Objective To compare the differences between doctor knowledge transfer willingness and patient knowledge transfer demand,and propose matching behavior model of Doctor-Patient knowledge transfer.Methods Useing empirical analysis through questionnaire survey,tests and verities investigate data's reliability,validity.Significant test of the differences between doctor knowledge transfer willingness and patient knowledge transfer demand is conducted with ANOVA,and the detail relationship is conducted by comparison of the average values.Results Patient knowledge transfer demand is much higher than doctor knowledge transfer willingness.What' s more,this paper divides content of Doctor Patient knowledge transfer into four kinds:high doctor intention-high patient demand,high doctor intention-low patient demand,low doctor intention-high patient demand,low doctor intention-low patient demand.Conclusions Mismatching of doctor knowledge transfer willingness and patient knowledge transfer demand is the main reason of medical information asymmetry.Doctor-Patient knowledge transfer strategies are suggested based on the performance features of the four groups.

Doctor-patient trust plays an important role in doctor-patient knowledge transfer.Investigating the basic features and trust performance of the patients, the authors classified by means of a cluster analysis, the patients into four groups with such criteria as the trust on hospital, trust on doctors, patient's awareness of the knowledge, and patient's compliance to the doctor's advice. The four groups are rational and suspicious, passive compliance, high self-confidence, and blind trust groups. In view of behavioral characteristics of the patients, different doctor-patient knowledge transfer strategies are suggested, in an effort to perform effective doctor-patient communication and to gain patient's trust.

Objective To investigate the role of renal nerve in cardioprotection provided by renal ischemic preconditioning(RIP).Methods The effects of ischemia-reperfusion and RIP on the hemodynamics, myocardial oxygen consumption, epicardial electrography and infarct size were examined in anesthetized rabbit.Results During the 45 min of myocardial ischemia and 180 min of reperfusion, all hemodynamic parameters and myocardial oxygen consumption decreased progressively significantly. Epicardial electrographic ST-segment was elevated significantly during myocardial ischemia and return to baseline progressively in the course of reperfusion. The myocardial infarct size occupied 55.80±1.25% of area at risk,and RIP significantly reduced the myocardial infarct size to 36.51±2.80%(P＜0.01). The renal nerve section (RNS) per se didn't affect myocardial infarct size produced by ischemia-reperfusion, while cardioprotection afforded by RIP was completely abolished by RNS.Conlusion RIP have the protective effect on heart, and activation of renal afferents by transient ischemia-reperfusion play an important role in such a cardioprotection.

This paper summarizes the experiences of observation and nursing of postoperative complications in 28 patients underwent orthopedic surgery for correction of severe kyphoscoliosis,the Cobb's angle was(150.0±25.3)°. Postoperative nursing focused on monitoring of patients' vital signs,observation of the feeling and motor function of lower limbs and wound drainage,nursing care of gastrointestinal reaction and respiratory complications. The postoperative complications were controlled effectively after timely treatment. There was no any severe complications of spine-cord injury after stage-II surgery.

Objective To investigate the influence of peer education on maintenance knowledge of patients with peripherally inserted central catheter (PICC) outside the hospital.Methods 74 patients with PICC were divided into the intervention group and the control group with 37 patients in each group according to the random digit table,the intervention group received peer education and the conventional health education,while the control group only received routine health education.The maintenance knowledge of PICC was investigated with questionnaires and the results were analyzed.Results xfter intervention,the maintenance knowledge of the intervention group was significantly higher than that of the control group [(36.95±2.84) scores vs.(31.78 ± 4.79) scores,t=5.639,P＜0.05].The incidence rate of complications in the intervention group was lower than that of the control group [21.6％ (8/37) vs.62.2％(23/37),x2=12.491,P＜0.01].Conclusions The peer education can improve patients' maintenance knowledge about PICC and reduce the occurrence rate of the complications of PICC.

Objective To study the incidence of rapid eye movement sleep behavior disorder (RBD) and its impact on the clinical manifestations of patients with Parkinson' s disease (PD). Methods One hundred and twenty-four PD patients were included into this study and each of them was given the non motor symptoms questionnaire (NMSquest) to investigate the incidence of RBD. The PD patients were then divided into the RBD group and non RBD group, according to their answers to the NMSquest. Then the clinical differences were investigated between PD patients with and without RBD on the aspects of demographic characters, Hoehn-Yahr (H-Y) stage, the scores of Unified Parkinson Disease Rating Scale (UPDRS) sub-items, the incidence of non motor symptoms, and the dysfunctions of non motor systems (cognitive impairment, anxiety, depression and sleep disorders ). The evaluation tools of non motor functions include Mini Mental State Exam ( MMSE), Hamilton Depression Scale (HAMD), Parkins' s Disease Sleep Scale (PDSS) and Epworth Sleepiness Scale (ESS). Results ( 1 ) 62.9% (78/124) of the PD patients have been experiencing RBD. (2) The course of the disease in RBD group ( 3.8 ± 2.8 ) was significantly shorter than non RBD group (5.0 ± 2.5, t = - 1. 972, P = 0. 048 ) while the sex, age, onset age and the mode of onset, Levodopa dose equivalents (LDE) and the kinds of medicines showed no difference between the two groups. (3) H-Y stage, the scores of UPDRS sub-items and the incidence of motor complications showed no difference between RBD and non RBD group. (4) Most of the non motor symptoms, including the gastrointestinal dysfunctions, autonomic dysfunctions, mood disorders and sleep disturbances, occurred much frequently in RBD group, however, the scores of MMSE, HAMD, HAMA,PDSS and ESS showed no difference between the RBD and non RBD group. Conclusion RBD commonly occurred in PD patients, and PD patients with RBD have a tendency to suffer from dysfunction of non motor systems.

ObjectiveTo investigate the histological features, clinical presentation, treatment and prognosis of small cell carcinoma of the prostate.MethodsThe clinical, pathological and follow-up data of two cases of small cell carcinoma of the prostate were respectively analyzed, and the related literature was reviewed.ResultsTwo cases of small cell carcinoma were diagnosed by transtectal prostate biopsy. Microscopically, the tumor arranged in nest structures and exhibited small round cells with the nuclei extremely hyperchromatic and scanty. Coagulated necrosis was easily observed. The immunohistochemical testing was positive for NSE and negative for PSA 、PAP. Case 1 received palliative surgery and postoperative chemotherapy of EP (VP-16, Cisplatin), and died of recurrence and distant metastasis after six months. Case 2 received palliative surgery and oral bicalutamide treatment, and died of recurrence and liver metastasis after three months.ConclusionsSmall cell carcinoma of the prostate has the biological behavior of invasive growth with an unfavorable prognosis, which is often in an advanced stage at first diagnosis. The ultimate diagnosis depends on histopathology and surgery combined with systemic chemotherapy and radiotherapy is the most effective treatment.

Objective To determine the prevalence of rapid eye movement(REM)sleep behavior disorder(RBD)in patients with Parkinson' s disease(PD)and to investigate the risk factors of PD-RBD and its effect on the progress of PD. Methods Using the minimal diagnostic criteria of parasomnias described in the International Classification of Sleep Disorders-Revised(ICSD-R)to diagnose clinically probable RBD(cpRBD), patients were assessed by Unified Parkinson's Disease Rating Scale(UPDRS),MMSE, Montreal Cognitive Assessment(MoCA)at baseline and followed for 2.5 years. Results The frequency of cpRBD ranged from 35.6%(47/132)to 41.7%(55/132)during the study period. 11.4% (15/132)patients dropped out from the study. Lower MoCA score and type of onset are independent factors with cpRBD; Lower MoCA score(OR =0. 817 ,P =0. 004)is the risk factor while tremor(OR =0. 247 ,P =0. 020)is the protective factor. PD in patients with PD-RBD may progress more rapidly than non PD-RBD patients(UPDRS Ⅲ change from baseline 9. 86 ± 4. 96 vs 6. 76 ± 4. 26, t = 2. 909, P = 0. 005; H-Y change from baseline 0. 77 ± 0. 54 vs 0. 33 ± 0. 49, t = 3. 664, P = 0. 000). Conclusion RBD may be a symptom predictive for rapid PD progression, declining cognition and psychosis.

Objective To explore the correlation between NF-κB signaling pathways activated by IL-18 in CD4+ T cells and the pathogenesis of PBC.Methods We detected the expression of IL-18 mRNA in PBMCs,IL-18 level in plasma,receptor IL-18R on surface of CD4+ T cell,proliferation rate of CD4+T cell and its NF-κB signaling pathway protein IκBα and NF-κB p65 by qRT-PCR,ELISA,flow cytometry,MACS and Western blot on 32 cases of patients with PBC (PBC group) and 32 healthy people (control group) in Guizhou provincial people′s hospital.Results The level of IL-18 in PBC group was significantly higher than that in control group (P<0.05).The relative expression of IL-18 mRNA in PBC group was significantly higher than that in control group (P<0.05).The percentage of CD4+T cells expressing IL-18Rα in PBC group was higher than that in control group (P<0.05).The proliferation rate of CD4+T cells stimulated by IL-18 in PBC group was significantly higher than that in healthy control group (P<0.01).The relative expression levels of NF-κB p65 protein were up-regulated in IL-18,and the expression of IκBα protein in each group was significantly increased,especially in PBC group (P<0.01).Conclusion IL-18 can activate NF-κB signal pathway in CD4+ T cells and participate in the pathogenesis of primary biliary cirrhosis.

Objective To assess the development,progression and change of nonmotor symptoms in patients with Parkinson' s disease and its impact on patients' quality of life.Methods Eighty-seven consecutive patients with idiopathic Parkinson' s disease were studied.Parkinsonian status was assessed at baseline and 3 years follow-up using Unified Parkinson' s Disease Rating Scale (UPDRS) part Ⅲ & Ⅳ,Nonmotor Symptoms Questionnaire (NMSQuset),Parkinson-related quality of life (PDQ) scales.Paired ttest,Chi-square test,Spearman rank order correlation and hierarchical regression of the major statistical procedures were employed.Results At 3 years follow-up,compared to baseline,the UPDRS Ⅲ score (22.21 ±11.31 vs 30.49± 11.68),UPDRS Ⅳ score(1.00±1.54 vs 2.94±3.12),NMS score (7.98±3.96 vs 12.35 ± 5.12) and PDQ score (28.11 ± 22.88 vs 36.65 ± 26.95) were significantly higher ( t =- 5.54,- 5.75,- 6.46,- 5.29,all P =0.000,respectively).The aggravation of motor and nonmotor symptoms caused the decline of quality of life.The prevalence of constipation,problem of remembenng thing,nocturia ranked tops,and depression,and anxiety were still in the middle,compared with baseline.The prevalence of pains,sweating,dribbling,sense of incomplete emptying etc were significantly increased during the follow-up,△R2 were 21.6％ and 23.4％ respectively,resulting in the deterioration of quality of life.Conclusions PD nonmotor symptoms appear from the early stage.The motor and nonmotor symptoms aggravate over time.