OBJECTIVE:To investigate the changes of flbrinogen before and after cardio-vascular stent implantation.METHODS:A computer-based online search was conducted in CNKI and Medline database between 1994 and 2009.A total of 26 articles were included in accordance with inclusion and exclusion criteria.This study was designed to summarize changes of fibrinogen,effect of cardio-vascular stent implantation on fibrinogen,and effect of anticoagulant on fibrinogen.RESULTS:Abnormal changes of fibrinogen were detected in patients with cardiovascular disease.Cardio-vascular stent implantation might stimulate vascular endothelial cells so as to destroy balance between blood coagulation and dissolving system,change content of fibrinogen,and induce complications.Additionally,anticoagulant might also influence generation of flbrinogen and cause varying therapeutic effects.CONCLUSION:The effect of anticoagulant on fibrinogen content before and after cardio-vascular stent implantation needs to be further studied.

ObjectiveTo analyze the clinical manifestation of hemolytic disease of the newborn (HDN) due to anti-M and Rhesus system.MethodsClinical information was collected and analyzed for three cases with HDN due to anti-M and 64 with Rhesus hemolytic disease, who were admitted to Department of Neonatology, Beijing Children's Hospital Affiliated to Capital Medical University from February 2011 to January 2015, as well as another 28 cases of HDN due to anti-M with complete information retrieved from literature in Wanfang and China National Knowledge lnfrastructure (CNKI) Database from 1992 to 2014.Chi-square test was performed for statistical analysis.ResultsTwo out of the 64 Rh hemolytic babies gave up therapy due to kernicterus and another two out of the 31 MN hemolytic babies, obtained from literature, died 24 h after birth because of anemia or edema, while the rest survived. Although more babies were the first child of the family in HDN due to anti-M than those of Rh hemolytic disease [26%(8/31) vs 9%(6/64),χ2=4.487, P=0.034], but lower incidence of jaundice [81%(25/31) vs 98%(63/64),χ2=9.686,P=0.002], less proportion of presentation of jaundice within 24 h after birth [29% (9/31) vs 64%(41/64),χ2=10.279,P=0.001] and lower positive rate of direct antiglobulin test [39%(12/31) vs 100%(64/64), Fisher exact test,P=0.000] were shown in HDN due to anti-M. No significant difference was found in the incidences of hyperbilirubinemia [58%(18/31) vs 66%(42/64),χ2=0.513], severe hyperbilirubinemia [23%(7/31) vs 36%(23/64),χ2=1.724], anemia [81%(25/31) vs 89%(57/64),χ2=1.253] and severe anemia [29%(9/31) vs 34%(22/64),χ2=0.271] between HDN due to anti-M and Rh hemolytic babies (allP>0.05).ConclusionsHDN due to anti-M and Rhesus hemolytic disease can cause severe pathological jaundice and/or anemia in newborns. Indirect antiglobulin test should be offered when direct antiglobulin test is negative which is helpful in the diagnosis of HDN due to anti-M.

Objective To observe the application effect of nurses-dominated rehabilitation management mode in acute stroke patients.Methods A total of 86 patients with acute ischemic stroke (AIS) in the department of neurology were selected for the study and were randomly divided into observation group (n =43) and control group (n =43) according to the order of admission.All patients were given routine treatment and nursing,and the control group was given the routine rehabilitation training for self-choice after in a stable condition,and the observation group was followed by a multidisciplinary team consultation to carry out the early comprehensive rehabilitation training.The activities of daily living in the two groups,nerve function,nutrition risk condition were compared before intervention and at 14d after intervention,and the related complications within 1 month after intervention were analyzed between the two groups.Results At 7 d after intervention,the MBI score and nutritional adequacy rate of the observation group were significantly higher than intervention before and were significantly higher than that of the control group (P ＜ 0.05).The NIHSS score and nutritional risk rate of the observation group were significantly lower than intervention before and were significantly lower than that of the control group (P ＜ 0.05).At 14 d and 1 month after intervention,the MBI score and nutritional adequacy rate of the two groups were significantly higher than intervention before,and those in the observation group were significantly higher than that of the control group at the same time period (P ＜ 0.05).The NIHSS score and nutritional risk rate of the two groups were significantly lower than intervention before,and the observation group were lower than the control group at the same time period (P ＜0.05).The incidence rates of post-stroke depression,brain-induced spasm,swallowing dysfunction and shoulder-hand syndrome were significantly lower in the observation group than that in the control group within 1 month after intervention (P ＜ 0.05).Conclusion Nurses-dominated ASU rehabilitation management mode can effectively improve the rehabilitation effect of patients.

Objective To observe the application effect of nurses-dominated rehabilitation management mode in acute stroke patients.Methods A total of 86 patients with acute ischemic stroke (AIS) in the department of neurology were selected for the study and were randomly divided into observation group (n =43) and control group (n =43) according to the order of admission.All patients were given routine treatment and nursing,and the control group was given the routine rehabilitation training for self-choice after in a stable condition,and the observation group was followed by a multidisciplinary team consultation to carry out the early comprehensive rehabilitation training.The activities of daily living in the two groups,nerve function,nutrition risk condition were compared before intervention and at 14d after intervention,and the related complications within 1 month after intervention were analyzed between the two groups.Results At 7 d after intervention,the MBI score and nutritional adequacy rate of the observation group were significantly higher than intervention before and were significantly higher than that of the control group (P ＜ 0.05).The NIHSS score and nutritional risk rate of the observation group were significantly lower than intervention before and were significantly lower than that of the control group (P ＜ 0.05).At 14 d and 1 month after intervention,the MBI score and nutritional adequacy rate of the two groups were significantly higher than intervention before,and those in the observation group were significantly higher than that of the control group at the same time period (P ＜ 0.05).The NIHSS score and nutritional risk rate of the two groups were significantly lower than intervention before,and the observation group were lower than the control group at the same time period (P ＜0.05).The incidence rates of post-stroke depression,brain-induced spasm,swallowing dysfunction and shoulder-hand syndrome were significantly lower in the observation group than that in the control group within 1 month after intervention (P ＜ 0.05).Conclusion Nurses-dominated ASU rehabilitation management mode can effectively improve the rehabilitation effect of patients.

Objective To evaluate the value of IgA and IgG antibodies against α-fodrin in both serum antibodies in SS is also assessed.Methods Samples from 39 patients with SS(25 primary and 14 secondary),8 patients with systemic lupus erythematosus(SLE),and 15 patients with rheumatoid arthritis (RA)as well as 10 healthy blood donors were collected.Anti-α-fodrin antibodies were measured using ELISA.Results The titer of serum anti-α-fodrin was higher in SS than in other connective tissue diseases group and healthy group(P<0.01).IgA type anti-α-fodrin antibodies was detected in 60%.44% of serum and saliva in patients with pSS respectively.IgG antibodies were detected in 43% of sera,and 29% of saliva of patients with pSS.The sensitivity and specificity of serum anti-α-fodrin IgA in SS was 54%and 85%.The level of anti-α-fodrin was positively associated with xerostomia and parotid swelling (P<0.05),and was negatively associated with xeroma,renal tubule acidosis,lung interstitial disease and hepatic damages(P>0.05).Conclusion Saliva and serLlm anti-α-fodrin level may be diagnostic for SS.It may be a useful screening marker.

Objective To investigate the methods of early identification and early intervention for newborn with life-threatening congenital heart disease.Methods Between January 2010 and December 2010,223 neonates with serious congenital cardiac malformations were hospitalized in PICU of Fuwai Hospi-tal.Results The most type of cardiac lesions was complete transposition of the great arteries,accounting for 59%(131 cases),and the second was total anomalous pulmonary venous connection,17%(39 cases).For the primary clinical symptoms,the most common were any cyanosis,dyspnea and cardiac murmur,accounting for 91 %(204 cases),56%(125 cases)and 53%(1 18 cases),respectively.Fifty-nine cases developed into critical conditions such as severe hypoxia,metabolic acidosis and heart failure and were sent to PICU for emergency rescue.Early intervention included maintaining ductus arteriosus open,correcting internal environ-ment disturbances,treatment of heart failure,and surgical treatment as soon as possible.Four cases died before operation and 10 cases were abandoned to continue care,which all died within 12 days after discharge.In 209 cases who received operation,9 cases died.The total operation mortality was 4.3%.Within 3 to 63 month following-up,the late death was in 2 cases,2 cases received two-stage corrective operation,and three for reop-eration.The others all were in normal cardiac function and growth.Conclusion Most of neonatal life-threat-ening congenital cardiac malformations were ductus dependent such as transposition of the great arteries and total anomalous pulmonary venous connection,which the baby needs immediate diagnosis and management for survival.Early recognition,appropriate preoperative management and operation as soon as possible are the key to rescue.

Objective:To explore the Application value of hospital-community-family integrated service in nursing management of children with bronchial asthma.Methods:From December 2018 to February 2019 in Haikou Hospital Affiliated to Xiangya Medical College of Central South University, 90 children with asthma were selected and divided into control group (45 cases) and observation group (45 cases) according to random digital table method. The patients in the control group received routine hospitalization diagnosis and health education, while the patients in the observation group received integrated management services of family type medical care. Six months after the intervention, the clinical efficacy, the number of acute attacks, psychological state, quality of life, length of stay and cost of the two groups were compared.Results:The total effective rate of the observation group (95.56%, 43/45) was significantly higher than that of the control group (82.22%, 37/45), the difference was statistically significant ( χ2 value was 4.050, P<0.05). The times of acute attack, the times of readmission, the time of hospitalization and the expenses of the children in the observation group were (7.36±2.19) times, (4.22±1.78) times, (13.89±4.32) d, (3 023.83±219.76) yuan respectively, which were significantly lower than those in the control group (12.03±3.98) times, (7.03±2.43) times, (21.73±5.32) d, (5 032.33±324.23) yuan, and the difference was statistically significant ( t values were 6.258-34.381, P<0.01). The scores of Self-rating Anxiety Scale (31.23±4.84) and Self-rating Depression Scale (37.62±2.61) in the observation group were significantly lower than those in the control group (36.11±2.72, (43.27 ± 2.94), the difference was statistically significant( t values were 5.896, 9.641, P < 0.01). The scores of symptom (6.50±1.63), emotion and activity(6.33±1.02), quality of life (6.54±0.98) in the observation group were significantly higher than those in the control group (5.77±1.55, 5.45±0.98, 5.78±0.67), the differences were statistically significant ( t values were - 2.177, - 4.173, - 4.295, P < 0.05 or 0.01). Conclusions:The application of hospital-community-family integrated care service in the nursing management of children with bronchial diseases can effectively improve the clinical therapeutic effect, reduce the number of acute episodes and hospitalization time, improve the psychological status and quality of life of children, which is worthy of wide clinical promotion.

Objective To discuss the application value of the APP client terminal in the improvement of the post-discharged continuing nursing of the patients with pituitary adenoma surgery.Methods One hundred and fifty-six patients with pituitary adenoma surgery who was hospitalized in the department of neurosurgery in Huashan Hospital Affiliated to Fudan University from July 2015 to June 2016 were included into the observation group. The continuing nursing in the observation group was made by APP client terminal. One hundred and sixty-seven patients with pituitary adenoma surgery who was hospitalized in the department of neurosurgery in Huashan Hospital Affiliated to Fudan University from July 2014 to June 2015 were included into the control group. The continuing nursing in the control group was conventional health education, telephone follow-up. Three months after the patients' discharge, the effects of the continuing nursing were evaluated for the patients in the two groups with the evaluation form of the continuing nursing for the patients with pituitary adenoma surgery.Results The score of the continuing nursing evaluation form for the patients with pituitary adenoma surgery in the observation group was (45.47±10.98), which was significantly higher than that in the control group (70.24±15.48) (t=16.67,P<0.05).Conclusions The APP client terminal can effectively improve the health education effects of the continuing nursing in the postoperative patients with pituitary adenoma, which is worth popularizing and referring.

Objective To investigate and analyze the prevalence of pressure ulcer and other skin injuries, and the implementation of pressure ulcer prevention measures among inpatients in Class ⅢGrade A hospitals in Hainan province. To provide basis for fomulating bundle of care model to prevent and intervent pressure ulcer, and establishing early warning management model on nosocomial pressure ulcer in ClassⅢGrade A hospitals in Hainan province. Methods A cross-sectional survey was conducted on inpatients from 7 ClassⅢGrade A hospitals in Hainan province. A investigation was performed by a self-designed inpatients'questionnaire and qualified tools on pressure ulcer and other skin injuries. Statistical analysis of data using by SPSS19.0 software. Results The content validity index of the self-designed inpatients'questionnaire and qualified tools on pressure ulcer and other skin injuries was 0.91, Cronbach α coefficient was 0.93. The prevalence of pressure sores was 2.28% (165/7 248), of which 66.06% (109/ 165) was family involvement, 30.30% (50/165) was hospital acquired, 3.03% (5/165) was community involvement,and 0.61% (1/165) was both from family and hospital acquired. Medical instrument related pressure ulcer accounted for 18.18%(30/165) of the total number of pressure ulcer. The most common site of pressure ulcer was the sacrococcygeal region, accounting for 47.94% (93/194). The proportion of pressure ulcer in stageⅡwas the highest (35.57% , 69/194). 52.01% (647/1 244) of patients at risk of pressure ulcer did not use the anti-pressure devices,and 81.40% (1 013/1 244) of patients' main compression sites were not covered by dressings.35.50%(442/1 244) of patients did not according to plans or regularly turn over, only 56.19% (699/1 244) patients turned over every 2 hours. 61.57% (442/1 244) patients who have pressure ulcer did not have anti-pressure ulcer signs. Among other skin injuries: the prevalence of incontinence related dermatitis was 0.88%(64/7 248), and the prevalence of avulsion skin injury was 0.37%(27/7 248). Conclusions The incidence of acquired pressure ulcer in ClassⅢGrade A hospitals in our province is slightly higher than other domestic investigation results. The reasons may be that anti-pressure devices in hospital configuration are not enough, lack of the tailored bundle of prevention measures of pressure ulcer, and failure to establish an effective early warning management model on pressure ulcer etc. So prevention and treatment of pressure ulcer should have a further standard management. Instrument related pressure ulcer and incontinence related dermatitis should also attract the attention of clinical nurses and managers.

Objective: To summarize the clinical features of 7 rare cases of hemolytic disease of newborn (HDN), and to improve the understanding of rare HDN. Methods: Data of clinical information, laboratory findings, treatments and outcomes were collected and analyzed for four cases with HDN due to anti-M, two cases due to anti-Kidd, and one case due to anti-Duffy. All of them were admitted to the Department of Neonatology, Beijing Children's Hospital Affiliated to Capital Medial University from July 2007 to June 2017. Results: Among the four MN hemolytic babies, two were males and two were females. Jaundice was found in three cases. Two cases had hyperbilirubinemia, one of them had severe hyperbilirubinemia. All the four cases developed anemia, including severe anemia in three cases. Two cases of Kidd hemolytic disease and 1 case of Duffy hemolytic disease had jaundice and anemia, but did not reach the level of severe hyperbilirubinemia and severe anemia. MN hemolytic disease babies got negative results in direct antiglobulin test, whereas the Kidd and Duffy hemolytic disease babies had positive findings in direct antiglobulin test. None of the babies had blood transfusion, and they were discharged from the hospital. Conclusions Without maternal and fetal blood group incompatibility (ABO or Rh blood-group system), for early onset of jaundice, severe jaundice or anemia, antiglobulin test to mother and child earlier should be administered, and MN, Kidd, Duffy and other rare hemolytic disease of the newborn should be pay attention to.