Objective To evaluate evidence-based practice of catheter removal strategy in patients with short-term indwelling catheter after partial nephrectomy. Try to apply the best evidence into practice, and further to improvethe quality of clinical nursing through quality review. Methods Two rounds of quality review were carried out in the 2 wards from July to December in 2016. Using the 5 review criteria of best evidence, we reviewed baseline of catheter removal strategies for patients with short-term indwelling catheter after partial nephrectomy and developed appropriate evidence-based practice. Further, the best evidence was integrated into clinical nursing practice, and the prognosis was reviewed after then. Results In the baseline review, the compliance of the 5 review criteria was 0. However, after introducing the best evidence into nursing practice,the compliance was up to 100%. The mastering of evaluation knowledge of catheter removal of nurses increased from 73.00 ± 9.35 to 94.81 ± 3.38 with significant difference (t=12.72, P<0.01). The indwelling time of catheter shorted from (5.69±0.79) d to(4.24±0.82) d. The difference was significant (t=5.47, P<0.01). Conclusions Evidence-based nursing practice improvesthe strategies of short-term catheter removal after partialnephrectomy, while closer cooperation between nurses and doctors are still needed to promote the continuous improvement of nursing quality.

OBJECTIVE: To evaluate the effect of patient education on patients with allergic rhinitis (AR). METHOD: From January 2009 to December 2013, 100 cases of allergic rhinitis were treated. The patients were randomly divided into experimental group or control group by Stochastic tables law,50 patients in control group accepted only drug treatment, 50 patients in experimental group accepted both drug treatment and patient education. The difference in compliance with treatment, treatment effect, incidence of adverse drug reactions and complications, average costs and times of treatment between two groups were evaluated by the rhinoconjunctivitis quality of life questionnaire (RQLQ) score. The independent sample t-test and χ2 test were used for statistical analysis. RESULT: The patients of experimental group showed more positive attitude to treatment compared to the patients of control group (P < 0.01). The average scores of each classification and overall symptoms after treatment in experimental group were lower than those in control group (P < 0.05). The incidence of adverse drug reactions (nose-bleed, dry nose,nasal mucosa ulcer)and complications in patients with AR (asthma, chronic cough, secretory otitis media) in experimental group was lower than that in control group, with statistically differences (P < 0.05). The average times of treatment and costs of diagnosis and treatment(calculation of budesonide nasal spray)in experimental group were significantly lower than those in control group (P < 0.01). The total score for RQLQ and the scores of seven dimensions in experimental group were lower than those in control group (P < 0.05). CONCLUSIONS Patient education can help the patients with AR to cooperate actively with treatment, to reduce the incidence of adverse drug reactions and AR complications, and to save medical costs and improve the quality of life.
Budesonide ; therapeutic use ; Chronic Disease ; Humans ; Incidence ; Patient Education as Topic ; Patient Participation ; Quality of Life ; Rhinitis, Allergic ; therapy ; Surveys and Questionnaires

Objective To investigate the correlation between the deletion of exon 13 of hMSH2 mRNA in peripheral blood leu-kocyte and ISV12(-6) T>C polymorphism with sporadic colorectal cancer .Methods Total RNA and genomic DNA were extracted from peripheral blood of colorectal cancer patients and healthy controls .RT-PCR and PCR were used to amplified the mRNA and exon 13 of hMSH2 gene .The sequences of amplified hMSH2 cDNA ,ISV12(-6) T>C polymorphism and exon 13 sequence were confirmed by DNA sequencing .Results 23 of 23 (100% ) patients and 31 of 35 controls (88 .6% ,P>0 .05) were found to have an hMSH2 truncated transcript caused by a deletion of exon 13 .No deletions of exon 13 in hMSH2 gene were identified in genomic DNA .16 of 23 patients (69 .5% ) and 19 of 35 control (52 .3% ,P>0 .05) were found to have the T >C transition six bases up-stream of exon 13 of hMSH2 .Conclusion Deletion of hMSH2 mRNA exon 13 in peripheral blood leukocyte and the ISV12(-6) T>C polymorphism are common variants in population and have no correlation with sporadic colorectal cancer .The variant of splice site ISV12(-6)T>C is not a reason causing the deletion of hMSH2 mRNA exon 13 .

Objective To study the current situation of pediatric emergency department of primary hospitals in Guangdong province,in order to provide evidence for the development of appropriate pediatric emergency skill.Methods A questionnaire survey was conducted in primary hospitals of Guangdong province by face to face and mail.The questionnaire was self-designed,including the hospital area and level set,the key equipment in pediatric emergency,common symptoms and diseases,the need for pediatric specialty in local medical colleges.Results60 questionnaires were released and 38(63.3％) were available,which were from 14 different cities of Guangdong province.Among the 38 hospitals,16 hospitals(42.1％) had no independent pediatric emergency;24 hospitals(63.2％) had no blood gas analyzer;23 hospitals(60.5％) without a defibrillator;22 hospitals(57.9％) had no bedside ultrasound,neonatal warm or warm box;17 hospitals(44.7％) had no bedside X-ray,infusion pump;13 hospitals(34.2％) without gastric lavage machine;12 hospitals(31.6％) without ventilator;8 hospitals(21.1％) without the monitor.Top five symptoms were fever,cough,vomiting,diarrhea,convulsion.The top five diseases were pneumonia,fever of unknown,acute gastroenteritis,hand-foot-mouth disease,convulsion of unknown.Only 5 hospitals (13.2％) thought there was no need for pediatric specialty in local medical colleges.Conclusion Shortages of the pediatric emergency equipments and specialists are very severe in primary hospitals,in order to improve the status of pediatric emergency,some ways can be explored:the construction of grassroots pediatric emergency should be speeded up;a grades regional system for child emergency transport should be improved as soon as possible;the appropriate pediatric emergency skills and training for primary hospitals should be explored and compiled into instructions;pediatric emergency health education could be implemented in child health care.

ObjectiveTo summarize the clinical significance of ultrasonic screening of fetal structural anomalies at 11-13+6 weeks.Methods We conducted a retrospective study of 4853 cases of nuchal translucency screening at 11-13+6 weeks in Maternal and Child Health Hospital of Bao?an of Shenzhen City from September 2011 to May 2014. The screening ultrasound planes included the median sagittal plane, neck sagittal section, cerebral transverse section, cardiac four-chamber view, three-vessel-trachea view, abdominal transverse section, bladder section, upper limb section and lower limb section of the fetuses. All the cases then underwent the ultrasonic structural screening in the second trimester (20-24 weeks) and the third (28-32 weeks) trimester and were followed up until 6 weeks after birth or the biopsy after abortion.Results Eighty-ifve fetal structural anomalies were detected among the 4853 pregnant women at 11-13+6 weeks of gestation with the detection rate of 1.75% (85/4853), including central nervous system abnormalities (28 cases), anterior abdominal wall anomalies (9 cases), cardiac anomalies (6 cases), urinary system malformation (3 cases), skeletal system malformation (2 cases), multilocular cystic tumor and dropsy embryo (35 cases), and abnormal twins (2 cases). Among above abnormal fetuses, 6 cases showed normal structure in the screening after 14 weeks and were born without malformations, while the rest 79 cases were taken artiifcial abortion (73 cases in the ifrst trimester and 6 cases in the second trimester). Only 9 cases were taken chorionic puncture or amniocentesis, including normal karyotypes (3 cases), 47, XN, +18 (3 cases) and 45, X (3 cases). The False negative rate in the ifrst trimester was 23% (25/110). Supplementary detection of fetal structural abnormalities in the second and third trimester were found in 22 cases (20%, 22/110). Two cases of VSD and 1 case of microtia were identiifed after birth.ConclusionsThe fetal malformation can be detected in the earlier gestation with the ultrasonic screening at 11-13+6 weeks, which provide the earlier termination to the abnormal fetus. It has important clinical signiifcance in effectively reducing fetal births with structural abnormalities.

Objective To develop a tool capable of early and exactly predicting various outcomes in comatose survivors who restore spontaneous circulation after cardiopulmonary resuscitation (CPR) and validate its performance.Methods Variables that were both readily available and predictive of outcomes were identified by systematically reviewing published literature on resuscitation.A value was assigned to these variables.We used these variables in combination with APACHE Ⅱ/score to devise a multifactorial prediction score system,which we called PRCSs Prognostication Score (PRCSs-PS).Outcomes in 115 hospitalized comatose survivors after CPR were retrospectively reviewed using PRCSs-PS.Score of patients with different outcomes was compared.The area under the receiveroperating characteristic (ROC) curve was determined to evaluate performance of this tool to identify patients with a poor outcome (CPC4 and 5) and other outcomes (CPC1,2,and 3).Results There were differences of PRCSs-PS score among multiple groups with five different outcomes (CPC1-5)(F=65.91,P=0.000).Pairwise groups with different CPC were compared:no significant difference was noted between CPC 1 and CPC2 (12.41±6.49 vs 17.38±6.91,P=0.092),but difference between other pairwise CPC groups was statistically significant (CPC2 vs CPC3:17.38±6.91 vs 24.50±5.80,P=0.041,CPC3 vs CPC4:24.50±5.80 vs 32.29±5.24,P=0.006).The performance of PRCSs-PS to discriminate patients with a poor outcome from patients with other outcomes went as follows:it had 100% sensitivity,78.6% specificity,and 178.6 diagnostic index at the score cut-off22.5; it had 77.8% sensitivity,100% specificity and 176.4 diagnostic index at the score cut-off32.5.Score 23 and 33 were two key cut-offpoints.The area under the ROC curve was 0.968,showing excellent discrimination.Conclusions The final outcomes in post-resuscitation comatose survivors can be accurately predicted using PRCSs-PS Score.

Objective To observe microvascular architecture and free radical metabolism in hippocampus after focal cerebral ischemia/reperfusion and to explore the effect of NBP (3-n-butylphthalide). Methods Fifty-four SD rats were ran?domly divided into NBP pretreatment group, ischemia/reperfusion group and sham operation group (n=18 in each group). The model of middle cerebral artery occlusion(MCAO)was established by suture method. The neurological scores were counted and the volume of infarction was measured;TA-Fe method was applied to observe the microvascular architecture of hippo?campus, Mivnt image analysis system was used to analyze the microvessel density(MVD)and the microvessel area density (MVA)of hippocampus quantitatively;The activity of SOD and content of MDA were measured by colorimetric method. Re?sults Compared to the ischemia reperfusion(IR)group, the neurological scores and the volume of infarction were decreased sharply in NBP group. What′s more, the activity of SOD, MVD and MVA were all enhanced but the content of MDA and the count of closed microvessels were both reduced(P < 0.01). Conclusion NBP can improve microvascular architecture of hippocampus and reduce the free radical injury. There is a protective effect on hippocampus of rats who suffered focal cere?bral ischemia reperfusion.

Objective To investigate the effects of 3-N-butylphthalide ( NBP ) pretreatment on the score of neurological deficit , oxidative stress and pathomorphology in rats with cerebral ischemia reperfusion injury ( CIRI ) . Methods Ninety male SD rats were randomly divided into sham operation group ( Sham group ) , model group ( IR group), NBP pretreatment low dose group (NBPⅠgroup), NBP pretreatment middle dose group(NBPⅡgroup) and NBP pretreatment high dose group(NBPⅢgroup), 18 rats per group.Pretreatment was given once a day within 1 week before establishing the model of cerebral ischemia reperfusion injury .The model of middle cerebral artery occlusion ( MCAO) was subjected by suture method .The score of neurological deficit was executed after ischemia for 2h and reperfusion for 24h in all the rats.The cerebral infarction was observed by TTC staining .The pathologic change of brain was observed by HE staining under the microscope .Hydroxylamine method was used to detect activity of SOD , chemical colorimetry method was used to measure activity of GSH-PX, and TBA method was used to detect content of MDA .Results (1) In Sham group, the score of neurological deficit and the percentage of infarction volume were zero , the morphology of nerve cell was regular , and activity of SOD, GSH-PX and content of MDA of brain tissue were normal .(2) Compared with IR group , the score of neurological deficit was significantly reduced in NBP pretreatment groups (all P<0.01); the score of neurological deficit was decreased progressively in turn in NBP Ⅰ,Ⅱ,Ⅲgroup (all P<0.05).(3) Compared with IR group, the percentage of infarction volume was cut down progressively in turn in NBPⅠ,Ⅱ,Ⅲgroup (all P<0.05), and neuron injury was also induced obviously in NBP pretreatment groups .(4) Activity of SOD, GSH-PX was largely increased , and content of MDA was greatly decreased in NBP pretreatment groups ( P<0.01 ) .Activity of SOD , GSH-PX went up progressively in turn , and contents of MDA were cut down progressively in turn in NBP Ⅰ,Ⅱ,Ⅲgroup ( all P<0.05 ) .Conclusion 3-N-butylphthalide can significantly up-regulate the activity of SOD and GSH-PX, decrease the content of MDA , reduce the percentage of infarction volume , and relieve the damage of nerve cell to preventively protect the rats with cerebral ischemia reperfusion injury .

Objective To investigate the association between levels of serum alanine aminotransferase (ALT) and the risks of metabolic syndrome in middle-aged and elderly Chinese. Methods After excluding subjects with known liver disease, excess alcohol consumption and serum ALT≥40 IU/L,1 664 subjects aged 40 years or older from Baoshan Community, Shanghai were recruited to undergo questionnaire interview, anthropometric measurements, and fasting blood sampling. Biochemical features were evaluated and the metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria with modification on waist circumference cutoff which is more appropriate for an Asian population. Results Increased ALT levels were associated with more unfavorable metabolic risk profiles. The prevalence rates of the metabolic syndrome in participants with increasing ALT quartiles were 29. 2% , 38. 0% , 44.9% , and 62. 9% , respectively (P for trend <0. 01 ). ALT concentrations were significantly elevated with increasing number of the metabolic syndrome components (P for trend<0.01). Serum ALT levels were significantly associated with the risks of metabolic syndrome and most of its components in a dose-response manner. As compared with participants in the first ALT quartile, the risks of metabolic syndrome were increased by 146% , central obesity by 204% , hypertension by 35% , high triglycerides by 133% , and hyperglycemia by 72% in participants of the fourth ALT quartile. Conclusions A high-normal serum ALT level was significantly associated with an increased risk of the metabolic syndrome in middle-aged and elderly Chinese.

Objective To investigate the characteristic MRI features of sporadic inclusion?body myositis(sIBM). Methods Clinical and MR imaging data of 6 patients with sIBM diagnosed by muscle biopsy from May 2013 to November 2014 were retrospectively analyzed. All patients showed insidious onset of lower limb muscle weakness and diagnosed as sIBM by muscle biopsies. All patients were evaluated by the score of the severity of fatty infiltration, inflammation and atrophy in MRI. Results All patients were observed fatty infiltration with different degrees. The fatty infiltration in thighs was characterized in a decreasing order of frequency:gluteus maximus (6 cases), vastuslateralis (6 cases), vastusintermedius (6 cases), vastusmedialis (6 cases), sartorius (5 cases), adductor magnus (5 cases), rectus femoris (4 cases), semi?membranosus (4 cases), semi?tendinosus (4 cases), biceps femoris (4 cases), gracilis (3 cases), adductor longus(2 cases).The fatty infiltration in thighs was characterized in a decreasing order of severity:vastuslateralis (3.2 points), vastusintermedius (3.2 points), vastusmedialis (3.0 points), adductor magnus (3.0 points), gluteus maximus (2.7 points), bicepsfemoris (2.2 points), semi?membranosus (2.1 points), semi?tendinosus (2.1 points), rectus femoris (1.5 points), sartorius (1.3 points), gracilis (0.8 points), adductor longus (0.7 points). All patients showed the features of distal distribution andsymmetry. Inflammation was observed in 3 patients. 1 patient only involved the vastuslateralis, the other 2 patients were observed muscle inflammation with different degrees in 12 muscles. Atrophy was observed in 5 patients. The atrophy in thighs was characterized in a decreasing order of frequency:vastuslateralis (5 cases), vastusintermedius (5 cases), vastusmedialis (4 cases), adductor magnus (4 cases), semi?membranosus (2 cases), rectus femoris (1 cases), sartorius (1 cases) and gluteus maximus;there was no atrophy in adductor longus, gracilis,semi?tendinosus, biceps femoris. Conclusion The MRI characteristic manifestations of sIBM is fatty infiltration and atrophy in the distal portion, particularly involving the vastuslateralis, vastusintermedius, vastusmedialis and adductor magnus.