Objective Optimizing the preparation technology of Red buttock ointment,by exploring the best extraction conditions of the alkannin,radix arnebiae seu lithospermi polysaccharides and so on.Methods Selecting radix arnebiae seu lithospermi 1kg and using orthogonal experiment to explore the best extraction conditions.Naphtho-quinone pigment chemicals were extracted by reflux extraction method;ethanol and paraffin wax were chosen as the composite solvent.Radix arnebiae seu lithospermi polysaccharide was extracted by water decocting,which to observe the rationality of process.Results The best extraction condition is A3 B2 C1 D1 , including section A:ethanol was 20 times the quality of medicinal materials (select radix arnebiae seu lithospermi 1kg and ethanol 20kg),section B:the amount of paraffin was 5% of ethanol(select radix arnebiae seu lithospermi 1kg and paraffin 1 kg),section C:Boiling water was 20 times the quality of medicinal materials,section D:the boiling time was 2h.Conclusion The more practical production process conditions:Ethanol was 10 times the quality of medicinal materials,and the amount of paraffin was 5%of ethanol.Boiling water was 10 times the quality of medicinal materials,and the boiling time was 1 h.This method is economic, simple, reasonable, stable, reproducible and easy to operation.Red buttock ointment obtained by this method possesses of excellent quality,good performance and superior effect.

Objective To explore the application effects of 3M circular opening self-adhesive wound dressing on changing tracheostoma dressing.Methods A total of 56 tracheotomized patients from January to December 2014 were randomly admited to either observation group or control group.Different tracheostoma dressings were chosen by the two groups,the patients of observation group adopted 3M circular opening selfadhesive wound dressing and the patients of control group received sterile gauze.Skin situation after tracheotomy,incision infection,dressing frequency,cost and patient's satisfaction were evaluated.Results Three cases suffered from adverse skin reaction in observation group and 13 cases in the control group,with a statistically significant difference(x2 =8.750,P ＜ 0.05);the frequency of changing dressing was no significant difference between two groups (P ＞ 0.05),the observation group was once a day,while the control group was three times a day;the hospitalization costs were (59 242.16 ± 3 276) (￥) in the observation group,while it was (50 369.22 ±2 892) (￥) in the control group (t =6.420,P ＜ 0.05);patient's satisfaction in observation group was 96.43％,but 71.43％ in the control group (x2 =4.766,P ＜ 0.05).Conclusions 3M circular opening self-adhesive wound dressing for neurosurgery patients after tracheotomy can reduce complications,the rate of incisional infection,the hospitalization costs and improve patients' satisfaction and comfort,which also reduce the working load of clinical nurse.

Objective To explore the effect of surgery observation process for surgical excutive nurse to improve comprehensive quality of nurses , patients′satisfaction and nursing quality .Methods There were 370 selective operation patients , in whom 185 had been chosen as control group from October to November 2013;while another 185 patients would have selective operation during December 2013 to January 2014 as experimental group.The patients in the control group received routine perioperative nursing while nurses in the experimental group provided seamless nursing after information collection before operation , surgery observation during operation and formulating corresponding nursing after operation . The quality of perioperative nursing and patients′satisfaction for nursing job compared between two groups .Results After surgery operation carrying out, the quality of postoperative nursing enhanced from (95.01 ±2.13) to (98.46 ±1.54) scores (t =-18.742,P<0.05), and patients satisfaction increased from (91.30 ±0.20) to (98.60 ±1.10) scores (t=-5.410,P<0.05).Conclusions The process of nurses′perioperative observation offered a seamless nursing for perioperative patients and benefits nurses′comprehensive quality , nursing quality and satisfaction .

Objective To explore the application of non-punitive night nursing ward round model on continuous improving the clinical nursing quality. Methods Night routine nursing rounds mode was utilized from January to July 2013 and non-punitive night nursing ward round model were carried out from August 2013 to April 2014. On the basis of the comprehensive quality control, we made dynamic monitoring of nursing quality with three-level quality management system in the process of night nursing ward round and compared the night nursing quality and degree of satisfaction of clinical head nurse, the night nurse with before. Results After applying non-punitive night nursing ward round model, clinical head nurse and night shift nurse satisfaction were improved from (91. 7 ± 3. 24) and (91. 3 ± 0. 20) to (97. 2 ± 2. 56) and (98. 6 ± 1. 10) (t = - 8. 934 9,- 110. 000 0;P < 0. 01). Nursing quality scores of night nursing ward round were improved from (92. 14 ± 2. 54) to (97. 79 ± 1. 85) (t = - 26. 669 3,P < 0. 01). Conclusions The non-punitive night nursing ward round model can improve the satisfaction of clinical nursing staff, enhance nursing quality and ensure the safety of patients.

Objective To assess the value of vascular endothelial growth factor (VEGF) expression in the prognosis of glioma patients.Methods PubMcd,EMbase,Cochrane Library,CNKI and Wanfang data were searched for collecting retrospective cohort studies on the correlation between VEGF expression and prognosis of glioma patients,and relevant articles were also retrieved from inception to June,2016.Two reviewers independently screened the literature,extracted the data,and evaluated the quality.Then Meta analysis was performed with RevMan5.3 software,and the publication bias of literature was evaluated by means of Begg's funnel plot and Egger's method.Results A total of 19 studies with 1657 cases were included.No significant publication bias was found in all groups.The analysis demonstrated positive associations between VEGF expression and poor prognosis (hazard ratio [HR]=1.39,95％CI:1.12-1.73),and the difference was statistically significant (P=0.003).Subgroup analysis showed that the high expression of VEGF in the European and American patients was more valuable than that in the Asian patients in the prognosis of gliomas;large samples of clinical studies of high VEGF expression were more valuable in the prognosis of gliomas than small samples.The detection of VEGF expression by different methods suggested that the patients with high expression of VEGF had poor prognosis;HR provided by the literature suggested that VEGF over-expression was associated with poor prognosis.Conclusion The expression of VEGF has predictive value for the survival time of glioma patients and VEGF can be recommended as a useful survival biomarker in clinical practice.

Objective To study application effect of setting up full-time supervision nurse and shift in neurosurgery patients discharge guidance. Methods Between March and August in 2014, a total of 408 patients were discharged from Neurosurgery Department, Huai′an First People′s Hospital, Nanjing Medical University, who were divided into control group ( 204 cases ) and observation group ( 204 cases ) according to the first treatment ward. Patients in control group received conventional discharge guidance, whereas observation group had an extra full-time supervision on discharge guidance. Full-time supervision personnel should visit the patients discharged that day in the ward, inform the patient or family invoicing process,attention about related disease, medication and dietafter discharge. Meanwhile, full-time supervision personnel should get to know the service attitude of nurses, nursing technology andwhether relevant health education had been grasped during the patients′ hospitalization, based which the full-time supervision personnel provided a targeted discharge guidance. One month later, we compared the two groups for mastering discharge health education and patient or family members′nursing satisfaction. Results Patients in observation grasped discharge health education better than those in control group (93. 30% vs 73. 89%;χ2 =26. 1168,P<0. 05). Patients or their family members in observation group were more satisfied with nursing than that in control group(96. 91% vs 86. 78%;χ2 =11. 236,P<0. 05). Conclusions Full-time supervision nurse and shift used in neurosurgery patients discharge guidance,which build a bridge between patients and health care members, can not only improve the quality of nursing service, but also elevate hospital′social efficiency with a good reputation.

Objective To explore the effect of physical restraint clinical pathway in the management of patients with restlessness in Neurosurgery Department.Methods A total of 84 restless patients with brain injury in neurosurgery of our hospital between October 201 4 and March 201 5 were included and randomly divided into observation group (n =42)and control group (n =42).The routine physical restraint was used in both groups, additionally,the physical restraint clinical pathway was performed in observation group.The nursing quality of physical restraint and satisfaction of patients or their families on the implementation of physical restraint were compared between two groups.Results The duration of first physical restraint in observation group was shorter than that in control group [(32.86 ±8.32)h vs.(35.48 ±8.1 3)h],but the difference between two groups has no statistical significance (t =1 .460,P >0.05).The score of nursing document quality of physical restraint in observation group was higher than that in control group [(98.1 2 ±1 4.1 1 )vs.(90.42 ±1 0.21 )],the difference between two groups was statistically significant (t =-2.865,P <0.05).The incidence of unplanned pulling out of ECG wires,transfusion lines and nasogastric tubes,and the complications of physical restraint such as peripheral circulation block were decreased.The differences between two groups were statistically significant (P <0.05).The satisfaction of patients or their families on the implementation of physical restraint in observation group was higher than that in control group (95.24% vs.78.57%),the difference between two groups was statistically significant (χ2 =5.126,P <0.05).Conclusions The application of physical restraint clinical pathway in the management of patients with restlessness in neurosurgery can increase the safety and effectiveness of physical restraint,reduce the occurrence of accidents,and improve the satisfaction of patients or their families.

Objective To explore the application effect of constrained patrol record form in safety management of agitated patients in neurosurgery. Methods A total of 84 cases of agitated patients with brain injury in the neurosurgery of our hospital from October 2014 to March 2015 were selected and divided into the control group and the observation group by random number table method, with 42 cases in each group. Patients in the control group were given routine constraint care management, while patients in the observation group were given safety management with the use of constrained patrol record form. The quality of constraint care was compared between two groups. Satisfaction of the nurses to the record form and the satisfaction of patients and their families to nursing were also compared between two groups. Results Before the application of constrained patrol record form, the number of complaints in the control group was 16, and the writing quality of nurses′constrained patrol record form was (91.42±10.21); after the application of constrained patrol record form, the number of complaints was 2 and the writing quality of record form was (97.12±14.11) (P<0.05). During the constrained period, the incidence rate and the number of cases of complications in the observation group were lower than that in the control group; and the nurses′s satisfaction to record form and patients′ satisfaction to nursing in the observation group were higher than that in the contro group ( P<0. 05 ) . Conclusions The application of constrained patrol record form in the safety management of agitated patients in neurosurgery, can effectively improve the nursing quality of agitated patients, reduce the occurrence of accidents, protect the safety of patients and improve the satisfaction of patients and their families.

ObjectiveTo discuss the effects of continuing nursing on the living condition of patients with severe craniocerebral injury in neurosurgery department.Methods A total of 303 patients with severe craniocerebral injury from January 2008 to December 2009 in neurosurgery department of Huai'an First People's Hospital,Nanjing Medical University were randomly divided into the control group (140 cases) and the intervention group (163 cases). Patients in the control group were followed up once by the phone at the first week after discharge. There was no longer follow-up after the first week and patients could call or visit hospital in case of problems. Patients in the intervention group received continuing nursing intervention by telephone follow-up visit,the establishment of continuing nursing WeChat group,family visit and the establishment of brain club. Patients were followed up from the first week after discharge until the death of patients or December 2015. Survival rate of two groups was evaluated by survival analysis.Results The survival rate of patients in the intervention group and the control group were 78.8% and 62.3%,which were calculated by the Kaplan-Meier method. The survival rate of patients in the intervention group was significantly higher than that in the control group (χ2=33.91,P<0.05).Conclusions Continuing nursing helps to improve the survival situation of patients with severe craniocerebral injury in the process of time.

Objective To explore the application effect of dynamic case scenario simulation in emergency ability training of new nurses in Department of Neurosurgery.Methods A total of 28 nurses newly recruited in 2015 and 2016 to Department of Neurosurgery, Huai'an First People's Hospital, Nanjing Medical University were selected. According to time of joining the department, the 15 nurses recruited in 2015 were selected as control group, and the 13 nurses enrolled in 2016 as observation group. Nurses in the control group were trained by stages, i.e. technique training after theory training. On the basis of above mentioned training stages, nurses in the observation group were trained in simulated scenario, with 1 dynamic case added to each training stage. Emergency management ability, self evaluation of the nurses and patients' satisfaction after the training were compared between the two groups.Results After the training, scores of ability in disease observation, emergency cooperation and first-aid operation of new nurses in observation group were (27.41±1.32), (29.59±1.06) and (38.55±1.58), all higher than those in the control group (t=7.24, 12.26, 10.07;P<0.01). It was shown in results of self-evaluation that, ability to link theory with reality, to arouse subjective initiative and participation of nurses in the observation group were higher than those in the control group (P<0.05). Satisfaction of patients towards nurses in the observation group was 96.15%, higher than 86.00% in the control group (χ2=8.524,P<0.01).Conclusions Trained with method of dynamic case scenario simulation, emergency response ability of new nurses can be improved rapidly in a short time. Also, patients are more satisfied with the nursing. This training management method is worth promoting.