Objective To explore and classify the subjective opinions of nurses on whistle- blowing, and identify the subjective characteristics of each type. Methods This study applied Q -methodology, protocols which could determinate subjective opinions of nurses on histle-blowing were set up and underwent interview investigation, data of the interviews went through Q-factor analysis. Results Most nurses had a positive attitude toward whistle - blowing because it could prevent any nursing activity not based on expertise and professional ethics from causing disadvantages for patients. At the same time, however, they requested the creation of a legal framework in which whistle-blowing was done in a way to increase trust among colleagues. Meanwhile, some nurses showed resistance to whistle - blowing. Conclusions Whether whistle - blowing can reach its aims depends on nurses' attitude toward it. Most Korean nurses support whistle-blowing. Nursing activity not based on expertise and professional ethics and causing disadvantages for patients can be avoided if a legal framework is established for whistle-blowing.

Objective To compare the effect of methotrexate combined with laparoscopic surgery on pregnancy outcome of patients with tubal pregnancy treated with conservative treatment.Methods 96 patients who were diagnosed of tubal pregnancy,fertility requirements and no clinical data given birth were analyzed retrospectively.Depending on the method of treatment was divided into 46 cases of methotrexate and laparoscopic group of 50 patients.Postoperative intrauterine pregnancy,ectopic pregnancy and secondary infertility situation again were compared.Results Laparoscopic group in intrauterine pregnancy rate was 70.0％,which was significantly higher than that in the methotrexate group(47.8％),and the difference was statistically significant(x2 =13.229,P ＜ 0.05) ;laparoscopic ectopic pregnancy rate was 14.0％ against 17.4％ with methotrexate group,the difference was not statistically significant(x2 =2.037,P ＞ 0.05) ; methotrexate group was 34.8％ of secondary infertility was significantly higher than thatin the laparoscopic group (16.0％),the difference was statistically significant (x2 =12.784,P ＜ 0.05).Conclusion Laparoscopic surgery after conservative treatment of tubal repregnancy outcome is better than methotrexate.

OBJECTIVE:To discuss the use of allopurinol for the reduction of serum uric acid level in patients with chronic kidney disease complicating hyperuricacidemia so as to delay the progression of chronic renal disease.METHODS:A total of 47 patients with chronic kidney disease complicating hyperuricacidemia were randomly divided into treatment group and control group:the treatment group was given allopurinol 100～200mg?d-1 in addition to the antihypertensive therapy as adopted in the control group or the common therapy for 12 months.RESULTS:As compared with the control group,serum creatinine level was lower and the rate of renal function deterioration was significantly decreased in the treatment group(P

TBX20 gene, a member of the T-box gene family, plays an important role during heart development and is required for maintaining adult heart function.TBX20 can act as both transcriptional activator and transcriptional suppressor during the development of the heart, and shows complex spatiotemporal regulation.TBX20 is an important candidate transcription factor for the pathogenesis of congenital heart disease(CHD), and its mutation or expression change can lead to the occurrence of CHD.In this paper, the latest research progress of TBX20 gene in the field of heart development is reviewed from the relationship between TBX20 and CHD, the signaling pathway involved in heart development and its interactions with other cardiac transcription factors.

[Summary] With the rapid development of economy ,obesity and type 2 diabetes (T2DM ) have become a serious social problem in China. Metabolic surgery was started to carry out in late 20th century in our country . Currently ,there were many deficiencies in the selection of operation indication ,surgical pattern and procedure ,prevention and treatment of complications ,perioperative management and postoperative follow‐up. Therefore ,to standardize nationwide surgical treatment of obesity and diabetes ,to reduce the incidence of postoperative complications ,Chinese Society for Metabolic & Bariatric Surgery (CSMBS) ,surgeon branch of Chinese Medical Doctor Association called domestic famous experts together to jointly draft a practical manual :Guide to Surgical Treatment of Obesity and Type 2 Diabetes in China (2014). With the spread of this guide ,the number of metabolic surgery increased significantly ,the procedure and management of surgery were further standardized.

Objective To explore the clinical effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke depression (PSD). Methods Sixty PSD patients were randomly divided into an rTMS group and a control group, each of 30 patients. In addition to conventional treatment, rTMS group members were given high-frequency rTMS treatment for 10 d while the control group were given sham stimulation. In order to test the efficacy, the two groups were compared using the Hamilton depression rating scale (HAMD) before and after 10 and 30 days treatment. Results After 10 days of treatment the rTMS group had significantly lower HAMD scores than before treatment, and average HAMD scores differed significantly between the rTMS group and the controls, with the former performing significantly better. There was no obvious difference in HAMD scores after 30 days of treatment between the two groups. Conclusions High-frequency rTMS is a safe and effective treatment for PSD.

Objective: The effect of whole body irradiation (WBI) on B7-1 and B7-2 express ion in peritoneal macrophages in mice was observed.Methods:Immunohistochemistry (ABC method) was used. Results: The upregulation of B7-2 expression induced by WBI X-rays appeared ea r lier than that of B7-1.The study on the dose-effect relationship showed that t he ex pression of both B7-1 and B7-2 reached its peak at 0.075 Gy after WBI X-rays. Th e doses inducing a second peak of B7-1 and B7-2 upregulation were higher in th e case of WBI in comparison with in vitro irradiation. Conclusion: The results suggested that the upregulation of expression of B7 mole cules after irradiation might be an important factor involved in the enhancing e ffect of low dose radiation on immunity.

Objective: Our purpose was to study the concentration of soluble tumor necrosis factor receptor-Ⅰ(sTNFR-Ⅰ) in the serum of patients with acute tuberculosis. Methods: The levels of soluble TNFR-Ⅰ in serum were measured in 11 patients with acute tuberculosis. Concentration of sTNFR-Ⅰ were measured by using enzyme-linked immunological binding assay. Results: In patients with acute tuberculosis, especially severe tuberculosis, serum levels of sTNFR-Ⅰ increased significantly (P<0.01), compared with those of control. After antituberculosis therapy, serum levels of sTNFR-Ⅰin patients with acute tuberculosis decreased by various degrees. Conclusion: Measurements of sTNFR-Ⅰ in serum of patients with acute tuberculosis could be an important index in the judgement of the outcome of the disease.

Macrophage migration-inhibitory factor (MIF) is a cytokine which can promote tumorigenesis.MIF can promote tumorigenesis by directly inducing oncogene transformation,stimulating cell division,as well as indirectly inhibiting tumor apoptosis,promoting its invasiveness and angiogenesis.MIF-targeted biological therapy may become a new therapeutic strategy for malignant tumor.

Clinical studies show that the factors that impact the quality of life (QOL) in patients with lung cancer are comprehensive.Physiological factors include breathing difficulties,cancer-related fatigue.Depression,anxiety and other psychological factors also play a major role.Social and family support is also crucial to improve the QOL in patients with lung cancer.