Based on the performance status quo of the deficiency of medical informing duty,this paper analyzed the causes,from the respects of system,management,medical side,patient side,legal,cultural and ethical factors.

Objective To explore the coping styles and family environment in patients with depression.Methods 90 patients with depression were evaluated with CSQ and FES-CV.Results There were significant differences in the family environment between depression group and normal control group(P＜0.01).The factor scores of seeking-help and solving question in depression group positively correlated with the factor scores of family intimacy and success(r=0.29,0.32,0.27,0.31,P＜0.05).The factor score of self-accusation in depression group negatively correlated with the factor score of affection expression(r=-0.27,P＜0.05).Conclusion The coping styles are associated to family environment in patients with depression.

Nurses play an important role in promoting asthma control. In order to improve the quality of nursing practice for adult asthma controlling, Registered Nurse' s Association of Ontario (RNAO) integrated the latest evidence and published the best practice guideline of Adult Asthma Care: Promoting Control of Asthma (Second Edition) in 2017. This article mainly introduces the development, application scope, main content, quality evaluation and subsidiary information of the guide.

High density lipoprotein cholesterol ( HDL-C) has received extensive attention because of its cardiovascular protective effects.Recent studies showed that HDL could promote reverse cholesterol transport ( RCT ) , be anti-inflammatory and antioxidant, and induce angiogenesis. Apolipoptrotein A-I (apoA-I), the most abundant protein of HDL, plays a pivotal role in the HDL mediated-functional activities.Short peptides based on the amphiphilic alpha helix structure of apoA-I have been designed and aimed at imitating the function of apoA-I.The function and metabolism of these mimetic peptides depend on their amino acids component and sequence , and have been proved to exert protection in against cardiovascular disease , infection, inflammation and oxidative damage, metabolic syndrome and tumor.Clinical trials confirmed their benefits, but high cost put them out of the practical applications..

A novel fluorescence homogeneous biosensing strategy was developed for simple, rapid and sensitive detection of melamine in milk by using the polythymine oligonucleotide T24 and SYBR Green Ⅰ. In the absence of melamine, the fluorescence of SYBR Green Ⅰ was weak. The interactions between the single strand oligonucleotide T24 and SYBR Green Ⅰ were weak. In contrast, the presence of melamine drove the formation of T-melamine-T folded structure and enabled the SYBR Green Ⅰ to intercalate into double-strand DNA, resulting in the enhancement of fluorescence intensity. The results revealed that the method allowed a sensitive, simple, and rapid assay of melamine with a linear response range from 0. 1 μmol/L to 10 μmol/L and a detection limit of 35 nmol/L.

0.05). All of the indexes in control group were lower on post-operative day 7 than those of pre-operation. The levels of pre-albumin,transferrin, fibronectin, IgG,IgM, CD~+_3, CD~+_4 T cells and nitrogen balance in the study group were significantly higher than those of control group.Negative nitrogen balance began to be positive in the study group on the post-operative day 7. However, the nitrogen balance in the control group was still negative on the post-operative day 10. The duration of hospitalization in the r-hGH group was shorter than that of the control group. The 1-year, 2-year and 3-year survival rates and recurrence rate were not different between two groups.(Conclusions) The post-operative short-term use of the r-hGH plus HPN in patients with excisable gastrointestinal cancer is safe, effective and benefit for the post-operative recovery.

Objective To evaluate the effectiveness of EEG bispectral index (BIS) as the feedback control variable of target-controlled infusion (TCI) of propofol for sedation in patients undergoing laparoscopic hysterectomy under epidural anesthesia. Methods A total of 60 patients for selective operation of laparoscopic hysterectomy under epidural anesthesia were randomly divided into two groups: the feedback TCI group (FTCI) and the TCI group (TCI),with 30 patients in each group.The target blood concentration of propofol was set up at a level of 2 mg/L.It was maintained unchanged in the TCI group throughout the surgery.The BIS value,as the control variable,was set up at 70 in the FTCI group.The highest and lowest BIS values,mean arterial pressure (MAP) and HR during the operation,the standardized unit dose of propofol,time for orientation recovery,the degree of amnesia during the operation and patient's satisfaction were recorded and compared between the two groups. Results Of the two groups: the maximum of BIS values were 76 1?6 4 and 86 0?8 6,respectively,with statistically significant difference ( t = -5 058, P =0 000),and the minimal values were 69 0?4 5 and 60 9?11 8,respectively,with significant difference ( t =-3 513, P =0 000); the highest MAPs were (90 9?14 2) mm Hg and (100 4?11 6) mm Hg,respectively,with significant difference ( t =-2 838, P =0 006),and the lowest,(74 2?12 5) mm Hg and (63 8?13 8) mm Hg,respectively,with statistical significance ( t =-3 059, P = 0 003); the time for orientation recovery was (440 8?141 0)s and (576 4?120 5)s,respectively,with significant difference ( t = -4 004, P =0 000).Total dose of propofol in the FTCI group [(510 48?82 75)mg] was statistically lower than that in the TCI group [(620 65?76 79)mg; t =-5 345, P =0 000],the same was the standardized unit dose of propofol [FTCI: (5 08?1 26)mg,TCI:(6 02?0 86)mg; t =-3 375, P =0 001].No significant differences were seen between the two groups in the degree of amnesia during the operation and patient's satisfaction. Conclusions BIS is feasible to be used as a feedback control variable in propofol anesthesia.It offers less propofol consumption,appropriate sedation,rapid recovery of orientation and more stable blood pressure.

Objective To observe the effect of different doses of propofol injection and propofol medium/long-chain fat emulsion injection in short time infusion on plasma ketone body ratio,to eva-lute its effecton hepatic energy metabolism.Methods Forty patients,aged 18-50 years old,ASA Ⅰ orⅡ undergoing selective surgery were randomly divided into 4 groups with 10 cases in each;propofol injection 4 mg·kg-1·h-1 maintain anesthesia (group L4 ),propofol injection 6 mg·kg-1·h-1 maintain anesthesia (group L6 ),propofol medium/long-chain fat emulsion injection 4 mg·kg-1·h-1 maintain anesthesia (group M4 ),propofol medium/long-chain fat emulsion injection 6 mg·kg-1·h-1 maintain anesthesia (group M6 ).MAP,HR,SpO2 and PET CO2 were recorded before anesthesia induction (T0 ),after tracheal intubation (T1 ),after 2 hours infusion of propofol (T2 )and operation completed (T3 ).The blood samples were collected at T1 and T2 to detect the level of acetoacetate,β-hydroxybu-tyrate and to calculate the blood ketone body ratio (the ratio of acetoacetate andβ-hydroxybutyrate). Results MAP,HR,SpO2 ,PET CO2 at T0-T3 and acetoacetate,β-hydroxybutyrate,blood ketone body ratio at T1 ,T2 showed no significant statistic difference.Conclusion Different doses of propofol and different doses of propofol medium/long-chain fat emulsion injection in short time continuous in-fusion has no obvious effect on hepatic energy metabolism;same dose of propofol injection and propo-fol medium/long-chain fat emulsion injection in short time continuous infusion has no obvious effect on hepatic energy metabolism.

To investigate the effects of freezing the area of first porta hepatis which involves Glisson duct system,16 pigs were randomly divided into 2 groups. Group A:structures of the first porta hepatis were frozen by a dish-like cryoprobe (D=3.0cm) with temporary blockage of hepatic portal blood during freezing,the temperature at the end of 1,2,3minutes of cryotherapy was -50℃,-110℃,-131℃.Group B:sham operation,only with hepatic portal blockage for 3 minutes. Liver function tests, 99mTc-EHIDA scintiscanning,and pathological observation were used to evaluate the effects of the cryosurgery postoperatively.The results showed that the bile duct systems on first porta hepatis were severely destroyed by the cryosurgery,the cryoimpairment of common bile duct and/or common hepatic duct led to complications of progressive, irreversible, cryptic necrosis, fistula and pyogenic angiocholitis. The large freezing necrotic lesion in the porta hepatis might compress the portal vein. The perfect protection of biliary system should be accomplished in the cryosurgery of the first porta hepatis to avoid severe complications.

The effects of polytetrafluoroethylene (e PTFE) membrane on periodontal ligament cell (PDLC) growth and periodontal tissues and new cement regeneration were studied, and the prospects of clinical application of e PTFE membrane were discussed. The results showed that PDLC grew well on the e PTFE membrane and no toxicity or inhibition was found. Close adhesion of the cells to the membrane was observed by scanning electron microscope. Histological studies suggested that the peculiar porous structure of e PTFE membrane protects and promotes healing of alveolar bone defect when the membrane edge was sealed perfectly on the crown side,exhibiting inhibition of growth of epithelium towards tooth root. The membrane was beneficial to regeneration of new alveolar bone and cement and establishment of new adhesion,and was regarded as a good substitute of old materials.