Objective:To investigate the perceptions of ICU patients on nurse caring behaviors and related factors,then raise nursing straties. Methods:101 ICU patient samples were selected from two tertiary general hospital(sGrdae A)in Fuzhou.The mod- ified caring behavior assessmen(tCBA)scale was used to interview the subjects. Results:The most important caring behaviors were to help patients satisfy their basical requiments. There were statistically significant differences in the perceptions of importance of nurse caring behaviors among the patients’demographic data such as marriage and length stayed in ICU.Conclusion:ICU patients need nurse caring behaviors. Nurses should provide patients with individual caring behaviors to satisfy their requi-ments. So nursing quality and patient satisfaction would be improved.

To enhance the quality education of nursing students and cultivate high quality nursing staff,who can meet the social requirements,a new mode of integrating humanistic quality education into clinical nursing education is proposed.Approaches to improve humanistic quality of nursing students are initiated from four aspects: determination of teaching goals,establishment of teaching tenet "human as basis",optimization of learning environment and vividness of teaching methods.The main purpose of this paper is to promote research and practice for further innovation in Chinese nursing clinical teaching.

Objective To evaluate the safety of conscious venous anesthesia with fentanyl and propofol in elderly patients over 70 during gastrointestinal endoscopy. Methods Clinical data of 826 elderly patients over 70, who underwent gastrointestinal endoscopy with venous anesthesia, were retrospectively analyzed. The patients were divided into 2 groups according to their ages, with 618 patients aging from 70 to 80 in group A, in which 342 received endoscopy and 276 underwent colonoscopy, and 208 patients older than 80 in group B, in which 112 underwent endoscopy and 96 had colonoscopy. Another cohort of 600 patients younger than 70, who underwent venous anesthetic endoscopy during the same time period, was randomly selected as the control group, in which 400 patients received endoscopy and 200 had colonoscopy. Blood pressure, heart rate, peripheral oxygen saturation (SpO2) and adverse reaction were monitored in each patient during the procedure and compared among different groups. Results No procedure-related perforation or sedation-related mortality was observed, and no procedure was terminated clue to sedation complication. The average dosages of propofol used in procedure of endoscopy in groups A, B and control were 54.22±21.36 mg, 40.22±12.46 mg, and 86.44±34.26 mg, respectively. The average dosages of propofol in colonoscopy were 82.56±40.64 mg, 45.36±15.44 mg and 102.23±46.32 mg, respectively. With same procedure, there was no significant difference in heart rate and blood pressure among different groups, nor was there any difference in these variables before and after the procedure in each group (P>0.05). Sedation exerted more influence on SpO<,2> in elderly patients. A total of 18 cases in groups A and B experienced SpO<,2> <90%, which was mainly due to aspiration of saliva and relieved by oxygen inhalation. Conclusion Under appropriate monitor, it is safe and feasible to give conscious sedation to elderly patients over 70 during gastroimestinal endoscopy.

ObjectiveTo discuss the hematological adverse reactions of oral omeprazole administration with convention dosage and treatment course in aged patients.MethodsFour hundred and nine cases of reflux esophagitis by endoscopic diagnosis from Beijing Hospital during January 2000 to December 2010 were divided into three groups according to their ages: group A ( 168 cases) aged from 60 to 69 years,group B ( 152 cases) aged from 70 to 79 years and group C (89 cases) aged equal to or above 80 years.Each group of patients was randomly divided into three subgroups,A 1 ( 56 cases),B 1 ( 51 cases) and C 1 ( 30 cases ) were administered with oral omeprazole,20 mg,bid; A2 ( 56 cases ),B2 ( 51 cases ) and C2 ( 30 cases ) were administered with oral famotidine,20 mg,bid; A3 ( 56 cases),B3 ( 50 cases),C3 ( 29 cases ) and all above subgroups were administered with oral sucralfate,10 ml,tid.The treatment course lasted for one month.The clinical efficacy,WBC count,RBC count,the Hemoglobin level,platelet count,as well as the prothrombin time,thrombin time,activated partial thromboplastin time,fibrinogen,Plasma fibronectin and serum D-Dimer were tested and compared after 10-days and 30-days treatment.ResultsAfter the treatment,all the patients had alleviated symptoms,to varied extend,especially in subgroups treated with oral omeprazole and sucralfate.After 30 days' treatment,blood WBC counting in B1 subgroup declined to lower than normal values in two cases; PLT counting drops in 1 case; blood WBC dropped in 6 cases and PLT dropped in4 cases of the C1 subgroup;blood WBC counting dropped in 1 case and PLT dropped in 2 cases of the C2 subgroup.Hemoglutination did not show significant change in all groups (P ＞ 0.05 ).Conclusion The hematological adverse reactions of oral omeprasole in aged patients,under convention dosage and treatment course,occured with age increase,especially for blood WBC and platelet counting.

Objective To investigate the clinical manifestations,pathological features hy endoscopy and possible risk factors of ischemic colitis (IC).Methods A retrospective analysis was made upon 89 hospitalized patients diagnosed as IC.Logistic regression analysis was performed to determine morbidity risk factors.Results The majority of patients with IC in our study group had histories of hypertension,heart disease,hyperlipidemia,diabetes,etc.The common features included abdominal pain (80.9％,72/89),hematochezia (76.4％,68/89),etc.Colonic mucosal lesions presented regional distribution under colonoscope (80％,72/89),with manifestations of petechial hemorrhages,edema,segmental erosion,pleomorphism ulcerations,visible lesion edge and sharply defined segment of involvement,even be characterized by lumens stricture (13.5％,12/89).Histopathological examination revealed mucosa edema,necrosis,hemorrhage and formation of ulceration,inflammatory cell infiltration,and submucous hemorrhage,etc.Laboratory examination showed that white blood cells,neutrophils,serum fibrin,D-Dimer,serum TC,TG and serum apolipoprotein B were higher than normal.Colonic mueosal roughness,thumbmark symptoms,etc,and even bowel limited spasm,stricture or curtailment were visible in 47 patients underwent barium enema.Colonic wall thickening was visible in 29 patients underwent mesentericography,however,strictured or closed blood vessels were not found logistic regression analysis showed that hypertension,diabetes,higher TG,atrial fibrillation were strongly associated with onset of IC (all P values ＜ 0.05).Conclusions Since IC symptoms are not typical,it requires early colonoscopy to clarify diagnosis.Hypertension,diabetes,hyperlipidemia,and atrial fibrillation are risk factors for IC.

Objective To evaluate the clinical significance of phural effusion and/or ascites and their prognostic role in patients with acute pancreatitis.Methods The clinical data of 312 patients with acute pancreatitis were collected and analyzed retrospectively.Results Pieural effusion was found in 47 patients and ascites in 18.of 47 cases with pleural effusion,there were 31 cases(65.9%)of severe pancreatitis(P＜0.01)and 27 cases (57.4%)complicated by pseudocyst(P＜0.01).Among 18 cases with ascites,there were 14 cases(77.7%)of severe pancreatitis(P＜0.01).6 cases with pleural effusion and/or ascites died of multiple organs failure.Conclusion Pleural effusion and/or aseites is closely associated with severe pancreatitis.

Objective To analyze the clinical characteristics of gastric polyps in different histopathological types. Methods Based on histopathological difference, gastric polyps were categorized into fundic gland polyps, hyperplastic polyps, inflammatory polyps, adenomatous polyps, etc; Different types of polyps in the aspects of distribution, Helicobacter pylori (H. pylori) infection, the relationship between the proton pump inhibitors (PPI) and the occurrence of gastric polyps to provide guidance on treatment Results 365 cases of gastric polyps were diagnosed in 10 197 patients who underwent gastroscopy. The prevalence was 3. 6%. The histopathological type of the polyps were fundic gland polyps (61. 1%), hyperplastic polyps (23. 3%) , inflammatory polyps (12. 3%) , adenomatous polyps (2. 2%). 289 cases showed single polyps, which was the majoriry across all types of gastric polyps. Majority of the gastric polyps were located in gastric body and fundus, followed by gastric antrum and cardia Most of the fundic gland polyps were located in gastric body and fundus; Majority of the hyperplastic polyps and adenomatous polyps were located in gastric antrum; The main locations of inflammatory polyps were cardia and gastric body and fundus. A higher percent (51. 6%) of fundic gland polyps patients used PPI. The difference was statistically significant compared with the hyperplastic polyps(8. 2%)and inflammatory polyps group(8.9%) (x2 = 48. 31,27. 63 ,P <0. 01). The H. pylori infection rate of hyperplastic polyps and inflammatory polyps were 72.4% and 74.4% ,respectively, both of which were higher than that of fundic gland polyps(20. 2%)(x2 =46. 50,35. 04, P < 0. 01) . One year after the H. pylori eradication, the recurrence cases of hyperplastic polyps and inflammatory polyps were 1/41 and 0/19,respectively. Conclusions The main histopathological type of gastric polyps is fundic gland polyps followed by hyperplastic polyps. The main location of the gastric polyps is gastric body and fundus, followed by gastric antrum and cardia. The distribution of different types of gastric polyps has some characteristics. Long-time usage of PPI may increase the risk of fundic gland polyps. The occurrence of hyperplastic polyps and inflammatory polyps may be related to H. pylori infection. The H. pylori eradication helps preventing the recurrence of hyperplastic and inflammatory gastric polyps.

Objective To summarize the clinical and pathological data of gastric polyps under gastroscope,and to investigate the clinical characteristics of gastric polyps in elderly patients.Methods The 692 cases of gastric polyps diagnosed by gastroscopy and pathology were retrospectively analyzed.The elder group was defined as aged 60 years and over.The young group was defined as aged less than 60 years.The data were analyzed by SPSS software.Results The detected ratios of gastric polyps were 3.9% in the elder group and 2.9% in the young group (χ2 =15.792,P<0.01).The rates of gastric polyps found in fundus,gastric body and gastric antrum were 32.0%,41.3% and 19.8% respectively in the elder group.And the corresponding rates in the young group were 37.5%,45.8% and 11.1% respectively (χ2 = 2.277,1.404,10.289,P = 0.131,0.236,0.001).The pathological types of the gastric polyps were in the order of fundic gland (60.0%),hyperplastic (26.2%),inflammatory (11.3%),adenomatous (1.7%) and others (0.8%).The diagnostic rates of hyperplastic polyps in the elder group and the young group were 31.7% and 21.9% respectively;the corresponding rates of adenomatous polyps were 3.0% and 0.8% respectively (χ2 = 8.525,4.834,P=0.004,0.028).Conclusions The detected ratio of gastric polyps is higher in the elder group than in the young group.In both groups,the polyps in the fundus and the body are more prevalent,followed by those in the antrum.The diagnostic rate of polyps in the antrum is significantly higher in the elder group than in the young group.Although the main pathological type of the gastric polyps is fundic gland in both groups,the diagnostic rates of hyperplastic polyps and adenomatous polyps are both higher in the elder group,the risk of cancer is higher as well.Therefore,in the elderly,the gastric polyps are recommended to be cut off as soon as possible and followed up closely.

Objective To investigate the effect of Helicobacter pylori (Hp) plantation in Barrett's esophagus (BE) columnar epithelium on esophageal adenocarcinoma (EA) in the elderly.Methods 109 patients with reflux esophagitis (RE),51 patients with Barrett's esophagus and 16 patients with esophagus adenocarcinoma were diagnosed by endoscopy and pathological biopsy.The 4-quadrant biopsies in esophagus lesions were respectively taken from each patients.1 were tested by silver staining and urease test for rapid detection of Hp,and the other were stained by HE staining for pathological analysis,AB /PSA staining and immunohistochemistry for gene expressions of cyclooxygenase-2 (COX-2) and B cell lymphoma / leukemia-2 (Bcl-2).Results Hp colonization in RE group,BE group and EA group were 0％,44.4％ and 42.1％ respectively.The expression levels of COX-2 in abnormal squamous epithelium in RE group,BE group and EA group were 46.7％,100％ and 100％ respectively.The expression of COX-2 was higher in BE and EA groups than in RE group (x2=126.21,both P＜0.05).Moreover,a gradually increase in COX-2 expression was observed in abnormal esophageal squamous epithelium from RE to BE to EA.COX-2 expression was significantly increased in mucosa in BE and EA patients with Hp plantation and in lower esophageal carcinoma in EA patients with Hp plantation and without Hp plantation.Bcl-2 expression in esophageal squamous epithelium was 40.2％,85％ and 100％ in RE,BE and EA groups respectively.The expression of Bcl-2 was higher in BE and EA groups than in RE group (x2 =125.25,P＜0.05).Bcl-2 expression was increased in mucosa BE patients with Hp plantation.Conclusions Hp plantation in BE esophageal columnar epithelium can increase the expression of COX-2,and induce its downstream Bcl-2 expression,inhibit cell apoptosis,and might lead to EA.

Objective To investigate the clinical characteristics of upper gastrointestinal diseases in very old people (aged ≥ 90 years),and to explore the necessity and safety of the gastroscopy for the super elderly people.Methods Clinical data of 50 very old people were retrospectively analyzed.Results The total detection rate of upper gastrointestinal disease was 76.0％ (38/50),in which the reflux esophagitis (RE) was the most common (26.0％),followed by erosive gastritis (20.0％),atrophic gastritis (18.0 ％),peptic ulcer (12.0 ％),gastrointestinal cancer (10.0％),duodenitis (8.0％) and fundic gland polyps (6.0％) respectively.RE lesions detected by gastroscopy were mainly mild and were divided into endoscopic grade LA-A (46.1％),LA-B (30.8％),LA C (7.7％),and LA-D (15.4％) according to the Los Angeles classification.The most common symptoms were abdominal distension and anorexia,and the both incidences were 12.0％.There was no significant difference in the prevalence of clinical symptoms between the elderly people with upper gastrointestinal disease and without abnormal gastroscopic findings [44.7％ (17/38) vs.41.7％ (5/12),x2 =0.035,P＞0.05].22 patients (44.0％) underwent gastroscopy under intravenous anesthesia.Conclusions The incidence of upper gastrointestinal disease is high in very old people,and mild reflux esophagitis is the most common.Clinical symptoms are little or asymptomatic in most very old people.Gastroscopy under intravenous anesthesia is safe and feasible for the very old people.