WHO released the International Classification of Functioning, Disability and Health (ICF) in 2001. ICF is a kind of classification of multi-purpose used for different disciplines and fields, it belongs to by WHO for different applications in the field of health and to establish the international classification of family, it is a tool for internationally accepted, its overall goal is to provide a unified, standard language and framework to describe the condition of health and health-related. This article will review the application status of ICF at home and abroad, to explore the nursing of ICF application value, in order to explore the application of ICF in nursing standardized terminology space.

Objective To explore the clinical manifestations,diagnosis,misdiagnosis and treatment of primary hyperparathyroidism.Methods The clinical data of 36 patients with primary hyperparathyroidism admitted into the First Affiliated Hospital of Chongqing Medical University from January 2009 to October 2014 were reviewed and analyzed retrospectively.Results The manifestations of primary hyperparathyroidism were various and atypical.Primary hyperparathyroidism was often misdiagnosed as other diseases by 25.0％ (9/36).Among the patients,the ratio of male to female was 1:1,and median age was 58 years old.Of all patients,there were 9 persons with joint pain,digestive system symptoms in 7 cases,cervical mass discovered in 6 cases(3 cases were found when B ultrasonic examination),urinary calculus in 5 cases,fatigue symptoms in 4 cases,osteoporosis and urinary calculus in 2 cases,1 case with fracture,2 cases without any symptoms.Their calcium and parathyroid hormone level were increased by various degree.The accuracy rates of level diagnosis of Color Doppler ultrasound combine with CT or 99Tcm-MIBI were improved obviously,85.2％ and 93.1％ respectively.Twenty-eight patients received surgical treatment and pathology examination confirmed the accurate pathological types after surgery.There were 23 cases of parathyroid adenoma,1 case parathyroid hyperplasia,1 case parathyroid carcinoma,2 cases of parathyroid adenoma with nodular goiter,parathyroid adenoma merged thyroid carcinoma in 1 case.Serum calcium and parathyroid hormone level declined obviously after operation.The other 8 patients received non-surgical treatment,7 cases were alleviated and 1 case died due to irreformable high blood calcium crisis.Conclusion There should be pay attention to recognize primary hyperparathyroidism,check the blood calcium,and about suspected cases should be performed as early as parathyroid tested,neck color Doppler ultrasound.Early surgical treatment can significantly improve the prognosis and quality of life.

Objective To compile "care operation and integration of nurse-patient communication program"and discuss its clinical application effect in older to improve the nursing care operations, communication and ability to communicate with patients and building a harmonious relationship between nurses and patients to improve quality of care. Methods We investigated and studied the problems existed in communicating with patients during care operations and put forward the concept of operation and integration of communication, compiled "nursing operation and integration of nurse-patient communication procedures" and put it into clinical application. Results Satisfaction degree surveys after application showed that patients' satisfaction degree increased and communication skills of nursing students increased. Conclusions Application of "nursing and the nurse-patient communication integration process" improved patients' satisfaction degree and make the nurse-patient relationship more harmonious.

Objective To evaluate the value of bile duct drainage using ureter catheter through cystic duct remnant with primary closure of the common bile duct(CBD) incision after CBD exploration.Methods (Retrospective) analysis of the clinical data of 218 cases using this method. Results All cases were operated on successfully.There were no complications such as bile leakage,bile duct stricture in this series.The (catheter) were removed 5-7 days after operation in 215 cases,10 days after operation in 3.None of the 218 cases had complications after removal of the catheter.The rate of stone clearance was 99.7%(217/218).Average hospitalization time after operation was(6.5?3.0)days.All the 218 cases were followed up for 1-5 years.On ultrosounography no bile duct stricture was found in the followed up cases.Conclusions (Using) ureteral catheter through cystic duct remnant for drainage of bile duct after CBD exploration with primary closure of the CBD is an effctive,reliable and safe method in preventing postoperative bile leakage,bile duct stricture and diagnosis of the postoperative retention of bile duct stones.

Objective To explore the relationship between the expression of human telomerase RNA component (TERC) gene , human papilloma virus (HPV) infection and mutation of chromosome 3 number with cervical lesions .Methods 81 women received the treatment in the Gynecology Department of the Second Affiliated Hospital of Kunming Medical University from June 2008 to February 2009 ,including the healthy group(normal pathological examination ,20 cases) ,CIN1 group(28 cases) ,CIN2 group(12 ca‐ses) ,CIN3 group(9 cases) and cervical cancer group(12 cases) .The TERC gene expression in uterine epithelial exfoliated cells was detected by using the fluorescence in situ hybridization (FISH) method ,meanwhile the HPV infection was detected by using the real time fluorescence quantitative polymerase chain reaction (FQPCR) technology .The correlation between cervical cancer with TERC gene and HPV was analyzed .At the same time the number of chromosome 3 mutations in 81 cases was recorded .Results In the cervical lesion detection ,the detection positive rate had no statistical difference between the TERC gene detection and HPV detec ‐tion (P> 0 .05) ,their positive rates in the CIN 1 ,CIN2 ,CIN3 and cervical cancer groups were significantly higher than that in the healthy group (P< 0 .05) ,the difference between the CIN1 group and the CIN2 group had no statistical significance (P > 0 .05) , while between the CIN3 group and the cervical cancer group had statistical significance (P< 0 .05) ,the higher the malignant degree , the higher the positive rate .The abnormal mutation rate of chromosome 3 number was 0% in the healthy group and the CIN1 group ,16 .7% in the CIN2 group ,66 .7% in the CIN3 group and 100 .0% in the cervical cancer group ,the positive rate in the CIN3 group and the cervical cancer group was significantly higher than that in the healthy group ,CIN1 group and CIN2 group ,the differ‐ences were statistically significant (P< 0 .05) .Conclusion The TERC abnormal gene expression ,high risk HPV infection and mutation of chromosome 3 number could play an important synergistic effect during the process of occurrence and progression of cervical cancer .

BACKGROUND: Huperzine A is a reversible cholinesterase inhibitor extracted initially by China from huperzia serrata,a Chinese herb. Its mechanism in improving choline function and ameliorating cognitive state of patients with dementia is to increase acetylcholine (Ach) concentration in neural synapse through impeding the hydrolysis of acetylcholinesterase.OBJECTIVE: To investigate the effects of huperzine A on the improvement of cognitive function of patients with Alzheimer disease (AD).DESIGN: A randomized controlled study based on patients.SETTING: Second internal department of neurology in a general hospital of military area command of Chinese PLA.PARTICIPANTS: Totally 69 AD patients hospitalized in the Second Department of Neurology,General Hospital of Jinan Military Area Command of Chinese PLA between March 2000 and December 2003 were allocated into huperzine A group( n = 38,male,aged between 68 and84 years old,average age of 76 years old) and control group( n = 31,male,aged between 68 and 80years old,average age of 74 years old) according to the wills of the patients.MAIN OUTCOME MEASURES: Positive expression percentage of Fas,Apo2.7 and Bcl-2 on platelet membrane and the integral of mini-mental state examination(MMSE),Hasegawa' s dementia scale(HDS) and activities of daily living (ADL) of two groups after therapy.RESULTS: The positive expression of Fas,Apo2.7 or Bcl-2 on peripheral platelet membrane after therapy in huperzine A group were (2.23 ± 0.49)%,(2.37 ±0. 36)%,or(2.01 ±0. 32)% respectively,which was significantly lower than(3.12 ± 0. 74)%,(2. 83 ± 0.67)% or (2. 59 ± 0. 54)% of control group ( P ＜ 0.01). The prognostic integral of MMSE,HDS or ADL of huperzine A group was 20.45 ±4. 14,21.39 ±4.89,or 36. 15 ±5.11,which was significantly higher or lower than that of the control group(15.76 ± 3.23,17.32 ±2.09,4.26 ±7.21)(P ＜ 0.05).CONCLUSION: HuperzineA actually can effectively improve the memory and cognitive function of AD,and effectively improve ADL as well.

Objective To evaluate the vascular endothelial dilatation function in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Thirty elderly patients with moderate to severe OSAHS and twenty-eight control subjects were studied. Their blood concentration of nitric oxide (NO) were quantified. Brachial artery diameter was measured with Doppler ultrasound under baseline conditions, during reactive hyperemia (an endothelium-dependent dilatation) and after sublingual administration of nitroglycerin ( an endothelium-independent vasodilator). The dilative rate of brachial artery in different conditions was calculated to evaluate the endothelial function. Subjects with OSAHS were treated by nasal continuous positive airway pressure (nCPAP) for 4 weeks, and the level of NO in plasma and vascular endothelial function were measured. Results Compared with control group, there was a significant decrease of NO level in elderly patients with moderate to severe OSAHS [(50. 35±8.65)μmol/L vs. (57.31±9.31)μmol/L, t=2.95,P=0.005], and the level of NO in plasma was increased after nCPAP treatment for 4 weeks [(55.77±8.87)μmol/L vs. (50.35± 8.65)μmol/L,t=2.40,P=0.023. The elderly patients with moderate to severe OSAHS had lower endothelium-dependent flow-mediated dilation (FMD) compared with control subjects [(9.78± 4.82)%vs. (13.21±5.81)%,t=2.45, P=0.017], and there was no significant difference in endothelium-independent nitroglycerin ( NTG)-induced dilation [( 16.87±6.15)% vs. (14.74 ± 5.82)%,t=1.36,P=0.18]. After nCPAP treatment for 4 weeks, the patients with moderate to severe OSAHS had significant increase in FMD[(14.33±6.13)% vs. (9.78±4.82)%, t=3.20,P= 0.002], whereas there was no significant change in NTG-induced dilation [(14.74±5.82)% vs. (15.15±4.21)%, t=0.31,P=0.76]. Conclusions The elderly patients with moderate to severe OSAHS have abnormal vascular endothelial function, and nCPAP treatment can reverse the dysfunction effectively, which may be associated with the reversal of intermittent hypoxia.

Objective To study the diagnostic value of common inflammatory markers in patients with infectious diseases. Methods One hundred sepsis patients, 100 viral infection patients,100 pulmonary tuberculosis patients and 100 gonorrhea patients were analyzed retrospectively. The contents of procalcitonin (PCT), C-reactive protein (CRP), haptoglobin (HP), ceruloplasmin (CER), α1-acid glycoprotein (α1-AAG), α1-antitrypsin (α1-AAT), white blood cell count (WBC) and erythrocyte sedimetation rate (ESR) were measured. The receiver operating characteristic curve (ROC curve), sensitivity, specificity, positive predictive value, negative predictive value, Youden's index,positive and negative likelihood ratios and total coincidence rate were calculated respectively. Results The area under the ROC curve, sensitivity, specificity, Youden's index and positive likelihood ratios,positive predictive value and total coincidence rate of PCT in sepsis patients were 0. 895, 0.84, 0.92,0.76, 10.50, 0.91 and 0.88, respectively, which were superior to CRP, HP, CER, α1-AAG, α1-AAT, WBC and ESR. Conclusions PCT is a better inflammatory reactive parameter than other parameters currently applied in practice and may serve as a rapid and sensitive test in the early stage of severe bacterial infections.

OBJECTIVE To analyze the antimicrobial resistance of Acinetobacter baumannii.METHODS A.baumannii was collected in our hospital from Jan 2003 to Dec 2006.Antimicrobial susceptibility testing was performed by disk-diffusion method.RESULTS A total of 548 A.baumannii were collected during 4 years.Of these isolates,130(23.7%) strains were from intensive care unit(ICU),190 strains(34.7%)from surgical,and others from medical and emergency departments.Most of strains(78.5%) were isolated from sputum,next from wound.The prevalence of A.baumannii was increasing during last 4 years.Results of susceptibility test showed that imipenem was the most active antibiotic against A.baumannii.The resistance rates were high to most antibiotics.Most of the resistant strains was from the ICU and the general ward differentand had significant difference.More than 50% of isolates were resistant to all antimicrobial agents tested except imipenem and ciprofloxacin in ICU.CONCLUSIONS The prevalence of A.baumannii is increasing.A.baumannii isolates show high resistance to multiple antibiotics,especially in ICU.

Objective:To investigate the effect of type ⅡNKT cells activated by sulfatide on airway inflammation in a murine model of asthma.Methods:Thirty-two BALB/c mice were randomly divided into four groups:normal control group ( n=8 ) , asthma group (n=8),sulfatide treatment group (n=8) and adoptive transfer group (n=8).The murine model of asthma was established by sensitization with intraperitoneal injection of ovalbumin ( OVA) and intranasal challenge in all animals except for the normal control group where PBS was used instead.Intraperitoneal injection of sulfatide in a sulfatide treatment group, adoptive transfer of sulfatide-activated typeⅡNKT cells in adoptive transfer group and PBS in asthma group were carried out 1 hour before the first challenge.PBS was used for intraperitoneal administration in the normal control group.Lung histology and goblet cell hyperplasia were analyzed by HE or PAS staining.Differential cell count in bronchial alveolar lavage ( BALF) was measured by May-Gruenwald Giemsa;levels of OVA-specific IgE in serum and L-4,IL-5 in BALF were measured by ELISA.The percentages of lung type Ⅱ NKT cells,IL-4+and IFN-γ+typeⅡNKT cells were detected by flow cytometry.Results:Inflammatory cell infiltration in lung tissue and goblet cell hyperplasia in the airway were decreased in sulfatide treatment group and adoptive transfer group.Percentages of eosinophil in BALF,level of OVA-specific IgE in serum,and levels of IL-4,IL-5 in BALF in sulfatide treatment group and adoptive transfer group were significantly lower than those in asthma group (all P<0.05).The percentages of lung IL-4+and IFN-γ+typeⅡNKT cells in sulfatide treatment group was significantly higher than those in asthma group ( P<0.01 ).Conclusion: Type Ⅱ NKT cells activated by sulfatide may inhibit airway inflammation in a murine model of asthma.