Objective To study the relationship between long-term high-salt water and the morbidity mechanism of chronic atrophic gastritis (CAG), The expression of HSP60 and ras protein were detected in the gastric mucosa of CAG rates induced by high-salt water.Methods The atrophic gastritis rat model was made by high-salt-hot water perfusion and the ultrastructure of gastric mucosa was observed by Laser Scanning ConfocaI Microscopy. Results There was no expression in gastric mucosa in normal group. The expression of HSP60 and ras was observed in the cell plasm of rats at 12 weeks. The higher expression was observed in the rats at 24, 32 and 65 weeks. Using laser scanning confocaI microscopy and immunofluorescence technique had observed coexistence of HSP60 and ras.Conclusion Long time high-salt-hot water can induce CAG and increasing the expression of HSP60 and ras. HSP60 and ras play an important role in the formation of atrophic gastritis.

Objective To study the risk factors and to provide preventive measures of pulmonary infection for patients with severe brain injury.Methods A total of 320 patients with severe brain injury were analyzed with hospital-based case-control study method.A total of 101 patients complicated with lung infection were set as the experimental group.Another 101 patients with no pulmonary infection according to the proportion of 1:1 choice over the same period were set as the control group.The related factors were analyzed with the univariate analysis and the multiple factors Logistic regression analysis.Results Univariate analysis showed that the occurrence of pulmonary infection of patients with severe brain injury was closely related to the old age,low GCS score,long time stay in the bed,long time hormone application,long time antibiotic application,the combined underlying disease,use of mechanic ventilation,long-term smoking history and indwelling gastric tube.Multivariable Logistic regression analysis showed that the application of mechanic ventilator,the combined underlying disease and long time stay in bed were the independent risk factors for pulmonary infection of patients with severe brain injury,but GCS score was a protective factor.Conclusions The occurrence of lung infection were related to the ventilator application,the combined underlying disease,long time stay in bed and low GCS score.Considering these risk factors,the medical staffs should take preventive measures early to control lung infection.

Objective To evaluate the effect of evidence-based nursing in preventing and controlling the pulmonary infection of patients with stroke.Methods The randomized controlled trials (RCT) on the evidence-based nursing in preventing and controlling the pulmonary infection of patients with stroke were collected using the domestic and foreign databases,which were analyzed by RevMan 5.2 software.Results Nine RCTs were included in the study.The results of Meta-analysis revealed that the effect of the amount of OR values and 95％ confidence interval of the incidence and the cure rate of pulmonary infection was 0.42 (0.33～0.54),14.10 (4.57-43.50).Conclusions The evidence-based nursing can reduce the incidence of the pulmonary infection and improve the cure rate.

Objective To evaluate the impact of programmed nursing intervention based on MEWS for potential accidents in critical patients.Methods The randomized controlled trials (RCT) on programmed nursing intervention based on MEWS for potential accidents in critical patients were collected using the databases of PubMed,Medline,FMJS,CNKI,Wanfang database,VIP.Data were analyzed with RevMan5.0 software.Results Four RCTs were included in the study.All were Chinese articles.The incidence of accidents in the intervention group was significandy lower than that of the control group,the difference was statistically significant.Conclusions Programmed nursing intervention based on MEWS can effectively reduce the potential accidents happened in critical patients.

Objective To evaluate the effect of the bundle of care interventions in preventing ventilator-associated pneumonia (VAP) in the mechanic ventilated patients.Methods The randomized controlled trials (RCT) on the bundle of care interventions in preventing ventilator-associated pneumonia (VAP) were collected using the databases of PubMed,Medline,Embase,Cochrane library,China National Knowledge Infrastructure (CNKI),Wanfang Periodical Databases and Chinese Science and Technology Periodical Databases (VIP),data were analyzed by RevMan5.0 software.Results Ten RCTs were included in the study.The results of Meta-analysis revealed that the incidence of ventilator associated pneumonia,mechanical ventilation time,ICU length of hospital stay and the mortality rate in the intervention group were different from the control group,the difference had statistical significance.Conclusions The bundle of care interventions can reduce the incidence of ventilator-associated pneumonia,mechanical ventilation time,ICU length of hospital stay and the mortality rate.

Objective To discuss the application effect of evidence-based nursing in preventing the phlebitis using the method of Meta analysis,and provide basis for clinical prevention of phlebitis.Methods The randomized controlled trials (RCT) on the evidence-based nursing in preventing the phlebitis were collected using the databases of China National Knowledge Infrastructure(CNKI),Wanfang Periodical Databases,Chinese Science Technology Periodical Databases (VIP) and PubMed which were analyzed by RevMan 5.0 software.Results Seven RCTs were included in the study.The results of meta-analysis revealed that the incidence of the phlebitis was effectively prevented by evidence-based nursing.Conclusions The evidence-based nursing can reduce the incidence of the phlebitis.

Objective To use the method of Meta-analysis to evaluate the effect of the evidencebased nursing in preventing the deep vein thrombosis after orthopaedic surgery,to provide the basis for clinical prevention of DVT.Methods The randomized controlled trials (RCT) on the evidence-based nursing in preventing the DVT were collected using the databases of China National Knowledge Infrastructure (CNKI),Wanfang Periodical Databases,Chinese Science Technology Periodical Databases (VIP) and PubMed and analyzed by RevMan 5.2 software.Results Nine RCTs were included in the study.The results of Meta-analysis revealed that the incidence of the DVT could be effectively prevented by evi-dencebased nursing.Conclusions The evidence-based nursing can reduce the incidence of the DVT after orthopaedic surgery.

Objective:To observe the effect of different clinical factors on the level of parathyroid hormone (PTH) and to predict the possibility of permanent hypothyroidism (PHP) after total thyroidectomy (TT) by monitoring the levels of PTH in serum and drainage fluid after TT.Methods:Retrospective analysis was made on 150 patients who underwent TT for papillary thyroid carcinoma (PTC) in the Department of Thyroid Head and Neck Surgery in Jilin Cancer Hospital from Jan. 2020 to Aug. 2021. The changes of serum PTH were recorded at 1, 3, 7, 30 days and 6 months after surgery. The risk factors of postoperative hypoparathyroidism (HP) were investigated by single factor and multi factor methods. The impairment of parathyroid function was predicted combined with the level of PTH in the drainage fluid 1 day after operation.Results:After TT, serum PTH returned to normal value in most patients 1 month after operation. The proportion of PHP was 3.33% (5/150). Univariate analysis showed that bilateral central lymph node dissection, Hashimoto’s thyroiditis, tumor diameter ≥2 cm and intraoperative selective parathyroid autologous transplantation were risk factors for temporary hypoparathyroidism (THP). Multivariate analysis showed that BCND ( OR=0.322, P=0.001) , intraoperative selective parathyroid autograft ( OR=5.442, P=0.001) and tumor diameter ≥2 cm ( OR=2.247, P=0.003) were independent risk factors for THP. ROC curve was used to compare the predictive effect of postoperative serum and drainage PTH levels on postoperative PHP. The statistical results showed that the highest predictive effect of postoperative PHP was found on the first day of drainage PTH level within 1 week after operation (AUC 0.81) . 54 cases whose serum PTH was lower than normal value on the first day after operation were divided into 4 groups according to the level of PTH in drainage fluid from high to low. The results showed that the lower the level of PTH in drainage fluid, the greater the possibility of PHP ( P<0.05). Conclusions:Most of the patients with low PTH one month after operation develop PHP, while bilateral central lymph node dissection, intraoperative selective parathyroid transplantation, tumor diameter ≥2 cm are risk factors for THP after TT. If the serum PTH is lower than the normal value on the first day after operation, there is a possibility of PTH. The lower the PTH in the drainage fluid, the greater the possibility of PHP, which should be paid attention to in clinical practice.

Objective To evaluate the effect of the rehabilitation software based on information-motivation-behavioral skills(IMB)model on meeting the rehabilitation needs, increasing the continuation of rehabilitation and the rehabilitation compliance, improving the outcome of rehabilitation among elderly patients with fracture. Methods Based on the theory of"information-motivation-behavior"and the unity of human- computer interaction as the design concept, the status quo of rehabilitation training and rehabilitation needs of elderly patients with fracture were reviewed. The rehabilitation training test was applied to 30 patients with fracture in orthopedic department of our hospital. 30 patients in the same period were randomly selected as control group. All patients underwent Self-Rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores before and 1 and 3 months after operation. Differences were tested using Student's t test. Results Developed rehabilitation application software based on information module、motivation module and behavior module. The test group using this software for rehabilitation training was compared with the control group. The results showed that there was no significant difference in preoperative SAS and SDS scores between the two groups (t=-0.648,-0.284, P>0.05). At 1 and 3 months after operation, the SAS scores in the test group were (40.05 ± 6.77), (32.01 ±5.86), which were lower than (45.50 ± 11.32), (39.55 ± 5.67) in the control group (t=-4.14,-4.89, P<0.01). The SDS scores in the test group were (42.30 ± 9.86), (33.23 ± 6.56), which were lower than (46.50 ± 10.32), (38.45 ± 7.80) in the control group (t=-3.52,-3.82, P=0.001). Conclusion Rehabilitation software can influence the rehabilitation behavior of elderly fracture patients from information and motivation factors, provide professional guidance and rehabilitation intervention, and promote the implementation of active rehabilitation.

【Objective】 To clarify the hematological characteristics and current situation of chronic mountain sickness among Tibetan residents in extreme high altitude area (more than 5 000 m above the sea level) of Ali district based on the analysis of physical examination and blood test results. 【Methods】 Totally 250 Tibetan residents were selected by convenient sampling for blood oxygen saturation (SpO2), heart rate, and blood routine examination. Chronic mountain sickness was determined according to the hemoglobin (Hb) level and SpO2. 【Results】 The red blood cell (RBC), Hb and hematocrit (HCT) of the Tibetan residents at 5 200-meter altitude were all higher than the normal physiological reference range of China. Mean red blood cell volume (MCV), mean red blood cell hemoglobin content (MCH), mean red blood cell hemoglobin concentration (MCHC), white blood cell (WBC) and platelet (PLT) were in the upper limit of the reference value. The RBC, Hb, HCT and MCHC of male Tibetan residents were higher than those of females, while PLT was lower than that of females, with significant differences. There were no statistical differences in MCV, MCH or WBC among different genders of Tibetan residents. The SpO2 of the Tibetan residents was about 85% of the normal value, and the males had higher SpO2 than the females in the same age group, and the difference was statistically significant, but the heart rate did not differ significantly. The prevalence rate of chronic mountain sickness in this area was as high as 16.4%, and the prevalence rate of heavy manual workers was significantly higher than that of light manual workers, with significant differences. 【Conclusion】 The high-altitude anoxic environment causes the changes in red blood cells, hemoglobin, and oxygen saturation of local residents, and the prevalence of chronic mountain sickness increases significantly. Labor intensity is one of the risk factors for chronic mountain sickness in high-altitude areas.