Background: Fatty acid-binding protein 4 (FABP4) has been demonstrated to be a predictor of early diabetic nephropathy. However, little is known about the relationship between FABP4 and diabetic retinopathy (DR). This study explored the value of FABP4 as a biomarker of DR in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 238 subjects were enrolled, including 20 healthy controls and 218 T2DM patients. Serum FABP4 levels were measured using a sandwich enzyme-linked immunosorbent assay. The grade of DR was determined using fundus fluorescence angiography. Based on the international classification of DR, all T2DM patients were classified into the following three subgroups: non-DR group, non-proliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group. Multivariate logistic regression analyses were employed to assess the correlation between FABP4 levels and DR severity. Results: FABP4 correlated positively with DR severity (r=0.225, P=0.001). Receiver operating characteristic curve analysis was used to assess the diagnostic potential of FABP4 in identifying DR, with an area under the curve of 0.624 (37% sensitivity, 83.6% specificity) and an optimum cut-off value of 76.4 μg/L. Multivariate logistic regression model including FABP4 as a categorized binary variable using the cut-off value of 76.4 μg/L showed that the concentration of FABP4 above the cut-off value increased the risk of NPDR (odds ratio [OR], 3.231; 95% confidence interval [CI], 1.574 to 6.632; P=0.001) and PDR (OR, 3.689; 95% CI, 1.306 to 10.424; P=0.014). Conclusion FABP4 may be used as a serum biomarker for the diagnosis of DR.

Epilepsy is a chronic and recurrent paroxysmal disease which is a manifestation of brain disorder caused by many reasons. The medication adherence of epilepsy children is affected by various factors and remains to be improved. This paper reviewed the measuring methods, current situation, influencing factors and intervention of medication adherence among epilepsy children so as to provide a reference for improving medication adherence and treatment effects of epilepsy children.

Objective? To explore the effects of cognitive behavior therapy (CBT) on negative emotion and medication compliance in school-age children with epilepsy. Methods? Totally 68 school-age children with epilepsy hospitalized from May 2017 to June 2018 were selected by convenient sampling. The children admitted between May and November 2017 were included into the control group (n=34), and the children admitted from December 2017 to June 2018 were included into the intervention group (n=34). Patients in the control group received conventional nursing care, while patients in the intervention group received CBT on this basis. The Screen for Child Anxiety Related Emotional Disorders (SCARED), Depression Self-Rating Scale for Children (DSRSC) and Medication Compliance Questionnaire were used to evaluate the children before and 2 months after intervention. Results? The SCARED and DSRSC scores of the intervention group were lower than those of the control group, and there was statistically significant difference between the two groups (P＜0.05). The Medication Compliance Questionnaire score of the intervention group was higher than that of the control group, and there was statistically significant difference between the two groups (P＜ 0.05). Conclusions? CBT can improve the negative emotion and medication compliance of school-age children with epilepsy.

Objective To study the effect of postoperative rehabilitation of meditation training on repeat cesarean section patients. Methods A total of 86 cases of repeat cesarean section from October 1st, 2014 to October 1st, 2016 were collected. The patients were divided into the observation group (43 cases) and the control group (43 cases) by random digits table method. The observationgroup received meditation therapy by a well-trained nurse based on the routine treatment. The control group was treated with routine treatment. The two groups were compared by postoperative pain score, anxiety and depression scores, the first breastfeeding time, the first urination time and satisfaction. Results After intervention, the postoperative pain visual scores of the observation group and the control group were 3.21 ± 1.51 and 5.41±1.45 respectively, the difference was statistically significant (t=3.817, P<0.01). After intervention, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) of the observation group were 10.86±1.95,9.22±2.76, and 16.88±2.09,14.02±3.79 in the control group, the differences were statistically significant (t=11.518, 6.317, P<0.01). The first out-of-bed time of the observation group were as follows:<4 h:9.30%(4/43), 4-6 h:88.37%(38/43),>6 h/failure:2.32%(1/43). While the data of the control group were <4h: 18.60%(8/43), 4-6 h: 67.44%(29/43), >6 h/failure: 13.95%(6/43), the differences were statistically significant (t=6.114, P<0.05). The satisfaction of the observation group and the control group were 98.47% (42/43) and 91.69% (39/43) respectively, the difference was statistically significant. (χ2=7.679, P<0.01). ConclusionsMeditation can effectively reduce the postoperative pain, reduce the incidence of anxiety, shorten the first time of breastfeeding and urination, and improve patients′satisfaction.

Objective The incidence rate of pressure ulcer is high in critical patients and off-loading mattresses and reposi-tioning are known as effective interventions for the prevention of pressure ulcers .However, evidence is lacking for selection of the right type of mattresses and suitable interval of repositioning .This study was to compare the effects of two types of off-loading mattresses with two different repositioning intervals in preventing pressure ulcers in critical patients . Methods According to the design of this ran-domized controlled trial , we made a training plan concerning the participants , methods of intervention and comparison , criteria and methods of observation , and methods of recording , and trained 26 nurses from 7 hospitals .Using non-inferiority design and the method of stratified blocked randomization , we divided 1194 patients with the risk of pressure ulcer into a trial group ( n=596) and a control group ( n=598) , a viscoelastic sponge mattress with every-four-hours repositioning used for the former and an automatic aeration mat-tress with every-two-hours repositioning for the latter , both for 7 successive days .We examined the patients every day , recorded the in-cidence and stages of pressure ulcer , and compared the data obtained between the two groups of patients . Results The total inci-dence rate of pressure ulcer was 1.09%(13/1194), significantly lower in the trial than in the control group (0.34%[2/596] vs 1.84%[11/598], P=0.012). Conclusion A viscoelastic sponge mattress with every-four-hours repositioning is superior to an automatic aeration mattress with every-two-hours repositioning and therefore is preferred to the latter in preventing the incidence of pressure ulcer in critical patients in the ICU .

Objective To explore the results of non-compliance of fluid intake in maintence hemodialysis patients.Methods The qualitative phenomenological research method was adopted in this study.Self-structured in-depth interviews were conducted with 13 maintenance hemodialysis patients.Data were analyzed by content analysis.Result Four themes were extracted including allotrigeusia,have a smattering of fluid intake knowledge,self-condemned and guilty,muddling along.Conclusions Fuild restriction is the most difficuilt prescribed treatment schedule among maintence hemodialysis patients.Nurses should pay attention to those people and provide multilevel,continual,individual and comprehensive measures.

Objective To verify the effects of critical-care pain observation tool ( CPOT) on pain assessment after lung transplantation. Methods 2 critical care nurses applied CPOT scale for pain assessment of 42 cases hospitalized in ICU after lung transplantation who would have pain assessment. The whole investigation were divided into 3 stages and 2 points of each stage ( rest before turning over and the simulation of turning over) with total 6 measuring point (T1-T6). The first stage was patients with general anesthesia ( no awareness) , the second stage ( patients with sanity and applied artificial respirator through oral trachea cannula, the third stage ( patients got off oral trachea cannula and ventilator paused ) . The measurement point was 1 min, recording patient′s value of CPOT from T1 to T6. The second stage was used digital scoring method. Results For 3 stages, the measurement points of turning over for CPOT value was higher than that of rest measurement point before turning over; 2 critical patients had high uniformity for CPOT score;in stage 2, patient′s CPOT score had high uniformity with NRS score. Conclusions CPOT is a effective way to assess pain for mechanically ventilated patients after lung transplantation.

Objective To explore the clinical value of 256-slice CT whole hepatic perfusion imaging in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods Twenty-three patients with hepatocellular carcinoma underwent whole hepatic perfusion with the JOG technique one week before TACE.The scanning data of cancer and liver tissues were analyzed using the perfusion software.The cancer tissue perfusion was repeated 4 to 6 weeks after treatment and was compared with that before treatment.Results (1) Before TACE,the HCC lesions were shown on the hepatic arterial perfusion (HAP) map as homogeneous hyper-perfusion lesions in 8 patients and as inhomogeneous hyper-perfusion lesions in 15 patients.The HAP and hepatic arterial perfusion index (HAPI) values of the tumor were higher than those of the liver tissues,while the hepatic portal perfusion (HPP) values of the tumor was lower than that of the liver tissues.The differences were all significant (P ＜ 0.05).(2) Mter TACE,the tumors were totally filled with lipiodol in 3 patients,partially filled with lipiodol in 13 patients,and sparsely filled with lipiodol in the remaining 3 patients.There was no blood perfusion in the lipiodol-filled areas and in the cancer necrotic tissues,but in the sparsely or partially lipiodol-filled areas blood perfusion could still be seen.21 patients received another session of TACE 6 to 8 weeks later.The results between the hepatic arterial digital subtraction angiography (DSA) and the CT perfusion were 100％ matching.The HAP and HAPI values of the tumor decreased when compared with before treatment,and the difference was significant (both P ＜0.05).The HPP values decreased slightly with no significant difference (P ＞ 0.05),while higher HAP and HPI and lower HPP were observed in the active cancer tissues when compared with the liver tissues after treatment (P ＜ 0.05).Conclusion 256-slice MSCT whole liver perfusion imaging can quantitatively reflect abnormal perfusion of hepatocellular carcinoma tissues and postoperative active tissues,and has important guiding significance in the preoperative evaluation,and the postoperative follow up of patients treated with TACE.

Objective To investigate clinical efficacy of finasteride on chronic heart failure(CHF)compli-cated with benign prostatic hyperplasia(BPH)in elderly patients.Methods 100 cases of elderly patients with CHF complicated with BPH were chosen,according to the number table method,they were divided into the observation group and control group,50 cases in each group,all patients were treated according to their cardiac function to regulate anti -CHF therapy.The patients in the observation group were added with finasteride treatment,the control group pla-cebo treated patients,the measurement indexes were compared between the two groups after treatment,including pros-tate volume,N terminal pro brain natriuretic peptide concentration,creatinine,international prostate symptom score and symptom score,need operation treatment intervention,incidence acute urinary retention rate.Results After treat-ment,the prostate volume,N terminal pro brain natriuretic peptide concentration,creatinine,international prostate symptom score of symptom scores of the observation group were (23.86 ±10.27)mL,(352.63 ±72.55 )g/L, (84.0 ±11.6)mol/L,(9.3 ±4.9),those in the control group were (39.11 ±12.53)mL,(483.46 ±76.47)g/L, (99.0 ±12.8)mol/L,(13.9 ±5.6).The difference was statistically significant(t =9.47,17.56,12.33,8.48,all P <0.05);the observation group need operation treatment intervention was 16.0%,obviously less than 52.0% in the control group,there was significant difference between two groups(χ2 =21.85,P <0.05);acute urinary retention in patients with the observation group the incidence rate of 14.0%,significantly lower than 38.0% in the control group, there was significant difference between two groups(χ2 =12.83,P <0.05).Conclusion Patients with CHF compli-cated with BPH aged at the same time standard anti heart failure treatment using finasteride,significantly reduce the prostate volume,reduce the measurement indexes,and significantly reduce the rate of operation intervention patients, safe and reliable,which is worthy of clinical application.

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.