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

The rutile structure titanium oxide (Ti-O) film was prepared on the pure titanium material TA2 (99.999%) surface by the magnetic filter high vacuum arc deposition sputtering source. The method can not only maintain the material mechanical properties, but also improve the surface properties for better biocompatibility to accommodate the physiological environment. The preparation process of the Ti-O film was as follows. Firstly, argon ions sputtered to the TA2 substrate surface to remove the excess impurities. Secondly, a metal ion source generated Ti ions and oxygen ions by the RF discharge. Meanwhile a certain negative bias was imposed on the sample. There a certain composition of Ti-O film was obtained under a certain pressure of oxygen in the vacuum chamber. Finally, X-ray diffraction was used to research the structure and composition of the film. The results showed that the Ti-O film of the rutile crystal structure was formed under the 0.18 Pa oxygen partial pressure. A Nano scratch experiment was used to test the coating adhesion property, which demonstrated that the film was stable and durable. The contact angle experiment and the platelet clotting experiment proved that the modified surface method had improved platelet adhesion performance, and, therefore, the material possessed better biocompatibility. On the whole, the evaluations proved the modified material had excellent performance.
Heart Valves ; Heart, Artificial ; Ions ; Materials Testing ; Oxygen ; Surface Properties ; Titanium ; X-Ray Diffraction

Objective To investigate the clinical effect of fissure for ligamentum teres hepatic (LTH) approach in hepatectomy.Methods The method of cross-sectional study was adopted.The clinical data of the 85 patients undergoing hepatectomy through fissure for LTH approach who were admitted to the West China Hospital of Sichuan University from February 2009 to December 2013 were collected.Among all the 85 cases, there were 61 of hepatocellular carcinoma, 12 of intrahepatic bile duct stones, 6 of bile duct cellular carcinoma and 6 of metastatic hepatic carcinoma.The operations involved dissecting fissure for LTH, dealing with portal vein, hepatic artery and bile duct inside the fissure, lowering the hepatic portal, mutilating hepatic parenchyma, and undergoing the hepatic left lateral lobectomy, left hemihepatectomy, mesohepatectomy, hepatic left and/or right trisegmentectomy.Operation method, operation time, volume of intraoperative blood loss, intraoperative blood transfusion, postoperative drainage-tube removal time and complications were recorded.The follow-up including recurrence and metastasis of tumor and survival of patients was conducted by outpatient examination and telephone interview up to August 2015.Measurement data with normal distribution were presented as (x) ± s.Measurement data with skewed distribution were presented as M (range).The survival rate was caculated by Kaplan-Meier method.Results The 85 cases of hepatectomy were successfully completed through fissure for LTH approach, including 19 cases of hepatic left lateral lobectomy (9 with hepatocellular carcinoma, 6 with intrahepatic bile duct stones, 1 with bile duct cellular carcinoma, 3 with metastatic hepatic carcinoma), 20 cases of left hemihepatectomy (8 with hepatocellular carcinoma, 5 with intrahepatic bile duet stones, 4 with bile duct cellular carcinoma, 3 with metastatic hepatic carcinoma), 5 cases of left hemihepatectomy + caudate lobectomy (3 with hepatocellular carcinoma, 1 with intrahepatic bile duct stones, 1 with bile duct cellular carcinoma), 14 cases of meso-hepatectomy (14 with hepatocellular carcinoma) and 27 cases of hepatic left and/or right trisegmentectomy due to hepatocellular carcinoma (15 of hepatic left trisegmentectomy and 12 of hepatic right trisegmentectomy).No perioperative death occurred.The median operation time was 280 minutes (range, 95-430 minutes).The median volume of intraoperative blood loss was 450 mL (range, 200-3 200 mL).There were 18 cases of intraoperative blood infusion.The postoperative peritoneal drainage-tube removal time was 3 days (range, 2-5 days).Eleven patients with postoperative complications recovered after symptomatic conservative treatment, including 6 with lung infection, 4 with peritoneal effusion and 1 with abdominal infection.There was no case of intra-abdominal bleeding, bile leakage or hepatic failure.No patient died within 1 month after operation.Seventy-nine patients were followed up for a median time of 38 months (range, 18-53 months) with a follow-up rate of 92.9％ (79/85).The 1-year overall survival rate and l-year disease-free survival rate were 79.0％ and 65.0％, and the 3-year overall survival rate and 3-year disease-free survival rate were 56.0％ and 34.0％, respectively.Conclusion Hepatectomy through fissure for LTH approach is safe, effective and easily operable, with a good short-term outcome.

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 explore the influence of various concentrations of amino acid on the stability of neonatal parenteral nutrition solutions .Methods Five formulations were designed with 5 different amino acid concentrations containing the same components .The final amino acid concentrations of admixtures were 0%, 1%, 2%, 3%, and 3.5%, respectively .The appearance , pH, and osmolality were observed or meas-ured after preparation (0 hour) and at 12, 24, 48 and 72 hours after preparation.The average size and the size distribution of the lipid globules were also evaluated by laser nanometer particle size analyzer .Results There was no observable alteration in color , phase separation , precipitate , and flocculation in any admixture at any of the observation time points.The mean pH values for all groups were between (5.49 ±0.01) to (6.19 ±0.01) within 72 hours.The mean osmolalities for all groups were between (774 ±3) to (1106 ±13) mOsm/kg.The mean diameters of lipid globules for all groups were between (280.6 ±0.7 ) mm to (332.2 ±2.0 ) nm.The mean polydispersity for all groups were between (0.200 ±0.011) to (0.245 ±0.012).The enrichment of ami-no acid concentration was linked to lower pH ( P=0.000 ) , higher osmolality ( P=0.000 ) and larger average lipid globules size ( P=0.000 ) .However , there was no distinct linear dependence between amino acid concen -tration and polydispersity value ( P=0.628 ) .Conclusion After 72 hours of storage at room temperature , the appearance, pH, osmolality, and the average lipid globules diameter of the parenteral nutrition solutions are within the safe range when the amino acid is not contained or the concentrations are no more than 3.5%.

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.

ive] To observe the therapeutic effect of Naoxing Granule (NG) for acute ischemic stroke (AIS) and to explore its mechanism. [Methods] Single-blind controlled trial was applied. Two hundred cases of AIS were randomly allocated to Group A (n = 150, treated with NG) and Group B (n = 50, treated with nimodipine). Therapeutic effect of NG was observed and plasma free radical levels and the ratio of thromboxane A2 (TXA2) and prostaglandin 2 (PGI2) were detected. [Results] The total effective rate was 91.3%and 76.0% , and the remarkably effective rate was 62.0% and 46.0% in Group A and Group B respectively ( P