Objective To understand the work content of community nurses in general practitioners team model in Chongqing.Methods A questionnaire was carried out among 210 community nurses from 12 communityhealth service centers in Chongqing city.Results The work content of community nurses most often did in general practitioners team model were health management,health care of elderly people,health education,chronic disease management and basic medical service.However,the work content of women's health care and inquiry of death cause were relatively done less.Conclusions There are both basic medical service and public health service in the work content of community nurses in Chongqing.The “Six in One” function of community nursing is gradually improved.

Lymphoid malignancies represent a heterogeneous group of malignancies with differing patterns of behaviour and response to treatment.Anaemia is common in patients with lymphoid malignancies and negatively impacts on quality of life and treatment outcomes and survival.We discuss the diagnosis and management of anaemia in patients with lymphoid malignancies.

Accordingtothe analysis ofthe characters and difficulties ofskill ofanimal surgery,we divide the teaching process into three stages:theory classes,aseptic technique and basic operating techniques,animal practice.PBL+LBL double-track teaching methods is performed,which can make up the defect of PBL in practice and should be advocated and spread in the teaching of skill of animal surgery.

By discussion the experience of surgery teaching for foreign students by the methods of CBL+MCAI, the successful teaching experience are the followings: making sufficient preparations before lesson according to the features and difficulties in the foreign students' surgery teaching; Emphasis on CBL teaching methods and rational application of multimedia computer assisted instruction,strengthening the teaching disciphne of foreign students and the cultivation of the spirit of students' active learning.These measures stimulated the enthusiasm of students' active learning and improved the quality of teaching.

Female patients, 50 years old, have a recurrent unilateral aggravating headache for 5 years. Without runny nose, sneezing, nasal hemorrhage, smell or vision loss. Prefessional examination: there is a visible hoar neoplasm in the right middle nasal meatus With smooth surface and rich in vascular. The nasopharyngeal MRI shows that there is a occupancy lesion in the right nasal cavity and sinuses, well-demarcated, about 21. 5 mm x 25.5 mm x 37.0 mm. Angiofibroma is the most likely diagnosis. Postoperative pathological section shows that tumor are hypercellular, which contains big nucleus. Cells are spindle or short fusiform shape, there are stripes and nuclear division in some cells. There are vortex structures in partial region. Immunohistochemical examination shows: CD34(++), Ki-67 (< 5%), CD68(-), Des (-), NSE(+), S-100(++), SMA(-), EMA (+). Histopathologic diagnosis: atypical meningioma, some were differentiated to rhabdoid meningioma. The final diagnosis is malignant meningioma in nasal cavity and paranasal sinuses.
Female ; Humans ; Meningeal Neoplasms ; diagnosis ; pathology ; Meningioma ; diagnosis ; pathology ; Middle Aged ; Nasal Cavity ; pathology ; Paranasal Sinus Neoplasms ; diagnosis ; pathology ; Paranasal Sinuses ; pathology

Interventional therapy is an important treatment for biliary stenosis.The treatment methods are different ac cording to the different causes.Conventional interventional therapy include biliary drainage,balloon dilatation and stent implantation.There are some new treatment methods such as radiofrequency catheter ablation and biliary stent loaded with 125I seeds.The applications of interventional therapy in biliary stenosis were reviewed in this article.

Objective To explore metformin improves hyperinsulinemia in obese children, glucose metabolism, serum lipid derived hormone levels. Methods 40 cases of healthy children were selected and included in the control group, 40 cases of mild, moderate and severe obese children in the obese group, moderately obese group, obese group given category; metformin in obese children orally for 3 months, then in each group of body mass index (BMI), the learning situation of adipose derived hormones, blood glucose levels were detected and compared. Results Compared the condition of blood glucose metabolism and body weight obviously, obesity group and control group before treatment there are very significant differences after treatment, the obese group appeared to be improved, indicates that the difference is obvious(P<0.05). Compare the hormone levels of serum leptin and adiponectin are visible in before the treatment and health examination Significant differences after the treatment showed some improvement, but the resistin in the treatment had no obvious improvement. Conclusion The application of metformin improves hyperinsulinemia in obese children with sugar metabolism, visible analysis of serum adipose derived hormones, the patients with improvement of glucose metabolism has a positive effect, while improving the serum hormone level, reduce patient weight (BMI), so it is worthy of clinical use.

OBJECTIVETo investigate the influence of the DNA integrity of optimized sperm on the embryonic development and clinical outcomes of in vitro fertilization and embryo transfer (IVF-ET).

METHODSThis study included 605 cycles of conventional IVF-ET for pure oviductal infertility performed from January 1, 2013 to December 31, 2014. On the day of retrieval, we examined the DNA integrity of the sperm using the sperm chromatin dispersion method. According to the ROC curve and Youden index, we grouped the cycles based on the sperm DNA fragmentation index (DFI) threshold value for predicting implantation failure, early miscarriage, and fertilization failure, followed by analysis of the correlation between DFI and the outcomes of IVF-ET.

RESULTSAccording to the DFI threshold values obtained, the 605 cycles fell into four groups (DFI value < 5%, 5-10%, 10-15%, and ≥ 15%). Statistically significant differences were observed among the four groups in the rates of fertilization, cleavage, high-quality embryo, implantation, clinical pregnancy, early miscarriage, and live birth (P < 0.05), but not in the rates of multiple pregnancy, premature birth, and low birth weight (P > 0.05). DFI was found to be correlated negatively with the rates of fertilization (r = -0.32, P < 0.01), cleavage (r = -0.19, P < 0.01), high-quality embryo (r = -0.40, P < 0.01), clinical pregnancy (r = -0.20, P < 0.01), and live birth (r = -0.09 P = 0.04), positively with the rate of early miscarriage (r = 0.23, P < 0.01), but not with the rates of multiple pregnancy (r = -0.01, P = 0.83), premature birth (r = 0.04, P = 0.54), and low birth weight (r = 0.03, P = 0.62).

CONCLUSIONThe DNA integrity of optimized sperm influences fertilization, embryonic development, early miscarriage, and live birth of IVF-ET, but its correlation with premature birth and low birth weight has to be further studied.

Abortion, Spontaneous ; Chromatin ; ultrastructure ; DNA Fragmentation ; Embryo Implantation ; Embryo Transfer ; Embryonic Development ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Infertility, Female ; Male ; Pregnancy ; Pregnancy Outcome ; ROC Curve ; Spermatozoa ; cytology

Objective To analyze the clinical key points of minimally invasive tracheostomy with percutaneous horn expansion applicated in ICU,and to discuss the problems encountered in minimally invasive surgery and the solutions.Methods The clinical data of 25 patients of minimally invasive tracheostomy with percutaneous horn expansion in ICU were analyzed retrospectively.Results Twenty-one patients with minimally invasive tracheostomy with percutaneous horn expansion were successfully performed in 25 patients of ICU (no incision sputum,subcutaneous emphysema,pneumothorax and other complications),2 patients had more postoperative bleeding,2 patients were difficult to imbedding catheter,of which 1 case abandoned the catheter and received conventional tracheotomy.Conclusion Percutaneous horn expansion minimally invasive tracheostomy has the advantages of small incision,less injury,less operative time,less blood loss and low incidence of complications.However,ICU patients are in severe condition and easy to change.Adequate preoperative preparation,controlling the key steps in the operation can find a solution to the problme.

Objective To explore the clinical curative effect on non-small cell lung cancer (NSCLC) patients by cinobufacini injection combined with first-line chemotherapy.Methods Eighty patients with NSCLC from January 2013 to January 2015 in our hospital were selected as the research objects.Then they were divided into the observation group (n =40)and the control group (n =40)by random number tables.The patients in control group accepted docetaxel and cisplatin combination chemotherapy regimens (TP).While the observation group accepted cinobufacini injection on the basis of the control group.Then the local control, adverse reactions and prognosis of the two groups were compared.Results The local control of observation group was 77.5%,while the control group was 62.5%,the local control of observation group was obviously higher than that of the control group (χ2 =5.36,P =0.03).Leucopenia incidence of the observation group was 27.5%,the control group was 50.0%,and the incidence of the observation group was obviously lower than that of the control group (χ2 =4.27,P =0.04).There was no statistically significant difference between the two groups in diarrhea,stomachache,vomiting,tinnitus (17.5% vs.27.5%,χ2 =1.15,P =0.28;25.0% vs.45.0%,χ2 =3.52,P =0.06;5.0% vs.7.5%,χ2 =0.34,P =0.56;7.5% vs.10.0%,χ2 =0.16,P =0.69).There was statistically significant difference between the two groups in median survival time (97 d vs.45 d,HR =8.934,χ2 =9.928,P <0.05).Conclusion The cinobufacini injection combined with docetaxel can effectively reduce the incidence of myelosuppression,and improve survival and local control with high safety,and the clinical effect is remarkable and can improve the prognosis of patients.