To explore the incidence and risk factors for spontaneous hemorrhagic transformation (HT) of cardioembolism (CE,n =150) and large artery atherosclerotic infarction (LAA,n =370).The incidence of HT was 29.3％ in CE.And it was significantly higher than 9.7％ (P ＜0.05).Infarct size,low-density lipoprotein-cholesterol (LDL-C) and admission National Institutes of Health Stroke Scale (NIHSS) score were independent predictors of spontaneous hemorrhagic transformation in LAA.OR values were 3.92,2.96 and 1.45 respectively.Infarct size,admission NIHSS score and random blood glucose level were independent predictors of spontaneous hemorrhagic transformation in CE.OR values were 4.86,2.42 and 1.42 respectively.As compared with LAA,CE was more prone to HT.LAA and CE-related factors of hemorrhagic transformation are not completely identical.

Objective To explore the effect of fluoxetine on the brain function of bulimia nervosa (BN) patients.Methods Seven female BN patients,who met criteria of the 3rd version Chinese Criteria of Mental Diseases (CCMD-3),accepted functional magnetic resonance imaging (fMRI) examinations before and after the antidepressant treatment (fluoxetine (20 mg/day)) for three months.Seven normal controls accepted the same fMRI examination only at baseline.fMRI imaging was block-design.Blocks of food or non-food stimulus containing pictures selected from International Affective Picture System (IAPS) which were shown by computer automatically.All subjects were evaluated by Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD17) and Likert Scale-likelihood evaluation to the same pictures in the fMRI imaging blocks.Results The average intensity and volume activated in BN before treatment were both significantly lower than that in the control (P＜0.05).But under stimulus of food pictures,bilateral prefrontal cortex and left amygdala of BN patients were significantly activated.After fluoxetine treatment,the intensity and volume activated both increased significantly (P＜0.01) and the main areas being activated were right temporal,cerebellum and bilateral prefrontal cortex.Conclusion Fluoxetine improves the bulimic symptoms of BN patients and decreases abnormal activation of prefrontal and limbic in these areas.The underline mechanism may be related to functions of serotonin system in prefrontal-limbic path.

This paper reviewed the basic content of the King′s theory of goal attainment and it′s application in nursing health education at home and abroad .Besides , this paper pointed out that the theory could provide theoretical direction for current implementation of nursing health education in China .Further more , the theory was useful for nursing workers to provide effective and individual health education for service objects and was beneficial to promote the development of health education .

Objective To establish a scientific and comprehensive quality of life ( QOL ) evaluation index system for the elderly living alone. Methods Based on the literature review, we organized theoretical analysis, in-depth interview with the old people living alone, experts group discussion;according to the principle of constructing index system, the QOL evaluation index system framework of the elderly living alone was initially constructed. Then 15 experts were consulted by two-round Delphi method. Each of the index was weighed by matrix dual comparison method. Results The QOL evaluation index system of the elderly living alone was established including 4 primary indexes, 9 secondary indexes and 32 tertiary indexes. Conclusions The index system can provide reference for the research of the QOL scale of the elderly living alone and the guidance for evaluation and enhancement of the QOL of the elderly living alone.

Objectives To discuss the clinical characteristic, cause and measures to prevention and control of nosocomial infection in a neonatal intensive care unit (NICU). Methods Retrospectively analyzed an nosocomial infection outbreak of Klebsiella pneumoniae in NICU. Results From Sept. 3, 2010 to Oct. 3, 2010, there were 7 cases of hospital infection in 12 cases of sputum cultured Klebsiella Pneumoniae. The gestational age (GA) of 7 hospital infection cases was 28.5±2.6 week. The birth weight of infection cases was 941.4±309.8 g. The onset of infection was at 31.7±12.8 d of hospitalization. The nosocomial incidence was 2.41%in the hospital, which was 5.79%in preterm infants, 50.00%in GA<28w infants, and 42.86%in extremely low birth weight infant (ELBW). All sputum culture results were displayed as multi-drug resistant of Klebsiella pneumoniae, penicillin and third-generation cephalosporin antibiotic resistance rate of 75%to 100%. The resistance rates to penicillin and cephem antibiotics were 75% -100%, carbapenems was 58.3%, piperacillin/tazobactam was 25.0%. All nosocomial patients were cured. Conclusions GA<28w and ELBW infants are at increased risk of nosocomial infection in NICU. The emergence of carbapenems resistant Klebsiella Pneumoniae has been increasing with the widespread use of carbapenems. Hospital infection can be controlled by standardized medical behavior, which can decline the nosocomial infection incidence and mortality of preterm infants in NICU.

This paper introduced the concept of music therapy , the present research and application in the patients with mechanical ventilation from four aspects including intervention assessment , program design , implementation and evaluation of music therapy .Besides, this paper put forward the deficiencies of music therapy with the prospect so as to provide references for improving the nursing care of patients with mechanical ventilation.

Objective To investigate the empty nest elderly's willingness of the five factors of the senior cohousing pension model, and provide reference for the localization of this pension model in China. Methods Totals of 550 empty nest elderly from Hangzhou were selected and investigated by questionnaire about the general information and the willingness. Results Among the empty nest elderly, 61.25% were willing to choose the senior cohousing pension model. The elderly put forward specific requirements to residence, population, financial support, health care and management operation. Conclusions In our country, it should be taken full account of the specific willingness of the elderly to residence,population, financial support, health care, and management operation when running the pension model of the senior cohousing.

Objective:To implement PRECEDE-PROCEED based intervention in community patients with type 2 diabetes mellitus (T2DM) and explore its effects on patients' diabetes knowledge and self-efficacy.Methods:Totally 86 T2DM patients treated in a community health service center in Hangzhou between May and October 2014 were selected using convenient sampling and divided into intervention group ( n=43) and control group ( n=43) . Patients in the intervention group received 6-month intervention based on PRECEDE-PROCEED, while patients in the control group received a regular community health education course once during the same period. The diabetes knowledge and self-efficacy scores were evaluated between the two groups before and 3 and 6 months after intervention. At last, a total of 40 patients in the intervention group and 42 patients in the control group completed the study. Results:Repeated measures analysis of variance showed that there were time-dependent, between-group and combined effects in diabetes knowledge and self-efficacy scores in the two groups ( P<0.05) . Pairwise comparison between the two groups revealed that there was no statistically significant difference in diabetes knowledge and self-efficacy scores between the two groups before intervention ( P>0.05) , but there were statistically significant differences in diabetes knowledge and self-efficacy scores between the two groups 3 and 6 months after intervention ( P<0.05) . Conclusions:The PRECEDE-PROCEED based intervention can effectively improve the diabetes knowledge and self-efficacy of T2DM patients, which is worth promoting in clinical practice.

Objective To explore the status of social participation and quality of life (QOL) of empty-nesters,and discuss the correlation between social participation and QOL of empty nesters.Methods Totally 243 empty-nesters were selected and investigated by self-designed social participation questionnaire and world health organization quality of life scale for old people (WHOQOL-OLD).Results The QOL score of empty nesters in Hangzhou were (90.98±10.40). Their self-evaluated social participation was positively correlated to QOL (r=0.346,P<0.01). Participating in economic activities and public welfare activities could predict the QOL.Conclusions The QOL of empty nesters in Hangzhou is above the middle level. Participation in economic activities and public service activities can improve the QOL of empty nesters.

The assurance and continuous improvement of the effect of health intervention on type 2 diabetes mellitus depends on the scientific guidance. The health intervention model of PRECEDE-PROCEED provides a new perspective for effective intervention of diabetes mellitus because of its comprehensive and systematic, dynamic, scientific and effective characteristics. This article aimed to imagine the model of community type 2 diabetes health intervention so as to provide references for the further research of diabetes community health interventions in community by combining with the situation and problems of present interventions and on the basis of systematic analysis of PRECEDE-PROCEED model.