Objective To evaluate the effectiveness of nurse-led discharge planning for hospital inpatients with chronic disease.Methods The Cochrane Library,PubMed,Medline,EMBASE,Chinese Biomedical Literature Database Database(CBM),China National Kmowledge Infrastructure (CNKI),VIP Chinese full text database (VIP) and Wanfang Data were searched for randomized controlled trials assessing nurse-directed discharge planning for hospital inpatients with chronic disease.Two reviewers independently extracted data and assessed risk of bias.Meta-analysis was conducted for the eligible studies by RevMan 5.3.4.Results Seventeen randomized controlled trials and 5 331 participants were included.Meta-analysis demonstrated that,compared to standard care,nurse-led discharge planning were effective in reducing hospital readmission [risk radio (RR)=0.73,95％ confidence interval (CI) 0.64-0.84,P＜0.01],duration of inpatient readmissions [mean difference (MD)=-2.48,95％CI-3.68--1.29,P＜0.01],and all-cause mortality (RR=0.78,95％CI 0.62-0.97,P＜ 0.05).However,no reduction in the length of stay of the index admission (MD=-0.18,95％CI-0.64-0.27,P ＞ 0.05) was demonstrated.Conclusions Nurse-led discharge planning has a positive impact on several aspects of care for hospital inpatients with chronic disease,including reducing readmission,readmission length of stay,and all-cause mortality.It is worth being popularized.

Objective To explore the correlation between polymorphism of interleukin-28B(IL-28B) rs12979860 T/ C and susceptibility of hepatocellular carcinoma( HCC). Methods All eligible case-control studies published up to 2014-09-30 were identified by searching PubMed,EMBase,CNKI,CBM,VIP and WanFang databases. Two reviews independently identified the literature according to inclusion and exclusion criteria. Meta-analysis was performed using Rev Man 5. 2 and Stata 12. 0 software. Results A total of 6 stud-ies comprising 1 138 cases and 955 controls were finally included. Meta-analysis showed that IL-28B rs12979860 T/ C polymorphism was associated with the susceptibility of HCC. Compared with the genotype CC and CT + CC,genotype TT increased the risk of suffering from HCC(TT vs CC:OR = 2. 26,95% CI:1. 40-3. 64,Z = 3. 33,P = 0. 000 9;TT vs CT + CC:OR = 1. 90,95% CI:1. 23-2. 93,Z = 2. 89,P = 0. 004). In stratification analysis by ethnicity,we observed that the polymorphism of IL-28B rs12979860 T/ C was associat-ed with the susceptibility of HCC among Caucasian populations(TT vs CC:OR = 2. 06,95% CI:1. 22-3. 47, Z = 2. 70,P = 0. 007;TT vs CT + CC:OR = 1. 71,95% CI:1. 07-2. 72,Z = 2. 23,P = 0. 03). Conclusion The polymorphism of IL-28B rs12979860 T/ C is associated with the susceptibility of HCC,genotype TT may increase the susceptibility to HCC.

Objective:To evaluate the effectiveness and safety of transepithelial photorefractive keratectomy (TransPRK) assisted by smart pluse technology (SPT) for the correction of high myopia.Methods:An observational case series study was conducted.Sixty high myopic patients (107 eyes) with spherical equivalent (SE)≥-6.0 D who received TransPRK assisted by SPT from January to December 2016 in Eye Hospital of Wenzhou Medical University were enrolled.Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) of the patients were examined and recorded in logarithm of the minimum angle of resolution (LogMAR) units, and refraction was examined with a subjective refractometer.The healing of corneal epithelium and corneal haze was observed with a slit lamp.Intraocular pressure (IOP) was measured with the non-contact tonometer.Safety index (SI) and efficacy index (EI) were analyzed.The follow-up time was 12 months.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Eye Hospital of Wenzhou Medical University (No.2019-197-k-177). Written informed consent was obtained from each patient prior to any medical examination.Results:The mean epithelial healing time was (3.77±1.02) days.There were statistically significant differences in UCVA and BCVA between before and after surgery ( Z=380.812, 267.313; both at P<0.001). And the 7-day, 6-month, and 12-month postoperative BCVA were better than preoperative BCVA, showing statistically significant differences (all at P<0.05). Mean SI was 1.10±0.12, and mean EI was 1.05±0.17 at 12 months after surgery.There was no significant difference between the attempted SE before surgery (-8.02±1.36)D and the achieved SE at 12 months after surgery (-8.04±1.51)D ( P=0.523). SE in the predictive range within ±0.50 D accounted for 79% (85/107) and that within ±1.0 D accounted for 92% (98/107). The IOP was slightly increased in 3 eyes at 7 days and 7 eyes at 1 month after surgery, respectively, which returned to normal after the use of ophthalmic solution for lowing IOP.The incidence of haze severer than grade 1 was less than 1% (1 eye), and haze gradually disappeared after application of drugs. Conclusions:TransPRK assisted by SPT for high myopia shows good safety, effectiveness and predictability.It is an ideal corneal surface surgery to correct high myopia.

Objective:To investigate the application value of pelvic floor ultrasound in screening early postpartum stress urinary incontinence (SUI).Methods:A total of 220 postpartum women, who were admitted by the Department of Gynecology and Obstetrics of The People's Hospital of Hechi from January 2018 to June 2019, were selected for this study. These women were divided into SUI ( n = 52) and no SUI ( n = 168) groups according to whether SUI occurred within 42 days after delivery. Pelvic floor ultrasound parameters and clinical data were compared between the two groups. The effects of each ultrasound parameter on postpartum SUI were assessed. The receiver operating characteristic (ROC) curve was plotted for each parameter. The area under the ROC was calculated. The risk factors for postpartum SUI were investigated using the logistic regression analysis. Results:The number of deliveries (≥ 2 times), the proportion of women subjected to vaginal delivery, and neonatal weight in the SUI group were significantly higher than those in the no SUI group [ χ2 = 4.13, 3.30, t = 4.43, all P < 0.05]. There were significant differences in the bladder neck position and levator hiatus area in the resting state between the two groups ( t = 2.29, 3.09, both P < 0.05). There were significant differences in the bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement between the two groups ( t = 13.14, 4.27, 15.64, 8.54, all P < 0.05). The areas under the ROC of bladder neck position and levator hiatus area in the resting state and the areas under the ROC of bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement were 0.707, 0.725, 0.730, 0.771, 0.813, and 0.836, respectively. The area under the ROC of parameters used in combination was 0.849. Logistic regression analysis results revealed that the number of deliveries (≥ 2 times), bladder neck position (> 27.286 mm) and levator ani hiatus area in resting state (> 16.663 cm 2), and bladder neck position (< -2.774 mm), levator hiatus area (> 21.915 cm 2), urethral rotation angle (> 80.445°), and bladder neck mobility (> 30.501°) during the Valsalva movement were the risk factors for postpartum SUI. Conclusion:Combined use of pelvic floor ultrasound parameters is valuable for the diagnosis of postpartum SUI. Abnormal changes in the bladder neck position, levator ani hiatus area, urethral rotation angle, and bladder neck mobility are closely related to the occurrence of postpartum SUI. Therefore, combined use of pelvic floor ultrasound parameters can be preferred to screen early postpartum SUI.