Objective To investigate the effect of Quality Control Circle (QCC) care model applied in internal medical nursing. Methods 1000 patients were randomly selected in hospital as research subjects, and they were randomly divided into observation groupand control group, with 500 cases in each group.Patients′satisfaction, patient care and safety knowledge awareness, nursing care error rateand incidence of adverse events were compared.Results The observation group patients′care satisfaction and patients′care safety knowledgerate were significantly higher (P <0.05), the error rate and nursing care adverse events rate in the observation group were significantlylower than the control group (P <0.05).Conclusion QCC care model uses in medical care could improve the quality of care to reducemedical malpractice and errors, and could improve patients′satisfaction degree and nursing care quality and safety.Quality control circlecare model could be worthy of clinical application.

Objective To explore the relationship between social supports and post-stroke fatigue among community stroke patients.Methods A total of 164 community stroke patients in Pingshan New Area of Shenzhen City were investigated by Fatigue Severity Scale (FSS) and Social Support Rating Sale (SSRS).Results Of the 164 cases,there were 72 cases diagnosed post-stroke fatigue (accounting for 43.9％);Patients with post-stroke fatigue had lower scores of SSRS than non-fatigue patients with statistically significant difference;The scores of FSS were significantly negative related with each dimension of SSSR;Patients who signed with the family physician had lower rate of post-stroke fatigue (P＜0.01),and the total levels of subjective support,objective support and social support were higher in signed patients than those in non-signed patients (P ＜0.01).Conclusion Post-stroke fatigue may be closely related to social supports;Family physician services can improve the levels of social supports in order to reduce the incidence of post-stroke fatigue.

目的 探讨将精细化护理模式应用于糖尿病(DM)合并脑梗塞(CI)中,对患者护理质量和治疗效率的影响.方法 随机选择200例DM合并CI患者,按随机数字法分为实验组和对照组,每组100例.结果 使用精细化护理模式后,实验组的脂质代谢指标、糖化血红蛋白(GHb)、空腹血糖(Glu)、血压水平、护理质量评分、不良护理事件发生率及患者满意度均优于对照组,差异有统计学意义(P＜0.05).结论 精细化护理模式能为DM合并CI患者提供更为优质、全面的高质量的护理服务,提高临床疗效,改善护患关系,减少护理医疗纠纷.

脑卒中，又称中风或脑血管意外，是一组突然起病，以局灶性神经功能缺失为共同特征的急性脑血管疾病，分为出血性和缺血性脑卒中，其中缺血性脑卒中占60%~80%。缺血性脑卒中即脑梗死，它是严重危害我国中老年人生命与健康的神经系统的常见和高发疾病，其发病率、复发率、致残率、致死率极高，其中病死率平均10%~15%，带来了沉重的社会与经济负担[1]。缺血性脑卒中患者中约4%~10%复发，复发脑卒中与首发相比其致死率、致残率更高，严重影响人类生命和生活质量[2]，因此缺血性脑卒中的防治已成为卫生工作中的一项重要课题，越来越引起业界的重视。近年研究发现，脂联素( Adpn)具有多种生物学作用[3]，参与葡萄糖和脂质代谢，与动脉粥样硬化的发生发展关系密切，由于动脉粥样硬化是缺血性脑卒中的基础病因，脂联素在缺血性脑血管病中的作用逐渐为人们所关注，现就血清脂联素与缺血性脑卒中的关联进行总结。

Objective To investigate the changes of serum interleukin -1β( IL-1β) level in patients with post stroke fatigue ( PSF) and effect of early nursing intervention , to provide references for prevention and treatment .Methods From December 2013 to June 2014, 105 patients with ischemic stroke were selected in our hospital , and they were randomly di-vided into control group (n=52) and intervention group (n=53) .Control group given routine treatment and nursing , while intervention group given early nursing intervention based on routine treatment and nursing.After 2 weeks of intervention , fatigue severity scale (FSS) was used to judge PSF, and blood glucose, HbA1c, IL-1β, HDL-C, LDL-C, TC, TG were detec-ted.Results The total score of FSS of intervention group was (2.9 ±1.5), was lower than that of control group of (3.8 ± 1.7) (P<0.05) .In the intervention group, 13 cases occurred PSF (intervention-PSF group), 40 cases did not (interven-tion-non PSF group ); in the control group , 13 cases occurred PSF ( control-PSF group ) , 29 cases did not ( control -non PSF group) .Blood glucose, HbA1c, IL-1β, HDL-C of intervention -PSF group were higher than those of control -PSF group and intervention-non PSF group , and those of control -PSF group were higher than those of control -non PSF group ( P<0.05).Conclusion Serum IL-1βlevel is higher in patients with PSF , which plays a important role in the onset and devel-opment of PSF , and early nursing intervention is helpful to reduce and postpone PSF .