Objective To describe the clinical features and imaging characteristics of nodular splenic sarcoidosis. Methods We describe a patient with splenic sarcoidosis and review the related medical literature, the etiology, symptomatology, pathology, diagnosis, differential diagnosis, management and prognosis of splenic sarcoidosis. Results The etiology of this rare disease remains unknown. Symptoms are scanty and usually mild; computed tomography usually reveals splenomegaly or the presence of multiple nodules, confusing with metastatic tumor in spleen. On histopathologic examination, sarcoid produces noncaseating granulomas. Sarcoid is typically treated only when symptomatic. Oral corticosteroids is the most important method of treatment in patients with progressive loss of organ functions. Prognosis has closed relationship with early clinical manifestation. Conclusion Splenic sarcoidosis is rare and often misdiagnosis as other diseases.

Objective To investigate the causes and risk factors of postpartum hemorrhage (PPH) in hepatitis B virus (HBV) infected parturient.Methods Retrospective analysis was performed on the 1021 HBV infected parturient from Shanghai Public Health Clinical Center from July 2005 to June 2011.The comparisons were done by chi-square test.Results Among 1021 cases of HBV infected parturient,868 (85.01％) were asymptomatic and the PPH rate was 2.76％ (24/868) ;the remaining 153 cases (14.99％) were chronic active hepatitis B and the PPH rate was 16.99％(26/153).The difference between two groups was statistically significant (x2 =56.541,P＜0.01).The total incidence rate of PPH was 4.89％ (50/1021) and 17 cases (34.00％) were postpartum hemorrhage＞1000mL.The causes of PPH included uterine inertia (30/50,60.00％),abnormal placenta (11/50,22.00％),dysfunction of coagulation (5/50,10.00％) and lesion of birth canal (4/50,8.00％).The risk factors of PPH included delivery mode (x2 =6.528,P=0.038),abortion times (x2 =16.269,P=0.000),delivery times (x2 =6.990,P=0.008),ALT levels (x2=56.541,P=0.000) and HBV DNA (x2 =64.706,P=0.000).Conclusions The main causes of PPH in HBV infected parturient include uterine inertia,abnormal placenta,lesion of birth canal and dysfunction of blood coagulation.PPH is correlated with abortion times,delivery times,delivery mode,liver function and HBV DNA.The incidence of PPH in parturient with chronic active hepatitis B is higher than asymptomatic parturient.

Objective To explore the effect of self-efficiency intervention for patients with peripherally inserted central catheter ( PICC ) at the intermission of the chemotherapy. Methods A total of 150 chemotherapy patients with PICC were selected from May 2013 to May 2014 and divided into experimental group ( n =75 ) and control group ( n =75 ) according to the date of admission. The patients of control group underwent conventional nursing, while the patients of experimental group received self-efficiency nursing including directed experience, vicarious experience, verbal persuasion, and support system. The general self-efficacy scale ( GSES ) was evaluated in two groups at admission and six months after discharge. The PICC complication rates were compared between two groups at admission and six months after discharge. Results At admission, the scores of self-efficiency were no significantly different between the experimental group and the control group (P>0. 05). At six months after discharge, the self-efficiency score of experimental group was higher than that of the control group (P <0. 01). Within six months after discharge, the complications of catheter-related infection, PICC ectopy in the experimental group were significantly lower than those of the control group (P<0. 05). Conclusions The self-efficiency intervention can enhance the level of self-efficiency among patients with PICC during the period of chemotherapy intermission. It also can increase patient′s confidence, promote patient′s ability of self-management, and decrease the PICC complications.