Objective To explore the effects of stage-based nursing on preventing prosthesis dislocation after artificial hip replacement.Methods By sampling, we selected 56 patients with artificial hip replacement of Shandong Provincial Hospital, the Affiliated Hospital of Shandong University, from July 2014 to July 2015 in control group with routine nursing; and we selected 56 patients with artificial hip replacement from August 2015 to August 2016 in observation group with comprehensive and targeted holistic nursing by postoperative stage-based nursing based on routine nursing. The activities of living, extremity motor function, incidence of prosthesis dislocation and recovery of hip joint of patients between two groups before and six months after surgery.Results Before surgery, there was no statistical difference in the scores of activities of living and extremity motor function of patients between two groups (t=0.233, -0.791;P>0.05). Six months after surgery, the scores of activities of living and extremity motor function all increased in observation group with statistical differences compared with those in control group (t=2.388, 2.142;P<0.05). The rate of prosthesis dislocation and the score of Harris hip score was 1.79％ and (76.89±12.30) in observation group with statistical differences compared with those in control group (P<0.05).Conclusions Postoperative stage-based nursing can improve patients' activities of living and extremity motor function, and reduce the rate of prosthesis dislocation and effective improve hip joint after artificial hip replacement.

Objective To investigate the effects of changes of miR-126 and spouty related EVH,domain containing proteinl(SPRED1) after transient ischemic attack(TIA)on prognostic value for pathogenesis of secondary cerebral infarction.Methods Retrospective analysis of the clinical data of 106 patients with TIA was performed.The expression levels of miR-126,SPRED1 and vascular endothelial growth factor(VEGF)in peripheral blood were detected at 3 h,6 h and 12 h after TIA onset respectively.The specificity and sensitivity of miR 126 and SPRED1 in the diagnosis of TIA were analyzed.The miR-126 and SPRED1 levels versus ABCD2 score were compared for evaluating their predictive value in the diagnosis of secondary cerebral infarction within 30 days after TIA onset.Results The miR-126 level was declined after TIA onset at 3 h(9.41±1.04),especially at 12 h(6.59 ±2.78),versus in healthy control (9.35±1.76)(t =-7.764,P=0.000).The SPRED1 level after TIA onset was increased at 3 h(58.05 ± 17.53)pg/L,12 h(82.64 ± 18.60)pg/L versus in healthy control(52.38 ± 13.24)pg/L(t=12.374,P =0.000).A closely negative correlation was found between levels of miR 126 and SPRED1 at 12 h point but not at 3 h and 6 h(r=-0.278,P=0.004).Both miR-126 and SPRED1 levels at 12 h after TIA were implied to sensitivity and specificity evaluation.Additionally,VEGF was significantly increased at 3 h (345.61 ± 76.76) pg/L,6 h (461.65 ±103.87)pg/L and 12 h (519.22 ± 103.55)pg/L after TIA onset as compared with healthy control (107.77± 26.04) pg/L(t =26.569,29.756,34.699,all P =0.000).The decrease of miR-126 and increase of SPRED1 at 12h after TIA indicated high incidences of cerebral infarction but their significance was less than ABCD2 score.Combination of miR 126,SPRED1 and ABCD2 score significantly improved the prediction for cerebral infarction(Z=2.105,P =0.035).Conclusions After the onset of TIA,levels of miR-126 and SPRED1 expression in combination of ABCD2 score can improve predictive value for cerebral infarction development.