Objective To study the application of the intelligent optimum tube voltage ( Care kV) combined with automatic tube current ( Care Dose 4D) technique in dual source CT scanning for the abdomen .Methods 180 adult patients underwent whole abdominal CT examination from February 2016 to March 2016 of were selected as the retrospective research objects .On the basis of reference mAs of the image quality the patients were divided into three groups using completely randomized grouping method with 60 patients in each group, such as 250 mAs group, 200 mAs group, and 150 mAs group.The other scanning parameters and image reconstruction parameters were the same .The liver parenchyma CT values and image noise( SD) at the second hepatic portal level were measured .The signal-to-noise ratios ( SNR) in the three groups were compared as well as contrast to noise ratio ( CNR ) , noise ( SD ) , the average volume CT dose index (CTDIvol), dose length product (DLP) and effective dose(E).Results The kV and mAs values in the plain scan , arterial phase scan and portal phase scan in the three groups of patients had statistically significant differences(F=35.25, P<0.05).With the reducing of the refference mAs, the frequency of choosing lower kV in three groups of patients increased gradually .The CTDIvol, DLP and E of plain scan, arterial and portal phase in three groups of patientshad significant difference (F=31.51, P<0.05).With the decline of the reference mAs, the radiation dose decreased gradually , with 150 mAs group lowest.The SNR, CNR and noise of three phases in 250 mAs group and 200 mAs group had no statistically significant difference (F=1.61, P>0.05).In 250 mAs group and 150 mAs group, the SNR and the noise of plain scan and arterial phase images had no statistically significant difference ( F=1.98, P>0.05) , and SNR of portal phase images and CNR of three phases had statistically significant difference (F=27.64, P<0.05);In group 200 mAs and group 150 mAs, the SNR, CNR and noise of plain scan and arterial phase images had no statistically significant difference (F=1.95, P>0.05), and the SNR and CNR of portal phase images had significant difference (F=19.63, P<0.05).Conclusions For the combined use of Care kV and Care dose 4D,it is feasible to select appropriate reference mAs in reducing radiation dose without sacrificing imaging quality .

Objective:To investigate and explore the science management mode for high- value medical consumables in order to solve the problem of management deficiency in purchase and using of high-value medical consumables.Methods: To strengthen the management for high value consumables on 5 aspects: systematized institution, normalized processes, standardized operation, scientific evaluation and informationalized management.Results:The normalized, standardized and programmed management mode for high-value medical consumables has been established and improved throughout the whole process monitoring and management of total life cycle for the consumables. This research normalized the management for these consumables and formed a new science management mode.Conclusion: The exploration and implementation of new management method and path for medical high-value consumables can effectively improve the level of hospital material management, reduce management loopholes, decrease the cost of high-value consumables and increase work efficiency.

Objective:To analyse the actual position of denture base and its relationship with the anatomic marks of alveolar ridge. Methods:According to the standardized process,10 sets of complete dentures were fabricated for edentulous patients by taking func-tional impression.Before and after completion of denture fabrication,trial wearing and full adjustment one week after application,the margin extension,thickness and form of the denture bases were measured.The relationship of denture base outline with anatomic marks of alveolar ridges was observed.Results:The most adjusted regions of upper and lower complete denture bases were hamular notch area,buccal shed area,far middle buccal corner region and retromylohyoid ridge area(P <0.05).Buccal outline of mandibular base was consistent with the external oblique ridge and the base edge corresponding to masseter muscle attachment in far middle buccal corner region was excluded from the base.Lingual outline was relieved in area of lingual frenum and was consistent with mandibular torus.Conclusion:Denture base is easily over extended in hamular notch area,buccal shed area,far middle buccal corner region and retromylohyoid ridge area.

Objective To explore the relationships among psychological empower, role stressors and job burnout in nurses.Methods From February to October of 2014, by random sampling method, 420 nurses from three hospitals of Jinzhou city of Liaoning province were selected and assessed with the psycho-logical empower questionnaires,the job burnout questionnaire,role stressors questionnaire.The data were ana-lyzed using pearson correlation analysis and logical multiple linear regression analysis.Results The average score of job burnout was (59.58±18.30) points, the average score of psychological empower was (38.87±7. 05) points.Job burnout and each dimension were negative correlated with self-determination of the psycho-logical empower ( r=-0.25--0.34, P<0.05) and self-efficacy ( r=-0.08--0.53, P<0.05).The scores of role stressors were positively correlated with the scores of emotional exhaustion( r=0.17-0.43, P<0.05) and cynicism ( r=0.07-0.46, P<0.05) .Multiple regression analysis showed that age(β=-0.104) ,education lev-el(β=-0.237),seniority(β=-0.334),self-determination(β=-0.152),self-efficacy(β=0.127),role am-biguity(β=0.284),role overload(β=0.325) were influencing factors of nursing burnout.Conclusion -Nurses role stressors and psychological empower can predict nurses’ burnout, so nurse managers can in-crease the level of authority to relieve psychological job burnout by reducing caregiver stress source.

OBJECTIVE:To observe the clinical efficacy of insulin glargine versus intermediate-acting insulins(NPH)injected subcutancously at bedtime in initial diabetes mellitus cases.METHODS:64 initial type 2 diabetes mellitus cases were assigned to insulin glargine group(A)or NPH insulin group(B).Both groups were subcutancously injected with short-action insulin on the basis of alimentary control and a certain amount of activity.Comparison was made between the two in respect of fasting blood glucose(FBG),duration of glycemic control,glycemic excursion,hypoglycemic incidence and total daily insulin dose.RESULTS:FBG,duration of glycemic controlling,glycemic excursion and hypoglycemic incidenc were lower in glargine insulin group than in NPH group(P

Concerning the dilemma between legal and ethical issues in the evolution and development of agential maternity for infertile women,this paper focuses on related ethical issues,including moral conflicts,rights and obligations,and moral evaluation,etc.The realistic value of agential maternity is also explored.

Helicobacter pylori infection is a common gastrointestinal infection,which is a major cause of chronic gastritis,peptic ulcer,stomach cancer and gastric mucosa-associated lymphoid tissue lymphoma and other diseases.In recent years,many studies show that Helicobacter pylori infection is closely related with many diseases,which may cause the retardation of children development and affect blood lipids and glucose metabolism.Helicobacter pylori infection may also lead to chronic inflammatory process,results in a large number of cytokines and play an important role in artery atherosclerosis.This paper reviews on the correlation between Helicobacter pylori infection and metabolic diseases and its mechanism as well.

Objective To investigate the effect of ipratropium bromide combined with budesonide /formoterol fumarate inhalation powder on serum FeNO and lung function of bronchial asthma patients.Methods 102 cases with clear bronchial asthma during Jan 2013 and Mar.2015 from the affiliated Qianfo Hill Hospital of Shandong University were randomly divided into three groups, control group A (34 cases) were treated with ipratropium bromide, control group B (34 cases) were treated with budesonide/formoterol fumarate powder, experiment group (34 cases) were given ipratropium bromide combined with budesonide/formoterol fumarate powder, all groups were treated for 6 months.Pulmonary function, serum FeNO and IgE levels, clinical efficacy were compared after treatment.Results The effective rate of control group A, B (70.59%, 67.65%) were significantly lower than experiment group (91.18%), the difference were significant (P<0.05).FEV1, FVC, FEV1%pre of experiment group were significantly higher than control group A and B after the treatment.Serum IgE and FeNO concentration were significantly lower than control group A, B, the difference were significant ( P<0.05 ) .Conclusion Ipratropium bromide combined with budesonide/formoterol fumarate powder for inhalation in bronchial asthma patients can effectively reduce FeNO concentration, improve lung function.

After major operation,a series of complicated pathological and physiological changes will occur during the trauma and stress state.The protein synthesis is affected,which results in negative nitrogen balance.In addition,the release of inflammatory factors can damage the capillary endothelial cells and increase the permeability of micrangium,induce vascular colloidal albumin leakage to the extravascular tissue,decrease plasma albumin,make wound edema,eventually lead to postoperative hypoproteinemia.Except for albumin supplement,it should be aimed at the mechanism to control the stress response and reduce the leakage caused by the release of inflammatory factors to solve this problem radically in clinical work.The reports about the causes and treatment of hypoproteinemia after major surgery were reviewed to provide evidence for clinical treatment.

ObjectiveTo investigate the etiological factors of endophthalmitis and evaluate the outcomes of vitrectomy for endophthalmitis.MethodsFrom January 1999 to December 2001, 53 consecutive patients (54 eyes ), 38 men and 15 women, diagnosed as endophthalmitis were retrospectively evaluated. The patients′ ages ranged from 1 year to 74 years (mean 32 years). Two patients (2 eyes) with mild inflammation received antibiotic medication therapy, 5 patients (5 eyes) with no light perception and severe inflammation underwent evisceration, and the other 46 patients (47 eyes) underwent pars plana vitrectomy. Postoperative follow-up ranged from 2 to 32 months (mean 10.5 months). ResultsEndophthalmitis was diagnosed as resulting from penetrating injury in 32 eyes (59.26%), endogenous endophthalmitis in 8 eyes (14.81%), cataract surgery in 7 eyes (12.96%), glaucoma surgery in 2 eyes (3.70%), vitrectomy in 3 eyes (5.56%), radial keratotomy in 1 eye (1.85%), and unknown reason in 1 eye (1.85%). The postoperative visual acuities (VA) of these patients increased significantly (P=0.003). The VA of the patients underwent vitrectomy in 3 days was obviously better than those after 3 days (P=0.014), and the VA of the patients underwent vitrectomy in 7 days was obviously beter than those after 7 days (P=0.021). Thirty-seven eyes (68.52%) had functional success (VA≥0.02), 47 eyes (87.04%) had anatomical success (VA