Objective To explore the concordance of nursing grades which are ordered by the nurses and the standards of nursing grade and the inpatients' needs. Methods 120 inpatients were rated using the three methods respectively, which were the nurses' order, the standards of musing grade and Bartbel index, and then compare the concordance of the nursing grades rated by the three. Results Then nurses' order was of well concordance with the standards of nursing grade and Barthel index,and the Kappa value was 0.862,0.611,P<0.01,respectively. Conclusions The nurses' order accords with the standards of nursing grade and the patients' needs, is helpful to develop the clinical work, and should be spreaded and exploited.

Objective To investigate the clinical features of patients with systemic lupus erythematosus (SLE) complicating with hepatitis B virus (HBV) infection.Methods The medical records of 40 inpatients with SLE complicating with HBV infection and 60 SLE inpatients without HBV infection were analyzed retrospectively.Chi-square test and t test were used for statistical analysis.Results Forty patients with SLE complicating with HBV infection were included,including 4 men and 36 women,with the mean age of (32±13) yr.Twenty-three patients suffered from chronic HBV hepatitis,5 patients were serological HBsAg carriers,12 patients with HBV occult infection.Twenty-one patients had mild liver dysfunction,presented mainly as increased ALT,2 patients presented with severe liver function abnormality.The main types of lupus rlephritis were Class Ⅳ and Class Ⅴ,2 patients complicating with HBV-associated glomerulonephritis.Compared with the control group,patients with SLE complicating with HBV infection had a significantly higher prevalence of fever,liver involvement,renal lesion,thrombocytopenia and cytomegalovirus infection respectively.One patient with severe liver abnormality had poor prognosis.Conclusion More attention should be paid to the clinical features of SLE complicating with HBV infection.Patients with SLE complicating with HBV infection have a significantly higher prevalence of fever,liver involvement,renal lesion,thrombocytopenia and cytomegalovirus infection respectively.Patients with SLE complicating with HBV infection may suffer from HBV-associated glomerulonephritis.Severe liver abnormality predicts poor prognosis.Anti-HBV drugs should be prescribed for SLE patients with serological positive HBsAg while immunosuppressive agents are used.

Objective To investigate the clinical efficacy and side reaction of tandospimne citrate capsules on treating patients with depression after stroke.Methods Seventy-eight patients who were diagnosed as anxiety and depression after stroke were taken as our subjects.They were randomly divided into control group (n =40) and treatment group (n =38).Patients in the control group were given conventional therapy for cerebral vascular disease and psychological treatment,while in the treatment group were given the same treatment besides tandospimne citrate capsules of 10 mg per times,3 times/d oral,and course of both two groups for 4 weeks.The patients of two groups were scored according to Hamilton Depression Scale(HAMD) at the time of pre-treatment and post-treatment.And the the clinical efficacy and side reaction were observed and compared.Results (1) HAMD scores of treatment group in 2,4 weeks after treatment had significantly lower than that before treatment ((8.09±2.21) vs.(6.31 ±2.28) vs.(11.98 ±2.17),P ＜0.05).HAMD scores of control group in the treatment at 2week was as same as that in 4 weeks((10.57 ±2.53) vs.(8.91 ±2.31)).There was statistically significant difference in two groups in 2,4 weeks after treatment in terms of HAMD scores(P ＞0.05).The total effective rate of control group was 31.6％ (12/38),and 92.5％ (37/40) in treatment group,and the difference was significant(x2 =63.69,P ＜ 0.01).In the course of treatment in the two groups,there were no obvious adverse reactions.Conclusion Tandospirone citrate capsules show the clinical curative effect in the treatment of anxiety and depression after stroke,and no obvious adverse reactions.

Objective To analyze and compare the independent and combined diagnostic values of high frequency ultrasonography (HFU) and molybdenum target imaging (MTI) for early breast tumor in a prospective study.Methods 258 patients with breast mass which were suspected as breast tumors by physical examination received HFU,MTI,their combined applications and operative treatments.Comparative studies were made between the surgical pathology and imaging evaluations.Results Totally 258 cases were enrolled in this study.Surgical pathology confirmed 135 cases of early breast cancer and 123 cases of benign breast tumor.For the diagnosis of early breast cancer,combined application was more effective than HFU or MTI alone in sensitivity (P<0.05),and more superior than MTI alone in accuracy.While the specificity,positive predictive value,negative predictive value, false positive rate, false negative rate had no difference among HFU, MTI and combined applications (P>0.05).In the patients of early breast cancer, compared with HFU,MTI found less nodules of calcification(18.3% vs 36.5%,P<0.01),but revealed more axillary lymph metastasis (69.0% vs 33.3%,P<0.01).Conclusion HFU and MTI alone or their combined application are reliable imaging methods for the diagnosis of early breast cancer.For the sensitivity and accuracy of diagnosis, combined applications has more superior advantages.

Objective:To survey the awareness of common primary care clinical guidelines among primary care providers in Qingdao city.Methods:A questionnaire survey on the awareness of common clinical guidelines in primary care was conducted in August 2020 among 659 providers (293 males and 366 females) from 81 primary medical institutions in Qingdao city. The contents of the questionnaire included the general information of primary physicians, the frequency of using the guidelines, the level of understanding of the guidelines, the effect of guidelines in clinical work, the attitudes towards promoting the guidelines, and the interest in learning the guidelines and the way of learning.Results:A total of 659 valid questionnaires were recovered with a recovery rate of 100.0%. The results showed that 14.7% (97/659) practitioners applied the guidelines in most cases, and 31.6% (208/659) frequently used. There were significant differences in use frequency among providers with different practice types, professional titles, education background, practice locations and institutions ( P<0.01). Among participants, 15.2% (100/659) did not know about primary care guidelines, 63.3% (417/659) knew but did not learned guidelines, 21.5% (142/659) knew and studied guidelines carefully. The top five of the learned guidelines (114, 80.3%) were bronchial asthma (113, 79.6%), type 2 diabetes (108, 76.1%), chronic obstructive pulmonary disease (101, 71.1%), and chronic cor pulmonale (83, 58.5%). Most participants who learnt the guidelines viewed the guidelines as quite helpful or very helpful, the score of usefulness for professional knowledge was the highest (4.44±0.60). Most of participants (94.2%, 621/659) thought it was necessary to develop primary care guidelines; and the major factors affecting the promotion were lack of training (79.8%, 526/659), difficulties in access (46.7%, 308/659) and ignorance or neglect (23.2%, 153/659).Most practitioners (93.8%, 618/659) were interested in learning primary care clinical guidelines, and the expected ways of training were online teaching (70.0%, 420/618), training courses(58.3%, 360/618) and special lectures (55.2%, 341/618). Conclusion:The current situation of learning clinical guidelines among primary care providers in Qingdao is not satisfactory, but they are willing to learn the guidelines for improving clinical practice. We should strengthen the training and promotion of primary care guidelines among primary care providers in the future.

Objective To develop a new instrument to assess swallowing function which will be suitable for nurses to screen dysphagia in the patients with stroke.MethodsItems closely related to symptoms and signs of dysphagia were found with literature review, forming a preliminary instrument. All items retrieved were selected and modified by experts interview and a pilot study in patients with stroke. Then, a clinical nursing swallowing assessment tool (CNSAT) was formulated.ResultsTotally, seven items of symptoms and signs related to dysphagia in patients with stroke were found with literature review. All the seven items retrieved were selected again by experts interview and finally a CNSAT was formed with six modified items by a pilot study in 10 patients with stroke, each item with four choice based on its severity of their symptoms and signs.ConclusionCNSAT is a simple, convenient and safe instrument and suitable for nurses to assess swallowing function of patients with stroke.

Objective To investigate the knowledge and attitude of nurses on prevention and intervention of common complications among bedridden patients in Chinese hospitals and to explore the influential factors.Methods It was a cross-sectional study.A total of 3 903 nurses from 6 tertiary hospitals,11 secondary hospitals and 8 primary hospitals from 6 provinces and cities were recruited by convenience sampling and surveyed using selfdesigned questionnaires.Results Nurses' average scoring rate of knowledge and attitude were 73.46％ and 85.02％.Level of hospitals,whether in ICU or not,age,working time,educational background,job title,position,employment form were influential factors for nurses' knowledge (P＜0.05).Meanwhile,level of hospitals,educational background,position,employment form were influential factors for nurses' attitude (P＜0.05).Conclusion Nurses took a positive attitude for prevention and intervention of common complications among bedridden patients,while the level of nurses' knowledge should be improved.

AIM: To examined the effects of hypoxic preconditioning ( HPC) on oxygen-glucose deprivation ( OGD)-induced PC12 cells, and to investigate its possible mechanisms of autophagy .METHODS: Cultured PC12 cells were randomly divided into control group , HPC group, 3-methyladenine (3-MA) group, HPC+OGD group, 3-MA+HPC+OGD group and OGD group .CCK-8 assay was used to detect the cell viability .The caspase-3 activity was also tested . TUNEL staining and flow cytometry were used to detect the cell apoptosis .The protein levels of apoptosis-related protein caspase-3 and autophagy-marked protein LC3-2 and beclin-1 were determined by Western blot .RESULTS:Compared with control group, the viability of PC12 cells was significantly reduced , and the activity of caspase-3 was significantly increased in OGD group.Compared with 3-MA+HPC+OGD group and OGD group , the viability of PC12 cells was significantly in-creased, and the activity of caspase-3 was significantly reduced in HPC +OGD group (P<0.05).The PC12 cell injury was apparent after OGD with a great increase in the apoptotic rate (P<0.05).Compared with OGD group, the apoptotic rate significantly decreased in HPC +OGD group ( P<0.05 ) .Compared with control group , the protein level of cleaved caspase-3 was significantly increased in OGD group ( P<0.05) .Compared with OGD group , the protein level of cleaved caspase-3 was significantly decreased , and the levels of LC3-2 and beclin-1 were significantly increased in HPC +OGD group (P<0.05).CONCLUSION:OGD decreases cell survival and induces apoptosis .Activation of cell autophagy may be the mechanism by which hypoxic preconditioning protects the PC 12 cells from OGD induced injury .

Aim To investigate the protective effects of hydrogen sulfide ( H2 S) on focal cerebral ischemia/reperfusion injury in rats and the possible mechanisms. Methods Male Sprague Dawley rats were divided into three groups randomly: sham-operated group, cerebral ischemia/ reperfusion ( I/R) group and sodium hydro-sulfide ( NaHS ) + I/R group. The left temporary middle cerebral artery occlusion ( MCAO ) model was established by the line-embolism method. After rats were suffered 2h/24h ischemia/reperfusion stress, the mortality rate was evaluated, and the nervous function-al defect degree was evaluated by Longe scoring, the volumes of cerebral infarction was evaluated by 2 ,3 ,5-triphenyltetrazolium chloride ( TTC) staining, and the expression of P2X7 receptor protein in brain tissue was detected by the immunofluorescence method. Results The mortality rate in NaHS + I/R rats ( 29.41%) was obviously lower than those of I/R group ( 42 . 86%) . The nervous defect scores in NaHS + I/R rats were significant lower than those of I/R group ( P <0.05 ) . The volumes of cerebral infarction in NaHS +I/R group (21.88% ±3.53%) were significant lower than those of I/R group ( 36.71% ±3.73%) ( P <0.01 ) . The results of immunofluorescence showed that the positive expression cells of P2X7 receptor protein in cerebral cortex and hippocampal CA1 area of I/R group were significantly higher than those of sham-op-erated group(P<0. 01). However, compared with I/R group, the positive expression cells of P2X7 receptor protein in cerebral cortex and hippocampal CA1 area of NaHS + I/R group were significantly decreased ( P<0. 01). Conclusions H2S exerts the neuroprotective effect on focal cerebral ischemia/reperfusion injury in rats, and the protective mechanism might be associated with down-regulating the expression of P2X7 receptor protein in brain tissue.

[ABSTRACT]AIM:ToexaminetheeffectsofhighconcentrationofextracellularATPonhumanneuroblastoma SH-SY5Y cell injury.METHODS: Cultured SH-SY5Y cells were grouped according to the concentrations of ATP and treatment time.The cell viability was detected by CCK-8 assay.The variation of autophagic vacuoles was observed with monodansylcadaverine staining .The cell apoptosis was analyzed by Hoechst 33258 staining.Meanwhile, apoptotic rate was detected by flow cytometry .The levels of caspase-3 and microtubule-associated protein 1 light chain 3-Ⅱ ( LC3-Ⅱ) were determined by Western blotting .RESULTS:Compared with control group , the survival rate of SH-SY5Y cells was signifi-cantly reduced by ATP at different concentrations (3, 6, 9, 12 and 15 mmol/L for 3 h) and different treatment time (1, 2, 3 and 6 h with 6 mmol/L ATP, peaking at 3 h).The autophagic vacuoles of SH-SY5Y cells were significantly increased at 1 h with ATP treatment , trended to decrease over time and returned to control level at 6 h.The protein expression of LC3-Ⅱwas significantly increased at 1 h with ATP treatment , which was consistent with the time points of increasing auto-phagic vacuoles .LC3-Ⅱexpression level gradually decreased at 2~3 h with ATP treatment , and returned to control level at 6 h.Compared with control group , the apoptotic rate and the expression level of caspase-3 were enhanced synchronously . The peak of apoptotic rate occurred at 3 h, and kept until 6 h.The level of cleaved caspase-3 expression peaked at 6 h. CONCLUSION:High concentration of extracellular ATP induces the autophagy and apoptosis of SH -SY5Y cells.The in-creased autophagy shows up , followed by the climax of apoptosis until 6 h.With the prolonged duration of ATP , apoptosis is the main process in the cells .