Atrial fibrillation is a most frequent arrhythmia, whose prevalence rate is high.Current therapeutic measures for atrial fibrillation include: (1) Control of ventricular rate;(2) Recovery and maintenance of normal sinus heart rate;(3) Management of risk factors for atrial fibrillation;(4) Prevention of thromboembolism;(5) Surgery.The present article made a review on the newest progress of atrial fibrillation treatment in recent years.

Objective Based on the theory of the Balanced Score Card framework and using Delphi method and analytic hierarchy process to construct the clinical nursing staff performance appraisal index evaluation system and provide reference for clinical nursing staff post management. Methods According to the theory of Balanced Score Card, constructed the preliminary establishment of index system for performance evaluation of clinical nursing. Used Delphi method to interview 26 nursing experts to select clinical nursing performance evaluation indicator. In the end, applied hierarchical analysis to determine index weight at all levels. Results Conducted two rounds of expert consultation;distributed 2 rounds of questionnaires by 27 and 26;recycled by 26 and 25;the recycling rate was 96.3%and 99.1%. It showed that the active coefficient of experts was higher. The degree of experts′authority was 0.89, which meaned the higher authority. Through two rounds of expert consultation, the Kendall coordination coefficient was 0.199-0.388. The significant test indicated that it was statistically significant (P<0.05), which meaned the experts tend to agree. After two rounds of expert consultation, the final clinical nursing staff performance appraisal indicators included 4 first-class indexes, 10 secondary indexes, 24 third-class indexes. Each index weight was determined by the analytic hierarchy process. In primary index, the internal process, learning and growth, performance indicators and the weight of customer satisfaction were 0.3, 0.3, 0.3 and 0.1 respectively. In secondary index weight, the top three were the work′s quality, post, and quantity. In the third class index weight, the top three were undertaking clinical work, annual nurse competence grading and the person-time of critical patients′management or surgical patient management. Conclusions Based on Delphi method and analytic hierarchy process to determine the clinical nursing staff performance appraisal evaluation index, whic can provide theoretical basis for clinical nursing staff post management.

Objective To observe the effect of the action research method in cultivating the scientific research ability of nurses.Methods 45 nurses were choosed as the research objects in our hospital from March to May in 2014 using the method of action research,and definiting the specific problems first,then through the training process of plan-action-observation-training,the study subjects were divided into three groups to participate in the three cycle of scientific research training by lottery.the training effect of scientific research ability in three cycles after training were evaluated.Results The scientific research level of nursing staff was in the medium level,and the total score was (42.33±15.10) points.After the three cycle,the total score of scientific research ability was increased to (79.73±10.77) points,and the difference was statistically significant (t=-13.199,P＜ 0.05).In the three cycle,the total score of scientific research ability respectively was (71.87±8.23) points,(8.39±88.87) points,(78.47±8.32)points,and the difference was statistically significant (F=15.940,P ＜ 0.05);the scores of the project plan respectively was (67.20±13.60)points,(70.13±14.31) points,(78.73±8.69) points,and the difference was statistically significant (F=3.474,P ＜ 0.05).Conclusions Using the action research method can effectively improve the ability of scientific research of nurses.

Opioid-induced constipation (OIC) is the most common side effect of opioid. OIC influences the quality of life of pa-tients suffering from cancer pain. However, given that the drug is often overlooked and underappreciated, most of the time, the patients would avoid or abandon using opioid and, as a result, they continuously suffer from cancer pain. Therefore, OIC prevention and man-agement must be made before opioid use. The consensus on the diagnosis of OIC has only been reached recently. Thus, a unified defini-tion of OIC must be developed to exchange therapeutic option among departments in hospitals and compare treatment outcome. The di-agnosis of OIC is discussed, and the management of OIC, including medicinal and non-medicinal treatment, is summarized. Mean-while, the initial program for prevention and treatment of OIC is established to make OIC management more convenient for clinical physicians. Much work is still needed to establish a consensus on OIC diagnosis and a suitable program for prevention and treatment of OIC.

Objective To understand the total suspended particulates(TSP)in ambient air and their characteristics on metallic elements in Xi an.Methods 96air samples were collected from the industrial area,industry-traffic mixed area,heavy traffic area and control area in Xi an during the heating season and unheating season,2001.The concentra-tions of TSP in ambient air and the contents of Pb,Mn,Cr,Ni,Cd in inorganic extracts of TSP were determined.Re -sults The concentration of TSP in ambient air(0.5865mg /m 3 )during heating season was significantly higher than that(0.3535mg /m 3 )during unheating season(P

Objective: To investigate the function of healthy education in early enteral nutrition after operation.Methods: 72 patients of upper digestive tract operation were divided into test group(n=36)and control group(n=36).The education about enteral nutrition knowledge was intensified in test group. Results: The degree of grasping enteral nutrition knowledge and the time of receiving enteral nutrition were increased in test group.The complications of EN were decreased in test group.Conclusion: It is helpful to intensify the healthy education in early enteral nutrition after operation.

ObjectiveTo study the relationship between type of vertebral fracture and degree of spinal cord injury.MethodsMRI signs of 200 cases of thoracolumbar SCI were analyzed retrospectively.ResultsAmong all cases, 49 cases were with compressed fracture, 60 cases with burst fracture, 79 cases with fracture and dislocation, 158 cases with angle formed posteriorly. The number of cases with complete SCI were respectively 14 cases, 39 cases, 54 cases and 94 cases.Conclusions Common sites of thoracolumbar SCI. were at T12 and L1 level (123 cases, 74%). The degree of SCI was related to the type of vertebral fracture. The complete SCI occurred most frequently in patients with burst fracture and patients with fracture and dislocation, the incidence of the latter was higher.

ObjectiveTostudytheinhibitioneffectof c-mycASODN(antisense oligodeoxynucleotide) and 5-FU (5-fluorouracil) on the expression of c-myc gene and the proliferation of human hepatomacellsHEPG-2. MethodsAfter treatedbyliposomemediatedc-mycantisense phosphorothioate oligodeoxynucleotide (APSODN) and 5-FU, the growth inhibition rate was detected by MTT assay, the expression of c-myc mRNA was detected by RT-PCR and immunohistocehemical methods HEPG-2cells. The cell cycle was analyzed by flow cytometric analysis. The morphological changes were observed by fluorescence staining and cellular genome electrophoresis. ResultsAfter sealing c-myc gene with ASODN,the growth of cells was repressed and the effect was time-dependent and dose-dependent ( P = 0. 02 ). The ability of proliferation decreased, the expression of c-myc gene was inhibited on transcription and translation levels; 5-FU can induce apoptosis of hepatoma cells HEPG-2 dramatically with the dose of 10 μ mol/L, when treated by both c-myc ASODN and 5-FU, HEPG-2 cells was induced apoptosis in a cooperative style ( P =0. 01 ).ConclusionsThe liposome mediated c-myc (APSODN) and 5-FU can inhibit the proliferation of HEPG-2 cells by inhibiting the expression of c-myc gene and can induce apoptosis of hepatoma cells HEPG-2 in a cooperative style. c-myc ( APSODN ) can increase the sensitivity of 5-FU to hepatoma cells and decrease the effective concentration of 5-FU.

ObjectiveTo summarize the cause of laryngeal stridor in infants in order to make accurate diagnosis and treatment of the disease.MethodsWe reviewed medical records of 297 cases of patients less than 3 year of age with the presenting symptom of stridor who were initially evaluated in the outpatient setting of otorhinolaryngological department from Jan 2005 to Jan 2010.The causes of stridor were clarified by examinations of ultrafine electronic laryngoscope,throat three-dimensional CT,and bronchoscopy in all cases.Patients underwent history-taking,physical examination and flexible laryngoscopy,CT examination or bronchoscopy evaluation in the operating room.ResultsOf all 297 patients,199 cases ( 67.0％ ) were diagnosed as congenital airway abnomalities for cause of stridor,which included congenital laryngeal abnomalities in 169(84.9％,169/199) and congenital tracheal abnormalities in 30 cases( 15.1％,30/199).Another 98 cases (33.0％,98/297) were diagnosed as acquired disease for cause of stridor.The most congenital laryngeal anomaly was laryngomalacia ( 159,94.1％,159/169 ).The most congenital tracheal abnormalities was tracheomalacia ( 14,46.7％,14/30 ).Sixty-four cases ( 65.3％,64/98 ) were diagnosed as foreign body in airway and 26 cases (26.5％,26/98) were respiratory infection,which were the first and second most common causes of acquired disease for stuidor.ConclusionCongenital airway structural abnormalities as a major cause of infant laryngeal stridor,followed by acquired disorders,including airway foreign body and infection.

Objective To investigate the relationship between the expression of p53 protein and Ki-67 antigen in order to detect its clinical characters and the significance of them in them occurrence and development of appendiceal mucinous neoplasms.Methods 42 tissues of appendiceal mucinous neoplasms were selected by pathological diagnosis in the department of pathology of the PLA general hospital from May 1993 to October 2007.The 10 samples of control group were obtained from simple appendicitis after surgery.Applied PV6000 immunohistochemical method,the expressions of p53 protein and Ki-67 antigen were detected.Results The expression of p53 protein in appendiceal mucinous neoplasms was higher than that in appendicitis tissue [31.0 ％ (13/42) vs 0 (0/10),x2 =4.127,P =0.042).The positive rate of p53 protein in appendiceal mucinous adenocarcinoma was higher than that in low-grade appendiceal mucinous neoplasm tissue (40.0 ％ vs 8.3 ％,x2 =4.0218,P =0.044).The positive rate of p53 protein in appendiceal mucinous neoplasms tissue with pseudomyxoma peritonei was higher than that in tissue without PMP (45.5 ％ vs 15.0 ％,x2 =4.5464,P =0.033).The expression of Ki-67 antigen in appendiceal mucinous neoplasms was higher than that in appendicitis tissue (45.2 ％ vs 10.0 ％,x2 =4.2374,P =0.039).Considering the different factors (such as gender,age,pathological type and PMP),Ki-67 antigen expressions were still not significantly different (P ＞ 0.05).In appendiceal mucinous neoplasms,the difference of positive rates of Ki-67 between the p53 positive expression group and the p53 negative group was statistically significant (x2 =7.6299,P =0.0057).Conclusion The expression of p53 protein was correlated with the expression of Ki-67 antigen.It's valuable that both p53 protein and Ki-67 antigen are used to evaluate the biological behavior of appendiceal mucinous neoplasms and predict the malignant degree.