Objective To investigate the impact of applying patient-centered care concept on easing the negative moods among the parents of the neonates hospitalized in NICU.Methods The parents of neonates (76 people) hospitalized in NICU from March to May in 2012 were selected as the control group,they conducted normal nursing.The parents of neonates hospitalized in NICU during June and August in 2012 were named as the observation group (81 people).In addition to the normal nursing,they were given nursing intervention according to patient-centered care concept.The anxiety and depression moods of the two groups was analyzed.Results Before the patient-centered care concept intervention,there was no statistical difference of SAS,SDS scores for both groups.For the observation group,the SAS,SDS scores after intervention were significantly lower than those before the intervention.While for the control group,there was no statistical difference of SAS,SDS scores.After intervention,the SAS、SDS scores of the observation group were significantly lower than those of the control group,and the difference was statistically significant.Conclusions The negative moods of the parents of hospitalized neonates can be eased significantly by applying patient-centered care concept intervention.

Objective To study the clinical values of dynamic changes of yon Willebrand factor (vWF) and ADAMTS13 (a disintegrin and metalloprotease with thrombospondin repeats-13 ) in aneurysmal subarachnoid hemorrhage. Methods Twenty-nine patients with aneurysmal subarachnoid hemorrhage admitted to Department of Neurosurgery from April 2010 through April 2011 were enrolled for retrospective study.They could be categorized into 3 sets of grouping:delayed cerebral ischemia group ( DCI group) and non-delayed cerebral ischemia group ( no DCI group ),cerebral vasospasm group ( CVS group ) and no vasospasm group (no CVS group),and good prognosis group and poor prognosis group,and another 20 healthy subjects as control group.All patients were examined with CT,DSA,or/and CTA to identify the intracranial subarachnoid hemorrhage resulted from aneurysm rupture.The exclusion criteria included:(1)the time from onset to admission was longer than 72 hours or patient was in imminent danger of death; (2)patients had surgery,interventiona] or conservative treatment outside the hospital; (3) patients were under the treatment of antiplatelet medicine such as aspirin,clopidogrel,or other anticoagulants such as warfarin,etc ; (4) patients had blood diseases,impaired kidney or liver function,pregnant,or with recent infections.Venous blood were taken one day,4 days and 10 days after SAH to determine plasma concentrations of ADAMTS13 and vWF by using enzyme-linked immunosorbent assay (ELISA). Transcranial Doppler ultrasonography (TCD) was used to measure mean blood flow velocity of middle cerebral artery (VMCA).Glasgow outcome scale (GOS) score was measured before discharge. Data were analyzed by using SPSS version 13.0 software. Results The levels of vWF were significantly higher in DCI group,CVS group and poor prognosis group compared with those in the control group 1 day,4 days and 10 days after SAH.There were differences in vWF between DCI group and no DCI group 1 day and 4 days after SAH ( P ＜ 0.05 ).There were significantly differences in vWF between CVS group and no CVS group,and between good prognosis group and poor prognosis group 4 days and 10 days after SAH ( P ＜ 0.01 ).In DCI group and poor prognosis group,the level of plasma ADAMTS13 was significantly lower 1 day after SAH than that in the normal control group (P ＜0.01) and in the no DCI group (P ＜0.O1 ); and there were no differences in ADAMTS13 between CVS group and no CVS group.Conclusions In the early stage,the increase in plasma vWF and decrease in ADAMTS13 activity are associated with DCI,and the decrease in ADAMTS13 activity can be used to predict the outcome.

Clinical data of 23 patients with T2a bladder cancer admitted from March 2008 to August 2013 were retrospectively analyzed.Among 23 patients,11 cases were treated with transurethral resection (TURBT) plus arterial catheterization chemotherapy (study group) and 12 cases were treated with radical cystectomy (control group).The overall survival time and recurrence free survival time of two groups were compared.Patients in study group were followed up for 20-68 months,recurrence occurred in 5 cases (5/11),including 4 cases of invasive recurrence;patients in control group were followed up for 2 ～86 months,1 case had superficial recurrent and underwent TURBT,2 cases dead due to bladder tumor.During the course of chemotherapy,the main adverse effects were digestive reaction (7/11),fever (4/11),bone marrow suppression (2/11),symptomatic treatment was given,which was tolerated.There were no significant differences in overall survival time and recurrence free survival time between two groups (P ＞ 0.05).The quality of life of study group was better than that of control group (P ＜ 0.05).It is suggested that the arterial interventional chemotherapy combined with transurethral resection for T2a stage invasive bladder cancer has a certain curative effect with the advantage of preservation of bladder function and higher quality of life.

Objective To comparatively analyze the HIV disease progression and the death situa-tion between injecting drug users (IDUs) with HIV infection and those with HIV/HCV co-infection.Meth-ods The counts of CD4+T cells were collected through a retrospective study and the data about death situa-tion were collected with follow-up cards from 2006 to 2014 .A statistical analysis was conducted for the two groups .Results Among the 175 cases with HIV infection , the average value of primary CD 4+T cell counts was 370 cell/μl and 25.71%of them, primary CD4+T cell counts were less than 200 cell/μl.The average change rate of CD4+T cell counts was -1.50 cell/μl in month.The annual mortality rate was 18.18%. Among the 325 cases with HIV/HCV co-infection, the average value of primary CD4+T cell counts was 420 cell/μl and 20.45%of them, primary CD4+T cell counts were less than 200 cell/μl.The average change rate of CD4+T cell counts was -2.76 cell/μl in month.The annual mortality rate was 32.14%.The differ-ences between the groups were significant (P<0.05).Conclusion Compared with patients with HIV infec-tion, those with HIV/HCV co-infection showed significantly decreased CD 4+T cell counts , resulting in a faster disease progression and a faster death .It was urgent for the management department to work out HIV prevention and therapeutic measures .

Objective To evaluate the value of ATP content of CD4+ T lymphocytes in the diagnosis of infection and its correlation with drug concentrations in renal transplant recipients.Methods 45 renal transplant recipients were reviewed from May 2010 to October 2011.There were 33males and 12 females,aged from 21 to 58 years old.The recipients were divided into non-infection group (n =34) and infection group (n =11) according to their clinical manifestation.11 cases of infection were diagnosed by the chest X-ray,CT imaging manifestations and etiological examination,among them 5 cases were pulmonary infection,4 cases were upper respiratory infection,1 case was urinary tract infection and 1 case was perineal abscess.23 healthy volunteers were enrolled as the control group.They were detected ATP content of CD4+T lymphocytes by Immuknow method.Thetrough concentrations of the FK506 and CsA were detected by microparticle enzyme immunoassay and fluorescence polarization immunoassay,respectively.The hs-CRP concentration was detected by immunoturbidimetry.Results The ATP content of CD4+ T lymphocytes of the control group,non infection group and the infection group were (295±74) μg/L,(35± 189) μg/L and (212± 155) μg/L respectively.The levels of ATP of infection group were obviously lower than the control group and non-infection group.There were statistically differences (P ＜0.05).24 recipients were followed up dynamicly.There were 4 cases whose ATP value was lower than the postoperative average levels in 5 infection recipients.The hs-CRP concentration of infection group were (12.4±4.8) mg/L,obviously higher than the non infection group's (3.3 ± 4.7) mg/L and the control group' s (0.5 ± 0.5) mg/L.There were statistically differences (P＜0.05).The ATP content of CD4+ T lymphocytes were no significant associated with drug trough concentrations (P＞0.05).Conclusions Low ATP level after renal transplantation is a risk factor for infection recipients.Immuknow cell function assay can make up for the inadequacy of the drug concentration monitoring,reduce the risk of infection,and guide clinical immunosuppressive adjustment.

Objective:To understand the application effect of traditional position and oblique supine lithotomy in percutaneous nephroscopy combined with ureteroscopy combined with double lithography, and explore the clinical nursing methods of oblique supine lithotomy.Methods:From January 2018 to January 2019 in our hospital, 82 patients with complicated calculi who underwent percutaneous nephroscopy combined with ureteroscopy and double lithoscopy were selected, and were divided into the control group ( n=40) and the observation group according to the random number table ( n=42). The control group took the lithotomy position after anesthesia, placed the ureteral stent tube and changed it to the prone position to complete the operation; the observation group placed the oblique supine lithotomy position to complete the operation after anesthesia, and there was no need to change the position during the operation. The posture time, blood pressure, heart rate, pulse oxygen, blood transfusion, bleeding, postoperative postural comfort and complications of the two groups were compared. Results:When placed in the position and at the end of the operation, the blood pressure of the control group was (109±31), (106±23) mmHg(1 mmHg=0.133 kPa), and the heart rate was (93 ±10), (95±15)times per minute; the blood pressure of the observation group was (130±19), (125±17)mmHg, the heart rate was (86±12), (85±9) times per minute, the difference between the two groups was statistically significant ( t value was 2.86-4.26, P<0.01). The posture time of the observation group was (12.4±3.0) min and the control group was (21.2±6.9) min with statistically significant difference between two groups( t value was 7.550, P<0.01). The number of uncomfortable patients in the observation group after operation was 3 cases and 7 cases occurred in the control group. The difference was statistically significant ( χ2 value was 2.450, P<0.05). Conclusion:It is safe and feasible to use the oblique supine lithotomy position in double -lens combined stone removal, which can reduce the patient's discomfort and complications, and effectively improve the surgical efficiency and quality.

Objective To explore the application value of preoperative methylene blue staining in locating for the operation of intraspi-nal tumors. Methods The clinical data of patients with intraspinal tumors from September 2010 to September 2012 in our hospital were ret-rospectively analyzed. The patients were divided into tag group and control group according to whether stained by methylene blue or not. The operation time( min) ,intraoperative hemorrhage,the rate of total resection of tumor,spinal instability rate,tumor recurrence rate,and reopera-tion rate of two groups were compared. Results The operation time of tag group was significantly shorter than that of the control group. The amount of intraoperative bleeding was significantly less than that of in control group, the differences were statistically significant(P<0. 05). The total resection rate of tumor was significantly higher than that in control group,the differences were statistically significant(P<0. 05). The spinal instability rate,tumor recurrence rate and operation rate of patients within 1 year in two groups were not significant. Conclusion The methylene blue method is simple and convenient,and provides favorable conditions for the operation,which reduces the operation time and intraoperative hemorrhage,increases the rate of complete tumor resection. There was no difference in recurrence rate,operation rate and the stability of the spine within 1 year compared to traditional method.

Objective To investigate the effects of dexmedetomidine (DEX) on the mRNA expression of triggering receptor expressed on myeloid cells 1 (TREM-1) in peripheral blood mononuclear cells of rats with acute obstructive suppurative cholangitis (AOSC).Methods Sixty healthy male Wistar rat models of AOSC induced by complete common bile duct ligation and injection of E.coli into the bile duct through an intubation tube were replicated successfully.After modeling,the peripheral blood was collected and mononuclear cells were isolated and cultured.According to random number table method,the mononeuclear cells were divided into model group (no drug added in culture of mononuclear cells) and low,medium and high dose DEX groups (final concentrations 0.4,0.8,1.2 μg/L DEX were in low,medium and high DEX mononuclear cell cultures,respectively).After the mononuclear cells were cultured for 24 hours,the levels of tumor necrosis factor-α (TNF-α),interleukins (IL-1 and IL-6) in the supernatant of the cultured mononuclear cells were detected by enzyme linked immunosorbent assay (ELISA).The level of C-reactive protein (CRP) was detected by immunity transmission turbidimetry.The expression of TREM-1 mRNA in the mononuclear cells was detected by reverse trantscription-polymerase chain reaction (RT-PCR).Results Compared with the model group,the levels of TNF-α,IL-1,IL-6,CRP were decreased,the TREM-1 mRNA expressions were down-regulated in the different DEX dose groups,and the degrees of descent in medium and high dose groups were more significant than those in low dose group [TNF-oα (ng/L):95.5±8.6,88.9±5.3 vs.131.1 ± 14.2;IL-1 (ng/L):53.5±8.3,48.3 ± 6.7 vs.73.7 ± 12.8;IL-6 (ng/L):266.9±26.2,252.1 ± 17.7 vs.349.9±40.4;CRP (ng/L):4.3 ± 1.1,3.9 ±0.7 vs.5.6 ± 1.7;TREM-1 mRNA (A value):0.43 ± 0.18,0.39 ± 0.16 vs.0.65 ±0.25,all P ＜ 0.05].Conclusion DEX can down-regulate the expression of TREM-1 mRNA and inhibit the formation and secretion of inflammatory factors TNF-α,IL-1,IL-6 and CRP in peripheral blood mononuclear cells of rats with ASOC.

ObjectiveTo investigate the clinical efficacy of gentle moxibustion in treating old interphalangeal collateral ligament injury.MethodSixty patients were randomly allocated to two groups. The treatment group of 30 patients received gentle moxibustion 20-30 min once daily for two consecutive courses of treatment. The control group of 30 patients received TDP irradiation 20-30 min once daily for two consecutive courses of treatment.ResultThe excellent rate and the total excellent rate were 56.7% and 83.3%, respectively, in the treatment group and 36.7% and 76.7%, respectively, in the control group; there were statistically significant differences between the two groups (P<0.01).ConclusionGentle moxibustion has a marked therapeutic effect on old interphalangeal collateral ligament injury.