Hedging is an important component of vague language. This paper retrieves high frequency expressions of hedgingby using medical English corpus. Pragmatic functions of hedging are analyzed, which can be summarized as politeness principle, authors' self-protection, avoidance of the absolute, pursuit of objectiveness as well as conversational implication. To medical researchers, it is necessary to cultivate the awareness of hedging and learn how to adopt it in their research papers.

ObjectiveTo investigate the risk factors,prevention measures and treatment methods of the pulmonary fibrosis patients with nosocomial pulmonary fungal infection. Methods50 pulmonary fibrosis patients with nosocomial pulmonary fungal infection were chosen as the observation group. In the same time,50 pulmonary fibrosis patients without nosocomial pulmonary fungal infection were chosen as the control group. The following factors were compared: hospital stay, corticosteroid use, antibiotic use, invasive procedures, a merger of the underlying disease.ResultsThere were 46％ (23/50) patients had long-term use of antibiotics in the observation group, much more than the control group(26％ ,13/50) ,the difference was statistically significant( P ＜0.05) ;More than half of patients in both groups using glucocorticoids, the ratio in the observation group was 84％ (42/50), which was significantly higher than the control group( P ＜ 0.05) ; In the observation group, the rates of patients with long time hospitalization ( ≥30 days), received invasive procedures, and associated with underlying diseases were much higher than the control group( all P ＜ 0.05). ConclusionMultiple risk factors could lead to the occurrence of pulmonary fibrosis patients with nosocomial pulmonary fungal infection,and the positive and effective preventions and standard treatment should be taken.

Objective:To explore the clinical application of permanent needle of deep venipuncture in early management of extensive burn.Methods:88 patients with extensively burn are analyzed.Results:The success rate of venipuncture was 96%.The effect was satisfactory,while the complication was less.Conclusion:The permanent needle of deep venipuncture shows an important role in early management of extensive burn.

Primary central nervous system lymphoma (PCNSL) is a rare type of extranodal lymphoma, and its incidence rate is increasing nowadays. Chemotherapy is the main means for treatment of PCNSL and the efficacy of high-dose methotrexate (HD-MTX) has been confirmed among those chemotherapeutics. Treatments of HD-MTX combined with other drugs have been studied extensively. Progress of HD-MTX and other drugs for PCNSL are reviewed in this article.

Acadamy is the basis of discipline construction,and the public trust is the life of academy.However,the decline of public trust has become prominent in our science field.This paper is aimed at revealing the potential factors for the decline,and to propose measures to counteract them,so as to to remodel the public trust in academia.

Objective To investigate midwives' role cognition and their working experience.Methods It was a qualitative study using the phenomenological method.10 midwives were interviewed and all the data were analyzed using the categorization method.Results Three main categories were identified:diversified midwife roles; capacities and qualities required to fulfill midwifery roles; positive and negative experiences coexisted.Conclusions Managers should develop humanized management approaches to facilitate the fulfillment of midwives' roles and improve their working experience.The research also revealed the need to improve Chinese midwifery education and the midwifery regulation systems.

Objective To study the treatment effect of rivet with thread,instead of clavicular hook plate,for Tossy Ⅱ & Ⅲ dislocation of acromioclavicular joint.Methods From January 2008 to February 2009,totally 31 patients with Tossy Ⅱ or Ⅲ dislocation of acromioclavicular joint were treated using rivets with thread,including 19 males and 12 females at the age of 33-49 years(mean,41 years).Among these patients,19 suffered fresh acromioclavicular joint dislocation,9 suffered old acromioclavicular joint dislocation,and 3 did a failed fixation by clavicular hook plate.None of them was combined fracture.Mitek 3.0 mm rivet with thread was embedded to coracoid,with nonabsorbable thread connected with the rivet passing through the clavicle for fixation,and meanwhile ligament coracoclaviculare was restored or acromiocoracoid ligament displaced.Among them,12 patients assisted Kieschner wire fixation.The treatment effect was evaluated using Japanese Orthopaedic Association(JOA)scoring system and acromioclavicular joint dislocation scoring system.Results All patients were followed up 11-23 months(mean,17 months).In the patients without Kieschner wire fixation,JOA shoulder score was 65-95,excellent for 8 cases,good for 9,fine for 1,poor for 1,excellent and good rate was 89.47%(17/19);In the patients with Kieschner wire assisted fixation,JOA shoulder score was 74-97,excellent for 5,good for 4,fine for 3; the excellent and good rate was 75.00%(9/12).With acromioclavicular joint dislocation scoring system,the overall excellent and good rate was 94.74%(18/19),and 91.67%(11/12)respectively.No complication that affected joint function was found.Conclusion Rivets with thread can be used for treating Tossy Ⅱ & Ⅲ dislocation of acromioclavicular joint.This surgical technique is characterized by small operation wound,fewer complications,no secondary operation,and satisfactory treatment effect.

Viral myocarditis involving the cardiac conduction system is easily associated with a variety of arrhythmias. Negative inotropic effect and the potentially induced arrhythmia of antiarrhythmic drugs limit their application. Non-drug treatment with the body injuries and high medical costs holds patients back and leads them to take a conservative treatment. Traditional medical treatment of this disease has a long history and rich experience. Clinical and experimental studies show that traditional Chinese medicine is effective and has few side effects. This article discusses the ideas of treatments of arrhythmia, from three aspects of differentiating diseases and syndrome type, dispelling wind-evil and dredging collaterals and using results of pharmacological researches reasonably.

AIM　To improve the treatmemt efficacy and reduce the side effect of carboplatin (CBP), the antitumor drug was incorporated into niosomes (NS). METHODS　Lung targeted niosomes of CBP (CBP-NS) were prepared by the method of hand shaking. The ultraviolet absorption spectrophotometric method was used for the determination of CBP. The method of dynamic dialysis was used for in vitro release of CBP from CBP-NS. The S-180 lung neoplasms models were established by iv cancer cells in mice. The number of pulmonary nodules was examined for evaluating the therapeutic efficacy. RESULTS　The data showed that the mean diameter of CBP-NS was 3.72 μm, with a span of 0.66. The entrapment ratio of CBP in CBP-NS was 29.2% and the CBP-NS were stable for three months stored at 3℃-5℃, 15℃-25℃ or 37℃ (relative humidity 75%). The release profile in vitro could be described by a biexpotential equation. The calculated values of the three targeting parameters indicated that CBP-NS showed good targeting efficiency. The results of therapeutic trials showed that the antitumor effects were significantly increased by injection of CBP-NS compared with CBP in the treatment of mice with lung carcinoma. CONCLUSION　The results indicated that CBP-NS have good targeting efficiency in vivo, and the biodegradable CBP-NS may decrease the side effects of carboplatin and improve its therapeutic efficacy.

AIM　To establish innovational triangular phase diagrams for preparation of pharmaceutical microemulsion (ME) with low toxicity as a result of reducing the amount of the emulsifiers. METHODS Lecithin and polyoxyethylene octyl phenyl ether (OP) were used as emulsifiers (E), absolute alcohol and n-octyl alcohol as assistant emulsifiers (A), ethyl oleate and olive oil as the oil phase (O). For the innovational triangular phase diagrams, lecithin-ethyl oleate-water and absolute alcohol (optimized ratio W/A=0.6)system, and OP(olive oil and n-octyl alcohol (O/A=0.34)-water system were used for preparation of the ME. While for the traditional triangular phase diagrams, OP and n-octyl alcohol (E/A=Km=1.5)-olive oil-water system, lecithin and absolute alcohol (E/A=Km=1.12)-ethyl oleate-water system were used. Then, the corresponding amounts of the emulsifiers used in both methods were compared. RESULTS　In the ME of lecithin systems by the innovational and the traditional methods, the amounts of emulsifier are 6%-28% and 28%-29.6%, respectively. In the ME of OP systems by the innovational and the traditional methods, the amounts of emulsifier are 23%-40% and 27.6%-49.8%, respectively. CONCLUSION　The method of innovational triangular phase diagram for preparation of ME is superior to the traditional method in finding out the lower amounts of emulsifiers for ME, and is a feasible method with guiding significance for preparing ME.