidance and nursing. B group received evidence based nursing. Results The incidence rate of adverse outcomes including premature rupture of membrane, premature, low birth weight, puerperal infection and neonatal infection of B group were evidently lower than the A group. The difference was evident, which had statistical significance (P<0.05). The life quality score of B group and the nursing satisfactory degree were evidently higher than that of A group, which had statistical significance (P<0.05). Conclusion The pathogens of genital tract anaerobic infec-tion of women during pregnancy are complicated, and have bad influence on pregnancy outcome. Giving patients psy-chological nursing and health education by the way of evidence-based nursing can improve the pregnancy outcome and improve the life quality of patients.

Objective To observe the clinical effect of applying responsibility holistic nursing to patients treated with double cannula irrigation drainage. Methods Seventy cases with severe acute pancreatitis were selected and divided in-to two groups randomly. The control group received conventional nursing ,and the observation group received responsi-bility holistic nursing. The standing time of drainage tube,drainage effect,length of stay and complications of two groups were recorded. And the nursing satisfaction of patients or family member was evaluated. Results The patients operative time,postoperative irrigation and drainage time and hospital stay were (49.57±5.82) min,(10.10±1.04) d and (29.14±3.52) d, significantly shorter than the control group, the cure rate was 97.44% of observation group, signifi-cantly higher than the control group;in the observation group catheter complication rate was 41.03%, significantly low-er than the control group;observation care patients and their families who were very satisfied and satisfied respectively 53.85%and 92.31%, significantly more than those in the control group. These differences were all statistically signifi-cant (P <0.05). Conclusion Applying double cannula washing drainage to the patients treated with double cannula washing drainage not only can reduce the treatment time and improve the treatment effect , but also can reduce the in-cidence rate of adverse reactions and improve the satisfaction degree of patients. So the nursing mode has great signifi-cance in clinical application.

Objective To explore the common problems and nursing effect of oral medication in hospitalized elderly patient. Methods One hundred and twenty elderly patients, who were hospitalized in our department from 2013 March to October, were investigated by the questionnaires for the common problems of oral drugs and nurses working and oral drug types. Nursing was implemented to solve the above problem. The drug using situations were compared before and after nursing intervention. Results In common problems on older patient oral medication, self medication incidence was highest, for 64.17%, secondly, the leakage medication incidence was 59.17%. Nursing work was not in place phe-nomenon on oral medication in elderly patients during the medication, and the drug leakage service station was 25.83%and 24.17%respectively. The oral medication orders of 120 elderly patients were 1217. The top three of the medication were cardiovascular drugs, respiratory system drugs and drugs for digestive system, whose constituent ratio were 19.80%, 17.83%, 17.33%, respectively. For patients with nursing intervention, the indexes were significantly higher than those before intervention, for example the compliance, medication, medication time, knowledge of medication, the understanding of taking the medication errors and irregular harm, and the understanding of adverse reactions and other indexes, the difference was statistically significant (P<0.05). Conclusion Nursing intervention in elderly patients with oral medication can strengthen oral medication safety management consciousness, so as to ensure the safety of medica-tion in elderly patients.