Objective To explore and classify the subjective opinions of nurses on whistle- blowing, and identify the subjective characteristics of each type. Methods This study applied Q -methodology, protocols which could determinate subjective opinions of nurses on histle-blowing were set up and underwent interview investigation, data of the interviews went through Q-factor analysis. Results Most nurses had a positive attitude toward whistle - blowing because it could prevent any nursing activity not based on expertise and professional ethics from causing disadvantages for patients. At the same time, however, they requested the creation of a legal framework in which whistle-blowing was done in a way to increase trust among colleagues. Meanwhile, some nurses showed resistance to whistle - blowing. Conclusions Whether whistle - blowing can reach its aims depends on nurses' attitude toward it. Most Korean nurses support whistle-blowing. Nursing activity not based on expertise and professional ethics and causing disadvantages for patients can be avoided if a legal framework is established for whistle-blowing.

Objective To compare the effect of methotrexate combined with laparoscopic surgery on pregnancy outcome of patients with tubal pregnancy treated with conservative treatment.Methods 96 patients who were diagnosed of tubal pregnancy,fertility requirements and no clinical data given birth were analyzed retrospectively.Depending on the method of treatment was divided into 46 cases of methotrexate and laparoscopic group of 50 patients.Postoperative intrauterine pregnancy,ectopic pregnancy and secondary infertility situation again were compared.Results Laparoscopic group in intrauterine pregnancy rate was 70.0％,which was significantly higher than that in the methotrexate group(47.8％),and the difference was statistically significant(x2 =13.229,P ＜ 0.05) ;laparoscopic ectopic pregnancy rate was 14.0％ against 17.4％ with methotrexate group,the difference was not statistically significant(x2 =2.037,P ＞ 0.05) ; methotrexate group was 34.8％ of secondary infertility was significantly higher than thatin the laparoscopic group (16.0％),the difference was statistically significant (x2 =12.784,P ＜ 0.05).Conclusion Laparoscopic surgery after conservative treatment of tubal repregnancy outcome is better than methotrexate.

OBJECTIVE:To discuss the use of allopurinol for the reduction of serum uric acid level in patients with chronic kidney disease complicating hyperuricacidemia so as to delay the progression of chronic renal disease.METHODS:A total of 47 patients with chronic kidney disease complicating hyperuricacidemia were randomly divided into treatment group and control group:the treatment group was given allopurinol 100～200mg?d-1 in addition to the antihypertensive therapy as adopted in the control group or the common therapy for 12 months.RESULTS:As compared with the control group,serum creatinine level was lower and the rate of renal function deterioration was significantly decreased in the treatment group(P

Combined Modality Therapy ; methods ; trends ; Heart Defects, Congenital ; therapy ; Humans

Pain is one of usual symptons of mid-late cancer patients, radioactive particle interstitial im- plantation can not only control tumor advancement,but also alleviate pain in different degree by inactivating part nerves or relieving compression. It has showed significant effect in system tumor--gastric cancer, colon cancer and head and neck cancer without severe cemplication,effering a new method of curing cancerous pain.

Objective To determine the factors influencing the indication for tracheostomy following cervical spinal cord injury.Methods A retrospective study was performed to analyze the 118 patients who had been treated for cervical fracture/dislocation along with cervical spinal cord injury from July 2004 to June 2014 and whose abbreviated injury scale score (AISS) was lower than 3.They were 96 men and 22 women,19 to 68 years of age (average,45.2 years).The patients were divided into a tracheostomy group (n ＝ 28) and a non-tracheostomy group (n =90).The 2 groups were compared in terms of gender,age,presence or absence of complete spinal cord injury at admission,injured segment,injury mechanism,smoking history,injury severity score (ISS),motor AISS,systolic pressure at admission,hospital stay,and ICU stay to determine the factors influencing allocation of tracheostomy.Results Compared with the non-tracheostomy group,the tracheostomy group had a higher rate of complete spinal cord injury at admission,a higher rate of smoking,a higher ISS at admission,a lower motor AISS,and longer hospital and ICU stay,with statistically significant differences (P ＜ 0.05).There were no significant differences between the 2 groups in gender,age,injured segment,injury mechanism,or systolic pressure at admission (P ＞ 0.05).Increased severity of cervical spinal cord injury was associated with significantly decreased motor AISA,increased rate of tracheostomy and increased ISS (P ＜ 0.05).Conclusion The influencing factors for indication of tracheostomy after cervical spinal cord injury are complete cervical spinal cord injury irrespective of the level of injury,ISS,motor AISS,and history of smoking.

The computerization of medical consumable warehouse-in&out has become a general trend of modern medical consumable management.The medical consumable management software in No.1 Military HIS is modified and improved so as to be integrated with practice for better management of medical consumable.

Objective To study the differential expression of matrix metalloproteinase-9(MMP-9) and tissue inhibitors of metalloproteinase-1(TIMP-1) in serum and decidua tissue from missed abortion and normal first trimester pregnancy,and to explore their function in early pregnancy .Methods The expression of MMP-9,TIMP-1 in serum was determined using enzyme-linked immunosorbent assay ( ELISA) ,and in decidua by immunohistochemical method . Results The MMP-9 serum level from missed abortion women was higher than that from normal first trimester preg -nancy women [(154.60 ±28.69)ng/mL vs.(135.75 ±18.35)ng/mL,t=3.50,P=0.001].The TIMP-1 serum level from missed abortion women was lower than that from normal first trimester pregnancy women [(253.03 ± 29.90)ng/mL vs.(323.15 ±33.62) ng/mL,t=9.86,P=0.000].The MMP-9 positive expression rate in decidua tissue was higher in missed abortion women than that in normal first trimester pregnancy women (82.5%vs.42.5%,χ2 =13.65,P=0.000).The TIMP-1 positive expression rate in decidua tissue was lower in missed abortion women than that in normal first trimester pregnancy women (87.5%vs.62.5%,χ2 =6.67,P=0.010).Conclusion The expression of MMP-9 and TIMP-1 in serum and decidua may be assosiated with missed abortion .

Objective To investigate the level of serum cartilage oligomeric matrix protein (COMP) and its relationship with vascular calcification in diabetic nephropathy (DN) patients .Methods COMP was tested in 54 (DN) group and 28 matched healthy persons (healthy group) .DN group was divided into vascular calcification group (VC) and non‐vascular calcification (non VC) group .DN group was also divided into cardiovascular disease group (CVD‐y) and without cardiovascular disease group (CVD‐n) in view of the company of cardiovascular disease .Serum COMP levels was compared between the DN group and the control group ,the VS group and the non VS group ,and the CVD‐y group and the CVD‐n group .The correlations between COMP level and the occur‐rence of cardiovascular disease ,the incidence of vascular calcification were estimated by Wald analysis of the application of Wald test .Results Serum COMP in DN group was significantly higher than the control group;Aortic arch calcification accounted for 75 .9% of the DN group .The serum COMP in VC group was higher than that of non VC group ,CVD‐y group had higher COMP than CVD‐n group old respectively with every 10 ng/mL increased in concentration of serum COMP .Conclusion The higher of concentration of serum COM P ,the more risk of vascular calcification and CVD .

BACKGROUND:Methylene blue can hinder abnormal pain conduction via the sensory nerve, and its mechanism is to block bradykinin-induced hyperalgesia and eliminate pain caused by local tissue inflammation.
OBJECTIVE:To observe the influence of methylene blue solution on the lumbar spinal cord and spinal ganglia function of rats, and to investigate whether methylene blue is safe for treating discogenic low back pain.
METHODTotal y 120 Wistar rats were randomly divided into five groupthree experimental groups, a saline control group and a blank control group, n=24 in each group. Lumbar segmental dura was exposed in rats. In the three experimental groups, 0.2, 1, and 2 mL methylene blue were injected epidural y, respectively. The saline control group was subjected to the epidural injection of 1 mL saline. In the blank control group, there was no treatment. Six rats from each group were selected randomly and perfused at 30 minutes, 2 hours, 24 hours, 72 hours after injection, respectively. Then, the corresponding segments of the spinal cord and ganglions were removed. Hematoxylin eosin staining was used for comparing histological and structural changes under light microscope.
RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that at 30 minutes, 2 hours, 24 hours and 72 hours after injection of methylene blue, the spinal dorsal side exhibited the structural integrity, clear boundaries between the white matter and gray matter, dense nerve fibers in the white matter, and round or oval nuclei of glial cells among fibers;dense nerve fibers in the posterior horn of gray matter;light-colored neuronal nuclei with prominent nucleoli;a bundle of nerve fibers among cellpopulations. There was no significant change in tissue structure of lumbar spinal cord and spinal ganglia between the experimental groups and the saline control group or between the experimental groups and the blank control group. Thus, the epidural injection of 1%methylene blue has no significant effect on the spinal cord and spinal nerve structures.