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 electrocardiogram analysis of electronic colonoscopy on patients with coronary artery heart disease,and to evaluate the safety of colonoscopy on patients with coronary artery heart disease.Methods Sixty patients who underwent colonoscopy from Jun.2012 to Jun.2013 were divided into experimental group (patients with coronary artery heart disease,Heart function class Ⅰ-Ⅲ) and control group (patients without coronary artery heart disease).The changes of electrocardiography during colonoscopy and before performance were compared between two groups through dynamic electrocardiogram.Results Heart rate of the two groups were no statistically significant difference before colonoscopy process (t =0.537,P ＞ 0.05).During the inspection process,there was heart rate increase at different degree in two groups.The heart rate in patients of experiments group was increased from (73.20 ± 7.91) times/min to (88.67 ± 7.79) times/min,which waas more than that in control group (from (73.40 ±6.44) times/min to (74.88 ±7.82) times/min),and the difference between the two groups was significant(t =4.462,P ＜ 0.05).During colonoscopy inspection,the arrhythmia rate arrhythmia in experiment and control group were 46.67％ (14/30),20.00％ (6/30),and the difference was statistically significant (x2 =4.8,P ＜0.05).Meanwhile,ST-T change rates in experimental group and control group were 26.7％ (8/30) and 10.0％ (3/30) (x2 =45.72,P ＜ 0.05).The rate of subjective discomfort the two groups were 40％,30％ (x2 =0.659,P ＞ 0.05).Conclusion During the inspection process of colonoscopy,patients with coronary heart disease are more susceptible to increase heart rate,cardiac arrhythmia,ST-T change than those without coronary heart disease.However,no serious electrocardiographic changes.It is relatively safe to get colonoscopy in patients with coronary heart disease.

We designed and applied the electronic data capture system (EDC) in order to strengthen the re-search quality and improve the efficiency of data collection of multi-center nursing research. According to the needs of research,we reasonably designed the EDC structure and functions,including data collection,verification, summary and export. Further improvement was performed after EDC was inputted into using. By using EDC,resear-chers from sub-centers completed the data collection smoothly,and the data quality met with research requirements. The design and application of EDC could effectively guarantee the data quality and improve the research efficiency.

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.

Objective To construct an evaluation index system of ward management,which can evaluate the efficiency of ward management fairly, and make the ward management more scientific and standardized.Methods Delphi method was used in semi-structured interview of 31 experts and 74 experts were subject to questionnaire consultation, so as to establish the index system.Results The index system of ward management so built consisted of three level-1 indexes of safety and quality, teamwork and patient satisfaction, six level-2 indexes of daily monitoring, service environment, adverse events, doctor-nurse cooperation, evaluation of administrators and patient satisfaction, and 25 level-3 indexes.Practice of this system in the past two years reduced adverse events and elevated quality of care.Conclusions This system as used clinically proves its operability and objectivity.

Quality management of scientific research is a systematic work,quality control of multicenter nursing research depends on perfect and effective quality management system,measures and procedures,as well as rigorous scientific attitude in project team. To establish and improve quality management system of scientific research,to for-mulate standard quality control procedures,to promote the usage of electronic data acquisition system in multicenter nursing researches,and to improve scientific,standard,and refined quality management of research are effective mea-sures to guarantee quality control of multicenter nursing research. This paper summarized quality control methods for multicenter investigation,to provide more experience for nursing researchers as references.

Objective To investigate the sleep condition and its influence factors in old patients with hypertension. Methods A total of 100 old patients with hypertension were investigated by Pitts-burgh sleep quality index (PSQI) and serf-designed questionnaire of influence factors. Results 76 per-cents of the old patients with hypertension had sleep disorders.The total score of PSQI,sleep quality,time take to fall asleep,hours of sleep,sleep effficiency,sleep disorders,hypnotic drugs and every score of daytime dysfunction were significantly higher than domestic norm(P<0.01).Surroundings(strange circumstances or noisiness), physio-pathology (disease distress or high frequency of going to toilet during nighttime),psycho-logical situations(the fear to the disease or worrying about medical fees) and drags(use of diuretics or the adverse effects of some antihypertensive agents) were the important factors affecting sleep quality. Con-clusions Old patients with hypertension have poor sleep quality,which relates with multiple factors.Valid nursing interventions should be adopted in order to control the various factors which affect sleep quality to improve patients' sleep quality.

Objective To estimate the characteristics of gastroesophageal reflux (GER) and its clinical association with pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) patients.Methods Two hundred and five patients with SSc,who fulfilled the American College of Rheumatology criteria were consecutively recruited.GER was recognized in patients with symptom of heartburn or regurgitation.Demographic,clinical,and laboratory data were analyzed.A six minute walk test,pulmonary function test and modified Rodnan's skin score (mRSS) were also calculated for GER and non-GER groups.x2 test,Fisher's exact test and t-test were used for statistical analysis.Logistic regression test was used for the analysis of risk factors.Results There were 90 patients with GER among 205 patients,the prevalence of GER was 43.9％.The presence of PAH (23.3％ vs 9.6％),Raynaud's phenomenon (98.9％ vs 92.2％ ) and fingertip ulcers (56.7％vs 51.3％) were significantly higher in patients with GER than those without GER.There was no difference in autoantibody profile between GER patients and non-GER patients (P＞0.05).The New York Heart Association (NYHA) functional class of SSc-related GER was worse than patients without GER (P=0.015).Pulmonary function test showed that diffuse capacity (DLCO)％,forced vital capacity (FVC)％,and forced expiratory volume (FEV1)％ were lower and the FVC％/DLCO％ ratio was higher in patients with GER than non-GER (P＜0.05).GER was an independent risk factor of PAH in SSc patients (P=0.047,OR=3.41 ).Conclusion GER frequently occurs in SSc patients,SSc patients presenting with GER should be screened for PAH.Targeting the underlying vascular dysfunction might prevent not only PAH,but also GER in SSc patients.

Objective To investigate the levels, phenotypes and functions of regulatory T cells (Treg) and Th17 cells in systemic sclerosis (SSc) patients and assess the role of imbalance between Treg and Th17 cells in the pathogenesis of SSc. Methods Peripheral blood mononuclear cells (PBMCs) of 31 SSc patients and 33 healthy controls were analyzed for the expression of CD4, CD25, CD45RA, the cytotoxic T-lymphocyte antigen-4 (CTLA-4), FoxP3, and IL-17 using flow cytometry. Treg immunosuppression capacities were measured in co-cultured experiments. The expressions of IL-17A, IL-22, IL-6 and IL-1β were measured by FlowcytoMix. The expression of FoxP3, CTLA-4, IL-17A, and RORC mRNA were measured by real-time polymerase chain reaction (PCR). The independent samples t-test was used to compare data between the groups. Results The frequency of Treg cells was significantly elevated in SSc [(3.6 ±1.1)%] compared with controls [(2.0±0.8)%, t=6.88, P<0.01)] and the expression of CTLA-4 was lower in Treg cells of SSc (P=0.034). The expression of CTLA-4 and FoxP3 mRNA was lower in SSc compared with controls (P<0.05), the immunosuppressive capacity of Treg cells were diminished in SSc (P=0.034). Th17 cells were increased in SSc (P<0.01); the levels of IL-17A, IL-22, IL-6 and IL-1β in the serums of SSc were higher than the controls (P<0.05). In SSc, CD25+FoxP3+IL-17+cells were increased[0.075%±0.032)%vs (0.049±0.027)%, t=3.52, P=0.029], but no difference of CD25+FoxP3+IL-17- was observed when compared with control. The expression of IL-17A and RORC mRNA were increased in SSc (P<0.01, respectively). Conclusion Both Treg and Th17 cells are increased in patients of SSc. Treg increases along with the deficiency of phenotype and function. FoxP3+IL-17+co-express cells are increased, and the balance between Treg and Th17 cells is broken.

Objective To understand the changes of NKT cells in the livers and spleens of mice infected with Schistosoma japonicum.Methods Twenty-four female BALB/c mice aged 6-8 weeks were randomly divided into 4 groups.Three groups of mice were infected with(14?2)cercariae of S.japonicum.In 3,6 and 12 weeks post-infection,the mice were randomly chosen from each group and sacrificed resectively and the lymphocytes were harvested from the livers and spleens.The cells were stained with fluorescein-isothiocyanate(FITC)-conjugated anti-mouse pan-NK cells(CD49b)and phycoerythrin(PE)anti-mouse CD3e monoclonal antibodies,respectively.The proportion of NKT cells was analyzed by flow cytometry.In the experiment in vitro,the lymphocytes from spleens of normal mice were harvested and stimulated with SEA,the protein constituents of eggs and lipid constituents of eggs,respectively.The proportion of NKT cells was also analyzed by flow cytometry.Results The proprotion of splenic NKT cells in lymphocytes in 12 weeks post-infection was(4.73?0.41)%,which was significantly higher than that of the control(2.07?0.12)%(P