Informed consent is one of the basic rights of patients.Nowadays it is very difficult to implement sufficiently in health care practice.The article analyzes the relative factors affecting the enforcement of the right of informed consent.from the point of law and ethic as well as psychology.

Objective To evaluate the effectiveness of biofeedback for anxiety patients by carrying out a Meta-analysis.Methods We searched CNKI,VIP,CBM(1989 to 2013) to identify relevant randomized-control trials applying biofeedback for anxiety patients.We used Review Management (RevMan) 5.0 software (provided by the Cochrane collaboration) to conduct Meta-analysis.Results We included 11 studies.Meta-analysis for the biofeedback group vs.the control group showed that biofeedback was significantly superior to control (SMD=-3.00,95％CI:-4.40～-1.61); Meta-analysis for the biofeedback plus drug group vs.drug group showed that biofeedback plus drug was significantly superior to drug (SMD=-1.33,95％CI:-1.82～-0.85).Conclusions We found evidence that biofeedback (applying alone or combined with drugs) is effective in improving anxiety symptom.But all the studies had methodological limitations,our conclusion needs further studies with strict design,high quality and consistent assessment tools to be expounded and proven.

AIM To study the effects of matrine (Ma) on the action potential and contractile force in guinea pig papillary muscles. METHODS Conventional microelectrode technique was used to record the fast action potentials (FAP) and slow action potentials (SAP) induced by histamine and BaCl_2 of guinea pig papillary muscles. RESULTS Ma 10,25,50 ?mol?L -1 dose-dependently prolonged the action potential duration at 50%, 90% repolarization (APD_ 50 , APD_ 90 ) and effective refractory period (ERP) of FAP, and lengthened the APD_ 50 , APD_ 90 of SAP induced by histamine and BaCl_2 when perfused with KCl 25 mmol?L -1 Tyrode's solution. The maximal upstroke velocity (V_ max ) of FAP, SAP and contractile force (Fc) were not affected by matrine 10,25,50 ?mol?L -1 . CONCLUSION It was suggested that Matrine could block K + channels in the myocardium.-

OBJECTIVE:To evaluate the economic effectiveness of different pharmacotherapeutic schemes for peptic ulcer and chronic gastritis with infection of Helicobacteria pylori(Hp) METHODS:To perform cost-effectiveness analysis of three ther_apeutic schemes for Hp infection RESULTS:The cost-effectiveness ratios of three therapeutic schemes were 8 71,10 12 and 13 99 CONCLUSION:Scheme A(omeprazole+amoxicillin+clarithomycin) is the best one

OBJECTIVE:To compare therapeutic efficacy and safety of laparoscopy combined with dienogest and laparoscopy combined with dienogest and TCM in the treatment of endometriosis. METHODS:126 endometriosis patients were selected and divid-ed into control group and observation group,with 63 cases in each group. Control group received combined with dienogest(25 mg/time,qd);observation group was additionally given TCM on the basis of control group. Therapeutic efficacy,recovery time of ovula-tion,menstrual recovery time and ADR were compared between 2 groups,and recurrence and pregnancy of them were followed up for 2 years. RESULTS:The total effective rate of observation group (93.65%) was significantly higher than that of control group (80.96%),with statistical significance (P<0.05). The menstrual recovery time and recovery time of ovulation in observation group were significantly shorter than control group,with statistical significance (P<0.05). The incidence of ADR in observation group (9.52%)was significantly lower than control group(26.98%),with statistical significance(P<0.05);the recurrence rate of observa-tion group (4.76%) was significantly lower than that of control group (17.46%),with statistical significance (P<0.05). In 2-year follow-up,there were 23 pregnancy patients in observation group,which was significantly higher than that of control group (9 cas-es),with statistical significance (P<0.05). CONCLUSIONS:Laparoscopy combined with dienogest and TCM in the treatment of endometriosis have better clinical effect,higher safety and lower recurrence rate. The patients are easily pregnant.

Objective To investigate the effects of eye movement desensitization and reprocessing (EMDR) versus cognitive behavior therapy (CBT) for treating adult posttraumatic stress disorder (PTSD) .Methods A total of 81 patients with PTSD con‐forming to the including standard were randomly allocated to the EMDR group ,CBT group ,and control group ,27 cases per group . The PTSD symptoms ,anxiety and depression moods in 3 groups were assessed before and after treatment by adopting the Clinician‐administered PTSD Scale (CAPS) ,Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) .Results The drop‐out rates were 29 .63% for the EMDR group ,7 .41% for the CBT group and 7 .41% for the control group respectively ;the re‐experience symptoms score of CAPS in the EMDR group was lower than that in the CBT group with statistical difference (P=0 . 036) .Conclusion Both EMDR and CBT are the effective psychological therapeutic method ,EMDR has more effective than CBT in the reproving the re‐experience symptoms of PTSD .The future studies should pay more attention to the application of stabilization technologies for reducing the dropout rate of EMDR .

Objective To evaluate the role of poly (ADP-ribose) polymerase 1 (PARP1) in spinal cord in a rat model of neuropathic pain.Methods One hundred and eighty male Wistar rats weighing 180-220 g were randomly divided into 4 groups( n =45 each): sham operation group(group S),neuropathic pain group (group NP),siRNA negative control group (group NS) and PARP1-siRNA group (group PS).Neuropathic pain was produced by L5 spinal nerve ligation (SNL).Viral of PARP1-siRNA or viral of siRNA negative control was injected intrathecally after SNL in groups PS or NS.Mechanical pain threshold was determined at 3,7 and 14 d after SNL.Then the rats were sacrificed and L5 lumbar spinal tissues were removed for determination of coexpression of PARP1 with glial fibrillary acidic protein (GFAP) (by immunohistochemistry double stain),protein expression of PARP1 and GFAP (by Western blot),and mRNA expression of PARP1 and GFAP (by RT-PCR).Results Compared with group S,mechanical pain threshold was significantly decreased and the protein and mRNA expression of GFAP and PARP1 up-regulated in groups NP,NS and PS( P ＜ 0.05).Compared with groups NP and NS,mechanical pain threshold was significantly increased and the protein and mRNA expression of GFAP and PARP1 down-regulated in group PS (P ＜ 0.05).There was no significant difference in above indexes between groups NP and NS(P ＞0.05 ).PARR1 was expressed in the astrocytes in the spinal cord.Conclusion PARP1 is involved in the formation and maintainance of neuropathic pain in rats via activating astrocytes.

Purpose　To study the effects of trihexyphenidyl (THP) on levels of monoamine neurotransmitters in the cerebral cortex after subarachnoid hemorrhage (SAH).　Methods　SAH model of rats were used,the levels of norepinephrine (NE),dopamine(DA),5-hydroxytrypatamine (5?HT) and hydroxyindoleacetic acid (5?HIAA) were measured by flurospectrophotometry.　Results　There was an extensive increase in levels of NE (P<0.01),5?HT (P<0.01) and 5?HIAA (P<0.01) in the cerebral cortex after SAH,DA had a tendency to increase without significance.The increase in levels of NE (P<0.01),5?HT (P<0.01) and 5?HIAA (P<0.05) in the cerebral cortex after SAH could be effectively inhibited by THP.　Conclusions　There will be a remarkable increase in levels of NE,5HT and 5HIAA in the cerebral cortex after SAH,THP could significantly ameliorate the metabolic disorder of NE and 5HT after SAH

Objective To explore impact of nursing intervention on the adverse reaction of patient con-trol epidural analgesia (PCEA) after abdominal operation. Methods 258 patients underwent PCEA after ab-dominal operation were selected from 2006 to 2007. The clinical data of 126 patients without nursing interven-tion were analyzed as the control group admitted to our hospital from January to December, 2006 and compared with those of 132 patients receiving nursing intervention as the experimental group from January to December, 2007. The control group was managed by the anesthetists and nurses only conducted routine nursing instruction, while the experimental group was given systematic and normative nursing intervention besides routine nursing instructions, including psychological intervention, behavioral intervention, close observation, of discovery of ad-verse reaction in time and giving early disposal. The incidence of adverse reaction of PCEA of the two groups such as urinary retention, nausea and vomiting, abdominal distension, skin indentation, catheter shedding, skin itching, numbness of lower limbs, respiratory depression was observed. Results Compared with the control group,the incidence of adverse reactions of PCEA in the experimental group such as urinary retention,nansea and vomiting, abdominal distension,skin indentation,catheter shedding was significantly lower. Conclusions The implementation of nursing intervention can reduce the adverse reaction of PCEA after abdominal operation, alle-viate the suffering of patients, and promote functional recovery and the body rehabilitation.