Objective To investigate the effect of celecoxib on serum biochemical parameters in rheumatoid arthritis patients and its clinical effect and safety assessment.Methods 92 cases of rheumatic arthritis were selected and divided into two groups.46 cases in control group were treated with methotrexate and hydroxychloroquine sulfate, and 46 cases in experitment group were treated on the basis of control group with celecoxib.The serum osteoprotegerin ( OPG) levels and related biochemical parameters, efficacy evaluation by doctors and self evaluation of patients and adverse reactions were compared between two groups.Results After treatment, the serum levels of IL-1, IL-6, CRP, C3, C4, RF, IgA, IgG and IgM levels after treatment were significantly lower than those before treatment in two groups ( P <0.05 ) , OPG serum level after treatment group was lower than that before treatment in experiment group ( P <0.05 ) , but there was no significant difference in control group.The above indexes in experiment group in experiment group were lower than those in control group after treatment.The efficacy evaluation by doctors in experiment group was 86.96%, which was higher than 69.57% in control group(χ2 =4.09,P<0.05), and efficacy self evaluation by patients was 84.78%, which was higher than 65.22% in control group (χ2 =4.70,P<0.05).The adverse reactions in experiment group was 13.04%, which was significantly lower than 45.56% in control group (χ2 =11.79,P<0.01).Conclusion Celecoxib could significantly improve clinical symptoms and physical sign and serum biochemical markers, and reduce adverse reactions in rheumatoid arthritis patients, which is an effective and safety treatment.

Objective To summarize the nursing experience of combination therapy of highly agglutinative staphylococcin (HASL) with cisplatin for patients with malignant pleural effusions. Methods After fully draining of pleural fluid in 62 cases with malignant pleural effusion through pleural puncture through central venous catheters and simply suction bottles, we injected HASL and cisplatin into the patients' pleural cavities. During the therapeutic process, firstly, we drained the pleural fluid fully before injection, secondly, we directed the patients to cooperate well and alter the positions properly, and thirdly, we closely observed the patients' condition and adverse reactions. Results 54 of 62 cases were effective after the therapies. The effective rate was 87.1%.Conclusions In order to achieve a satisfled curative effect and reduce the adverse reactions, we need the cooperation of the patients, fully draining of the pleural fluid before injection and proper alternation of the patients' positions during the treatment process.

Objective To evaluate the monitoring value of serum albumin and plasma von willebrand factor in patients with stroke.Methods Serum albumin and plasma von willebrand factor were measured from 145 patients with stroke(95 patients with nonpoor outcome and 50 patients with poor outcome) in two weeks and after six months from stroke onset to study the relationships with prognosis.Results Serum albumin level was significantly higher in patients with nonpoor outcome(mRS≤2) after six months stroke onset than those with poor outcome(mRS≥3) and was lower after six months stroke onset than in two weeks from stroke onset.On the other hand,plasma vWF level in patients with stroke was significantly higher than that in healthy controls and was higher in two weeks than after six months from stroke onset.Patients with poor outcome had higher plasma vWF level than patients with nonpoor outcome in two weeks and after six months from stroke onset,but had no significant difference.Conclusion The level of serum albumin and plasma von willebrand factor is related with nutritional status,active extent and prognosis in patients with stroke.

Objective To explore the characteristics and influential factors of resilience in empty-nest elderly with mild cognitive impairment(MCI) living in the poor area.Methods A total of 1 188 empty-nest elderly in the poor area of Hunan was sampled,analysis of covariance (ANCOVA),path analysis was used to analyze the data which were investigated by the two questionnaires including Index of SRQS.Results The prevalence of MCI in these 1 188 empty-nest elderly in rural area was 37.6％.The empty nest elderly in MCI group reported low resilience scores than those in cognitive normal group((58.84t 11.53) vs (63.58± 11.62) ; P＜0.001).ANCOVA and path analysis indicated that direct influences of income (β=3.324),education level (β=2.041),MoCA score (β=0.281) while age had indirect influences on it(β=-0.173).Conclusion Resilience in empty-nest elderly with MCI is low.Cognitive function,income and education are the direct influencing factor for resilience of the empty-nest elderly in the rural area.

Objective To evaluate the effects of dexmedetomidine combined with subanesthetic dose of ketamine on the emergence agitation in the patients undergoing thoracotomy.Methods Eighty ASA physical status Ⅱ or Ⅲ patients,aged 55-75 yr,weighing 50-75 kg,scheduled for elective esophageal cancer resection,were randomly divided into 4 groups (n =20 each) using a random number table:normal saline group (NS group),dexmedetomidine group (group D),subanesthetic dose of ketamine group (group K),and dexmedetomidine combined with ketamine group (group DK).In DK and K groups,ketamine 0.5 mg/kg was injected intravenously (within 1 min) at 10 min before the end of the operation.In DK and D groups,dexmedetomidine 0.5 μg/kg was infused intravenously over 10 min starting from 10 min before the end of operation.In group NS,the equal volume of normal saline was infused intravenously over 10 min starting from l0 min before the end of operation.The emergence time,extubation time,duration of ICU stay,occurrence and degree of agitation,and development of cardiovascular events and hypoxemia within 24 h after operation were recorded.Ramsay sedation scores were recorded before induction of anesthesia (T1),immediately after completion of administration at the end of surgery (T2),and at 0,5,10 and 30 min after extubation (T3-6).Results There was no significant difference in the emergence time,extubation time,and duration of ICU stay between the four groups.Compared with group NS,Ramsay sedation scores were significantly increased at T3-6,the incidence and degree of agitation were decreased,and the incidence of cardiovascular events and hyoxemia was decreased in D,K and DK groups.Compared with D or K group,Ramsay sedation scores were significantly increased at T3-6,the incidence and degree of agitation were decreased,and the incidence of cardiovascular events and hyoxemia was decreased in group DK.Conclusion Dexmedetomidine combined with subanesthetic dose of ketamine can prevent the emergence agitation in the patients undergoing thoracotomy,which provides better efficacy than either alone.

Objective To construct Four in One informational teaching model based on cloud platforms, simulation training, nursing micro-lectures and multidimensional evaluation investigate, and to explore the effect of theFour in Oneinformational teaching model applied in Medical Nursing teaching. Methods Two classes students of 2014 were selected by randomized sampling and were divided into experiment group and control group, the experiment group operated the Four in One informational teaching mod, the control group operated regular teaching. After the experiment,using the medical nursing theory test, the skill test, the questionnaire survey to evaluate the teaching effectiveness. Results The theoretical examination score, skill examination score and overall results of experiment group were (78.81±6.44), (82.01±5.22), (80.41±6.32) points, while (71.12±8.12), (76.74±6.3), (75.57±5.51) points of control group, and the difference was statistically significant (t=5.47, 4.86, 3.22, P<0.01 or 0.05). The students' interested in the informational teaching model of the experimental group reached 78.72%(37/47) and learning satisfaction reached 91.48% (43/47). Conclusions The Four in One informational teaching model applied in Medical Nursing teaching can improve the study effect .

Objective To found sensitive and reliable method to identify trophoblastic tumor cells in the peripheral blood of the patients suffered from gestational trophoblastic tumor.Methods Given numbers of JAR cell from ten to million were mixed into 10ml non pregnant peripheral blood as a model. Detection of ? hCG mRNA with fluorescence quantitative reverse transcription polymerase chain reaction (FQ RT PCR) and then estimation of the numbers of tumor cell in the blood. Nine cases of peripheral blood were collected from the pretreatment patients of gestational trophoblastic tumor to assay ? hCG mRNA with FQ RT PCR, then to estimate the numbers of tumor cell in the circulation blood. Results FQ RT PCR could detect ? hCG mRNA when ≥10 2 JAR cells were mixed into 10ml non pregnant peripheral blood. Four cases of bloods had been detected ? hCG mRNA expression in 9 cases of gestational trophoblastic tumor, and the numbers of tumor cell from 10 4 to 10 7 per 10ml blood. Conclusion FQ RT PCR of which primers and probe are designed for ? hCG had been proved to be very sensitive detection means, it could be used to detect gestational trophoblastic tumor cells from patient preipheral blood; With FQ RT PCR the tumor cells had been detected in some patients of gestational trophoblastic tumor.

OBJECTIVE To retrospectively investigate the ciprofloxacin-resistance rate of Escherichia coli(ECO) and its main impact factors,and then guide empiric therapy for its infection. METHODS We looked up relative data in Hubei Network for Surveillance of Bacterial Antimicrobial Resistance.WHONET 5.2 Software was used to analyze resistance rates,and SAS software to perform univariate and multivariate Logistic regression assay. RESULTS Ciprofloxacin-resistance rate of ECO was and is on the rising,meanwhile,its resistance rates were different for laboratory,patient origin,age group,gender and so on,and the differences were all very significant(P

Objective To explore the relating factors for cognitive dysfunction in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods Totally 150 patients with acute exacerbation of COPD (AECOPD) and 150 gender and age-matched healthy subjects (controls) received the cognitive and depression function assessment.150 AECOPD cases were classified into two groups:COPD patients with or without cognitive dysfunction.Fasting blood uric acid (UA) was measured and compared between the two groups.Relating factors for cognition dysfunction were analyzed.Results The score of Montreal Cognitive Assessment (MoCA) was reduced in AECOPD patients as compared with controls [(19.01±3.58) vs.(26.58±1.42)scores,t=-3.48,P=0.032].The score of Hamilton depression (HAMD) scale was higher in AECOPD patients than in controls [(18.05 ± 4.50) vs.(9.98 ± 3.51) scores,t =4.63,P =0.028].The prevalence of cognitive impairment in the patients with AECOPD was 82 cases (54.7％).The serum UA level was lower in the AECOPD patients with cognitive impairment than in patients without cognitive impairment [(235±42) μmol/L (n=82) vs.(332±45) μmol/L (n=68),t=-6.65,P=0.003].In AECOPD patients,the cognitive function was correlated with education,length of hospital stay,serum UA level,COPD stages,disease duration and the depression level,but was not correlated with smoking and body mass index.Conclusions The cognitive impairment is highly prevalent in patients with AECOPD,which is associated with lower serum UA level,longer hospital stay and disease severity.

Objective To evaluate the effect of health belief model combined with PDCA circulation in preventing DVT of patients undergoing total hip replacement and total knee replacement.Methods Patients who met our inclusion criteria were randomly divided into the intervention group and the control group with 45 cases in each group.The patients in the control group received routine health education.In addition,the intervention group received health education based on health belief model combined with PDCA circulation besides the routine.The intervention results were compared between the two groups.Results The patients' mastery of DVT disease related knowledge,health belief and the implementation of preventive measures in the intervention group were significantly better than those of the control group one week after surgery.The score of the health belief,perceived susceptibility,perceived severity,perceived benefits of action and serf-efficacy in the intervention group were significantly superior to those of the control group.1 patient appeared blood stasis in the intervention group.However,in the control group,there were 2 patients with DVT and 6 patients with blood stasis.The effect of preventive measures in the intervention group was better than the control group.Conclusions Health education based on health belief model combined with PDCA circulation could effectively enhanced the patients' DVT disease related knowledge,health belief and the implementation of preventive measures,thereby reduce the risk of DVT and improve the patients' quality of life.