Objective To explore the ill experience of patients with deep vein thrombosis (DVT),and supply reference for making corresponding intervention.Methods The qualitative phenomenological study method was adopted in this study.Self-structured in-depth interviews were conducted with 12 patients with deep vein thrombosis and data were collected for analysis.Results After repeated refinement of the collected data,the early ill experience of deep vein thrombosis could be extracted as 4 topics.Conclusions According to the ill experience of patients with DVT,nurses can provide targeted intervention for such diseases to instruct clients to rehabilitate rapidly and improve the patients' quality of life.

OBJECTIVE To strengthen the hospital infection management in community health service centers,in order to reduce the onset of hospital infection.METHODS According to Hospital infection administration regnltions and Shenzhen medical service hospital infection control quality evaluation management demands we had investigated and evaluated the hospital infection management in 9 community health service centers.RESULTS The monitoring,surveillance and management of hospital infection in community health service centers as a quality evaluation index of hospital medical service still had many problems,it should further enhance the quality in the field of administration management,sterilization and disinfection,surveillance and sevage treatment.CONCLUSIONS The hospital infection management in community health service centers is a part of whole hospital medical service,but their quality at present is weak.To strengthen the hospital infection management is important to guarantee the medical service quality and medical care safety.

OBJECTIVE To evaluate the role of qulity control in hospital infection management.METHODS The data were collected in 2005-2007.The mean,standard deviation s,95% confidence interval(? 1.96 s) and 99% confidence intervals(? 2.58 s) were calculated to determine the forewarning threshold value.RESULTS The burn department was under the threshold value(85.95) lower than the respiratory department(87.85) and neurosurgery department(86.90).After intervention,the management improved.CONCLUSIONS With the help of quality control to forewarning and regulation of hospital infection management the problems can be found out in time.It is valuable for preventing hospital infection outbreac.

Objective We aimed to construct the handbook of self-management for patients with permanent colostomy by using the Delphi method.Methods Based on htemture review,23 experts were consulted twice by using the Delphi method about the related problems of constructing the handbook of self-management for patients with permanent colostomy,and the consulting results were analyzed later.Results The valid response rates of two rounds of expert consultation were 91.3％ and 100.0％,respectively.The authority coefficient of the experts (Cr) was 0.879,and coordination coefficients of the experts' opinion (W) were 0.387 and 0.307,respectively.Finally,the handbook of self-management for patients with permanent colostomy was determined by two rounds of expert consultation.Conclusions The handbook of self-management for patients with permanent colostomy,consmucted by using the Delphi method,provides a practical and effective tool for the patients with permanent colostomy to manage themselves,so as to provide a guidance and supervision role on self-management,such as stoma management,role management and emotion management,fither more,it provides references for the clinical and community nursing of the patients with permanent colostomy.

Objective The survey aimed to investigate the self-efficacy of permanent colostomy patients at different stages,and explore its impact factors.Methods A total of 267 cases of permanent colostomy patients at different stages (postoperative hospital stay,postoperative chemotherapy and home rehabilitation),coming from many domestic top three hospitals were investigated using the general information questionnaire,C-COH,the Stoma Self-Efficacy Scale,and Perceived Social Support Scale (PSSS).Results The total score of self-efficacy of 267 colostomy patients was (75.97 ± 23.92),ranked in the middle level,and it showed a rising tendency at postoperative hospitalization,postoperative chemotherapy and home rehabilitation.The influencing factors of self-efficacy of the patients at postoperative hospitalization included psychological well-being,BMI and age the regression coefficients were 7.126,1.512 and-0.281.the influencing factors of self-efficacy of the patients at postoperative chemotherapy included psychological well-being,age,the proportion of medical insurance,living state and caregiver,the regression coefficients were 5.182,-0.726,0.238,7.993 and 6.083; the influencing factors of self-efficacy of the patients at home rehabilitation included spiritual well-being,social support,self-care degree,gender and the monthly cost of ostomy supplies,the regression coefficients were 7.215,-7.820,-9.616 and-4.762.Conclusions The influencing factors of self-efficacy of permanent colostomy patients at different stages was different,the medical staff should assess and screen the high-risk factors of self-efficacy positively,according to the individual circumstance and stage,to formulate the individualized intervention measures,so as to enhance the patients' self-confidence to deal with and manage the disease,thereby increasing the level of self-efficacy.

Objective To investigate the expressions of RGC-32 and E-cadherin in pancreatic cancer and analyze their clinicopathological significance and the correlation with each other.Methods SP immunohistochemistry was used to detect the expressions of RGC-32 and E-cadherin in 42 cases of pancreatic cancer tissues,12 cases of chronic pancreatitis tissues and 8 cases of normal pancreatic tissues.Results The positive staining for RGC-32 was predominantly observed in the cytoplasm of pancreatic acinar cells.The positive staining for E-cadherin was mainly observed in the cytomembrane of normal pancreatic and chronic pancreatitis acinar cells,but aberrant expression ( cytoplasm expression and ( or ) weaker expression) could be found in pancreatic cancer cells.The positive expression rate of RGC-32 and aberrant expression rate of E-cadherin were 78.6％ (33/42) and 54.8％ (23/42),respectively,in pancreatic cancer tissues,which were significantly higher than those in normal pancreatic tissues [37.5％ (3/8) and 0] and chronic pancreatitis [41.7％ (5/12)and 8.3％ (1/12) with statisticai significance,P ＜0.05].The expression of RG C-32 in pancreatic cancer was associated with lymph node metastasis and TNM staging (P =0.016,0.025,respectively),but not with age,gender and differentiation degree ( P =0.831,1.000,0.629,respectively).The aberrant expression of E-cadherin was associated with differentiation degree,lymph node metastasis and TNM staging ( P =0.024,0.004,0.004,respectively),but not with age and gender ( P =0.970,1.000,respectively).A significantly positive correlation was found between positive expression rate of RGC-32 and aberrant expression rate of E-cadherin (r =0.458,P ＜0.01 ).Conclusions Both positive expression rate of RGC-32 and aberrant expression rate of E-cadherin are up-regulated significantly in pancreatic cancer tissues and RGC-32 may be involved in the invasion and metastasis of pancreatic cancer by regulating epithelial mesenchymal transition.

ObjectiveTo investigate the influence of cobalt chloride ( CoCl2 )-mimetic hypoxia on theproliferation,apoptosis and migration of human pancreatic cancer cell fine PANC1.MethodsPANC1 cells were treated with 0(control),100,200,400,800 μmol/L CoCl2 respectively for 24 h.Real-time RT-PCR and Western blot were used to determine hypoxia induced factor ( HIF)-1o mRNA and protein expression respectively,and cell counting kit-8(CCK-8) assays,flow cytometry and cell scratch test were used to examine the proliferation,apoptosis and migration of PANC1 cells,respectively.ResultsIn the control group and 100,200,400 and 800 μmol/L CoCl-2 groups,the expressions of HIF-1t mRNA were 1,1.08 ±0.12,1.12 ± 0.09,1.04±0.11,0.66 ±0.07,and the expressions of VEGF mRNA were 1,2.69±0.35,4.81 ±0.54,2.19 ± 0.21,0.79 ± 0.08,while the expressions of HIF-1 α protein were 0.23 ± 0.03,0.36 ± 0.04,1.15 ± 0.11,1.08 ± 0.09,0.44 ± 0.04; and the expressions of VEGF protein were 0.14 ± 0.02,0.12 ± 0.01,0.95 ±0.09,0.87 ±0.09,0.55 ±0.06; and cell viability rates were 100％,(98.43 ±2.88)％,(76.15 ± 0.70)％,(53.87 ±0.77)％,(35.23 ±0.67)％ ; while cell apoptotic rates were (5.2 ±1.12)％,(5.74 ± 1.07)％,(6.82 ± 1.85)％,(12.09 ±3.53)％,(31.88 ±6.95)％ ; the cell migration distance of PANC1 cells were (43.24 ±3.67)％,(59.46 ±5.39)％,(80.56 ±8.05)％,(63.89 ±5.96)％,(9.09 ± 1.59 ) ％.Compared with those of control group,the expressions of VEGF mRNA,VEGF and HIF-1 α protein,cell migration distance showed a two-way variation ( ascending first and descending later) (P ＜0.05 ),and the expression of HIF-1α mRNA and cell proliferation rate was decreased in a dose-dependent manner,while the cell apoptosis was increased in a dose-dependent manner.Conclusions CoCl2 significantly inhibits the proliferation and promotes apoptosis of PANC1 cells at certain level.CoCl2 has a two-way effect on the migration of PANC1 cells,and it may be related to the direct injury of high concentration of CoCl2 on cells.

Objective To realize the contamination status of dental unit waterlines (DUWL)in general hospitals, and provide scientific evidence for making preventive measures.Methods Three hospitals were selected for study, water source adopted by hospital A,B and C was running water,reservoir water,and filtered water through reverse osmosis filtration system respectively,specimens of dental handpiece spray water and flushing water of dental chair units were collected quarterly,total bacterial colony in water were detected.Results The qualified rate of source wa-ter,handpiece spray water,and flushing water in hospital A was 75.00%(3/4),0 (0/40)and 0 (0/40)respectively,col-ony count of handpiece spray water and flushing water was (1.20×103 -5.53×104 )CFU/mL(M=3.80×104 CFU/mL) and (2.11×104 -1.66×105 )CFU/mL(M=4.80×104 CFU/mL)respectively.The qualified rate of source water,hand-piece spray water,and flushing water in hospital B was 50.00%(2/4),60.00%(24/40)and 72.50%(29/40)respectively, colony count of handpiece spray water and flushing water was (0.00 -3.71 ×106 )CFU/mL(M=83.00 CFU/mL)and (0.00-2.39×106 )CFU/mL(M=72.00 CFU/mL)respectively.The qualified rate of source water,handpiece spray wa-ter,and flushing water in hospital C was 100.00%(4/4),55.00%(22/40)and 65.00%(26/40)respectively,colony count of handpiece spray water and flushing water was (0.00-6.20×103 )CFU/mL(M=96.00 CFU/mL)and(0.00-1.63×103 )CFU/mL(M=87.50 CFU/mL)respectively.Conclusion Water of DUWL in general hospitals is seriously con-taminated,disinfection and standardized management of source water and DUWL must be strengthened.

Objective To investigate the predictive value of the whole nodule size and solid component size of lung adenocarcinoma manifesting as subsolid nodule(SSN) in three different dimensions for pathologic grade.Methods We evaluated retrospectively preoperative chest HRCT data of 125 patients with 127 SSNs surgically resected and pathologically conformed lung adenocarcinomas.All specimens were divided into two groups: a total of 69 SSNs in group A, including 22 AIS and 47 MIA;a total of 58 SSNs in group B, only including IAC.Computer aided diagnosis software were used to measure the one dimension maximum diameter of solid component with lung window setting(1D-SCLW),two dimension maximum diameter of solid component with lung window setting(2D-SCLW),one dimension maximum diameter of solid component with mediastinal window setting(1D-SCMW),two dimension maximum diameter of solid component with mediastinal window setting(2D-SCMW),one dimension maximum diameter of whole nodule with lung window setting (1D-WNLW), two dimension maximum diameter of whole nodule with lung window setting (2D-WNLW), and volume of solid component with threshold of-300 HU (SCT) of all SSNs.Results 1D-SCLW, 2D-SCLW,1D-SCMW,2D-SCMW,1D-WNLW,2D-WNLW and SCT of the group B were significantly larger than those of the group A(P=0.000).ROC analyses indicated that the diagnostic efficiency of SCT for the pathologic grade was the highest among 7 CT features(AUC=0.887, sensitivity:81%,specificity:93%);The cut-off values of 1D-SCLW,2D-SCLW,1D-SCMW,2D-SCMW,1D-WNLW, 2D-WNLW and SCT were 17.50 mm,14.75 mm,9.50 mm,7.75 mm,0.50 mm,1.25 mm and 139.00 mm3.Multiple Logistic regression analysis revealed that SCT was the independent predictor of pathologic grade(OR=4.978,95%CI=1.430-17.331,P=0.012).SCT of 139.00 mm3 or greater was a significant indicator of IAC.Conclusion Among the whole nodule size and solid component size of SSN in three different dimensions on preoperative HRCT, SCT is found to be the independent predictor of pathologic grade, which may provide reference for surgery.

Objective To investigate whether ultrasonic coupling agent (UCA)can produce shielding or antago-nistic effect on iodine disinfectant for preoperative skin disinfection.Methods Shielding or antagonistic effect of UCA on iodine disinfectant were detected by laboratory carrier immersion killing test and on-the-spot skin disinfec-tion test.Results Antagonistic effect:after the mixing of iodophor with UCA,the average killing rate of iodophor containing available iodine 2 500mg/L and 625 mg/L to Staphylococcus aureus decreased from 100.00% to 99.67%-99.78% and 96.85 % - 98.25 %,respectively;the average killing rate to Escherichia coli decreased from 100.00% to 99.71 %-99.82% and 95 .93 %-98.56%,respectively.Shielding effect:after smearing with UCA, the average killing rate of iodophor and iodine tincture + alcohol to Escherichia coli decreased from 100.00% to 30.76% and 100.00% to 94.48%,respectively;the average killing rate to Staphylococcus aureus decreased from 99.99% to 55 .55 % and 100.00% to 98.22%,respectively.On-the-spot skin disinfection test:the killing rate of io-dophor and iodine tincture +alcohol to natural bacteria on skin surface were both 99.99%,after skin was smeared with UCA,the killing rate decreased to 92.62% and 93 .57%,respectively.Conclusion UCA remained on the oper-ative field has shielding and antagonistic effect on iodine disinfectant.