Objective To compare and evaluate the reliability and validity of the application of three pressure ulcer risk assessment scales in hospitalized elderly patients by Norton,Braden and Waterlow pressure ulcer risk assessment scales. Methods We selected 271 elderly patiehts from a certain thirdclass and first-grade hospital and assessed their pressure ulcer risks by 3 assessment scales.The reliability and validity of these Scales were evaluated and compared by the following methods such as Cronbaeh's α coefficient,content validity index,factor analysis and ROC curve. Results The Cronbach's α coefficient of these 3 scales were 0.71,0.79 and 0.32 respectively.The content validity indices of them were 0.85,0.91and 0.87.The cumulative variance explained were 71.73%,70.34%and 65.76%respectively.The sensitivity and specificity upon cut-off points were(0.75,0.62),(0.74,0.59)and(0.86,0.59).Conclusion The Waterlow scale showed insufficient internal consistency but good predictive ability.The Braden scale showed moderate reliability and validity but with a lower predictive ability compared with the Norton and Waterlow scales.

Objective To explore pressure ulcer risk factors among hospitalized elderly patients.Methods 271 patients were selected from departments of high pressure ulcer incidence of a srade three A hospital.Multiple factors were assessed prospectively and the occurrence of pressure ulcer monitored.Logistic regression was applied to analyze the correlation between the factors and the occurrence of pressure ulcer.Results Correlated factors included medical and nursing interventions,surgery,impaired activity and impaired tissue tolerance.Similar results were found for two kinds of dependent variables,namely suge I and stage Ⅱ pressure ulcers.Conclusions Medical and nursing interventions,surgery,impaired activity and impaired tissue tolerance are considered risk factors of pressure ulcers for hospitalized elderly patients.Relative prevention and interventions should be integrated in clinical nursing care.

Objective To assess the efficacy and safety of co-administration of aspirin and low-dose clopidogrel in patients undergoing percutaneous coronary intervention (PCI) after 1 year.Methods From March 2004 to September 2010,a total of 3366 patients with successful drug-eluting stents implantation after 1 year were divided into group A (aspirin combined with low-dose clopidogrel,n=1682) and group B (aspirin alone,n=1684).The average follow-up period was (29.5±16.3) months (19 months-76 months).The major adverse cardiovascular and cerebrovascular events and clinical complications were evaluated.Results Rates of cardiovascular death were 0.1 ％(2 cases) in combination group and 0.9％ (15 cases) in aspirin group,the risk ratio (HR) was 0.154 [(95％ CI:0.035 0.675),P＜0.05].Myocardial infarction occurred in 9 patients (0.5％) in group A and 27 patients (1.6％) in group B,the risk ratio (HR) was 0.036 [(95％ CI:0.153-0.741),P＜0.01].Rates of stroke were 0.4％ (7 cases) in group A and 1.6％ (27 cases) in group B,the risk ratio (HR) was 0.301 [(95％ CI:0.131 0.693),P ＜ 0.01].Recurrent ischemia with rehospitalization occurred in 152 patients (9.0％) in group A and 274 patients (16.3％) in group B,the risk ratio (HR) was0.601 [(95％ CI:0.491-0.735),P＜0.01].The cumulative survival rate in patients died of cardiac causes was significantly better in group A than in group B (P＜0.01).The cumulative incidence of major adverse cardiovascular and cerebrovascular events was significantly lower in group A than in group B (P＜0.01).There were no significant differences in total number of deaths,target vessel revascularization,stent thrombosis,incidences of severe bleeding,mild bleeding,leukopenia and thrombocytopenia between the two groups (all P＞0.05).Conclusions In patients with PCI after 1 year,the co-administration of aspirin and low-dose clopidogrel reduces the risks of major adverse cardiovascular and cerebrovascular events,and does not increase the risks of bleeding and cytopenia.

The paper analyzes the supply, demands and market mechanism characteristics of medical full - text databases frequently used in college and university libraries. Some suggestions are proposed according to current status of medical full - text database market, including establishing science and technology information center, discovering more channels to get more free full - text and regulating the market by government guide.

Objective To build clinical nursing pathway for artificial abortion operation and explore the effect of this method. Methods The nursing pathway was designed and carried out. The satisfaction degree with nursing, status of patients' awareness about contraception and artificial abortion operation was compared before and after the nursing pathway was implemented. Results Before and after the nursing pathway was implemented,the proportion of missing item of operation record was 0.636 and 0.013, the satisfaction degree with nursing was 77.0% and 92.3%, rate of patients' awareness about contraception and artificial abortion operation was 47.6% and 96.1%. Conclusions The clinical nursing pathway for artificial abortion operation may improve the degree of satisfaction- and the status of patients' awareness about contraception and artificial abortion operation, and decline the proportion of missing item of operation note, it ensures high nursing quality and safety surgery, which is worthy of popularizing.

Objective To investigate the relationship between the severity of infant/toddlers wheezing and hand,foot and mouth disease (HFMD) infection.Methods We selected infant/toddlers wheezing with HFMD cases in respiratory department of our hospital from January 2010 to January 2012,and 30 cases of enterovirus 71 (EV71) were selected as the experimental group and 30 cases of coxsackie virus A type 16 (CA16)as the control group,respectively,according to HFMD pathogen infection.Wheezing cases by severity were divided into intermittent stares with mild persistent group (A) and moderate and severe persistent group (B).HFMD by severity were divided into ordinary and severe cases group.Wheezing severity before and after HFMD,relationship between HFMD severity and wheezing severity and the content of serum cytokines such as interferon-γ(IFN-γ) and interleukin-4 (IL-4) were compared between EV71 group and CA16 group,and statistical analysis was performed.Results (1) Wheezing severity(A,B) corresponding cases:EV71 group(25,5),(5,25),and CA16 group(24,6),(15,15) before and after HFMD.The case-constituent ratio in EV71 and CA16 same group was compared before and after infection,and the differences were statistically significant(P ＜ 0.05).The differences in EV71 group and CA16 group were not statistically significant (x2 =0.11,P ＞ 0.05)before infection,and were statistically significant(x2 =7.50,P ＜0.05) after infection.(2) Severe cases,ordinary group and severe wheezing (A,B) corresponding cases:(17,1),(32,10) before infection,and (2,16),(18,24) after infection.The upgrade cases constituent ratio of wheezing severity after infection were compared between severe and ordinary cases group,and the difference was statistically significant (x2 =5.88,P ＜ 0.05).(3) The content of serum cytokines as IFN-γand IL-4 and IFN-γ/IL-4 ratio were compared in EV7l group and CA16 group before and after infection,and the differences were statistically significant (P ＜ 0.001) ; and the differences compared in EV71 group and CA16 group were not statistically significant(P ＞0.05) before infection and statistically significant(P ＜ 0.05) after infection.Conclusions Infant/toddlers wheezing with HFMD and wheezing severity of severe disease and EV7l infections were exacerbated trend in the short term after infection.The infection of EV71 may promote Th1/Th2 drift.

Objective To study the protective effect and mechanism of safflower solution on warm ischemia reperfusion injury(IRI) of liver in rats.Methods Male Sprague-Dawley rats were randomly divided as 4 groups: Group S(sham group);group I/R(IRI group);group IPC(ischemic preconditioning group);group SPC(safflower solution preconditioning group).The rats were sacrificed at 24 h after reperfusion,serum levels of ALT and AST were measured and HE staining of liver tissues were made to detect rat liver histological changes and grade liver IRI(Suzuki score);apoptosis were monitored by TUNEL;TNF-?,MIP-2 and ICAM-1 mRNA of liver were measured by RT-PCR;NF-?B gene products of liver were detected by Western blotting.The mean value of all the assay tests was compared.Results After 24 h reperfusion,compared with group I/R,the liver function(ALT and AST) in group SPC and group IPC was significantly improved(P

Objective To investigate the effect of portal vein ligation combined with in situ splitting on liver regeneration in rats .Methods Seventy-five healthy male Sprague-Dawley rats were selected and randomly assigned into sham operation group ( S) , portal vein ligation group ( PVL) and portal vein ligation combined with in situ splitting group ( ALPPS) .On 1 d, 3 d, 7 d, 10 d, 14 d after operation , the hepatic regeneration rate ( HRR) of right median lobe was calculated , the serum alanine aminotransferase ( ALT) , aspartate aminotransferase (AST), IL-6, HGF, VEGF were detected.mRNA of IL-6, HGF, TNF-α, TGF-βwas assayed by real-time PCR, and the hepatic proliferating cell nuclear antigen ( PCNA) labeling index was evaluated by immunohistochemistry .Results Comparing with PVL group , the HRR of the right median lobe obviously increased on day 3, 7, 10 and 14 in ALPPS group (P<0.05), and ALT and AST level were increased on 1 d (P<0.05).On day 1 and 3, the content of serum IL-6, HGF and VEGF were all in-creased in ALPPS group [(70.7 ±14.6) pg/ml vs.(134.2 ±31.4) pg/ml; (0.70 ±0.04) ng/ml vs. (0.74 ±0.02) ng/ml;(82.1 ±12.6) pg/ml vs.(103.5 ±14.7) pg/ml], respectively (P<0.05).The mRNA expression of IL-6, HGF, TNF-α, TGF-βand the PCNA labeling index were also increased in ALPPS group in comparison with those in PVL group on day 1 and 3 (P<0.05).All the indexes in the two groups were all higher than those in the group S ( P<0 .05 ) .Conclusions Portal vein ligation combined with in situ splitting could significantly enhance liver regeneration .The possible mechanisms were related to the inflammation reaction and stress response caused by in situ splitting and up-regulation of cytokines in the regenerating lobe after portal vein ligation combined with in situ splitting , especially IL-6, HGF and TNF-α.

We reviewed the clinical data of 24 patients with postpartum hemorrhage undergoing transcatheter arterial embolism from March 2009 to September 2011.Twenty out of 24 patients underwent uterine artery embolism,while other 4 underwent internal iliac artery embolism.The hemorrhage reduced markedly 2 to 9 min after arterial embolism in all patients,except 2 who underwent secondary embolism due to the intermittent postoperative hemorrhage. The postoperative complications included low fever and discomfort in lower abdomen.Nineteen patients were followed up for a mean period of ( 17.3 ± 1.1 ) months,no recurrent hemorrhage was observed after discharge.The normal menstrual cycle recovered 4 to 6 months after operation.Three patients underwent pregnancy successfully after discharge.The results indicate that transcatheter arterial embolism is safe and effective in the treatment of postpartum hemorrhage and it should be recommended as a feasible choice in clinical practice.

BACKGROUND:Cel transplantation offers a new promise of rebuilding the damaged myocardium. But the results of them are not consistent. It is not clear if the transplanted cel s can permanently improve heart function and the mechanism underlying this therapeutic effect. OBJECTIVE:To study the effect of intracoronary autologous bone marrow mononuclear cel transplantation on cardiac function, and angiogenesis and cytokine production in canines with acute myocardial infarction. METHODS:Left anterior descending coronary artery ligation was used to produce acute myocardial infarction models in hybrid canines. Bone marrow mononuclear cel s were harvested by using puncture of anterior crest and posterior superior iliac spine to prepare cel suspension. Sixteen hybrid canines were randomly divided into transplantation group (n=10) and control group (n=6). Bone marrow mononuclear cel s (transplantation group, n=10) or normal saline (control group, n=6) were intracoronarily infused into infarction-related arteries 2 hours after acute myocardial infarction. To evaluate the heart function, we used echocardiography at 2 hours and 6 weeks after acute myocardial infarction. Capil ary density was assessed 6 weeks after transplantation by using von Wil ebrand factor test. The mRNA levels of vascular endothelial growth factor 188, vascular endothelial growth factor 164, basic fibroblast growth factor and matrix metal oproteinase-9 in the infarct area were determined by reverse transcription-PCR at 6 weeks after transplantation. RESULTS AND CONCLUSION:In contrast to the control group, ejection fraction and stroke volume at 6 weeks after transplantation increased significantly in the transplantation group. The transplantation group had a greater amount of new vessels in the peri-infarct area than the control group. Compared with the control group, the mRNA levels of vascular endothelial growth factor 188, vascular endothelial growth factor 164, and basic fibroblast growth factor significantly increased in the transplantation group, but the mRNA level of matrix metal oproteinase-9 significantly decreased in the transplantation group. These findings suggest that intracoronary transplantation of autologous bone marrow mononuclear cel s may improve the cardiac function, and increase capil ary density, especial y in the border zone of infarcted myocardium. Otherwise, bone marrow mononuclear cel transplantation can increase the mRNA levels of vascular endothelial growth factor 188, vascular endothelial growth factor 164, and basic fibroblast growth factor, but decrease the mRNA level of matrix metal oproteinase-9.