Objective To obtain a two-dimensional evaluation result of the quality of examination paper on fundamental nursing and the students' performance,so as to find the weakness and problems in teaching and learning,and to put forward some suggestions.Methods With the S-P chart analytic system which was designed by using the technology of Excel VBA,we made an analysis of 164 papers of fundamental nursing.Results Both the P-curve and S-curve were in the lower right corner.There wasn't any long vertical line in P-curve.There wasn't any long horizontal one in S-curve either.Caution index of 4 questions and 15 students exceed 0.75.The totality difficulty index of the paper was 0.79.The suitability index was 0.43.The stability index was 0.48.Conclusions Propositional contents about physician orders management,gastric lavage,administering medication,observation of disease and pain need to be reformed into both wide coverage and clear focuses.There are no faults in students' grades.Different learning levels do exist,but with little difference.S-P chart affords multiplex and huge amount of information.Its graphics and parameters help to analyze both the students' and teachers' performance from the macroscopic and microcosmic angle,so as to make teachers self-reflective on teaching fundamental nursing and producing papers from various aspects.

Acupuncture and Tuina plus functional training were used to treat forty cases of shoulder impingement syndrome. Twenty-seven cases were cured clinically, accounting for 67.5%; 9 cases had marked effectiveness, accounting for 22.5%; 3 cases had effectiveness, accounting for 7.5%; 1 case obtained no effect, accounting for 2.5%; the total effective rate was 97.5%.

Background The cytochrome P450-dependent monooxygenase 2D6 (CYP2D6) ac- tivity can he estimated by investigating the metabolism of model drugs or by genotyping the most com- mon CYP2D6 alleles. The CYP2D6 allele frequencies are well investigated in Caucasians whereas no comprehensive allele analysis has been done in mainland Chinese. The aim of the study was to investi- gate C2938T, G1846T, G1846A and C188T gene mutation in mainland Chinese. Methods Three tet- ra-primer PCR assays and one allele specific amplification (ASA)-PCR assay were developed to easily genotype C2938T, G1846T, G1846A and C188T mutation in CYP2D6 allele in 223 cases of mainland Chinese. Results The most frequent allele was * 10 (C188T) with a prevalence of 51.3%, followed by * 2 allele (C2938, 15. 5%) in mainland Chinese. The distribution frequence of a novel variant CYP2D6 * 14B was 2.0%. This novel * 14B allele was different from * 14 allele by the absence of the C188T substitution and by the additional G1749C substitution. Conclusion This comprehensive study of CYP2D6 allele in mainland Chinese shows some genetic diversity compared to Chinese from other regions. Genotyping is a useful method in applying drug individuation.

BACKGROUND: Clinical study of insomnia is performed by monitoring the alpha wave of the brain signals with the polysomnography (PSG). PSG has two deficiencies in recording electroencephalogram (EEG): ①The testee is wrapped by long electrode wires so that they cannot sleep normally. As a result, the testee's mental and physical status is affected and the results are inaccurate. ②As the alpha wave consists of very weak biomedical signals, it is easily affected by the alternating current (AC) interference, so that the analytical software cannot identify the desired signals. For these reasons, a monitoring system that overcomes such deficiencies is needed. OBJECTIVE: To design a wireless EEG sensors system for detecting brain signals. It can obtain the brain signals in an accurate and non-disturbed way without affecting the testee's mental and physical status. DESIGN: The actual application circuit was implemented after analyzing and building the circuit model. SETTING: The 305 Hospital of Chinese PLA.MATERIALS: The clinical experimental environment was provided by the 305 Hospital of Chinese PLA. The PSG made by Beijing Rising Sun Science-Tech Co., Ltd. was served as experimental instrument for comparison test and analytical software was designed by MATLAB.METHODS: Theoretical analysis was performed at the 305 Hospital of Chinese PLA in 2005 to create the anti-interference model and the wireless EEG sensors system model. In 2006, the circuit model helped us realize the small-sized wireless brain wave sensor that could suppress the interference effectively. The sensor was put into practical use at the 305 Hospital of Chinese PLA from February to August 2006. The experiment was approved by the hospital ethics committee. The volunteer testees were those who worked in the hospital and they had full knowledge of the objective, process and results of the experiment. Besides, those signals were compared with what the PSG recorded. MAIN OUTCOME MEASURES: Frequency spectrum of signals obtained in interference environment. RESULTS: For the brain signals that were captured by the wireless EGG sensors in the presence of interference, the power spectrum peak value was 6 926.043 within the alpha wave ranged at 8-12 Hz. For the AC interference, the power spectrum peak value was 0.356 at 50 Hz. Meanwhile, for the brain signals that were captured by the PSG, the power spectrum peak value was 1112.3 within the alpha wave ranged at 8-12 Hz; for the AC interference, the power spectrum peak value was 85 440 at 50 Hz.CONCLUSION: The system can obtain satisfying brain alpha wave signals and can suppress AC interference effectively.

Objective To compare the efficacy and safety of combined epidural/general anesthesia (CEGA) versus total intravenous anesthesia (TIVA) for laparoscopic cholecystectomy. Methods Forty patients were assigned to group TIVA and group CEGA by random digits table with 20 cases in each. The systolic and diastolic arterial pressure,heart rate, oxygen saturation,Steward score, visual analogue scale (VAS) score and adverse reaction were monitored. Results Steward score 4,6 min after operation in group CEGA [(4.5 ±0.6), (5.7 ±0.2) scores] was higher than that in group TIVA [(2.8 ±0.4), (4.1 ±0.5)scores](P ＜ 0.05 ). The VAS score 2,3,4 h after operation in group CEGA [( 1.8 ± 0.3 ), (1.5 ± 0.4), (1.7±0.3 ) scores] was lower than that in group TIVA [( 3.2 ± 0.5 ), ( 3.7 ± 0.4), (4.2 ± 0.6) scores] (P＜0.05 ).There was no significant difference in abdomen pain, shoulder pain and adverse reaction between two groups.The incidence of postoperative side effects was lower in both groups (P ＞ 0.05). Conclusions The use of CEGA for laparoscopic cholecystectomy seems to be effective and safe, and to offer some advantages as compared to TIVA alone. CEGA can control pain due to CO2-induced peritoneal irritation, provide excellent infra-operative and postoperative analgesia. CEGA does not require the use of intraoperative intravenous opioids and shortens recovery time, without increasing the incidence of adverse reaction.

Objective　To investigate the effect of combining use of methotrexate and mifepristone on treating unruptured tubal pregnancy.Methods　Treatment consisted of 300mg of mifepristone administered orally one time and 20mg of methotrexate injected intravenously consecutively for 5 days.The previous cases who received only 20mg methotrexate injected intravenously were selected as control group.Results　The success rate of the combination group was 87.5% which was significantly higher than that of the control group.The effect of treatment was related to serum β-hcG levels and whether there was embryos with cardiac activity or not.Conclusion　The treatment of unruptured tubal pregnancy with the combination of methotrexate and mifepristone is safe and effective.It is suitable for the unruptured tubal pregnancy with stable vital signs,but without acute abdominal pain or embryonic cardiac activity and β-hCG＜30μg/L.

Spontaneous abortion is one of the most common gestational conditions, with the morbidity of 1% to 5% in married women. It is a serious problem troubling women at the reproductive age. There are many factors causing spontaneous abortion, among them, spontaneous abortion resulting from endocrine abnormalities can be detected and treated. Prolactin is a major endocrine hormone participating in reproductive regulation and playing an important role in early pregnancy implantation and pregnancy maintenance. When there are unusual levels it is closely related to spontaneous abortion, leading to a necessity to further study the relationship between them. International and domestic research developments in recent years about the correlation between prolactin and spontaneous abortion are discussed in this paper.

Insulin resistance exists in various chronic liver diseases such as fatty liver disease, liver cirrhosis, hepatitis, etc. Insulin resistance not only participates in the development of chronic liver diseases but also affects the efficacy of drug treatment. Paying more attention to diagnosis and treatment of insulin resistance will enhance the therapeutic effect and improve the prognosis of the patients. Traditional Chinese medicine has displayed its characteristics and advantage in treating insulin resistance. Investigation to chronic liver diseases based on lifestyle interference, exploration of the syndrome mechanism of insulin resistance, and scientific evaluation of the efficacy of Chinese herbal prescriptions will contribute to the research of traditional Chinese medicine in preventing and treating insulin resistance in chronic liver diseases.

The early life of nutrition is closely related to obesity and metabolic syndrome in adult.Lipid metabolic dysfunction is one of the important mechanisms in the development of adult diseases.Liver plays a key role in lipid metabolism.Hepatic lipid metabolism mainly includes fatty acid uptake,synthesis,esterification,oxidation and export.Exposed to a optimal nutrition environment in early life might lead to some adaptive effects in the liver and its organization structure,cell numbers and metabolic function.These adaptive responses might play a persistent effect in each way of hepatic lipid metabolism.Clarifying the programming effect of early nutrition on hepatic lipid metabolism and the relative molecular mechanism might provide related theoretical basis and practical molecular target for the prevention of adult diseases during childhood.

Phototherapy is the most common and effective method to intervene and treat neonatal hyperbilirubinemia in clinic.The application of phototherapy varies from gestational age,birth weight,age and many other factors.Beside the traditional phototherapy instruments,more advanced high-intensive phototherapy instruments are applied to phototherapy.With the increasing application of phototherapy,many problems have showed up.This paper reviews based on the research of the indication,clinical application and adverse reactions on phototherapy.