Objective To observe effect and toxicity reaction using the treatment of Docetaxel combined with Gimeracil and Oteracil porassium capsules or capecitabine on elderly patients with advanced gastric cancer.Methods Sventy-eight cases elderly patients with advanced gastric cancer were divided into the combination group (n =40) and the monotherapy group (n =38) randomly by the random number table from February 2010 to December 2012.The patients on the monotherapy group were treated with capecitabine or oral Gimeracil and Oteracil porassium capsules,while the patients on the combination group were treated with Docetaxel in combination of capecitabine or Gimeracil and Oteracil porassium capsules.All therapy were repeated each 3 weeks,and 2 cycles chemotherapy were done at least;meanwhile effect and toxicity reaction were evaluated.At last,time to progress(TTP),median survival time(MST),1-year survival rate and 2-year survival rate were evaluated after completion of follow-up.Results On one other,response rate of the combination group and the monotherapy group were 95％ (38/40) and 79.0％ (30/38),and patients were 38 and 30,respectively;and response rate of the combination group was higher than the monotherapy group(x2 =4.4928;P＜0.05).TTP were 7.9 and 7.6 months on the combination group and the monotherapy group,and the MST were 13.1 months and 12.6 months respectively.The 1-year survival rate were 32.5％,28.95％,and 2-year survival 15.0％,5.27％,similarly,there was no remarkable significance on survival rate(x2=0.12,2.01,P＞0.05).On the other hand,the combination group exhibited more remarkable significance of toxicity reaction than the monotherapy group(P＜0.05),such as hepatotoxicity,baldness,hepatic injury.Conclusion Effect of the combination group was superior to the monotherapy group on elderly patients with advanced gastric cancer.However,there is no longer survival time and more toxicity reaction on the combination group.

Objective To investigate influence of hohstic nursing intervention on psychological state and gastrointestinal function of patients after abdominal operation. Methods 48 patients undergoing abdominal surgery with epidural anesthesia were divided into the intervention group and the control group. Holistic nursing intervention and routine nursing were given to the two groups respectively. Self-rating anxiety scale (SAS) and serf-rating depression scale (SDS) were used to evaluate the psychological state of all patients and gastrointestinal tract function were also measured. The result underwent t test. Results SAS and SDS scores were lower on the fifth day after operation and the time of borborygmus recovery, anal exsufflation and defecation was shorter in the intervention group when compared with those of the control group. Conclusions Hohstic nursing to patients after abdominal surgery can eliminate anxiety and depression and improve recovery of gastrointestinal tract function.

Vitamin K deficiency is a common problem in neonates and infants,vitamin K deficiency bleeding can be life threatening.There is still a high incidence of vitamin K deficiency even if the prevention by retrospective analysis a large number of the global data.In recent years,with the increase of premature infants,incidence is higher than before,China is the same trend.There is no recognized prevention and treatment measures,and less related research data.Therefore,to carry out related investigation,to provide the basis for clinical prevention and treatment are an urgent task.

Objective To explore the effects of resistance exercise on intradialytic blood pressure variability and the lowest blood pres-sure. Methods From September, 2015 to March, 2016, 80 patients with intradialytic hypotension frequently during maintenance hemodialy-sis were included, and divided into control group (n=40) and intervention group (n=40) by drawing lots. Both groups accepted routine nurs-ing, while the intervention group accepted resistance exercise during hemodialysis. The coefficient of variation (CV) of blood pressure and the lowest blood pressure were compared twelve weeks later. Results The CV of systolic blood pressure was less in the intervention group than in the control group (t=-4.356, P<0.001), while the lowest blood pressure, both systolic and diastolic, were more (t>4.122, P<0.001). Conclusion Resistance exercise may reduce the intradialytic systolic blood pressure variability and increase the lowest blood pressure in pa-tients with frequent intradialytic hypotension.

Objective To investigate the association of serum uric acid (UA) level with ventricular hypertrophy,ventricular remodeling,and ventricular electromechanical activity dyssynchrony in patients with chronic heart failure by studying the correlation among left ventricular mass index (LVMI),QRS duration (QRSd) and UA.Methods Four hundred and fifty-three patients were selected in this study.Each patient received examinations of echocardiography,electrocardiogram (ECG),blood routine,and blood biochemistry.According to the different UA level,the patients were divided into group Ⅰ (UA≤360 μmol/ L),group Ⅱ (360 μmol/L ＜ UA≤420 μmol/L),group Ⅲ (420 μmol/L ＜ UA≤480 μmol/L),group Ⅳ (480 μmol/L ＜ UA ≤540 μmol/L),and group Ⅴ (UA ＞ 540 μmol/L).The differences in LVMI,QRSd,Left ventricular ejection fraction (LVEF),and NYHA class among five groups were compared,and the correlation among LVMI,QRSd and UA were analyzed.Results According to the different UA,from groups Ⅰ to Ⅴ,with increase in UA,LVMI values increased,there was significant difference among five groups [(93.89 ±30.25) g/m2,(94.44 ±32.46) g/m2,(101.04 ± 37.22) g/m2,(124.39 ± 63.22)g/m2,and (133.51 ±41.85) g/m2,respectively] (F =17.501,P ＜ 0.01).UA level correlated positively with LVMI (r =0.329 P ＜0.01).According to the different UA,from groups Ⅰ to Ⅴ,with increase in UA,QRSd prolonged,there was significant difference among five groups [(93.10 ± 14.56) ms,(92.77 ± 21.12)ms,(94.00±19.95)ms,(97.55 ±20.37)ms,and (101.73 ±25.57)ms,respectively] (F=2.516,P ＜ 0.05).UA level correlated positively with QRSd (r =0.167,P ＜ 0.01).According to the different UA,from groups Ⅰ to Ⅴ,with increase in UA,LVEF was reduced [(54.94 ± 10.26) ％,(53.06 ±13.43)％,(51.79 ±14.01)％,(45.82±13.90)％,and (4-3.76±12.01)％,respectively] (F=14.299,P ＜ 0.01),and the proportion of NYHA class Ⅳ increased (3.85％,4.29％,4.00％,21.05％,and 67.11％,respectively) (x2 =326.566,P ＜ 0.01).Conclusions With the increase in UA level in patients with chronic heart failure,LVMI value increased,QRSd prolonged,LVEF decreased,and cardiac function reduced.It indicated that the elevated level of UA might reflect the severity of the ventricular remodeling,and ventricular electromechanical activity in dyssynchrony and development of heart failure.

Objective: To explore the correlation among plasma fibrinogen (Fg), serum uric acid (SUA) level, severity of premature coronary heart disease (PCHD) and major adverse cardiovascular events (MACE).Methods:A total of 195 PCHD patients diagnosed by coronary angiography (CAG) were selected, including 72 cases with stable angina pectoris (SAP), 67 cases with unstable angina pectoris (UAP) and 56 cases with acute myocardial infarction (AMI).Another 75 healthy subjects were enrolled as normal control group.Plasma Fg and serum urea acid(SUA)levels were compared among four groups, and their relationship with coronary disease severity and incidence of MACE during six-month follow-up were analyzed.Then ROC curve was used to assess predictive value of plasma Fg and SUA levels for PCHD.Results: Compared with normal control group and SAP group, there were significant rise in levels of plasma Fg[(2.80±0.26) g/L, (2.85±0.32) g/L vs.(3.44±0.32) g/L, (4.25±0.35) g/L]and SUA[(306.56±15.55) μmol/L, (308.81±16.77) μmol/L vs.(349.48±15.59) μmol/L, (368.86±20.72) μmol/L]in UAP group and AMI group (P<0.05 or <0.01), and those of AMI group were significantly higher than those of UAP group (P<0.05 both);Spearman correlation analysis indicated that plasma Fg and SUA levels were significant positively correlated with Gensini score (r=0.750, 0.743, P<0.01 both);levels of plasma Fg and SUA in those suffering from MACE during follow-up were significantly higher than those of patients without MACE, P<0.05 or <0.01.Meanwhile, ROC curve suggested that plasma Fg and SUA possessed certain diagnostic value for PCHD[area under the curve (AUC) =0.867, 0.736].Conclusion: Plasma fibrinogen and serum uric acid detection can provide certain evidence for diagnosing PCHD and determining disease severity.

Objective: To evaluate the quality of gentiana macrophylla from different origins in Gansu by determination the content of gentiopicroside.Methods: HPLC method was used.Results: The calibration curve of gentiopicroside was linear within 0.52-5.2?g(r=0.9991),the average recovery rate was 99.2%(RSD=1.23%,n=5).Conclusion: The content of gentiopicroside among gentiana macrophylla from different origins in Gansu are different,and all of them are higher than the standard of China Pharmacopoeia.Gentiopicroside content in planting gentiana macrophylla is higher than that of wild gentiana macrophylla.It provides a scientific basis of cultivating gentiana macrophylla and protecting wild gentiana macrophylla.

Twelve community nursing managers were interviewed.The consensus was reached that there should be 4 main themes concerning evaluation indicators of community nursing quality:necessity,content,format and expectation.The interviewed nursing managers expressed their need for a system of community nursing quality evaluation,and those indicators should be comprehensive,concrete and practical.The format of evaluation should facilitate the development of nursing quality and the criteria should meet the requirements of Minister of Health and international standards.

Objective To evaluate the diagnostic efficiency of fiberoptic ductoscope versus galactography for nipple discharge. Methods Literatures on comparing the diagnostic value of galactography with fiberoptic ductoseope (FDS) on the nipple discharge were searched from the Cochrane library, Evidence based medicine (EBM ),PubMed,China Vip database, and 8 studies were intaked. Then the data was analyzed by software Metadisc1.4 and Review Manager5.1. Results There are 1170 patients in the 8 studies. The pooled estimates for sensitivity of FDS and galactography was 82%, 78%, and the pooled estimates for specificity was 51%, 50%, respectively. The weighted AUC (area under curve) was 0.776, 0.705, Q*values was 0.715, 0.657, respectively. The sensitivities and specificity of the 2 methods were not significantly different. The overall diagnostic efficacy of FDS was better than that of galactography. Conclusion FDS is better than galaetography in the diagnostic value of nipple discharge.

Unplanned extubation (UEX) is defined as premature removal of the indwelling catheter tube by a patient (deliberate unplanned extubations) or by staff during nursing and medical care (accidental extubations). UEX, either deliberate or accidental, can cause severe damage of patients, with the increasing of hospital costs and medical disputes. Identifying high-risk patients is the key point of reducing UEX. This review conclude risk assessment tools reported for UEX.