Objective To investigate diagnostic and prognostic significance of protein C in acute leukemia with disseminated intravaseular coagnlation(DIC). Methods APTT, P-T, D-Dimer, Fbg, antithrombin (AT) and protein C(PC) were determinated in plasma of 44 DIC patients with acute leukemia and 30 normal controls. Results PC was markedly lower in disseminated intravaseular coagulation with acute leukemia group(67.03±36.98) than that of control group (99.53±45.20), and significantly correlation DIC score( r = -0.57,P＜0.01). PC of abnormality rate in DIC group was 86.36 %. APTT, PT, D-Dimer, Fbg were significantly increased and AT was decreased during the progress of DIC in relation to values observed in the control group. Conclusion DIC is related to the disorder of coagulation and fibfinolysis system. PC is a sensitive index to diagnose and prognose DIC in acute leukemia.

Objective To observe the short-term clinical effect of compound sophora injection combined with Java brucea fruit oil emulsion injection for palliative treatment of advanced malignant tumors. Methods Totally 120 cases of advanced malignant tumor patients were randomly divided into treatment group and control group, each contains 60 cases. The control group was treated with Java brucea fruit oil emulsion, and the treatment group took compound sophora injection additionally by intravenous infusion one time daily. The cycle was 24 d. After 3 cycles, the curative effect, pain relief, improvement situation of quality of life and adverse reactions of the two groups were observed. Results Feasible curative effect evaluation of 112 patients showed:The disease control rate in the treatment group was 89.5% (51/57), and the control group was 74.5% (41/55). The total effective rate of cancer pain relief of the treatment group was 91.2%(52/57), and the control group was 70.9% (39/55). The improvement rate of life quality of the treatment group was 70.2% (40/57), and the control group was 49.1% (27/55). The differences between the two groups was significant (P<0.05). There was no difference in hematology toxicity, liver and kidney function, gastrointestinal adverse reactions and itchy skin incidence between the two groups (P>0.05). And the treatment group had a lower incidence of phlebitis than the control group (P<0.05). Conclusion Compound sophora injection combined with Java brucea fruit oil emulsion for palliative treatment can improve curative effect, significantly improve patients’ quality of life, it was a safe and effective way in treating advanced malignant tumors.

Objective:To summarize the complications' prevention and nursing experience for patients after autologous transplantation of the microvascular submandibular gland for severe keratoconjunctivis sicca.Methods:Retrospective analysis of 141 patients(151 sides) after autologous microvascular submandibular gland transfer operation was undertaken to record the timing and incidence of major complications and to summarize the nursing experience.Results: The main complications after the transplantation were: vascular crisis,catheter obstruction,salivary fistula and temporary paralysis of hypoglossal nerve.Related nursing measures in response to these complications were discussed.Conclusion:Targeted nur-sing interventions for patients with autologous transplantation the submandibular gland have a positive effect on the prevention of the surgical complications.

Objective To evaluate the clinical effects of voice training on the speech ability in patients with oral cancer af. ter free flap reconstruction. Methods Fifty-five patients with oral cancer after free flap reconstruction were assigned to the voice training group(28 cases)and control group(27 cases)from the third week after operation. Their speech function was eval-uated by Chinese Speech Definition Word Table before operation and 2 weeks,3 months and 6 months after the operation. Results The score of speech definition was significantly higher in the voice training group than that of the control group (P< 0.01). Conclusion Postoperative voice training can effectively improve the speech definition for the patients with oral cancer after free flap reconstruction.

Objective To observe the effect of Qingrequzhuo capsule on blood pressure of patients with type 2 diabetes metabolism syndrome. Methods 72 cases with type 2 diabetes and metabolic syndrome were randomly recruited into a control group and a treatment group. Based on the conventional treatment, the treatment group was treated with Qingrequzhuo capsule, 5 tablets/time, 3 times/d; While the control group was treated with ramipril tablets 2.5 mg, 1 times/d, respectively. After 3 months, the value of blood pressure and blood lipids were observed. Results After treatment, the blood pressure and blood lipid were significantly improved in both groups(P<0.05), but no significant difference between the two groups (P>0.05). Conclusion Besides improving blood lipids, Qingrequzhuo capsule can also reduce high blood pressure and improve a variety of risk factors to cardiovascular disease.

Objective To assess the clinical significance of detecting the immune markers in idiopathic thrombocytopenic purpura (ITP). Methods The frequencies of circulating B cells secreting platelet-specific antibody, platelet-specific antibody, the percentage of T lymphocyte subsets, the percentage of reticulated platelet and the level of thrombopoietin in 64 ITP patients and 31 healthy controls were measured with enzyme-linked immunospot assay (ELISPOT),modified monoclonal antibody immunobilization of platelet antigens assay (MAIPA), flow cytometry and sandwich enzyme-linked innnunosorbent assay respectively. Results Compared with the controls[1.3 ± 0. 5/105 peripheral blood mononuclear cell (PBMC), (0.33±0.06,0.41±0.03), (22.08±4.54)% and (8.19±2.46)%], the frequencies of circulating B cells secreting platelet-specific antibody (7.6±4.6/105 PBMC in acute ITP group, 5.3±3.0/105 PBMC in chronic ITP group), platelet-specific antibody (including the anti-GP Ⅱ b/Ⅲa antibody, anti-GP Ⅰ b/X antibody) (0.51 ±0.11, 0.48±0.06 in acute ITP group; 0.49±0.10,0.46±0.09 in chronic ITP group), the percentage of CD8+ T Lymphocyte (27.09±9.86 ) %, the percentage of reticulated platelet in ITP patients[the megakaryocyte cytosis group (24. 85 ± 19. 18)%, the normal megakaryocyte group (23.89±18.90)%]were significantly increased ( all P＜0.05).The frequencies of circulating B cells secreting platelet-specific antibody in acute ITP patients were notably increased (P＜0.05) compared to the chronic ITP patients. In T lymphocyte subsets, the percentage of CD3+T lymphocyte and CD4+ T lymphocyte and the ratio of CD4+/CD8+ in the patients with ITP[(60.88±14.59)%, (28.41±10.55)%, 1.18±0.59]were notably decreased than those in the healthy controls [(69.89±6.43)%, (35.38±5.05) %, 1.64±0.29, P＜0.05]. There was no apparent difference of the level of thrombopoietin between ITP patients with megakaryocyte cytosis (72. 09 ± 41.64 ) and health controls (75.37± 26. 32, P ＞ 0. 05 ), however, the level of thrombopoietin of ITP patients with normal megakaryocyte apparently increased (118.60±70.72, P＜0.05). Conclusion Detecting the frequencies of circulating B cells secreting platelet-specific antibody, platelet-specific antibody, the percentage of T lymphocyte subsets, the percentage of reticulated platelet and the level of thrombepoietin in the patients with ITP may improve the diagnosis and guide clinical therapy.

Objective To explore the the influence ofFurong-Tongmai capsules on myocardial expression of LN and CollagenⅢ in diabetes mellitus (DM) rats.Methods A total of 60 rats were randomly divided into the control group, the model group, the low-, middle- high-dosageFurong-Tongmai capsules group (n=10). The low-, middle-high-dosageFurong-Tongmai group was given 1.4, 0.7, 2.8 g/(kg body weight) Furong-Tongmai capsules. The other two groups were given the same dose of purified water. After 8 weeks treatment, the myocardial was taken to make pathology slice with SP immunohistochemistry staining. The expression of LN and CollagenⅢ were detected.Results Compared with model group, the expression of LN (0.67% ± 0.04%,0.65% ± 0.09%vs. 1.08% ± 0.13%) and CollagenⅢ (0.67% ± 0.15%, 0.69% ± 0.13%vs. 1.17% ± 0.12%) in the middle-high-dosageFurong-Tongmai groups significantly decreased (P<0.05). However, there were no statistical differences between the low-, middle- high-dosageFurong-Tongmai groups and the model group (P>0.05).Conclusions TheFurong-Tongmai capsules could inhibit the expression of LN and CollagenⅢ in DM rats.

ObjectiveTo review the efficacy and safety in secondary prevention of ischemic stroke with cilostazol or aspirin.Methodswe searched Cochrane Library(the 4th issue, 2009 ), PubMed(1980.1～2009.11), EMBASE(1980.1～2009.11), CBM(1978.1～2009.11), CNKI(1979.1～2009.11) and some other databases, then collected all of the studies describing the outcomes in curing the ischemic stroke after taking cilostazol or aspirin. According to the strict inclusion and exclusion criteria, two reviewers independently selected trials, extracted datas, made cross-checking and methodological quality assessment of the homogeneity studies by using the Cochrane systematic review methods, then made Meta analysis using RevMan 5.0 software.ResultsThis systematic review study included two randomized controlled trials and a cross-over trial, which contained a total of 838 participants. The evidence quality of one of the randomized controlled trials was high, however, the evidence quality of another randomized controlled trial and the cross-over trial was poor. Meta analysis results suggested that the effectiveness of cilostazol and aspirin in the secondary prevention of ischemic stroke performed no significantly statistical difference: primary endpoint(30 d［RR=3.00, 95%CI(0.31,28.70)］; 90 d［RR=1.67, 95%CI(0.40,6.92)］; 180 d［RR=1.25, 95%CI(0.50, 3.13)］; 360 d［RR=0.65, 95%CI(0.33, 1.29)］; 540 d［RR=0.80,95%CI(0.54, 1.18)］); combined endpoint(30 d［RR=4.00, 95%CI(0.45,35.61)］; 90 d ［RR=1.75,95%CI(0.52,5.93)］; 180 d［RR=1.00, 95%CI(0.48, 2.07)］; 360 d ［RR=0.77, 95%CI(0.45, 1.29)］; 540 d［RR=0.66,95%CI(0.40,1.09)］); the recurrence of ischemic stroke: cilostazol group: RR=0.64, 95%CI(0.31,1.30)，aspirin group: RR=0.21, 95%CI(0.04,1.06); PDMP［RR=1.00, 95%CI(0.39, 2.58)］. But in terms of the probability of intracranial hemorrhage (［RR=7.14, 95%CI(0.7,58.33)］) and other safety standards, taking cilostazol performed lower than taking aspirin.ConclusionThe side effects of cilostazol and aspirin in the treatment for ischemic stroke were similar to each other, but in terms of the probability of dizziness, headache, tachycardia and palpitation, taking cilostazol performed higher than taking aspirin, however, taking cilostazol performed lower in the probability of intracranial hemorrhage and other organ hemorrhage than taking aspirin. Since this study included a small amount of studies, in which the evidence quality of one of the randomized controlled trials and the cross-over study was poor, therefore, it would be necessary to make a further validation with lots of high-quality clinical trials.

Objective:To build a sensitive quality index system of dental clinic nursing.Methods:Based on the Donabedian "structure-process-results" three-dimensional quality model, the indicators at all levels of the sensitive quality index system of dental clinic nursing was preliminarily constructed through literature review. The Delphi method was used to develop a system of sensitive quality indicators for dental outpatient care through two rounds of correspondence with 15 experts from the fields of dental care management, oral health care, quality of care management, and health policy.Results:The effective response rates of the two rounds of expert inquiry questionnaires were 100% (15/15), and the average authority coefficient of the experts was 0.93. The Kendall's harmony coefficients of the overall indicators were 0.115 and 0.141, respectively ( P<0.05). A sensitive quality indicator system for dental clinic nursing was finally determined, including 3 primary indicators, 7 secondary indicators and 19 tertiary indicators. Conclusions:The sensitive quality indicator system for dental clinic nursing constructed in this research is scientific and reliable. After verification through future research, it can serve as a basis for improving the quality of dental clinic nursing.

Objective To understand the current status and influencing factors of patient perception for humanistic care in China hospitals,and to provide a basis for developing nursing humanistic care measures and improving the quality of nursing humanistic care services.Methods A total of 30,099 outpatients and inpatients from 107 hospitals in 30 provinces(autonomous regions and municipalities)from July to August 2022 as survey subjects.A general information questionnaire and the Relational Caring Questionnaire-Patient Form were used for a cross-sectional survey,and a single-factor analysis was used to analyze the influencing factors of patient relationship care.Results Finally,29 108 valid questionnaires were collected,and the effective questionnaire recovery rate was 96.7％.The patient evaluation of relationship care was(65.72±8.61)points.Single-factor analysis showed that gender,age,marital status,children's situation,education level,occupation,place of residence,average family income,medical insurance type,visiting department,and location of the visiting hospital,and whether or not surgery were influencing factors of patient relationship care(P＜0.05).Conclusion The evaluation score of caregiver-patient relationship care among Chinese hospital patients is above average,but there is still room for improvement in western and rural regions,seriously ill and outpatient patients,low-income and low-medical insurance reimbursement populations,and non-surgical patients.Medical institutions at all levels should optimize and improve nursing humanistic care services based on influencing factors,and further enhance patients'perception of nursing humanistic care.