Objective This paper investigated and analyzed medical service of clinical pathway which carries out during five tertiary hospitals from August 2010 to August 2011 in order to understand the weight of high quality nursing care in the clinical pathway and satisfaction for hospitalized patients.Methods 959 hospitalized patients were investigated by way of questionnaire survey,561 in CP wards and 398 in non-CP wards.Some influential data were statistically analyzed using SPSS17.0 statistical software.Results High quality nursing care in clinical pathway possessed a higher proportion of the actual weight.It had positive func-tion for improvement of the satisfaction degree of hospitalized patients.Conclusions It is an impor-tant way for continuous improvement of medical service by carrying out the clinical pathway combined with high quality nursing demonstration project.

Objeract:To evaluate the effects of controlled release tinidazole(TNZ) membrane in the treatment of adult periodontitis. Methods:Adult periodontitis was treated with TNZ membrane in 15 cases (25 teeth),with Metronidazole(MNZ) in 15 cases (24 teeth) and with vehicle membrane in 15 cases (25 teeth).The effects were evaluated by clinical observation,biochemical examination and becteria test. Results: TNZ membrane more significantly inhibited bacteria (P

Objective To investigate the variation of interleukin-6 ( IL-6 ) , vascular endothelial growth factor(VEGF),E-selectin and intercellular adhesion molecule-1(ICAM-1)in children with sepsis and the clinical significance. Methods This was a prospective and control study. Thirty-two children diagnosed as sepsis in PICU from December 2008 to December 2009 served as the sepsis group. According to whether there was a shock, sepsis group were divided into shock subgroup and no shock subgroup. Fifteen healthy children served as control group. The serum levels of IL-6,VEGF,E-selectin and ICAM-1 were detected with enzyme linked immunosorbent assay. Results The serum level of IL-6 was 65. 00(30. 49~237. 14) ng/L in shock subgroup and 48. 68(30. 25~75. 00) ng/L in no shock subgroup,which were significantly higher than that in control group[0. 80(0. 60 ~1. 00) ng/L](P<0. 05). There was no significant difference between shock subgroup and no shock subgroup. The serum levels of VEGF and E-selectin showed no significant differences among the three groups. The serum level of ICAM-1 was 998. 72(666. 93~1 526. 44) ng/ml in shock subgroup,and 925. 71(683. 53~1 225. 12) ng/ml in no shok subgroup,which were significantly high-er than that in control group[660. 59(525. 48~685. 47) ng/ml]. Compared with those who survived in sep-sis group,the serum levels of VEGF and E-selectin in the died children with sepsis showed no significant difference,but IL-6 and ICAM-1 significantly increased(P<0. 05). Conclusion IL-6 and ICAM-1 increase greatly and accentuate inflammation in septic patients,the changes of which may help to determine the prog-nosis of sepsis.

Objective To study the risk factors for children with acute central nervous system(CNS)viral in-fection,so that pediatrician may identify children with poor prognosis at early stages of the disease,and provide them with a theoretical basis for clinical treatment. Methods The clinical data of a cohort patients of acute CNS viral infec-tion who were hospitalized at the First Affiliated Hospital of Fujian Medical University between January 2010 and June 2013 were retrospectively collected and analyzed. According to Glasgow outcome scale on discharge,children were di-vided into good prognosis group and poor prognosis group. Clinical data and outcomes were analyzed by using univariate analysis and binary Logistic regression multivariate analysis. Results Three hundred and one cases were enrolled,278 (92. 36% )patients were assigned to the good prognosis group,and 23(7. 64% )patients were assigned to the poor prognosis group. By univariate analysis,the patients in the poor prognosis group had longer duration of sickness before admission,longer time of fever,lower white blood cell count in cerebrospinal fluid,a relatively lower calcium level,con-scious disturbance at the early stage,multiple seizures,convulsive status epilepticus,meningeal irritation sign,muscle weakness,severe changes in electroencephalogram(EEG),and abnormal neuroimaging findings(computed tomography or magnetic resonance imaging,or both)had significant differences between the good prognosis group and the poor short - term outcome groups(all P < 0. 05). By binary Logistic regression multivariate analysis,factors indicating a poor prognosis during the early stage were conscious disturbance at the early stage(0R = 4. 885,95% CI:1. 523 - 15. 670, P = 0. 008),multiple seizures(0R = 6. 352,95% CI:1. 905 - 21. 178,P = 0. 003),severe changes in EEG( 0R =4. 269,95% CI:1. 708 - 10. 666,P = 0. 002),and abnormal neuroimaging findings( 0R = 9. 740,95% CI:2. 360 -40. 192,P = 0. 002). Conclusions Conscious disturbance at the early stage,multiple seizures,severe changes in EEG and abnormal neuroimaging findings are risk factors for acute viral infection of CNS in children.

Objective Investigate the clinical efficacy of treating retreated smear-positive tuberculosis patients with conventional anti-tuberculosis chemotherapy combined with levofloxacin. Methods Divide 60 retreated smear-positive tuberculosis patients registered in our hospital between October 2012 and October 2014 into two groups using random number table method: levofloxacin group and conventional treatment group. Each group contains 30 patients that were treated for 9 months , and the efficacy the both treatment methods were compared. Results The sputum conversion rate in the levofloxacin group is 93.33% and 96.67% after treating for 6 months and 9 months , respectively; which are substantial higher than that of the conventional treatment group with sputum conversion rate of 70% and 73.33% after 6 months and 9 months of treatment , respectively (P < 0.05). The absorption rate of the levofloxacin group is significantly higher than that of the conventional treatment group (P < 0.05). The cavity improvement rate of the levofloxacin group is 73.33%, which is significantly higher than that of the conventional treatment group (33.33%) (P < 0.05). The clinical efficacy of the LVFX group is substantially higher than the routine treatment group (P < 0.05). The overall effectiveness of LVFX group reached 100% , which is significantly higher than that of the conventional treatment group (86.67%) (P < 0.05). Conclusions Levofloxacin combined with conventional anti-tuberculosis chemotherapy can effectively improve the clinical efficacy in the treatment of tuberculosis.

Objective To investigate the value of theory-practice integrated in the course of medical imaging diagnosis. Methods The teaching method of bone and joint system was adjusted based on theory-practice integration. 212 students of department of medical imaging were divided into group A (95 students, Grade 2009) and group B (117 students, Grade 2010). The traditional teaching method was adopted in group A, and the theory-practice integrated teaching method was adopted in group B. The teaching effect was evaluated by the exam results(theory and experimentation) and ques-tionnaire. SPSS 13.0 software was used and the measurement date were expressed by x±s. Statistical analysis was performed using t test, with the level of test α=0.05. Results The results of theoretical exam (P=0.024),practical exam (P=0.017) and questionnaire of group B was higher than group A (P=0.00). Conclusions LBL、CBL、TBL integrated teaching method is better than traditional teaching method, especially in improving the students' ability of linking up theory with practice, learning initia-tive, teamwork.

Objectives To study the psychological characteristics of children with attention deifcit hyperactivity disorder (ADHD). Methods Human ifgure drawings (HFD) as a projective technique was performed in 107 children with ADHD aged (8.69 ±1.48) years old (6.5~11.5 years), and 107 matched healthy children. Characteristic features of the HFDs in children with ADHD, and correlations between emotional indicators of the HFDs and factors of child behavior checklist (CBCL) were assessed and com-pared with the control group. Results Signiifcant differences in emotional index were found between ADHD and healthy chil-dren, including bad body composition, short arms, long arms, big ifgure, omission of hands and omission of feet (P<0.05). Nega-tive correlation was found between the HFDs emotional index and the factors of activity and social ability in the CBCL (P<0.05), but a positive correlation was found between the HFDs emotional index and behavioral problem (P<0.05). Conclusion Human ifgure drawings can relfect some emotional characteristics of children with ADHD, and when combined with CBCL, it can pro-vide evidence for diagnosis and intervention for ADHD.

Objective To observe the influence of recombinant human brain natriuretic peptide(rhBNP)treatment on serum C-reactive protein(CRP)level in patients with congestive heart failure.Methods Forty patients with congestive heart failure(NYHA class Ⅳ)were divided into experimental group(n=20)receiving rhBNP and control group(n=20)receiving isosorbide dinitrate.Blood pressure and central venous pressure were observed and hypersensitive CRP was checked before and one week after treatment in both groups.Results No obvious change of blood pressure at each time point was found after BNP treatment(systolic blood pressure:P=0.804;diastolic blood pressure:P=0.492)while significant decrease of CVP was noted(P=0.016).Serum CRP level was significantly decreased one week after BNP treatment(10.1?7.4 mg/L vs 7.7?5.0 mg/L;P=0.013)in experimental group,obviously different from that in the control group(P=0.044).hsCRP change was positively related to CVP change(Pearson correlation:0.469,P=0.043).Conclusion Brain natriuretic peptide effectively decreases serum C-reactive protein level in the patients with congestive heart failure,indicating its possible role in relieving inflammation in heart failure.

AIM:To construct eukaryotic expression vector expressing double shRNA sections targeting Survivin gene.METHODS: Eukaryotic expression vector expressing double shRNA sections targeting Survivin gene were designed and chemically synthesized.They were directionally inserted into plasmid pGenesil-1 with respectively U6 promoter and termination code,the common green fluorescence protein(EGFP) gene and Neo gene. In this way,the vector of pGenesil-1 shRNA containing 2 sections of Survivin shRNA were constructed and they were transfected into the pancreatic cancer cell Bx-PC3.Transfection was detected by fluorescence microscope.The inhibition expression of Survivin mRNA was measured by RT-PCR.RESULTS: HE1 and HE2 plasmids were identified by the biocatalyst cut which confirmed the exactitude and were analyzed by the sequence analysis which verified the perfect clone plasmid inserted by them.CONCLUSION: A eukaryotic expression vector of double short hairpin RNA for Survivin gene is successfully constructed.The pancreatic cancer cells Bx-PC3 succeed to be transfected and expression of Survivin mRNA is inhibited obviously.

Objective To investigate nontraumatic avascular necrotic of the femoral head with different etiology whether or not having similar MRI and pathologic findings.Methods MRI features of nontraumatic avascular necrosis of the femoral head caused by differant etiology in 98 patients(152 hips) were retrospectively analysed.The causes of osteonecrosis of the femoral head included steroid-induced in 49 patients(86 hips),alcoholic in 18 patients(25 hips) and idiopathic cause in 31 patients(41hips).Gross section and pathologic examinations were performed on 34 femoral heads obtained after total hip replacement from 25 patients.Results Osteonecrosis of the femoral head with different etiology occurred at the anterior superior part of femoral head.The necrotic zones both on pathological gross section and MRI were consisted of cartilage,necrotic focus,proliferative zone and normal bony zones along the lesions.The proliferative zone surrounded necrotic area was low signal intensity on both T1WI and T2WI.There was correlations between localized MRI signal behavior and specific histopathologic features of femoral head osteonecrosis.Conclusion Nontraumatic osteonecrosis of the femoral heads associated with different etiology have similar characteristics on both MRI and pathology