Objective To describe the impact of administrative penalties for medical disputes on the medical staff, including their perception on the penalty and its impact on their mind and body, professional behavior, career development, etc, and to provide a theoretical basis for health policy making and hospital management. Methods The phenomenological research method was adopted to conduct in-depth interview to 10 hospital staff in Taian who were involved in medical disputes and got punished, and the Giorgi qualitative data analysis was used in the research. Results The interviewees′perception and impacts of the punishment were concluded into five aspects:physiologically, psychologically, cognitively, behaviorally and professional development. Conclusions It is concluded that the current punishment to individuals has caused quite negative effects, and a new mechanism should be established to systematically reconstruct the procedure and reduce the medical disputes to the minimum.

Objective To explore the effects of three kinds of respiratory training methods on pulmonary function and quality of life in patients with thoracic cancer radiotherapy. Methods A total of 76 patients with thoracic cancer were divided into the control group (20 cases), the retracting-lip breathing group (19 cases), the blowing balloons group (18 cases), and the resisting respiratory exercise group (19 cases) by the draw method. Based on conventional health services, the retracting-lip breathing group, the blowing balloons group, and the resisting respiratory exercise group were given respiratory training (one month), whereas the control group only followed routine nursing care. The pulmonary function and quality of life were measured at the first and the thirtieth day of radiotherapy by electronic pulmometer and quality of life instruments for cancer patients-general module respectively. Results The indicators of pulmonary function at thirtieth day of patients in each group were lower than those at the first day, the intragroup differences were significantly (t=2.17-6.32, P<0.01), whereas no significantly different among intergroups (P>0.05). Scores of quality of life of the retracting-lip breathing group were (78.74±5.51) points, the blowing balloons group were (78.43 ± 7.41) points, the resisting respiratory exercise group were (79.11 ± 8.84) points, which were significantly increased than that of control group (73.01 ± 7.46) points(F=3.00, P < 0.05). Conclusions The pulmonary function of patients with thoracic cancer radiotherapy significantly reduces after radiotherapy. Three kinds of respiratory training show no effects on pulmonary function, but the quality of life of patients with thoracic cancer radiotherapy could be improved.

Objective To develop pain assessment scale for cognifively impaired elderly (PACIE) and to test its reliabihty and validity. Methods Based on the foreign related pain assessment tools, the pain as-sessment scale for cognitively impaired elderly was developed. Five experts specialized in pain, anaesthesia and nursing were invited to evaluate the content validity of the pain assessment instrument and made modification. Reliability and validity of the pain assessment instruments was evaluated. Results PACIE had 8 items, index of content validity (CVI) of PACIE was 0.978, factor analysis demonstrated that two factors soluted in PACIE, that cumulative explained 69.008% of the total variability, the two factors were named pain objective factor and pain subjective factor. PACIE and NRS were significantly correlated, it could identify pain and painlessness patients overtly that demonstrate the discriminate validity was fine. Adequate levels of inter-rater reliability of PACIE was achieved between two raters with the intra-class correlation coefficient as 0.954 (95%CI=0.812～ 0.989). Satisfactory test-retest reliability was achieved with the Cronbach'α ot as 0.851. Conclusions The pain assessment scale for cognitively impaired elderly (PAC1E) has satisfactory validity and reliability, is suit-able for assessing the pain indentity of cognitively impaired elderly.

Objective To observe the effects of insulin-like growth factor-2 (IGF2) in the course of mouse embryon-ic stem cells induced to differentiate into islet-like cells. Methods Mouse ES cells were induced to differentiate into islet-like cells in vitro. The expression of islet specific markers was tested by RT-PCR and immunofluorescence assay. RT-PCR/RFLP was used to test the imprinted genes IGF2 parental expression in cells at different stages. Results Islet specific mark-ers were expressed in differentiated cells, such as insulin, glucagon and C-peptide. PCR-RFLP showed that imprinted genes IGF2 derived from embryonic stem cells were biallelic expression and loss of imprinting. Conclusion Gene imprinting sta-tus of IGF2 was changed in differentiated cells in vitro.

Objective To provide a representative,objective and operable evaluation tool for agsessing tlle quality of clinical internship of nursing students,and through fuzzy evaluation and feeding back information scientmcauy to improve clinical teaching quality comprehensively.Methods Employing the method of"sorting of experts contrast"to score assessing indicators according to the importance in the undergraduate nursing internship by 10 experts,using mathematical methods to calculate the index weight,and applying fuzzy mathematics to the quality evaluation of nursing internship. Results The project had appropriate indicators and objective and reasonable weight.By applying this system,the general state of intemship students asessod by the clinical teachers and the head nurses was evaluated fuzzily,which was in accordance with the actual performance of students.Conclusions The index system with the characteristics of modern practice teaching concepts combines comprehensiveness with innovation,importance with completeness,accords with the teaching goals of nursing students,and the fuzzy evaluation of that will be better to evaluate the internship quality of nursing students comprehensively and objectively.

Dexamethasone intravitreal implant(Ozurdex)is approved for the treatment of macular edema secondary to retinal vein occlusion, diabetic retinopathy, and non-infectious uveitis. It has also been reported to treat macular edema after intraocular surgery and macular edema secondary to other inflammation-related ocular fundus diseases. With the widespread application of dexamethasone intravitreal implant, uncommon complications such as migration of dexamethasone intravitreal implant into the anterior chamber are gradually receiving attention. Anterior chamber migration of dexamethasone intravitreal implant usually occurs in the eyes with an incomplete complex of suspensory ligament and lens capsule or after vitrectomy. After dexamethasone intravitreal implant migrates into the anterior chamber, it tends to sink to a lower angle, resembling hypopyon, causing vision impairment and eye pain, accompanied by corneal edema and intraocular hypertension. If corneal edema occurs, dexamethasone intravitreal implant should be repositioned or removed as soon as possible to reduce the risk of corneal endothelial decompensation. Miosis and avoiding predispositions, such as lying prone, jumping, or long flights, can prevent dexamethasone intravitreal implant from migrating into the anterior chamber. In this paper, the recent advances in anterior chamber migration of dexamethasone intravitreal implant are reviewed to provide a reference for the diagnosis, treatment, and prevention.

Objective To describe the level of self-perceived burden (SPB) and analyze its influencing factors among the patients with advanced lung cancer, in order to provide a theoretical basis for individualized nursing care. Methods A total of 102 hospitalized patients with lung cancer from 3 hospitals in Shandong province were investigated by the Self-Perceived Burden Scale for Cancer Patient (SPBS-CP). Results The total score of the SPBS-CP was (60.31±17.06) points, which indicated at a moderate level. Those patients rated the highest score on the sub-scale of economic/family burden (22.04±6.72) points, the lowest score on the sub scale of care burden (10.28±3.62) points. Single factor analysis and regression results showed that different work conditions, different stages were related with SPB. Conclusions Patients with moderate and advanced lung cancer had a moderate or higher level of SPB. Staff nurses should focus on the psychological status of the patients and take positive interventions to release the negative emotional experiences.

Objective To investigate whether Ivor-Lewis esophagectomy combined with adjuvant radiotherapy prevents lymphatic metastatic recurrence in esophageal cancer patients.Methods 113 Stage Ⅱ A esophageal squamous cell carcinoma patients after Ivor-Lewis esophagectomy were accpected mRNA expression of Mucin1 gene detection.Positive patients were enrolled into adjuvant radiotherapy group(with postoperative adjuvant radiotherapy).Negative patients were enrolled into control group (without postoperative adjuvant radiotherapy or chemotherapy).The radiotherapy area consisted of the neck,supraclavicular region and the superior mediastinum(including praesophageal and pratracheal region).Survival difference was compared by x2 test,the Kaplan-Meier method was performed to calculate the survival rate and recurrence rate.Logistic regressive analysis was performed to determined independent risk factors.Results The radiotherapy area lymphatic metastatic recurrence rate in adjuvant radiotherapy group(16.7％,5/30) was lower than patients without postoperative adjuvant radiotherapy (45.8％,38/83) (P ＜ 0.05).Only compared to positive patients without postoperative adjuvant radiotherapy(60.0％,6/10),the rate (16.7％,5/30) was significantly lower(P ＜ 0.01).Cancer recurrence was recognized in 48.6％ (55/113) patients within 3 year after operation,including 38.1％ (43/113) patients with radiotherapy area recurrence.In logistic analysis the T status (P＜ 0.01) and adjuvant radiotherapy (P ＜ 0.05) were independent risk factors of lymph node metastasis in the first 3 years after operation.Conclusion In Mucin1 mRNA-positive esophageal squamous cell carcinoma patients,adjuvant radiotherapy could significantly reduce the lymph node metastasis rate in the radiotherapy area after Ivor-Lewis esophagectomy.Compared with traditional therapeutic methods,Ivor-Lewis esophagectomy combined with adjuvant radiotherapy can achieve similar curative effects in Mucin1 mRNA-positive patients.

Objective To investigate the level and influencing factors of stigma among patients with lung cancer, in order to provide evidence for staff nurses to take pertinent interventions for assisting patients to deal with stigma. Methods Totally 234 hospitalized patients with lung cancer were cross-sectional survey with General Demographic Questionnaire, Disease Information Questionnaire, Chinese version of Cataldo Lung Cancer Stigma Scale (CLCSS-CV). Results The total score of stigma was (72.35±10.85) points. The total scale score and each subscale score was divided by the item number. The mean score of CLCSS-CV was (2.68±0.40) points, the rate of the patients with lung cancer with moderate above stigma was 51.20% (120/234). The patients rated higher scores on the subscales of smoking (2.90±0.58) points, while lower scores on the subscales of discrimination (2.47 ±0.55) points. Multiple stepwise regression analysis showed that the number of children and the clinical stages were influencing factors of lung cancer stigma, where regression coefficients were -0.065, 0.136 respectively, coefficients of determination was 0.178. Conclusions Patients with lung cancer have a moderate or higher level of stigma. The medical staff should communicate with patients, evaluate the psychological status, impose public health education, mobilize the social support for assisting them to deal with stigma.

Objective To validate the effectiveness of nursing intervention on alleviating negative emotions and improving quality of cancer patients′ life based on story theory. Methods This study adopted the method of quasi-experimental research,100 patients with cancer chemotherapy were divided into the experimental group(50 cases),and the control group(50 cases).Based on conventional care,the experimental group received 3 weeks of nursing intervention based on story theory.The scores of mood and quality of life were collected in the 1st day and 23rd day after chemotherapy by using Profile of Mood States-Short Form(POMS-SF)and Quality of Life Questionnaire-core(QLQ-C30),thus evaluated the effect of intervention. Results The scores of POMS-SF in the 1st day and 23rd day after chemotherapy were (17.28±5.41),(35.84±12.35)points in the experimental group,and the difference was significant(t=7.54, P<0.05).The scores of QLQ-C30 in the 1st day and 23rd day after chemotherapy were(7.72±1.53),(8.17± 0.94) points in the control group, and the difference was significant(t =-4.07, P<0.05). There was no statistical difference in the scores of POMS-SF and QLQ-C30 between the 1st day and 23rd day after chemotherapy in the control group(P>0.05). Conclusions The nursing intervention based on story theory demonstrated significant improvement of negative emotions and quality of life, which is a quite practical psychological care for cancer chemotherapy patients.