Patients with long-standing history of ulcerative colitis have an increased risk of developing colitis-associated colorectal cancer.The risk factors include longer duration of colitis,greater anatomic extent of colitis,degree of inflammation of the bowel,family history of colorectal callcer,the presence of primary sclerosing cholangitis.etc.The two kinds of molecular pathogenesis that contribute to colon carcinogenesis are chromosomal instability and microsatellite instability.In order to reduce cancer morbidity,colonescopic surveillance and chemoprevention should be carried out in patients with ulcerative colitis especially in those high risk patients.New endoscopic techniques increase the sensitivity and shed a new light on tumor surveillance.

Academic powers and administrative power are two primary kinds of power coexisting in the hospital. The two kinds of power,which are essentially different,both overlap and conflict,leading inevitably to the complexity and variety of the power structure in the hospital. By analyzing the current situation of the power structure in the operation and management of hospitals in China,the paper aims to help bring about checks and balances of academic and administrative powers in domestic hospitals and offer some insight into possible models of power operation in Chinese hospitals that fit in with the times and regional features.

Objective To investigate the different effects of 2 species of Fructus aurantii immaturus on cardiovascular and respiratory system.Methods The extract of 2 species of Fructus aurantii immaturus were administered to anesthetized rats by duodenum and the dosages were 4.2,2.1 g crude drug/kg respectively.After administration,a continuous observation of blood pressure,respiration and ECG effects for 4 hours were performed.Results Compared with the control group,both of Citrus aurantium and Citrus sinesis exerted a transient increase to respiration rate after 20 min administration.No significant impact was observed during the experiment period on the ECG.The influence of Citrus aurantium on blood pressure was more significant.Compared with the control group,the effects of SBP,DBP and MBP reduced was observed in high-dose group of Citrus aurantium after 40,60,80 min administration,and so in low-dose group of Citrus aurantium after 60 min.The impact duration was up to 2 hours or more.However,the antihypertensive effect of Citrus sinesis was not obvious.And the blood pressure lowering effect of Citrus aurantium was superior to Citrus sinesis.Conclusion The 2 species of Fructus aurantii immaturus exert a transient excitatory effect on respiratory system.And the direct effect of them on heart is not obvious.The blood pressure lowering effect of Citrus aurantium is superior to Citrus sinesis.The attention should be given in the clinical usage of Fructus aurantii immaturus.

Objective To study the correlation between the hope levels and medical coping modes of maintenance bemedialysis(MHD) patients.Methods 118 hemodialysis patients were sampled from a hospital in Fuzhou city in October,2007.A survey was conducted among these patients by questionnaires.And the col-lected data were analyzed with SPSSll.5.Results 98.3% of surveyed patients got a mediate or high-level in hope level.Compared to common patients,MHD patients got a higher score both in wriggly and subdued coping modes,and a lower score in facing mode.The choice of coping modes was affected by the hope levels of MHD patients.Conclusions Pafients with higher hope level tend to adopt wriggly and facing coping modes,while those with lower hope level generally take subdued coping mode.The nurses should help MHD patients seek supports from others in order to increase their hope level and promote them to adopt effective coping modes,in doing 80,it Can promote their mental healthy and improve their qu~ty of life.

Objective To investigate the role of angiogenesis and expression of vascular endothelial growth factor (VEGF) in the pathophysiology of adenomyosis of the uterus. Methods The study included 32 patients with histologically proven adenomyosis and 30 patients with asymptomatic leiomyoma of the uterus. Immunohistochemical staining was used to detect VEGF expression in different parts of the uterus. A computerized morphometric study on the VEGF expression was performed. Results The VEGF H-Score of glandular cells in the endometrium of adenomyosis uterus [proliferative phase (9.6?1.4), secretory phase (11.7?1.6)] was much higher than that of leiomyoma uterus [proliferative phase (8.3?1.7),secretory phase (10.2?1.5)] (P0.05). The VEGF H-Score of myometrium around the ectopic lesions [proliferative phase (9.5?1.3), secretory phase (8.7?1.3)] was higher than that of normal myometrium [proliferative phase (4.8?1.9), secretory phase (4.5?1.4)] (P

Objective To evaluate the effect of group cooperative learning on the experimental teaching of obstetrics and gynecology nursing.Methods We chose 113 undergraduate nursing students,using the traditional self-learning mode in the experimental teaching of cleaning and disinfection of the vulva and the group cooperative learning mode in the experimental teaching of vaginal douching.Their practical manipulations of the nursing skills by the two teaching modes were compared.A self-designed questionnaire was adopted to investigate the student's attitude to the group cooperative learning.Results The examination achievement by the group cooperative learning was better than that by the traditional self-learning,(Z=-4.986,P<0.001).89.4%of the students approved of the group cooperative learning.Conclusion The group cooperative learning may improve the effects of experimental training,contribute to the cooperative spirits of students,and also make full use of the human resources in teaching.

Objective To determine the long-term changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) and macular retina after acute primary angle closure.Methods Prospective clinical case-control study.A total of 26 patients (30 eyes) with acute primary angleclosure glaucoma (APACG) were in the APACG group,whose intraocular pressure were control after a single episode acute primary angle closure;30 age-and sex-matched healthy subjects (30 eyes) in the control group.All subjects underwent three dimensional optical coherence tomography (3D-OCT) examination with 3D optic disk scanning or circle optic disk scanning and 6 mm× 6 mm macular scanning.The parameters included average thickness of entire CP-RNFL,thickness of nasal,superior,temporal and inferior quadrant of CP-RNFL,disc area,disc cup area,rim area,cup/disc (C/D) area ratio,C/D horizontal diameter ratio and C/D vertical diameter ratio.The foveal retinal thickness,center retinal thickness (≤ 1 mm from the fovea),4 quadrants of macular inner-ring (＞ 1 mm but ≤3 mm from the fovea) retinal thickness,4 quadrants of macular outer-ring (＞3 mm but ≤6 mm from the fovea) retinal thickness,average thickness of macular retinal thickness and macular volume were measured and analyzed.Results The disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio and C/D vertical diameter ratio in APACG group were significantly bigger than the control group (t=3.22,4.12,3.90,3.00,3.23;P＜0.05),rim area was smaller than the control group (t=-2.63,P＜0.05).The average thickness (t=-6.68) and the thickness of superior (t =-5.90),temporal (t =-11.64) and inferior (t =-5.06) quadrants of CP-RNFL,center retinal thickness (t=-2.50),4 quadrants of macular inner-ring retinal thickness (t=-4.91,-4.88,-2.83,-3.59),nasal (t=-2.13) and superior (t=-2.49) quadrants of macular outerring retinal thickness as well as average thickness of macular retinal thickness (t=-2.65) were significantly thinner than the control group (P＜0.05),and the macular volume (t=-2.69) was significantly smaller than the control group (P＜0.05).There was no statistically difference at nasal CP-RNFL (t=-0.11),foveal retinal thickness (t=-0.59),temporal (t=-0.67) and inferior (t=-1.02) quadrants of macular outer-ring retinal thickness between two groups (P＞0.05).Conclusions In comparison with the healthy subjects,the disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio in APACG eyes were bigger,while rim area was smaller;the CP-RNFL and macular retinal thickness were thinner except nasal CP-RNFL,fovea,temporal and inferior quadrants of macular outer-ring retinal.

Objective To evaluate the clinical value of early alterations of carotid arterial intima-media thickness (IMT) and elastic function in patients with hypertriglyceridemia (HTG) using ultrasound radio-frequency technique.Methods 48 patients (triglyceride value ≥ 1.8 mmol/L) were chosen as HTG group.Quantitative intimamedia thickness (QIMT) and quantitative arterial stiffness (QAS) techniques were used to observe the alterations of carotid arterial IMT and elastic index,including diameter of carotid artery (D),distensibility coefficient (DC),compliance coefficient (CC),elasticity coefficient (α),elasticity coefficient (β) and pulse wave velocity (PWV).50 healthy subjects were recruited in control group.Differences of the above-mentioned parameters were analyzed,as well as the elastic index connections between the two groups.Results IMT,α,β,and PWV index of bilateral carotid arteries in HTG group was higher than that of the control group,while the DC and CC index was lower,and the differences was statistically significant (P＜0.05).Within the groups there were differences between the elastic indexes of bilateral carotid arteries.In control group and the HTG group:CCL＞CCR,αL＞αR,βL＞βR,PWVL＞PWVR.CC was negatively correlated to α,β and PWV (P＜0.05).Meanwhile,there was positive correlation among α,β and PWV (P＜0.05).The differences of D between two groups had no statistical significance (P＞0.05).Conclusions The abnormity of arterial occurs earlier than the morphological change,while the ultrasound radio-frequency technique can provide information of earlier alteration of common carotid arteries structure and elastic function in patients with HTG,which is a significant method of testing early alteration of carotid elastic in patients with HTG.

Objective To observe the changes of circumpapillary retinal nerve fiber layer (CP-RNFL)thickness and optic disk parameters in retinitis pigmentosa (RP) eyes.Methods Prospective clinical case-control study.A total of 25 patients (42 eyes) with RP were in the RP group,and 42 age matched healthy subjects (84 eyes) in the control group.All subjects underwent optical coherence tomography (OCT) examination,in which 37 eyes with 3D optic disk scanning and 5 eyes with circle optic disk scanning.The parameters included average thickness of entire CP-RNFL,thickness of nasal,superior,temporal and inferior quadrant of CP-RNFL,disc area,disc cup area,rim area,cup/disc (C/D) area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume and disc rim volume.Results The average thickness and the thickness of temporal and nasal quadrants of CP-RNFL in RP group were significantly thicker than the control group (t=2.27,3.73,6.44;P=0.027,0.00,0.00),while the thickness of inferior and superior areas were the same as control group(t=-1.49,-1.19;P=0.14,0.24).The disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume in RP group were significantly bigger than control group (P＜0.05),while rim area and rim volume were not significant differences (t=1.75,0.40;P=0.08,0.59).Conclusion In comparison with the healthy subjects,the average thickness and temporal and nasal areas of CP-RNFL in RP eyes were thicker,and the disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume in RP eyes were bigger.

Objective To investigate the effect of applying web based problem-based learning in the teaching of bilingual curriculum.Methods 2009 grade nursing undergraduate bilingual class (n =57) was taken as control group and traditional teaching method was used.2010 grade nursing undergraduate bilingual class (n =60) was taken as experimental group and bilingual course of introduction to nursing was used to do web based (Blackboard platform) PBL teaching.Teaching process of the grouping-question posing-data gathering-discussion-mid-term feedback-presentation-summary and evaluation was implemented.Result comparison method,network based PBL learning evaluation sheet and content analysis were employed to complete teaching effect evaluation.Data were analyzed by t test and P ＜ 0.05 signifies statistically significant differences.Results Test scores of experimental group were significantly higher than that in control group (P ＜ 0.05).Mean scores of positive items in web based PBL teaching scale were ≥3.84.Electronic learning file content analysis showed that excellent rates of 7 indicators (student participation,thinking ability,inquiry,etc) were ≥66.7％.Conclusion Web based PBL teaching model is good for improving teaching effectiveness in the teaching of bilingual curriculum.