Objective To identify the framework of Beijing midwives' core competency.Methods A semi-structure interview was developed by using the framework of the International Confederation of Midwives (ICM)as a guideline,questionnaires were distributed to 14 Beijing midwife professionals.Content template analysis was conducted and the template was based on the ICM's framework.Results Five critical components were identified as representing midwives' core competency.Condusions The critical components for constructing Beijing midwives' core competency are some what similar to the ICM's framework,and the different components were health care before pregnancy and competence of community health care.

Objective To evaluate the reliability and validity of Midwife Core Competency Scale.Methods A total of 369 midwives from 32 hospitals in Beijing were investigated by using the Midwife Core Competency Scale,and the reliability and validity were measured.Results The scale had good internal consistency (Cronbach's α =0.950) and stability (the test-retest reliability was 0.832).The distribution of 54 items in 6 public factors (the cumulative variance＝68.405％) extracted from them was consistent with the original scale,yielding an acceptable construct validity.The scale also had good validity to discriminate different categories.Conclusions The Midwife Core Competency Scale had good reliability and validity,which provides an useful tool to evaluate midwifes' core competency.Larger sample from different areas need to be considered for scale improvement and application.

Objective To investigate clinical characteristics and psychological problems of patients with severe acute respiratory syndrome,and to study the effects of drug therapy and psychological intervention.Methods To analysis clinical characteristics and psychological qustioniare results.Results Fifty-one patients (male twenty-nine,female twenty-two,age range 15～68,average age (33 2?8)were analysed.Clinical symptoms were fever(96 1%),muscle pain and fatige(80 4%),cough 56 9%,chest distress and short breath(25 5%),dizziness and headeache(27 5%),diarrhea(3 9%).Psychological questionare results were depression and anxiety(90 2%),sleepless (51 2%),anorexia (31 7%),despair of disease (34 1%),restlessness (65 9%),fear unjustified attitude of other people after discharge (61 0%).Anti-viral drugs were used in 84.0% of the patients (ribavirin 0 4～1 2gram/day,clinical course 7～15 days).Antibiotics were used in 70 0% of the patients,mainly azithromycin and levofloxacin.Glucocortical steroid was used in 57 0% of the patients,mainly methylprednisolone 40～320 microgram per day with clinical course 3～15 days.Psychological intervention include such therapies as supporting,recognition,drug-assiting, suggestion, telephone talking etc.all of the patients were cured and discharged.Conclusion Comprehensive drug-therapy,especially glucocortical steroid was effective,psychological intervention was an important assisted therapy

Objective To study the expression and significance of CD44v6 and E-Cadherin( E-cd) in human renal cell carcinoma. Methods Immunohistochemical method was used to detect CD44v6 and E-cd expression in 20 normal renal tissues and 72 primary renal cell carcinoma tissues. Results The postive expression rate of CD44v6 in normal renal tissues and primary renal cell carcinoma tissues was 15 00% and 66 67% respectively with significant difference (P

Aged ; Female ; Hemangioma ; Humans ; Nose Neoplasms ; Turbinates

PurposeTo evaluate the curative effect and possibility of the intraarterial chemotherapy followed by radical hysterectomy for locally advanced cervical cancer. Methods59 patients with FIGO stage lb-IV cervical cancer were enrolled and the tumor size with stage lb and Ua must be more than 4 cm. Treatment consisted of bilateral internal iliac artery infusion of cisplatin 80 rog, 5-Fu 1 500 rog, and AT1258 60 mg for 1 - 3 courses separated by 3 weeks. The tumor size was measured by vagina ultrasonic and CT before and after chemotherapy to calculate the shrunk size percent. All patients underwent radical hysterectomy. Patients with disease in the vagina, parametrium, pelvic lymphnodes or microscopic tumor emboli were followed postoperative pelvic irradiation. Results59 patients underwent 122 courses of intraarterial chemotherapy for 1 - 3 courses each. The total response rate was 95 %. Complete response (CR) was achieved in 18 of 59 patients (31%) ,while a partial response (PR) was noted in 38 (64%) and stable disease (SD) in 3 (5% ). No patient had progressive disease. 14 patients with pelvic lymphnode metastasis were all found to have PR and SD. No patient had lymphnode metastasis in CR. Of 18 patients with CR, 17 patients had not recurrence. Only one patient with stage lla recurred 20 months after operation. But he also cured. All 18 patients with CR were living free of disease. But 3 in 38 patients with PR died and 3 patients with SD were all died. There were no severe complications related to intraarterial chemotherapy and radical hysterectomy. Conclusionslntraarterial chemotherapy before operation can shrink tumor size, decrease the lymphnode metastasis. It is feasible in helping elevating cure rate of patients with locally advanced cervical cancer who are at high risk for failure with conventional treatment.

OBJECTIVE:To observe clinical efficacy and safety of Jiedu xiaoyu cream combined with Glucosamine potassium sulfate capsules in the treatment of knee osteoarthritis. METHODS:196 patients with knee osteoarthritis were randomly divided in-to observation group and control group,with 98 cases. Both group were given Glucosamine potassium sulfate capsules 0.5 mg/time, bid;observation group additionally received Jiedu xiaoyu cream for local use,once a week;control group additionally received Di-clofenac diethylamine emulsifiable paste for local use,bid. A treatment course lasted for 2 weeks,and both groups received 3 cours-es of treatment. Clinical efficacy,VAS scores,WOMAC scores and ADR of 2 groups were observed. RESULTS:The total effec-tive rate of observation group was 94.7%,which was significantly higher than that of control group(88.3%),with statistical sig-nificance(P<0.05). Compared with before treatment,VAS and WOMAC scores of 2 groups decreased obviously,with statistical significance(P<0.05);the decrease of observation group was more significant than that of control group,with statistical signifi-cance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Jie-du xiaoyu cream combined with Glucosamine potassium sulfate capsules has good clinical efficacy in the treatment of knee osteoar-thritis,can relieve knee pain and improve the function of activity.

BACKGROUND:Mesenchymal stem cels can secrete a variety of cytokines and growth factors that promote the survival of surrounding cels and play a paracrine role. OBJECTIVE:To investigate the effect of human umbilical cord mesenchymal stem cels on the proliferation and apoptosis of ectopic endometrial cels. METHODS:After isolation and culture, human umbilical cord mesenchymal stem cels and ectopic endometrial cels were co-cultured as observation group, and ectopic endometrial cels cultured alone served as control group. At 24, 48, 72 hours of culture, the proliferation and apoptosis of ectopic endometrial cels were detected by MTT and flow cytometry, respectively; RT-PCR was used to measure the expression ofPTEN gene in ectopic endometrial cels. RESULTS AND CONCLUSION:At 24, 48 and 72 hours, the proliferation of ectopic endometrial cels in the observation was inhibited significantly as compared with the control group, and the hypodiploid peak ratio also increased significantly (P < 0.05). Over time, the cel inhibition rate was gradualy declined, and there were significant differences at different time points (alP < 0.05). Compared with the control group, the expression of PTEN gene was up-regulated significantly in the observation group (P < 0.05). In the observation group, the expression ofPTEN gene at 48 and 72 hours was significantly higher than that at 24 hours (P < 0.05). These findings indicate that in the human umbilical cord mesenchymal stem cels can inhibit the proliferation of ectopic endometrial celsin vitro and promote their apoptosis by up-regulation ofPTEN mRNA expression.

Objective To study the frequency and characteristics of secondary monoclonal gammopathy of undetermined significance(sMGUS) in multiple myeloma (MM),and analyze the impact on survival.Methods The data of 515 patients with MM admitted were analyzed retrospectively.73 cases of patients underwent stem cell transplantation and 442 patients received thalidomide or bortezomib based chemotherapy.Immunofixation electrophoresis(IFE) and clinical characteristics were respectively analyzed,and the comparison of survival between sMGUS group and non-sMGUS group was performed.Results Thirty-five cases (6.8 ％) of myeloma patients with sMGUS were found in all patients.The incidence of sMGUS after hematopoietic stem cell transplantation treatment is significantly higher than that of receiving chemotherapy (19.2 ％ versus 4.8 ％,x2 =20.587,P =0.002).The CR rates of sMGUS group and non-sMGUS group were 45.7 ％ (16/35) and 14.3 ％ (59/480) (x2 =22.961,P ＜ 0.001).The median survival time of patients with sMGUS was much prolonged compared with the control cohort (42.0 versus 14.0 months,P ＜ 0.001).However,when the analysis was restricted on patients underwent stem cell transplant,patients with sMGUS had a negative impact on outcome,and the median overall survival was 30.8 and 39.3 months (P =0.002).Conclusion The sMGUS may be attributed to either immune reconstitution or immune system dysregulation after highly immunosuppressive therapy.The incidenceof sMGUS after auto-SCT treatment is higher than chemotherapy.The sMGUS group has the higher response rate and longer survival.But for auto-SCT treatment patients,sMGUS may be not a good prognostic factor.

Objective To investigate the clinical effectiveness and safety of acupuncture at Zusanli (ST36),Taichong(LR3) and Hegu(LI4) points combined with three-step analgesic ladder for the treatment of gastric cancer pain.Methods Sixty patients with moderate and severe pain induced by gastric cancer were randomly divided into study group and control group,30 cases in each group.The study group was treated with acupuncture at Zusanli,Taichong and Hegu points combined with three-step analgesic ladder for gastric cancer pain management,and the control group was treated with three-step analgesic ladder only.After treatment for 7 days,the clinical effectiveness was evaluated with the average pain scores of Numerical Rating Scale(NRS),Quality of Life Scale(QOL-BREF by WHO),Self-rating Depression Scale(SDS).And the incidence of adverse reaction was also observed.Results (1) After treatment,the markedly-effective analgesic rate of the study group was higher than that of the control group (P ＜ 0.05).(2) After treatment,QOL scores of both groups were much improved as compared with those before treatment(P ＜ 0.05),and the improvement of the study group was superior to that of the control group(P ＜0.05).(3) The depression scores of both groups were much improved after treatment (P ＜ 0.05 compared with those before treatment),but the difference between the two groups was insignificant(P ＞ 0.05).(4) The incidence of adverse reaction of the study group was lower than that of the control group(P ＜ 0.05).Conclusion The effect of acupuncture at Zusanli,Taichong and Hegu points combined with three-step analgesic ladder is better than three step analgesic ladder alone for the treatment of gastric cancer pain.