Through the investigation on medical students' understanding of hospice care and their cognition and attitudes on voluntary services in hospices in Wenzhou,this paperconcluded that medical students accepted hospice care highly but knew little about it,and medical students were willing to participate in hospice care but actually rarely attended it.It is also suggested that universities should strengthen the propaganda and education of hospice care and volunteer service,joint efforts should also be given to expand the service opportunities and channels,and trainings should be provided to improve the development of hospice care volunteer services among medical students.

Objective To investigate the clinical efficacy of warm needling plus palm pressing spine reduction technique in treating postpartum thoracic facet joint disorder.Methods Forty patients with postpartum thoracic facet joint disorder were randomly allocated to treatment and control groups, 20 cases each. The treatment group received warm needling plus palm pressing spine reduction technique and the control group, warm needling alone. The numeric pain rating scale (NPRS) score, the Oswestry Disability Index (ODI) score and the Quality of Life Scale score were recorded in the two groups before and after treatment and the clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 95.0% in the treatment group and 75.0% in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant pre-/post-treatment differences in the NPRS score and the ODI score in the treatment group (P<0.01). There was a statistically significant pre-/post-treatment difference in the NPRS score in the control group (P<0.01). There were statistically significant post-treatment differences in the NPRS score and the ODI score between the treatment and control groups (P<0.01,P<0.05). There were statistically significant pre-/post-treatment differences in the SF-36 PF, RP, BP, VT, SF and MH scores in the treatment group (P<0.01,P<0.05). There were statistically significant pre-/post-treatment differences in the SF-36 PF BP, SF and MH scores in the control group (P<0.01,P<0.05).Conclusion Warm needling plus palm pressing spine reduction technique is an effective way to treat postpartum thoracic facet joint disorder.

Objective To evaluate the efficacy and side-effects of the levonorgestrel-releasing intrauterine device (Mirena) in the treatment of dysfunctional uterine bleeding .Methods 45 cases of dysfunctional uterine bleeding diagnosed by pathology were installed with Mirena.The endometrial thickness by ultrasound hemoglobulin increase and pathologic changes of endometria were recorded before and 24 months after the installation.ResultsThe endometrial thickness before and after the insertion of Mirena were(15.6 ±4.2) mm and (3.2 ± 1.3)mmrespectively (P ＜ 0.01) .Six months after the insertion of Mirena, patients' hemoglobulin was significantly increased from (97.6 ± 8.2)g/L to (123.7 ± 8.1)g/L (U = 2.26, P ＜ 0.05) .After the installation of Mirena, patient experienced metrorrhagia.Conclusions Mirena is a device providing effective and continual therapy for dysfunctional uterine bleeding .It can not only significantly reduce the menstrual blood loss but also reverse the complex hyperplasia effectively.

BACKGROUND: Researches find that grape seed proanthocyanidins (GSP) can eliminate free radicals, protect heart against ischemia-reperfusion injury and enhance learning and memory abilities in experimental animal, but their effects on the cerebral ischemia-reperfusion injury remain unclear.OBJECTIVE: To study the protective effects of proanthocyanidins derived from grape seeds on the cerebral ischemic reperfused brain by measuring the total antioxidative capacity (T-AOC), nitric oxide synthase activities and malondialdehyde (MDA) content in brain tissue of mice.DESIGN: A completely randomized and controlled study.SETTING: Department of Pathophysiology and Functional Central Laboratory, Jinzhou Medical College; Department of Neurology, the First Affiliated Hospital of Jinzhou Medical College.MATERIALS: The experiment was conducted in the Department of Functional Central Laboratory, Jinzhou Medical College from March to August 2004. Forty Kunming mice, provided by the Experimental Animal Center, Jinzhou Medical College, were randomly divided into five groups: sham control group, cerebral ischemia-reperfusion group (IR group) and cerebral ischemia-reperfusion treated with low or high dose of GSP or nimdipine (IR+GSP or IR+Nim) group with eight mice in each group.METHODS: ① Animal model establishment: The animals were anesthetized with ether. Then they were incised through median incision of the neck. The bilateral common carotid arteries were then occluded by microaneurysm clips for 30 minutes. After removing the clips, return of flow was visualized in the arteries. ② Model group and control group:The mice in low or high dose of GSP treated group or nimdipine treated group were injected GSP or nimdipine 10, 40, 2 mg/kg body mass respectively during the common carotid arteries occlusion and again at 24hours after reperfusion, while the mice in sham control group were injected the same volume distilled water with 40 mg/kg body mass. After 72-hour reperfusion, nitric oxide synthase activities, the total antioxidative capacity and MDA content in brain tissue of mice in each group were detected with chemical chromatometry. ③ The results were assessed by t test.MAIN OUTCOME MEASURES: Nitric oxide synthase activities, the total antioxidative capacity and MDA content in brain tissue of mice in each group were detected.RESULTS: Data of forty Kunming mice was entered the results analysis without any loss. ① Total antioxidative capacity: Total antioxidative capacity in cerebral ischemia-reperfusion group was obvious lower than that in the sham control group (t=8.145, P=0.000) while total antioxidative capacity in low or high dose of GSP treated group and nimdipine treated group was obvious higher than that in the cerebral ischemia-reperfusion group (t=6.313, 8.956, 4.14, P ＜ 0.01). ② Nitric oxide synthase activities: Nitric oxide synthase activities in cerebral ischemia-reperfusion group was obvious higherthan that in the sham control group (t=12.541, P ＜ 0.01), while nitric oxide synthase activities in low or high dose of GSP treated group and nimdipine treated group was obvious lower than that in the cerebral ischemia-reperfusion group (t=2.231, 8.956, 7.260, P ＜ 0.05-0.01). ③ MDA content: MDA content in cerebral ischemia-reperfusion group was obvious higher than that in the sham control group (t=7.883, P ＜ 0.01), while high dose of GSP treated group and nimdipine treated group was obvious lower than that in the cerebral ischemia-reperfusion group (t =5.234,4.518, P ＜ 0.01).CONCLUSION: GSP exerted a protective effect on the cerebral ischemic reperfused brain by enhancing total antioxidative capacity and reducing lipid peroxidantion and nitric oxide synthase activities.

Objective To evaluate the relationship between the existence of DME and the SFCT in DR pa-tients. Methods We collected 70 cases which were clinical diabetic involving 122 eyes. They are 36 men with 64 eyes and 34 women with 58 eyes. The average age is 56.7 ± 9.7 year-old. All patients had been examined by oph-thalmologic examination. Grouping: patients without diabetic retinopathy (NDR) group; mild-to-moderate NPDR group; severe NPDR group; PDR group. The last three groups were divided into two subgroup groupsrespectively , which were cases with and without significant macular edema (CSME + / CSME). EDI was used to measure the SFCT. SPSS 17.0 software was used for statistical analysis. Results The average SFCT of NDR group, mild-to-moderate NPDR group, severe NPDR group and the PDR group respectively were (282.94 ± 104.21)μm, (313.62 ± 94.40)μm, (382.44 ± 76.91)μm, (335.00 ± 73.82)μm. Compared with the NDR group, SFCT was thicker than the other three groups, and difference was statistically significant (F = 2.786, P = 2.786). There were no statisti-cally significant difference of SFCT between the mild-to-moderate NPDR/CSME - group and mild-to-moderate NPDR/CSME + group, severe NPDR/CSME - group and severe NPDR/CSME + group PDR/CSME-group, PDR/CSME + group. Conclusions The SFCT of DR patients could potentially be thickenedas disease became serious. When considered the same degree DR, there is no obvious difference of SFCT between patients with CSME and without CSME.

Objective To observe the clinical efficacy of auricular acupuncture plus acupoint injection at Zusanli (ST 36) in treating shoulder pain due to gynecologic laparoscopy.Method Totally 120 patients with shoulder pain due to gynecologic laparoscopy were randomized into a treatment group and a control group, 60 cases in each group. The treatment group was intervened by auricular acupuncture plus acupoint injection at Zusanli (ST 36), while the control group was by ordinary analgesics. The clinical efficacies were compared after 2 treatment courses.Result The Visual Analogue Scale (VAS) scores, Present Pain Intensity (PPI), and the item scores of the Short-Form (36) Health Survey (SF-36) were significantly changed in both groups after treatment (P<0.01,P<0.05). There were no significant differences in comparing the VAS score, PPI, and the item scores of SF-36 between the two groups (P>0.05). The total effective rate was 95.0% in the treatment group versus 75.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Auricular acupuncture plus acupoint injection at Zusanli (ST 36) is effective in treating shoulder pain due to gynecologic laparoscopy, and it can effectively reduce the occurrence of complications.

Objective To analyse the factors influencing the death of patients with aortic dissection (Stanford type A arota dissection) who underwent urgent surgery.Methods The clinical data of 197 patients with aortic dissection (Stanford type A arota dissection) treated with urgent surgery from the First Affiliate Hosiptal of Xinjiang Medical University were retrospectively analyzed between January 2009 and June 2015 in order to determine the factors influencing the early-mortality.Results Of them,23 patietns dead.In univariant analysis,the rate of mortality was 11.68％.The following factors at admission were independetly associated with early-mortality:hypertension,coronary atherosclerotic heart disease,LVEF ≤ 50％,time consumed for CPB ≥ 180 min,time required for cross-clamping aorta ≥ 120 min,Cr ≥ 130 μmol/L,rethoracotomy for hemostasis (P ＜0.05).The preoperative renal failure (Cr≥130 μmol/L) and time consumed for cross-clamping aorta ≥ 120 min were strongly associated with the early-mortality based on the logistic regression analyses.Conclusions The risk of aortic dissection surgery is very high,and it is mondatory to carefully evaluate the patient' s general condition and the indications during peroperative period,and to take active measures to shorten the time of clamping aorta and total operation time in order to reduce the risk of operation and increase the survival rate of patients.

Objective To observe the clinical efficacy of the early activity on preventing deep vein thrombosis after joint replacement. Methods A total of 90 patients who undergone skeleton and knee joint replacement from January 2014 to January 2015 were randomly divid-ed into the observation group and the control group (with 45 cases in each group)according to the random number table method.The control group were given routine nursing care to prevent thrombosis,while the observation group were given intervention nursing,namely implementa-tion of early activities.The related symptoms of deep venous thrombosis and D-dimer level of high blood coagulation state of plasma of the two groups were observed and compared before and after treatment.Results The symptoms of deep vein thrombosis of the observation group in the early postoperative period were less than that of the control group,and the difference was significant(P <0.05).The D-dimer level of the observation group was lower than that of the control group 7 days after the operation with a significant difference (P <0.05).Conclusion Systematic nursing intervention of early activities can significantly reduce the related symptoms of forming deep vein thrombosis after joint re-placement.In addition,it has an apparent effect on lowing the high blood coagulation state and preventing deep vein thrombosis.

Objective To analyze the present situation of technical efficiency in TCM hospitals throughout the country, discuss the influencing factors causing inefficiency and propose corresponding suggestions. Methods The technical efficiency in 60 TCM hospitals in the country was analyzed using the stochastic frontier cost model for panel data and the influencing factors causing inefficiency were discussed using the multiple stepwise regression method. Results The average technical inefficiency was 22.59% and inefficiency showed an upward trend as the areas shifted from the eastern through the middle to the western regions. Five factors, including the utility rate of beds and the proportion of health technicians among the entire hospital staff, were statistically significant so far as the effect on the increase of the overall cost was concerned. Conclusion The stochastic frontier cost model for panel data is the best method for evaluating the technical efficiency in TCM hospitals. On the basis of the above analysis, suggestions for strengthening scientific management, improving the utility rate of resources and reducing unnecessary waste are put forward.

Objective To determine the content of polysaccharide of prepared pinellia tuber. Methods The content was determined by sulfuric acid-anthrone colorimetric method with wavelength at (624?1)nm. Results The content of polysaccharide was 2.533 mg/g in prepared pinellia tuber. The average recovery was 99.54% and RSD was 1.69%. Conclusion The methods was simple, steady and reproducible.