Objective To explore effect of daily clearance and improvement mode application in man-agement of clinical nursing responsible group. Methods 200 patients from hand and foot surgery department of our hospital between January to June, 2007 were included into the control group, and 200 patients who were in hospital between July to December, 2007 were included into the experimental group. Then quality of care and satisfaction of patients were compared respectively between the two groups to study application effect of daffy clearance and improvement mode. Results After six months application of daily clearance and improvement mode, significant difference was seen in the two groups. Condusions Application of daffy clearance and improvement mode in management of clinical nursing responsible group is an effective method in nursing supervision.

Objective To discuss the prognoais after hyperglycemia and electrolyte imbalance caused by stress in moderate or severe hypoxic ischemic encephalopathy newborns. Methods Blood sugar and electrolyte of 73 HIE patients, who hospitalized in our hospitial, including 73 moderate or severe patients and 63 mild patients. Results There was significant difference with increase of serum glucose,decrease of serum sodium and calcium between mod- erate or severe and mild HIE. The rate of hyperglycemia, hyponatremia and hypocalcemia was higher in moderate or severe HIE with 2 or more organ dyafunction than I alone. Conclusion The moderate or severe HIE newborns early time presents the hyperglycemia and the low blood sodium, the low serum calcium often prompts organism existence serious stress response, and prompts electrolyte disorder.

Objective To explore a new surgical method for the treatment of refractory fistula after breast augmentation and to improve patients healing efficiently.Methods This paper had collected two groups,a total of 178 cases of injected breast augmentation,who had shown the polyacrylamide hydrogel(PAAG)mixture shift,and caused abdominal fistula.Among them,89 cases further adopt new design in the treatment of fistula by using breast muscle membrane tissue flap and improve the effect of fistula treatment after the removal of fistula.And the other 89 cases were token the pure clean the cavity away caused by the abnormal material shift into the chest and abdominal wall.Results It was observed that PAAG widely distributed in the chest and abdominal wall and formatted the fistula connected mammary gland,axillary,chest abdominal wall.The area of lesions lacuna shrink by 80％ for the group used tissue flap after 2 weeks,but those not with tissue flap shrink by 45％(P＜0.01).At 4th week,all the patients of flap group achieved tissue healed,while the completely heal ratio of control group was only 73％.Compared two groups of healing rate,the group with tissue flap was obviously better than ones only with surgical method.Conclusion It suggests that main reasons for the liquidity bag and huge cavity are PAAG mixture shift into thoracic and abdominal wall and formed chronic fistula and connected the chest and abdominal wall.Local muscle membrane tissue flap can obviously promote the chest and abdominal wall fistula healing.

Objective To explore the clinical effects of injection rhinoplasty with non-absorpted material and prevention of the complications.Methods A total of 578 patinets with rhinoplasty in Interpretation Medical Cosmetic Center of Wuhan City and Southwest Hospital from March 2010 to January 2016 were selected,who included 239 cases injected by absorbed material,213 cases injected by non-absorbed material and 126 cases implanted by silicone prosthesis.Then the clinical effects,curative keeping time and complications of three groups in 0,1,3,6 and 12 months after injected or implanted were observed.Results 578 patients of nasal shape and outline were significantly improved immediately after surgery and injection,but the adverse reaction and complication of silicone prosthesis increased more than those of other two groups,the differences were significant(P<0.01).While,the nose shape and outline and cosmetic effects of patients by silicone prosthesis or absorbed material postoperated became worse from 6 months to 1 year(P<0.05),and the non-absorbed groups had kept much better in the nose shape and outline and the satisfactory effects than the other two groups,the differences were significant(P<0.01).Conclusion Injection of rhinoplasty is safe and effective,meanwile the injection rhinoplasty with non-absorbed material is more suitable for Asian with less adverse reaction.

Objective To explore the characteristics of clinical symptoms and serum brain-derived neurotrophic factor(BDNF)level between depressive patients with and without attempted suicide behavior.Methods Serum BDNF level in depressive patients with(n=36)and without(n=55)attempted suicide behavior were assayed by ELISA,the severity of depression was measured by Hamilton rating scale for depression(HAMD).Results HAMD24 total scores(t=3.632,P=0.000),cognitive disturbance(t=-2.339,P=0.019)and hopelessness factor scores(t=-2.812,P=0.005)in depressive patients with attempted suicide behavior were significantly higher than those in depressive patients without attempted suicide behavior.There were no significant differences of anxiety/somatization,body weight,diurnal variation,psychomotric inhibition and sleeping disturbance fator scores between two groups(P＞0.05).The serum BDNF level in depressive patients with attempted suicide behavior was significantly lower than that in depressive patients without attempted suicide behavior(t=-2.122,P=0.037).There was no significant difference of serum BDNF level between male and female patients(P＞0.05).Conclusion There were certain characteristics on clinical symptoms of depressive patients with attempted suicide behavior.The low serum BDNF level might play an important role in the risk of suicide in depressive patients.

Objective To explore the serum levels of brain-derived neurotrophic factor in patients with depression and their correlation with age,gender,age of onset,illness course,depressive severity.Methods Serum BDNF levels in 91 depressive patients and 36 healthy controls were assayed by the ELISA method .The clinical char-acteristics were assessed by the Hamilton Rating Scale for Depression ( HAMD) .Results The serum BDNF levels in depressive patients were (24.38 ±6.27)μg/L,which was significantly lower than (31.44 ±10.72)μg/L in controls (t=3.708,P <0.01) and were unrelated to age,gender,age of onset,illness course,depressive severity (r =-0.034,t=0.068,r =-0.025,0.026, -0.076,P >0.05).Conclusion Serum BDNF levels in depressive patients was decreased and low levels of BDNF in serum may be a state characteristic for depression .

Objective To investigate the status of nursing professional values and its influencing factors to make contribution for nursing managers to improve nursing professional values.Methods 280 registered nurses selected by convenient sampling method were investigated by demographic questionnaires and the Revised Nursing Professional Values Scale (NPVS-R).Results The score of nursing professional value was (100.70 ± 6.36) points,the highest scoring dimension wasprofessional characteristic ,followed by trust, behavioristand providing care.The scores of protecting patients privacy,being trusted by patients,constantly improving professional ability,etc.were higher.The scores of involving in research,peer review and public decision,etc.were lower.Medical department,profession and interest,job satisfaction were the influencing factors,F values were 2.575,3.750 and 2.909.Conclusions The nursing professional value was higher than middle level and unbalanced development.Nursing managers should take individualized approach to improve nursing professional values based on the characteristics of departments and lower score parts.

Objective To investigate the feasibility and clinical efficacy of laparoscopic disc hand assisted laparoscopic splenectomy(LDHALS) for patients with ruptured spleen.Methods LDHALS was performed in 14 patients with ruptured spleen,and among them,8 cases were combined with other visceral trauma.Results All cases were performed successfully by using LDHALS.The median operation time was 70 min(45～100 min).The average hospital stay was 7 days in 6 cases with only spleen trauma and 13.5 days in 8 cases combined with other injuries.No major operative complications and mortality occurred.Conclusion The LDHALS is safe,effective,simple and flexible performed for patients with ruptured spleen.

In order to investigate the effects of puerarin on pulmonary vascular remodeling and protein kinase C-alpha (PKC-alpha) in chronic exposure smoke rats, 54 male Wistar rats were randomly divided into 7 groups: control group (C group), smoke exposure groups (S(4w) group, S(8w) group), puerarin groups (P(4w) group, P(8w) group), propylene glycol control groups (PC(4w) group, PC(8w) group). Rats were exposed to cigarette smoke or air for 4 to 8 weeks. Rats in puerarin groups also received puerarin. To evaluate vascular remodeling, alpha-smooth muscle actin (alpha-SM-actin) staining was used to count the percentage of completely muscularised vessels to intraacinar pulmonary arteries (CMA/IAPA) which was determined by morphometric analysis of histological sections. Pulmonary artery smooth muscle cell (PASMC) apoptosis was detected by in situ end labeling technique (TUNEL), and proliferation by proliferating cell nuclear antigen (PCNA) staining. Reverse transcription-polymerase chain reaction (RT-PCR), immunofluorescence staining and Western blot analysis were done to detect the PKC-alpha mRNA and protein expression in pulmonary arteries. The results showed that in cigarette smoke-exposed rats the percentage of CMA/IAPA and alpha-SM-actin expression were increased greatly, PASMC apoptosis was increased and proliferation was markedly increased; Apoptosis indices (AI) and proliferation indices (PI) were higher than in C group; AI and PI were correlated with vascular remodeling indices; The expression of PKC-alpha mRNA and protein in pulmonary arteries was significantly higher than in C group. In rats treated with puerarin, the percentage of CMA/IAPA and cell proliferation was reduced, whereas PASMC apoptosis was increased; The expression levels of PKC-alpha mRNA and protein were lower than in smoke exposure rats. There was no difference among all these data between S groups and PC groups. These findings suggested that cigarette smoke-induced pulmonary vascular remodeling was most likely an effect of the imbalance of PASMC proliferation and apoptosis. Puerarin appears to be able to reduce cell proliferation and vascular remodeling possibly through PKC signaling transduction pathway.
Apoptosis ; Cell Proliferation ; Endothelium, Vascular/*drug effects ; Isoflavones/*pharmacology ; Lung/*drug effects ; Myocytes, Smooth Muscle/cytology ; Myocytes, Smooth Muscle/*drug effects ; Protein Kinase C-alpha/*metabolism ; Pulmonary Artery/cytology ; Pulmonary Artery/*drug effects ; Rats, Wistar ; Smoking ; Tobacco Smoke Pollution ; Vasodilator Agents/pharmacology

Objective To explore the clinical application of treating severe soft tissue defect on distal leg and foot with sural nerve nutrient vessels retrograde island flap.Methods A total of 34 cases of patients who were treated with sural nerve nutrient vessels retrograde island flap were regared as the observation group, and the other 12 cases who were treated with local rotation skin flap grafting were regared as the control group.The postoperative survival rate of skin flap,complications,functional recovery and local sensation of the two groups were evaluated.Results The transplanted skin flap of the observation group all survived after operation.There were 3 cases of partial necrosis of the skin flap distal edge which were cured with dressing change.A few tension vesicle occured in 3 patients and they were cured with dressing change.The transplanted skin flap of the control group all survived after operation,but there were different degree of scar contracture,flap deformation and flap atrophy 6 months after surgery.The postoperative function,local sensation,scar size of the observation group were better than those of the control group with statistically significant difference (P<0.05).Conclusion To treat severe soft tissue defect on distal leg and foot with sural nerve nutrient vessels retrograde island flap is a good method which can promote severe tissue defect repair on the lower extremity and foot.