Objective To investigate the effect of four integrated care model of physical,mental,social and spirit on the quality of life of patients with breast cancer.Methods 100 cases of postoperative breast cancer patients were randomly divided into the intervention group and the control group with 50 cases in each.The control group received routine nursing care; the intervention group was given four integrated care model of physical,mental,social and spirit by specialized trained nurses,including systematic psychological counseling,rehabilitation knowledge of health education and behavior intervention on the patients themselves and their family members.Before intervention and 3 months after the intervention,the quality of life of patients after operation was surveyed by the FACT quality of life questionnaire.Results 3 months after the intervention the quality of life score of the intervention group was significantly higher than that of the control group.Conclusions To strengthen postoperative patients of breast cancer with targeted and personalized four integrated care model of physical,mental,social and spirit,can significantly improve the quality of life of patients,help to improve their physical and mental health and alleviate psychological reaction of depression.

OBJECTIVE To compare the cleaning efficacy of manual cleaning with ultrasonic cleaning on laparoscope and choose the best way to clean laparoscope under present condition.METHODS The laparoscopes were collected from each department based on the weekly usages.The efficacy of the cleaning way was the focus.The cleaniness of the laparoscopes were inspected with naked eyes.RESULTS The cleaning effect of the ultrasonic cleaning method was better than the manual cleaning method for the laparoscope.It would help for the cleaning effect to remove the air bubble in the laparoscope pipeline.CONCLUSIONS Ultrasonic cleaning method plus removing the air bubble in the laparoscope pipeline could guarantee the cleaning quality for the laparoscope.

Objective To explore the curative effect of stomatitis spray combined with 3M liquid dressing on degree II red buttocks in infants and summarize key points of nursing care. Methods From April 2012 to June 2016, 64 infants with degree II red buttocks were treated in our department. According to the admission time, the infants were divided into control and experiment groups in equal number. The control group was treated with zinc oxide ointment, and the experiment group with stomatitis spray combined with 3M liquid dressing. The curative effect, total effective rate, and wound healing time were compared after treatment between the groups. Results The curative effect and total effective rate of red buttocks in the experiment group were significantly better than those of the control group (P<0.05). Moreover, the wound healing time in the experiment group was obviously shorter than that of the control (P<0.05). Conclusions Compared to zinc oxide ointment, the stomatitis spray combined with and 3M liquid dressing is more effective in the treatment of severe red buttocks of the infants. Moreover, the latter is advantageous in wound healing time, compliance, treatment, and curative effect, which indicates its potential application in clinic.

Objective To investigate the predictive value of cardiovascular risk factors in coronary atherosclerotic heart disease.Methods A total of 400 patients who underwent coronary angiography (CAG) in our hospital was divided into multiple vascular lesion group,single vascular lesions group,and non-CAD group according to the result of CAG and their clinical data were analyzed retrospectively.The correlation between cardiovascular risk factors and coronary artery lesions was analyzed,and the independent risk factor of CAD was screened by multi-factorial logistic regression analysis.Results There was significant difference in total cholesterol (TC),triglycerides (TG),high density lipoprotein cholesterol (HDLC),fasting blood glucose (FBG),inflammatory cells,carotid artery plaque,brachial-ankle pulse wave velocity (baPWV),high-sensitivity C-reactive protein (Hs-CRP) between the CAD group and the non-CAD group (P ＜ 0.05 or P ＜ 0.01).The number of coronary artery lesion branch was increased significantly when risk factors,such as age,body mass index(BMI),hypertension,diabetes mellitas,smoking,carotid artery plaque,TG,TC,low density lipoprotein cholesterol (LDL-C),FBG,WBC,monocytes (M),neutrophils (N),neutrophils/lymphocytes (N/L),baPWV,and Hs-CRP.Other risk factors including TC,HDL-C,L were decreased with a statistically significant difference (P ＜ 0.05).There was no significant relation among,and left ventricular ejection fraction (LVEF)％.The most significant risk factor was carotid artery plaque that was independently associated with coronary heart disease (b =1.264,P ＜ 0.01),followed by smoking (b =1.204,P ＜0.01),HDL-C (b =1.104,P ＜0.01),TC (b =1.082,P ＜0.01) diabetes mellitus (b =0.956,P ＜0.01),baPWV increased (b =0.741,P ＜0.01),WBC (b=0.721,P ＜0.01),hypertension (b =0.602,P ＜0.01),the age (b =0.538,P ＜0.01),and HsCRP(b =0.421,P ＜ 0.01).Conclusions The results suggest that the hypertension,hyperlipidemia,smoking,age,baPWV,inflammatory cells,Hs-CRP,and carotid artery plaque was a significant independent CHD risk factors.

Objective To study the value of oxygen treatment on elderly patients with acute ischemic stroke.Methods From April 2010 to March 2012,a total of 140 cases of elderly patients with acute ischemic stroke for oxygen therapy combined with drug and rehabilitation were divided into two groups,outside high-flow oxygen group of 71 cases,hyperbaric oxygen group of 69 cases.The neurological functional defects scale was used to evaluate the effect.Two groups of patients were given conventional drug therapy including improving the microcirculation,vegetative neural drugs,and rehabilitation treatment.Results The total effectiveness respectively was 98.6％ (70/71),91.3％ (63/69),and there was significant difference (P ＜ 0.05).After treatment,the nerve function damage grades of two groups respectively was (10.4 ± 1.7),(15.6 ± 1.8) scores,and there was significant difference compared with that before treatment [(28.2 ± 2.5),(28.7 ± 2.6) scores] (P ＜ 0.05).There was significant difference in treatment adherence between two groups (P ＜ 0.05).Conclusion For patients of elderly patients with acute ischemic stroke,oxygen therapy is necessary,while outside high-flow oxygen therapy is better than hyperbaric oxygen therapy.

Objective To explore the effects of hyperbaric oxygen(HBO) on brain derived neurotrophic factor(BDNF) and the changes of neuron structure after cerebral ischemia-reperfusion(CIR) in mice. Methods Twenty-seven mice were randomly and evenly divided into three groups : a HBO group, a control group and a sham-operation group (SO group). CIR models were established by clamping both carotid arteries in mice for 30 min,and then, untying clamps. 0.20 MPa HBO was applied once a day for 10 days after establishment of models in HBO group,but not in the control and SO groups. Following sacrifice after treatment and acquirement of cortex and hippocamal tissues, HE stain and immunohistochemistry technique were used to observe the changes of neuron structure and expression of BDNF. Results The neural degeneration and necrosis in cortex and hippocampus (issues) were observed under light microscope after CIR, and the amount of abnormal cells in the control group was more than that in HBO group (P

Objective Base on the local pathology, the early diagnosis and a reasonable treatment for congenital esophageal stenosis (CES) were discussed. Methods Forty two cases of congenital esophageal stenosis during 1980～2000 were reviewed retrospectively, including age, vomitus and frequency, nutrition and development, diagnostic method used and operative pathological findings, time of normal feeding and time of nutritional restoration. Results According to local pathology, there were 26 cases of tracheobronchial remnant, 11 fibromuscular stenosis, 3 membranous diaphragm, and 2 ectopic gastric mucosa. Membranous diaphragm excision gave the best result without postoperative dilatation. The patients were followed up for 4～10 years, Normal feeding was restored in 1 month in 78 6%, 9 5% in 6 months, and 11 9% in 1 year. Conclusion Persistent vomiting of undigested food and failure in gaining weight are the chief complaints of congenital esophageal stenosis. The confirmatory diagnosis depends on barium swallowing and esophagoscopy. A good result can be achieved by follows local resection and necessary postoperative dilatation.

On the basis of the summarization about some MPH education experience in Sun Yat-sen University,we make the assumption concerning construction of MPH training quality assurance system ,expound the content and operating mode of this training quality system,and then offer reference for improvement of MPH training quality.

Objective To evaluate the impact of serum cystatin C (Cys C) level on short term prognosis in elderly patients with unstableangina (UA). Methods 167 patients with US were involved in this study. The serum Cys C level was measured by immunonephelometric assay.The patients were divided into normal group (Cys C<1.5 mg/L, n=102) and high Cys C group (Cys C≥1.5 mg/L, n=65) according totheir baseline of the first Cys C level within 24 hours. The clinical outcomes, including major cardiac events, mortality and readmission duringhospitalization and 6 months in the follow-up period were observed and evaluated. Results The major cardiac events, mortality and readmissionrate were higher in the high Cys C group than in the normal group (χ2=4.16, P=0.042). Conclusion The serum of Cys C level isclosely related to the short term prognosis of UA, it could be a risk factor to predict major cardiac events in patients with UA.

Background:With the emergence of bacterial resistance,the efficacy of Helicobacter pylori(Hp)eradication therapy is decreasing in recent years. After the previous failed course of eradication therapy,the possibility of failure of re-eradication therapy is greater. Therefore,choosing the rescue therapy for Hp re-eradication is particularly important. Aims:To investigate the efficacy of levofloxacin-based triple therapy combined with probiotics as a rescue therapy for Hp re-eradication. Methods:A total of 192 patients with a previous failed course of standard triple therapy for Hp eradication were enrolled and randomly assigned into four groups. Group A:lansoprazole 30 mg + amoxicillin 1 000 mg + levofloxacin 200 mg bid for 14 days;group B:regimen of group A with the addition of bismuth potassium citrate 600 mg bid for 14 days;group C:bifidobacterium and lactobacillus triple live bacteria 2 000 mg tid for 14 days followed by regimen of group A for 14 days;group D:regimen of group A with the addition of bifidobacterium and lactobacillus triple live bacteria 2 000 mg tid for 14 days. At 4 weeks after end of treatment,Hp eradication was assessed by 13 C-urea breath test. Adverse effects during the course of treatment were recorded. Results:A total of 177(92. 2% )patients completed the study,the completion rates in group A,B,C and D were 87. 5%(42 / 48),83. 3%(40 / 48),97. 9%(47 / 48)and 100% , respectively;the completion rates in group C and D were significantly higher than those in group A and B(P < 0. 05). By intention-to-treat(ITT)analysis,the eradication rates of group A,B,C and D were 60. 4% ,68. 8% ,81. 3% and 83. 3% ,respectively;the eradication rates in group C and D were significantly higher than that in group A(χ2 = 5. 042, P = 0. 045;χ2 = 6. 235,P = 0. 013). By per-protocol(PP)analysis,the eradication rates of group A,B,C and D were 69. 0% ,82. 5% ,83. 0% and 83. 3% ,respectively;no statistically significant differences were found among the four groups(P > 0. 05). Adverse effects included constipation,taste distortion,bloating and anorexia,the incidences of adverse effects in group A,B,C and D were 79. 2% ,95. 8% ,29. 2% and 22. 9% ,respectively;the incidences in group C and D were significantly lower than those in group A and B(P < 0. 05). Conclusions:Levofloxacin-based triple therapy combined with bifidobacterium and lactobacillus triple live bacteria can decrease the adverse effects of traditional triple and quadruple therapies and improve the patient compliance,thus increases the efficacy of rescue therapy for Hp re-eradication.