Objective To analyze the risk factors of mortality in hospitalized patients with peptic ulcer bleeding (PUB).Methods From January 2003 to December 2012,1 210 patients with PUB were collected.Among them,1 170 patients were cured (cured group) and 40 patients died (dead group).The general information and clinical data of patients were collected,which included gender,age,smoking history,non-steroidal anti-inflammatory drugs intake,haematemesis,shock,blood infusion and rebleeding.The information of patients combined with other diseases was also collected.The lab findings and gastroendoscopy findings were also collected,including hemoglobin,platelets,serum albumin,blood urea nitrogen,serum creatinine levels,coagulation,location of ulcer and Forrest classification.Chi-square test was performed for comparison between groups of count data.The t-test was used for comparison between groups of measurement data and normally distributed,and Mann-Whitney rank sum test was used for non-normal distribution.The risk factors of mortality of patients with PUB were analyzed by univariate and multivariate Logistic regression analysis.Results The rates of age over 65,combined with other diseases,shock,rebleeding,abnormal coagulation,Forrest classification above Ⅱ b,medicine spraying to stop bleeding under gastroendoscope,gastroendoscopic hemostasis with titanium clip and operation of dead group (57.5％,23/40; 27.5％,11/40; 25.0％,10/40; 42.5％,17/40; 25.0％,10/40; 35.0％,14/40; 15.0％,6/40; 12.5％,5/40 and 17.5％,7/40) were all higher than those of cured group (25.0％,293/1 170; 7.4％,86/1 170; 12.5％,146/1 170; 13.1％,153/1 170; 5.1％,60/1 170; 20.9％,244/1 170; 4.8％,56/1 170; 4.1％,48/1 170 and 6.5％,76/1 170).The differences were statistically significant (x2 =21.117,18.651,5.400,27.728,9.203,4.613,6.332,4.661 and 5.710,all P＜0.05).The serum albumin level of dead group ((28.71±7.13) g/L) was lower than that of cured group ((32.82±7.55) g/L) and the difference was statistically significant (t=2.215,P＜0.05).Between the groups,there were no significant differences in gender distribution,rate of patients smoking,rate of patients taking non-steroidal anti-inflammatory drugs,rate of patients with haematemesis,volume of blood infusion,location of ulcer,dosage of proton pump inhibitor (PPI),average hemoglobin level,blood urea nitrogen level,serum creatinine and platelet count (all P＞0.01).Age over 65,combined with other diseases and rebleeding were the independent risk factors of mortality of patients with PUB during hospitalization (OR=4.821,12.959 and9.627,all P＜0.01).Conclusion Age over 65,combined with other diseases and rebleeding are the independent risk factors of mortality of patients with PUB during hospitalization.

Objective To evaluate the efficacy of 10-day compound allantoin containing quadruple regimen in the treatment of chronic gastritis with Helicobacter pylori (H.pylori) infection,and to compare with the bismuth-containing quadruple therapy.Methods Altogether 173 patients with H.pylori positive chronic gastritis confirmed by gastric endoscope were divided into 10-day compound allantoin containing quadruple regimen group (n =43),24-day compound allantoin containing quadruple regimen group (n =46),10-day bismuth-containing quadruple regimen group (n =42) and 24-day bismuth-containing quadruple regimen group (n =42).After the treatment,the eradication rate of H.pylori,the rate of gastrointestinal symptoms (epigastric pain,bloating and belching) relief and the adverse effects of each group were observed.Intention-to-treat (ITT),per-protocol (PP) statistical analysis and chi-square analysis were performed for statistical analysis.Results H.pylori eradication rates of 10-day compound allantoin containing quadruple regimen group,24-day compound allantoin containing quadruple regimen group,10-day bismuth-containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group analyzed by ITT were 90.7％ (39/43),91.3％ (42/46),90.5％ (38/42) and 88.1％ (37/42),respectively; while analyzed by PP were 90.7％ (39/43),93.3％ (42/45),90.5％ (38/42) and 90.2％ (37/41),respectively.And there were no statistical differences between groups (all P＞0.05).Ten days after the treatment,the rates of epigastric pain relief of 24-day compound allantoin containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group were 81.1％ (30/37) and 78.8％ (26/33),respectively,the rates of bloating relief were 82.4％ (28/34) and 71.0％ (22/31),respectively,and the rates of belching relief were 76.9％ (20/26) and 75.0％ (21/28),respectively.There were no statistical differences between the two groups (all P＞ 0.05).However after 24-day treatment,the rates of epigastric pain relief of 24-day compound allantoin containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group were 91.9 ％ (34/37) and 87.9％ (29/33),respectively,the rates of bloating relief were 94.1％ (32/34) and 87.1％ (27/31),respectively,and the rates of belching relief were 96.2％ (25/26) and 85.7％ (24/28),respectively.There were no statistical differences between the two groups (all P＞0.05).And the rates of epigastric pain and bloating relief increased after 24-day treatment compared with those of 10-day treatment,however the differences were not statistically significant between the two groups (all P＞ 0.05).In 24-day compound allantoin containing quadruple regimen group,the rate of belching relief was higher after 24-day treatment compared with that of 10-day treatment,and the difference was statistically significant (x2=4.127,P=0.042).No severe adverse effects were observed in each group,and there were no adverse effects such as oral metal odor,tongue black and melena in compound allantoin containing quadruple therapy.Conclusions Ten-day compound allantoin containing quadruple therapy as first-line approach in the treatment of chronic gastritis with H.pylori infection can get better H.pylori eradication and the efficacy is similar to bismuth quadruple therapy.Meanwhile the symptom relief rate is high and no obvious adverse effects were found.

Objective To study nursing of polymyositis/dermatomyositis associated respiratory damage in 83 cases.Methods A total of 83 polymyositis/dermatomyositis patients with respiratory damage were selected as research objects, the nursing staff implemented targeted nursing during the treatment, and the nursing effect was observed.Results Out of 83 cases, 1 died of respiratory failure, 3 autonomously gave up treatment, disease condition of 79 was effectively controlled and were discharged after improvement, and the total effective rate was 95.18%.Conclusion Analysis of the causes by the nursing staff according to specific symptoms and corresponding nursing measures for polymyositis/dermatomyositis patients with respiratory damage during the treatment can improve the curative effect, and improve outcomes of disease.

Objective To study nursing of polymyositis/dermatomyositis associated respiratory damage in 83 cases.Methods A total of 83 polymyositis/dermatomyositis patients with respiratory damage were selected as research objects, the nursing staff implemented targeted nursing during the treatment, and the nursing effect was observed.Results Out of 83 cases, 1 died of respiratory failure, 3 autonomously gave up treatment, disease condition of 79 was effectively controlled and were discharged after improvement, and the total effective rate was 95.18%.Conclusion Analysis of the causes by the nursing staff according to specific symptoms and corresponding nursing measures for polymyositis/dermatomyositis patients with respiratory damage during the treatment can improve the curative effect, and improve outcomes of disease.

Objective? To investigate the status of readiness for hospital discharge(RHD)in patients after total hip arthroplasty(THA)and to explore the influencing factors. Methods? A total of 161 patients undergoing THA in 3 ClassⅢ Grade A hospitals in He'nan Province during July of 2017 to October of 2018 were selected by convenience sampling method. General Information Questionnaire, RHD Scale, Hospital Anxiety and Depression Scale(HADS), and Harris Hip Score(HHS) were used in the survey to investigate their readiness of hospital discharge. Single factor analysis and multiple stepwise regression analysis were used to analyze the influencing factors of patients' discharge readiness. Results? The RHD of patients after THA was (94.56±10.31). Multivariate stepwise regression analysis showed that education level, disease type, anxiety score and hip joint score were the main influencing factors of discharge readiness (P＜ 0.05), which together explained 34.2% variances of RHD. Conclusions The readiness of discharge in patients after THA is at a moderate level, suggesting that doctors and nurses should pay more attention to patients with low educational level, poor psychological status, slow recovery of joint function and acute fracture in clinical work.

Objective:To explore the effect of hierarchical diagnosis, treatment and nursing management based on mobile network information platform on the rehabilitation effect of patients with coronary heart disease.Methods:Using the convenient sampling method, a total of 150 patients with coronary heart disease who were admitted to Department of Cardiology of the First Affiliated Hospital of Harbin Medical University from March 2020 to March 2021 were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 75 cases in each group. The control group was given routine publicity, education and follow-up management measures, while the observation group was given hierarchical diagnosis, treatment and nursing management based on the mobile network information platform on the basis of the control group. After 3 months of intervention, levels of cardiac function indexes, disease knowledge scores and nursing satisfaction of patients with coronary heart disease were compared between the two groups.Results:After intervention, the left ventricular ejection fraction in the observation group was higher than that in the control group, and the left ventricular end-systolic diameter and the left anterior descending coronary artery level were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The total score of disease knowledge and the scores of each dimension (disease concept, inducing factors, clinical manifestations, examination methods, treatment methods, drug knowledge, and secondary prevention knowledge) in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The total score of the satisfaction scale and the scores of each dimension (perceived quality, perceived value, public expectation, user trust, user participation and public satisfaction) in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The implementation of hierarchical diagnosis, treatment and nursing management based on the mobile network information platform is conducive to improving the cardiac function of patients with coronary heart disease at home during the rehabilitation period and it can improve the disease cognition and satisfaction of patients.

Objective:The study aims to establish a perfect BCR-ABL (P210) internal quality control system and ensure the long-term stability and comparability of the detection results between laboratories and to popularize and apply it in the three hospitals.Methods:The Qilu Hospital of Shandong University (H1) prepared a set of the BCR-ABL (P210) quality control substances to establish and improve internal quality control system. We went to other three participating hospitals (H2, H3, and H4) to inspect quality control before the measurement. In addition, we mailed 25 sets of quality control substances to each of the hospital for detection. The slope and intercept of the standard curve of each hospital and the detection results were analyzed and statistically judged using the Levey-Jennings quality control chart combined with the Westgard multirule theory. Then, we made a quality control evaluation.Results:①An internal quality control system for the BCR-ABL (P210) transcript levels monitoring was successfully established for the quality inspection before the measurement, statistical judgment during the measurement, and evaluation after the measurement. ② Both the slope and intercept of the standard curve of the four hospitals was under control. ③The multicenter quality control substance judgment results were as follows: for H1 hospital, two times of "1 2s" warning were found in the middle-level quality control substance, which was judged as being under control; for H2 hospital, one time of "1 2s" warning was found for each quality control substance, which was judged as being "2 2s" out of control; for H3 hospital, its high-level quality control substance violated the "1 3s" rule, and low-level quality control substance appeared "1 2s" warning, which was judged as "1 3s" out of control; and all quality control substances were under control in H4 hospital. ④The quality control evaluation and correction were as follows: two hospitals were under control, and the other two hospitals had an "out of control." We found out the reason for the out of control and corrected them. ⑤The comparisons of the original values of the multicenter quality control substance were as follows: there were statistical differences in the results of high-level quality control substance among the four hospitals, and no significant difference was found in the results of the medium-level and low-level quality control substance. ⑥The comparisons of the IS values of the multicenter quality control substance were as follows: the IS values of the three quality control substance in H2 and H3 hospitals were significantly higher than those of H1 hospital, and H2 hospital was significantly higher than H3 hospital. Conclusion:A perfect and stable internal quality control system for the BCR-ABL (P210) transcripts has been established, which can effectively ensure the accuracy and stability of the clinical detection results. This internal quality control system has been successfully popularized and applied in other hospitals.