Objective To explore the fatigue in patients with rheumatic diseases and put forward nursing countermeasures.Methods 173 patients with rheumatic diseases were investigated by Fatigue Scale-14 (FS-14) and Self-rating Depression Scale (SDS).Results The score of physical fatigue,mental fatigue and total score in the patients were 5.03±2.19,2.62±1.56,7.65±3.03,respectively,which were higher than those in healthy people (P＜ 0.01).Of the 173 patients,74 (42.8％) patients suffered from physical fatigue,52 (30.1％) patients suffered from mental fatigue,32 (18.5％) patients suffered from both.There were statistical differences in the physical fatigue and total score (P ＜ 0.01),no statistical difference in the mental fatigue (P ＞ 0.05) among the groups,which were divided according to the course of disease.There were statistical differences in the physical fatigue,mental fatigue and total score among the groups,which were divided according to the depression index (F=5.28,5.98,8.58,P ＜ 0.01).The regression analysis further showed the course of disease and depression index could positively predict the fatigue in patients with rheumatic diseases.Conclusions The prevalence of fatigue was high in patients with rheumatic diseases,the course of disease and depression influenced the fatigue in patients.Controlling deterioration of disease and relieving psychological stress would help prevent and alleviate the fatigue in patients with rheumatic diseases.

To evaluate percutaneous dilatational tracheostomy (PDT) with continuous aspiration of subglottic secretions in intensive care unit (ICU) elder patients.A total of 32 elder patients were selected randomly for PDT and 36 controls for traditional surgical tracheostomy (TST).The PDT group required regular mechanical ventilation with continuous aspiration of subglottic secretions.The operative duration was significantly shorter in PDT group than that in TST group [ ( 10.6 ±3.4)vs.(30.9 ±7.1)min,P ＜0.01].Incision length was significantly less in PDT group than that in TST group [ ( 1.3 ± 0.2 ) vs.(3.2 ± 0.3 )cm,P ＜0.01].Blood loss volume was significantly less in PDT group than that in TST group [ ( 10.4 ±3.8 ) vs.(40.7 ± 11.7 ) ml,P ＜ 0.01].The incidence of ventilator associated pneumonia (VAP) was significantly lower in PDT group than that in TST group ( 15.6％ vs.38.9％,P ＜ 0.05 ).With multiple advantages of mini-invasiveness,safety,simplicity,convenience and easier installation,PDT is quite suitable for elder patients in ICU.

AIM:To investigate LPS(lipopolysaccharide)stimulated cytokine secretion from normal rat kupffer cells in vitro. METHODS: Kupffer cells were isolated from wistar rats liver and cultured. Tumor necrosis factor - α (TNF- α) and endothelin- 1 (ET- 1 ) secreted by LPS stimulated kupffer cells were detected. RESULTS: LPS had an stimulative effect on kupffer cell activity. LPS in definite concentrations promoted kupffer cell secretion. CONCLUSION: LPS promotes kupffer cell secretion, which may be associated with liver injury induced by LPS.

Emodin is the main effective monomer of Rhubarb, which has a variety of pharmacological actions and valuable clinical applications.Recently, there are many reports about molecular mechanisms of emodin pharmacological actions,and they givehighly attention on the dephlogisticating and antineoplastic effects. These effects are achieved through affecting the concentration and transportation of ions, resisting of oxidation and free radical, and affecting the secretion of inflammatory factor and the enzyme activity and apoptosis and so on. This article summarizes the reports and hopes to provide theoretical basis for the practical application.

Objective To investigate the effects of FTY720 on retinal photoreceptor cells and microglial following light-induced degeneration in rat retina.Methods 120 Sprague-Dawley rats were randomly divided into four groups including FTY720 group,solvent control group,model group and normal group.The rats of normal group were not intervened.The FTY720 group,solvent control group and model group establish retinal light injury mode.FTY720 was injected into abdominal cavity of the rats in FTY720 group 0.5 hours before light exposure.50％ dimethylsulfoxide was injected into abdominal cavity of the rats in solvent control group.The expressions of microglial cells in rat retinal were quantified using flow cytometry,the expressions of interleukin (IL)-1β were examined by enzyme-linked immuno sorbent assay at 6 hours,1 day,3 days,7 days after light exposure.The apoptosis of retinal photoreceptor cells were measured by terminal-deoxynucleoitidyl transferase mediated nick end labeling at 1 day after light exposure.The morphological change of retinal were viewed by haematoxylin and eosin staining at 7 days after light exposure.Results The expressions of microgilal and IL-1β began to rise at 1 day after light exposure,reached at peak at 3 days and decreased at 7 days.The expressions of IL-1βand microglial in FTY720 group were significantly lower than solvent control group and model group,but higher than normal group (P＜0.05).One day after exposure to light,the apoptosis cell ratio in normal group,model group,solvent control group and FTY720 group were 0,(87.66 ± 2.50) ％,(86.00 ± 2.44) ％,(49.66 ± 2.80) ％.The apoptosis cell in FTY720 group were higher than normal group,lower than solvent control group and model group (P＜0.05).Seven days after exposure to light,the retinal in normal group was structured and the cell was arranged well,the cell in solvent control group and model group was irregular arrangement and the outer nuclear layer (ONL) was thin after light exposure.The thickness of the ONL in FTY720 group was significantly higher than solvent control group and model group,below normal group.Conclusion FTY720 can prevents retinal photoreceptor cells from apoptosis and inhibits activation of microglial.

[Objective]Summary of the experience of Professor LIU Wenqiong in the treatment of leukoplakia vulvae of the aged.[Method]By using the method of the collection and collation of Professor LIU Wenqiong in the treatment of elderly patients with leukoplakia vulvae case,and combination with the related discussion of ancient.This paper summarizes the experience of Professor Liu in the treatment of leukoplakia vulvae of the aged from the etiology and pathogenesis,treatment based on syndrome differentiation,prescriptions and so on,and for proven cases.[Results]Professor LIU Wenqiong thinks that the root of the disease is mainly characterized by the dysfunction of Zang Fu organs and deficiency of qi and blood,the brounch of the disease is characterized by endogenous wind disturbance.Organs are mainly related to liver and kidney.The type of syndrome is yin deficiency of liver and kidney and blood deficiency and wind dryness.The treatment is mainly nourishing liver kidney yin,followed by eliminating wind and relieving itching,and combinating with traditional Chinese external washing medicine for local administration.It lists a successful case,and reflects that Professor LIU Wenqiong has great skill to make prescription accuratedly.Effect is significant.[Conclusion] The clinical experience of Professor LIU Wenqiong in treatment of leukoplakia vulvae is effective,and she provides ideas and methods for the treatment of this discase,which has the value of popularization and application in clinical practice.

Objective: To study the impact of the residents’ health investment income growth, and analyze rural-urban differences and regional differences. Methods: According to the provincial panel data from 1996 to 2011, two-way fixed effects model ( Two-way FE) is established in empirical analysis. Results: Health investment has positive effects on the income growth of residents, but rural-urban differences and regional differences exist. The health investment income growth effect of rural area is higher than urban, and the effect of western area is higher than the east. Conclusion: While improving the level of urban medical health investment, it needs to focus on health investment in rural and western area. To make the health investment on income growth effect play its work efficiently, and narrow the rural-urban income gap and regional income gap.

Objective:To investigate the clinical effect of Pijiling Liniment for seborrheic dermatosis on 327 cases. Methods:327 patients with seborrheic dermatosis were treated with Pijiling Liniment. The clinical effects were compared with that of the control group(Co.Resorcinol Ointment, 76 cases). Results:The total effective rate and curative rate of the treatment group for seborrheic dermatitis were 93.5% and 33.3%, respectively. The effective rate for acne was 80.6% and for dermatomycosis microsporina was 7.5%. The total effective rate and curative rate of the control group were 92.1% and 2.6 %, respectively. Conclusions:There is a significant difference in the curative rate between two groups( P 0.05) through x 2 test.

Objective To investigate clinical effect of surgical treatment for spinal stenosis with lumbar degenerative de novo scoliosis with spinal stenosis.To discuss selection of operation methods and ranges of fusion.Methods 27 patients of degenerative scoliosis with spinal stenosis were treated by oper-ation.We performed posterior decompression on the segments and selected fusion,then performed correc-tion deformity.Measured Cobb 's angle,lumbar lordosis angle,the distance between C7 plumb line (C7PL),upper edge of S1 vertebral body(SVA),and the distance between C7PL and center sacral verti-cal line(CVA)after operation and final follow up were compared with preoperative data.JOA score system were used to evaluate clinical effects.The SF-36 questionary was used to evaluate the patients'life quality before and after operation as well.Results All patients were followed up with an average of 20 months. Preoperative,postoperative and final follow up,Cobb's angle was(22.1 ±10.5 )°,(10.2 ±7.3)°and (10.4 ±4.8)°,respectively;lumbar lordosis angle was(21.2 ±10.3)°,(25.7 ±12.2)°and(25.3 ± 12.3)°,respectively;SVA was(7.5 ±6.1)cm,(0.6 ±3.1)cm and(0.5 ±2.4)cm,respectively;CVA was(6.9 ±5.3)cm,(2.8 ±1.3)cm and(2.9 ±1.2)cm,respectively.There was significant difference in data before and after operation(P >0.05).JOA score was 10.8 ±1.4,21.3 ±2.4 and 23.5 ±2.3,re-spectively;All domains of SF-36 score were significantly improved postoperatively(P <0.05).Conclu-sion For surgical treatment with limited decompression,pedicle screw fixation and fusion will be effective methods for degenerative scoliosis with spinal stenosis,individualized surgery design should be made ac-cording to clinical symptoms,signs and imaging features.

Radiotherapy plays an important role in the treatment of lung cancer .Radiation-induced lung injury is a major complication in the process of radiotherapy .It is of great significance for the treatment and prog-nosis of the diseases to predict the early stage of radiation -induced lung injury in the clinical treatment .TGF-β1(transforming growthfactor-β1) can induce some inflammatory cells including lymphocytes ,neutrophils,mon-ocytes ect,contributing to the formation of fibrosis .Plasma TGF-β1 shows different levels followed different sta-ges of radiation-induced lung injury .This article reviews the value of cytokine TGF -β1 in predicting the radia-tion-induced lung injury over various aspects such as singlely used ,combined with radiation physics and other cytokines,and genomics.