The authors expound the idea and service priorities of terminal care, making it clear that pain control and emotional support of relatives after the death of the patient are the major content of terminal care at present. They suggest that nursing in terminal care be implemented according to the situation of our country. Firstly, institutions for terminal care need to be established. Secondly, education of patients, their relatives and medical workers themselves regarding death ought to be strengthened. Thirdly, training in knowledge and skills of consolation should be conducted among nurses. And fourthly, nurses should be encouraged to cultivate noble moral sentiments, enhance training in clinical skills, receive education in psychology, and master nursing skills in psychology so as to do a good job of terminal care.

ObjectiveTo study the proper braking and bed rest time for patients with TACE operation. Methods Divided 236 patients with TACE operation into the control group (100 cases) and the experimental group (136 cases) randomly. In the control group, the braking time and the bed rest time was 8 hours and 24 hours respectively, while in the experimental group, they were 5 hours and 12 hours respectively.Compared incidence rate of complication between the 2 groups. Results The differences of complications which relevant to puncture between the two groups were not significant,P值=0.419, while the complications which irrelevant to the puncture between the two groups were significant,P

Objective To investigate the current knowledge and attitudes towards people living with HIV/AIDS (PWHAs) in Chinese registered nurses (RNs) and describe the relationships between the nurses' HIV/AIDS related knowledge and attitudes towards PWHAs. Methods A cohort of 1350 RNs from 51 comprehensive hospitals in Hunan, China were studied over a 4-month period. A 3-stage random sampling method was used. Results The total correct rate in AIDS Knowledge Scale was 63.2%. Most nurses were good at conceptions of routes of AIDS infection and some basic characteristics, with more than 80% of the correct responses rate of relevant items. Their weakness was in the knowledge of some activities which would not transfer AIDS, such as "eating in a restaurant where the cook has AIDS may infect HIV", with less than 50% of the correct response rate of relevant items. As for attitudes, 94% of the nurses sympathized with HIV patients. About 82.7% of the nurses showed little sympathy to patients getting HIV by sexual promiscuity. Among all the AIDS related knowledge, nurses' conception of non-infectious activities was significantly related to their attitudes to HIV/AIDS.Conclusion Chinese nurses waster well about HIV/AIDS basic characteristics and the routes of infection, and most nurses sympathize with PWHAs. Their weakness is in the knowledge of non-HIV-infectious activities and they hold different attitudes to those patients getting HIV/AIDS in different ways. There are some barriers for Chinese nurses to take care of all patients equally. Professional development programs are urgently needed to remedy this situation including clarifying the nurses' misconceptions on AIDS related knowledge, developing non-judgmental professional attitudes, and using universal prevention measures when they take care of all patients.

OBJECTIVE:To carry out individualized pharmotherapy and pharmaceutical care for patients.METHODS:With the aid of windows 98 operating platform,the Access 2000 database software was adopted to develop the patients'drug administration records on the basis of the results of the blood drug level monitoring and clinical information.RESULTS:The non-paper drug administration records built by Access had the advantages of convenient data process,huge information store,rapid inquiry system and so on.CONCLUSION:Access database software is worth recommending for clinical pharmacy and further studying.

Objective To investigate the clinical features of non-steroidal anti-inflammatory drugs (NSAIDs) caused gastrointestinal bleeding in the elderly.Methods We performed a retrospective analysis ofNSAIDs caused gastrointestinal bleeding with 308 cases admitted to Department of Gastroenterology,The Second Hospital of Tianjin Medical University.Patients were divided into elderly group(≥65 years,n =208) and young group (＜ 60 years,n =100) to make a comparative analysis of two group differences in clinical characteristics.Results The NSAIDs in the elderly taking were mainly Aspirin (55.8 ％ (116/208)),which was significantly more frequent than that of young group (37.0％ (37/100),x2 =9.517,P ＜ 0.05).There was no significant difference on the blood routine and coagulation between the two groups (P ＞ 0.05).The recent bleeding rate of the elderly group (21.2％ (44/208)) was lower than the young group (63.0％ (63/100))(x2 =52.161,P ＜0.05).The two groups had no significant difference on the history of uleer and Hp infection (P ＞ 0.05).Conclusion The clinical characteristics of NSAIDs caused gastrointestinal bleeding on the elderly were different with young or middle-aged.This infers that elderly patients need individualized treatment.

Objective To investigate clinical significance of intermittent sinusoidal feial heart rate at third trimester.Methods From Jan 2002 to Dec 2010,48 pregnant women at 33 to 41 gestational weeks undergoing electronic fetal heart rate(FHR)monitoring presented with intermittent sinusoidal FHR in Department of Obstetrics and Gynecology,Second School of Clinical Medicine,Jinan University were enrolled in this retrospective study.Twenty-one cases were categorized into continuous group(i.e.with sinusoidal feature and a constant duration≥10 minutes).while the other 27 cases were categorized iuto intermittent group(i.e.with a duration＜10 minutes).In the mean time.76 normal cases were chosen randomly matched as control group.Blood gas and hemoglobin were measured in umbilical artery after fetal head delivery.General neurological system examination were performed in those fetus in hospitalization.The outcome of those fetuses was compared.Results (1)Neonatal complications:the rate of asphyxia,meconium-stained amniotic fluid and fetal anemia were 63%(17/27),33%(9/27)and 63%(17/27)in group of intermittent sinusoidal FHR,which were significantly higher than 1%(1/76),4%(3/76),3%(2/76)in control group(P＜0.05).When compared with 67%(14/21),52%(11/21),76%(16/21)in group of continuous sinusoidal,the statistical difierence were not observed(P＞0.05).(2)Blood gas in neonate:the rates of pH less than 7 were 18%(5/27)in intermittent group,52%(11/21)in continuous group and 0 in control group,which all reached statistical difference among those three groups(P＜0.05).(3)Brain damage and death:the rates of brain damage and death were 48%(13/27)and 11%(3/27)in intermittent group,81%(17/21)and 43%(9/21)in continuous group,and 0 in control group,which all showed significant difference between them(P＜0.05).Conclusion Intermittent and continuous sinusoidal FHR are typical graphics of severe fetal anemia at third trimester.Intermittent sinusoidal FHR is indicative of serious fetal hypoxia.

Objective To examine whether IFN-λ has the ability to inhibit HIV-1 infection of blood monocyte-derived macrophages and its mechanism(s). Methods Macrophages were pretreated with IFN-λ/ IFN-λ2 for 24 h before infected by HIV-1 R5 strains (Bal, Jago, and JRFL). And then the culture supernatants were detected HIV-1 reverse transcription (RT) activity and p24 protein expression by HIV-1 BT assay and ELISA. The expressions of IFN-λ receptor, CD4, CCRS, CXCR4 were evaluated by real-time PCR. Results Both IFN-λ1 and IFN-λ2, when added to macrophage cultures, inhibited HIV-1 infection and replication. This IFN-λ-mediated anti-HIV-I activity is broad, as IFN-λ could inhibit infection by both laboratory-adapted and clinical strains of HIV-1. Investigations of mechanism(s) responsible for the IFN-λ action showed that although IFN-λ had little effect on HIV-1 entry receptor CD4 and co-receptor CCR5 and CXCR4 expression, IFN-λ inhibited HIV-I infection of macrophages through connecting with IFN-λ recep-tor. Conclusion IFN-λ could inhibit HIV-I replication in macrophages. These findings indicate that IFN-λ may have a therapeutic value in the treatment of HIV-1 infection.

Objective To discuss operative treatment of old fractures of pelvis. Methods Since February 2000, 14 cases with old fracture of pelvis have been treated in our hospital with operative scar or callus settlement, traction and reduction, and internal fixation. Results All patients were followed up from 6 months to 3 years and 6 months. According to such indexes as pelvic shape, length difference between lower limbs, gait, and radiogram, the scores were excellent in 8 cases, fine in 4 and poor in 2, with the excellent and good rate being 85.7%. Conclusion With reasonable design and appropriate method, operative treatment is fit for old fractures of pelvis because it can avoid severe disability and improve the quality of life of the patients.

Objective:To experimentally intervene safe injection by medical staff in basic-level hospitals and observe the recent and long-term effect atfer the intervention and to provide practical measures to improve safe injection. Methods:We used random sampling methods to set up groups in county hospitals and township hospitals of Hunan Province, and offered lectures, delivered safe injection guide, brochure and on-site guidance in the experimental group. We surveyed the 2 groups atfer the intervention at 1 month and 6 months to compare the effect of unsafe injection behaviors and safe injection behaviors. Results:One month after the intervention, the unsafe injection rate in the experimental group decreased from 27.8%to 21.7%, while in the control group injection the unsafe injection rate rose from 26.0%to 27.9%, with signiifcant difference (P<0.01). Six months atfer the intervention, the unsafe injection rate in the experimental group declined to 18.4%while the unsafe injection rate in the control group also dropped to 22.4%, with signiifcant difference (P<0.01). Unsafe injection rate was decreased in the experimental group at different intervention points, with signiifcant difference (P<0.01). The safe injection behavior scores in the experimental group were higher than those in the control group after the intervention of 1 month and 6 month intervention (P<0.01);the experimental group got higher scores atfer the intervention (P<0.01). Conclusion:Training of safe injection, distribution of safe injection guide, and comprehensive intervention model can significantly change the primary care practitioners’ behaviors in unsafe injections and it is worth promoting.

Objective To study changes in serum homocysteine(Hcy) and its correlation with serum levels of folic acid and high sensitivity C-reactive protein(hs-CRP)in Tibetan patients with mildto-moderate Alzheimer's disease at various high altitude areas,so as to direct the clinical diagnosis and treatment of AD in plateau hypoxia environment Method 108 cases were divided into four groups:23 AD Tibetan patients at middle altitude(AD/middle altitude group)and 23 healthy Tibetan subjects (healthy/middle altitude group) in Qinghai-Tibet Plateau Xining region,altitude at 2,260 m,31 AD Tibetan patients (AD/high altitude group)and 31 healthy Tibetan elderly subjects (healthy/high altitude group)in Yushu region at altitude of 3,800 m.Among the total study subjects,half are males,aged from 60 to 85 years.The levels of serum Hcy,Vitamin B12 and folic acid(FA)were measured by the Fluorescence Polarization Immunoassay(FPIA).Serum hs-CRP,triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)were measured by automatic biochemistry analyzer.Correlation of Hcy with FA and hs-CRP was analyzed.Result Both high altitude and middle altitude group showed the levels of Hcy and hs-CRP were significantly higher in AD Tibetan patients than in healthy control at the same altitude(allP＜0.05).The levels of Hcy,LDL-C and hs-CRP of subjects were higherat high altitude than at middle altitude(P＜0.05).In contrast,folic acid levels in AD and control groups were lower at the high altitude than at middle altitude(P＜0.05).The levels of vitamin B12 and TG were not significantly different among all four groups.Multiple logistic regression analysis showed that altitude,folacin and hs-CRP were the risk factors for Hcy in patients with AD at plateau(OR =0.351,2.794,3.021,P=0.045,0.037,0.016).Conclusion Along with increased altitude,serum level of Hcy is significantly increased in AD Tibetan patients living in high altitude area.High altitude,high hs-CRP and lower folacin may be the risk factors for hyper-homocysteine in AD Tibetan patients with high altitude,and their combined effects are involved in the occurrence and development of AD.