Objective:To observe the therapeutic effect of donepezil combined nimodipine on vascular dementia. Methods:A total of 45 patients with vascular dementia aging 54~76 years were randomly divided into donepezil +nimodipine group (n= 24)and huperzine + piracetam group (n= 21).Scores of mini-mental state examination (MMSE)and activity of daily living (ADL)were examined in two groups before and after treatment,and therapeu-tic effect was compared between two groups.Results:Compared with before treatment,after treatment,MMSE score [(15.8±6.3)scores vs.(21.6±7.4)scores]significantly rose and ADL score [(50.3±6.4)scores vs.(40.2 ±7.1)scores]significantly reduced in donepezil + nimodipine group;MMSE score [(14.6±6.9)scores vs.(18.5 ±7.2)scores]significantly rose,ADL score [(49.3±7.8)scores vs.(43.5±8.2)scores]significantly reduced in huperzine + piracetam group,P <0.01 all;but there were no significant difference between two group after treat-ment (P =0.08,0.07).Conclusion:Therapeutic effect of donepezil combined nimodipine on vascular dementia is quite to huperzine + piracetam.

Objective To explore the mechanism 、diagnosis of pancreatic encephalopathy(PE);To evaluate the therapy of PE.Methods To analyze the treatment and diagnosis of 23 PE patients.Results 12 PE patients were cured.11patients were dead,the mortality is 47.8%,5patients in operation group died,the mortality is 62.5%.6 patients in non-operation group were dead,the mortality is 40%,among them,5patients died for multiple organ system falure.one died for septic shock.Conclusions PE is relating to serum amylase inflammatory mediators and infection etc.The diagnosis of PE is based on AP and neurological and mental abnormality.The relative auxiliary diagnosis standard is uncertain.the conventional therapy of PE 、the remedy of MOSF and disorder in water and electroltes were basic therapy.the nerve preserving is necessary for PE's therapy.

Objective To investigate the effect of strengthening self -management on the treatment compliance and outcome in hepatitis B patients with decompensated cirrhosis treated with entecavir.Methods A total of 120 hepatitis B patients with decompensated cirrhosis, who received antiviral therapy with entecavir in our hospital from January 2010 to January 2012,were randomly divided into control group (n=60)and intervention group (n =60).Both groups received routine nursing care;in addition,regular telephone follow -up was performed for the intervention group to provide guidance for the self -management during the comprehensive prevention and treatment of decompensated cirrhosis.The two groups were compared in terms of withdrawal rate,rehospitalization rate,hepatitis B virus (HBV)DNA negative conver-sion rate,incidence of primary liver cancer,and mortality one year later.Continuous data were analyzed by t test,and categorical data by chi -square test or Fisher′s exact test.Results The withdrawal rate and rehospitalization rate in the intervention group were 0 and 18.3%, respectively,versus 8.3% and 35% in the control group (P <0.05 for both).The HBV DNA negative conversion rate,incidence of prima-ry liver cancer,and mortality in the intervention group were 90%,3.3%,and 5.3%,versus 88.3%,5%,and 6.7% in the control group (P >0.05 for all).Conclusion Strengthening self -management,as well as regular health education,can improve treatment compliance and promote recovery in hepatitis B patients with decompensated cirrhosis treated with entecavir.

Objective To observe the efficacy and safety of fondaparinux sodium prolonged treatment in patients with acute myocardial infarction underwent primary percutaneous coronary intervention (PCI).Methods A total of 121 patients with acute ST segment elevation myocardial infarction (STEMI) underwent primary PCI from February 2011 to April 2012 were divided into three groups by random digits table method:40 patients in fondaparinux sodium general treatment group (A group),41 patients in fondaparinux sodium prolonged treatment group (B group) and 40 patients in enoxaparin group (C group).The basic treatment was similar among three groups.The patients in A group were given fondaparinux sodium 2.5 mg/d for 5-7 d,and the averaged time was 6.02 d.The patients in B group were given fondaparinux sodium 2.5 mg/d for 10-15 d,and the averaged time was 12.61 d.The patients in C group were given enoxaparin 5000 U/12 h for 5-7 d,and the averaged time was 6.21 d.Main outcome indexes including re-myocardial ischemia,new-myocardial infarction,death and bleeding were observed within 15 d after treatment.Results The incidence of death,re-myocardial ischemia,new-myocardial infarction and overall cardiovascular events in B group [4.9％(2/41),0,0,4.9％(2/41)] were significantly lower than those in A group [25.0％(10/40),12.5％(5/40),10.0％(4/40),47.5％(19/40)] and C group [27.5％(11/40),15.0％(6/40),12.5％ (5/40),55.0％ (22/40)],and there were significant differences among three groups (P ＜ 0.05or ＜0.01).The incidence of mild bleeding,severe bleeding and overall bleeding in C group [32.5％(13/40),15.0％ (6/40),47.5％ (19/40)] were significantly higher than those in A group [10.0％ (4/40),2.5％(1/40),12.5％(5/40)] and B group [14.6％(6/41),2.4％(1/41),17.1％(7/41)],and there were significant differences among three groups (P ＜ 0.05 or ＜ 0.01).Conclusions Fondaparinux sodium prolonged anticoagulation treatment can significantly reduce overall cardiovascular events in patients with STEMI underwent primary PCI,and does not increase bleeding.It is safe and effective.

Objective To acknowledge the spouse comorbid conditions of diabetes patients by comparing the average blood sugar level of the spouse of the diabetes patients with normal Guangzhou residents.Methods To sift and analyze the spouse test results of 152 hospitalized diabetes patients from January 2012 to January 2013,by testing the blood sugar level of the experimental subjects,comparing the different blood sugar level results between when they were with empty stomach and 2 hours after oral glucose tolerance test (OGTT).Results There were 32 cases with diabetes,9 cases with impaired glucose tolerance (IGT) and 11 cases with impaired fasting glucose (IFG) in the above 152 experimental subjects.The morbidity rates were 21.05％,5.92％ and 7.24％.All the above results were higher than the Guangzhou residents survey level,there were statistical differences between them.Conclusions The high morbidity rates of diabetes and impaired glucose regulation in diabetes patients spouse are obvious.The works for diabetes sifting and analyzing together with the health education instruction need to be strengthened.

Objective To test and evaluate the geometric accuracy of delineation of organs at risk ( OARs) in head and neck cancer using an atlas?based autosegmentation ( ABAS) software. Methods The atlases for the ABAS software was generated using images from 40 patients with head and neck cancer undergoing intensity?modulated radiotherapy. The software was tested in 40 new patients. Automatic delineation of OARs was carried out on computed tomography images by single?( one to one ) and multi?template ( ten to one) approaches. In order to evaluate the feasibility of the automatic delineation in clinical application, differences in volume (ΔV%), position (Δx,Δy, andΔz), conformability (sensitivity ( Se ), specificity ( Sp ) , and dice similarity coefficient ( DSC) ) , and delineation time were assessed between the automatic and manual delineation. The comparison between the two automatic delineation approaches was made by paried t test. Results For all OARs, the multi?template automatic delineation achieved a significantly smaller mean ΔV% value and a significantly larger mean DSC value than the single?template automatic delineation (-0.02%± 0?29% vs. -0.16%± 0?41%, P<0?05;0.74± 0?16 vs. 0.68± 0?20, P<0?05);the position differences between two automatic delineation approaches were less than 0?4 cm in all three directions except for the temporal lobe, lower jaw, and spinal cord;in the receiver operating characteristic curve defined by Se versus 1-Sp , the data points were all within the first quadrant except for the optic nerve and chiasm;automatic delineation saved 42%?72% of time compared with manual delineation. Conclusions The ABAS software achieves satisfactory results of automatic delineation for most of OARs in patients with head and neck cancer. The multi?template automatic delineation, particularly, has better outcomes than the single?template one. In addition, it greatly shortens the time the clinicians spend on delineation of OARs.

Objective To investigate the modified methods and effects of the flaps with nutrient vessels of superficial vein-cutaneous nerve of lower limb which used for repair of the lower extremity soft-tissues defects.Methods Between December 2003 and September 2009, 18 patients were treated with this modified skin flap, in which 11 cases male; 7 cases were female, age from 5 to 73 years.Average age was 45.9 years.Repair parts: 4 cases of dorsal foot, 3 cases of foot, heel in 2 cases, the ankle weeks in 2 cases, calves under 1 / 3 of 7 cases, of which 8 cases of bone exposure wounds, tendons exposed in 3 cases.Surgical repair of soft tissue defect size of about 6 cm×4 cm-22 cm × 10 cm, which retained the donor sural nerve function retrograde sural nerve flap in 4 cases, with a thin layer of muscle retrograde sural nerve flap in 4 cases.Results All the flaps were survived completely without any complications.The appearance and functional results were satisfactory with following up for 3 to 36 months.18 cases of flap were survived completely, primary healing, without any complications such as vein congestion or engorgement.The 4 cases which remains the cutaneous nerve in site had an average recovery time about 13 days of the donor site.The innervated region of the cutaneous nerve had no acroesthesia or dysesthesia.Conclusion This modified operation methods of flap, enhanced the blood support of the flap, impmved the survive rates and also preserved the sensory function of the patients' donor site.This modified flap with nutrient vessels of superficial vein-cutaneous nerve is a convenient and safe method in repairing lower extremity soft-tissues defects.

Information department in hospitals shoulders the tasks of construction,operation,maintenance and super-vision of hospital information system ( HIS) . The work load increases with the update of HIS. The key issues con-cerned by the chief of HIS include the over planning of resources,optimizing the allocation of techniques,enforcing the means of management, improving the level of service and the efficiency of support. The principles for the design of performance appraisal program and the specific appraisal indicators in Information Department of Chinese PLA Second Artillery Forces were thus described in this paper in an attempt to provide reference for the information management in other hospitals.

OBJECTIVE To observe the disinfection efficacy of nano-light catalytic air disinfector(Jian Bai Le disinfector) in ophthalmic outpatients operating room.METHODS The efficacy of disinfection of the disinfector in the operating room without and with staff was detected respectively.This efficacy of disinfection was compared with that of ultraviolet ray.RESULTS The average eliminated rate of natural bacteria in the air was 88.9% vs 89.7%,and the average bacterial colony number was 63.9 vs 75.0 CFU/m3,respectively,after disinfection by the disinfector or by ultraviolet ray without staff.When the device worked continuously with staff,Their average bacterial colony number was 26.6,92.2,150.0 and 155.3 CFU/m3,vs 150.2,166.7,355.1 and 738.4CFU/m3 in the period of 30,60,120 and 180 minutes after operation,respectively.CONCLUSIONS The bactericidal efficacy of disinfector is distinctly better than that of ultraviolet ray lamp.

Objective To investigate the influence of mental intervention on the self-image of breast cancer patients.Methods Fifty patients with breast cancer who were hospitalized in our hospital from January to September,2015 were enrolled as the control group in the study,where routine nursing intervention,health education on disease related knowledge and psychological nursing were carried out.During October 2015 to June 2016,50 patients with breast cancer were enrolled as the observation group,where psychological awareness intervention was carried out apart from the routine nursing intervention.The self-image level of breast cancer patients from the two groups was evaluated by self-image questionnaire for breast cancer patients (BIBCQ).Result After intervention,the scores on self-image in the observation group were significantly higher than those in the control group (P＜0.05).Conclusion Mental intervention can improve the self-image of breast cancer patients and help improve their quality of life.