The holistic nursing care which central is “nursing procedure” require nurse to find the health problems of patients and solve them.But in professional nursing,it is urgent and generates that how to master and give correctly nursing diagnosis.In this article,we sum up and analysis 542 cases of the nursing diagnosis about 175 stroke patients.Then give the trend of centralized distribution and limitation about diagnosis.After it,we give the way to solve them.

In this article we collected 2 embryos and 69 fetuses between 7 and 30 weeks of gestational age and 3 neonates to study the development of the human stomach by histological, histochemical and immunogold-siver methods. In 7-week embryo, the superficial layer of gastric mucosa was stratified columnar epithelium, containing a large amount of glycogen. In 9-week fetus, simple columnar epithelium, gastric pits and glandular buds were observed. At this stage a few parietal cells could be identified at the bottom of the glands. The pyloric glands contained parietal cells as fundic glands. At 13-14 week the muscularis mucosa appeared and the wall of stomach formed definitively as the adult. A few argyrophil cells in antrum and fundus were found at 12-week fetus. They scattered in the surface epithelium and concentrated in the lower portion of the glands. The argyrophil cells were round, pyramidal or spindle in shape. More argyrophil ceils were found in the antrum from 14-week on. At 18-week, the argyrophil cells were most numerous. Some cells possessed processes extending to the basement membrane or parietal cells. Between 15-30 weeks various shaped EC cells in fundus were found, with some open-type endocrine cells. G cells in antrum were mostly rounded and often in groups at 13,16 and 21 week. Developing G cells were observed under EM.

Objective To assess nutritional status of critically ill children,and to investigate the correlation of nutritional status with illness severity and clinical outcomes,so as to provide a theoretical basis for rational nutrition support of critically ill children.Methods All patients hospitalized in the pediatric intensive care unit of Beijing Children's Hospital from November,2010 to January 2011 were enrolled and studied prospectively.We collected anthropometric parameters (body length/height,body weight,head circumference,etc) for nutritional assessment,as well as their clinical data such as underlying diseases,pediatric risk of mortality scores (PRISM),length of hospital stay and mechanical ventilation duration.Results tn 196 cases,the prevalence of malnutrition was 21.9％ (43/196).Malnutrition group had greater PRISM scores,higher mechanical ventilation rate and a lower 28-day survival rate than normal nutritional status group (all P ＜ 0.05).Conclusions The prevalence of malnutrition on admission to the PICU was high and poor nutritional status indicated greater illness severity and adverse clinical outcomes

Vitamin D is a kind of essential nutrient.Besides participating in calcium-phosphate metabolism,vitamin D also plays a role in the immune regulation.Sepsis is a common condition in ICU which can lead to immune disturbance and is associated with high mortality.Vitamin D deficiency in septic patients is more common than in the healthy peers.The mechanism of immune dysfunction in septic patients,the immunomodulatory role of vitamin D,the interaction between vitamin D and immune function were reviewed in this article.

Objective To evaluate the effect of combination of HANS (Han's Acupoint Nerve Stimulator) and diazepam(D) or tramadol(T) on labor pain and influence on mother and infant. Methods Two-hundred and seventy normal term pregnancy and primipara with single vertex presentation were randomly divided into six groups, HANS+D ((HANS plus diazepam 10mg, iv), HANS, D(diazepam 10 mg, iv), HANS +T (HANS plus tramadol 100mg, im), T (tramadol 100mg, im) and control group . Pain relief methods were given when the cervix dilated to 2~3 cm. Labor pain was evaluated by VAS (visual analogue scale) at different stage. Results The effective rate of analgesia for HANS+D was the highest, 90.5%, for HANS+T and HANS were 78.9% and 59.8%, respectively. The VAS of the groups combination of HANS and drugs at the time one hour after analgesia, cervix dilating 7~8 cm, second stage, were much lower than that before analgesia and that of control group (P

Objective To investigate the psychological characteristics and personality of perinatal women, and to provide evidence for effective psychological intervention. Methods Five hundred and seventy pregnant women were randomly selected from the out-patient department from October, 2002 to March, 2003. Eysenck Personality Questionnaire(EPQ) , Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) were applied for their personality, psychological characteristics and the influencing factors. Psychological surveys were performed in 216 cases in labor, and 300 cases were followed up during 1-5 days and 42-60 days postpartum. Results During pregnant period, the incidence of anxiety and depression was 10. 5% and 10. 2%, respectively, while 4. 0% and 5. 3% during early stage of puerperium. The rate of depression was 40. 7% and 10. 0% during late stage of puerperium and after puerperium. Pregnant women with personality of stability were less likely to have psychological disorder. Conclusions The rate of psychological disorder varies in different per sonallity. Proper intervention among high risk pregnant women is important in perinatal psychological

Objective To investigate the incidence,etiology and risk factors of cardiorespiratory arrest (CRA) in pediatric emergency room and preliminarily evaluate the efficacy of cardiopulmonary resuscitation (CPR).Methods The unified,standard in-hospital Utstein style was used for data collection with filling answers in the questionnaire.The survey items included the causes of cardiorespiratory arrest and the factors influencing the efficacy of CPR.The restoration of spontaneous circulation (ROSC) was used to evaluate short-term efficacy of CPR.Results Totally 182 380 patients aged from 28 days to 18 years were admitted to emergency room of Beijing Children' s Hospital between July 1,2008 and February 28,2010.Of them,237 patients (0.13％) were subjected to cardiorespiratory arrest,of which 169 patients received CPR and 88 patients (52.1％) got sustained ROSC.Neither sex nor age distribution affected ROSC.The primary cause of CRA and kind of initial abnormal rhythm of heartbeat leading to CRA were associated with the rate of ROSC.The rates of ROSC occurred in patients with or without pre-hospital transport were 64.1％ and 44.8％,respectively.The rate of ROSC was closely related to time consumed for getting ROSC by CPR,and as CPR durations were ≤ 10 min,10 to 30 min,and ＞ 30 min,the rates of ROSC were 67.5％,61.4％ and 30.5％,respectively.Multiple stepwise logistic regression analysis showed that kind of initial abnormal rhythm and CPR duration were associated with the rate of ROSC.Conclusions The incidence of CRA in emergency was 0.13％,and the rate of ROSC after CPR was 52.1％.The kind of initial abnormal rhythm of heartbeat and CPR duration were independent factors associated with the rate of ROSC.

Objective To investigate the expression of nm23-H1 in human benign and malignant colorectal lesions and the relationship between invasion,metastasis in colorectal carcinoma.Methods The expression of nm23-H1 were determined by ABC immunohistochemical technique in 80 cases human colorectal carcinoma,and compared with that in adenoma and normal mucus.Result Positivity expression rates of nm23-H1 were 66.7% in colorectal carcinoma.No significant difference of the expression of nm23-H1 in normal mucus,adenoma and cancerous tissue (P>0.05).The positive rates of nm23-H1 expression in different pathological grading,lymph node metastasis and post-operative survival (3 years) were showed significant difference (P<0.05).Conclusions It is suggested that the deletion of nm23-H1 low expression might play an important role in the carcinogenesis,development,metastasis and prognostic value of human colorectal carcinoma.

Objective To investigate the use of glucocorticoid in severe hand-foot-mouth disease in Henan and Sichuan Province and to compare the therapeutic effects of different dose of glucocorticoid.Methods In this multicenter retrospective study,320 cases of severe hand-foot-mouth disease,which were randomly sampled from Jan.to May 2011 in Henan and Sichuan Province were collected.The use of intravenous glucocorticoid was calculated.Accor-ding to the dose of corticosteroids which had been used,these cases were divided into 3 groups:the non-corticosteroids group,the low-dose group and the high-dose group.The cure rate,febrile duration,nervous system involvement duration,time of staying in hospital,vital signs and serum glucose in 3 groups were compared.Results Patients who used intravenous glucocorticoid accounted for 90.9％ (291/320 cases),and only 29 patients had not used (9.1％).The cure rate among 3 groups were not significantly different(P ＞0.05).In the low-dose group and the high-dose group,the nervous system involvement duration,the febrile duration and time of staying in hospital were longer than those in the non-corticosteroids group (all P ＜ 0.05).Comparing the blood pressure among 3 groups on the first day and the third day of hospitalization,the diastolic blood pressure in the high-dose group was much higher than that in other 2 groups on the third day of hospitalization(all P ＜ 0.05).Conclusions Glucocorticoid is generally used in severe hand-foot-mouth disease in Henan and Sichuan Province.The high-dose glucocorticoid is more often used in the situation that fever,nervous system involvement are not relieved.Glucocorticoid can never improve the cure rate in patients with severe hand-foot-mouth disease or shorten the course,relieve clinical symptoms.The therapeutic effects of glucocorticoid in severe hand-footmouth disease are not confirmed.The therapy of high-dose glucocorticoid may increase medicinal side effects.

On the basis of systematicly reviewing the developmental history of acupuncture and moxibustion and profoundly understanding its academic connotations,the authors of the present article make a summary and analysis on the key factors influencing the development of acupuncturology. These key factors are 1) the emergence of "microacupuncture needle regulating-Qi" and the establishement of their corresponding theory system,2) a large number of practitioners who inherited the learnings of acupuncturology generations by generations,and abundant medical classical works which recorded the valuable academic thoughts and clinical experience of the predecesors,3) the application of acupuncture charts and manikins,and 4) modernizing changes of acupuncture learnings after introduction of western medicine to China. Just under the influence of these key factors,the acupuncture medicine separates itself from the level of the simple experience medicine,and has formed a set of special theory system and developed into a mature subject.