Objective:To improve hypertension management in peritoneal dialysis patients through CQI process. Methods: Using the 4 step problem solving framework called the PDCA cycle-plan, do, check and act, we conducted a CQI program. Results: One hundred and forty five peritoneal dialysis patients dialyzed for more than 3 months participated in the study. In 49 prevalent patients, the incidence of uncontrolled hypertension (BP≥140/90 mm Hg, 1 mm Hg=0.133 kPa) decreased from 49% to 16.3% although there were no significant changes in antihypertensive medication and total fluid removal. The incidence of uncontrolled hypertension in incident patients decreased from 61.3% to 28%. Height normalized extracellular water decreased significantly. In males it was from (10.8?1.4) kg/m to (10.3? 1.7) kg/m and in females (9.6?1.2) kg/m to (8.6?1.2) kg/m. Conclusion:CQI is a useful method in the management of hypertension in peritoneal dialysis patients.

Objective To investigate the changes of plasma vascular endothelial growth factor( VEGF) of patients of advanced primary liver cancer before and after interventional treatment and its clinical Significance. Methods Forty-six patients with advanced primary liver cancer were performed the hepatic arterial chemoembolization and served as observation group. Sixty healthy people were served as control group and measured their level of serum VEGF. The level of serum VEGF of patients in observation group before treatment and intervention 1 month were measured. Results Before interventional treatment,the serum VEGF level of observation group were(510. 0 ± 310. 0)ng/L,significantly higher than that of control group((27. 0 ± 23. 0) ng/L,P﹤0. 001). After interventional treatment,he serum VEGF level decreased to(316. 4 ± 240. 7)ng/L and the difference was statistically significant( P=0. 036 ). After one month interventional treatment,4 cases were complete remission(8. 70%),34 cases were partial remission(73. 91%),6 cases were in stable(13. 04%),and 2 cases were progress( 4. 35%),and the total effective rate were 82. 61%( 38/46 ). The 38 cases who were complete remission and partial remission were been served as effective group,the other 8 cases were served as invalid group. The serum VEGF level in effective group were( 260. 6 ± 70. 5 )ng/L,lower than that in invalid group(( 346. 7 ± 61. 3 )ng/L,P = 0. 046 ). Conclusion Hepatic arterial chemoembolization treatment on primary liver cancer curative effect is a better approach. VEGF involves in the development of primary liver cancer,and the high serum VEGF level with poor prognosis can be the reference of efficacy.

Objective To approach the medicine-Schisandraceae-protective actions to the mice of experimental Kidney Yin deficiency from different angles. Method To observe the level of SOD and OFR in the female rats ovary tissue in order to prove the medicine’s curative effect. Result Schisandraceae can obviously increase the SOD and decrease the OFR to experimental Kidney Yin deficiency mice. Conclusion Schisandraceae has very obviously protective action to experimental Kidney Yin deficiency by influencing content of SOD and OFR of female mice ovary tissue.

Objective To know the nursing scientific research status in recent years,and to reveal the differences between Chinese nursing scientific researches and foreign nursing scientific researches,in order to promote the rapid development of nursing cause in China.Methods Five Chinese journals of nursing and four foreign nursing journals were analyzed covered China National Knowledge Infrastructure (CNKI),PubMed and Google data ranged from 2008 to 2013.By adopting bibliometrics method,regional distribution,the number of people participation,the cooperation between units,the source of financial funding,research content and nature of Chinese nursing research papers were analyzed,and also compared to research content and nature of foreign nursing journals.Results The amounts of published papers were 1 527 pieces.The geographical distribution of research papers were all spread over 28 provinces,autonomous regions sand municipalities directly under the central government,most of which was Guangdong province [12.64％ (193/1 527)];The majority of research papers were completed by single unit and more than five people,which about [68.4％(1 045/1 527)],[38.6％(589/1 527)],respectively;Provincial level of research papers were more than national level [81.4％(1 243/1 527) vs.18.6％(284/1 527)];The papers focused on the clinical nursing research [37.8％(577/1 527)] and clinical basic nursing research [34.6％(529/1 527)].Almost researches were descriptive research,while 40.7％(622/1527) of which were clinical analysis.Foreign nursing scientific researches paid more attention to psychological research and nursing profession which were related to humanities and investigation was major method used;Compared with the foreign nursing papers at the same time,the number of Chinese nursing research papers increased rapidly (P ＜ 0.05);Papers were completed more than five units rapidly increased compared with the pre-upgrade,as well as the national subjects,the difference was statistically significant (P ＜ 0.05).Conclusions The number of nursing research programs tended to increase year by year and the enthusiasm of nurses participating in scientific research was higher than before.Different units needed to further strengthen cooperation in scientific research.The research content and direction were diversity,which had not yet formed central tendency.The research method was still limited to descriptive studies,and the creativity of the research methods was needed,especially laboratory research.

Objective To evaluate the efficacy of modification and care improvement in endotracheal tubes (ETTs) to prevent ventilator associated pneumonia (VAP) in patients receiving mechanical ventilation (MV).Methods PubMed,China National Knowledge Infrastructure (CNKI) were searched,literature information was extracted and classified according to the inclusion criteria,the data were statistically analyzed.Results Totally 46 clinical research articles and 6 laboratory research articles were involved,the data showed that polyurethane (PU) cuff [23.809％ (35/147)],silver-coated ETTs [4.830％ (37/766)],subglottic drainage duct [19.492％ (759/3 894)],discontinuous subglottic drainage[13.603％ (256/1 882)] were associated with a decreased incidence of VAP compared with polyvinyl (PVC) cuff [40.179％ (45/112)],non-silver-coated ETTs [7.537％ (56/743)],conventional ETTs[45.733％ (1 088/2 379)],continuous subglottic drainage [25.000％ (503/2 012)],the differences in the incidence of VAP were statistically significant,respectively,P＜ 0.05.The incidence of VAP in cylindrical PU cuff was 25.000％ (8/32),the tapered PU cuff was 21.875％ (7/32),the difference in the incidence of VAP was not statistically significant.Conclusions The modification of the ETTs and the care improvement can effectively reduce the incidence of VAP.

Objective To know the effects of training for community residents about cardiopulmonary resuscitation.Methods 60 community residents were trained by CPR with varied training methods,evaluated the effects by the ABC for life questionnaire.Results The knowledge of cardiopulmonary resuscitation among the trained community residents were better than before expect 4 aspects.Conclusions The knowledge of cardiopulmonary resuscitation in community residents was not enough,systemic training can effective promote their skills of CPR.

The article gives a brief analysis of student characteristics of medical independent college and the aim and purpose of medical education to propose the corresponding measures to improve the students work of independent college.

Objective To study the origin, position, pathogenesis and differentiation rule of depressive disorder in ancient medical records, Er Xu Ming Yi Lei An. Methods Study medical records in ancient medical books, Ming Yi Lei An, Xu Ming Yi Lei An, Er Xu Ming Yi Lei An. Adopt Excel to establish medical records' database about depressive disorder, and use frequency analysis method to summarize medication rule of Chinese materia medica for treating depressive disorder. Results Six body symptoms referred in medical records are anorexia,lassitude, sweating, abdominal distension, insomnia, and hypochondriac pain, account 53.41% in top ten symptoms;regulating Qi method is the most frequently used treatment; The most frequently use prescriptions in a descending order are Xiaoyaosan, Buzhong Yiqi Tang, Taoren Chengqi Tang, Modified Guipi Tang, Wendan Tang, Liujun Zi Tang, Suanzaoren Tang, et. Most frequently applied medical herbs in a descending order are bupleurum, dried tangerine peel, white peony alba, tumeric root tuber, fossilia ossis mastoid, and Chinese angelica, et. Conclusion There are certain rules in the origin, pathogenesis, diagnosis and prescriptions of depressive disorder in ancient medical records, Er Xu Ming Yi Lei An.

Objective To determine ff cognitive dysfunction induced by neonatal ketamine anesthesia can persist into adulthood.Methods Thirty 7-day-old SD rats of both sexes were randomly divided into 3 groups.Control group received normal saline 0.2 ml intraperitoneally (IP) (group C),while ketamine groups 1 and 2 received ketamine 25 and 50 mg/kg IP respectively (groups K1,K2 ).Morris water maze test was performed and hippocampal long-term potentiation (LTP) recorded when the rats were 2.5 months old.Results LTP was significantly lower in groups K1 and K2 than in group C.There was no significant difference in LTP between groups K1 and K2.The escape latency and swimming time were comparable among the 3 groups.Conclusion Neonatal ketamine anesthesia can decrease the cognitive function in adult rats.There is no significant difference between light and deep ketamine anesthesia.

ObjectiveTo introduce the operative technique of pedicle evolution from isolated perforator to perforator-plus-adipofascial,and investigate its clinical results in venous drainage and safety in distallybased sural flaps.MethodsAfter identifying the proper viable perforators,the whole flap was designed in an eccentric propeller shape,with the perforating vessels corresponding to the pivot point.The proximal larger blade was a fasciocutaneous flap, while the distal smaller blade was a subdermal vascular plexus flap,preserving at least a quarter area of adipofascial tissue around the perforator.From January 2008 to December 2010,we performed distally perforator-adipofascial pedicled sural fasciocutaneous propeller flap in 12 patients,with 180 degrees rotation to cover foot and ankle defects.Postoperatively,flap swelling,survival and functional recovery were evaluated. Results There were 7 posterior tibial artery perforator flaps from the posteromedial and 5 peroneal artery perforator flaps from the posterolateral sural region. The proximal fasciocutaneous flap measured 4 cm × 8 cm-6 cm × 18cm, and the distal cutaneous flaps measured 2 cm × 2cm-4 cm × 4 cm.Flap swelling was noted under grade 2 in 9 cases,grade 3 in 2 cases,and grade 4 in 1case with some distal superficial skin necrosis,which occurred in the largest flap in our series.All flaps survived eventfully.After average 13 months follow up,the wound were cured successfully,and all patients recovered walking and shoe wearing function. ConclusionPedicle evolution by keeping some adipofascial tissue around the pivot perforator, can preserve more venous return routes and relieve flap swelling. This technique should be recommended in perforator pedicled propeller flaps,as it enhances flap safety,and without increasing the difficulty of 180 degrees rotation.