Objective To explore the risk of tuberculosis infection in patients with malignant tumors.Methods The sputum samples and blood samples from 396 patients with malignant tumor and 80 healthy subjects were detected by modified Roche cul-ture,real-time fluorescence quantitative PCR,colloidal gold,T cell spots(TSPOT.TB)and single immunodiffusion(SRID).Results The positive rate of the experimental group of 396 cases of malignant tumor patients with five kinds of methods for detection of Mycobacterium tuberculosis were improved Lowenstein Jensen 12.1%(48/396),real-time PCR(169/396)42.7%,colloidal gold 38.9%(154/396),TSPOT.TB 44.9%(178/396),SRID 10.4%(41/396).In the control group,the positive result was detected only by real-time fluorescent PCR 8.7%(7/80),colloidal gold 6.3%(5/80),and TSPOT.TB 27.5%(22/80).The differences of the results of the same detection method were statistically significant(P<0.01).The experimental group was grouped according to the location of the lesion,and there was no statistical difference between the indexes of each group(P>0.05).In comparison with other types of tumor,there were no statistical differences in every index of every group(P>0.05).But the positive rates of liver cancer patients were lower than those of other types of tumor,and all the positive rates of lung cancer patients were higher than those of other types of tumor.Conclusion Patients with malignant tumor is a high-risk group of TB infection.It is suggested that early screening and regular monitoring of TB infection should be done for patients with malignant tumor,so as to achieve early de-tection and early treatment.

Objective: To discuss the application of problem management mode in care quality management. Methods: The care quality was monitored by area supervisors, combined with problem management mode, to detect the problems timely, analyze and solve problems in order, and achieve continuous improvement of the care quality. Results: The quality awareness of all nurses was obviously increased, and the care quality and wounded monthly satisfaction were also markedly improved. Conclusion: The nursing quality management effectiveness and predictability were effectively improved by the problem management mode, which fully reflected the importance of primary care and quality control personnel in nursing quality management.

[目的]探讨脐血干细胞移植治疗失代偿期肝硬化的护理措施。[方法]28例病人在无菌条件下取健康产妇足月生产的脐带血，分离纯化脐血干细胞，通过肝动脉途径，将纯化的脐血干细胞移植入病人肝脏内。[结果]28例接受脐血干细胞移植的肝硬化病人术中术后无明显不良反应发生。移植后病人临床症状改善明显，食欲不振、乏力、腹腔积液等减轻甚至消失；血清学检测：白蛋白水平较术前明显升高，凝血酶原时间、总胆红素较术前明显下降。[结论]脐血干细胞移植治疗失代偿期肝硬化是一种安全、有效的方法，尤其是在提高白蛋白水平及改善凝血功能方面有很好的疗效，可作为肝移植治疗的过渡或补充治疗。

<正>肝硬化门静脉高压症在临床较为常见,往往导致食道静脉曲张大出血,严重威胁患者的生命安全。经颈静脉肝内门体分流术(TIPS)是治疗晚期肝硬化门静脉高压症的新技术〔1〕。此技术的应用,可以在微创性操作中置入内支架进行分流,从而达到降低门脉压及控制食管胃底静脉曲张破裂出血的目的〔2〕。对行TIPS治疗门静脉高压患者,按不同年龄

<正>护理教学查房是临床护理教学工作中不可缺少的部分,是提高护生理论知识和发现、分析及解决问题的一种重要形式,教学查房的形式可直接影响护理查房的效果。而以问题为基础的查房是一种以学生为中心的小组讨论式教学方法,强调学生从问题着手去探索知识,并运用知识分析和解决问