Objective To investigate the effect of exception questions/miracle questions in SolutionFocused Approach in nursing on affects,confidence to solve problem,the perception of problem's difficulty,and actual solving problems,to provide practical basis for practitioners of Solution-Focused Approach.Methods A total of 102 nurses were randomly divided into exception questions in Solution-Focused Approach group (exception group),miracle questions in Solution-Focused Approach group (miracle group)and cause questions in the traditional psychotherapy pattern group(cause group).The difference among three groups on the aspect of the change of affects,confidence to solve problem and the perception of problem's difficulty,and the help form the questions immediately and after 1 week (immediate help and 1 week after help) were studied.Results Eventually subjects effectively,34 nurses in exception group,31 nurses in miracle group,31 nurses in cause group.The difference among three groups in aspect of the change of affects,the change of confidence to solve problem,immediate help and 1 week after help were statistically significant (Z=9.68-18.58,P＜ 0.05).Furthermore,change in problem solving confidence on exception group was higher than cause group(51.9 vs.35.6,P ＜ 0.05),change in affects on exception group and miracle group were higher than cause group (53.8,55.1 vs.36.0,P ＜ 0.05),the immediate help on exception group and cause group were higher than miracle group (59.8,52.5 vs.32.0,P ＜ 0.05),and 1 week after help on exception group was higher than miracle group and cause group(64.5 vs.42.3,37.0,P ＜ 0.05).Conclusions Exception/miracle questions can both improve the emotional state,and exception questions can enhance the confidence to solve problems and provide more help for nurses.

Objective: To observe therapeutic effects of ticagrelor combined tirofiban on patients with ST elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) and their short-term prognosis.Methods: A total of 280 STEMI patients undergoing emergency PCI were selected.According to random number table, patients were randomly divided into clopidogrel group (received clopidogrel combined tirofiban therapy) and ticagrelor group (received ticagrelor combined tirofiban therapy).TIMI blood flow grade of infarct related arteries, platelet aggregation rate and P2Y12 reaction unit (PRU) before and after PCI, and incidence of major adverse cardiovascular events (MACE) within 30d follow-up, hemorrhage event and cardiac function were measured and compared between two groups.Results: Compared with clopidogrel group after PCI, there was significant rise in percentage of TIMI blood flow grade 3 (81.4% vs.91.4%), and significant reductions in platelet aggregation rate [(55.2±4.1)% vs.(50.8±4.4)%] and PRU [(196.2±15.1)U vs.(180.8±12.0)U] in ticagrelor group, P<0.05 all.Compared with clopidogrel group after 30d follow-up, there were significant reductions in incidence rates of re-myocardial infarction (5.0% vs.2.9%) and cardiogenic death (2.9% vs.0.7%), left ventricular end-diastolic dimension [(53.1±2.8)mm vs.(49.0±2.0)mm] and left ventricular end-systolic dimension [(40.2±2.1)mm vs.(37.4±1.8)mm], and significant rise in left ventricular ejection fraction [(51.8±2.7)% vs.(55.4±2.5)%] in ticagrelor group, P<0.05 all.There were no severe hemorrhage events in both groups, and no significant difference in incidence rate of mild hemorrhage (5.0% vs.6.4%) between clopidogrel group and ticagrelor group, P=0.591.Conclusion: For STEMI patients undergoing emergency PCI, ticagrelor combined tirofiban can effectively reduce platelet aggregation rate, improve TIMI blood flow of infarct related arteries, therapeutic effects and their short-term prognosis without increasing hemorrhage risk, which is worth extending.

Objective To examine the effects of sinomenine (Sin) on inflammatory cell numbers of subarachnoid small perivascular and explore the role of anti-inflammatory of Sin in the treatment of migraine in a rat model of migraine. Methods Healthy wistar rats were randomly divided into 6 groups:normal group, model group and Sin low dose group, Sin middle dose group and Sin high dose group. The rat migraine model was established by subcutaneously administration of nitroglycerin. The brain and mater of rats were decapitated following 4 h of medical intervention. HE staining was used to stain inflammatory cells and inflammatory cells within perivascular spaces were counted under light microscope. Results Compared to normal group, the inflammatory cells (mainly lymphocyte and monocyte) within perivascular spaces were in-creased significantly in model group [(28.10 ± 2.28) vs. (1.60 ± 1.07),P<0.01)];The inflammatory cells in all three Sin groups were significantly reduced compared with model group [Sin high dose group (2.60 ± 1.43)、Sin middle dose group (5.10±1.37)、Sin low dose group (9.10±0.88) vs. (28.10±2.28),P<0.01]. Conclusions Sin can significantly reduce inflam-matory cells within perivascular spaces in the rat model of migraine, suggesting that Sin can effectively treat migraine.

Objective To investigate pathogens distribution and their drug resistance of hospital acquired pneumonia (HAP) in local elderly paraplegic patients,and to help to gain experience in early using antibiotics.Methods One hundred and thirty six elderly patients diagnosed as HAP from January 2007 to December 2010 in our hospital were selected.Pathogens distribution and their drug resistance were detected.Results One hundred and fifty two pathogens are isolated from the 136 patients,and most of them are gram negative bacteria which accounts for 70.4％.The first three pathogens are Klebsiella pneumonia(24.3％),Escherichia coli (20.4％) and Pseudomonas Aeruginosa (18.4％).Gram-positive cocci accounts for 25.0％ in total pathogens,among them,staphylococcus aureus and streptococcus pneumoniae account for the most,and the number of Fungi is the fewest.Drug resistance rate of gram-negative bacteria is higher than that of Gram-positive bacteria.Gram-negative bacteria has higher resistance to ampicillin,cefoperazone,ciprofloxacin,levofloxacin and eotrimoxazole.Gram-positive bacteria has higher resistance to penicillin,cefazolin and gentamicin.Conclusion To elderly paraplegic HAP patients,the main pathogenic flora is gram-negative bacterium which shows multiple resistances.Being familiar with the features of pathogens and their drug resistance will provide better guidance on early treatment and improve prognosis of elderly paraplegic HAP patients.

AIM:To establish the quality control for Finger-citron Formula Granule. METHODS: The TLC,HPLC and fingerprint chromatogram were used to make quality standard. RESULTS: The TLC spots were clear and 5,7-dimethoxy-coumarin showed a good linearity at a range of 0.46-4.14 ?g.The average recovery was(99.01%)(n=6) with RSD 1.58%. CONCLUSION: The method could be used as the quality control of Finger-citron Formula Granule.

Objective To analyze the congenital anomalies of inferior vena cava (IVC) with their color Doppler and clinical features, and to evaluate the value of color Doppler ultrasound in the diagnosis of congenital anomalies of the IVC. Methods Between July 2009 and March 2012, 22 patients who were diagnosed as IVC anomalies by color and spectral Doppler ultrasound were retrospectively analyzed. After careful and comprehensive scanning on multiple planes, the final diagnosis was made based on the findings obtained on B-mode, color Doppler and spectral Doppler ultrasound. All the results obtained by sonography were compared with computerized tomography angiography, digital subtraction angiography, and other clinical examinations. Results There were 22 cases diagnosed as congenital anomalies of IVC, including 5 cases of the left IVC, 3 cases of the double IVC, 3 cases of membranous obstruction of the IVC (MOVC) and 11 cases of the anomalies of the left renal vein. In left IVC, the infrarenal left-sided IVC entered into the left renal vein, then crossed anterior to the aorta to join the right-sided suprarenal IVC. In double IVC, bilateral IVCs could be seen on both sides of the abdominal aorta, and the left IVC joined the right IVC over aorta then entered into the right atrium. Some patients of the left IVC and double IVC had left renal vein hypertension. All the cases of MOVC in our study presented as Budd-Chiari syndrome, in which B-mode ultrasonography showed the existence of the membranous obstruction in inferior vena cava at the level of entrance to the right atrium. On color Doppler lfow image (CDFI), reverse blood lfow into lumbar and ascending lumbar vein was found. Eleven cases of left renal vein malformations were also seen in present study, including 9 cases of retroaortic
left renal vein, 1 case of circumaortic left renal vein and 1 case of the left renal vein into the left common iliac vein. Among them, 9 cases were associated with left renal vein hypertension. Conclusion Color and spectral Doppler ultrasound can clearly identify the congenital anomalies of IVC with the evaluation of their hemodynamic modiifcation, and can be used as an important approach in the diagnosis of the anomalies of the IVC.

OBJECTIVE To ascertain the current situations of nosocomial infection control in local general hospitals,and to provide reliable data for future work.METHODS A random sampling questionnaire(method) was adopted to investigate the current situations of nosocomial infection control in 15 local hospitals in eight counties and cities.RESULTS Altogether 15 hospitals at the county and urban levels have been surveyed,(among) which 14 hospitals have fewer than 300 sickbeds and only 1 hospital has over 500 sickbeds.Seven hospitals did not have full-time staff of infection control till 2003.In the 15 hospitals,each full-time staff was(responsible) for an average of 143.9(sickbeds);in terms of the constitution of the full-time staff,nurses accounted for 73.7%,doctors,21.9%,and technicians,5.2%;of the full-time staff,63.2% held an intermediate(professional) position,and 36.8% held a junior professional position;with regard to the chances of further professional training in other places,19 full-time staff had 56 chances.The applications of sterilized agents and protective equipments were increasing each year.CONCLUSIONS The(infection) control in local general hospitals is gradually on the right track,but in some aspects,improvements are still needed.The prerequisites for improving infection control work in local general hospitals are that leaders should pay more attention to nosocomial infection control,and that more human and(material) resources should be pooled in it.

Objective To study the clinical effect of the combination of cataract ultrasonic emulsification and multifocal aspherical intraocular lens in cataract patients through evaluating different intraocular lenses elimi-nating spherical aberration. Methods 180 patients(180 eyes)with senile cataract were included between,2001 and 2005.The patients were divided into three group (n = 60 each),based on the admition time. Implantion of ReSTOR-SN60D3 is multifocal aspherical intraocular lens(SN60D3),implantion of SN60AT lens is single spheri-cal intraocular lens (SN60AT),and implantion of SN60WF lens is single aspherical intraocular lens (SN60WF group). Three months after operation,the refractive state,focus depth,modulation transfer function(MTF),and higher-order aberrations were measured ,and the visual quality were investigated. Results There was no signifi-cant difference in vision in three groups before operation(P > 0.05). After operation,the UCNVA of SN60D3 group was significantly better than the SN60AT group and SN60WF group(P < 0.05). Under 3 mm pupil diame-ter,spherical aberration of SN60D3 group and SN60WF Z(4,0)were less than SN60AT group(P < 0.05), SN60D3 group and SN60WF only under 5 CPD spatial frequency MTF(HOA)value was superior to the SN60AT group(P<0.05);The score of near vision,reliance on vision correction and limitation of operation of patients in SN60D3 group were higher than other two groups(P<0.05). Visual clarity and day vision fluctuations of patients in SN60D3 group is better than single focal sphere group(P<0.05). Conclusion In multifocal aspherical intra-ocular lens,general spherical aberrations and higher-order aberrations is smaller,effect of naked near vision is bet-ter and the rest of the vision is stable ,which can bring good visual quality for cataract patients after operation.

OBJECTIVE:To observe the effect of intravenous administration of amiodarone on postoperative heart failure and ventricular arrhythmia.METHODS:A total of 42 postoperative heart failure patients with ventricular tachycardia and multi-source ventricular premature beat were treated with lidocaine,but clinical efficacy was not obtained.Those patients received intravenous administration of diluted amiodarome 150 mg.After 30 minutes the dose of amiodarone was kept at 0.5～1.0 mg?min-1,and the total dosage ranged from 1 000 mg to 1 200 mg within 24 h.Clinical symptoms were recorded in every hour,such as cardiac rhythm,heart rate,blood pressure,heart failure.RESULTS:After 24 h of treatment,17 cases of ventricular arrhythmia had apparent effect(40%),20 cases of partial effect(47%),5 cases of no effect(12%),there were statistical significance in difference before and after treatment(P

Objective To explore the necessity and effect of the motivational interviewing/MIcurriculum in medical school students. Methods Helping smoking cessation in standard patients with coronary heart disease was assumed as the expected goal. MI was carried out for medical school students to master basal knowledge and skills of MI and help using MI methods in persuading smoking quitting. The teaching mode of MI curriculum was comprised of a lecture series and small group dis-cussion with videotaped practice in role plays. Motivational Interviewing Treatment Integrity (MITI) scoring tool was applied to assess the teaching effect of MI curriculum with students' performance videotapes. Questionnaire was used to evaluate the quality and efficacy of the MI curriculum, and SPSS 13.0 was used to t test measurement data. Results Analysis of the MITI scores showed students had general mastery of MI knowledge. Nevertheless, they did not reach recommended professional profi-ciency level. The scores of empathy and MI spirit in global ratings were (4.11 ±0.32) and (5.82 ± 0.17), respectively (recommended level, 6 score). In the videotape evaluation of behavior counts, MI adherentreached (70.96%±24.34%) (recommended level, 90%). Open question reached (31.42%±8.51%) (recommended level, 70%). Total refection counts were (7.84±3.22) counts per video (recom-mended level, 10). The standard questions recommended in MI for behavior change were better used by students. 93.75%and 87.50%students used ranking questions to evaluate the importance and con-fidence of smoking quitting. Nevertheless, the exploration questions about importance and confidence were less used to know the reason behind their ranking . The results of questionnaire showed that 83.33%students felt MI curriculum effective to help them improve confidence and skills in counseling with patients. 97.91%students thought the mastery of MI methods as an important skill for physicians to have. Conclusion The teaching practice of MI curriculum in medical school students is necessary and feasible with good teaching results. It is worth for professional counseling regarding unhealthy be-havior change in patients.