rgency response mechanism in place;and effective research work.

Standardized training program for residents will be in full swing in China,making 5-year medical undergraduate education plus 3-year resident-training the fundamental mode for clinician education.As such,the residency standardized training system,starting from postgraduate education of medical students and centering on level-2 disciplines,will take a key role in education at teaching hospitals.Therefore,such hospitals should make residency training program a key element of their medical education,discipline development and human resource development considerations,and take due measures.

Objective To explore the nursing risks on hemodialysis patients,and seek nursing countermeasures.Methods The quality and safety summaries from blood purification center of Sichuan Provincial People's Hospital (2009 to 2011,monthly) were studied.Nursing risk factors were firstly classified on the basis of adverse events which had occurred or had been avoided because of preventive measures.And then,a nursing risk management team was founded,and the main role of which was to analyze the cause and process of nursing risks,improve the process management and enhance nursing measures.Results Nursing skills and patients' satisfaction were obviously improved through strengthening the nursing risk management and training program.There were statistically significant differences between the indicators.Conclusions It can improve nursing skills and patients' satisfaction degree and reduce the occurrence of nursing risk by establishing risk management mechanism,culturing nursing stuffs risk awareness,paying more attention to detail management and continuous quality improvement.

Non-syndromic cleft lip with or without cleft palate is a common birth defect with complex causes,now widely considered as the result of interactions between genetic and environmental factors.Susceptible genes of congenital cleft lip with or without cleft palate have become a focus since the whole genome sequencing was available.Numerous candidate genes which were screened out are being constantly validated by gene polymorphism detection,case-control study and meta analysis.But the results are inconsistent.In this article,we review the research progress on susceptible genes of non-syndromic cleft lip with or without cleft palate and the relationship between environmental factors and cleft lip with or without palate in recent years.

OBJECTIVE: To investigate the anti-inflammatory effects of the extract of Rubus scuaivissimus cultivated in Guangxi. METHODS: The inhibition effects of the extract of R. scuaivissimus on vasopermeability and acute mice ear swelling induced by croton oil, and mice paw swelling induced by carrageenan were observed. The content of nitric oxide (NO) and the mRNA expression of iNOS in mice peritoneal macrophages were detected using Griess and RT-PCR assay. RESULTS: The extract of R. scuaivissimus cultivated in Guangxi can conspicuously inhibit the increase of vasopermeability and acute ear swelling induced by croton oil in mice,and mice paw swelling induced by carrageenan. Furthermore, R. scuaivissimus extract also showed depressant effect on the release of NO and genes expression of iNOS mRNA in mouse peritoneal macrophages. CONCLUSION: The extract of R. scuaivissimus cultivated in Guangxi has conspicuous anti-inflammatory effects. The mechanism of action may be associated with its inhibition effects on the release of NO and mRNA expression of iNOS.

Objective To improve hospital service flow for more convenient treatment.Methods Making the best of Hospital Information System and centered on patients,medical treatment flow is redesigned to reasonably arrange medical resources.Results The improvement not only saving the time of patients,but also raise the medical staff's working efficiency.Conclusion The application of Hospital Information System changes previous service flow,so better results is gained.

Objective In this research we established rapid atrial pacing rabbit models, to investigate the effects of simvastatin on changes of early atrial effective refractory period (AERP) and protein expression of atrial α1c sub-unit of L-type calcium channel on atrial remodeling. Methods 42 rabbits were randomly divided into 3 groups:control group,rapid pacing group and simvastatin group,simvastatin 5 mg/( kg·d) was given intragastrically daily for two weeks before electrophysiology study in simvastatin group, normal saline was given intragastrically in control and rapid pacing group instead. Control group with no pacing, in simvastatin group and rapid pacing group, right atrium was paced at 800 beats/min for 8 hours to establish acute atrial fibrillation models, right atrial effective re-fractory period(AERP)was measured at the basic cycle length of 200 ms and 150 ms before pacing and 1,2,4,6, and 8 hours after the onset of the pacing, the changes of rate adaptation of AERP (AERP200-AERP150) were ana-lyzed . Right atrium tissue was obtained for measurement of protein expression of atrialα1 c subunit of L-type calcium channel by Western blot. Simultaneously,lipid levels in each group was examined. Results No significant differ-ence in lipid levels among three groups was observed. The AERP was shortened and the rate adaptation of AERP (AERP200-AERP150) disappeared during pacing compared with those before pacing(P<0.05). The shortening of AERP was reversed and AERP200-AERP150 was maintained in simvastatin group. Compared with the control group,the protein expression levels of atrial α1c subunit of L-type calcium channel decreased significantly after 8 hours pacing in rapid pacing group(P<0.01). The protein expression levels of simvastatin group decreased insig-nificantly . Conclusion Atrial rapid pacing can induce the shortening of the AERP and the losing of adaptability to the frequency of AERP,pretreatment with simvastatin can improve the degree significantly and maintain the adapta-bility to frequence basically. The protein expression levels of atrial α1c subunit of L-type calcium channel de-creased significantly after 8 hours pacing,pretreatment with simvastatin can prevent this change without lowering the lipid levels,thus contributing to the ionic mechanism of simvastatin for antiarrhythmia.

Objective To understand patients' experience of intensive care with mechanical ventilation at intensive care units to provide a more holistic approach to patient care. Methods In-depth interviews were applied to 11 participants who survived from mechanical ventilation. The pa-tients were asked to describe their experience by responding to the research question "what is it like to experience mechanical ventilation treatment at an ICU?"The data were analyzed by Giorgi's ph e-nomenological procedures. Results Five mutually exclusive themes emerged, which were titled "be-ing in an unconventional environment", "suffering from physical discomfort", "encountering psycho-logical crisis", "self-encouragement", and"self-reflection". Conclusions Patients' experiences while receiving mechanical ventilation at an intensive unit were poignant and afeard, but "self-encour-age-ment" and "self-reflection" will enhance patients' self-confidence which will be beneficial for their re-covery of critical illness.

Objective To evaluate the clinical efficacy and safety for the CAG regimen combined with thalidomide in elderly patients with acute myelogenous leukemia (AML).Methods 51 untreated elderly cases with AML were randomly divided into treatment group (treated with CAG regimen combined with thalidomide,26 cases) and control group (treated with CAG regimen alone,25 cases),and the clinical efficacy and safety were observed.Results After 2 cycles of treatment,the complete remission (CR) rates of treatment group and control group were 61.5 ％ (16/26) and 48.0 ％ (12/25) respectively,the difference was not significant (P =0.404).With regard to prostecdtive efficacy,the difference was markedly significant,1-year CR rates of treatment group and control group were 53.8 ％(14/26) and 24.0 ％ (6/25) respectively (P =0.045),and 2-year CR rates were 42.3 ％ (11/26) and 12.0 ％ (3/25) respectively (P =0.027).During the follow-up of 2 years,overall 1-and 2-year overall survival rates were 73.1％ and 46.1％ in treatment group versus 52.0 ％ and 24.0 ％ in control group.During the follow-up of 2 years,the estimated mean overall survival time in treatment group was 22 months and it was 13 months in control group (P =0.018).The induction mortality rates and myelosuppression showed no difference between the two groups.Compared with control group,the side effect rate of nausea and vomiting was significantly decreased in treatment group (P =0.025).Conclusion The CAG regimen combined with thalidomide is effective with little side effects for elderly AML,and is worthy of further study and clinic application.

Objective To find a new way to promote the regeneration of injured peripheral nerve after surgical repair, and to interpret its application and advantages. Methods Eighty adult male Wistar rats with sciatic transplantation were divided into group A(control group) and group B(exponential curve electric stimulus group). The effect of pace, hair and unfold claw reflex were observed, and the sciatic nerve function index(SFI), nerve conduction velocity, wet weight of triceps surae were measured at different time. The curative effects of two groups were compared statistically. Results The group of exponential curve electric stimulus had positive effect on the recovery of nerve conduction velocity, the slower of the denervated disuse of triceps surae, the recovery of SFI, the acceleration of distal nerve degeneration, at last promote the injured nerve regeneration and the good recovery of function. The group of exponential curve electric stimulus is of significant difference statistically with the control group. Conclusion Exponential curve electric stimulus can promote the injured nerve regeneration.