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.

[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.

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.

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.

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.

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 -? (TNF-?) 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.

Objective To inspect the rate of success of anastomosis and tissue damage with different power levels of photocoagulation in the treatment of experimental branch retinal vein occlusion (BRVO) by laser induced chorioretinal venous anastomosis. Methods Forty pigmented rabbits (80 eyes) were divided into four groups in random, and 10 (20 eyes) in each. Chroioretinal venous anastomosis was attempted to create using the krypton red laser with 4 different power levels (group A: 400 mW,group B: 600 mW,group C: 800 mW,group D: 1000 mW) in these animals in which BRVO had previously been created photodynamically. Fundus photography and fundus fluorescein angiography were performed at various times after the treatment and histological examination was taken at the end of the study. Results The model of BRVO was successfully set up. At the lowest power of 400 mW there was an absence of anastomosis formation and the damage to the retina and choroid was mild, Bruch′s membrane showed no evidence of rupture. At the power levels of 600 mW and 800 mW an anastomosis formed in 15% and 55% respectively and the damage was medium in degree. At the highest power level of 1 000 mW a 80% rate of success was obtained, however, the damage to the retina and choroid tended to be severe. The difference of the rate of success of anastomosis between different groups was highly significant ( P =0 001), the difference between group B and group C was also highly significant ( P BC =0.008), and the difference between group A and group B, group C and group D was not significant ( P AB =0 072、 P CD =0 091). Conclusion The optimal power level of krypton red laser induced chorioretinal venous anastomosis is 800 mW, 0.1 s, 50 ?m in our study.

Objective To compare the differences between three kinds of reconstruction methods of the multi-planar spiral CT in diagnosing fractures of skull base , in order to appraise fractures of skull base in forensic medical examinations. Method 40 cases with suspicious basio-cranial fractures after cranio-cerebral trauma were examined by multi-planar spiral CT scanning. The data were imported into workstation for ax-ial scanning, multi-planar reconstruction (MPR) and 3D-reconstruction (using SSD). Results In 24 cases with anterior fossa fractures, 9 cases were found by axial scanning, 24 cases by MPR, 9 by SSD. The comparison between these groups showed significant statistical difference (P

Objective To investigate clinical effect of surgical treatment for spinal stenosis with lumbar degenerative de novo scoliosis with spinal stenosis.To discuss selection of operation methods and ranges of fusion.Methods 27 patients of degenerative scoliosis with spinal stenosis were treated by oper-ation.We performed posterior decompression on the segments and selected fusion,then performed correc-tion deformity.Measured Cobb 's angle,lumbar lordosis angle,the distance between C7 plumb line (C7PL),upper edge of S1 vertebral body(SVA),and the distance between C7PL and center sacral verti-cal line(CVA)after operation and final follow up were compared with preoperative data.JOA score system were used to evaluate clinical effects.The SF-36 questionary was used to evaluate the patients'life quality before and after operation as well.Results All patients were followed up with an average of 20 months. Preoperative,postoperative and final follow up,Cobb's angle was(22.1 ±10.5 )°,(10.2 ±7.3)°and (10.4 ±4.8)°,respectively;lumbar lordosis angle was(21.2 ±10.3)°,(25.7 ±12.2)°and(25.3 ± 12.3)°,respectively;SVA was(7.5 ±6.1)cm,(0.6 ±3.1)cm and(0.5 ±2.4)cm,respectively;CVA was(6.9 ±5.3)cm,(2.8 ±1.3)cm and(2.9 ±1.2)cm,respectively.There was significant difference in data before and after operation(P >0.05).JOA score was 10.8 ±1.4,21.3 ±2.4 and 23.5 ±2.3,re-spectively;All domains of SF-36 score were significantly improved postoperatively(P <0.05).Conclu-sion For surgical treatment with limited decompression,pedicle screw fixation and fusion will be effective methods for degenerative scoliosis with spinal stenosis,individualized surgery design should be made ac-cording to clinical symptoms,signs and imaging features.