Objective To explore the fatigue in patients with rheumatic diseases and put forward nursing countermeasures.Methods 173 patients with rheumatic diseases were investigated by Fatigue Scale-14 (FS-14) and Self-rating Depression Scale (SDS).Results The score of physical fatigue,mental fatigue and total score in the patients were 5.03±2.19,2.62±1.56,7.65±3.03,respectively,which were higher than those in healthy people (P＜ 0.01).Of the 173 patients,74 (42.8％) patients suffered from physical fatigue,52 (30.1％) patients suffered from mental fatigue,32 (18.5％) patients suffered from both.There were statistical differences in the physical fatigue and total score (P ＜ 0.01),no statistical difference in the mental fatigue (P ＞ 0.05) among the groups,which were divided according to the course of disease.There were statistical differences in the physical fatigue,mental fatigue and total score among the groups,which were divided according to the depression index (F=5.28,5.98,8.58,P ＜ 0.01).The regression analysis further showed the course of disease and depression index could positively predict the fatigue in patients with rheumatic diseases.Conclusions The prevalence of fatigue was high in patients with rheumatic diseases,the course of disease and depression influenced the fatigue in patients.Controlling deterioration of disease and relieving psychological stress would help prevent and alleviate the fatigue in patients with rheumatic diseases.

To evaluate percutaneous dilatational tracheostomy (PDT) with continuous aspiration of subglottic secretions in intensive care unit (ICU) elder patients.A total of 32 elder patients were selected randomly for PDT and 36 controls for traditional surgical tracheostomy (TST).The PDT group required regular mechanical ventilation with continuous aspiration of subglottic secretions.The operative duration was significantly shorter in PDT group than that in TST group [ ( 10.6 ±3.4)vs.(30.9 ±7.1)min,P ＜0.01].Incision length was significantly less in PDT group than that in TST group [ ( 1.3 ± 0.2 ) vs.(3.2 ± 0.3 )cm,P ＜0.01].Blood loss volume was significantly less in PDT group than that in TST group [ ( 10.4 ±3.8 ) vs.(40.7 ± 11.7 ) ml,P ＜ 0.01].The incidence of ventilator associated pneumonia (VAP) was significantly lower in PDT group than that in TST group ( 15.6％ vs.38.9％,P ＜ 0.05 ).With multiple advantages of mini-invasiveness,safety,simplicity,convenience and easier installation,PDT is quite suitable for elder patients in ICU.

Radiotherapy plays an important role in the treatment of lung cancer .Radiation-induced lung injury is a major complication in the process of radiotherapy .It is of great significance for the treatment and prog-nosis of the diseases to predict the early stage of radiation -induced lung injury in the clinical treatment .TGF-β1(transforming growthfactor-β1) can induce some inflammatory cells including lymphocytes ,neutrophils,mon-ocytes ect,contributing to the formation of fibrosis .Plasma TGF-β1 shows different levels followed different sta-ges of radiation-induced lung injury .This article reviews the value of cytokine TGF -β1 in predicting the radia-tion-induced lung injury over various aspects such as singlely used ,combined with radiation physics and other cytokines,and genomics.

Objective To investigate the safety and efficacy of intravenous ibandronale in treating glucocorticoid-induced osteoporosis. Methods One hundred and fifty-three glucocorticoid-induced osteoporosis patients were randomly divided into three groups: (1)control group (C group, 49 patients). (2) ibandronate group (1 group, 52 patients): Patients received intraveous injection of ibandronate (2 mg)once three mouths. (3)alfacaleidol group (R group, 52 patients): 0.25 ?g Rocaltrol once a day for six months. Each patient of the three groups received a daily 600 mg calcium supplement for six months. The efficacy was assessed by determining the subsequent change in bone mass density (BMD) of lumbar spine and femoral neck, intact parathyroid hormone (iPTH), serum calcium, serum phosphorus, serum alkaline phosphatase (AKP). Results (1) At the end of the trial, there was a significant increase of BMD of lumbar spine and femoral neck in I group and R group compared with the C group (P

Hydrocephalus is a common disease caused by the disorder of the physiological metabolism of cerebrospinal fluid.The damage mechanism is abnormal expansion of the ventricular system and impairment to the surrounding brain tissue.Hydrocephalus in children can show individual clinical symptoms along with the age of onset and different causes,leading to brain growth retardation.It is particularly important to understand its pathogenesis and etiology and put forward targeted treatment strategies by early diagnosis.This paper reviews the pathophysiology,etiology and characteristic manifestations of hydrocephalus in children.

Objective:To explain the supplier induced demand theory paradigm,track the empirical research progress,so as to provide references for health care reform in China.Methods:The new classical theory,game theory and behaviorism school were launched to process theoretical derivation of induced demand.The classical empirical research and the latest research progress were introduced to systemically review on supplier induced demand.Results:The generation of supplier induced demand was related with incentive system,the type of diseases and the crowd of research.Conclusion:It could effectively reduce the induced demand for health care that constraining hospital internal incentive,conducting medical supply side structural reform,developing the “Internet +medical” and building Diagnosis Related Groups (DRGs) payment system.

[Objective]Summary of the experience of Professor LIU Wenqiong in the treatment of leukoplakia vulvae of the aged.[Method]By using the method of the collection and collation of Professor LIU Wenqiong in the treatment of elderly patients with leukoplakia vulvae case,and combination with the related discussion of ancient.This paper summarizes the experience of Professor Liu in the treatment of leukoplakia vulvae of the aged from the etiology and pathogenesis,treatment based on syndrome differentiation,prescriptions and so on,and for proven cases.[Results]Professor LIU Wenqiong thinks that the root of the disease is mainly characterized by the dysfunction of Zang Fu organs and deficiency of qi and blood,the brounch of the disease is characterized by endogenous wind disturbance.Organs are mainly related to liver and kidney.The type of syndrome is yin deficiency of liver and kidney and blood deficiency and wind dryness.The treatment is mainly nourishing liver kidney yin,followed by eliminating wind and relieving itching,and combinating with traditional Chinese external washing medicine for local administration.It lists a successful case,and reflects that Professor LIU Wenqiong has great skill to make prescription accuratedly.Effect is significant.[Conclusion] The clinical experience of Professor LIU Wenqiong in treatment of leukoplakia vulvae is effective,and she provides ideas and methods for the treatment of this discase,which has the value of popularization and application in clinical practice.

Emodin is the main effective monomer of Rhubarb, which has a variety of pharmacological actions and valuable clinical applications.Recently, there are many reports about molecular mechanisms of emodin pharmacological actions,and they givehighly attention on the dephlogisticating and antineoplastic effects. These effects are achieved through affecting the concentration and transportation of ions, resisting of oxidation and free radical, and affecting the secretion of inflammatory factor and the enzyme activity and apoptosis and so on. This article summarizes the reports and hopes to provide theoretical basis for the practical application.

AIM:To investigate LPS(lipopolysaccharide)stimulated cytokine secretion from normal rat kupffer cells in vitro. METHODS: Kupffer cells were isolated from wistar rats liver and cultured. Tumor necrosis factor - α (TNF- α) and endothelin- 1 (ET- 1 ) secreted by LPS stimulated kupffer cells were detected. RESULTS: LPS had an stimulative effect on kupffer cell activity. LPS in definite concentrations promoted kupffer cell secretion. CONCLUSION: LPS promotes kupffer cell secretion, which may be associated with liver injury induced by LPS.

Erythrocytes were frozen with DMSO of different concentrations (not over 20%) as a cryoprotec-tive agent in freezers of different temperatures.The rate of temperature drop was not controlled. Of the erythrocytes actually frozen, the average recovery rate after thawing was 91.3 per cent (range 87.5~ 95%). The average survival rate of erythrocytes stored at -20℃, -30℃, or -80℃ for up to eight months was 90.9 per cent (range 88.2~ 94.5). As compared with glycerol, which is in common use internationally, DMSO seems to be a better cryoprotective agent.