Objective To establish a sensitive and specific method for quantitative detection of Hantavirus RNA in serum of patients with hemorrhagic fever with renal syndrome(HFRS)by means of multiple TaqMan-MGB fluorescence quantitative RT-PCR.Methods 96 copies of HFRS have been selected as the test object patients serum,according to hantaan viruses(HV)strains sequence to design primer and TaqManTM probe,through the preparation of genomic DNA primers concentration,probe concentration and other conditions for optimization,the initial formation of HV virus multiple TaqMan-MGB fluorescence quantitative RT-PCR fast detection methods.Results Through the optimization laboratory conditions were after muhiple TaqMan-MGB fluorescence quantitative RT-polymerase chain reaction(PCR)are the most iueal reaction conditions,set up the rapid detection of HV virus method,test process process for 1.5 hours.Conclusion Multiple TaqMan-MGB fluorescence quantitative RT-PCR has high sensitivity,high specific characteristics,detection of short time,improve the detection of the hantaan viruses,help to diagnosis.

0bjective To explore the application of clinical nursing pathway combined with PDCA cycle in chemotherapy patients with diffuse large B cell lymphoma(DLBCL).Methods 160 chemotherapy patients with DLBCL were divided into experimental group and control group, with 80 patients in each group.Patients in the control group were given the conventional chemotherapy and patients in the experimental group were given clinical nursing pathway combined with PDCA cycle.Health education,job satisfaction,the occurrence of adverse reactions and the average hospitalization days were compared between the two groups.Results The awareness of health education and job satisfaction in experimental group were better than that in the control group(P <0.05).The occurrence of adverse reactions and the average hospitalization days in ex-perimental group were lower than that of control group(P <0.05).Conclusion The standard-ized management of clinical nursing pathway combined with PDCA cycle can increase the cognitive ability for diseases and improve the work efficiency as well as satisfaction.

0bjective To explore the application of clinical nursing pathway combined with PDCA cycle in chemotherapy patients with diffuse large B cell lymphoma(DLBCL).Methods 160 chemotherapy patients with DLBCL were divided into experimental group and control group, with 80 patients in each group.Patients in the control group were given the conventional chemotherapy and patients in the experimental group were given clinical nursing pathway combined with PDCA cycle.Health education,job satisfaction,the occurrence of adverse reactions and the average hospitalization days were compared between the two groups.Results The awareness of health education and job satisfaction in experimental group were better than that in the control group(P <0.05).The occurrence of adverse reactions and the average hospitalization days in ex-perimental group were lower than that of control group(P <0.05).Conclusion The standard-ized management of clinical nursing pathway combined with PDCA cycle can increase the cognitive ability for diseases and improve the work efficiency as well as satisfaction.

Objective Dilated cardiomyopathy (DCM) is generally considered to be accompanied by both left and right ventricular dysfunction,but most studies only analyze the left ventricular function. In this study, we evaluated the effect of arotinolol on right ventricular function in patients with DCM. Methods Right ventricular ejection fraction (RVEF) and right ventricular diameter (RVD) were measured by two-dimensional echocardiography (2-DE) in 33 DCM patients; RVEF measured by first-pass radionuclide angiography (FPRA) was compared with that by 2-DE. Results The treatment with arotinolol for one year resulted in a reduction in the right ventricular diameter (baseline, 23.0 ± 8.3 mm vs after one-year treatment, 20.7 ± 5.4 mm; P=0.004 ) and an associated increase in ejection fraction (baseline, 36.9 ± 10.3% vs after one-year treatment, 45.8 ± 9.6%; P ＜ 0.001 ); there is a high correlation between the 2-DE method and radionuclide ventriculographic method. The correlation coefficient is 0.933 (P＜0.001). Conclusion Arotinolol therapy could not only improve left ventricular function, but also improve right ventricular function in DCM patients.

Objective? ?To?analyze?the?risk?factors?of?delirium?in?patients?in?cardiac?surgery?intensive?care?unit?(CSICU).? Methods? A?prospective?observational?study?was?performed.?Patients?admitted?to?CSICU?of?Fujian?Medical?University?Union?Hospital?from?March?to?August?in?2017?were?enrolled.?The?combination?of?the?Richmond?agitation?sedation?scale?(RASS)?and?the?ICU-confusion?assessment?method?(CAM-ICU)?were?used?to?evaluate?delirium.?The?patient?was?assessed?on?the?second?day?after?CSICU?admission,?twice?a?day,?the?evaluation?was?stopped,?and?the?follow-up??observation?was?terminated?after?the?patient?was?discharged?from?CSICU.?The?patients?were?divided?into?two?groups?according?to?whether?delirium?occurred?in?CSICU.?The?general?and?clinical?treatment?data?(including?condition,?operation,?anesthesia?and?CSICU?treatment)?of?the?two?groups?were?compared.?The?related?factors?of?delirium?were?identified?by?univariate?analysis?and?multifactor?Logistic?regression?analysis.? Results? A?total?of?318?cases?were?included?in?this?study.?Among?them,?93?cases?had?delirium?and?the?incidence?of?delirium?was?29.2%.?It?was?shown?by?univariate?analysis?that?age,?history?of?hypertension,?type?of?surgery,?surgical?procedure,?American?Society?of?Anesthesiologists?(ASA)?anesthesia?classification,?usage?of?propofol,?plasma?transfusion,?red?blood?cells,?platelet?transfusion,?blood?loss,?operative?time,?cardiopulmonary?bypass?(CPB)?time,?myocardial?block?time,?acute?physiology?and?chronic?health?evaluation?Ⅱ?(APACHEⅡ),?duration?of?mechanical?ventilation,?the?length?of?intensive?care?unit?(ICU)?stay,?postoperative?usage?of?diazepam,?midazolam,?fentanyl,?morphine,?chlorpromazine,?etc.?which?were?related?to?delirium,?and?occupation?? (on-the-job?or?self-employed),?medical?insurance?(city?or?provincial?medical?insurance),?education?(primary?to?junior?high?school,?high?school?or?above)?could?reduce?the?risk?of?delirium.?Colinearity?diagnosis?was?performed?on?variables?with?statistically?significant?differences,?and?variables?with?variance?expansion?factor?(VIF)?

Objective To prospectively evaluate the short-term test-retest reproducibility of intravoxel incoherent motion (IVIM) parameters for lung cancer,and to investigate its impact factors.Methods Thirty-eight lung cancer patients underwent twice free breathing IVIM scanning (0.5-1.0 h interval).Two radiologists independently analyzed IVIM images to obtain true diffusion coefficient (D),pseudo-diffusion coefficient (D*) and perfusion fraction (f).All the parameters were compared between repeated measurements and scans.Intra-and inter-observer,test-retest reproducibility was assessed with interclass correlation coefficients (ICCs).The impact of lung cancer type (peripheral and central),size (the largest diameter ≥2 cm and ＜2 cm) and location (upper,mid,and lower lung field) on short-term reproducibility were compared by using coefficient of variations (WCVs).Results There was no significant difference between repeated measurements for all parameters (all P＞ 0.05).All the parameters showed good intra-and inter-observer agreement.WCVsof D* and f (19.88％-36.83％) were higher than those of D (2.97％-4.62％).WCVs of D were higher for central lung cancer and the largest diameter ＜2 cm,and increasing from apical to lower zone.WCV of f was larger in the central lung cancer and the largest diameter ≥2 cm,while D* was greatly influenced by type,size and location of lung cancer.Conclusion The test retest reproducibility of D is good,while of D* and f are poor in lung cancer.The type,size and location of lung cancers are the impact factors of IVIM parameters.

Objective To explore the difference of PICC utilization in different time on phlebitis occurrence among patients with tumor by chemotherapy. Methods According to peripheral venous chemotherapy, 325 cases had been divided into chemotherapy group (n = 93) and the first time chemotherapy group (n = 232). We observed the occurrence of patients with phlebitis in two groups after PICC implantation. Results The probability of phlebitis occurrence in patients after PICC placement in chemotherapy group was 26. 9% and that in the first time chemotherapy group was 12. 5% (χ2 = 9. 91,P < 0. 05). ⅠandⅡ grade of phlebitis incidence rates of patients in chemotherapy group were 18. 3% and 8. 6% , but that in the first time chemotherapy group were 9. 5% and 3. 0% (P > 0. 05), there were no Ⅲ grade phlebitis happened in both groups. Conclusions The PICC should be adopted by the patients as early as possible for patient with the first time chemotherapy to reduce the peripheral venous stimulation and reduce the phlebitis occurrence.

Objective:To observe the clinical effect of vacuum sealing drainage (VSD)combined with autologous free skin grafting in the treatment of multiple calf venous refractory ulcer.Methods:A total of 7 patients (16 lesions)with lower limb varicose vein complicated by multiple calf venous refractory ulcer,who underwent vascular surgery for treatment of the primary disease,received wound closure with VSD technology after debridement.And 7-10 days later,wound was repaired by VSD combined with autologous free skin graft based on patients'status.Results:The ulcers in 7 cases were all healed.Postoperative pressure bandaging was done with elastic bandage.There was no recurrence in six months'follow-up.Conclusions:For multiple calf venous chronic ulcer wound caused by varix of lower limb,the timely wound repair by VSD combined with autologous free skin graft and pressure bandaging after cure can improve the cure rate and decrease the recurrence rate.

Objective To explore the application effect of SCD EXPRESS pressure system in preventing postoperative deep venous (DVT) thrombosis in patients with malignant tumors.Methods Management group of DVT prevention was founded.The operative procedure of SCD EXPRESS pressure system was developed and all people received training.120 patients in Nantong Tumor Hospital from June 2014 to June 2015 were selected and were assigned to the observation group and the control group according the order of admission,with 60 cases in each group.Patients in the control group received routine preventive nursing measures,while patients in the observation group received SCD EXPRESS pressure system to prevent DVT based on the routine measures.The incidence rate of DVT,the time that treatment and care spend,daily cost,average hospitalization time and patient satisfaction degree were compared between two groups.Results One week after surgery,in the intervention group,the incidence rate of DVT was 3.3％,and it was 15.0％ in the control group (x2=4.22,P＜ 0.05).In the intervention group,the time that treatment and care spend was (6.73± 1.04) h and the average hospitalization time was (10.71±1.05) d;while in the control group,they were [(15.57±2.52) h,(17.00± 1.80) d].The satisfaction degree in the intervention group was (93.50±5.50) points and it was higher than that in the control group (84.90 ± 6.40) points (t =17.761,17.876,5.600;P ＜ 0.05).The daily cost in the intervention group was (624.38±85.21) yuan,and it was (593.62±71.74) yuan in the control group (t =-1.76,P＞ 0.05).Conclusions SCD EXPRESS pressure system can effectively prevent the formation of postoperative DVT in patients with malignant tumors;save the time that treatment and nursing spend;shorten the average confinement;improve patient satisfaction;and will not increase the daily cost of treatment.

Objective To explore the effects of early ambulation and exercise with multifunctional infusion support on improving the gastrointestinal function of patients who received radical resection for esophageal cancer.Methods Totally 83 patients who received radical resection for esophageal cancer and admitted in the Department of Thoracic Surgery of Nantong Tumor Hospital from October 2015 to October 2016 were randomly and equally divided into an observation group and a control group. Patients in the observation group, on the basis of conventional surgical nursing, started early ambulation and exercise with multifunctional infusion support 24 hours after surgery, while patients in the control group received conventional nursing for esophageal cancer and started ambulation 2-3 days after surgery. Then the patients in the two groups were compared in time of anal exhaust and such gastrointestinal intolerance symptoms as abdominal distention, diarrhea, nausea, vomiting and regurgitation 72 hours after being treated with enteral nutrition.Results The patients in the observation group showed a lower incidence of abdominal distention, diarrhea, nausea, vomiting and regurgitation than the patients in the control group (P<0.05).Conclusions Early ambulation and exercise with multifunctional infusion support can help to improve the gastrointestinal function of patients who received radical resection for esophageal cancer.