Objective To evaluate the nursing outcomes of patients with chronic diseases discharged from various fields,and to analyze the related factors,and provide the basis for the nursing of patients with chronic diseases.Methods A total of 640 patients with chronic diseases discharged from hospital were investigated by the general information questionnaire and the Chronic Disease Patients Nursing Outcomes Classification Evaluation Form.Results In nursing outcome classification evaluation of patients with different diseases,the score of patients with cardiovascular disease was (250.27 ± 38.82) points,the score of patients with chronic obstructive pulmonary disease was (267.27± 32.46) points,the score of patients with cerebral apoplexy was (238.69 ± 38.80) points,and the score of patients with diabetes was (287.71 ± 21.86) points,the differences were statistically significant (F=40.062,P＜ 0.01).Evaluation in each dimension,physiological,functional outcome scores higher,cognitive,behavioral health outcome scores lower;,in addition,education,place of residence,average annual family income,types of illness,mentality,the whether hospitalized for the first time become discharged patient care of the main factors.Conclusions Nursing care should be guided by the classification of nursing outcome,and individual nursing intervention for the differences between the types of illness and individual factors.

Objective To explore the relationship between social support and professional identification among nursing students,and to examine the mediating role of resilience.Methods A total of 650 nursing students were evaluated with Social Support Rating Scale,Professional Identity Questionnaires for Nursing Students and Chinese revision of Connor-Davidson Resilience Scale.Results The scores of nursing students' social support,resilience and professional identification were (38.93±5.30),(66.79±11.93),(57.45±9.95).Professional identification could positively influence their professional identification(r=0.233-0.422,P＜0.01).Resilience mediated the relationship between social support and professional identification,the effect sizes were 52.27％.Conclusions Resilience plays a mediating role between social support and professional identity.It is important to pay attention to social support and resilience and take proper interventions to promote nursing students professional identification.

Objective To examine the psychological resilience and its influencing factors of the nursing students in medical university.Methods A total of 693 nursing students were investigated by using general questionnaire,Chinese version of CD-RISC,Professional Identity Questionnaires of Nursing Students,TCSQ,EPQ and SSRS.Results The average score of CD-RISC was (66.79±11.93),different grade students had significant differences in psychological resilience,resilience scores of nursing students were different in aspect of professional knowledge,occupation expectation and interpersonal satisfaction.Resilience was positively correlated with positive coping,professional identity,social support,extraversion,and negatively correlated with negative coping,neuroticism and psychoticism; Positive coping,professional identity,extraversion and neuroticism could predict 48.6％ of total variation in psychological resilience.Conclusions The resilience average score of nursing students was low.Nursing educators can implement mental intervention according to psychological characteristics of nursing students in different periods by cultivating professional emotion,guiding coping style and shaping healthy personality to promote the resilience and mental health of nursing students.

Objective:To analyze the situation and problems of prescription medication for pregnant patients in outpatient depart-ment of our hospital in order to improve and ensure the safe and rational drug use. Methods: The prescriptions concerning pregnancy except normal pregnancy monitoring in our outpatient department in 2014 were selected and analyzed and reviewed according to classifi-cation, related regulation and medicine instruction issued by FDA. Results:Totally 882 prescriptions were selected with average varie-ties of (1. 3 ± 0. 1) and sum of (77. 7 ± 0. 2) yuan. Among them, 31 ones were irrational prescriptions accounting for 3. 5%. Con-clusion:In order to promote the rational and safe drug use in pregnant patients, it is necessary to strengthen relevant knowledge educa-tion and prescription review of clinical pharmacist.

Sleep-disorderedbreathingarecloselyassociatedwithischemicstroke.Sleep-disordered breathing includes obstructive sleep apnea and central sleep apnea. Studies have show n that obstructive sleep apnea is an independent risk factor for stroke, w hile stroke can also increase the incidence of sleep-disordered breathing. This article review s the latest research progress of sleep-disordered breathing and stroke.

Objective To investigate risk factors and prognosis of hemorrhagic transformation(HT)in acute cerebral infarction patients treated by intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA).Methods All 128 patients with acute cerebral infarction were treated with intravenous rtPA within 6 hours from stroke onset.The clinic records and laboratory datas of pre-and post-treatment were statistically analyzed between HT group and non-HT group to find potential risk factors to HT and contributors of prognosis.Results HT occurred in 29 patients(22.66％),including 16 patients with symptomatic ICH(12.50％)and 2 patients died(6.90％ of HT).Logistic regression analysis showed that history of atrial fibrillation(OR =1.293,95％ CI 1.224-1.589,P =0.001),CT density changes with mass effect or edema(OR =2.452,95％ CI 1.132-3.309,P =0.034),diastolic blood pressure ≥ 100 mm Hg before thrombolytic therapy(1 mm Hg =0.133 kPa,OR =9.265,95％ CI 1.435-59.836,P =0.019),blood glucose ≥ 11.1 mmol/L(OR =3.037,95％ CI 0.252-57.593,P =0.047),NIHSS score ＞ 15 points (OR =8.752,95％ CI 1.035-30.285,P =0.023)and thrombolysis time ＞ 3 h(OR =98.74,95％ CI 5.067-186.120,P =0.002)are independent risk factors for HT; among these factors,baseline blood glucose(OR =3.265,95 ％ CI 0.435-59.863,P =0.045),NIHSS score(OR =10.453,95 ％ CI 5.647-38.185,P =0.003)and thrombolysis time(OR =2.541,95％ CI 1.098-51.086,P =0.017)also are prediction factors of the prognosis of HT.Conclusion Risk factors associated with HT are diastolic blood pressure before thrombolysis,glucose level,degree of neurological deficits,CT early changes,atrial fibrillation and thrombolytic time.Glucose level,neurological deficits and thrombolysis time affects the prognosis of patients.

Objective To evaluate the diagnostic significance of full-field digital mammography (FFDM)for atypieal breast cancer findings.Methods Seven hundred-eighteen cases with breast cancer were examined using FFDM and atypical mammographic findings were found in 134 cases.Craniocaudal (CC)view and mediolateral oblique(MLO)view were conducted for each patient.Mediolateral view or spot view Was achieved if necessary.Preoperative localization Was conducted for the patients with nonpalpable breast cancer8.Results (1)The masses with well.circumscribed margin on mammography were more common in infiltrating duetal carcinoma(22/106),mucinous carcinoma(8/10),medullary carcinoma (5/6),and increased with age and reduction of the mass density.(2)Long spieulation,architectural distortion,patchy high density were mainly found in infiltrating ductal carcinoma and 30-40(24 cases),41-50(34 cases)years old patients.Long speculation wag mainly found in 30-40 years old patients (10/30).(3)Hish homogenous density and subcutaneous edema in the entire breast and mass-like area were most ffequendy found in infiltrating ductal carcinoma at 30-40(2 cases)and 41-50(5 cases)years old.High density and subcutaneous edema were only found in dense breast(8 cases).Conclusion The atypical findings of breast cancer in foil-field digital mammography are associated with the pathological type of cancer.patient age and the gland density of the breast.

ObjectiveTo investigate clinical features and outcomes in acute ischemic stroke patients with remote symptomatic intracranial hemorrhage (sICHr) after intravenous thrombolysis.MethodsThe acute ischemic stroke patients with sICHr after intravenous thrombolysis therapy were enrolled retrospectively.The clinical data were collected and the related literature was analyzed and summarized.ResultsA total of 6 acute ischemic stroke patients with sICHr were enrolled, including 4 males.Three patients had a history of using antiplatelet agents, 2 with atrial fibrillation, 4 with hypertension, 3 with previous stroke history, 4 with smoking history, and 4 had sICHr at 2 h after intravenous thrombolysis.Of the 14 hemorrhagic foci (except in the infarct areas), 10 were in the cerebral cortex.Three patients died within 1 week, and 1 was in a persistent vegetative state.Conclusions SICHr after intravenous thrombolysis in patients with acute ischemic stroke is mainly located in the cerebral cortex.The outcomes in acute ischemic stroke patients with SICHr after intravenous thrombolysis are poor, and the mortality is high.

Objective To compare and analyze the etiology,clinical manifestations and imaging differences of bilateral pontine infarction (BPI) and unilateral pontine infarction (UPI),and investigate the possible independent risk factors for BPI.Methods Consecutive patients with pontine infarction admitted to the Department of Neurology,the First People's Hospital of Kunshan from January 2015 to December 2017 were enrolled retrospectively.They were divided into BPI group and UPI group.The risk factors,laboratory findings,National Institutes of Health Stroke Scale (NIHSS) scores,clinical manifestations,and basilar artery lesions were compared between the two groups.Multivariate logistic regression analysis was used to determine the independent risk factors for BPI relative to UPI.Results A total of 131 patients with pontine infarction were enrolled,aged 66.22 ± 12.29 years,97 patients (72.52％) were male;14 (10.69％) were BPI,and 117 (89.31％) were UPI.In terms of clinical symptoms,consciousness disorder (35.71％ vs.6.83％;x2 =8.657,P =0.003),quadriplegia (50.00％ vs.5.12％;x2 =30.202,P ＜ 0.001),and dysphagia (71.42％ vs.29.91％;x2 =7.804,P =0.005) in the BPI group were more common than those in the UPI group.In terms of etiological classification,vertebrobasilar large artery disease (VLAD) was more common in the BPI group (85.71％ vs.27.35％;x2 =16.567,P ＜ 0.001),while small artery disease (SAD) was more common in the UPI group (49.57％ vs.7.14％;x2 =7.460,P =0.006).In addition,the baseline NIHSS scores (12.43 ±11.1 vs.3.78 ±3.98;t=2.873,P=0.013),white blood cell count ([9.21±2.81] ×109/L vs.[6.92± 2.40] ×109/L;t=3.191,P=0.002),baseline systolic blood pressure (170.57 ±31.21 mmHg vs.156.75 ±23.50 mmHg,1 mmHg =0.133 kPa;t =2.004,P =0.047),as well as the proportion of patients with severe stenosis or occlusion in basilar artery (78.57％ vs.8.55％;x2 =40.49,P ＜ 0.001) and with other site infarction (78.57 ％ vs.11.11％;x2 =33.652,P ＜ 0.001) in the BPI group were significantly higher than those in the UPI group.Multivariate logistic regression analysis showed that severe basilar artery stenosis or occlusion (odds ratio [OR] 20.195,95％ confidence interval [CI]2.308-176.703;P =0.007),baseline NIHSS score (OR 1.147,95％ CI 1.019-1.292;P =0.023),and infarction at other sites (OR 19.483,95％ CI 2.969-127.868;P =0.002) were independently associated with BPI.Conclusion Compared with UPI,patients with BPI had more severe clinical symptoms and most of them with other site infarction.Severe stenosis or occlusion of the basilar artery was an independent risk factor for BPI.

OBJECTIVE: To analyze the indications of the therapies for rheumatoid arthritis (RA) with neural network model analysis. METHODS: Three hundred and ninety-seven patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine (WM) treated group, 194 cases; and traditional Chinese herbal medicine (CM) treated group, 203 cases. A complete physical examination and 18 common clinical manifestations were prepared before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included Glucosidorum Tripterygii Totorum Tablet and syndrome differentiation treatment. The American College of Rheumatology 20 (ACR20) was taken as efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. The relationships between each variable and efficacy were analyzed, and the variables with P<0.2 were included for the data mining analysis with neural network model. All data were classified into training set (75%) and verification set (25%) for further verification on the data-mining model. RESULTS: Eighteen variables in CM and 24 variables in WM were included in the data-mining model. In CM, morning stiffness, swollen joint number, peripheral immunoglobulin M (IgM) level, tenderness joint number, tenderness, rheumatoid factor (RF), C-reactive protein (CRP) and joint pain were positively related to the efficacy, and disease duration and more urination at night negatively related to the efficacy. In WM, erythrocyte sedimentation rate (ESR), weak waist, white fur in tongue, joint pain, joint stiffness and swollen joint were positively related to the efficacy, and yellow fur in tongue, red tongue, white blood negatively related to the efficacy. In the analysis with the neural network model in the patients of verification set, the predictive response rates of 20% patients would be 100% and 90% in the treatment with CM and WM, respectively. CONCLUSION: Neural network model analysis, based on the full clinical trial data with collection of both traditional Chinese medicine and modern medicine diagnostic information, shows a good predictive role for the information in the efficacy in rheumatoid arthritis.