The rehabilitation compliance of stroke patients is generally low.Evaluating the rehabilitation motivation of patients is helpful to promote the rehabilitation management of patients,enhance the rehabilitation enthusiasm and compliance of patients,and improve the rehabilitation outcome.This paper reviews the existing stroke patients rehabilitation motivation assessment tools,and expounds the main contents,application status,characteristics and limitations of stroke patients rehabilitation motivation assessment tools,in order to provide references for the appropriate selection of clinical assessment tools,the rehabilitation management of stroke patients and the development of domestic localized stroke rehabilitation motivation assessment tools.

Objective:To investigate the relationship between prolonged PR interval and carotid atherosclerosis(CAS)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 537 middle-aged and elderly inpatients with T2DM in the Southern Branch of the Sixth People′s Hospital of Shanghai Jiaotong University from January 2019 to January 2021 were selected as the research objects. Color Doppler ultrasound was used to detect bilateral carotid artery intima-media thickness(CIMT). The subjects were divided into carotid atherosclerosis group(CAS group, n=352)and non-carotid atherosclerosis group(NCAS group, n=185). The difference in the PR interval of ECG between the two groups was compared. Pearson or Spearman rank correlation analysis was used for evaluating the correlation of PR interval and CAS lesions with various clinical index. The relationship between PR interval and CAS lesions was adopted by multivariate logistic regression analysis. Results:The average PR interval of middle-aged and elderly patients with T2DM was(164.57±23.02)ms. The average PR interval in CAS group was significantly higher than that in NCAS group [(169.76±24.28) vs (154.70±16.42)ms, P<0.01]. The results of multifactorial logistic regression analysis showed that age, low density lipoprotein-cholesterol, serum osteocalcin, and PR interval were independent factors influencing the development of CAS lesions in middle-aged and elderly patients with T2DM( OR=1.079, 1.936, 0.879, 1.039, respectively, P<0.05 or P<0.01)where each 1 ms increase in PR interval was associated with a 3.9% increase in the risk of CAS in middle-aged and elderly patients with T2DM( OR=1.039, 95% CI 1.006-1.073, P=0.020). Multivariate logistic regression analysis showed that middle-aged and elderly type 2 diabetic patients with PR interval≥158 ms were 4.072 times more likely to have CAS lesions than those with PR interval<158 ms( OR=4.072, 95% CI 1.417-11.702, P<0.01). Conclusion:The PR interval of electrocardiogram is correlated with CAS lesions in middle-aged and elderly patients with T2DM. Middle-aged and elderly type 2 diabetic patients with significantly prolonged PR interval should be reminded to screen for CAS lesions early.

Objective The aim of this study was to investigate the expression of CCDC8(coiled-coil domain containing 8, P90)and transforming growth factor β 1(TGF- β1)in none small cell lung cancer(NSCLC),and its relationship with clinicopatho-logical characteristics. Methods The expression of CCDC8 and TGF-β1 in NSCLC was analyzed in the TCGA database. The Kap-lan-Meier curve was plotted to analyze its correlation with survival of patient. The expression of CCDC8 and TGF-β1 in 204 cases of conventional paraffin-embedded NSCLC was detected by immunohistochemical staining and their relationship with clinicopatholog-ical features of NSCLC was analyzed. The relationship between the expression of CCDC8 and TGF-β1 and the overall survival(OS) of patients was analyzed by Cox regression. Results The expression of CCDC8 in NSCLC patients was positively correlated with TGF-β1 expression in the TCGA data(P<0. 05). OS was low in patients with the low expression of CCDC8(HR=1. 32,P=0. 0437). In 204 NSCLC tissues,CCDC8 expression was positively correlated with TGF-β1 expression(P=0. 023). Cox univariate analysis of CCDC8 expression in NSCLC was associated with OS(P=0. 013);whereas the expression of CCDC8 and TGF-β1 was not associat-ed with survival in patients with NSCLC(P=0. 967,P=0. 816). Cox multivariate analyses of TNM staging and CCDC8 were progno-sis factors in patients with NSCLC(P=0. 016). Conclusion The expression of CCDC8 is correlated the expression of TGF-β1 in NSCLC. CCDC8 may be a prognostic factor for patients with NSCLC.

Nurses from all medical environments have close contacts with asthma patients, it can recognize the early indicators of poor asthma control, and provide self-management education and play important roles in the promotion of asthma control. In order to improve the quality of nursing practice in adult asthma control, Registered Nurses＇ Association of Ontario(RNAO) in Canada published the guidelines of Adult Asthma Care: Promoting Control of Asthma (Second Version) in 2017 after summarizing the latest evidence in order to provide systematic guidance. This articles analyzed the suggestions in the nursing practice guidelines and introduce the suggestions from all sections including nursing assessment, planning, implementation and evaluation in nursing practice.

INTRODUCTIONThe purpose of this meta-analysis was to compare the efficacy of transarterial chemoembolisation (TACE) and iodised oil infusion chemotherapy without embolisation (TAI) in patients with hepatocellular carcinoma.

MATERIALS AND METHODSWe searched for randomised controlled trials, retrospective cohort studies, and two-arm prospective studies that compared the clinical outcomes in patients who received TACE and TAI treatment. Database search was performed through 14 December 2016. Rates of survival and therapy response were compared using odds ratios (OR) with 95% confidence intervals (CI).

RESULTSSurvival rates and therapy response rates were similar between patients who received TACE and TAI treatments (pooled OR: 1.278; 95% CI, 0.783 to 2.086,= 0.327; and pooled OR: 1.502; 95% CI, 0.930 to 2.426,= 0.096, respectively).

CONCLUSIONOur results suggest that treatment intensification by adding embolisation did not increase overall survival and therapy response over TAI in patients with hepatocellular carcinoma.

Objective To observe the changes of blood lipid and intestinal short-chain fatty acids in rats with non-alcoholic fatty liver disease (NAFLD) induced by high-fat diet,and to explore the role of intestinal short-chain fatty acids in the pathogenesis of NAFLD.Methods Male SD rats (n =12) were randomly divided into control group and high-fat group according to the random number table.The control group was fed with normal diet,while the high-fat group was fed with high-fat diet.The rats were sacrificed at the end of eighth week after experiment.HE staining was used to observe the pathological changes of the liver in the two groups,the changes in serum lipid profile were measured,and the changes of the contents of feces short-chain fatty acids in the two groups of rats were determined by gas chromatography.Results The levels of serum alanine transaminase [(139.6 ± 17.29) U/L vs.(37.67 ±5.28) U/L],aspartate transaminase [(367 ±49.36) U/Lvs.(97.67 ±13.92) U/L],triglyceride [(0.83±0.08) mmol/Lvs.(0.60± 0.04) mmol/L],totalcholesterol [(6.34±0.53) mmol/Lvs.(1.77±0.29) mmol/L],andvery-lowdensity lipoprotein [(0.31 ±0.03) mmol/L vs.(0.22 ±0.01) mmol/L] in the high-fat group were significantly higher than those in the control group (P ＜ 0.05).Compared with the control group,the contents of acetic acid,propionic acid and total short-chain fatty acids in the high-fat group were significantly lower [(0.16 ± 0.03) ng/μlvs.(0.21±0.04) ng/μl;(0.05±0.01) ng/μlvs.(0.08±0.01) ng/μl;(0.25±0.05) ng/μl vs.(0.33 ± 0.05) ng/μl;all P ＜ 0.05).Conclusions The level of intestinal short-chain fatty acids is reduced in the NAFLD rats induced by high-fat diet.Monitoring of feces short-chain fatty acids may play an important role in the diagnosis and treatment of NAFLD.

OBJECTIVE:To compare the efficacy and safety of ferrous succinate or Shengxuening in the adjuvant treatment of renal anemia in patients with diabetic nephropathy peritoneal dialysis (CAPD). METHODS:64 diatetic nephropathy CAPD pa-tients with renal anemia were randomly divided into observation group (32 cases) and control group (32 cases). All patients re-ceived subcutaneous injection of insulin for blood glucose control (adjusted the insulin dosage based on fasting blood glucose lev-els),hypertension patients actively controlled blood pressure,corrected acid-base and electrolyte balance disorders,orally received fo-lic acid and vitamin B12,ambulant CAPD,then rhEPO was subcutaneously injected with initial dose of 100-150 U/(kg·week) for 2-3 times and other conventional treatment. Based on it,observation group received 1 g of Shengxuening tablet,3 times a day;control group received 0.2 g Ferrous succinate tablet,3 times a day. The treatment course for both groups was 16 weeks. The rhEPO dose was monthly adjusted to make Hb 100-120 g/L. Clinical efficacy,serum iron,serum ferritin,total iron binding capacity,transfer-rin saturation before and after treatment,Hb,Hct,hs-CRP,rhEPO dose before treatment and after 4,8,12 and 16 weeks of treat-ment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There was no significant difference in the total effective rate between 2 groups (P>0.05). After treatment,serumiron,total iron binding capacity,transferrin saturation,Hb and Hct in 2 groups were significantly higher than before,and it gradually increased by treatment time,serum ferritin,hs-CRP was sig-nificantly lower than before,and it gradually decreased by treatment time,the differences were statistically significant(P<0.05);but there was no significant difference between 2 groups(P>0.05). The rhRPO dose in observation group 8,16 and 16 weeks af-ter treatment and in control group 8 weeks after treatment were significantly lower than 4 weeks after treatment,and 12 and 16 weeks after treatment in observation group were lower than control group,the differences were statistically significant (P<0.05). The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on conventional treatment,both ferrous succinate and Shengxuening show good ef-ficacy in the adjuvant treatment of renal anemia with diabetic nephropathy CAPD,both can improve anemia and iron metabolism, while Shengxuening is superior to ferrous succinate in terms of improving microinflammatory state and reducing rhEPO dose,with better safety.

Objective To investigate the role of a small RNA interference against VEGF in radiation sensitivity in melanoma .Methods A375 human melanoma cell lines were transplanted into nude mice ,which with malignant melanoma were randomly divided into control group , VEGF negative plasmid group and VEGF positive plasmid group, followed by 4Gy irradiation twice a week for 2 weeks.The volume of tumor was calculated twice a week, the area of tumor necrosis was assayed by HE,the expression of VEGF in tumor was determined by Western-blot and Immunohistochemical. ResuIts The expression of VEGF in VEGF positive plasmid group decreased significantly (P<0.05), VEGF positive group had more tissue necrosis, tumor growth was significantly inhibited (P<0.05).ConcIusion siRNA-VEGF in tumor injection liposome encapsulated in malignant melanoma has a role in the radiation sensitization, which provides an experimental basis for the clinical development of targeted therapy combined with radiotherapy for the treatment of VEGF gene.

Objective To study the drug resistance of Staphylococcus aureus in 2006 -2011 ,and to provide the evidence for treatment infection .Methods The isolated bacteria were identified and antibiotic sensitivity were tested by automated system in 503 Staphylococcus aureus collected from 2006 to 2011 .Methicillin resistant Staphylococcus aureus(MRSA) was screened by oxacillin disk diffusion .Results 503 strains mainly derived from secretion and sputum .The incidence of MRSA was 44 .9% during 6 years . Detection rate of MRSA was decreased year by year .The difference was statistically significant between 2009 ,2010 ,2011 and 2006 , 2007 ,2008(P<0 .05) .No resistance to quinupristin/dalfopristin ,linezoiid ,vancomycin and nitrofurantoin was found .The resistance of Staphylococcus aureus was below 30% to levofloxacin ,imipenem ,compound sulfamethoxazole and rifampicin ,above 80% to ce-fazolin and penicillin .Although the resistant to cefazolin ,levofloxacin ,imipenem was risen ,the resistant rate of rest antibiotics was downed year after year .Conclusion Monitoring of drug resistance should be strengthened .The antimicrobial therapy should be de-fined on the basis of drug-sensitive test in order to control the incidence of infection and to delay the growth of clinical resistant strains of Staphylococcus aureus .

A series of surveillance and management actions was taken to minimize out-of-plan re-operations. These actions include: 1) Building and completing the surveillance and management mechanism against unplanned re-operations; 2) Building a real-time surveillance and reporting mechanism; 3) Enhancing quality control and continuous improvement at the operating departments; 4) Enhancing the supervision on regulations implementation by quality control departments of the hospital; 5) Enhancing quality control for medical records; 6) Building a feedback mechanism for surveillance results; 7) Building a penalty and reward mechanism. Efforts for one year and a half on such surveillance and management proved successful, as the incidence of out-of-plan re-operations fell from 1.7% before these actions to 1.0% afterwards.