Objective To acknowledge the psychological authority status under the foundation of autho0rization management,in order to analyze the effectiveness of authorization management.Methods 364 clinical nurses were investigated with Psychological Empowerment Scale and the results were performed statistic analysis through descriptive statistical method and variance analysis.Results The average score of clinical nurses was(3.22±0.70),which was at the moderate point.The four dimensional scores listed in descending order were self efficient,career significance,autonomy and job influence.Clinical nurses of different ages,different ranking,different working period,different marriage status had statistical outstanding variance.But nurses of different education background showed no significant difference in score of each dimension.Conclusions The nursing management shall not only focus on the authorization management itself,but also on the psychological authority status of clinical nurses.Through an efficacious incentive,we can enhance the psychological recognition and experience on authorization and activate the working motivation,maximize the working initiative and thus promote the innovation and expansion of nursing work.

Objective To evaluate the effects of chain model of kindred-like nursing on self-nursing of patients with ankylosing spondylitis (AS). Methods Sixty patients with AS were randomized into test group and control group. Based on the therapy with same drugs, test group were given contact cards and served with continuous health care, while control group were only given routine instruction on functional exercises. Both groups were measured with Bath ankylosing spondylitis disease activity index (BASDAI) and Bath ankylosing spondylitis functional index (BASFI) before and after treatment. Results After treatment for 3 months, BASDAI and BASFI of test group were significantly improved compared with control group(P＜0.05). Conclusion Chain model of kindred-like nursing improves nursing ability at home, and plays an important role in disease activity and function recovery of patients with AS.

Objective To investigate the role of leukemia inhibitory factor (LIF) in cell survival of cone photoreceptors and the underlying mechanism following oxidant injury.Methods 661W cells were cultured and randomly divided into normal control group,LIF intervention group,H2O2 intervention group,S3 I201 intervention group,H2O2 + LIF intervention group,H2O2 + S3I201 intervention group and H2O2 + LIF + S3I201 intervention group,according to the different intervention drugs.MTT assay and Western blot were used to detect the effects of LIF pretreatment on 661W activity and the expression of STAT3 protein and its phosphorylation level after oxidative damage.Using STAT3-specific inhibitor S3I201 to block the STAT3 signal transduction pathway,MTT assay and real-time PCR were used to detect the effects of STAT3 signaling pathway on 661 W activity and the mRNA expression of survivin bcl-2 and bcl-xi after oxidative damage.Results Compared to H2O2 intervention group,the relative protein expression of p-Tyr705-STAT3 was increased in H2O2 + LIF intervention group,the difference was statistically significant (P ＜ O.05);The relative protein expression of p-Tyr705-STAT3 was decreased in H2O2 + S3I201 intervention group,the difference was statistically significant (P ＜ 0.05).Compared to H2O2 intervention group,the cell activity of 661W cells was increased in H2O2 + LIF intervention group,the difference was statistically significant(P ＜0.05).Compared to H2O2 + LIF intervention group,the cell activity of 661W cells was decreased in H2O2 + LIF + S3I201 intervention group,the difference was statistically significant (P ＜ 0.05).Compared to normal control group,the mRNA expression of bcl-2 and bcl-xl were increased in LIF intervention group,H2O2 intervention group and H2O2 + LIF intervention group,the differences were statistically significant (all P ＜ 0.05).Compared to H2O2 + LIF intervention group,the mRNA expression of bcl-2 and bcl-xl were decreased in H2O2 + LIF + S3I201 intervention group,the differences were statistically significant (all P ＜ 0.05).Conclusion LIF has protective effect on oxidative injury of cone photoreceptors,and it may contribute to cell survival through activation of the STAT3 signaling transduction pathway and its related survivin.

[Objective]To study various surgical approaches to the treatment of scapular neck and body fratures,and evaluate the clinical results.[Method]From January 1996 to December 2006,thirty-two cases with scapular neck and body fratures including 21 males and 11 females with age range from 18-56 years (mean 29 years) that had been admitted to the author's hospital were retrospectively analyzed.On the basis of the fracture patterns,straight incision along lateral border of the scapula,posterior approach,Judet approach were performed with plates or lag screws for open reduction and internal fixation.[Result]All cases were followed up for a period of 8-22 months.The mean time of bone union was 6-8 weeks.According to Hardegger's evaluation,22 cases showed excellent results,7 good,2 fair,1 poor.[Conclusion]Open reduction and internal fixation are emphasized to the severe separated scapular neck and body fractures.Straight incision along lateral border of the scapula,posterior approach or Judet approach can be chosen on the basis of the fracture patterns.Most scapular neck and body fractures can be treated by straight incision approach along lateral border of the scapula.This surgical approach can provide exposure of the fratures directly with saved surgical time and attain perfect reduction and fixtion with less trauma.

[Objective]To study the perioperative management and effect of total hip arthroplasty (THA) in elder patients with developmental dysplasia of the hip (DDH). [Methods]THA was applied in 24 patients (32 hips) who sufferring osteoarthritis and femoral head necrosis due to developmental dysplasia of the hip. The patients ranged from 70 to 82 years old with an average age of 74.3,and they all had metabolic diseases or more than one organ dysfunctions. The patients fulfilled the conditions of the surgery after sufficient perioperative period preparation.[Results]The follow-up time was from 2 to 8 years (averaged 3 years).Cardiopulmonary function was improved in all patients and the artificial joints were stable. And the patients could walk stably and powerfully without pain and deformity of the hip. The average Harris score after the operation was 87.2 points,and it was higher than 38.5 points before the operation.[Conclusion]For the reason of osteoarthritis and femoral head necrosis due to DDH,the patient's activity decreased,and so with their organ functions. And these patients always had metabolic diseases.All these can affect the safety and the outcome of THA. Therefore,sufficient perioperative management is as important as the surgery technique to obtain a stable,painless and functional joint in these patients.

Objective To study the distribution and drug resistance of clinical Providencia stuartii isolates and provide the basis data for clinical therapy.Methods A data analysis for the specimen source,the distribution of departments with infection and the antibiotic susceptibility results to 76 isolates was conducted in retrospectively. Results Among 76 strains were mainly from sputum (71.1%),wound secretions (10.5%) and blood (6.6%);the proportion of these strains from ICU was 40.8%,from respiratory department was 9.2%and from general surgery was 7.9%;The bacteria's drug resistance was more serious,multi drug resistant (MDR) strains accounted for 65.8%,pan drug resistant ( PDR) strains accounted for 26.3%,the mortality of patients with PDR strains infection was 45.0%,which was higher than 5.8%of no PDR strains infection.A low resistance rate of antibiotics were imipenem,fluoro-quinolones andamikacin,et al,and the rate of imipenem resistant was lowest(31.5%).Conclusion The multidrug resistance phenomenon of Providencia stuartii is serious, the first choice for the treatment is imipenem, the second choice was fluoroquinolones or amino glycopeptides antibiotics,the hospital infection caused by the bacterium infection in monitoring should be strengthened.

Objective: To investigate a moderate dose of levobupivacaine in spinal anesthesia for caesarean section.Methods: Eighty parturients undergoing caesarean section were randomly divided into 4 groups: GroupⅠ(0.75% levobupivacaine 1.00ml+10% glucose 1.00ml+cerebrospinal fluid 1.00ml),GroupⅡ(0.75% levobupivacaine 1.33ml+10% glucose 1.00ml+ cerebrospinal fluid 0.67ml),Group Ⅲ(0.75% levobupivacaine 1.67ml+10% glucose 1.00ml+ cerebrospinal fluid 0.33ml) and Group Ⅳ(0.75% levobupivacaine 2.00ml+10% glucose 1.00ml).The spinal puncture sites were all located at L_2,3.The onset time of sensation block,the highest plane of analgesia,the time to reach the highest plane of analgesia,the time of regression to the L_1 segment,the degree of motor block,VAS scores,the degree of muscle relaxation,the rate of hypotension incidents and neonatal Apgar scores were recorded. Results: There were no statistically significant differences in the onset time of sensation block,the time to reach the highest plane of analgesia and the highest plane of analgesia among the 4 groups.But the durations of regression to the L_1 segment were dramatically shorter in GroupⅠand Ⅱthan in Group Ⅲ and Ⅳ(P

Objective To observe the effect of Chinese herbal compound Tangbikang on the level of plasma β-EP of diabetic peripheral neuropathy rats, and to discuss its mechanism of neuroprotection and abirritation. Methods STZ and feeding high fat forage induced diabetic rats were randomly divided into diabetic model group, Mecobalamin group, Tangbikang high dose group, Tangbikang medium dose group, Tangbikang low dose group, with 10 normal rats as control. The control group and model group were daily gavaged with distilled water, Tangbikang groups were given Tangbikang with different dose. Mecobalamin was used as the control medicine. Body weight and FBG was detected every 4 weeks, rats’ unilateral sciatic nerve were taken out at the 16th week. Pathological variation of sciatic nerve was presented by HE staining, and radioimmunoassay method was used to detect the levels of plasma β-EP of diabetic peripheral neuropathy of rats. Results The weight and FBG had obviously changed in the 16th week. Compared with the model group, pathological injury of diabetic peripheral neuropathy rats in the Tangbikang groups were significantly improved. The level ofβ-EP of model group was significantly decreased (P<0.01) compared with normal group. Tangbikang medium and high dose group significantly increased the level of plasma β-EP (P<0.01). Conclusion Chinese herbal compound Tangbikang could reduce the fasting blood glucose, protect nervous system and promote the level of plasmaβ-EP of diabetic peripheral neuropathy rats.

BACKGROUND: Chronic osteomyelitis is difficult to manage clinically, and two or more operations were commonly needed. No satisfactory method for one-stage repair has been currently available.OBJECTIVE: To examine the possibility of using fibrin glue(FG) as the common carrier for both bone morphogenetic protein(BMP) and gentamicin for one-stage repair of infected bone defects.DESIGN: A completely randomized controlled experiment.SETTING: Center of Orthopaedic Surgery, Lanzhou General Hospital of Lanzhou Area Command of of Chinese PLA.MATERIALS: The experiment was conducted using 48 healthy adult Chinchilla rabbits of either sex on normal diet with body mass of 1.9 to 2.4 kg,provided by the Institute of Biological Products, Lanzhou, Gansu Province.INTERVENTIONS: Animal models of chronic osteomyelitis were established in 48 Chinchilla rabbits, and after thorough debriding of the wounds,an elongated semicircular bone defect was induced 1.5 cm to the medial proximal metaphysis in the tibias. Three treatments were subsequently given with FG, MP and gentamicin complex(Group A), FG/BMP complex(Group B), and nothing(control group, Group C), respectively.MAIN OUTCOME MEASURES: The general conditions of the rabbits were observed postoperatively. Bacterial culture of the bone specimen, bacterial counting, X-ray and histological examination were performed.RESULTS: Rabbits in Group A exhibited obviously better infection control and greater regenerated bone mass than those in Group B, and no significant difference was noted in infection control between Groups B and C, the latter group showing poor bone defect repair.CONCLUSIONS: FG, BMP and gentamicin complex helps to control infection and promotes bone formation, and can be used to repair bone defects caused by infection and open injury with severe contamination.

Objectives:To study the clinicopathological features of extraovarian peritoneal serous papillary carcinoma.Methods:The clinical pictures and pathological characteristics of 6 cases extraovarian peritoneal serous papillary carcinoma admitted to our hospital from 1992 to 1999 were studies retrospectively.H & E staining,histochemical staining and immunohistochemical staining were used.Results:The ages of the 6 patients were between 32～62(43.7) years old.The bilateral ovaries and fallopian tubes were almost normal.Tumors were examined histomorphologically by microscope and electron microscope,periodic acid-Schiff (PAS) stain was used in the histochemical study and carcinoembryonic antigen (CEA),CA125,p53,AE1 and AE3 monoclonal antibody assays were detected immunohistochemically.The results revealed no difference between extraovarian peritoneal serous papillary carcinoma and ovarian serous papillary carcinoma.Conclusions:Extraovarian peritoneal serous papillary carcinoma is considered arising from the secondary Müllerian system.Histologically,extraovarian peritoneal serous papillary carcinoma was identical to that of the similar epithelial carcinomas arising from the ovaries.The diagnosis was made only when the ovaries were not involved and without any evidence of similar epithelial carcinoma obtained in the ovaries.Histochemical staining and immunohistochemical staining are helpful as accessory criteria for the differential diagnosis between primary carcinoma of the peritoneum and malignant mesothelioma.The prognosis is poor.