This research applied the theory of customer satisfaction model in the evaluation of the clinical information system. By means of qualitative and quantitative methods, it made validity and reliability measurement on the measurement tools in use. In addition, it extracted the structure validity of the factor regulating scale via a factor analysis, and developed the scale for clinical information system measurement These efforts provided the hospitals with the useful measurement tool to improve their information system, promoting positive and practical hospital informationziation.

ObjectiveTo study the factors which affect the nurses' implementation of cardiac rehabilitation. MethodsData of 134 nurses who worked or are working in cardiology ward in No.1 and No.2 hospital of China Medical University was analyzed by using descriptive and inferential statistics.ResultsThe overall barriers is at a moderate level. The types of the barriers in order of mean score were no formal rehabilitation program, lack of knowledge, lack of facility, lack of support, and lack of understanding. Conclusions In order to improve the motivation of nurses to implement cardiac rehabilitation nursing, something must be done to improve nursing practice , nursing administration, and nursing education.

AIM: To assess the prevalence of refractive errors in middle school students in Lanzhou city and explore the risk factors for myopia.METHODS: A cross-sectional survey was conducted. A questionnaire assessed the students' socioeconomic background and visual tasks followed by visual acuity assessment and a full eye examination including slit lamp examination, fundus evaluation, retinoscopy, and subjective refraction.RESULTS: Among 2 256 enumerated students aged 15-19 years, 2 037 (90.3%) students had significant refractive errors. Myopia was the leading refractive error (1 951/2 256,86.5%), astigmatism was the second most common refractive error (921/2 256, 40.8%), but amblyopia (10/2 256, 0.4%),strabismus (5/2 256, 0.2%), hyperopia (4/2 256, 0.2%) and other treatable eye disorders were uncommon. Almost 95.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, visual tasks, and a parental history of myopia were risk factors for myopia.CONCLUSION: The prevalence of refractive errors and the risk factors for myopia in schoolchildren in Lanzhou city are similar to those reported in other regions of China.Interventions of myopia progression should be performed to protect the visual acuity of school-aged students.

AIM: To observe the efficacy of Medpor porous polyethylene implants in treatment of enophthalmos combined with orbital fracture.
METHODS: Seventeen cases ( 17 eyes ) with enophthalmos caused by orbital fracture underwent surgical treatment with Medpor porous polyethylene implants. All accepted a 6-mo follow-up and the data of enophthalmos, eyeball movement and diplopia were collected.
RESULTS: The average difference of exophthalmos between damaged eyes and undamaged eyes was (3. 4±1. 5 ) mm preoperatively, two cases had residual 1mm enophthalmos 6mo after surgery, while other 15 cases were completely corrected. Seventeen cases suffered from eyeball movement restriction and diplopia preoperatively, 16 cases had normal eyeball movement without diplopia 6mo after surgery, 1 case with limitation of abduction and horizontal diplopia. There was no extrusion, rejection, infection or other complications occurred during follow-up.
CONCLUSION: Medpor porous polyethylene implants can effectively improve the orbit volume to repair enophthalmos caused by orbital fracture.

AIM:To evaluate the efficacy and stability by comparing acuity and diopter of small incision lenticule extraction ( SMILE) , femtosecond laser in situ keratomileusis ( FS-LASIK ) and laser in situ keratomileusis ( LASIK ) in treating myopia with a follow-up of 6mo.
METHODS: A retrospective study, 42 cases ( 84 eyes ) received SMILE, 37 cases ( 74 eyes ) received FS-LASIK and 31cases (62 eyes) undergone LASIK in our hospital during Apr. 2014 to Jun. 2014 were involved. The follow-up data of 6mo was analyzed. The preoperative spherical equivalent was -5. 91±1. 83D, -5. 89±1. 96D, -5. 88±1. 68D in SMILE, FS-LASIK and LASIK group, respectively. The differences of preoperative best corrected visual acuity ( BCVA ) , pupil diameter ( PD ) and central corneal thickness ( CCT ) had no statistically significant between three groups. The postoperative uncorrected visual acuity ( UCVA) , BCVA and diopter were comparative analyzed at 1wk, 1, 3 and 6m after surgery.
RESULTS:1) No patients lost to follow-up of 1wk and 1mo. A total of 10 eyes (5 cases), 10 eyes (5 cases) and 8 eyes (4 cases) lost to follow-up of 3m in SMILE、FS-LASIK and LASIK group, respectively, and raised to 18 eyes (9 cases), 12 eyes (6 cases) and 14 eyes (7 cases) in follow-up of 6m. 2) At 1wk follow-up, the differences of UCVA between SMILE group, FS- LASIK group vs LASIK group was statistically significant respectively ( t=4. 098, P=0. 000;t=2. 493, P=0. 004). 3) In LASIK group, the differences of UCVA between 1wk vs 3, 6m follow-up was statistically significant respectively (t=3. 410, P=0. 001;t=3. 771, P=0. 000), the differences of UCVA between 1m and 6m follow-up was statistically significant (t=2. 283, P=0. 026). 4) The differences of diopter were not statistically significant among three groups at 1wk, 1, 3 and 6mo follow-up respectively (χ2=0. 119, P=0. 942;χ2=1. 504, P=0. 471;χ2=0. 949, P=0. 622; χ2=0. 277, P=0. 871). 5) the differences of eyes with UCVA≥5. 0 was statistically significant between SMILE group vs FS-LASIK group, LASIK group at 1wk follow-up (χ2=9. 249, P=0. 002<0. 05/3;χ2=12. 906, P=0. 000<0. 05/3), there was no significant statistical difference between FS-LASIK group and LASIK group (χ2=0. 500, P=0. 604). 6) there was no significant statistical difference of eyes with SE (±0. 50D) at any time post operation among three groups (χ2=0. 809, P=0. 697;χ2=1. 176, P=0. 634;χ2=0. 871, P=0. 736;χ2=0. 683, P=0. 770).CONCLUSION: All of SMILE, FS-LASIK and LASIK are effective and stable on treating myopia according to follow-up of 6mo. However, in this study, SMILE group shows more effective than FS-LASIK and LASIK at 1wk, which could enhance postoperative UCVA more rapidly.

Objective To evaluate the therapeutic effects of vitrectomy on chronic and refractory Beh et′s diseases. Methods The clinical data of 8 patients (10 eyes) with Beh et′s diseases from 0.5 to 3 years after vitrectomy were retrospectively analyzed. Pre-and post-operative visual acuity, control of inflammation after the surgery, and the recurrence were observed and analyzed. Both of the eyes were involved in all of the patients, including complete Beh et′s diseases in 5 and incomplete in 3. Results Vitreous opacity and liquefaction were found in all of the involved eyes, dark retina and thin retinal vessels were seen in most of the eyes, and vascular obstruction or sheath-like changes in different degrees were detected in some eyes. Improvement of visual acuity was observed in all of the eyes which had undergone the treatment after the operation. There was significant difference between the visual acuity before the surgery and at the 1st and 2nd week and the 1st and 6th month after the surgery. During the follow-up period, recurrence of the inflammation was found in 3 eyes within 1 month and in 6 eyes within 6 months; no recurrence was found in 4 eyes after the operation. No acute recurrence of inflammation was found after operation in the involved eyes. Conclusion Vitrectomy for chronic and refractory Beh et′s diseases may improve the visual acuity of the involved eyes, and the surgery is safe and effective.

OBJECTIVETo explore the efficacy and safety of prostatic arterial embolization (PAE) in the treatment of benign prostatic hyperplasia ( BPH) in high-risk aged males.

METHODSWe retrospectively analyzed the clinical data about 21 high-risk BPH patients aged 77-91 (mean 80) years treated by PAE.

RESULTSPAE was successfully performed in all the 21 patients, with the operation time of 90-120 min. At 2 weeks, 3 months, 6 months, and 12 months after surgery, the International Prostate Symptom Scores (IPSS) were 18.3 ± 3.1, 9.8 ± 2.7, 9.4 ± 2.5, and 10.1 ± 2.2, the quality of life scores ( QOL) were 4.6 ± 1.4, 4.3 ± 1.2, 4.6 ± 1.1, and 4.9 ± 0.6, the maximum urinary flow rates ( Qmax) were (12.5 ± 2.5), (15.8 ± 2.4), (16.6 ± 2.2), and (16.3 ± 1.8) ml/s, and the postvoid residual urine volumes (PVR) were (35.0 ± 3.4), (13.0 ± 3.3), (10.0 ± 3.0), and (8.0 ± 2.5) ml, respectively, markedly improved as compared with the baseline (IPSS: 24.5 ± 3.7, QOL: 5.7 ± 1.6, Qmax: [8.3 ± 2.1] ml/s, and PVR: [98.0 ± 11.0] ml), with statistically significant differences in IPSS, QOL, Qmax, and PVR (all P < 0.05). The maximal velocity of blood flow in the prostate was obviously decreased and the prostate volumes were (74.4 ± 4.8), (42.5 ± 4.4), (38.3 ± 4.0), and (36.7 ± 3.5) cm3 at 2 weeks, 3 months, 6 months, and 12 months, respectively, also significantly reduced in comparison with (84.3 ± 5.4) cm3 preoperatively (all P < 0.05).

CONCLUSIONPAE is a safe and effective option for the treatment of BPH in high-risk aged males.

Aged ; Aged, 80 and over ; Arteries ; Blood Flow Velocity ; Embolization, Therapeutic ; methods ; Humans ; Male ; Prostate ; blood supply ; Prostatic Hyperplasia ; therapy ; Quality of Life ; Retrospective Studies ; Treatment Outcome ; Urination

Objective To evaluate the effects of dexmedetomidine on the permeability of blood-brain barrier in rats subjected to global cerebral ischemia-reperfusion (I/R).Methods Thirty-six male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =12 each):sham operation group (group S),global cerebral I/R group (group I/R) and dexmedetomidine group (group D).Global cerebral I/R was induced by occlusion of bilateral common carotid arteries combined with hypotension (MAP was maintained at 35-45 mm Hg) in anesthetized rats.In group D,dexmedetomidine was infused at a rate of 3μg· kg-1 · h-1 until 2 h of reperfusion after a loading dose of dexmedetomidine 3 μg/kg was injected intravenously immediately after onset of I/R.The rats were sacrificed at 24 h of reperfusion and their brains were immediately removed for microscopic examination of hippocampal CA1 region and for determination of the cell apoptosis,brain water content,Evans blue content and aquaporin 4 (AQP4) expression.Results The number of apoptotic cells was significantly larger,and brain water content,Evans blue content and AQP4 expression were higher in groups I/R and D than in group S (P ＜ 0.05 or 0.01).The number of apoptotic cells was significantly smaller,and brain water content,and Evans blue content and AQP4 expression were lower in group D than in group I/R (P ＜ 0.05 or 0.01).Global cerebral I/R-induced pathological changes were significantly attenuated in group D.Conclusion Dexmedetomidine can decrease the permeability of blood-brain barrier and attenuate global cerebral I/R injury in rats,and down-regulation of AQP4 expression may be involved in the mechanism.

Objective To observe the characteristic features of musculoskeletal ultrasound (MSUS) in gouty arthritis (GA) and to assess its value in GA diagnosis.Methods Patients with GA and non-GA who underwent MSUS examination in Chinese PLA General Hospital were enrolled in this study. The synovitis,tenosynovitis,soft tissue swelling,bone erosion,bursitis and ossification were measured by greyscale ultrasound,and the synovial vascularity was measured by power Doppler ultrasound to evaluate the degree of inflammation.Results The ultrasound images of GA were intended to have specific features like tophus,hyperechoic deposition on the surface of the articular hyaline cartilage ( double contour sign ),hyperechoic deposition in the synovium appearing as bright stippled foci,and bright strap in tendons with a significant difference when compared with non-GA group (P ＜ 0.05).The percentage of tenosynovitis and bone erosion in non-GA group was higher than that in the GA group with a significant difference (P ＜0.05 ). Tophus,double contour sign,bright stippled foci or bright stippled foci in tendons together suggested gout with a specificity of 92.4％ and a sensitivity of 60.3％,the AUC of ROC was 0.764 ( P ＜0.05).Conclusion Tophus,double contour sign,bright foci and bright strap detected by MSUS are of diagnostic value on GA and MSUS may be a promising tool in diagnosing GA.

Objective To evaluate the influence of preoperative MRI on tumor-positive rate of resection margins in breast cancer patients eligible for breast-conserving surgery.Methods Study group consisted of 64 consecutive patients with breast cancer eligible for breast-conserving surgery,while 73 cases as history control group.For the two groups,a first plan for breast-conserving surgery was made on the basis of conventional imaging and clinical evaluation.Study group underwent preoperative breast MRI and re-evalu-ated before final surgical plan was made.Rates of tumor-positive resection margins were compared between the 2 groups.Surgical plan alteration was recorded in the study group.Results Study group had lower rate of tumor-positive resection margin compared with control group (9.6% vs 24.7%,P =0.04).Furthermore,18.8% of study group altered the finial surgical plan to mastectomy after breast MRI.Conclusion Preoperative breast MRI can more acurately evaluate the extent of breast cancer,therefore decrease rate of tumor-positive resection margin in breast cancer patients eligible for breast-conserving surgery.