Objective To understand the influencing factors of job satisfaction degree among community nurses in Qiqihar city.Methods Using stratified systematic cluster sampling method,we conducted self-administered questionnaire,results were subsequently analyzed.Results Logistic regression analysis was introduced,influencing factors of job satisfaction degree included work location,age,marital status,professional title,properties of jobs,monthly income and work length.Conclusions The government should pay attention to community health care services,gasp the situation of job satisfaction degree of community nurses timely,take innovative measures,improve job satisfaction degree of community nurses,stabilize community nursing teams and promote the development of community health services.

Objective To investigate the clinical outcomes of proximal femoral nail antirotation (PFNA) Ⅱ in the treatment of femoral intertrochanteric fractures.Methods From January 2011 to June 2016,240 patients with intertrochanteric fracture were treated at our department.They were 132 males and 108 females,aged from 30 to 106 years (average,71.4 years).Of them,168 cases were older than 70 years.According to AO classification,21 patients were of type 31-A1.1,15 of type 31-A1.2,27 of type 31-A1.3,39 of type 3 1-A2.1,51 of type 3 1-A2.2,32 of type 3 1-A2.3,12 of type 3 1-A3.1,23 of type 3 1-A3.2 and 20 of type 31-A3.3.The time from injury to surgery in this series ranged from 38 to 140 hours,averaging 52 hours.All the patients were treated by fixation with PFNA Ⅱ.Results The average operating time was 45 min,average operation incision 5 cm,and average blood loss during operation 85 mL.Primary wound healing was achieved in 239 patients,and one patient developed postoperative incision infection which was cured after implants were taken out and debridement was carried out 8 weeks after operation.This group obtained an average follow-up of 31.5 months (from 6 to 51 months).Primary fracture healing was achieved in 235 patients after 6 to 23 weeks (average,12.6 weeks);fracture healing was delayed in 5 patients after 36 to 96 weeks (average,56 weeks).There was no in-hospital mortality,and the survival rate 6 months after operation was 98.8％ (237/240).One year after operation,132 patients obtained an average Harris hip score of 85.2 (from 72 to 94).No implant-related complications or implant failure happened.Conclusions Internal fixation with PFNA Ⅱ is an effective treatment for different types of femoral intertrochanteric fractures,because it is simple and less invasive,and leads to limited complications,especially for senile patients.

ObjectiveTo summarize the early postoperation complications and treatments in children with total anomalous pulmonary venous connection (TAPVC).MethodsThirty TAPVC children who were treated with corrective operation and transferred into PICU were collected.Patients were monitored routinely for electrocardiogram,blood pressure and SpO2.The routine treatment measures included mechanical ventilation,sedation,hemostasis,positive inotropic agents,diuresis,vasodilator,antibiotics and symptomatic treatment.Adrenaline or isoproterenol was used when low cardiac output syndrome appeared and temporary pacemaker was employed in the case of bradycardia.Alprostadil and sildenafil were added instantly after corrective operation when severe preoperative pulmonary hypertension or reactive postoperative pulmonary hypertension was present.ResultsThe early postoperation complication was found in 30 cases of TAPVC,which included 13 cases of pneumonia (43.3％ ),8 of arrhythmia (26.7％ ),7 of low cardiac output syndrome (23.3％),6 of respiratory failure (20.0％ ),4 of pulmonary hypertension ( 13.3％ ),3 of pulmonary edema or atelectasis( 10.0％ ) and 1 of pneumorrhagia ( 3.3％ ).Two cases died postoperatively.The interval of stay in PICU was 1 ～ 21 d and the mean time was (5.95 ± 4.94) d.ConclusionOccurrence of respiratory complications is high among early postoperative complications of TAPVC.Therefore,preventing pulmonary infection and maintaining pulmonary function should be viewed as the key points in early postoperative monitoring and managing.In addition,more attention should also be paid on correction of arrhythmia,prophylaxis and treatment of low cardiac output syndrome and pulmonary hypertension crisis,which may improve the postoperative survival rate and care quality of TAPVC.

Background and purpose: Cerebral gliomas is one of the common brain tumors, and has a poor prognosis. Therefore, multidisciplinary treatment strategy has been much investigated recently. This study investigated the efficacy of 3 dimensional conformal radiotherapy (3D-CRT) concurrent with Temozolomide chemotherapy in the treatment of postoperative cerebral gliomas. Methods: Sixty-two patients with cerebral glioma who had residual tumor surgery after surgery were randomized into 3D-CRT group (radiotherapy group, n=31) and 3D-CRT concurrent chemotherapy group (chemoradiotherapy group, n=31) prospectively. All patients received a dose of 50-60Gy/25-30F/5-6 weeks by 6MV-X ray, 1fx/day, 5 times a week. Chemotherapy regimen was Temozolomide: 75 mg/(m~2·d),concomitantly with radiotherapy,followed by 150-200mg/(m~2·d)for 5 days,28 days per cycle for total 3-6 cycles. Results: The total response rate was 35.3% (11/31) in the radiotherapy group, and 61.3% (19/31) in the chemoradiotherapy group. The difference was significant (P=0.042). But no significant difference was observed in terms of survival in the two groups (P=0.263). Stratified analysis showed that patients with grade Ⅲ gliomas in chemoradiotherapy group had better prognosis than those in the radiotherapy group (P=0.043). Conclusion. 3D-CRT concurrent with chemotherapy can improve the survival of pathological grade Ⅲ gliomas.

OBJECTIVE:To explore the new mode of industry-university-institute unification for pharmacy professionals. METHODS:The research-teaching interactive platform was established through the principles of“complementary advantages, shared interests and mutual benefits”. RESULTS:It changed the traditional teaching mode,and it ensured the professional plan-ning,curriculum development and training objectives of students based on“4 analysis,2 setting and 1 implementation”. CONCLU-SIONS:The opportunities for cooperation between students and employers were broadened and students’awareness of innovation and entrepreneurship was enhanced. It cultivates project-based pharmaceutical,technical and skilled personnel,solves the problem of industry-university-institute unification and has certain significance for the development of China’s pharmaceutical education.

Objective To evaluate the efficacy and safety of domperidone combined with flupentix-ol,melitracen ( deanxit ) and alprazolam in the treatment of functional dyspepsia .Methods One hundred and sixty patients with functional dyspepsia were randomly divided into the treatment group ( n =80 ) and the control group ( n =80 ) .The treatment group was given domperidone combined with flupentixol , meli-
tracen (deanxit) and alprazolam, and the control group was only given domperidone for 4 weeks.The im-provement of clinical symptoms such as stomach burn ,early enough, abdominal distension, sour regurgita -tion and eructation were evaluated by clinical symptom score .Results Compared with patients in the con-trol group, the rate of marked improvement and rates of improvement for patients in the treatment group were all better ( P <0.01).Furthermore, the adverse reaction is light .Conclusion The application of domp-eridone combined with flupentixol, melitracen ( deanxit ) and alprazolam is quite effective in treating patients with FD.

The latest literature concerning operative treatment for distal radius fracture was reviewed to find out the newest developments in this field.This paper summarizes bilateral internal fixation with combined palmar and dorsal incisions,dorsal open reduction and plate internal fixation,internal fixation with LCP(locking compression plate),dorsal Pi-plate internal fixation combined with external fixators,and arthroscopic treatment of distal radius fractures,for they are reported to have reached excellent or good results.The reports show that each subtype of distal radius fractures merits a unique approach,because distinct fracture patterns result from different mechanisms of injury.

Objective To evaluate prognostic factors of patients with cerebral postoperative glioma treated with three-dimensional conformal radiotherapy (3DCRT). Methods62 patients with cerebral glioma who had residual tumor received 3DCRT. Factors such as gender, age, location of the glioma, pathological type, pathological grade, degree of surgical resection, combined chemotherapy, radiation dose, Karnofsky score before treatment were analyzed to show wether the impact on prognosis, Drawing survival curve with the Kaplan-Meier method, Log-rank test for univariate analysis and multivariate analysis were performed by using COX regression model.ResultsLast follow-up time was April 1, 2009. Median follow-up was 22 months, 43patients died. The 1-, 2- and 3-year overall survival rate were 65.7 %, 34.2 % and 20.5 %. In univariate analysis, the survival was related to age (P=0.008), pathological grade (P=0.016), degree of surgical resection (P=0.000), Karnofsky score before treatment (P =0.018). In COX multivariate modal, age (P =0.031), degree of surgical resection (P =0.000), Kamofsky score before treatment (P =0.035) were independent prognostic factors. ConclusionAge ＜40 years, Karnofsky score before treatment ≥70 and mostly resection are independent factors for predicting better survival of glioma patients.

Objective To evaluate the clinical value of choledochoscopy combined with electrohydraulic lithotripsy (EHL) for the treatment of pancreatolithiasis. Methods From October 2002 to July 2006, choledochoscopy combined with EHL was used in 11 patients with pancreatolithiasis during a dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis (EHL group). The data of these patients were compared with the data of 12 patients with pancreatolithiasis, who were treated by routine dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis from January 1995 to September 2002 (Routine group). Results The intraoperative blood loss and the postoperative rate of residual stones in the EHL group were significantly less than those in the routine group [(145.5?82.0) ml vs (406.7?384.9) ml, t=-2.201, P= 0.039; and 0% vs 41.7%, P= 0.037]. The postoperative rate of pain relief in the EHL group was higher than that in the routine group (90.9% vs 58.3%), however the difference was not significant (P=0.155). In the EHL group, 6 patients had diarrhea before the operation, 4 of them achieved relief after the surgery (4/6), which was not significantly more than that in the routine group (5/9, P=1.000). Before the operation, 7 patients in the EHL group and 9 in the routine group had diabetic mellitus; in each group, the disease was relieved in 2 patients after the operation (2/7 vs 2/9, P=0.665). Conclusions Choledochoscopy combined with EHL is effective for the treatment of pancreatolithiasis. The procedure can increase the rate of stone removal, decrease the intraoperative blood loss, and elevate the postoperative rate of pain relief.