0.05).②Laser retinal visual acuity was from 0.12 to 0.4 preoperatively,and from 0.2 to 0.63 postoperatively,the difference was significant (P

This study presents a fitting method for the intensity-response curve of electroretinogram. The data of b-wave amplitudes from 10 eyes with idiopathic macular hole and their contra-lateral contrast eye (normal) were analyzed. It was observed that the Rmax de creased significantly (P=0.013) in the eyes with idiopathic macular hole.

Objective To evaluate the effect of anticoagulant therapy in the patients with non-small cell lung cancer (NSCLC).Methods One hundred and fifty-nine patients with NSCLC without venous throm-boembolism (VTE)were divided into anticoagulant therapy group (81 cases)and control group (78 cases)by random number table method.The 81 cases in anticoagulant therapy group were treated with anti-tumor therapy and anticoagulant therapy,using low molecular heparin calcium 5 000 U subcutaneous injected for 1 0-30 days, once every 1 2 hours.The 78 cases in control group were merely treated with anti-tumor therapy.Results After treated with anticoagulation therapy,patients in anticoagulant therapy group had prolonged prothrombin time [(1 3.56 ±4.30)s vs (1 5.1 6 ±2.1 2 )s;t =3.1 95,P =0.001 ],active partial thromboplastin time [(28.24 ±5.28)s vs (30.26 ±3.28)s;t =2.71 2,P =0.007)],and a lower FIB [(3.85 ±0.75)g/l vs (4.25 ±2.65)g/l;t =2.971 ,P =0.003]compared with the patients in control group.The incidence of thrombosis rates of the two groups were 2.47% and 1 6.67% respectively,with statistical significance (χ2 =9.901 ,P =0.002).Both the 1 ,2 years overall survival rates of patients in anticoagulant therapy group were longer than those in control group,with statistical significances (χ2 =5.496,P =0.026;χ2 =4.540,P =0.046),while the 1 ,2 years progression-free survival rates of patients in the two groups were no statistical sig-nificances (χ2 =2.034,P =0.1 82;χ2 =0.091 ,P =0.395 ).Adverse reactions such as hemorrhage (4.94% vs 6.41 %),thrombocytopenia (9.88% vs 8.98%),skin necrosis incidence (3.70% vs 1 .28%) in the anticoagulant therapy group and control group were no statistical significances (χ2 =0.51 6,P =0.685;χ2 =0.008,P =1 .000;χ2 =0.847,P =0.632).Conclusion For patients with NSCLC,prophylactic antico-agulant therapy can improve coagulation status,reduce the incidence of thrombosis,prolong OS,and no obvi-ous adverse reactions.

ObjectiveTo evaluate the efficacy of stereotactic body radiotherapy combined with coinstan taneous gemcitabine,and gemcitabine alone for advanced pancreatic cancer.Methods56 advanced pancreatic cancer patients were assigned into observation group,which accepted stereotactic body radiotherapy combined with coinstantaneous gemcitabine 500 mg/m2,d1,d8.Other 50 patients were assigned into the control group which only accepted gemcitabine 1 000 mg/m2,d1,d8,d15.Stereotactic body radiotherapy was delivered with a total dose of 4 000-4 500 cGy in 10 fractions.ResultsCT examinations were carried out 2 months after treatment.The response rate of the observation group and control group was 82％ and 16％ respectively,and the pain relief rate was 67％ and 17％ respectively.The time to progression of the observation group was 14 months,and was better than that of the control group(7.5 months,x2 =7.31,P =0.032).The median survival time of the observation group and control group was 15.8 months and 13.2 months,and the difference had no statistical significance(x2 =3.28,P =0.082).ConcolusionStereotactic body radiotherapy combined with gemcitabine has a better overall response rate and a pain relief rate.It can prolong the time to progression,but can't improve the overall survival.

Objective To detect anti-cell membrane DNA ( cmDNA) antibody with human B lym-phocyte Raji cells and human promyelocytic leukemia HL60 cells as substrates and to compare the diagnostic value of anti-cmDNA antibody with that of anti-nucleosome antibody ( AnuA ) , anti-Sm antibody and anti-double-stranded DNA ( dsDNA) antibody in juvenile systemic lupus erythematosus ( JSLE) patients. Meth-ods We recruited 92 JSLE patients and 71 patients with other rheumatic diseases. Anti-cmDNA antibody an-dantinuclear antibody ( ANA ) was detected in patient serum by indirect immunofluorescence assays ( IIF ) . Anti-dsDNA antibody were detected by combining enzyme-linked immuno sorbent assay ( ELISA) and IIF. Anti-Sm antibody were detected by double immunodiffusion assay and immunoblotting, while anti-nucleosome antibody ( AnuA) were detected by ELISA. We collected concurrent clinical data. Results Anti-cmDNA antibody demonstrated stronger intensity of fluorescent patterns in using Raji cells as substrate than HL60 cells. JSLE patients had a significantly higher positive percentage of anti-cmDNA than patients with other rheu-matoid diseases. The sensitivity of anti-cmDNA on cell line Raji was higher than that of anti-dsDNA and anti-Sm (P<0. 01), the specificity of anti-cmDNA was close to anti-dsDNA (P>0. 05) and was lower than anti-Sm and AnuA (P<0. 01). The sensitivity of anti-cmDNA was similar to AnuA (P>0. 05) and the specificity was lower than AnuA (P<0. 01). The sensitivities of anti-dsDNA, anti-Sm and AnuA by combining with an-ti-cmDNA were much higher than that of the above antibody detected respectively ( P<0. 05 ) . Anti-cmDNA had no correlation with SLE disease activity index ( P=0. 907 ) . Conclusion The high sensitivity and speci-ficity of anti-cmDNA antibody make it a valuable diagnostic tool for JSLE. Combined detection of anti-cmDNA and other autoantibody might further improve the sensitivity in JSLE. Anti-cmDNA detected with IIF on cell line Raji was better than cell line HL60.

Objective To observe the efficacy and adverse reaction of intrapleural hyperthermic perfusion and intrapleural chemotherapy for patients with malignant pleural effusion (MPE) caused by lung cancer.Methods A total of 103 patients with MPE caused by lung cancer were assigned into one of two groups:intrapleural hyperthermic perfusion group (n =65) and intrapleural chemotherapy group (n =38).The disease control rate,MPE progress free survival,the relationship between vascular endothelial growth factor (VEGF) concentration in pleural effusion and curative effect and adverse reactions were observed.Results The overall disease control rate in intrapleural hyperthermic perfusion group and intrapleural chemotherapy group was 81.5％ and 52.6％ respectively,with a significant difference (x2 =9.834,P =0.002).The median MPE progress free survival of the two groups was 3.10 and 2.15 months respectively,with a significant difference (x2 =10.512,P =0.001).A significant difference of the median MPE progress free survival was observed in low VEGF concentration subgroup between intrapleural hyperthermic perfusion and intrapleural chemotherapy (3.34 months vs.2.20 months;x2 =9.409,P =0.002),but no difference was observed in high VEGF expression subgroup (2.85 months vs.2.10 months;x2 =2.429,P =0.119).The main adverse reactions included gastrointestinal adverse reaction,fatigue and hematotoxicity.Fatigue occurred in intrapleural hyperthermic perfusion group more commonly compared with intrapleural chemotherapy group (67.7％ vs.13.2％;x2 =28.595,P ＜ 0.001).Conclusion Compared with intrapleural chemotherapy,intrapleural hyperthermic perfusion can better improve disease control rate and MPE progress free survival in MPE patients caused by lung cancer,and it's adverse reactions are tolerated easily.The MPE progress free survival prolonging is observed especially in VEGF low expression subgroup.VEGF level in pleural effusions maybe could predict efficacy of intrapleural hyperthermic perfusion.

Objective To evaluate the effect of comprehensive intervention measures on improving hand hygiene (HH)compliance of health care workers(HCWs)in intensive care units (ICUs)by multicenter study.Methods A total of 47 hospitals in 12 provinces and cities were enrolled in the study,from October 2013 to September 2014, HH compliance among HCWs in ICUs was investigated according to World Health Organization HH investigation method,HH compliance rates before and after intervention were compared.Results HH compliance rate of HCWs in ICUs increased from 73.70%(11 155/15 135)before intervention to 78.70%(18 206/23 132)after intervention (χ2 =128.16,P <0.01);except northeast region ,HH compliance of HCWs in the other provinces increased signif-icantly after intervention(all P <0.05);among all departments,HH compliance of HCWs in general ICUs,respira-tory ICUs,emergency ICUs,and surgical ICUs increased significantly(all P <0.05);HH compliance of HCWs of all kinds of occupations increased significantly(all P <0.05);HH compliance rates before touching a patient,before clean/aseptic procedure,after touching a patient,and after touching patient surroundings increased significantly after intervention(all P <0.01 ).Conclusion Comprehensive interventions are helpful for improving HH compliance of HCWs in ICUs. Objective To evaluate the effect of comprehensive intervention measures on improving hand hygiene (HH)compliance of health care workers(HCWs)in intensive care units (ICUs)by multicenter study.Methods A total of 47 hospitals in 12 provinces and cities were enrolled in the study,from October 2013 to September 2014, HH compliance among HCWs in ICUs was investigated according to World Health Organization HH investigation method,HH compliance rates before and after intervention were compared.Results HH compliance rate of HCWs in ICUs increased from 73.70%(11 155/15 135)before intervention to 78.70%(18 206/23 132)after intervention (χ2 =128.16,P <0.01);except northeast region ,HH compliance of HCWs in the other provinces increased signif-icantly after intervention(all P <0.05);among all departments,HH compliance of HCWs in general ICUs,respira-tory ICUs,emergency ICUs,and surgical ICUs increased significantly(all P <0.05);HH compliance of HCWs of all kinds of occupations increased significantly(all P <0.05);HH compliance rates before touching a patient,before clean/aseptic procedure,after touching a patient,and after touching patient surroundings increased significantly after intervention(all P <0.01 ).Conclusion Comprehensive interventions are helpful for improving HH compliance of HCWs in ICUs.

PURPOSE: As midwives witness and attend the whole process of childbirth, they have a better understanding of which factors may cause traumatic childbirth. However, because most of the studies paid their attention on mothers, little is known about psychological birth trauma from the perspective of midwives. This study aims to gain a full understanding of which factors may contribute to psychological traumatic childbirth from the perspective of midwives.METHODS: A qualitative research was conducted using in-depth interviews, which involved fourteen midwives from the maternal ward of a tertiary hospital. The interviews were recorded and transcribed, and then, Colaizzi's method was used to analyze the contents of the interviews.RESULTS: We proposed four themes and eight subthemes on the influencing factors of psychological traumatic childbirth from the perspective of midwives: low perceived social support (lack of support from family and lack of support from medical staff), hard times (protracted labor in the first stage and futile efforts during the second stage), poor birth outcomes (poor birth outcomes of the mother and poor birth outcomes of the baby), and excruciating pain (unbearable pain of uterine contraction and labor pain was incongruent with the mother's expectations).CONCLUSION: Medical staff should pay attention to psychological traumatic childbirth and its effects, and emphasis on the screening and assessment of birthing women with negative feelings so that their psychological traumatic childbirth can be prevented and decreased.
Female ; Humans ; Labor Pain ; Mass Screening ; Medical Staff ; Methods ; Midwifery ; Mothers ; Natural Childbirth ; Parturition ; Pregnancy ; Psychological Trauma ; Qualitative Research ; Tertiary Care Centers ; Uterine Contraction

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.

Purpose: Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses,usually working directly with elderly patients, have a better understanding of what factors may causeelder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect fromthe perception of nurses in the context of Chinese culture. Methods: Face-to-face, in-depth interviews were conducted from November 2018 to December 2018.Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a generalhospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed toanalyze the data. Results: Our conceptual model illustrated the findings based on the three themes of the conflict betweenpersonal recognition and social judgment, the choice between current needs and individual beliefs, aswell as the compromise between insufficient abilities and limited resources. Conclusion Nurses together with family members and social workers can help older adults improvetheir awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs,as well as seek as much support as possible. Nurses should also respect the autonomy and selfdeterminationof elder self-neglecters because self-neglect is related to older adults' values. Furthermore,larger studies are needed to quantitatively test and refine the model.