Objective To explore the establishment and implementation of nursing quality evaluation system in department of orthopedics. Methods Randomly 527 patients hospitalized in the department of orthopedics from December 2011 to December 2012 were selected and assigned into the control group, where a traditional evaluation system was used. Another 528 patients hospitalized from April 2013 to June 2014 as the observation group, where orthopedics specialist evaluation system was used. The two groups were compared in terms of hospital evaluation accuracy, observation accuracy, accuracy rate of specialist intervention complications, the qualified rate of nursing records and patient satisfaction. Result The hospital evaluation accuracy, observation accuracy, the accuracy rate of specialist intervention complications, the qualified rate of nursing records and patients satisfaction of the observation group were significantly higher than those of the control group (P<0.01) and there was no incidence in two groups. Conclusion The establishment of orthopaedic nurse quality evaluation system can make up the shortage of traditional evaluation system and improve the quality of the orthopaedic nursing management.

Objective At present , there is only a small amount of survey scale of caregivers′cognitive level on continuous nursing care for premature infants , which had not been subject to stringent testing of reliability and validity .This paper aims at developing a suitable survey scale of caregivers′cognitive level oncontinuous nursing care for 0-1 year premature infants , and testing its reliability and validity. Methods Convenience sampling method was used and totally 495 caregivers of premature infants of Army General Hospi-tal affiliated BaYi Children hospital from April to August 2016 has been investigated .After we had preliminary content of the question-naire, two-round Delphi consultations were used to identify the draft of the scale , and the reliability and validity were tested . Results Totally 419 valid questionnaires from 495.Questionnaires effective recovery was 84.65%.Critical ratio for each entry was 9.355-23.179 ( P<0.05) , which suggested that entries had good distinction .Coeffi-cient of correlation between scale items and total score was 0.500-0.775(P<0.05), whichindicated highly homogeneity between entries and table.By exploratory factor analysis , 5 entries were removed and 77 entries remained .The final scale of caregivers′cognitive level on continuous nursing care for premature infants included 4 indicators in level one , 15 indicators in level two and 77 indicators in level three .The Cronbach′s alpha was 0.985 for overall questionnaire and 0.848-0.939 for each dimension .The split-half reliability was 0.895 for overall questionnaire and 0.814-0.939 for each dimension .The content validity index was 0.963.The cumulative contribution rate of each dimension was 64.645%-83.236%. Conclusion The scale content was scientific and comprehensive .It can be used to investigate the caregivers′cognitive level on continuous nursing care for 0-1 year pre-mature infants, direct nurses to provide continuous care for premature infants , and evaluate the continuous nursing effect .

Objective To summarize the characteristics of treatment and outcomes of extremely low birth weight infants (ELBWI).Methods The clinical data of 81 cases of ELBWI admitted to Bayi Children's Hospital Affiliated to General Hospital of Beijing Military Command from October 1st.2008 to August 31st.2011 were retrospectively analyzed.The survival rate and mortality of ELBWI with different gestational age and birth weight were compared with Chi-square test.Results Of 81 ELBWI,43 were male and 38 were female; the mean gestational age at birth was (28.4 ±2.1) weeks; the average birth weight was (903.5 ± 95.4) g.Complications of them included respiratory distress syndrome (68/81,84.0％),patent ductus arteriosus (47/81,58.0％),retinopathy of prematurity (41/81,50.6％),intraventricular hemorrhage (23/81,28.4％),bronchopulmonary dysplasia (17/81,21.0％),sepsis (15/81,18.5％),periventricular leukomalacia (2/81,2.5％) and necrotizing enterocolitis (1/81,1.2％).Among 81 infants,96.3％ (n =78)received oxygen inhalation with the average time was 19.1 d (median 11 d,0-121 d) ; 70.4％ (n=57)received pulmonary surfactant; 27.2％ (n =22) received nasal continuous positive airway pressure;34.6％ (n =28) received normal frequency mechanicalfrequency ventilation.All 47 ELBWI with patent ductus arteriosus received ibuprofen treatment,among which 6 cases received arterial canal ligation after failure of ibuprofen treatment.20 out of 41 cases of retinopathy of prematurity received laser surgery.Total parenteral nutrition was required in 74 infants(91.4％),the average age of beginning enteral feeding was 5.2 d (median 6 d,0-17 d)and achieved full gastrointestinal feeding time was 31 d (median 28 d,7-65 d).The survival rate of ELBWI with gestational age of ≤26,-28 and ＞28 weeks was 25.0％ (4/16),72.0％ (18/25) and 77.5％ (31/40),respectively; the corresponding mortality was 12.5％ (2/16),8.0％ (2/25) and 2.5％ (1/40),respectively.The survival rate of ELBWI with birth weight ≤800,-900 and ＞900 g was 33.3％ (4/12),58.3％ (14/24) and 77.8％ (35/45),respectively; and corresponding mortality of them was 16.7％ (2/12),8.3％ (2/24) and 2.2％ (1/45),respectively.Conclusions The outcome of ELBWI is closely related to gestational age and birth weight.Professional and sophisticated treatment might improve the survival rate and general outcome of ELBWI.

Objective To compare the clinical efficacy of Freka trelumina (FT) vs.feeding jejunostomy (FJ) in carrying out postoperative early enteral nutrition (EEN) in old patients with gastric cancer.Method 168 old gastric cancer cases were derided into FT group (n =54) with EEN, FJ group (n =50) with gastric tube and EEN, and total parenteral nutrition (TPN) group (n =64).Results Compared with TPN group, postoperative body weight, serum albumin and prealbumin level in FT and FJ groups were significantly higher, intestinal function recovery time, days of postoperative hospitalization and costs were significantly lower.The incidence of cough, sputum and sore throat of patients in FT group were significantly higher than those in FJ and TPN groups (P ＜ 0.05).Conclusions Postoperative EEN through FT and FJ was effective to improve nutritional parameter, accelerate intestinal function recovery, reduce the number of days of postoperative hospitalization, total costs, anastomotic stomal leak and gastroparesis rate.

Objective To determine the incidence and risk factors of retinopathy of prematurity (ROP) in preterm infants.Methods Fundus examinations were performed by RetCam Ⅱ ophthalmoscopy on 2185 premature infants (birth weight ≤ 2000 g or gestational age≤34 weeks)admitted into the neonatal intensive care unit of Beijing Bayi Children's Hospital from January 1st 2009 to December 31st 2010.According to the results,all infants were divided into ROP group and nonRO P group.Two-sample t test and Logistic regression analysis were used to investigate the risk factors of ROP.Results Among 2185 premature infants,287 (13.1 ％) cases were diagnosed with RO P.According to International Classification of RO P,34 cases (11.9 ％) were in zone Ⅰ,147 cases (51.2％) in zone Ⅱ,and 106 cases(36.9％) in zone Ⅲ.And there were 117 cases (40.8％) with stage 1 lesion,142 cases (49.5％) with stage 2 lesion,28 cases (9.7％) with stage 3 lesion,and no stage 4 or 5 lesion was identified.Thirty-six cases (12.5 ％) were accompanied by additional diseases.Logistic analysis showed that small gestational age (OR=0.859,95％CI:0.770-0.958,P=0.006),low birth weight (OR=0.729,95％CI:0.6340.838,P=0.000),long duration of oxygen supplement (OR=2.221,95％CI:1.904-2.592,P=0.000),assistant ventilation (OR=3.104,95％CI:2.0964.956,P=0.000),apnea (OR=1.767,95％CI:1.103 2.831,P=0.018) and=anemia (OR=2.242,95％CI:1.641-3.604,P=0.000) were independent risk factors of ROP.Conclusions The incidence of ROP in premature infants is high.Small gestational age and low birth weight,long duration of oxygen supplement,assistant ventilation,apnea and anemia are risk factors of ROP.Preventive measures should be taken against these factors.

Objective To analyze the clinico-pathological characteristics and prognostic factors of patients with gastric neuroendocrine carcinoma(G-NEC).Methods Clinical data of 40 cases of G-NEC form January 2003 to August 2013 at Ren Ji Hospital of Shanghai Jiaotong University were analyzed.Tumors were classified into different grades and stages according to the 2010 WHO classification and the 2006 European neuroendocrine tumor society (ENETS).Follow-up was conducted by telephone.The survival curves were drawn using Kaplan-Meier method.Univariate analysis was performed by the Log-rank test and multivariate analysis was performed by the COX proportional hazards model.Results Among the 40 G-NECs patients,29 were male(72％) and 11 were female(28％),with an median age of 61 years.Tumors located in the gastric cardia in 20 cases,in the gastric antrum in 11 cases and in the gastric body in 9 cases.Tumor ranged from 1 cm-20 cm.All patients were G-NEC (G3).Follow-up rate was 100％ (40/40).The median overall survival rate was 12 months,and one-year survival rate was 82％.Immunohistochemically G-NEC cells were positive for CgA and Syn in 11 cases.Gender (x2 =5.673,P ＜ 0.05),Ki-67 index (x2 =8.612,P ＜ 0.05),and lymphnode involvement (x2 =0.559,P ＜ 0.05) were prognostic factors of G-NEC patients.Conclusions The symptoms of G-NEC are nonspecific.Its diagnosis relies on pathological examination and immunohistochemistry.Syn and CgA are the most important markers.Female gender,lower Ki-67 index and lower lymph node metastasis predict a survival advantage.

AIM:To explore the differential expression of interleukin-19 (IL-19) and its receptors (IL-20R1/IL-20R2) in the samples of chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP and CRSsNP), and to investigate the correlation of IL-19 and its receptors with tissue remodeling factors, including matrix metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of metalloproteinase (TIMP)-1 in CRS.METHODS:The polyps from CRSwNP patients (n=30), the sinus mucosa from CRSsNP patients (n=15) and the inferior turbinal mucosa of nasal septum de-viation patients (n=15) were collected.The expression of IL-19 and its receptors (IL-20R1/IL-20R2) in each group was detected by real-time RT-PCR and immunohistochemistry.The expression of tissue remodeling factors MMP-2, MMP-9 and TIMP-1 in different groups was detected by real-time RT-PCR and ELISA.RESULTS:Increased mRNA and protein expression levels of IL-19, IL-20R1, IL-20R2 and MMP-9 were observed in CRSwNP group compared with CRSsNP and control group (P<0.05), while elevated expression level of TIMP-1 was observed in CRSsNP group compared with CRSwNP and control group (P<0.05).The relative expression of MMP-2 among the 3 groups showed no obvious difference.The expression of IL-19 and its receptors showed significantly positive correlations with MMP-9 in CRSwNP (P<0.05).No significant correlation between IL-19 and/or its receptors with TIMP-1 in CRSwNP group was observed.CONCLUSION:The high expression levels of IL-19, IL-20R1 and IL-20R2 and their positive correlations with MMP-9 in CRSwNP indica-te that IL-19 and its receptors may be involved in the tissue remodeling of chronic rhinosinusitis.

Objective To explore the reasons and preventive measures of early dislocation after total hip arthroplasty in elder patients. Method A retrospective study was done to analyze dislocation time, reason and time of 168 elderly patients with early anti-dislocation after total hip arthroplasty in joint surgery. Results Only 7 patients (4.1%) had type I joint dislocation, including 2 male and 5 female patients aged 65~89 years. The dislocation happened in 4~5 weeks postoperatively, mainly resulting from hip joint over flexion when urinating in bed, sleep-turning, loaded-moving, walking and stoop and diachoresis. Conclusions For the elderly patients after total hip replacement, it is type I dislocation which happened 4 ~ 5 weeks after operation, more femal than male, reasons including over-exercrse. Effective prevention measures includes regular rehabilitation training, early precautions enhanced mental support and safety nursing.

Objective To investigate the impact of pain care standard training on the pain-related knowledge and attitude of junior nurses in orthopedics department.Methods The standard pain care training was done for the junior nurses in the orthopedics department. The scores of questionnaires related to pain-related knowledge and attitude were collected and compared between pre-and post-training. Result There was significant statistical difference in the measurements related to the junior nurse’s knowledge and attitude between pre-and post-standard training(P<0.05).Conclusion The standard pain care training can enhance junior nurses knowledge,improve the attitude towards pain,and set up apporiate pain management behavior.

Background: Aberrant Bcl-2 transcription is closely related with nodal diffuse large B-cell lymphoma (DLBCL), however, the relationship between Bcl-2 and primary gastrointestinal DLBCL (PGI-DLBCL) was not fully studied.Aims: To investigate the relationship between Bcl-2 gene amplification and protein expression and clinicopathological characteristics, immunophenotype and prognosis of PGI-DLBCL.Methods: Clinical data was collected from 136 PGI-DLBCL patients receiving surgical treatment, and a telephone interview was conducted for survival information.Bcl-2 gene amplification and protein expression in tumor tissue were determined by fluorescence in situ hybridization and immuno-histochemistry, respectively, and relationships between Bcl-2 and clinicopathological characteristics, immunophenotype and prognosis of PGI-DLBCL were analyzed.Results: Among 136 PGI-DLBCL patients, 33 (24.3%) showing gene amplification and 90 (66.2%) showing protein expression of Bcl-2;gene amplification was correlated with primary tumor location, Ann Arbor stage, serum lactate dehydrogenase level, B symptom and International Prognostic Index (IPI) score (P<0.05), while protein expression was correlated with primary tumor location and immunophenotype (P<0.05).5-year overall survival (OS) in patients positive for Bcl-2 gene amplification and patients with non-GCB immunophenotype and positive for Bcl-2 protein expression were inferior to those negative ones (41.5%vs.71.5%, P<0.05;54.6% vs.84.6%, P<0.05).In Bcl-2 gene amplification or protein expression positive patients, 5-year OS of CHOP chemotherapy was inferior to that of rituximab combined with CHOP chemotherapy (48.6%vs.80.3%, P<0.05;66.4%vs.83.4%, P<0.05).Conclusions: Detection of Bcl-2 gene amplification is useful for prediction of prognosis in PGI-DLBCL.Both patients with Bcl-2 gene amplification and non-GCB patients with Bcl-2 protein expression have a poorer prognosis.Rituximab may improve the prognosis in patients with Bcl-2 gene amplification or protein expression.