50 tracheotomy patients with mechanical breathing were performed respiratory tract control for suitable breathing. Result 5 patients recovered and had spontaneously breathing without respirator in 3~5days, then the trachea cannulas were pulled out in 1~2 weeks. Conclusion effective respiratory tract control may enhance the curative rate and improve patients' life quality.

Objective To understand the subjective perception and influential factors of physical assessment technique in clinical nurses. Methods Using self-designed physical assessment skills questionnaire to investigate nurses in the six provinces of China, 1115 questionnaires were valid. Results There were 11 items in this questionnaire. The first four were: physical assessment is an essential skill of nurses (88.1%),the importance of continuous learning (84.8%), lack of maturity assessment tools (79.8%), heavy workload,lack of time (60.8%). The result of multiple regression analysis (stepwise) showed that hospital-level and regional were the main factors affecting the subjective perception. Conclusions The development of physical assessment reies mainly on rational allocation of human resources structure, establishing the physical assessment framework, and make sure different departments have their own characteristics and the importance of continuing education.

Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant inherited disease,and may be related to the mutation of CDH1 or CTNNA1 genes.Microscopically,signet-ring cell carcinoma is suggested frequently in endoscopic biopsy or gastrectomy specimens.Some patients may have concomitant extra-stomach tumor (frequently breast cancer in females).Detection of CDH1 gene mutation should be performed in high-risk individuals,and diagnosis and treatment should be carried out by a multidisciplinary team.Prophylactic gastrectomy is recommended for those with pathogenic CDH1 mutation.Endoscopic surveillance is an option for those with CDH1 mutation of undetermined significance and those without germline CDH1 mutation.This review discussed the concept,genetic characteristics,clinicopathological features and genetic screening of HDGC for providing a reference for clinicians.

Objective To study the effects of pronunciation after cochlear implantation in children,and find out the common rules of initials consonant pronunciation errors.Methods We used the cards as the pronunciation articulation test from hearing impairment children's hearing,language competency assessment standards and methods to evaluate auditory-verbal ability after cochlear implantation,then recorded and analyzed the errors of the initials consonant.Results After training for 10 months,we evaluated speech articulation of prelingually deaf children of 3 to 5 years old with cochlear implants 73.93%±12.76%.The most incorrect pronunciations were/s/,/z/,/sh/,/g/,/ch/,/j/,/k/,/l/,/c/,/zh/,/f/and/p/,which had resulted in substitution.According to the classification of pronunciation articulation,it focused on supradialectical and velar while the least in bilabial and blade-alveolar.Ac-cording to the classification of pronunciation method,nasal,lateral and unaspirated stop had low error rates.Conclu-sion Only do when we comprehend rules of cochlear implants in children pronunciation as well as study,can we solve problems and do well in language training.The most incorrect pronunciations in children with CI are supradia-lectical and velar,the language training should be performed aecordingly.

Objective To study the changes of eotaxin expression during different phrases of recovery process of mucosa in sinus cavity after endoscopic sinus surgery. Methods Expression of eotaxin during different phrases of recovery process of mucosa in sinus cavity in 10 patients with type Ⅰ and type Ⅱ chronic sinusitis after endoscopic sinus surgery was determined by immunohistochemitry and Western blotting. Results At 1-2 weeks after surgery, there was a significant difference in expression of eotaxin (P

Objective To explore relationship of CD44 and transforming growth factor-? 1 (TGF-? 1) in endometriosis (EM) patients. Methods The histopathological changes and the expressions of CD44 and TGF-? 1 were observed and determined by immunohistochemistry in 17 cases of ectopic endometrium of EM patients and 17 cases of ovarian ectopic endometrium of EM patients. The other 20 cases of non-endometriosis and non-tumorous endometrial tissues were used as the control group. Results No difference in the expressions of CD44 and TGF-? 1 was found in the ectopic endometrium of EM patients and the control group, but the expressions in the ovarian ectopic endometrium of EM patients were significantly higher than those in the control group. Conclusion The abnormal expressions of CD44 and TGF-? 1 in ectopic endometrium of EM patients may be associated with the genesis and progression of EM.

[Objective]To study the diagnosis and treatment of sacral fracture accompanied by neurological damage.[Method]Twelve patients with sacral fracture accompanied by nerve injuries were treated and analyzed during 1999 to 2004,including 9 males and 3 females. Final diagnosis was given according to the evaluation of physical examination,X-ray,CT and MRI examinations. Dennis classification found 2 cases of I type,6 cases of Ⅱ type and 4 cases of Ⅲ types.The surgical approach of these patients were selected according to the Dennis classification,Type Ⅰ and type Ⅱ were treated with conservative methods,and operations were taken if little symptom was no or a little improved. Posterior approach enlargement for sacral nerve canal,exploration and endoneurolysis on sacral nerve were performed on type Ⅲ as early as possible.Old fracture of type Ⅱ and type Ⅲ with neurologic signs had to be operated early.Conservative and operative treatments were taken 7 and 5 respectively.[Result]After six months to three years following up,two cases of Denis type Ⅰ,six cases of Denis type Ⅱ and one in four Denis type Ⅲ cases were recovered completely.Two cases of Denis Ⅲ were improved significantly while one case was improved a little.[Conclusion]The anatomical position of sacrum is not conspicuous and the symptom caused by neurological damage is too tiny to detect.Carefully physical examination combined with image analysis is necessary to elevate the rate of final diagnosis.Different surgical treatments were used to different type of sacral fracture. Posterior approach enlargement for sacral nerve canal and exploration and endoneurolysis on sacral nerve may be an ideal choice to treat sacral fracture accompanied by neurological damage.Nerves injuries is an critical operation indication for delayed sacral fracture.

The nutritional value of rice germ additive was evaluated by biological method. The experiment was divided into four groups: in the first and second groups the rats were fed with 10% and 20% rice germ additive, the third group as a positive control received 1.1% casein additive, and the fourth was rice germ free group. The main nutrients such as protein, fat and carbohydrate contents in the first three groups were basically equal.The experimental results showed that the growth curve and other criteria of the rice germ additive were as same as the 1.1% casein additive group but 10% rice germ group was slightly better than the 20% group, especially the weights of males were increased more rapidly than the females.At the end of the experiment, no significant differences were found among the four tested groups in hemoglobin contents, weights of cerbrum, spleen and thymus. The data indicated that the nutritional effect of 10% rice germ additive was comparable to 1.1% casein additive. So the rice germ may be acceptable as a new potential source of protein, vitamin and mineral for human and animal foods.

In this paper, the authors analyzed the current problems in domestic hospital nursing human re-source such as widespread erosion, nursing staff slack and others. From the characteristics of nursing ethics and be-havior dynamic analysis, suggest to establish a focus on the humanities concern nursing ethics culture of the people-oriented, fundamentally effectively motivate nurses, specific include: respecting nurses and ethical personality differences;to establish a trust mechanism for nursing staff;meet the needs of nursing staff learning;to establish a nursing staff self management team, thus improve hospital nursing ethics management work, for the nursing staff to provide a stable and efficient working and living environment.

Objective To study the changes in number and function of peripheral blood T helper cell 17(Th17) in acute urticaria patients .Methods The percentages of Th17 in peripheral blood from 50 acute urticaria patients and 50 healthy persons were ana‐lyzed by immunofluorescence staining and bicolor flow cytometry (FCM ) in vitro .Retinoic acid‐related orphan nuclear receptor γt (RORγt) mRNA from the same research objects were detected by quantitative realtime PCR (qPCR) method .Peripheral blood transforming growth factor‐β(TGF‐β) ,interleukin(IL)‐6 ,IL‐17A and IL‐17F were tested by enzyme linked immunosorbent assay (ELISA) from the same research objects .Results The quantity of percentages of Th17(t= 36 .634 1 ,P< 0 .05) and levels of RORγt mRNA(t=23 .840 1 ,P<0 .05) in urticaria patients were higher than those in healthy persons obviously .Meanwhile ,the levels of TGF‐β(t=15 .521 1 ,P<0 .05) ,IL‐6(t=7 .247 3 ,P<0 .05) ,IL‐17A(t=15 .415 3 ,P<0 .05) and IL‐17F(t=13 .032 1 , P<0 .05) in urticaria patients were higher than those in healthy persons significantly .Conclusion Dysfunction of Th17 in periph‐eral blood may involve in the immunopathogenesis of acute urticaria .