Objective To investigate and compare the clinical efficacy and safety of laparoscopic and traditional open surgery in the rectal cancer surgery.Methods From March 2007 to February 2013,86 patients with radical resection of rectal carcinoma in General Surgery Department of Pinggu District Hospital of Beijing were selected as research objects,according to random number table method,they were divided into laparoscopic group(n=43) and laparotomy group(n=43).The laparoscopic group was given laparoscopic radical resection of rectal cancer,the laparotomy group was given traditional open surgery.The baseline data,operative incision length,intraoperative blood loss,operative time,postoperative hospital stay,total number of lymph nodes cleaning,exhaust time,time to get out of bed,hospitalization expenses,VAS score and postoperative complications between the two groups were observed and compared.And the survival rates of the two groups were compared.Results.The operative incision length of laparoscopic group was shorter than laparotomy group((4.20±1.15) cm vs.(16.53±4.62) cm),the intraoperative blood loss was less than laparotomy group((167.43±16.24) ml vs.(220.74±22.53) ml),postoperative hospital stay,exhaust time,time to get out of bed were shorter than laparotomy group((8.26±2.09) d vs.(13.52±2.97) d,(3.24±1.42) d vs.(4.23±1.60) d,(3.07±0.84) d vs.(4.23±1.29) d),the hospitalization expenses was higher than laparotomy group(all P<0.05).The VAS score and postoperative complication rate of laparoscopic group were lower than laparotomy group((5.32±1.18) points vs.(8.16±1.25) points,2.33%(1/43) vs.20.93%(9/43),P<0.05).There were no significant differences inoperative time and total number of lymph nodes cleaning between the two groups(P>0.05).The 5 year overall survival rate of laparoscopic group was 52.6%,the laparotomy group was 47.4%,there was no significant difference between the two groups(χ2=0.465,P>0.05).Conclusion The clinical efficacy of laparoscopic and traditional open surgery in the rectal cancer surgery are the same,and laparoscopic radical surgery is safe and effective,it has the advantages of less trauma,less complications and quick recovery,is worth popularizing.

Objective To investigate the charge nurses' leadership style perceived by nurses and nurse's self-efficacy,and then analyze the relationship between them.Methods Totally 368 staff nurses from 3A hospitals in Sichuan were investigated with questionnaires.The results underwent analysis.Results The score of charge nurses' transformational leadership style was 58.06±12.10,from high to low in turn was intellectual stimulation (3.10±0.69),inspirational motivation (2.92±0.73),idealized influence (2.88±0.67) and individualized consideration (2.71±0.74).The score of charge nurses' transactional leadership style was 35.77±8.58,from high to low in turn was contingency reward (3.11±0.71),passive exemplary management (3.09±0.75) and active exemplary management (2.75±0.90).The score of nurses' self-efficacy was 83.51±11.62.The transformational leadership style had positively predictive impact on nurses' selfefficacy.Conclusions Nursing managers should apply transformational leadership to improve nurses selfefficacy,promote the physical and mental health of nurses and the long-term development of hospital.

Objective To investigate the calbindin D\|28K (CB) neurons that receive the visceral nociceptive information in the interstitial nucleus of the spinal trigeminal tract (INV) directly project to the nucleus of the solitary tract (NTS). Methods Triple\|labeled methods of fluorogold (FG) retrograde tracing combined with Fos and CB proteins immunofluorescence histochemistry after formalin stimulating upper alimentary tract. Results Most of FG\|retrograde labeled neurons distributed in the paratrigeminal nucleus (PaV) and the dorsal paramarginal nucleus (PaMd) of INV ipsilateral to the FG injection. About 71\^2% of FG\|retrograde labeled neurons contained CB and 31\^5% of FG/CB double\|labeled neurons exhibited positive Fos\|immunoreaction in INV.Conclusion The results suggested that a part of neurons containing CB in INV receive the visceral nociceptive information and directly project to NTS. CB neurons might play an important role in transmitting visceral nociceptive information from INV to NTS. [

Objective　To investigate the influence of pretr eatment with anti-B lymphocyte serum on the immunogenecity and endocrine functi on of islet preparations.Methods　Porcine ICCs were pretre ated with anti-B lymphocyte serum which was produced using the mixed adult porc i ne B lymphocyte as antigen.The immunogenecity of islet was measured by mixed isl et lymphocyte culture (MILC) and SLA-DR positive cell number within the islet and the islet function was assayed with insulin release test.Results 　The cpm value of MILC of the group pretreated with anti-B lymphocy te serum and the MHCⅠ antigen and SLA-DR antigen positive cell numbers was mar kedly decreased in comparison with that of control group (P＜0.001).There wa s no significant difference in insulin release of additional different groups.[ WT5”HZ Conclusion　The pretreatment of islet preparation with anti -B lymphocyte serum may decrease the immunogenecity of islet preparation,while there is no marked influence on its insulin release function.

Objective To understand status quo of the domestic and foreign iceberg competency model application,and to provide basis for further study in the nursing iceberg competency model.Methods A literature review about the application of competency iceberg model at home and abroad since 2009 was carried out,the relevant data was listed,and the research situation of domestic and foreign nursing iceberg competency model was summarized.Results According to the 141 total literatures whose theme was the iceberg competency model,only 3 articles were related to the nursing field,while most of the iceberg competency model aimed at the study of enterprises in the high-level management personnel,sales personnel and so on.More researches on competency iceberg model were conducted abroad,involved in all walks of life,an research direction of nursing had turned from general iceberg competency model to the study of specific posts.Conclusions The iceberg competency model applied to the management of nursing human resources in China is developed lately and the studies lack breadth,depth and scientificalness.Compared with foreign countries,there is a big gap.A thorough iceberg competency model for human resource management is ought to be studied to provide a new perspective and a more useful tool for the early Chinese nursing theory and practice.

[Objective]To introduce the knowledge for the diagnosis of acute gout arthritis that attacked initially in the knee and improve its early treatment.[Method]Seventeen cases with acute gout arthritis in the knee were diagnosed and treated under arthroscopy since 2000.The experiences were analysed retrospectively and the therapatic results were observed through a follow-up of more than 6 months.[Result]Before arthroscopy,only 5 cases were considered as acute gout arthritis,the other 12 cases were given a misdiagnosis.All the patients were diagnosed and given a debridment simutaneously under arthoscopy.Then,the patients were given an postoperative systematic drugs therapy.The follow-up(ranged from 10 to 24 months)showed that all the patients acquired a short-term and long-term satisfactory therapeutic effect.[Conclusion]The acute gout arthritis attacked initially in the knee is rare and its misdiagnosis rate is very high.The significant improvement and extensive application of arthroscopic techniques will improve its diagnosis rate and provide a new way for its early surgical treatment.

[Objective] To enhance the understanding of the diagnosis of benign tumor in the knee joints.[Method] Thirteen patients(9 males and 4 females,aged 7 to 49 years,38.2 years arerage)with tumor in the knee joints were diagnosed and treated under arthroscopy since 1996.There were 3 with the synovial hemangioma,2 with tensoynovial giant cell tumor,4 with ganglion cysts of cruciate ligament and synovial cysts,1 with chondroma in the soft tissue,2 with desmoid tumor in the cruciate ligament and 1 with cruciate ligament desmoid.The curative effects were observed through a follow-up of more than half a year.[Result]All the cases were diagnozed under arthroscope and confirmed by the pathological examinations.All the patients were treated under arthroscope and followed by 11 months to 6 years.Clinical symptom improved obviously and no recurrence was found after the operation.Assessment of the curative effects were 46% excellent,39% good and 15% fair.[Conclusion]Benign tumor in the knee joints is rare.It's often difficult to diagnoze in the clinical practice.Arthroscopy is a very useful method for the diagnosis and treatment of the suspected patients with benign tumor in knee joints.

Objective To study the expression of estrogen receptor beta in the lung tissue of mice treaded with B[a]p alone or combined with estrogen (17 ?-estradiol, E2) in female Kunming strain mice and to explore the effect of estrogen in the lung cancer of mice induced by benzo[a]pyrene (B[a]P). Methods One hundred and twenty-five female Kunming mice were randomly divided into 5 groups: normal control group was group 1 ;group 2 was treated with subcutaneous injection of estrogen ( 900 ?g/kg); group 3 was given B[a]P(75 ?mol/kg) by gavage;the last two groups were given the same dosage of B[a]P (75 ?mol/kg)plus two different dosage of estrogen: 900 ?g/kg and 300 ?g/kg. After 8 weeks,there was a recovery period of 8 weeks. Then, the lung tissue was obtained by surgical resection. The expression of estrogen receptor-? gene and estrogen receptor-? protein of the lung tissue was detected by real-time PCR and Western blotting technology respectively. Results The expression of estrogen receptor-? protein and estrogen receptor-? gene in the B[a]P group and the B[a]P plus low dosage estrogen group was significantly higher than the normal group (P

Objective To analyse the causes of complications and accidents of arthroscopy and a discussion of the preventive measures. Methods 1 540 cases of arthroscopy were carried out from May 1980 to May 1999, including 1 426 cases of the knee, 59 of the ankle, 17 of the wrist, 21 of the first metatarsophalangeal joint, 8 of the hip, 6 of the elbow and 3 of the shoulder. Results Surgical instruments (blade, tip of forceps) broken in the articular cavity took place in 8 cases, injury of the normal tissue including the cartilage, meniscus, and ligaments happened in 40 cases, nerve branch and vascular injured around the inlets in 11 cases, water seeping out in 13 cases, infection following the formation of hematoma in 5 cases, refracture of patella during operation in 1 case, myocardial infarction after operation in 1 case, totally, complications and accidents were seen in 79 cases (5.1％ ). Conclusion Arthroscopic complications are mainly related to unskillful manipulation of the instruments, poor team work, inadequate exposure of intra-articular structure and negligence of timely replacing the nearly worn parts of the apparatus. The complications can all be prevented by improving above mentioned points.

0.05). The duration of normoglycemia in experimental group was 23～65 days (mean 48 days), while 3～6 days (mean 5 days) in control group, with the difference being very significant between the two groups (P