Objective To explore the application effect of the adult education theory in the nursing round. Methods 340 trainee nurses, who were trained at our surgical department between June 2008 and December 2009, were randomly divided into the experimental group(178 cases)and the control group(162cases). The adult education theory was adopted in the experimental group, whereas the traditional education method was used in the control group, a questionnaire was carried out after the nursing visit. Results The experimental group was more satisfied with the round visit than the control group. Conclusions The application of the adult education theory in the round visit is beneficial not only to the students' selection of the topics of nursing visit, but also to the improvement of the students' understanding and communicating capacity, the students' studying interests and the students' creative thinking, finally the degree of satisfaction to the round visit is increased by the adoption of this theory.

Objective To obtain the matched parameters between image quality and radiation dose by exploring the influence of the exposure parameters of screening mammography on both the image quality and radiation dose.Methods The correlation between the exposure parameters and average glandular doses to 507 patients undergoing screening mammography were retrospectively analyzed.The influence of breast compression thickness on radiation dose by exposing different thickness of PMMA was obtained.The correlation with image quality was analyzed by combined testing of contrast detail test mode ( CDMAM3.4 )and different thickness of PMMAs.Results The groups aged 30 to 49 years were the main groups in 507examined patients,up to 67.06％ of the total.The mean value of average gland doses ( AGD ) in contrastprior mode was the highest in three kinds of exposure modes,accounting for 137.5％ of standard mode.In standard mode,target material/filtration board combination was Mo/Mo,Mo/Rh and Rh/Rh,accounting for 1/3 respectively.Mo/Rh and Rh/Rh were selected in dose-prior mode,accounting for 50％ respectively.Mo/Mo was mainly selected in contrast-prior,accounting for 52％.Breast compression thickness was positively correlated with average gland doses.Image quality figure inverse (IQFinv) under three kinds of modes (STD,DOSE,CNT) was 98.32,95.41 and 107.02,respectively,and IQFinv of contrast-prior mode was the highest among them.IQFinv was in general agreement in the three kinds of exposure modes when the thickness of PMMA plates plates was greater than or equal to 5 cm.Conclusions In clinical practice,when the breast is of density type and pressed thickness is less than 4 em,the dose-prior mode should be selected.When the pressed thickness is between 4 and 6 cm,the standard exposure mode should be selected.When the pressed thickness is larger than 6 cm,the manual mode should be selected.

Objective To evaluate the effects of baseline and changes of peritoneal transport characteristics on the prognosis of maintaining peritoneal dialysis (PD) patients.Methods Five hundred and eight-six PD patients who started PD from September 11,2006 to October 30,2014 in a single center were included and followed up until March 30,2016.According to their baseline D/Pcr value in peritoneal equilibrium test (PET),the patients were divided into high transport (H) group (D/ Pcr 0.82-1.03),high average transport (HA) group (D/Pcr 0.65-0.81),low average transport (LA) group (D/Pcr 0.50-0.64) and low transport (L) group (D/Pcr 0.34-0.49).According to the changes of follow-up D/Pcr comparing with baseline D/Pcr,the patients were also divided into ascending group,descending group and no-change group.The patient and technical survival rates were estimated by Kaplan-Meier analysis.Cox proportional hazards analyses were used to analyze the risk factors for PD patient death and technical failure.Results There were 67 patients in L group,229 patients in LA group,252 patients in HA group,and 38 patients in H group.The patient survival rate in H group was significantly lower than those of L group (P=0.036),LA group (P=0.008) and HA group (P=0.041).There was no significant difference on technical survival rate among these 4 groups.According to the tendency of follow-up D/Pcr changes,there were 127 patients in ascending group,101 patients in descending group and 179 patients in no-change group.There was no significant difference on patient survival among these 3 groups (P=0.064).However in patients with a high transport rate (D/Pcr≥0.65),the patient survival was lower in descending group than those in ascending group (P=0.033) and nochange group (P=0.049).Age over 65 years old (HR=2.499),malnutrition during follow-up (HR=3.144),ultrafiltration less than 400 ml/d during follow-up (HR=1.863) and high sensitive C reactive protein≥ 10 mg/L (HR=4.526) were the independent risk factors for patient death (all P ＜ 0.05).Gender (HR=1.609),age over 65 years old (HR=1.929),ultrafiltration less than 400 ml/d during follow-up (HR=1.708),high sensitive C reactive protein ≥10 mg/L (HR=1.829),malnutrition (HR=1.876) and change of peritoneal transport function (HR=0.579) affect technical failure (all P ＜ 0.05).Conclusions The survival rate of PD patients with basal high peritoneal transit is relatively low,especially for patients with descending transport rate during follow-up.The concern on the peritoneal transport status is constructive for the prognosis of PD patients.

Objective To investigate the relationship between serum anticardiolipin antibody-immune globulin G (ACA-IgG),interleukin-10 (IL-10 ),IL-17 levels and intracranial large-artery atherosclerotic stenosis in patients with ischemic stroke. Methods From March 2014 to March 2015,a total of 176 consecutive patients with the first-ever ischemic stroke admitted to the Department of Neurology,Liaocheng People′s Hospital,Shandong Province,China,and performed DSA were enrolled prospectively. Seven of the patients with cardiogenic embolism,5 with moyamoya disease,8 with arteritis,2 with artery dissection,9 with autoimmune diseases or acute and chronic inflammation were excluded,21 with extracranial arterial stenosis were not enrolled,and finally 124 were enrolled in the study. According to the findings of DSA,the degrees of intracranial large artery stenosis were divided into a stenosis-free group (n = 34),a mild-stenosis group (n = 30),a moderate-stenosis group (n = 32),and a severe-stenosis group (n = 28). The differences of serum ACA-IgG,IL-10,IL-17 levels and baseline factors of the 4 groups were compared,and multivariate logistic regression analysis was used to analyze several factors that affected intracranial large-artery stenosis. Results There were no significant differences in sex,age,alcohol consumption rate,smoking rate,and incidence of hyperlipidemia among the 4 groups of patients (all P >0. 05). Compared with the stenosis-free group,there were significant differences in the incidences of hypertension and diabetes among the mild-stenosis,moderate-stenosis and severe-stenosis groups (the incidence of hypertension,80. 0% [n = 24],93. 8% [n = 30],89. 3% [n = 25]vs. 55. 9% [19 cases];χ2 = 8. 271,8. 920,and 10. 877,respectively;P = 0. 038,0. 032,and 0. 014,respectively). The incidences of diabetes were 33. 3% (n = 10),43. 8% (n = 14),60. 7% (n = 17)vs. 8. 8% (n = 3),(χ2 = 7. 960, 8. 733,and 9. 285,respectively;P = 0. 043,0. 035,and 0. 027,respectively). Incidence of diabetes of the severe-stenosis group was higher than that of the mild-stenosis group (χ2 = 9. 348,P = 0. 025). There were no significant differences in the incidences of hypertension and diabetes among other groups (all P >0. 05). There were significant differences in ACA-IgG levels (23 ± 5,39 ± 8,51 ± 9,and 65 ± 10 kU/ L);IL-10 levels (108 ± 33,85 ± 25,77 ± 21,and 62 ± 19 ng/ L),and IL-17 levels (38 ± 10,58 ± 22,63 ± 31, and 75 ± 26 ng/ L)among the stenosis-free,mild,moderate and severe-stenosis groups (F = 17. 754,9. 827, and 12. 656;respectively;all P < 0. 01). Compared with the stenosis-free group,the ACA-IgG and IL-17 levels of the patients in the mild,morderate,and severe stenosis groups increased significantly (ACA-IgG level:t =2. 307,2. 559,and 3. 374,respectively;P = 0. 026,0. 014,and 0. 001,respectively,the IL-17 levels:t =2. 183,2. 549 and 3. 159,respectively;P = 0. 037,0. 013,and 0. 002,respectively),while the IL-10 level decreased significantly. There were significant differences among the groups (t = 2. 036,2. 351,and 2. 762, respectively;P = 0. 042,0. 023,and 0. 006,respectively). Compared with the mild-stenosis group,the ACA-IgG and IL-17 levels of the severe stenosis group increased significantly (t = 3. 154 and 2. 976 respectively;P = 0. 002 and 0. 004 respectively). There were no significant differences among the pairwise comparisons of other groups (P >0. 05). The results of logistic regression analysis showed that hypertension, diabetes,ACA-IgG level,and IL-17 level were the risk factors for intracranial large-artery stenosis (OR, 3. 043,95% CI 1. 606 -5. 875,P = 0. 003;OR,2. 912,95% CI 1. 513 -5. 824,P < 0. 01;OR,1. 837,95% CI 2. 057-3. 416,P = 0. 037;OR,1. 453,95% CI 1. 346 -2. 721,P = 0. 014). Conclusion ACA-IgG and IL-17 may play an important role in the occurrence and development processes of intracranial large-artery atherosclerotic stenosis.

Objective To investigate the effect of early rehabilitation intervention model on improving intelligence, motor function and prognosis in premature infants with brain injury. Methods 150 cases of premature infants with brain injury who were diagnosed in the department of pediatrics in our hospital from June 2012 to October 2015 were selected. A total of 114 cases whose parents actively participated in the intervention guidance were selected as the observation group. 36 cases whose parents were not willing to participate in the early intervention guide were selected as the control group. The control group was given routine intervention, and the observation group was given early rehabilitation intervention model on the basis of the control group. The two groups of children were given intervention for 24 months. The intelligence and motor development index 12 and 24 months after intervention were observed and compared between the two groups, and the rate of nerve disability was compared. Results After intervention for 12 and 24 months, MDI and PDI in the observation group were significantly better than those in the control group (P＜0. 05). After intervention for 24 months, the incidence rate of neurological disability in the observation group was significantly lower than that in the control group(P＜0. 05). Conclusion Early rehabilitation intervention model has a positive effect on the recovery of premature infants with brain injury, which can improve the level of intelligence and motor development, develop the potential of children, reduce the rate of nerve disability, and improve the prognosis of children.

Objective To evaluate the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) in treatment of patients with liver cancer.Methods Totally 20 patients with liver cancer undergoing DEB-TACE treatment were enrolled.Clinical efficacy included complete response (CR),partial response (PR),stable disease (SD) and progressive disease (PD).The overall response rate (ORR) was defined as proportion of patients achieved CR and PR.Results After treatment of DEB-TACE,the ORR,CR,PR,SD,and PD of patients were 80.00％ (16/20),40.00％ (8/20),40.00％ (8/20),15.00％ (3/20),and 5.00％ (1/20),respectively;while for single tumor nodule,the ORR,CR,PR,SD,and PD were 81.58％ (31/32),50.00 (19/38)％,31.58％ (12/38),15.79％ (6/38),and 2.63％ (1/38),respectively.After the treatment of DEB-TACE,the relapse free survival rate in half year was 85.00％,and the overall survival rate was 95.00％.The adverse events of patients were mild pain,fever,nausea and vomiting.Conclusion CalliSpheres(R) DEB-TACE is an effective and well tolerated treatment in liver cancer patients.

Objective:To compare the clinical effects between the homodigital radial flap of the dorsal cutaneous branch of radial palmar proper digital artery (PPDA) and the homodigital reverse island flap of the ulnar dorsal digital artery (DDA) on reconstruction of defects in thumb-tip or thumb-pulp.Methods:The retrospective case-control study method was used. From January 2016 to August 2022, a total of 65 thumb-tip or thumb-pulp defects were treated in the Department of Hand Surgery of the Second Hospital of Tangshan. Thirty-five defects of thumbs were reconstructed with the homodigital radial flap pedicled with dorsal cutaneous branch of radial PPDA (PPDA group) and the other 30 thumbs were treated by the homodigital ulnar reverse island flap pedicled with ulnar DDA (DDA group). Sizes of the wounds and flaps in PPDA group were 1.9 cm×1.5 cm to 2.9 cm×2.4 cm and 2.1 cm× 1.7 cm to 3.1 cm×2.6 cm, respectively, and the dimensions of the wounds and flaps in DDA group were 2.0 cm× 1.7 cm to 2.9 cm×2.5 cm and 2.2 cm×1.9 cm to 3.2 cm×2.8 cm, respectively. The wounds of donor site in both groups were all directly closed. Survival of the flaps and wound healing of donor sites were observed in both groups. The time of surgery and duration of follow-up of the 2 groups were recorded. Postoperative follow-up included outpatient clinic visits, telephone reviews and WeChat video-clips. At the final follow-up, record of total active motion (TAM) of the injured thumbs, angle of first web of the affected hands, static TPD of the flaps, patient satisfaction of the appearance of flaps and donor sites were taken. According to the Michigan Hand Function Questionnaire (MHQ) evaluation criteria, the patient satisfaction of the appearance of flaps and donor sites were evaluated. The measurement and count data acquired from both groups were compared by independent sample t-test and χ2 tests or Fisher's exact test, respectively. P<0.05 was considered statistically significant. Results:All 35 flaps in PPDA group and 26 flaps in DDA group survived primarily, except 4 flaps in the DDA group that showed blisters and healed with dressing changes. The primary survival rate of flap in PPDA group (100%) was higher than that of DDA group (87%), and the difference was statistically significant ( P<0.05). Donor sites of both groups healed primary. The time of surgery and duration of follow-up in PPDA and DDA groups were 59.11 minutes±5.42 minutes and 15.37 months±3.32 months, and 61.27 minutes±5.96 minutes and 16.17 months±3.60 months, respectively. There was no statistically significant difference between the 2 groups ( P>0.05). At the final follow-up, the thumb TAM and angle of thumb web in PPDA and DDA groups were 135.14°±10.04° and 90.29°±4.36° and 132.17°±11.04° and 89.00°±4.81°, respectively. There was no statistically significant differences between the 2 groups ( P>0.05). The static TPD, patient satisfaction of the appearance of flaps and donor sites in PPDA group were 7.11 mm±1.21 mm, 4.69 point±0.47 point and 4.43 point±0.50 point, which were better than DDA group [8.20 mm±1.47 mm, 4.40 point±0.50 point and 4.13 point±0.57 point, respectively] with a statistically significant difference ( P<0.05). Conclusion:The homodigital radial flap of the dorsal cutaneous branch of radial PPDA and the homodigital ulnar reverse island flap of the ulnar DDA are both suitable for reconstruction of defects in thumb-tip or thumb-pulp. Compared with the homodigital reverse island flap with the DDA, a homodigital radial flap with the dorsal cutaneous branch of PPDA has advantages in higher primary survival rate, better flap sensation and appearance at both of recipient and donor sites.