Objective To explore the effect of acupuncture-rehabilitation therapy on neurological function and expression of Flt-1 and Flk-1, members of vascular endothelial growth factor receptors, after permanent focal cerebral ischemia in rats. Methods Ninety male Sprague-Dawley rats were divided into five groups, namely sham group, model group, acupuncture group, rehabilitation group and acupunc-ture-rehabilitation group, and each group was further divided into 3-day, 7-day and 14-day subgroups, equally. Their middle cerebral arteries were occluded except those of sham group. The sham and model groups accepted no treatment, while the acupuncture group accepted clus-ter needling of scalp acupuncture, the rehabilitation group accepted treadmill training, and the acupuncture-rehabilitation group accepted both acupuncture and treadmill training. They were assessed with modified Neurologic Severity Score (mNSS) 3, 7 and 14 days after model-ing, while the expression of Flt-1 and Flk-1 were determined with Western blotting. Results The mNSS score reduced in all the treatment groups (P<0.05) compared with that of the model group at every time point, and was the least in the acupuncture-rehabilitation group (P<0.05) 7 and 14 days after modeling among the treatment groups. Meanwhile, the expression of Flt-1 and Flk-1 protein increased in all the treatment groups (P<0.05), and was the most in the acupuncture-rehabilitation group (P<0.05). Conclusion Acupuncture-rehabilitation thera-py can promote the neurological function recovery in rat with permanent focal cerebral ischemia, which may be associated with the continu-ous inducement of Flt-1, Flk-1 protein expression in ischemic penumbra cortex.

Objective To explore the effect of timing for removing the catheter on prognosis in elderly patients with catheter-related bloodstream infection(CRBSI)and on the death-relevant risk factors.Methods 166 elderly patients with vein detaining catheter and a suspected CRBSI in General Hospital of Tianjin Medical University from 2010 to 2015 were retrospectively analyzed.The patients were divided into a group(n=80)of removing the catheter immediately and a group(n=86)of temporarily not removing the catheter.Mortality rate within 30 days was compared between two groups and mortality-related factors were analyzed.Results In patients with CRBSI,pathogen culture results showed that the detection rate of gram-positive bacteria(G+)was 40.4％ (n=67),the rate of gram-negative bacteria(G)was 40.4％(n=67),and the rate of fungi infection were 19.3％ (n =32).The mortality rate within 30 days was 17.5 ％ in group of removing the catheter immediately,and 31.4％ in group of temporarily not removing catheter.The incidence rate of CRBSI in elder patients was also lower in group of removing the catheter immediately versus not immediately(x2 =4.303,P =0.038).Multiple Logistic regression analysis showed that tumor and diabetes were independent risk factors for death in elder patients with CRBSI (OR =2.805,2.502;P =0.017,0.019).Tumor was a relative risk factor for patients who died after removal of catheter immediately (x2=4.033,P =0.045).Conclusions Removing the vein detaining catheter immediately is an urgent need when the suspected CRBSI symptoms such as chill and hyperpyrexia appear in elderly patients with vein detaining catheter.Nephrotic syndrome,hypoalbuminemia,tumor,diabetes and antibiotic usage＞7 days are risk factors for mortality in CRBSI patients.

cases of aphasics were tested by using Test Scale of Boston Diagnostic Aphasia Exami-nation- Chinese Version. The result shows.This scale has a good role in diagnosing various aphasia syn-drome and can be used to observe the changes of various language functions.

Objective To study the influence of continuous blood purification(CBP) on cardiac out-put of pediatric patients using bioreactance. Methods Patients underwent CBP in PICU and nephrology ward from March 2014 were prospectively enrolled after approval by ethics committee. CBP therapies were all performed by Fresenius Medical Care hemodialysis machine. Cardiac output values were obtained using the non-invasive cardiac output monitoring ( NICOM) device ( Cheetah Medical). Blood pressure, heart rate, cardiac index(CI) and stroke volume index(SVI) were recorded before the therapy,at the beginning of ther-apy,during the course of therapy,and at the end of each therapy. Results Twenty-one pediatric patients (from 1. 0 year to 15. 5 years) were recruited and 69 treatments were recorded from March 2014 to Decem-ber 2016. The basic CI was 3. 4 (2. 4,6. 1) L/(min·m2),basic SVI was 43 (26,75) ml/(m2·beat). Dur-ing the beginning of therapy,mean arterial pressure(MAP),CI and SVI all dropped from the baseline ( P<0. 001),whereas heart rate increased. During the course of CBP,CI and SVI (were both recorded every 4 hours) kept on dropping and stayed at a relatively lower level. Course CI was 3. 0 (2. 4,4. 6) L/(min·m2) and course SVI was 28 (21,57) ml/(m2·beat). At the end of therapy,CI was 3. 4 (2. 5,5. 3) L/(min· m2),with no significant difference from the baseline CI (P＝0. 073). However,the SVI at the end of therapy was 35 (25,67) ml/(m2·beat),higher than the course SVI but still lower than the basic SVI,the differences were statistically significant ( P<0. 05). Conclusion CI and SVI continue to decline at the beginning of CBP treatment and remain at a lower level throughout the course of treatment. After the therapy, CI has returned to the basic level whereas SVI has not recovered.

Objective To investigate the transitional care needs of ischemic stroke patients when they were discharged and analyze the influencing factors.Methods Transitional care needs of stroke patients questionnaires were conducted in 136 ischemic stroke patients in the department of neurology from April 2014 to December 2014.Results Telephone follow-up was the easiest way of transitional care to be accepted by patients. The transitional care needs included five aspects:safe medication(86.0%),blood pressure self monitoring(83.1%),diet guiding(83.1%),rehabilitating exercise(80.1%) and stroke knowledge(75.7%). The influencing factors of transitional care needs were:the patients with previous medical history demanded much more on the safe medication intervention than the patients without history disease. The demand of the patients with previous medical history was 7.17 times as much as that of the patients without previous medical history (OR=7.15,95%CI:1.83-27.94).The demand of the patients with previous medical history on "rehabilitation exercise" was 4.68 times as much as that of the patients without previous medical history (OR=4.68,95%CI:1.40-15.63). The demand of the patients over 60 years old on "diet guiding" was 11.41 times as much as patients under 50 years old (OR=11.41,95%CI:1.75-74.46).Conclusions For ischemic stroke patients,telephone follow-up can be used as the method of transitional care. Older patients and patients with previous medical history are the main patients who need transitional care.

Objective:To explore the effect of solution-focused model psychological intervention on disability acceptance of ischemic stroke patients.Methods:From May to July 2020, 200 patients with ischemic stroke who were admitted to the Neurology Department of the Second Hospital of Hebei Medical University were selected as the study subject by convenience sampling. The patients were randomly divided into the control group and the observation group by the envelope method, with 100 cases in each group. The control group was given routine nursing, while the observation group received solution-focused model psychological intervention on the basis of routine nursing. The Acceptance of Disability Scale (ADS) and Stroke Specific Quality of Life Scale (SS-QOL) were used to compare the disability acceptance and quality of life at admission, three months and six months after discharge in the two groups. There were two cases lost in the observation group and two cases lost in the control group, and 98 patients were included in the final observation group and the control group respectively.Results:There was no statistical difference in the scores of ADS and SS-QOL between the two groups at admission ( P>0.05) . At three and six months after discharge, the scores of ADS and SS-QOL of patients in the observation group were higher than those at admission, and the scores in the observation group were higher than those in the control group, with statistically significant differences ( P<0.01) . Conclusions:The solution-focused model psychological intervention can improve the disability acceptance and quality of life of stroke patients, which is worthy of clinical application.

Objective To investigate the effect of long-term high-fat diet on cognitive function and hippocampus neurons ultrastructure in obese rats.Methods Forty SD rats were randomly assigned to a high fat diet (HFD) group and a common diet (CD) group.Meanwhile,HFD-induced obese rat model were established.The spatial learning and memory were measured by the Morris water maze,and the neurons ultrastructural changes in rat hippocampus CA1 region at the corresponding period were observed by transmission electron microscopy.Results The average weight of rats was 25％,28％,and 22％ higher in the HFD group than in the CD group at the 12,16,and 20 weeks,respectively;the Lee's indexes were 6％,4％,and 8％ higher;the average swimming latency were 52％,44％,and 40％ longer;the average swimming distance were 85％,45％,and 51％ longer;the average swimming speed were 57％,34％,and 18％ higher;the duration of staying in the target quadrant were 32％,54％,and 63％ shorter;and the average times of crossing the plate form were 30％,34％,and 34％ shorter,respectively (all P ＜0.001).In comparison of ultrastructure in hippocampus CA1 region of rats at corresponding time points,the amounts of degenerated and necrosis neurons,of the deformed and vacuolar mitochondria,and of the less rough endoplasmic reticulum were significantly more at 12,16,and 20 weeks in the HFD group than in the CD group.Conclusions Long-term HFD-induced obesity damages the structure of neurons in the hippocampus,impairs spatial learning and memory function,and accelerates cognitive aging in rats.

Objective To investigate the status of leader-member exchange quality , organizational identification and job performance of nurses , to discuss the relationship among them , and to clarify the internal mechanism.Methods Three hundred sixty-nine clinical nurses were surveyed by leader-member exchange scale, organizational identity scales and job performance scale according to the cross-sectional sampling methods.Results Three hundred sixty-nine questionnaires were issued and 267 questionnaires were responsive with an effective response rate of 72.36%.The average score of nurses ’ perception of leader-member exchange was (5.22 ±1.09), and the average score of nurses ’ perception of organizational identification was (5.60 ± 1.09), and the average score of nurses ’ perception of job performance was (5.45 ±1.11), and the average scores of three variables were above average .There were significant positive correlation the nurses ’ perception of leader-member exchange quality and organizational identification (r=0.56, P<0.01), and job performance (r=0.53, P<0.01).There were also significant positive correlation the nurses ’ perception of organizational identification and job performance (r=0.63, P<0.01).The nurses’ perception of leader-member exchange quality had positive influences onorganizational identification (β=0.53, P<0.01) and job performance (β=0.26, P<0.01).The organizational identification played an intermediary role in the relationship between the leader-member exchange quality and the job performance (β=0.254, P <0.01).Conclusions Nursing administrators should strengthen the communication with nurses , form a good psychological and emotional bond , and further to promote the organizational identification and job performance of nurses .

Objective To explain the relationship between transformational leadership style of head nurse and subordinate ’ s team performance .Methods A cross-section survey was used to collect data and the structural equation model was used to analyze the data .Results The mean score of the transformational leadership of head nurse was (5.353 ±1.180).The mean score of team performance was (5.619 ±1.178). There was a significant positive correlation between the transformational leadership and team performance (β=0.72,P<0.01).Conclusions Both the level of transformational leadership and team performance were above the average .The transformational leadership of head nurse can help promote subordinate ’ s team performance , so the nursing managers should pay attention to shaping their own leadership style .

Objective:To explore the nutritional risk status and related factors of elderly inpatients.Methods:Using the convenient sampling method, 321 elderly stroke patients who were hospitalized in the neurology department of a ClassⅢ Grade A hospital from April to October 2018 were selected as the research objects for nutritional risk screening. Serum albumin (ALB) , serum prealbumin (PA) and other related nutritional indexes were recorded, and ADL, tooth, cognition, psychology and sleep of the patients were evaluated.Results:A total of 31.5% (101/321) of elderly stroke patients had nutritional risk. Among elderly stroke patients over 70 years old, 13.39% (43/321) had NRS-2002 ≥ 3 points. There were statistically significant differences in the incidence of nutritional risk among elderly stroke patients of different ages and degrees of dysphagia ( P<0.01) . Correlation analysis showed that the nutritional risk of elderly stroke patients was related to swallowing disorder, activity of daily living, intelligent mental state, and depression state ( P<0.05) . Conclusions:The older the elderly stroke patients, the higher the incidence of nutritional risk. Age, dysphagia, activity of daily living, BMI, intelligent mental state and depression are related to nutritional status, which should be paid attention to by medical staff and timely nutritional intervention should be given.