Objective To explore and classify the subjective opinions of nurses on whistle- blowing, and identify the subjective characteristics of each type. Methods This study applied Q -methodology, protocols which could determinate subjective opinions of nurses on histle-blowing were set up and underwent interview investigation, data of the interviews went through Q-factor analysis. Results Most nurses had a positive attitude toward whistle - blowing because it could prevent any nursing activity not based on expertise and professional ethics from causing disadvantages for patients. At the same time, however, they requested the creation of a legal framework in which whistle-blowing was done in a way to increase trust among colleagues. Meanwhile, some nurses showed resistance to whistle - blowing. Conclusions Whether whistle - blowing can reach its aims depends on nurses' attitude toward it. Most Korean nurses support whistle-blowing. Nursing activity not based on expertise and professional ethics and causing disadvantages for patients can be avoided if a legal framework is established for whistle-blowing.

OBJECTIVE:To discuss the use of allopurinol for the reduction of serum uric acid level in patients with chronic kidney disease complicating hyperuricacidemia so as to delay the progression of chronic renal disease.METHODS:A total of 47 patients with chronic kidney disease complicating hyperuricacidemia were randomly divided into treatment group and control group:the treatment group was given allopurinol 100～200mg?d-1 in addition to the antihypertensive therapy as adopted in the control group or the common therapy for 12 months.RESULTS:As compared with the control group,serum creatinine level was lower and the rate of renal function deterioration was significantly decreased in the treatment group(P

Objective To compare the effect of methotrexate combined with laparoscopic surgery on pregnancy outcome of patients with tubal pregnancy treated with conservative treatment.Methods 96 patients who were diagnosed of tubal pregnancy,fertility requirements and no clinical data given birth were analyzed retrospectively.Depending on the method of treatment was divided into 46 cases of methotrexate and laparoscopic group of 50 patients.Postoperative intrauterine pregnancy,ectopic pregnancy and secondary infertility situation again were compared.Results Laparoscopic group in intrauterine pregnancy rate was 70.0％,which was significantly higher than that in the methotrexate group(47.8％),and the difference was statistically significant(x2 =13.229,P ＜ 0.05) ;laparoscopic ectopic pregnancy rate was 14.0％ against 17.4％ with methotrexate group,the difference was not statistically significant(x2 =2.037,P ＞ 0.05) ; methotrexate group was 34.8％ of secondary infertility was significantly higher than thatin the laparoscopic group (16.0％),the difference was statistically significant (x2 =12.784,P ＜ 0.05).Conclusion Laparoscopic surgery after conservative treatment of tubal repregnancy outcome is better than methotrexate.

Objective To investigate the effect of Shuxuetong injection on anticoagulation of nephrotic syndrome.Methods 42 patients were randomly divided into 2 groups:Shuxuetong group and control group.The Shuxuetong group were injected Shuxuetong injection while the control group were injected low molecular dextran and Danshen injection.Hemorheology and clotting index were detected before and after treatment.Results Hemorheology and clotting index of the two groups were improved.Hemorheology and clotting index of the Shuxuetong group were improved better than that of the control group.Conclusions The results suggested that the Shuxuetong injection was a safe and effective anticoagulation drug for the treatment of nephrotic syndrome.

Objective:To explore the prevalence of posttraumatic stress symptoms among preschool children and its related factors after the Ludian earthquake.Methods:A total of 62 children's guardians were visited.They were interviewed with the Posttraumatic Stress Disorder Semi-Structured Interview for Infants and the Young Children and the Child Behavior Checklist-Posttraumatic Stress Disorder scale (CBCL-PTSD) consisted of 15 items from the CBCL.All of the participantsresided in Longtoushan settlement and Longtoushan town (the epicenter).They were randomly visited from west to east in that region.Results:The rate of scored 9 (or more) on the CBCL-PTSD among children was 51.9％ (27/52) in 1-2 months after the earthquake.However,based on the Semi-Structured Interview,the rate of the children's posttraumatic stress symptoms was 26.9 ％ (14/52).The numbers of posttraumatic stress symptoms,intrusion symptoms,avoidance symptoms,hyperarousal symptoms,the new symptoms and the CBCL-PTSD scores were positively correlated (0.30-0.73,P ＜0.05),except the relation between intrusion symptoms and hyperarousal symptoms.The rate of intrusion symptoms was significant higher among those who experienced earthquake than those who didn't (96.2％ vs.60.0％,P ＜0.01).And the rate of intrusion symptoms was also higher among those who was injured during the earthquake than those who wasn't (100％ vs.84.6％,P ＜ 0.05).And the other symptoms were not difference in children under different conditions (P ＞ 0.005).Conclusion:The preschool children who experienced earthquake or were injured suffer more posttraumatic stress symptoms.

Delayed cerebral vasospasm is the leading cause of death in patients with subarachnoid hemorrhage. A good in vivo animal model of cerebral vasospasm after subarachnoid hemorrhage helps to understand the occurrence, development of this cerebral vasospasm, and the complicated and various pathophysiological mechanisms. It will provide important information for clinical interventions

Objective To explore the clinical effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke depression (PSD). Methods Sixty PSD patients were randomly divided into an rTMS group and a control group, each of 30 patients. In addition to conventional treatment, rTMS group members were given high-frequency rTMS treatment for 10 d while the control group were given sham stimulation. In order to test the efficacy, the two groups were compared using the Hamilton depression rating scale (HAMD) before and after 10 and 30 days treatment. Results After 10 days of treatment the rTMS group had significantly lower HAMD scores than before treatment, and average HAMD scores differed significantly between the rTMS group and the controls, with the former performing significantly better. There was no obvious difference in HAMD scores after 30 days of treatment between the two groups. Conclusions High-frequency rTMS is a safe and effective treatment for PSD.

Objective:To explore effectiveness of Russell Barkley's parent training in children with comorbid attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD),and to evaluate its applicability in mainland China.Methods:Parents of 30 DSM-Ⅳ ADHD+ODD children were given 10 weekly trainings.Results:Total numbers of symptoms,symptoms of ADHD,symptoms of inattention,hyperactivity/impulsivity and ODD declined significantly(P

Objective:To explore risk factors of attention deficit hyperactivity disorder(ADHD) comorbid with oppositional defiant disorder(ODD) in children.Methods:Parents of 43 pure ADHD+ODD children,and 43 pure ADHD children(criteria of DSM-Ⅳ;group matched by sex,age and ADHD subtypes) were asked to complete a set of investigation questionnaires including child and family information;family history;pregnancy,delivery and infancy complications;physical development and temperament;and predisposing factors and parents' or teachers' responses toward children's misbehaviors.Results:Probabilities of psychosis or schizophrenia of family members,long-term conflict between parents and parents' constant/stringent criticism to children in ADHD+ODD group were significantly higher than those in ADHD group(psychosis or schizophrenia of family members(16% vs 2%,P=0.058,OR=8.167);long-term conflict between parents(23% vs 7%,P=0.035,OR=4.040);parents' constant/stringent criticism to children(51% vs 28%,P=0.027,OR=2.706);probability of having anoxia at birth in ADHD group was significantly higher than that in ADHD+ODD group(12% vs 0,P=0.055,OR=0.469).Setting diagnosis of ADHD+ODD as dependent variable,and factors with significant difference between the two groups as independent variables,after 2 steps of regression analyses,one factor,i.e.parents' constant/stringent criticism to children was left in the model(P=0.054,OR=2.879).The regression formula had a sensitivity of 53.5%,a specificity of 83.7%,and total correction rate of 68.6%.Conclusion:Inappropriate parenting is a risk factor of ADHD comorbid with ODD,and long-term conflict between parents and positive family history of psychoses might have influence on ADHD comorbid with ODD.

[Objective] To discuss the therapeutic effect of different methods in the treatment of intertrochanteric femur fracture. [Methods]Totally 118 middle aged or old patients with intertrochanteric femur fracture were fixed with dynamic hip screw (DHS), Gamma nail or PFNA.[Results]Totally 112 cases were followed up, and the average time was 16 months, in those 45 patients were fixed with DHS: 29 were excellent, 11 cases were good, and 5 were poor, and the excellent to good rate was 88.9%; 36 patients were treated with Gamma nail, and the excellent, good, poor results were 28, 2, 1, respectively, and the excellent to good rate was 96.8%; 36 patients were fixed with PFNA, and the excellent, good, poor results were 29, 6, 1, respectively. The differences were significant (P=0.02, analyzed by Logistic regression with SPSS software). The excellent and good superiority of Gamma nail and PFNA were 5.1552 and 2.3726 times compared to DHS, and there was significant differences between the groups.[Conclusion]Surgical treatment of intertrochanteric femur fracture can improve the functional recovery and reduce the complication incidence, and PFNA fixing method can shorten the operative time, reduce the bleeding and the therapeutic effect is reliable, and suitable for old patients combined with osteoporosis.