Objective To evaluate the impacts of self-management on quality of life of patients with chronic obstructive pulmonary disease (COPD) in community. Method A total of 130 patients with COPD from selected 3 neighbourhood residential committees in Longhua community were randomized into intervention group (65 cases) and control group (65 cases). The control group was treated with conventional health education, the intervention group was treated with self-management education program. Both groups were evaluated by the Chinese version of the chronic disease self-management study measures and SF-36 profile before and after the 6 months intervention. Result After 6 months, the scores of the chronic disease self-management study in the control group were holistic health (3.52 ± 0.64), symptom (18.86 ± 3.06), shortness of breath (3.92 ± 1.74), somatic function (8.15 ± 0.51) and impact on life (22.21 ± 7.14), while the scores in the intervention group were holistic health (2.43±0.43), symptom (15.68±3.66), shortness of breath (2.06 ± 1.30), somatic function (5.73 ± 1.08) and impact on life (16.43 ± 5.17) , and the differences were statistically significant (P<0.01). Compared with the control group, the dimensions and total score of quality of life of the intervention group were (52.41±7.90 vs. 71.63±8.11, P<0.01). Conclusion The effective self-management could improve symptoms, the ability of self-management and their quality of life.

Animals ; Antibodies, Monoclonal ; metabolism ; therapeutic use ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; therapy ; Drug Delivery Systems ; Epidermal Growth Factor ; immunology ; metabolism ; physiology ; Epithelial-Mesenchymal Transition ; GPI-Linked Proteins ; Humans ; Immunotherapy ; methods ; Intercellular Signaling Peptides and Proteins ; Membrane Glycoproteins ; immunology ; metabolism ; physiology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasm Proteins ; immunology ; metabolism ; physiology

Objective To observe the relationship between the levels of plasma VEGF,PAI-1 and the severity of the diabetic retinopathy in type 2 diabetic patients.Methods ELISA method was used to measure the levels of VEGF and PAI-1.Results The level of VEGF was increased in all diabetic patients compared with the normal control group[(17.86?12.25)ng/L],and that of the patients with BDR[(93.41?54.69)ng/L]was higher than that of the patients with NDR[(52.17?21.81)ng/L]and PDR[(61.24?37.55)ng/L].The level of PAI-1 was also increased in all diabetic patients.The increase tendency was more obvious in patients with BDR[(58.29?20.53)?g/L]and PDR[(66.84?23.81)?g/L].Conclusion The damage of the vascular endothelial cell and the impaired fibrinolysis state exist in diabetic retinopathy.So it is very important to measure the levels of VEGF and PAI-1 for the early diagnosis and intervention treatment of diabetic retinopathy.

Objective To know the status of professional knowledge and comprehensive abilities among graduates majoring in health laboratory science of laboratory medicine through selfevaluation,and to provide a scientific basis for adjusting the education plan. Methods A selfdesigned questionnaire was used to make a census of 92 graduates majoring in health laboratory science of laboratory medicine. Results More than 90% of graduates thought that their abilities of grasping basic knowledge and technology,practising ability,humanistic quality,innovative and practical ability were improved through 5year study. 11.6% of graduates thought that their abilities of experiment design,9.4% of graduates thought that their ability of basic experiment operation,9.2% of graduates thought that their abilities of grasping speciality English,and 9.1% of graduates thought that their oral expressing abilities were improved. Conclusion Though good effect on students’ability training was got through the reform in teaching methods and talent projects,more attention should be paid to innovative and practical ability training.

Objective To discuss the perioperative nursing care for patients with hepatic cancer located near the central bile duct, who receive microwave ablation treatment by using bile duct cooling protection technique. Methods A total of 21 patients with hepatic cancer located near the central bile duct received percutaneous microwave ablation treatment (PMWA) using bile duct cooling protection technique. Preoperative routine nursing and psychological nursing, close cooperation, close postoperative observation and prompt nursing measures were strictly carried out. Results PMWA was successfully accomplished in all the 21 patients, and no biliary complications occurred. All 21 patients were cured at the time of discharge, no nursing-related complications or death occurred. Conclusion In treating hepatic cancer located near the central bile duct, bile duct cooling protection technique is a new treatment technology. Effective perioperative nursing care can improve the operative success rate and reduce the incidence of complications.

Objective To study the clinical value of bedside ultrasound in predicting the fluid responsiveness in pa?tients with septic shock in intensive care unit (ICU). Methods Forty-two mechanically ventilated patients with septic shock who admitted to ICU of the Affiliated Hospital of North China University of Science and Technology from January 2015 to April 2015 were included in this study. All patients were treated with volume expansion (VE) text. Hemodynamics in?dexes were obtained by ultrasound before and after each test, including stroke volume (SV), aortic peak blood flow velocity variation rate of breathing (△VpeakAO), inferior vena cava expansion index (△IVC) and brachial artery maximum speed vari?ation rate (△VpeakBA). Clinical data and central venous pressure (CVP) were recorded. Based on the responsiveness of SV, patients were divided into responsive group (R) and non-responsive group (NR), respectively. The differences of the above in?dexes were compared between two groups. The correlation of△IVC,△VpeakAO,△VpeakBA and△SV was determined. The role of the hemodynamic index for predicting volume responsiveness was evaluated by receiver operating characteristic ROC curves. Results A total of 47 VE tests were performed in 42 patients, 25 in R group and 22 in NR group. Before VE test, the hemodynamics indicators of△IVC,△VpeakAO and△VpeakBA were significantly higher in R group compared with those of NR group (P<0.05). The values of△IVC,△VpeakAO and△VpeakBA were positively correlated with△SV in two groups. The areas under the ROC curve of the hemodynamics indicators were 0.825, 0.853 and 0.866 for △IVC, △VpeakAO and△VpeakBA, and they all showed high sensitivity and specificity. Conclusion The hemodynamic index measured by bedside ultrasound can predict the volume responsiveness in mechanically ventilated patients with septic shock fluid therapy, and which can be used to fluid therapy with a high degree of specific and sensitivity in clinical practice.

Objective To investigate the relationship of the serum bilirubin level with acute ischemic stroke (AIS), and Chinese isch-emic stroke subclassification (CISS), stroke severity and short-term outcome of AIS patients. Methods 616 patients with AIS as well as 664 patients without stroke matched with gender and age were compared and analyzed with the non-conditional Logistic regression. The AIS pa-tients were divided based on the CISS, and their bilirubin levels were compared. The AIS patients were divided into high bilirubin group and normal bilirubin group, their scores of the National Institute of Health Stroke Scale (NIHSS) as admission and discharge, and neural func-tion improvement rate were compared. Results The levels of total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) were higher in the AIS group than in the control group (P<0.01), and the TBIL was the independent risk factors of AIS (OR=1.026, 95%CI 1.012-1.041, P<0.001). There was no significant difference of the levels of TBIL, DBIL and IBIL among the patients of CISS (P>0.05). The NIHSS score was higher in the high bilirubin group than in the normal bilirubin group as admission (P<0.05), but it was not significant as discharge (P>0.05), nor the rate of neural function improvement (P>0.05). Conclusion The serum bilirubin level elevated and correlated with the severity in the AIS patients, which might be the risk of pathogenesis and AIS. The bilirubin was not various with the CISS, and might be less involved in the short-term outcome of AIS.

Objective To investigate the risk factors of recurrent ischemic stroke, and evaluate the severity and short-term outcome. Methods From March, 2014 to March, 2015, 238 patients with recurrent ischemic stroke and 378 patients with initial ischemic stroke matched with gender and age were enrolled. The clinical data of two groups were compared and the non-conditional Logistic regression model was made to analysis the risk factors of recurrent ischemic stroke. The National Institute of Health Stroke Scale (NIHSS) score as ad-mission and discharge, and the neural function improvement rate of two groups were compared. Results The incidences of leukoarailsis (χ2=8.666), hypertension (χ2=8.189), smoking (χ2=6.973) and alcohol consumption (χ2=4.722) were higher in the recurrent group than in the pri-mary group (P<0.05). Logistic regression analysis showed that leukoarailsis (OR=1.690, 95%CI:1.198~2.384, P=0.003), hypertension (OR=1.715, 95%CI:1.135~2.592, P=0.010) and smoking (OR=1.896, 95%CI:1.233~2.915, P=0.004) were the independent risk factors of recur-rent ischemic stroke. The NIHSS scores as admission and discharge were significantly higher (t=-3.645, t=-4.675, P<0.001), and the neural function improvement rate was lower (t=2.643, P<0.01) in the recurrent group than in the primary group. Conclusion Hypertension, leuko-arailsis and smoking are independent risk factors for recurrent ischemic stroke. Recurrent ischemic stroke is more serious than initial isch-emic stroke, and the short-term neural function recovers more slowly.

Objective To assess the efficacy and safety of 800 nm diode laser for removing unwanted hair of Ⅲ-Ⅴ skin type.Methods A total of 114 patients were treated with 800 nm diode laser on 234 sites.Four sessions were performed at an interval of 6-8 weeks.Percentage of hair reduction was evaluated 3 months after each session by comparing the terminal hair count to the baseline values.Follow-up was performed 6-8 months after the last session.In addition,subjective satisfaction of physicians and patients was evaluated according to a four-grade scale and the satisfaction rates were calculated.Results After fouth session,97.01％ of patients had more than 40 ％ hair reduction,and 83.33 ％ patients had more than 60 ％ hair reduction.Hyperpigmentation was observed on 15 (6.41％) sites,and disappeared after 6-8 months follow-up.The satisfactory rates of the physicians and the patients were 98.25 ％ and 96.12 ％,respectively,with no statistical difference (x2 =3.33,P＞0.05).Conclusions 800 nm diode laser for removing unwanted hair of Ⅲ-Ⅴ skin type is a safe and effective treatment option for hair removal,with relatively less side effect.

Objective: To investigate the ultrasound evaluation on lfuid responsiveness in patients with septic shock. Methods: There 42 septic shock patients treated by mechanical ventilation in our hospital from 2015-01 to 2015-04 were studied. All patients received volume expansion (VE) text, ultrasound examination was conducted to measure hemodynamic parameters of inferior vena cava variation rate of breathing (ΔIVC), aortic peak blood lfow velocity variation rate of breathing (ΔVpeakAO), brachial artery maximum speed variation rate (ΔVpeakBA) and stroke volume (ΔSV) at before and after text. Based on the response to VE text, the patients were divided into 2 groups as Responsive group and Non-responsive group, the above indexes and their correlations to ΔSV were analyzed. The clinical values of those parameters for predicting volume responsiveness were evaluated by ROC curves. Results: A total of 47 VE tests were conducted in 42 patients including 25 cases in Responsive group and 22 cases in Non-responsive group. Before VE test, the parameters of ΔIVC, ΔVpeakAO and ΔVpeakBA were higher in Responsive group than Non-responsive group; ΔIVC, ΔVpeakAO and ΔVpeakBA were obviously related to ΔSV (r=0.631, 0.668 and 0.619). The area of ΔIVC, ΔVpeakAO and ΔVpeakBA under ROC curves were 0.817, 0.853 and 0.866 respectively, they were all with the high sensitivity and speciifcity. Conclusion: Ultrasound monitored hemodynamic parameters may predict the volume responsiveness in septic shock patients with mechanical ventilation, it could be used for guiding liquid treatment in relevant patients.