Objective:To study the application effect of hierarchical management in medical care. Methods:A retrospective analysis about sixty-eight patients were taken hierarchical management methods in nursing work from February 2009 to February 2010. Results:The quality of nursing and patients nursing satisfaction were obviously higher than before the management layer in 68 patients,, the result is significant difference(t=3.02,t=3.69;P<0.05). Conclusion: The hierarchical management method not only can effectively improve the quality of nursing, but also greatly improve the patient care satisfaction and the clinical application and popularization.

ObjectiveTo evaluate combined pneumatic lithotripsy and vacuum suction during ureterorenoscopy.MethodsCombined pneumatic lithotripsy and vacuum suction during ureterorenoscopy was conducted for 52 cases of urolithiasis with the average age of the patients 36 years old.There were 3 cases of renal stone,9 upper ureteral stone,12 middle ureteral and 28 lower ureteral stone.The average surface area of the stones was 79 mm2.ResultsThe average operation time was 31 min and the fragmentation in situ 100.0%.The stone upward displacement rate was 1.7%.Fragmentation of the stone has been incomplete in 2 cases and ESWL was instituted.49 patients have been followed up for 1～3 months and the stone clearance rate was 96.0%.ConclusionsThe procedure would reduce the high instillation pressure which might cause upward displacement of the stone and liquid reflux to the renal parenchyma.The vacuum pressure set to -0.2～-0.4 bar is the most ideal.

Cyanobacterial toxins may pose a threat to human health through drinking water and recreational water exposure. The official guideline limits of cyanobacterial toxins have not been established. The human health effects, exposure routes, possible guideline limits and calculation method were introduced in the present paper. The knowledge will provide a base to undertake risk management for the toxins and will also contribute to establishing official guideline limits of cyanobacterial toxins in water and will be benefit for ensuring the safety of drinking water.

Objective To probe into the effect of nursing intervention on complications and compliance of cancer patients with PICC. Methods 86 tumor patients selected from June 2007 to June 2010were randomly divided into the intervention group and the control group with 43 patients in each group. After the two groups of patients were diagnosed they were treated with routine care, the intervention group wasgiven additional comprehensive nursing interventions aiming at PICC complications and compliance. The complications and treatment compliance of the patients were analyzed. Results Compared with the control group, the rate of full compliance significantly improved and the rate of partial compliance significantly decreased in the intervention group. At the same time, compared with the control group, the incidence rate of phlebitis, catheter-related bloodstream infection and catheter blockage and catheter off of the intervention group were significantly lower. Conclusions Nursing intervention for cancer patients with PICC can reduce complications and improve treatment compliance of them and is of great clinical significance.

Objective To investigate the effect of liraglutide combined with glargine insulin in treating the patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods Sixty-one cases of newly diagnosed T2DM in the endocrinology department of Affiliated Chaozhou Central Hospital of Southern Medical University,from August 2014 to December 2015 were selected and divided into two groups according to the random number table.The observation group (29 cases) was treated with liraglutide combined with glargine insulin and the control group (32 cases) was given the intensive insulin therapy.The curative effects before and after treatment were analyzed and compared between the two groups.Results The fast plasma glucose(FPG),postprandial 2 h blood glucose(PPG),glycosylated hemoglobin(HbA1c),fasting C peptide(FCP),postprandial 2 h C peptide(PCP),insulin resistance index(HOMA-IR),blood lipid indicators and body mass index after 12-week treatment were decreased in the treatment and follow up periods,while pancreatic β cell function index (HOMA-β) and HDL-C were increased,indicating that the two kinds of treatment method all were effective.The effect onset in the observation group was faster,the above indexes after 4-week treatment were significantly improved compared with before treatment.The above indexes after 4-,12-week treatment in the observation group were significantly superior to those in the control group,the difference was statistically significant(P<0.05).Conclusion Liraglutide combined with glargine insulin has better effect in the aspects of reducing blood glucose,regulating blood lipid,decreasing the body mass and islet function recovery than the intensive insulin treatment and is worthy of clinical promotion and application.

Objective; To study the chromatic distribution of the chromatic value of Vitapan 3D- Master shade guide in color space. Methods: The color space of.Vitapan 3D-Master shade guide was measured and analyzed with CIE-1976-L* a* b. system and MINOLTA chromatic instrument (CR-321 ) under D65 standard source. Results: 26 shades of Vitapan 3D-Master could be divided into 5 groups according to the 3-dimensional layers. Inside the 2nd, 3th and 4th group, 6 shades distributed as equidistant ring circling M2 shade because their hue and chroma were different. The hue of L1. 5 and L2. 5 deflected to yellow, R1.5 and R2. 5 to red,that of M1-3 was intervenient. Conclusion: Vitapan 3D-Master shade guide is equidistant in color space and can be used more effeciently than Vitapan classical. Its chromatic value distribution perfectly and evenly covered color region of nature tooth.

Objective To develop kinesthetic and visual imagery questionnaires applicable to Chinese stroke survivors and evaluate their test-retest reliability,inter-rater reliability and internal consistency.Methods The English version of a kinesthetic and visual imagery questionnaire (KVIQ) was translated into Chinese using wellaccepted questionnaire translation procedures.Thirty stroke survivors were each assessed twice using two versions of the translation (the KVIQ-20 and the KVIQ-10) by two experienced raters with an interval of 7 days between the tests.The test-retest reliability,inter-rater reliability and internal consistency of the visual imagery score (visual imagery subscale),the kinesthetic imagery score (kinesthetic imagery subscale) and the total scores for the KVIQ-20 and KVIQ-10 versions were analyzed.Results The test-retest coefficients,the inter-rater reliability correlation coefficients and Cronbach's alphas for the KVIQ-20 version ranged from 0.879 to 0.945,from 0.894 to 0.936 and from 0.867 to 0.919,respectively.The corresponding measurements for the KVIQ-10 vcrsion were 0.914 to 0.953,0.852 to 0.900 and 0.827 to 0.878.Conclusion Both the KVIQ-20 and KVIQ-10 Chinese instruments have shown good testretest and inter-rater reliability and good internal consistency in assessing stroke survivors.Either is an effective tool for assessing their motor imagery ability.

Objective:To implement an intervention with community-dwelling middle-aged and elderly people through a new science promotion approach, and to evaluate changes in the level of bone health awareness.Methods:From April 2017 to June 2017, 200 community-dwelling middle-aged and elderly people aged 50 years and over were randomly included.They were divided into the intervention group receiving a new science promotion intervention(n=100, with 50 males and 50 females)and the control group(n=100, with 50 males and 50 females). Baseline and follow-up assessments of bone health awareness were performed before and after the one-year intervention.A questionnaire survey on preferences for different types of science promotion articles in WeChat accounts was conducted.Differences in scores for intervention effects before and after intervention were compared between the two groups.Potential influencing factors for the scale score were examined by a multi-factor analysis.Results:After one year of intervention, scores for intervention effects were higher in the intervention group than in the control group( P<0.001). In the intervention group, scores were higher after intervention than before intervention( P<0.001). In the control group, scores after follow-up were slightly higher than those at baseline(29.4±11.4 vs.27.9±10.1, P<0.001). The increase in scores before and after intervention was greater in the intervention group than in the control group( P<0.001). Baseline score, group designation, history of drinking and diabetes impacted the scores in middle-aged and elderly women, while other factors did not.Most middle-aged and older people preferred texts illustrated with pictures, and older people were more receptive to videos. Conclusions:The new science promotion method is beneficial to bone health management, can improve bone health awareness in middle-aged and elderly people.

Objective To compare the safety and efficacy of direct and remedial rotational atherectomy in the treatment of heavily calcified coronary artery lesions.Methods We retrospectively reviewed 58 patients admitted in the Shanghai Chest Hospital and Liaocheng People Hospital from May 2012 to July 2015 who had received stent implantation and rotational atherectomy.The 58 patients were divided into two groups which were the direct atherectomy group (n =27) and the remedial atherectomy group (n =31).General clinical date,lesion and procedural characteristics,intraoperative complications,in-hospital and follow-up MACCE were compared between the two groups.Results There were no differences between the two groups in general clinical date intraoperative complications,amount of contrast agent used,proceduraltime,rates of in-hospital and follow-up MACCE.Nevertheless,compared with the direct artherectomy group,the remedial group had more number of balloon dilations during procedure [3 (1,5) vs.2 (1,2),P ＜ 0.001] and higher peak cardiac troponin levels [1.1 (0.3,3.0) μg/L vs.0.5 (0.1,2.3) μg/L,P =0.032].Conclusions Remedial rotational atherectomy with drug-eluting stent had the same safety and efficacy as direct atheretomy with drug-eluting stent in treating patients with heavily calcified coronary lesions.It is reasonable and safe to transform routine PCI to remedial rotational atherectomy when the 2.0 mm semi compliant balloon or/and 2.5 mm non-compliant balloon cannot pass through or dilate the lesions.

Objective To investigate the application effect of tracking control method in the evaluation of nursing quality management , in order to provide the basis for the establishment of overall assessment standards for nursing quality .Methods The structured evaluation method of traditional quality control was used in the control group and the tracking control method was used in the observation group .The nursing quality in the hospital was evaluated at different time intervals .The comprehensive score of nursing quality and patients ’ satisfaction with nursing in each month were evaluated in the two groups .Results The comprehensive score of nursing quality in each month from July to December 2012 in the observation group was significantly higher than that in the control group from July to December 2011 [(92.5 ±0.7) vs (89.0 ±0.6), (93.5 ±0.6) vs (90.0 ±0.6), (94.0 ±0.4) vs (91.0 ±0.6), (92.5 ±0.6) vs (89.0 ±0.9), (93.5 ±0.5) vs (90.5 ± 0.8), (92.0 ±0.3) vs (88.5 ±0.4)], and the differences were statistically significant (t=2.570, 2.862, 2.842,2.670, 3.014, 2.942, respectively; P <0.05).The result of patients ’ satisfaction survey in the observation group was considered satisfactory in 238 cases, basic satisfactory in 16 cases and dissatisfactory in 10 cases, and 225,15 and 24 cases in the control group , respectively, with statistically significant difference (Z=2.543 1, P<0.05).Conclusions Application of tracking control method in the evaluation of nursing quality management can improve the nursing quality , increase the patients ’ satisfaction with nursing , and promote the continuous improvement of nursing quality .