Objective To investigate the distribution and severity of cerebral artery stenosis and the prognosis in elderly patients with acute cerebral infarction using digital subtraction angiography (DSA). Methods The 432 elderly patients with acute cerebral ischemia infarction underwent DSA,and they were divided into two groups: elderly group (n= 320) and non-elderly group (n= 112). The characteristics of distribution and severity of cerebral artery stenosis, the relationship between artery stenosis and relative risk factors, and the prognosis of acute cerebral infarction were analyzed.Results In elderly group, 270 cases (84.3%) had intra- and extra- cranial artery stenosis, of which 98 patients (30.6%) with pure extracranial arterial stenosis, 132 patients (41.3%) with combined extra- and intra-cranial artery stenosis. They were both significantly higher than the corresponding data in non-elderly group [23 cases (20.5%) and 28 cases (25%), P＜0.05 and 0.01]. The prevalences of moderate and severe cerebral artery stenosises were higher in elderly group than in nonelderly group [224 locations (52.1%) vs. 51 locations (40.8%), P＜0. 05]. The number of patients with previous history of cerebrovascular disease was much more and the prognosis was much worse in elderly group than in non-elderly group (both P＜0.05), Conclusions The elderly patients with cerebral infarction have severer cerebral artery stenosis, increased proportion of multivessel disease and poor prognosis. So it is very important to take aggressive treatment as soon as possible, and to make secondary prevention and effective rehabilitation so as to improve their prognosis.

Objective To explore effective methods to improve specialized nurses' professional ability and standardize the post management. Methods Since 2015, Hu'nan Children's Hospital has adopted the the three-level (including the national, provincial and hospital level) specialized nurses training and management program to cultivate the hospital-level specialized nurses in neonatology, intensive care, infection and other departments. The training program was carried out in three-level, including the whole hospital, big departments and their own department (small departments). The assessment of the program also covered three parts, including the specialized theoretical knowledge, technical and academic competence. From 2015 to 2016, the professional academic ability and the development of professional technique were censused. The development speed with link relative method and the comparative growth on moving base of specialized nurses' academic and technical competence were calculated. At the same time transfer rate of specialized nurses was censused. Results The qualification rate of 202 hospital-level nurses reached 95.5% in 2015, and that of 244 nurses reached 96.7% in 2016. Over the past two years, the specialized nurses have been responsible for the hospital-level nursing rounds and consultation for 11 times and the department-level nursing ward rounds for 209 times. A total of 19 new technique projects have been approved by the hospital, and 7 hospital-level and above-hospital-level projects have been set up. The number of the overview published have reached 153 and that of published scientific articles beyond the hospital was 231. Conclusions The three-level (including the national, provincial and hospital level) training and post management program of specialized nurses can effectively improve the ability of specialized nurses from the children's hospitals, promote the stability of specialized nursing team, and guarantee the improvement of the quality and influence of specialized nursing.

Objective Baseline investigation was conducted on the current situation of intravenous infusion treatment in a Class Ⅲ Grade A children's hospital in Hu'nan Province, and the quality improvement was carried out according to the investigation results, and explored the quality improvement effect. Methods The baseline investigation on intravenous infusion treatment was conducted in a Class Ⅲ Grade A children's hospital in Hu'nan Province in September 2016. A total of 558 children from 18 clinical departments were selected as research subjects by random number table method. Quality improvement was carried out according to the survey results. A total of 1 088 cases of children undergoing intravenous treatment were investigated for the second round in September 2017. The infusion site, puncture tool, catheter fixation, catheter related complications, catheter maintenance and connection mode were compared before and after quality improvement. Results The selection of infusion sites before and after quality improvement meets the requirements. The usage rate of indwelling needle increased from 88.5% to 94.4%, and the usage rate of spiral joint increased from 56.6% to 73.8%. Both the differences were statistically significant (χ2=78.38, 50.0;P＜0.05). After quality improvement, the incidence of catheter missing was decreased from 92.5% to 82.5% when nurses performed catheter maintenance, with statistical significance (χ2=30.1,P＜0.05). Conclusions By practicing standards for clinical venous treatment, strengthening training, and carrying out process quality control, the quality of work for nursing staff in the selection of infusion tools and the control of complications of indwelling catheters has been significantly improved.