Objective:To investigate the clinical value of detection of fetal umbilical artery and middle cerebral artery blood flow by ultrasound in predicting the pregnancy outcome among births affected by velamentous umbilical cord insertion.Methods:Ninety pregnant women who undergo regular prenatal examination and delivered births with velamentous insertion of the umbilical cord from April 2017 to April 2020 in Quzhou Maternal and Child Health Hospital were included in this study. All patients were examined by transabdominal color Doppler ultrasound in the second trimester of pregnancy. The resistance index (RI) and systolic/diastolic flow velocity ratio (S/D) of fetal umbilical cord and middle cerebral artery were recorded and compared between pregnancy outcomes. The RI and S/D of umbilical cord and middle cerebral artery of births affected by velamentous umbilical cord insertion were correlated with adverse pregnancy outcome.Results:The RI and S/D of umbilical cord in births affected by adverse pregnancy outcome were higher than those in births not affected by adverse pregnancy outcome [ RI: (0.72 ± 0.08) vs. (0.63 ± 0.05); S/D: (3.08 ± 0.46) vs. (2.59 ± 0.35)]. The RI and S/D of middle cerebral artery in births affected by adverse pregnancy outcome were lower than those in births not affected by adverse pregnancy outcome [RI: (0.55 ± 0.06) vs. (0.79 ± 0.09); SD: (3.41 ± 0.37) vs. (5.26 ± 0.61)]. The differences were statistically significant ( t = 8.327-15.429, P = 0.000-0.000 < 0.05). RI and S/D of umbilical cord in births affected by velamentous insertion of the umbilical cord were positively correlated with adverse pregnancy outcome ( r = 0.779, 0.883, P = 0.004, < 0.05). RI and S/D of middle cerebral artery in births affected by velamentous umbilical cord insertion were negatively correlated with adverse pregnancy outcome ( r = -0.752, -0.847, P = 0.007, < 0.05). Conclusion:Detection of RI and S/D of umbilical cord and middle cerebral artery by color Doppler ultrasound in the second trimester of pregnancy is of certain clinical value in predicting the pregnancy outcome among births affected by velamentous umbilical cord insertion. This should be paid more attention in department of obstetrics and gynecology.

Objective To explore the clinical value of application research in business process reengineering in transferring of inpatients for check-up. Methods We reorganized transferring of inpatients for check-up and service tache by introducing the Systematic Redesign method from the therory of Business Process Reengineering. The reengineered process was adopted and applied in the transferring processes. We randomly selected patients for check-up(126 cases for electrocardiogram,130 cases for Xrayand 128 cases for CT examination)and investigated the time cost for check-up and patients satisfaction rate. The above results were compared with those patients(112 cases for electrocardiogram,112 cases for Xrayand 120 cases for CT examination)before use of reengineered process. Results The time cost for the above mentioned check-up was shorter and patients satisfaction rate were alleviated compared with those before use of reengineered process(U=14.55,12.26,13.57;x2=17.37,14.65,10.75,P＜0.01).Conclusion Application of business process reengineering in the transferring process of inpatients for check-up proved pivotal important in that it could shorten time cost for transferring process and improve patients satisfaction rate.It possessed realistic significance for increasing benefit and competitions for hospitals.

Objective To study the psychological nursing on the rehabilitation effect of patients with acute coronary syndrome(ACS)accompanied by depression.Methods 126 ACS patients were divided into the nursing group(64 cases)and the control group(62 cases)randomly.The control group adopted roUtine rehabilitative nursing measurs.While the nursing group received canonical and selective psychological nursing.The Zung Self-rating Depression Scale(SDS)and hamilton depression scale(HAMD)were used to evaluate the their psychological status.The electrocardiogram,clinical symptom and cardiovascular complications were observed and compared.Results The SDS and HAMD scores were different between the nursing group and the control group(P＜0.01)5 weeks after rehabilitative nursing but not before it.The ischemic changes of electrocardiogram,incidence frequency of angina pectoris and cardiovascular complications were significantly decreased in the nursing group compared with the control group(P＜0.05).Conclusion Psychological nursing could not only alleviate the depression of patients with ACS but also could improve the clinical symptoms of these patients and decrease the incidence frequency of cardiovascular events.

Objective To detect the levels of high mobility group box 1 protein HMGB1),tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),C-reactive protein (CRP) in order to explore the clinical significance of HMGB1 in patients with severely traumatic brain injury.Methods A total of 75 patients composed of 40 male and 35 female with severely traumatic brain injury were hospitalized from March 2011 through March 2012.The scores of Glasgow Coma Scale (GCS) were 5-8 within 12 hours after brain injury.Casualties with history of hypertension,diabetes,severe diseases of heart,liver and kidney,and with concurrent trauma of other parts of body were excluded.Another 50 healthy subjects were enrolled as controls.Serum samples were taken from both patients and controls at admission.The levels of HMGB1,TNF-α and IL-6 were measured by using enzyme-linked immunosorbent assay (ELISA).The level of CRP was measured by using automatic biochemistry analyzer.Comparisons of the levels of HMGB1,TNF-α,IL-6and CRP between casuahies and healthy controls were carried out.The correlations of HMGB1 with TNF-α,IL-6,CRP in patients with severe traumatic brain injury were analyzed.Thereafter,75 patients were divided into two groups post hoc:the death group and the survival group.On the 1st day,the 3rd day and the 7th day after trauma,serum HMGB1 was detected.The comparison of HMGB1 was made between death group and survival group by using t-test.Results Serum HMGB1 level in the traumatic patients was higher than that of healthy controls (P ＜ 0.01).Correlative analysis showed that there was a positive correlation between HMGB1 and TNF-α (r =0.365,P＜0.05),IL-6 (r=0.530,P＜0.05),CRP (r=0.661,P＜0.05) in patients with severe traumatic brain injury.Serum HMGB1 level in the death group was higher than the survival group (P ＜ 0.01).Conclusions Increased serum HMGB1 level was found after severe traumatic brain injury.There were positive correlations between HMGB1 and three inflammatory factors,TNF-α,IL-6and CRP.Serum HMGB1 should be used as reliable hiomarker to judge the prognosis of patients with severe traumatic brain injury.

Objective To design a questionnaire to explore nursing care behavior demand from patients'vision, and verify its reliability and validity. Methods The nursing care behavior index entry pool were summed up through literature analysis and discussion, and then a questionnaire containing 40 items was designed through per-investigation. A total of 150 patients from 30 departments in general hospital of Shenyang military region were selected for questionnaire survey using the convenience sampling method. The SPSS 19.0 was used to test the reliability and validity. Results Totally 149 effective questionnaires were recycled. Finally the questionnaires contained 6 dimensions and 35 items. Six factors were extracted with exploratory factor analysis, which explained 57.976% variance respectively. Total questionnaire Cronbach alpha coefficient was 0.892, the dimension Cronbach alpha coefficient was 0.747-0.914; Total remeasuring reliability was 0.824, the remeasuring reliability was 0.733-0.867. Binary validity was 0.806, binary coefficient was 0.748-0.872. Conclusions This study scientifically and reliably built a nursing care behavior demand questionnaire from patients′vision, which can be used to survey patients′satisfaction on nursing humanities.

Objective To explore the prevalence and related factors of post-traumatic stress disorder (FTSD) among nurses who took part in rescue of 5.12 Wenchuan earthquake after two years.Methods The PTSD Checklist-Civilian Version (PCL-C) was used to diagnose PTSD among nurses from Mianzhu,one of the city where the earthquake happened.Results Totally 223 subjects finished the evaluation.The incidence rate of PTSD among the nurses was 1.7％(PCL-C＞50),and 8.2％ people had different degree of post-traumatic stress disorder.Comparing the three symptom clusters,hyper-arousal was the most prominent one.Different age,professional position,marriage,health condition significantly influenced the prevalence of PTSD.The risk factors of PTSD was bad health condition and being divorced or widowed.Conclusions The nurses still showed some symptoms of PTSD two years after the earthquake,individualized psychological intervention should be applied to them.