Objective To explore the effect of improving nursing evaluation system on the quality of life in patients with stage Ⅲ and Ⅳ stage non small cell lung cancer (NSCLC).Methods From January 2011 to December 2014,100 patients with NSCLC were randomly divided into observation group and control group , 5 0 cases in each group.The observation group was treated with 1 month as a treatment course.The control group was treated with rou-tine treatment and nursing.Before treatment and 2 months after treatment,serum tumor markers (CEA,CYFRA21 -1,NSE,CA125) were detected,the clinical symptom score,quality of life (KPS score) and body weight were recor-ded.Results (1)The total effective rates of the observation group and the control group were 88% and 90% respec-tively,the difference was not statistically significant (χ2 =0.381,P >0.05);(2)There were no significant differences in the clinical symptoms between the two groups (t =0.382,1.521,all P >0.05) before and after intervention.After intervention,the clinical symptoms of the two groups were lower than before intervention,the difference was statistical-ly significant (t =6.493,4.398,all P <0.05);Before intervention,there was no significant difference in KPS score and body weight between the two groups (t =1.483,2.480,all P >0.05);After 6 months of intervention,the KPS score and body weight of the observation group were significantly higher than those in the control group,the differences were statistically significant (t =5.493,4.326,all P <0.05);(3)In the observation group and the control group,the median PFS was 5.93 months (1.67,12.87),6.21 months (1.55,14.12);the median OS was 16.24 months (3.87,26.49) and 17.09 months (4.02,29.33),the differences were not statistically significant between the two groups(t =0.942,1.843,all P >0.05);(4) Before the intervention,there were no significant differences in serum tumor markers (t =0.483,1.264,1.762,1.264,1.795,1.678,1.253,1.469,all P >0.05);After intervention,ser-um markers in the two groups were significantly lower than before intervention,the differences were statistically signifi-cant (t =6.393,3.490,4.728,7.943,4.883,5.478,7.684,11.383,all P <0.05);After intervention,there was no significant difference between the two groups (t =1.456,1.548,1.559,1.259,1.895,0.639,0.248,1.127,all P >0.05).Conclusion For patients with stage III,IV NSCLC,improving nursing evaluation and implementation system has no significant difference in reduce the level of tumor markers and long -term survival compared with the control group,and improve the nursing evaluation and implementation system has certain advantages in maintaining the quality of life of patients.

Objective To evaluate the clinical effect of treating chloasma with acupuncture and bloodletting therapy.Methods 176 cases with chloasma were recruited into two groups randomly. Acupuncture and bloodletting therapy was adopted in the treatment group (90 cases), and exclusive acupuncture was applied in the control group (86 cases). Results The effective rate was 96.7% in the treatment group and 51.2% in the control group. There was a significant statistical difference between two groups (P＜0.05). Conclusion The treatment of acupuncture and bloodletting therapy has a definite therapeutic effect on chloasma, being worthy of spread.

Objective To develop the severity score of pediatric hand foot and mouth disease (HFMD),guide health care providers in the early detection and intervention of critical ill cases,in order to improve the survival rate and reduce the incidence of complications and mortality.Methods Based on PCIS,the severity score of HFMD in children was designed by adding fever and nervous system damage symptoms,which was the common symptoms of severe cases.The data of the cases who admitted in April 2008 to November 2010 (group A,88 cases) was retrospectively analyzed to evaluate the validity and credibility of the score.The score were prospectively applied to all of the HFMD cases who admitted from May 2011 to October 2013(group B,118 cases),delivering corresponding treatment and care measures based on scoring result as well.At last the outcome of the two groups was compared.Results It exhibited quite good consistency between the scores and the clinical condition of patients with HFMD.The general information of two groups was not significantly different,but the survival rate,the incidence of neurological sequel and the mortality between two groups were significantly different by x2 test.Conclusions The score can objectively and accurately assess the severity of HFMD in children.Clinical application of this scoring method to assess the children with HFMD can identify critical ill cases as early as possible.Corresponding intervention delivering in time may improve the outcome.It is proved to have positive clinical value to increase the survival rate,decrease the incidence of neurological sequel and the mortality of critical ill HFMD cases,and is worthy of clinical application in pediatric department.

Objective: To challenge the previously proposed anticancer mechanism of nitidine chloride, which suggest there exist anti tumor C(6)=N(5) double bond structure. Methods: An antitumor alkaloid, nitidine chloride, was treated in aqueous sodium hydroxide solution without the presence of certain kinds of amino acids and oxygen. Results and Conclusion: It had been revealed that virtually equal amount of 5, 6 dihydronitidine and oxynitidine was produced under such circumstances. The results suggest the anticancer mechanism of nitidine chloride need further investigation. [

Objective To explore how the different intervention measures affect the outcome of central venous catheter-related thrombosis (CRT) in children. Methods A retrospective analysis was carried out to collect the clinical data of patients with CRT from the nursing management system of the Children′s Hospital Affiliated to Zhejiang University School of Medicine which reported by each nursing unit from January 1,2015 to December 31,2015. Results Totally 108 cases were included (72 boys and 36 girls), median age of 24.5 months (ranged from 1 month to 14 years old). Nearly 42.59% (46/108) patients suffered from neurological diseases. Nearly 55.56%(60/108) CRT was detected in the first week after catheterization. Once CRT conformed, there were four kinds clinical intervention options applied. Intervention 1: thrombolytic therapy with urokinase combined anticoagulation with nadroparin calcium. Intervention 2: anticoagulant therapy only. Intervention 3: thrombolytic therapy alone. Intervention 4: no medications. The differences of effective between the four kinds of intervention were statistically significant (χ2=13.380, P=0.004). The single-factor regression analysis was done to each relevant factor. Finally the multivariate regression analysis showed four factors had impacts upon the results. The factors were as follows:gender (OR=10.400, 95%CI 1.879-57.563, P=0.007);interval (OR=1.107, 95%CI 1.035-1.184, P = 0.003), size of thrombus(OR = 1.562,95%CI 1.033-2.362,P=0.035; Intervention 2 (OR =11.757, 95% CI 2.254- 61.327, P = 0.003), intervention 4 (OR = 35.397, 95% CI 3.493-358.760, P =0.003). Conclusions The earlier and small size thrombus is more soluble. Thrombolytic therapy or combined anticoagulation is more effective. It is recommended that if no contraindications presents, thrombolytic combined with anticoagulant therapy should start early standardized treatment.

Objective To investgute the effect of lO-Hydrocamptothecin (HCPT) on collagen induced arthritis (CIA) rats, and to explore the potential value of it in the treatment of Rheumatoid arthritis(RA). Methods After the model of CIA was established ,the rats were randomly divided into five groups: control group, CIA model group, MTX treatment group, high dose HCPT treatment group and low dose HCPT treatment group. The synovium was examined with regular HE stain and the apoptosis of synoviocytes was detected with TUNEL All these pathological changes were evaluated. In addition, the change of articular volume was measured,and the serum TNF-α and IL-1β level was also measured at different time point. The results were analyzed by the statistical software SPSS 11.5. Results Comparing to CIA model group, both MTX and HCPT group could improve patients' general condition, alleviate joint swelling, inhibit proliferation of synoviocytes, induce apoptosis of synoviocyte and decrease the plasma level of TNF-α, IL-1β (P<0.05), however, there was no significant difference could be found between the MTX and HCPT group (P>0.05). Conclusion HCPT has the potential value in the treatment of RA.

Objective To study the structures of the plasmids of Klebsiella pneumoniae KF3 at the genome metagenome level througth with whole plasmid DNA sequencing, to analyze the functional genes carried by plasmid and to identify the correlation of resistance and pathogenicity between the plasmids and the host strains. Methods The alkaline lysis method was used to extract plasmids. We constructed the small insert pUC18 library and the large insert Forsmid library, sequenced and used the Phred / Phrap / Consed package to assemble these sequences and gained a complete sequence. The open reading frame(ORFs) were predicted by the Glimmer software and annotated, analyzed the functions of these genes. Results We successfully constructed the pUC18 library and the Fosmid libraries for the plasmid DNA and obtained three circular double-stranded DNA plasmids: pKF3-70 (69 477 bp), pKF3-90 (91 327 bp) and pKF3-147 ( 147 416 bp). There were drug resistant genes, conjugative transfer genes and mobile DNA elements identified on three plasmids. Conclusion The three plasmids of KF3 could be transferred among different strains. It would lead to the dissemination of the resistant genes.

Objective To investigate the association between the minisatellite polymorphism in the first exon of PLA2G4C gene and schizophrenia, and to reveal the important role of DNA sequence polymorphism in the pathogenesis of schizophrenia.Methods The minisatellite polymorphisms in the first exon of PLA2G4C gene in 91 patients with schizophrenia (case group)and 81 healthy persons (control group)were detected with PCR-sequencing analysis.The chi-square (χ2 )goodness-of-fit test was used to analyze the distribution of the PLA2G4C minisatellite polymorphism in various groups and to explore the association between the minisatellite polymorphism in the first exon of PLA2G4C gene and schizophrenia. Results There were minisatellite polymorphisms in PLA2G4C gene.Three kinds of polymorphisms 1×27 bp,2×27 bp and 3×27 bp were found by sequencing.The distribution of allelic frequencies at PLA2G4C polymorphism showed no statistical significance between case group and control group (P>0.05 ). No statistically significant difference was found in 3-homozygous haplotypes in PLA2G4C gene between case group and control group (P>0.05).At the same time,there was no statistically significant difference between 3-heterozygous haplotypes in PLA2G4C gene between case group and control group (P>0.05).Conclusion The minisatellite polymorphisms in the first exon of PLA2G4C gene are found,but the minisatellite polymorphism in the first exon of PLA2G4C gene may be not associated with the occurrence of schizophrenia.

Objective To summarize the surgery nursing cooperation points of liver procurement of brain death contributions (DBD) donor in the uninterrupted blood flow way . Methods Complete the following preoperativepreparation such as personnel,brain death donation donor,environment ,surgical content,multiple organ repair system and other related equipments;intraoperative preparation includes surgical instruments and related equipments ,assisting intubation of arteria lienalis ,portal vein and the choledochus and the organ procurement . Result About 3 cases of donor liver procurement were successfully implemented in the interrupt blood flow way, operation time was 3~4 h,bleeding was 200~400 mL,an average of 300 mL. Conclusions Uninterrupted flow liver transplantation can protect liver function to the greatest extent , thus greatly avoids the common complication of organ transplantation.The tacit understanding surgery cooperation improves the rate of surgery successfully.

Objective:To construct the evaluation index system of the core competence of neonatal specialist nurses, so as to provide reference for clinical training of neonatal specialist nurses.Methods:From January 2020, through literature review, theoretical analysis, interview, Delphi method and superiority chart, the evaluation index and weight of core competence of neonatal specialist nurses were determined.Results:Totally 28 experts in China were invited for 3 rounds of consultation. The effective recovery rate of the questionnaires was 93.33%(28/30) in the first round. The effective recovery rate of the questionnaires was 100.00%(28/28) in the second and third rounds. The authority coefficient of the experts was 0.85 in the third round. The Kendall′s coefficients of concordance of the first-level indexes, second-level indexes and third-level indexes were 0.150, 0.221 and 0.161, respectively. The final evaluation index system of the core competence of neonatal specialist nurses included 5 first-level indicators, 17 second-level indicators and 58 third-level indicators.Conclusions:The evaluation index system of the core competence of neonatal specialist nurses constructed in this study has certain scientific, reliable and clinical application value, which is conducive to the training of newborn specialized nurses in China.