Objective To investigate the relationship between plasma albumin and hemoglobin(Hb) levels and prognosis in patients with severe craniocerebral trauma. Methods The clinical data of 124 patients with severe craniocerebral trauma form January 2010 to January 2014 were analyzed retrospectively. The relationship between plasma albumin and Hb levels and prognosis were analyzed. Hb level was obtained in 3 days of admission, and then the patients were divided into Hb <90 g/L group, Hb 90-99 g/L group, Hb 100-110 g/L group, Hb >110 g/L group, and also were albumin <25 g/L group, albumin 25-28 g/L, albumin 29-31 g/L group, albumin>31 g/L group according to the mean albumin level. Multifactor Logistic regression analysis was used to analyze the relationship between Hb, albumin levels and prognosis. Results Among 124 patients, 37 patients (29.8%) were given red blood cell (RBC) transfusion, and 28 patients (22.6%) received albumin treatment. The hospital mortality was 20.2% (25/124). The age, scores of Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ ), and hospital mortality in different Hb level groups had no significant differences (P>0.05). The age, scores of GCS score and APACHEⅡ score in different albumin level groups had no significant differences (P>0.05), but the hospital mortality in different albumin level groups had significant difference: 31.2%(10/32), 24.2%(8/33), 9.7%(3/31), 14.3%(4/28), P<0.05. Multifactor Logistic regression analysis showed that albumin level was the relevant factor for the severe craniocerebral trauma (P<0.01), the hospital mortality was decreased with the rising of the albumin level, but the risk of death was higher in albumin>31 g/L group than that in albumin 29-31 g/L group. Conclusions 29-31 g/L albumin level is the best for severe craniocerebral trauma patients. There is no significant impact of Hb on the prognosis for severe craniocerebral trauma patients.

Objective To study the protective mechanism of astragaloside on skin photoaging. Methods BALB/c mice were randomly divided into four groups: model group irradiated with ultraviolet rays (UV), model plus matrix group pretreated with the matrix before UV irradiation, model plus astragaloside group pretreated with astragaloside 0.08% cream before UV irradiation, normal control group received no irradiation or pretreatment. After 4-week irradiation, the mice were sacrificed, and skin tissues were resected from the back of these mice. Then, reverse transeription PCR (RT-PCR) and immunohistochemistry were performed to detect the mRNA and protein expression of TGF-βR Ⅱ and Smad 7, respectively. Gray scale ratio was used to represent the mRNA levels of TGF-βR Ⅱ and Smad 7. Results There was a significant difference in the mRNA level (F = 80.98, 736.80, respectively, both P < 0.01) and protein positivity rate (F = 45.36,132.25, respectively,both P < 0.01) of TGF-βR Ⅱ and Smad 7 among the 4 groups. The mRNA level and protein positivity rate of TGF-βR Ⅱwere 0.2588±0.0283 and (28.20 ± 5.24)% respectively in the model group, significantly lower than those in the normal control group[0.5688 ± 0.0439, (53.00 ± 4.72)%, both P < 0.01] and model plus astragaloside group [0.3767 ± 0.0374, (41.64 ± 2.59)%, both P< 0.01]; on the contrary, the mRNA level and protein positivity rate of Smad 7 in the model group [0.8637 ± 0.0514, (82.06 ± 2.18)%] were significantly higher than those in the normal control group [0.5900 ± 0.0585, (47.50±3.81)%, both P < 0.01] and model plus astragaloside group [0.7131 ± 0.0410, (64.36 ± 2.62)%, both P< 0.01]. In the model plus astragaloside group, the mRNA level and protein positivity rate of TGF-βR Ⅱ were significantly higher than in the model plus matrix group [0.2653 ± 0.0456, (28.74 ± 2.28)%, both P < 0.01], while those of Smad 7 were statistically lower than in the model plus matrix group [0.8553 ± 0.0575, (82.62 ± 4.02)%, both P < 0.01]. However,no significant difference was observed in the mRNA level or protein positivity rate of TGF-βR Ⅱ or Smad 7 between the model group and model plus matrix group (all P > 0.01). Conclusion Astragaloside can prevent skin photoaging by the alteration of TGF-β pathway via up-regulating TGF-βR Ⅱ expression and down-regulating Smad 7 expression.

Objective To establish a scientific and reasonable evaluation index system of nursing quality for cystoscopy. Methods After 2 rounds of Delphi survey technique, get the consensus of the evaluation indicators of the initial evaluation of the 18 experts,and ultimately build a system for nursing quality evaluation index during cystoscopy. Results After 2 rounds of expert consultation, the evaluation index system based on the three level structure of the medical quality framework includes:3 first-level indicators,8 second-level indicators,33 third-level indicators. Conclusions The evaluation index system established in this study is helpful to standardize the nursing behaviors of nurses in the examination process,improve the quality of nursing service in the process of cystoscopy, and improve the accuracy and reliability of inspection.

Objective To construct a self management program for patients with ureteral stoma, then validate the proposal. Methods The expert consensus reached an agreement after 2 rounds of Delphi expert consultation of "self management programme", according with the contents of the manual requirements,the intervention patients(41 cases)were given these self management interventions:regular one-on-one ostomy skills training, mental support and motivational interview, recording stoma diary, the control patients were given routine nursing interventions,after 1,3 and 6 months of implementation,their results of self management was evaluated. Results The total score of self-management ability was 99.32±10.41,105.34±13.75,109.18±10.91 in the control group after the intervention of 1,3 and 6 months respectively,and 106.73 ± 13.82,117.65 ± 15.47,129.43 ± 12.37 in the test group,the differences were statistically significant (t=7.847, 9.318, 11.416, P<0.01). The total score of quality of life was 167.18 ± 24.62, 173.36 ± 25.33, 179.48 ± 22.17 in the control group after the intervention of 1, 3 and 6 months respectively,and 178.66 ± 23.47,185.41 ± 22.67,213.17 ± 26.75 in the test group,the differences were statistically significant (t=6.839, 10.241, 13.926, P<0.01). Conclusions The construction of the ureterostomy self-management program, enhance patients'self-management consciousness, and improve the ability of self-management.

Objective: To investigate the prevalence of work-related musculoskeletal disorders(WMSDs) among intensive care unit (ICU) nurses, assess its relationship with ergonomic load and overall exposure levels. Methods: A total of 272 ICU nurses from two tertiary hospitals in a city were selected as the research subjects using convenient sampling method. The Chinese Musculoskeletal Disorder Questionnaire was used to investigate the prevalence of WMSDs among the ICU nurses. The Quick Exposure Check (QEC) was used to assess the ergonomic load on the back, shoulder/arm, hand/wrist, and neck during different clinical nursing operations. Results: The annual prevalence of WMSDs was 75.7% among ICU nurses. The annual prevalence of WMSDs in different body parts, from high to low, was as follows： lower back, neck, shoulder/arm, back, knee, hip/leg, hand/wrist, ankle/foot, and elbow (54.8% vs 43.4% vs 40.8% vs 36.0% vs 21.3% vs 19.9% vs 18.8% vs 18.4% vs 8.1%, P<0.01). ICU nurses had the highest QEC scores on the back (dynamic), shoulder/arm, hand/wrist, and neck with assisting patient turning (all P<0.05) among the six clinical nursing items. During the operation of patient turning, patient lifting, patient bathing, and bed sheet changing for bedridden patients, the back (dynamic) and shoulder/arm were at a high load level, while the hand/wrist and neck were at a mild load level. When nurses were providing tracheostomy care and oral care for intubated patients, their back (static), shoulder/arm, hand/wrist, and neck were at a mild load level. The overall exposure rate for assisting patient turning, patient lifting, oral care for intubated patients, bed sheet changing for bedridden patients, patient bathing, and tracheostomy care were 77.8%, 66.5%, 63.6%, 60.2%, 58.5%, and 57.4%, respectively. The risk for assisting patient turning was classified as level four, while the risk for other clinical nursing items was level three. Conclusion: The prevalence of WMSDs in ICU nurses is high. Both ergonomic load level and total exposure rate of back, shoulder/arm, hand/wrist and neck were high during clinical nursing operations.

Objective: To evaluate peripheral vein puncture assisted with Eyes-On vascular imaging glasses in vulneralis shock. Methods: Between February 2017 and June 2018, 110 patients in vulneralis shock were distributed to treatment group, and 128 patients between January 2016 and January 2017 were distributed to control group. Peripheral vein puncture were underwent in treatment group assisted with Eyes-On vascular imaging glasses, and with traditional operation in control group. Successful rate of first puncture, second puncture, puncture more than three times, and failure rate, operating time, rate of complications were recorded. Results: Successful rate of first puncture in treatment group and control group were 97.03% (98/101) and 9.38% (12/128). There was significant difference between two groups (χ²=173.771, P=0.001). Operating time of treatment group and control group were (1.16±0.41), (5.01±1.03) min, there was significant difference between two groups (t=7.693, P<0.01). In the observation group, puncture was successful while in the control group, puncture failed in 5 cases, with a failure rate of 3.91%(5/128). And there was no significant difference in failure rate of puncture (P >0.05). Regard as complications, there were no significant differences in leakage and bleeding (P>0.05), but there were significant differences in blockage and hematoma which were 5.94%(6/101), 1.98%(1/101) and 21.09%(27/128), 11.71%(15/128)(χ²=10.510, 7.791, P<0.01). Conclusion Eyes-On vascular imaging glasses can operated easily and vein imaging directly, and nurses can independently proceed puncture quickly and effectively in vulneralis shock. Eyes-On glasses is a recommended device.